scholarly journals A novel biomechanical injury risk score demonstrates correlation with lower limb posterior chain injury in fifty elite level rugby union athletes

Author(s):  
Rhys Hughes ◽  
Matt Cross ◽  
Keith Stokes

ABSTRACTObjectivesLower limb posterior chain injury (PCI) is common amongst athletic populations, with multi-factorial risk factors including age, previous injury, strength measurements, range of motion and training load. Biomechanics are commonly considered in the prevention and rehabilitation of PCI by performance staff. However, there is no documented testing method to assess for associations between biomechanics and PCI. The aim of this study was to investigate whether there is an association between an easily applicable, novel biomechanical assessment tool and PCI.MethodsFifty male elite-level rugby union athletes (age 22.83±5.08) participating in the highest tier of England were tested at the start of the 2019 pre-season period and PCIs (N=48) were recorded over the 2019/20 playing season. Participants’ biomechanics were analysed using two-dimensional video analysis against an Injury Risk Score (IRS) system in the performance of the combined movement – prone hip extension and knee flexion. Participants’ biomechanics in carrying out this movement were scored against the 10-point IRS, where the more compensatory movement recorded sees an increase in an individual’s IRS. Participants’ IRS were then compared against the number of PCI sustained and Spearman’s correlation coefficient was utilised for analysis.ResultsThere is a good significant association between IRS and PCI (R=0.573, p<0.001). Linear Regression demonstrated that an increase of 1 in IRS was associated with a 35% increase in PCI incidence (R2=0.346).ConclusionA good significance between the IRS and PCI provides preliminary support for its use as an injury risk assessment tool.

2021 ◽  
Vol 7 (4) ◽  
pp. e001062
Author(s):  
Rhys Hughes ◽  
Matt Cross ◽  
Keith Stokes ◽  
Daniel Tobin ◽  
Eoin Power ◽  
...  

ObjectivesLower limb posterior chain injury (PCI) is common among athletic populations, with multifactorial risk factors including age, previous injury, strength measurements, range of motion and training load. Biomechanics are commonly considered in the prevention and rehabilitation of PCI by performance staff. However, there is no documented testing method to assess for associations between biomechanics and PCI. The aim of this study was to investigate whether there is an association between an easily applicable, novel biomechanical assessment tool and PCI.MethodsFifty male elite-level rugby union athletes (age 22.83±5.08) participating in the highest tier of England were tested at the start of the 2019 preseason period and PCIs (N=48) were recorded over the 2019/2020 playing season. Participants’ biomechanics were analysed using two-dimensional video analysis against an injury risk score (IRS) system in the performance of the combined movement—prone hip extension and knee flexion. Participants’ biomechanics in carrying out this movement were scored against the 10-point IRS, where the more compensatory movement recorded sees an increase in an individual’s IRS. Participants’ IRS was then compared against the number of PCIs sustained and Spearman’s correlation coefficient was used for statistical analysis.ResultsThere is a significant association between IRS and PCI (R=0.542, p<0.001). Linear regression demonstrated that an increase in 1 in IRS was associated with a 35% increase in PCI incidence (R²=0.346).ConclusionA significance between the IRS and PCI provides preliminary support for its use as an injury risk assessment tool.


2018 ◽  
Vol 53 (15) ◽  
pp. 969-973 ◽  
Author(s):  
James Rafferty ◽  
Craig Ranson ◽  
Giles Oatley ◽  
Mohamed Mostafa ◽  
Prabhat Mathema ◽  
...  

ObjectivesTo investigate concussion injury rates, the likelihood of sustaining concussion relative to the number of rugby union matches and the risk of subsequent injury following concussion.MethodsA four-season (2012/2013–2015/2016) prospective cohort study of injuries in professional level (club and international) rugby union. Incidence (injuries/1000 player-match-hours), severity (days lost per injury) and number of professional matches conferring a large risk of concussion were determined. The risk of injury following concussion was assessed using a survival model.ResultsConcussion incidence increased from 7.9 (95% CI 5.1 to 11.7) to 21.5 injuries/1000 player-match-hours (95% CI 16.4 to 27.6) over the four seasons for combined club and international rugby union. Concussion severity was unchanged over time (median: 9 days). Players were at a greater risk of sustaining a concussion than not after an exposure of 25 matches (95% CI 19 to 32). Injury risk (any injury) was 38% greater (HR 1.38; 95% CI 1.21 to 1.56) following concussion than after a non-concussive injury. Injuries to the head and neck (HR 1.34; 95% CI 1.06 to 1.70), upper limb (HR 1.59; 95% CI 1.19 to 2.12), pelvic region (HR 2.07; 95% CI 1.18 to 3.65) and the lower limb (HR 1.60; 95% CI 1.21 to 2.10) were more likely following concussion than after a non-concussive injury.ConclusionConcussion incidence increased, while severity remained unchanged, during the 4 years of this study. Playing more than 25 matches in the 2015/2016 season meant that sustaining concussion was more likely than not sustaining concussion. The 38% greater injury risk after concussive injury (compared with non-concussive injury) suggests return to play protocols warrant investigation.


PeerJ ◽  
2018 ◽  
Vol 6 ◽  
pp. e4895 ◽  
Author(s):  
Mark Roe ◽  
John C. Murphy ◽  
Conor Gissane ◽  
Catherine Blake

Managing injury risk requires an understanding of how and when athletes sustain certain injuries. Such information guides organisations in establishing evidence-based priorities and expectations for managing injury risk. In order to minimise the impact of sports injuries, attention should be directed towards injuries that occur frequently, induce substantial time-loss, and elevate future risk. Thus, the current study aimed to investigate the rate at which elite Gaelic football players sustain different time-loss injuries during match-play and training activities. Datasets (n = 38) from elite Gaelic football teams (n = 17) were received by the National Gaelic Athletic Association Injury Surveillance Database from 2008 to 2016. A total of 1,614 time-loss injuries were analysed. Each season teams sustained 24.0 (interquartile ranges) (IQR 16.0–32.0) and 15.0 (IQR 10.0–19.0) match-play and training injuries, respectively. When exposure was standardised to 1,000 h, greater rates of injury (12.9, 95% CI [11.7–14.3]) and time-loss days (13.4, 95% CI [12.3–14.9]) were sustained in match-play than in training. Acute injury rates were 3.1-times (95% CI [2.7–3.4]) greater than chronic/overuse injuries. Similarly, non-contact injury rates were 2.8-times (95% CI [2.5–3.2]) greater than contact injuries. A total of 71% of injuries in elite Gaelic football affected five lower limb sites. Four lower limb-related clinical entities accounted for 40% of all time-loss injuries (hamstring, 23%; ankle sprain, 7%; adductor-related, 6%; quadriceps strain, 5%). Thus, most risk management and rehabilitation strategies need to be centred around five lower limb sites—and just four clinical entities. Beyond these, it may be highly unlikely that reductions in injury susceptibility can be attributed to specific team interventions. Thus, compliance with national databases is necessary to monitor injury-related metrics and future endeavours to minimise injury risk.


2020 ◽  
Vol 10 (21) ◽  
pp. 7816
Author(s):  
Alan Griffin ◽  
Ian C. Kenny ◽  
Thomas M. Comyns ◽  
Mark Lyons

A training monitoring system (TMS) should be both attainable and scientifically grounded; however, the optimal method of monitoring training is not yet fully understood. The purpose of this study was to develop and evaluate an online TMS for amateur rugby union. The experimental approach to the problem consisted of five phases: (1) establishing the current training and training load (TL) monitoring practices of amateur rugby union teams, (2) designing and developing the TMS, (3) recruiting teams and subsequently introducing the TMS, (4) supporting the strength and conditioning (S&C) coaches using the TMS, and (5) evaluating the TMS. The findings of this study support the use of an online TMS as a useful and effective method of facilitating training prescription and design in an effort to reduce injury risk and enhance performance. The main barriers impeding player compliance are the lack of feedback on their data and evidence of its use in training design, coaching, and prescription. The effectiveness of the system is dependent on the extent to which the associated challenges are mitigated to ensure quality and consistent data. However, this study offers a method of monitoring training that can be effective while also establishing pitfalls to avoid for both practitioners and researchers alike.


2021 ◽  
Vol 7 (2) ◽  
pp. e001018
Author(s):  
Craig Barden ◽  
Keith A Stokes ◽  
Carly D McKay

ObjectivesThe implementation of the Activate injury prevention exercise programme has not been assessed in an applied context. This study aimed to (1) describe the knowledge and perceptions of school rugby coaches and players towards injury risk, prevention and Activate and (2) evaluate Activate implementation in schoolboy rugby using the reach, effectiveness, adoption, implementation and maintenance framework.MethodsBespoke electronic surveys were administered to coaches (including support staff) and players at participating English schools (2018–2020). Most questions and statements were answered using a 7-point Likert scale. At baseline, participants detailed their Activate awareness and perceptions of injury risk and prevention in schoolboy rugby. At postseason, participants reported Activate use throughout the study and their perceptions towards the programme.ResultsAt baseline, significant differences existed between coaches (n=106) and players (n=571) in Activate awareness (75% and 13% respectively; χ2=173.5, p<0.001). Coaches perceived rugby had a significantly greater injury risk than players, while holding more positive perceptions towards injury prevention. At postseason, coaches reported greater Activate adoption compared with players (76% and 18% respectively; χ2=41.8, p<0.001); 45% of players were unaware if they used the programme. Median session adherence was twice weekly, with a median duration of 10–15 min. This suggests Activate was not implemented as intended, with recommendations of three 20 min sessions per week. Both groups identified common barriers to implementation, such as lack of time and inclusion of a ball.ConclusionCoaches are instrumental in the decision to implement Activate. Targeting behavioural change in these individuals is likely to have the greatest impact on intervention uptake.


2020 ◽  
pp. bmjnph-2020-000134
Author(s):  
Emily A Johnston ◽  
Kristina S Petersen ◽  
Jeannette M Beasley ◽  
Tobias Krussig ◽  
Diane C Mitchell ◽  
...  

IntroductionAdherence to cardioprotective dietary patterns can reduce risk for developing cardiometabolic disease. Rates of diet assessment and counselling by physicians are low. Use of a diet screener that rapidly identifies individuals at higher risk due to suboptimal dietary choices could increase diet assessment and brief counselling in clinical care.MethodsWe evaluated the relative validity and reliability of a 9-item diet risk score (DRS) based on the Healthy Eating Index (HEI)-2015, a comprehensive measure of diet quality calculated from a 160-item, validated food frequency questionnaire (FFQ). We hypothesised that DRS (0 (low risk) to 27 (high risk)) would inversely correlate with HEI-2015 score. Adults aged 35 to 75 years were recruited from a national research volunteer registry (ResearchMatch.org) and completed the DRS and FFQ in random order on one occasion. To measure reliability, participants repeated the DRS within 3 months.ResultsIn total, 126 adults (87% female) completed the study. Mean HEI-2015 score was 63.3 (95% CI: 61.1 to 65.4); mean DRS was 11.8 (95% CI: 10.8 to 12.8). DRS and HEI-2015 scores were inversely correlated (r=−0.6, p<0.001; R2=0.36). The DRS ranked 37% (n=47) of subjects in the same quintile, 41% (n=52) within ±1 quintile of the HEI-2015 (weighted κ: 0.28). The DRS had high reliability (n=102, ICC: 0.83). DRS mean completion time was 2 min.ConclusionsThe DRS is a brief diet assessment tool, validated against a FFQ, that can reliably identify patients with reported suboptimal intake. Future studies should evaluate the effectiveness of DRS-guided diet assessment in clinical care.Trial registration detailsClinicalTrials.gov (NCT03805373).


2007 ◽  
Vol 31 (3) ◽  
pp. 300-312 ◽  
Author(s):  
Oren Cheifetz ◽  
Mark Bayley ◽  
Sharon Grad ◽  
Debbie Lambert ◽  
Cass Watson ◽  
...  

This study assesses the reliability and predictive validity of the Lower Limb Extremity Amputee Measurement Scale (LLAMS), which is an assessment tool designed to predict the length of stay (LOS) of patients with lower limb amputations in a rehabilitation program. In order to evaluate inter-rater reliability a prospective evaluation was completed by five independent evaluators ( n = 10). Predictive validity was evaluated retrospectively by comparing the LLAMS predicted LOS to actual LOS ( n = 147). The ability of the amputee team members to administer the LLAMS to patients was very high (ICC [2,1] = 0.98, CI 95% = 0.96 – 0.99, F[9, 36] = 78.71, p < 0.05). In addition, a moderate positive correlation was found between the LLAMS predicted LOS and the actual LOS (Pearson Correlation Coefficient, r = 0.465, p < 0.01), and the LLAMS was able to identify those patients who required short versus long rehabilitation stays. The incorporation of the LLAMS into the physiatrist's initial assessment of patients in the amputee clinic has enhanced the ability to manage better the LOS and the time patients wait to enter the rehabilitation program.


2020 ◽  
pp. 1-10
Author(s):  
Matthew K. Seeley ◽  
Seong Jun Son ◽  
Hyunsoo Kim ◽  
J. Ty Hopkins

Context: Patellofemoral pain (PFP) is often categorized by researchers and clinicians using subjective self-reported PFP characteristics; however, this practice might mask important differences in movement biomechanics between PFP patients. Objective: To determine whether biomechanical differences exist during a high-demand multiplanar movement task for PFP patients with similar self-reported PFP characteristics but different quadriceps activation levels. Design: Cross-sectional design. Setting: Biomechanics laboratory. Participants: A total of 15 quadriceps deficient and 15 quadriceps functional (QF) PFP patients with similar self-reported PFP characteristics. Intervention: In total, 5 trials of a high-demand multiplanar land, cut, and jump movement task were performed. Main Outcome Measures: Biomechanics were compared at each percentile of the ground contact phase of the movement task (α = .05) between the quadriceps deficient and QF groups. Biomechanical variables included (1) whole-body center of mass, trunk, hip, knee, and ankle kinematics; (2) hip, knee, and ankle kinetics; and (3) ground reaction forces. Results: The QF patients exhibited increased ground reaction force, joint torque, and movement, relative to the quadriceps deficient patients. The QF patients exhibited: (1) up to 90, 60, and 35 N more vertical, posterior, and medial ground reaction force at various times of the ground contact phase; (2) up to 4° more knee flexion during ground contact and up to 4° more plantarflexion and hip extension during the latter parts of ground contact; and (3) up to 26, 21, and 48 N·m more plantarflexion, knee extension, and hip extension torque, respectively, at various times of ground contact. Conclusions: PFP patients with similar self-reported PFP characteristics exhibit different movement biomechanics, and these differences depend upon quadriceps activation levels. These differences are important because movement biomechanics affect injury risk and athletic performance. In addition, these biomechanical differences indicate that different therapeutic interventions may be needed for PFP patients with similar self-reported PFP characteristics.


2002 ◽  
Vol 16 (2) ◽  
pp. 138-159 ◽  
Author(s):  
Clive J. Brewer ◽  
Robyn L. Jones

The purpose of this paper is to propose a five-stage process for establishing both validity and reliability in new systematic observation instruments. The process is contextualized within the working behaviors of elite level rugby union coaches within the practice setting. The sequential stages began with observer training and progressed through the identification of coaching behaviors through induction (to establish content validity), to establishing face validity through a domain-referenced test. The objectivity and reliability of the developed behavioral classifications are determined through an interobserver agreement test while, finally, the researcher’s ability to reliably reproduce data with the developed instrument is determined using a test/retest intraobserver reliability check. The developed instrument (the Rugby Union Coaches Observation Instrument: RUCOI) is deemed able to record the situationally unique behaviors arising from the nature of the sport and of the elite standard, both of which were considered to impinge upon the pedagogical process in the said context.


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