The functional movement test 9+ is a poor screening test for lower extremity injuries in professional male football players: a 2-year prospective cohort study

2017 ◽  
Vol 52 (16) ◽  
pp. 1047-1053 ◽  
Author(s):  
Arnhild Bakken ◽  
Stephen Targett ◽  
Tone Bere ◽  
Cristiano Eirale ◽  
Abdulaziz Farooq ◽  
...  

BackgroundThe 9+ screening battery test consists of 11 tests to assess limitations in functional movement.AimTo examine the association of the 9+ with lower extremity injuries and to identify a cut-off point to predict injury risk.MethodsProfessional male football players in Qatar from 14 teams completed the 9+ at the beginning of the 2013/2014 and 2014/2015 seasons. Time-loss injuries and exposure in training and matches were registered prospectively by club medical staff during these seasons. Univariate and multivariate Cox regression analyses were used to calculate HR and 95% CI. Receiver operating characteristic (ROC) curves were calculated to determine sensitivity and specificity and identify the optimal cut-off point for risk assessment.Results362 players completed the 9+ and had injury and exposure registration. There were 526 injuries among 203 players (56.1%) during the two seasons; injuries to the thigh were the most frequent. There was no association between 9+ total score and the risk of lower extremity injuries (HR 1.02, 95% CI 0.99 to 1.05, p=0.13), even after adjusting for other risk factors in a multivariate analysis (HR 1.01, 95% CI 0.98 to 1.04, p=0.37). ROC curve analysis revealed an area under the curve of 0.48, and there was no cut-off point that distinguished injured from non-injured players.ConclusionThe 9+ was not associated with lower extremity injury, and it was no better than chance for distinguishing between injured and uninjured players. Therefore, the 9+ test cannot be recommended as an injury prediction tool in this population.

2018 ◽  
Vol 4 (1) ◽  
pp. e000311 ◽  
Author(s):  
Anu M Räisänen ◽  
Kati Pasanen ◽  
Tron Krosshaug ◽  
Tommi Vasankari ◽  
Pekka Kannus ◽  
...  

Background/aimPoor frontal plane knee control can manifest as increased dynamic knee valgus during athletic tasks. The purpose of this study was to investigate the association between frontal plane knee control and the risk of acute lower extremity injuries. In addition, we wanted to study if the single-leg squat (SLS) test can be used as a screening tool to identify athletes with an increased injury risk.MethodsA total of 306 basketball and floorball players participated in the baseline SLS test and a 12-month injury registration follow-up. Acute lower extremity time-loss injuries were registered. Frontal plane knee projection angles (FPKPA) during the SLS were calculated using a two-dimensional video analysis.ResultsAthletes displaying a high FPKPA were 2.7 times more likely to sustain a lower extremity injury (adjusted OR 2.67, 95% CI 1.23 to 5.83) and 2.4 times more likely to sustain an ankle injury (OR 2.37, 95% CI 1.13 to 4.98). There was no statistically significant association between FPKPA and knee injury (OR 1.49, 95% CI 0.56 to 3.98). The receiver operating characteristic curve analyses indicated poor combined sensitivity and specificity when FPKPA was used as a screening test for lower extremity injuries (area under the curve of 0.59) and ankle injuries (area under the curve of 0.58).ConclusionsAthletes displaying a large FPKPA in the SLS test had an elevated risk of acute lower extremity and ankle injuries. However, the SLS test is not sensitive and specific enough to be used as a screening tool for future injury risk.


Author(s):  
Richard N Puzzitiello ◽  
Coleen F Rizzo ◽  
Kirsten D Garvey ◽  
Elizabeth G Matzkin ◽  
Matthew J Salzler

Year-round intensive, single-sport training beginning at an young age is an increasingly common trend in the youth athlete population. Early sport specialisation may be ineffective for long-term athletic success and contribute to an increased risk of physical injury and burn-out. The medical community has noted that repetitive movement patterns may occur in non-diversified activity and this may contribute to overuse injury in young athletes. Studies have begun to identify an association between early sport specialisation and lower extremity injuries in the youth athlete population that is independent of training volume. Recent literature has suggested that sport diversification, not specialisation, is a better path for athletic success and minimised lower extremity injury risk.


2019 ◽  
Vol 47 (12) ◽  
pp. 2853-2862 ◽  
Author(s):  
Gary L. Helton ◽  
Kenneth L. Cameron ◽  
Rebecca A. Zifchock ◽  
Erin Miller ◽  
Donald L. Goss ◽  
...  

Background: Running-related overuse injuries are very common among recreational runners, with the reported annual injury rates ranging from 39% to 85%. Relatively few large prospective cohort studies have been conducted to investigate injury risk associated with different running shoe characteristics, and the results of the existing studies are often contradictory. Purpose/Hypothesis: The purpose was to investigate the relationship between running shoe characteristics and lower extremity musculoskeletal injury. It was hypothesized that the risk of injury would be increased in individuals wearing shoes with minimal torsional stiffness and heel height compared with those wearing shoes with greater levels of torsional stiffness and heel height. Study Design: Cohort study; Level of evidence, 2. Methods: The study included 1025 incoming cadets. Shoe torsional stiffness and heel height were calculated and recorded. Demographic data were recorded and analyzed as potential covariates. Lower extremity injuries sustained over 9 weeks during cadet basic training were documented by use of the Armed Forces Health Longitudinal Technology Application and the Cadet Illness and Injury Tracking System. Kaplan-Meier survival curves were estimated, with time to incident lower extremity injury as the primary outcome by level of the independent predictor variables. Risk factors or potential covariates were carried forward into multivariable Cox proportional hazards regression models. Absolute and relative risk reduction and numbers needed to treat were calculated. Results: Approximately 18.1% of participants incurred a lower extremity injury. Cadets wearing shoes with moderate lateral torsional stiffness were 49% less likely to incur any type of lower extremity injury and 52% less likely to incur an overuse lower extremity injury than cadets wearing shoes with minimal lateral torsional stiffness, both of which were statistically significant observations. Injury risk was similar among cadets wearing shoes with minimal and extreme lateral torsional stiffness. Conclusion: Shoes with mild to moderate lateral torsional stiffness may be appropriate in reducing risk of lower extremity injury in cadets. Shoes with minimal lateral torsional stiffness should be discouraged in this population.


2016 ◽  
Vol 51 (11) ◽  
pp. 905-918 ◽  
Author(s):  
Scott D. Carow ◽  
Eric M. Haniuk ◽  
Kenneth L. Cameron ◽  
Darin A. Padua ◽  
Stephen W. Marshall ◽  
...  

Context: Specific movement patterns have been identified as possible risk factors for noncontact lower extremity injuries. The Dynamic Integrated Movement Enhancement (DIME) was developed to modify these movement patterns to decrease injury risk. Objective: To determine if the DIME is effective for preventing lower extremity injuries in US Military Academy (USMA) cadets. Design: Cluster-randomized controlled trial. Setting: Cadet Basic Training at USMA. Patients or Other Participants: Participants were 1313 cadets (1070 men, 243 women). Intervention(s): Participants were cluster randomized to 3 groups. The active warm-up (AWU) group performed standard Army warm-up exercises. The DIME groups were assigned to a DIME cadre-supervised (DCS) group or a DIME expert-supervised (DES) group; the former consisted of cadet supervision and the latter combined cadet and health professional supervision. Groups performed exercises 3 times weekly for 6 weeks. Main Outcome Measure(s): Cumulative risk of lower extremity injury was the primary outcome. We gathered data during Cadet Basic Training and for 9 months during the subsequent academic year. Risk ratios and 95% confidence intervals (CIs) were calculated to compare groups. Results: No differences were seen between the AWU and the combined DIME (DCS and DES) groups during Cadet Basic Training or the academic year. During the academic year, lower extremity injury risk in the DES group decreased 41% (relative risk [RR] = 0.59; 95% CI = 0.38, 0.93; P = .02) compared with the DCS group; a nonsignificant 25% (RR = 0.75; 95% CI = 0.49, 1.14; P = .18) decrease occurred in the DES group compared with the AWU group. Finally, there was a nonsignificant 27% (RR = 1.27; 95% CI = 0.90, 1.78; P = .17) increase in injury risk during the academic year in the DCS group compared with the AWU group. Conclusions: We observed no differences in lower extremity injury risk between the AWU and combined DIME groups. However, the magnitude and direction of the risk ratios in the DES group compared with the AWU group, although not statistically significant, indicate that professional supervision may be a factor in the success of injury-prevention programs.


2021 ◽  
Vol 9 (5) ◽  
pp. 232596712110034
Author(s):  
Toufic R. Jildeh ◽  
Fabien Meta ◽  
Jacob Young ◽  
Brendan Page ◽  
Kelechi R. Okoroha

Background: Impaired neuromuscular function after concussion has recently been linked to increased risk of lower extremity injuries in athletes. Purpose: To determine if National Football League (NFL) athletes have an increased risk of sustaining an acute, noncontact lower extremity injury in the 90-day period after return to play (RTP) and whether on-field performance differs pre- and postconcussion. Study Design: Cohort study, Level of evidence, 3. Methods: NFL concussions in offensive players from the 2012-2013 to the 2016-2017 seasons were studied. Age, position, injury location/type, RTP, and athlete factors were noted. A 90-day RTP postconcussive period was analyzed for lower extremity injuries. Concussion and injury data were obtained from publicly available sources. Nonconcussed, offensive skill position NFL athletes from the same period were used as a control cohort, with the 2014 season as the reference season. Power rating performance metrics were calculated for ±1, ±2, and ±3 seasons pre- and postconcussion. Conditional logistic regression was used to determine associations between concussion and lower extremity injury as well as the relationship of concussions to on-field performance. Results: In total, 116 concussions were recorded in 108 NFL athletes during the study period. There was no statistically significant difference in the incidence of an acute, noncontact lower extremity injury between concussed and control athletes (8.5% vs 12.8%; P = .143), which correlates with an odds ratio of 0.573 (95% CI, 0.270-1.217). Days (66.4 ± 81.9 days vs 45.1 ± 69.2 days; P = .423) and games missed (3.67 ± 3.0 vs 2.9 ± 2.7 games; P = .470) were similar in concussed athletes and control athletes after a lower extremity injury. No significant changes in power ratings were noted in concussed athletes in the acute period (±1 season to injury) when comparing pre- and postconcussion. Conclusion: Concussed, NFL offensive athletes did not demonstrate increased odds of acute, noncontact, lower extremity injury in a 90-day RTP period when compared with nonconcussed controls. Immediate on-field performance of skill position players did not appear to be affected by concussion.


Author(s):  
Alhassan Abass ◽  
Lawrence Quaye ◽  
Yussif Adams

Aim: This study aims at determining the upper and lower extremity injury pattern and severity of motorcycle accidents in the Tamale metropolis, Ghana. Methods: A retrospective hospital-based study comprising data on 190 motorcycle accident victims at the Accident and Emergency Centres of three major hospitals (Tamale Teaching Hospital, Central and West Hospitals) in Tamale metropolis from February to April 2018. Demographic data, injury type, injury location, use of crash helmet and injury outcomes were retrieved from the medical records registry. Data was analysed using SPSS version 23.0. Categorical variables were compared using Chi-square test and One-way ANOVA test was done to compare groups. Results: From the 190 victims, 78.9% were treated and discharged, 17.4% were disabled and 3.7% died. Injury mechanism was significantly (F-test = 22.64, p = 0.00) linked with injury outcome. Victims who had frontal impact collision and died (71.4%) were significantly (p<0.05) more than those who were treated and discharged (26.7%). Accident victims with upper extremity injury who became disabled (18.2%) were more (p<0.05) than those treated and discharged (16.7%). Out of the 190 victims involved in motorcycle accidents, 64.2% were not wearing crash helmet. There was significant relationship (p<0.05) between use of crash helmet and injury outcome. More (23.0%) of accident victims disabled were not wearing crash helmet and among those who died, none (0.0%) had a crash helmet on. Conclusion: Upper and lower extremity injuries as well head and neck injuries were high among motorcycle accident victims. The study recommends capacity building for healthcare professionals to manage head, neck, upper and lower extremity injuries at the Accident and Emergency Centres. Regular training programs should be conducted by law enforcement authorities in northern Ghana to train motorcycle riders and educate them on road traffic regulations. Compliance to the use of crash helmet by motorcyclists should strongly be enforced. Further prospective studies are needed to delineate these injury patterns and ascertain reason behind non-usage of crash helmet by motorcyclist in the Metropolis.


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Anna C. Davis ◽  
Nicholas P. Emptage ◽  
Dana Pounds ◽  
Donna Woo ◽  
Robert Sallis ◽  
...  

Abstract Background Neuromuscular warmups have gained increasing attention as a means of preventing sports-related injuries, but data on effectiveness in basketball are sparse. The objective of this systematic review was to evaluate evidence of the effectiveness of neuromuscular warmup-based strategies for preventing lower extremity injuries among basketball athletes. Methods PubMed and Cochrane Library databases were searched in February 2019. Studies were included if they were English-language randomized controlled, non-randomized comparative, or prospective cohort trials, tested neuromuscular and/or balance-focused warmup interventions among basketball players, and assessed at least one type of lower extremity injury as a primary outcome. Criteria developed by the USPSTF were used to appraise study quality, and GRADE was used to appraise the body of evidence for each outcome. Due to heterogeneity in the included studies, meta-analyses could not be performed. Results In total, 825 titles and abstracts were identified. Of the 13 studies which met inclusion criteria for this review, five were balance interventions (3 randomized controlled trials) and eight were multicomponent interventions involving multiple categories of dynamic neuromuscular warmup (5 randomized controlled trials). Authors of four of the studies were contacted to obtain outcome data specific to basketball athletes. Basketball specific results from the studies suggest significant protective effects for the following lower extremity injuries: ankle injuries (significant in 4 out of the 9 studies that assessed this outcome); ACL injuries (2 of 4 studies); knee injuries generally (1 of 5 studies); and overall lower extremity injuries (5 of 7 studies). All but one of the non-significant results were directionally favorable. Evidence was moderate for the effect of multicomponent interventions on lower extremity injuries generally. For all other outcomes, and for balance-based interventions, the quality of evidence was rated as low. Conclusion Overall, the evidence is supportive of neuromuscular warmups for lower extremity injury prevention among basketball players. However, most studies are underpowered, some used lower-quality research study designs, and outcome and exposure definitions varied. Due to the nature of the study designs, effects could not be attributed to specific intervention components. More research is needed to identify the most effective bundle of warmup activities.


2021 ◽  
Vol 30 (1) ◽  
pp. 158-160
Author(s):  
Scott Benson Street ◽  
Thomas Kaminski

Clinical Scenario: Hamstring injuries are the most prevalent lower-extremity injury among soccer players. The Fédération Internationale de Football Association (FIFA) has addressed this issue by developing the FIFA 11+ program, which is focused on improving strength and decreasing the incidence of lower-extremity injuries in the sport. This critically appraised topic focuses on this program as well as one of its components, the Nordic hamstring exercise, in the prevention of hamstring injuries. Clinical Question: Does the FIFA 11+ program prevent hamstring injuries in college-aged male soccer players? Summary of Key Findings: Four studies were selected to be critically appraised. The PEDro checklist was used to score the articles on methodology and consistency. All 4 articles demonstrated support for the clinical question. Clinical Bottom Line: There is moderate evidence to support the use of the FIFA 11+ program and Nordic hamstring exercise as part of a college soccer team’s warm-up routine. Strength of Recommendation: Grade B evidence exists in support of incorporating the FIFA 11+ program to reduce the incidence of hamstring injuries in male college soccer players.


2019 ◽  
Vol 20 (6) ◽  
pp. 839-844
Author(s):  
Parisa Namazi ◽  
Mostafa Zarei ◽  
Hamed Abbasi ◽  
Fariborz Hovanloo ◽  
Nikki Rommers ◽  
...  

2008 ◽  
Vol 23 (3) ◽  
pp. 114-119
Author(s):  
Mamie Air ◽  
A B M (Boni) Rietveld

Dancers frequently experience lower-extremity injuries which require dance activity restriction, if not full “time off” and/or surgery. Recovering dancers are frequently over-eager to return to dance, but engaging in too high an activity level too soon can be detrimental. Currently, there are no formal guidelines for general physicians about advising injured or postoperative dancer-patients about when or how to return to dance activity. Socioeconomic hurdles further prohibit many dancers from seeking rehabilitative services from a dance physical therapist. Therefore, there is a need for physician education about general dance-rehabilitation principles, as well as access to a dance-specific structured rehabilitation program. We present here rehabilitation advice from an expert in dance orthopedic surgery and an example of a “preventive rehabilitation program” for injured or postoperative dancer-patients with lower-extremity injury.


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