Gender Differences in Anterior Cruciate Ligament Injury vary with Activity

2007 ◽  
Vol 35 (10) ◽  
pp. 1635-1642 ◽  
Author(s):  
Sally B. Mountcastle ◽  
Matthew Posner ◽  
John F. Kragh ◽  
Dean C. Taylor
Keyword(s):  
Anterior Cruciate Ligament ◽  
Confidence Interval ◽  
Incidence Rate ◽  
Rate Ratio ◽  
Incidence Rate Ratio ◽  
Cruciate Ligament ◽  
Ligament Injury ◽  
Men And Women ◽  
Incidence Proportion ◽  
Anterior Cruciate

Background Previous studies have shown that women involved in similar activities as men are at increased risk for anterior cruciate ligament injuries. Hypothesis The incidence rate of complete anterior cruciate ligament tears for men and women in our athletic, college-aged population is similar. Study Design Descriptive epidemiology study. Methods Students graduating in class years 1994 to 2003 at our institution who sustained complete anterior cruciate ligament tears were assessed for mechanism of injury and type of sport played at time of injury. We calculated the incidence proportion, an estimation of risk, by gender and class year, and the incidence proportion ratio comparing men and women by class year. We also calculated incidence rates by gender and type of sport played and incidence rate ratios comparing men and women. Results There were 353 anterior cruciate ligament injuries in the 10 classes studied. We found an overall, 4-year incidence proportion of 3.24 per 100 (95% confidence interval, 2.89-3.63) for men and 3.51 (95% confidence interval, 2.65-4.65) for women (incidence proportion ratio, 1.09 [95% confidence interval, 0.80-1.47]). The overall anterior cruciate ligament injury rate, excluding male-only sports, was significantly greater in women (incidence rate ratio, 1.51 [95% confidence interval, 1.03-2.21]). We found significantly greater injury rates among women in a gymnastics course (incidence rate ratio, 5.67 [95% confidence interval, 1.99-16.16]), indoor obstacle course test (incidence rate ratio, 3.72 [95% confidence interval, 1.25-11.10]), and basketball (incidence rate ratio, 2.42 [95% confidence interval, 1.05-5.59]). Conclusion We found little gender difference in the overall risk of an anterior cruciate ligament tear; however, there were gender differences in injury rates when specific sports and activities were compared and when male-only sports were removed from the overall rate assessment.

scholarly journals Compliance With Neuromuscular Training and Anterior Cruciate Ligament Injury Risk Reduction in Female Athletes: A Meta-Analysis

2012 ◽  
Vol 47 (6) ◽  
pp. 714-723 ◽  
Author(s):  
Dai Sugimoto ◽  
Gregory D. Myer ◽  
Heather M. Bush ◽  
Maddie F. Klugman ◽  
Jennifer M. Medina McKeon ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Confidence Interval ◽  
Rate Ratio ◽  
Female Athletes ◽  
Incidence Rate Ratio ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Neuromuscular Training ◽  
Acl Injuries ◽  
Anterior Cruciate

Context No consensus exists about the influence of compliance with neuromuscular training programs on reduction of the risk of anterior cruciate ligament (ACL) injury. Objective To systematically review and synthesize the published literature to determine if compliance with neuromuscular training is associated with reduced incidence of ACL injury in young female athletes. Data Sources We searched PubMed, SPORTDiscus, CINAHL, and MEDLINE for articles published from 1995 to 2010 using the key words anterior cruciate ligament prevention, ACL prevention, knee prevention, prospective knee prevention, neuromuscular training, and neuromuscular intervention. Study Selection Criteria for inclusion required that (1) the number of ACL injuries was reported, (2) a neuromuscular training program was used, (3) females were included as participants, (4) the study design was prospective and controlled, and (5) compliance data for the neuromuscular training program were provided. Data Extraction Extracted data included the number of ACL injuries, total number of participants per group, observation time period, number of participants who completed each session, number of sessions completed by an entire team, and number of total sessions. Attendance was calculated as the number of participants who completed each session converted into a percentage of the total number of participants. Intervention completion was calculated as the number of sessions completed by an entire team converted into a percentage of the total number of training sessions. These data were used to calculate an overall rate of compliance. Data Synthesis Six of 205 identified studies were included. Incidence rates of ACL injury were lower in studies with high rates of compliance with neuromuscular training than in studies with low compliance rates (incidence rate ratio = 0.27 [95% confidence interval = 0.07, 0.80]). Tertile analysis indicated rates of ACL injury incidence were lower in studies with high compliance rates than in studies with moderate and low compliance rates (incidence rate ratio = 0.18 [95% confidence interval = 0.02, 0.77]). Conclusions A potential inverse dose-response relationship exists between compliance with neuromuscular training and incidence of ACL injury. Attending and completing recommended neuromuscular sessions appears to be an important factor for preventing ACL injuries.

scholarly journals Epidemiology of Anterior Cruciate Ligament Injury in Italian First Division Soccer Players

2019 ◽  
Vol 12 (3) ◽  
pp. 279-288 ◽  
Author(s):  
Alberto Grassi ◽  
Luca Macchiarola ◽  
Matteo Filippini ◽  
Gian Andrea Lucidi ◽  
Francesco Della Villa ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Incidence Rate ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Soccer Players ◽  
Injury Incidence ◽  
Acl Injuries ◽  
Professional Soccer ◽  
Incidence Proportion ◽  
Anterior Cruciate

Background: The burden of anterior cruciate ligament (ACL) injury in professional soccer players is particularly relevant as it represents a potentially career-threatening injury. Hypothesis: Our hypotheses were that (1) injury incidence rate would be similar to that reported in the literature, (2) we would identify a uniform distribution of the injuries along the season, and (3) injury incidence rate would be similar in high-ranked and lower ranked teams, based on final placement in the league. Study Design: Descriptive epidemiological study. Level of Evidence: Level 4. Methods: Professional male soccer players participating in the Serie A championship league in 7 consecutive seasons (2011-2012 to 2017-2018) were screened to identify ACL injuries through the online football archive transfermarkt.com . Exposure in matches and training were calculated. Results: There were 84 ACL injuries found (mean player age, 25.3 ± 4.2 years). Overall, 25% of ACL injuries were reruptures (15%) or contralateral injuries (10%). ACL incidence rate was 0.4215 per 1000 hours of play during Serie A matches, 0.0305 per 1000 hours of training (rate ratio [RR], 13.8; 95% CI, 8.4-22.7; P < 0.0001), and 0.0618 per 1000 hours of total play. Injury distribution had a bimodal peak, with the highest number of events in October and March. Alternatively, training injuries peaked in June and July. A significantly higher incidence rate was found for the teams ranked from 1st to 4th place compared with those ranked 5th to 20th (0.1256 vs 0.0559 per 1000 hours of play; RR, 2.2; 95% CI, 1.4-3.6; P = 0.0003). A similar finding was found for injury incidence proportion (3.76% vs 1.64%; P = 0.0003). Conclusion: The overall incidence rate of ACL injuries in Italian Serie A was 0.062 per 1000 hours, with a 14-fold risk in matches compared with training. Relevantly, 25% were second injuries. Most injuries occurred in October and March, and an almost 2-fold incidence rate and incidence proportion were noted in those teams ranked in the first 4 positions of the championship league. Clinical Relevance: Knowing the precise epidemiology of ACL injury in one of the most competitive professional football championship leagues could help delineate fields of research aimed to investigate its risk factors.

Differences in Kinematics and Electromyographic Activity between Men and Women during the Single-Legged Squat

2003 ◽  
Vol 31 (3) ◽  
pp. 449-456 ◽  
Author(s):  
Brian L. Zeller ◽  
Jean L. McCrory ◽  
W. Ben Kibler ◽  
Timothy L. Uhl
Keyword(s):  
Anterior Cruciate Ligament ◽  
Lower Extremity ◽  
Muscle Activation ◽  
External Rotation ◽  
Cruciate Ligament ◽  
Rectus Femoris ◽  
Ligament Injury ◽  
Electromyographic Activity ◽  
Men And Women ◽  
Anterior Cruciate

Background Numerous factors have been identified as potentially increasing the risk of anterior cruciate ligament injury in the female athlete. However, differences between the sexes in lower extremity coordination, particularly hip control, are only minimally understood. Hypothesis There is no difference in kinematic or electromyographic data during the single-legged squat between men and women. Study Design Descriptive comparison study. Methods We kinematically and electromyographically analyzed the single-legged squat in 18 intercollegiate athletes (9 male, 9 female). Subjects performed five single-legged squats on their dominant leg, lowering themselves as far as possible and then returning to a standing position without losing balance. Results Women demonstrated significantly more ankle dorsiflexion, ankle pronation, hip adduction, hip flexion, hip external rotation, and less trunk lateral flexion than men. These factors were associated with a decreased ability of the women to maintain a varus knee position during the squat as compared with the men. Analysis of all eight tested muscles demonstrated that women had greater muscle activation compared with men. When each muscle was analyzed separately, the rectus femoris muscle activation was found to be statistically greater in women in both the area under the linear envelope and maximal activation data. Conclusions Under a physiologic load in a position commonly assumed in sports, women tend to position their entire lower extremity and activate muscles in a manner that could increase strain on the anterior cruciate ligament.

scholarly journals Trends in incident acute myocardial infarction in Norway: An updated analysis to 2014 using national data from the CVDNOR project

2018 ◽  
Vol 25 (10) ◽  
pp. 1031-1039 ◽  
Author(s):  
Gerhard Sulo ◽  
Jannicke Igland ◽  
Stein Emil Vollset ◽  
Marta Ebbing ◽  
Grace M Egeland ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Confidence Interval ◽  
Incidence Rate ◽  
Rate Ratio ◽  
Incidence Rate Ratio ◽  
Age Groups ◽  
Incidence Rates ◽  
Myocardial Infarctions ◽  
Men And Women

Background We updated the information on trends of incident acute myocardial infarction in Norway, focusing on whether the observed trends during 2001–2009 continued throughout 2014. Methods All incident (first) acute myocardial infarctions in Norwegian residents age 25 years and older were identified in the Cardiovascular Disease in Norway 1994–2014 project. We analysed overall and age group-specific (25–64 years, 65–84 years and 85 + years) trends by gender using Poisson regression analyses and report the average annual changes in rates with their 95% confidence intervals. Results During 2001–2014, 221,684 incident acute myocardial infarctions (59.4% men) were identified. Hospitalised cases accounted for 79.9% of all incident acute myocardial infarctions. Overall, incident acute myocardial infarction rates declined on average 2.6% per year (incidence rate ratio 0.974, 95% confidence interval 0.972–0.977) in men and 2.8% per year (incidence rate ratio 0.972, 95% confidence interval 0.971–0.974) in women, contributed by declining rates of hospitalisations (1.8% and 1.9% per year in men and women, respectively) and deaths (6.0% and 5.8% per year in men and women, respectively). Declining rates were observed in all three age groups. The overall acute myocardial infarction incidence rates continued to decline from 2009 onwards, with a steeper decline compared to 2001–2009. During 2009–2014, gender-adjusted acute myocardial infarction incidence among adults age 25–44 years declined 5.3% per year, contributed mostly by declines in hospitalisation rates (5.1% per year). Conclusion Acute myocardial infarction incidence rates continued to decline after 2009 in Norway in both men and women. The decline started to involve individuals aged 25–44 years, marking a turning point in the previously reported stagnation of rates during 2001–2009.

Injuries in Female Soccer Players

2005 ◽  
Vol 33 (11) ◽  
pp. 1694-1700 ◽  
Author(s):  
Oliver Faude ◽  
Astrid Junge ◽  
Wilfried Kindermann ◽  
Jiri Dvorak
Keyword(s):  
Anterior Cruciate Ligament ◽  
Confidence Interval ◽  
Incidence Rate ◽  
Physical Therapists ◽  
Cruciate Ligament ◽  
Sports Participation ◽  
Soccer Players ◽  
Injury Incidence ◽  
Traumatic Injuries ◽  
Anterior Cruciate

Background In contrast to the high number of studies about soccer injuries in men, epidemiologic data in high-level female soccer players are scarce. Purpose Analysis of injury incidence in elite female soccer players. Study Design Descriptive epidemiology study. Methods There were 165 female soccer players (age, 22.4 ± 5.0 years) from 9 teams competing in the German national league, who were followed for one complete outdoor season. Their trainers documented the exposure to soccer on a weekly basis for each player, and the team physical therapists reported all injuries with regard to location, type, and circumstances of occurrence. An injury was defined as any physical complaint associated with soccer that limited sports participation for at least 1 day. Results There were 241 injuries sustained by 115 players (70%) reported; 39 injuries (16%) were owing to overuse, and 202 injuries (84%) were traumatic. Overall, 42% of the traumatic injuries occurred during training (2.8/1000 hours of training; 95% confidence interval, 2.2-3.4) and 58% during matches (23.3/1000 match hours; 95% confidence interval, 19.1-27.5); 102 of the traumatic injuries were caused by a contact situation, whereas 95 occurred without any contact. Most injuries (80%) were located at the lower extremities, concerning mainly the thigh (n = 44), knee (n = 45), and ankle (n = 43). Ankle sprain (n = 37) was the most often diagnosed injury. There were 51% minor injuries, 36% moderate injuries, and 13% major injuries. Eleven anterior cruciate ligament ruptures were observed during the season. Conclusion The results revealed a high injury incidence rate in games as well as a comparably low incidence rate during training. An important finding of this investigation was the frequent occurrence of anterior cruciate ligament ruptures. Preventive measures should thus focus on the high prevalence of anterior cruciate ligament tears, mostly occurring in noncontact situations.

Anterior cruciate ligament injury risk factors in football

2019 ◽  
Vol 59 (10) ◽  
Author(s):  
Gian Nicola Bisciotti ◽  
Karim Chamari ◽  
Emanuele Cena ◽  
Andrea Bisciotti ◽  
Alessandro Bisciotti ◽  
...  
Keyword(s):  
Risk Factors ◽  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Injury ◽  
Injury Risk ◽  
Cruciate Ligament ◽  
Ligament Injury ◽  
Injury Risk Factors ◽  
Anterior Cruciate

scholarly journals Single-Leg Landings Following a Volleyball Spike May Increase the Risk of Anterior Cruciate Ligament Injury More Than Landing on Both-Legs

2020 ◽  
Vol 11 (1) ◽  
pp. 130
Author(s):  
Datao Xu ◽  
Xinyan Jiang ◽  
Xuanzhen Cen ◽  
Julien S. Baker ◽  
Yaodong Gu
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Flexion ◽  
Sagittal Plane ◽  
Cruciate Ligament ◽  
Flexion Angle ◽  
Ligament Injury ◽  
Time Range ◽  
Acl Injuries ◽  
Volleyball Players ◽  
Anterior Cruciate

Volleyball players often land on a single leg following a spike shot due to a shift in the center of gravity and loss of balance. Landing on a single leg following a spike may increase the probability of non-contact anterior cruciate ligament (ACL) injuries. The purpose of this study was to compare and analyze the kinematics and kinetics differences during the landing phase of volleyball players using a single leg (SL) and double-leg landing (DL) following a spike shot. The data for vertical ground reaction forces (VGRF) and sagittal plane were collected. SPM analysis revealed that SL depicted a smaller knee flexion angle (about 13.8°) and hip flexion angle (about 10.8°) during the whole landing phase, a greater knee and hip power during the 16.83–20.45% (p = 0.006) and 13.01–16.26% (p = 0.008) landing phase, a greater ankle plantarflexion angle and moment during the 0–41.07% (p < 0.001) and 2.76–79.45% (p < 0.001) landing phase, a greater VGRF during the 5.87–8.25% (p = 0.029), 19.75–24.14% (p = 0.003) landing phase when compared to DL. Most of these differences fall within the time range of ACL injury (30–50 milliseconds after landing). To reduce non-contact ACL injuries, a landing strategy of consciously increasing the hip and knee flexion, and plantarflexion of the ankle should be considered by volleyball players.

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