Biologic Treatments for Sports Injuries II Think Tank—Current Concepts, Future Research, and Barriers to Advancement, Part 1

BackgroundTime-to-event modelling is underutilised in sports injury research. Still, sports injury researchers have been encouraged to consider time-to-event analyses as a powerful alternative to other statistical methods. Therefore, it is important to shed light on statistical approaches suitable for analysing training load related key-questions within the sports injury domain.ContentIn the present article, we illuminate: (i) the possibilities of including time-varying outcomes in time-to-event analyses, (ii) how to deal with a situation where different types of sports injuries are included in the analyses (ie, competing risks), and (iii) how to deal with the situation where multiple subsequent injuries occur in the same athlete.ConclusionTime-to-event analyses can handle time-varying outcomes, competing risk and multiple subsequent injuries. Although powerful, time-to-event has important requirements: researchers are encouraged to carefully consider prior to any data collection that five injuries per exposure state or transition is needed to avoid conducting statistical analyses on time-to-event data leading to biased results. This requirement becomes particularly difficult to accommodate when a stratified analysis is required as the number of variables increases exponentially for each additional strata included. In future sports injury research, we need stratified analyses if the target of our research is to respond to the question: ‘how much change in training load is too much before injury is sustained, among athletes with different characteristics?’ Responding to this question using multiple time-varying exposures (and outcomes) requires millions of injuries. This should not be a barrier for future research, but collaborations across borders to collecting the amount of data needed seems to be an important step forward.

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Masking in reports of “most serious” events: bias in estimators of sports injury incidence in Canadian children

Health Promotion and Chronic Disease Prevention in Canada ◽

10.24095/hpcdp.36.8.01 ◽

2016 ◽

Vol 36 (8) ◽

pp. 143-148 ◽

Cited By ~ 2

Author(s):

A. Gupta ◽

C. M. Davison ◽

M. A. McIsaac

Keyword(s):

Health Care Providers ◽

Sports Injuries ◽

Sports Injury ◽

Future Research ◽

Injury Incidence ◽

Care Providers ◽

Survey Length ◽

Serious Injury ◽

Injury Reporting ◽

The One

Introduction Surveys that collect information on injuries often focus on the single “most serious” event to help limit recall error and reduce survey length. However, this can mask less serious injuries and result in biased incidence estimates for specific injury subcategories. Methods Data from the 2002 Health Behaviour in School-aged Children (HBSC) survey and from the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) were used to compare estimates of sports injury incidence in Canadian children. Results HBSC data indicate that 6.7% of children report sustaining a sports injury that required an emergency department (ED) visit. However, details were only collected on a child’s “most serious” injury, so children who had multiple injuries requiring an ED visit may have had sports injuries that went unreported. The rate of 6.7% can be seen to be an underestimate by as much as 4.3%. Corresponding CHIRPP surveillance data indicate an incidence of 9.9%. Potential masking bias is also highlighted in our analysis of injuries attended by other health care providers. Conclusion The “one most serious injury” line of questioning induces potentially substantial masking bias in the estimation of sports injury incidence, which limits researchers’ ability to quantify the burden of sports injury. Longer survey recall periods naturally lead to greater masking. The design of future surveys should take these issues into account. In order to accurately inform policy decisions and the direction of future research, researchers must be aware of these limitations.

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Medical Care for Wheelchair Athletes

Adapted Physical Activity Quarterly ◽

10.1123/apaq.5.2.90 ◽

1988 ◽

Vol 5 (2) ◽

pp. 90-95 ◽

Cited By ~ 2

Author(s):

Brent C. Mangus

Keyword(s):

Sports Injuries ◽

Psychological Impact ◽

The Body ◽

Medical Attention ◽

Future Research ◽

Sporting Events ◽

Physiological Factors ◽

Wheelchair Athletes ◽

Area Of Concern ◽

Wheelchair Athlete

The number of wheelchair-bound athletes training for and competing in local, state, national, and international sporting events increases every year. As participation increases, sports injuries associated with the training and competition of these athletes also increase. Medical attention for wheelchair athletes during training and competition should be provided by competent professionals. However, even with competent professionals providing medical attention to wheelchair athletes, injuries do occur. Typical injuries experienced by the wheelchair-bound athlete include carpal tunnel syndrome, various shoulder problems, numerous problems with the hands, and lacerations, abrasions, and contusions to all parts of the body. The ability of the wheelchair athlete to thermoregulate his or her own body is also an area of concern for those providing health care during practice and competition. More researchers are studying injuries and injury rates to the wheelchair athlete, and the body of literature in this area is becoming larger. Future research can begin to document the effects of strength training, nutrition, various conditioning strategies, the biomechanics of the wheelchair motion, and the psychological impact of athletic injuries. Although some physiological factors have been studied, many remain to be addressed in an effort to shed light on the injuries experienced by wheelchair athletes.

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Epidemiology of School Injuries: A 2-Year Experience in A Municipal Health Department

PEDIATRICS ◽

10.1542/peds.79.1.69 ◽

1987 ◽

Vol 79 (1) ◽

pp. 69-75 ◽

Cited By ~ 1

Author(s):

Samuel B. Sheps ◽

G. Dewey Evans

Keyword(s):

Elementary School ◽

Secondary School ◽

Elementary School Students ◽

Secondary School Students ◽

Injury Severity ◽

Sports Injuries ◽

Health Department ◽

Future Research ◽

School Students ◽

Severe Injuries

School injuries occurring in a municipal school system during a 2-year period were reviewed to identify epidemiologic features of school injuries, to determine data requirements for ongoing injury surveillance, and to identify potential preventive strategies. Overall, 3,009 injuries were reported (2.82/100 students per year). Elementary school students had only a slightly higher rate (2.85) than secondary school students (2.78). However, the cause, nature, school location of injury, and body area injured formed distinct patterns in these two groups. Playgrounds were responsible for the highest overall and elementary school rates, whereas sports areas and classrooms had the highest rates among secondary school students. Falls were the most frequent cause of injury in elementary schools whereas, as expected, sports injuries were the most frequent cause among secondary school students. Contusions and abrasions of the head were the most frequent type of injury for both groups, although more common among elementary school students, whereas fractures, sprains, strains, and dislocations were more frequent among secondary school students. Although the proportion of severe injuries to secondary school students was slightly higher (39 v 35%), the rate of referral of students to a hospital or physicians among secondary school students (1.21 per 100 student-hours) was almost twice the rate of elementary school students (0.65 per 100 student-hours). Problems with definition of injury severity and the need to explore the social aspects of schools as a factor in injuries emerged as important considerations for future research.

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Epidemiology of Severe Injuries among United States High School Athletes

The American Journal of Sports Medicine ◽

10.1177/0363546509333015 ◽

2009 ◽

Vol 37 (9) ◽

pp. 1798-1805 ◽

Cited By ~ 181

Author(s):

Cory J. Darrow ◽

Christy L. Collins ◽

Ellen E. Yard ◽

R. Dawn Comstock

Keyword(s):

United States ◽

High School ◽

Sports Injuries ◽

Injury Rate ◽

Sports Participation ◽

Severe Injury ◽

Future Research ◽

High School Athletes ◽

Severe Injuries ◽

Injury Rates

Background Over 7 million students participate in high school athletics annually. Despite numerous health benefits, high school athletes are at risk for injury. Hypothesis Severe injury rates and patterns differ by gender and type of exposure. Study Design Descriptive epidemiology study. Methods Sports-related injury data were collected during the 2005-2007 academic years from 100 nationally representative United States high schools via RIO (Reporting Information Online). Severe injury was defined as any injury that resulted in the loss of more than 21 days of sports participation. Results Participating certified athletic trainers (ATCs) reported 1378 severe injuries during 3 550 141 athlete-exposures (0.39 severe injuries per 1000 athletic exposures). Football had the highest severe injury rate (0.69), followed by wrestling (0.52), girls’ basketball (0.34), and girls’ soccer (0.33). The rate in all boys’ sports (0.45) was higher than all girls’ sports (0.26) (rate ratio [RR], 1.74; 95% confidence interval [CI], 1.54-1.98; P < .001). However, among directly comparable sports (soccer, basketball, and baseball/softball), girls sustained a higher severe injury rate (0.29) than boys (0.23) (RR, 1.28; 95% CI, 1.08-1.52; P = .006). More specifically, girls’ basketball had a higher rate (0.34) than boys’ basketball (0.24) (RR, 1.43; 95% CI, 1.10-1.86; P = .009). Differences between boys’ and girls’ soccer and baseball/softball were not statistically significant. The severe injury rate was greater in competition (0.79) than practice (0.24) (RR, 3.30; 95% CI, 2.97-3.67; P < .001). Nationally, high school athletes sustained an estimated 446 715 severe injuries from 2005-2007. The most commonly injured body sites were the knee (29.0%), ankle (12.3%), and shoulder (10.9%). The most common diagnoses were fractures (36.0%), complete ligament sprains (15.3%), and incomplete ligament sprains (14.3%). Of severe sports injuries, 0.3% resulted in medical disqualification for the athletes’ career, and an additional 56.8% resulted in medical disqualification for the entire season. One in 4 (28.3%) severe injuries required surgery, with over half (53.9%) being knee surgeries. Conclusion Severe injury rates and patterns varied by sport, gender, and type of exposure. Because severe injuries negatively affect athletes’ health and often place an increased burden on the health care system, future research should focus on developing interventions to decrease the incidence and severity of sports-related injuries.

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Strength training as superior, dose-dependent and safe prevention of acute and overuse sports injuries: a systematic review, qualitative analysis and meta-analysis

British Journal of Sports Medicine ◽

10.1136/bjsports-2018-099078 ◽

2018 ◽

Vol 52 (24) ◽

pp. 1557-1563 ◽

Cited By ~ 24

Author(s):

Jeppe Bo Lauersen ◽

Thor Einar Andersen ◽

Lars Bo Andersen

Keyword(s):

Systematic Review ◽

Qualitative Analysis ◽

Strength Training ◽

Publication Bias ◽

Sports Injuries ◽

Meta Analysis ◽

Sports Injury ◽

Future Research ◽

Training Volume ◽

Strength Of Evidence

ObjectiveThis review aims to analyse strength training-based sports injury prevention randomised controlled trials (RCT) and present best evidence recommendations for athletes and future research. A priori PROSPERO registration; CRD42015006970.DesignSystematic review, qualitative analysis and meta-analysis. Sorting of studies and quality assessments were performed by two independent authors. Qualitative analyses, relative risk (RR) estimate with robustness and strength of evidence tests, formal tests of publication bias and post-hoc meta-regression were performed.Data sourcesPubMed, Embase, Web of Science and SPORTDiscus were searched to July 2017.Eligibility criteria for selecting studiesRCTs on strength training exercises as primary prevention of sports injuries.ResultsSix studies analysed five different interventions with four distinct outcomes. 7738 participants aged 12–40 years were included and sustained 177 acute or overuse injuries. Studies were published in 2003–2016, five from Europe and one from Africa. Cluster-adjusted intention-to-treat analysis established RR 0.338 (0.238–0.480). The result was consistent across robustness tests and strength of evidence was high. A 10% increase in strength training volume reduced the risk of injury by more than four percentage points. Formal tests found no publication bias.ConclusionThe included studies were generally well designed and executed, had high compliance rates, were safe, and attained consistently favourable results across four different acute and overuse injury outcomes despite considerable differences in populations and interventions. Increasing strength training volume and intensity were associated with sports injury risk reduction. Three characteristically different approaches to prevention mechanisms were identified and incorporated into contemporary strength training recommendations.

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Parents Pursuing a Doctorate of Education: A Mixed Methods Examination of How Parents Manage the Roles of Student and Parent

International Journal of Doctoral Studies ◽

10.28945/4741 ◽

2021 ◽

Vol 16 ◽

pp. 253-272

Author(s):

Amy J Catalano ◽

Susan T Radin

Keyword(s):

Mixed Methods ◽

Doctoral Students ◽

Doctoral Programs ◽

Doctoral Program ◽

Future Research ◽

Barriers To Advancement ◽

Family Responsibilities ◽

Education Doctorate ◽

Student Parents ◽

Decisions To Leave

Aim/Purpose: Doctoral students who are parents are increasingly more common, particularly in female-dominated disciplines, such as education. This study aims to examine the experiences of parents pursuing an education doctorate Background: This study examines the experiences of doctoral students who are parents and their perceptions of support in order to determine how programs and faculty can better serve students. Methodology: This mixed methods study examines the experiences of 52 doctoral students who were parents or became parents during their doctoral program. Methods includes surveys and interviews. Contribution: Very little published literature focuses on the experiences of both mothers and fathers who are doctoral students. This study is unique in that education doctoral students are generally established professionals with families and career success. Findings: Among participants, 37% were women who became pregnant during the program. While most parents persisted in the program to graduate with a doctorate, several participants, including fathers, discussed their decisions to leave the doctoral program due to family responsibilities. Recommendations for Practitioners: In order to uphold standards for a high-quality doctoral education, while also supporting student-parents, recommendations are presented for both doctoral programs and students. Recommendation for Researchers: Further research is needed on LGBTQ families and single-parent families of lower incomes. Impact on Society: Differences between workloads and barriers to advancement still persist for mothers in comparison to fathers. Future Research: Future research should examine the experiences of fathers more fully.

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Biomechanics of oral implants: future research directions

Journal of Dental Education ◽

10.1002/j.0022-0337.1988.52.12.tb02279.x ◽

1988 ◽

Vol 52 (12) ◽

pp. 775-787 ◽

Cited By ~ 12

Author(s):

JB Brunski

Keyword(s):

Future Research ◽

Research Directions ◽

Oral Implants ◽

Future Research Directions

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