Performance on a Single-Legged Drop-Jump Landing Test Is Related to Increased Risk of Lateral Ankle Sprains Among Male Elite Soccer Players: A 3-Year Prospective Cohort Study

Background: Soccer has a high injury rate, with lateral ankle sprains being a common injury. Therefore, an approach to prevent or at least reduce the occurrence is warranted. Injury prevention can be improved by identifying specific risk factors and individuals at risk. Purpose: To assess drop-jump landing performance as a potential predictor of lateral ankle sprain within 3-year follow-up. Study Design: Case-control study; Level of evidence, 3. Methods: Single-legged drop-jump landing tests were performed by 190 elite soccer players. Based on ground-reaction forces, 6 outcome measures were calculated that aim to reflect the impact and stabilization phase. Lateral ankle sprains were registered during up to 3 years of follow-up. Following a z score correction for age, a multivariate regression analysis was performed. Results: During follow-up, 45 players (23.7%) suffered a primary lateral ankle sprain. Of those, 34 were regarded as severe (absence >7 days). Performance was related to increased risk of ankle sprain ( P = .005 for all sprains and P = .001 for severe sprains). Low mediolateral stability for the first 0.4 seconds after landing (a larger value indicates more force exerted in the mediolateral direction, resulting in rapid lateral stabilization) and high horizontal ground-reaction force between 3.0 and 5.0 seconds (a smaller value indicates less sway in the stabilization phase) were identified as risk factors. A player that scored 2 SD below average for both risk factors had a 4.4-times-higher chance of sustaining an ankle sprain than a player who scored average. Conclusion: The current study showed that following a single-legged drop-jump landing, mediolateral force over 0 to 0.4 seconds and/or mean resultant horizontal ground-reaction force over 3 to 5 seconds has predictive value with regard to the occurrence of an ankle sprain among male elite soccer players within 3 years.

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Systematic Review of Postural Control and Lateral Ankle Instability, Part I: Can Deficits Be Detected With Instrumented Testing?

Journal of Athletic Training ◽

10.4085/1062-6050-43.3.293 ◽

2008 ◽

Vol 43 (3) ◽

pp. 293-304 ◽

Cited By ~ 187

Author(s):

Patrick O. McKeon ◽

Jay Hertel

Keyword(s):

Postural Control ◽

Ankle Sprain ◽

Ankle Instability ◽

Chronic Ankle Instability ◽

Effect Sizes ◽

Ankle Sprains ◽

Lateral Ankle Sprain ◽

Lateral Ankle ◽

Increased Risk ◽

Clinical Questions

Abstract Objective: To answer the following clinical questions: (1) Is poor postural control associated with increased risk of a lateral ankle sprain? (2) Is postural control adversely affected after acute lateral ankle sprain? (3) Is postural control adversely affected in those with chronic ankle instability? Data Sources: PubMed and CINAHL entries from 1966 through October 2006 were searched using the terms ankle sprain, ankle instability, balance, chronic ankle instability, functional ankle instability, postural control, and postural sway. Study Selection: Only studies assessing postural control measures in participants on a stable force plate performing the modified Romberg test were included. To be included, a study had to address at least 1 of the 3 clinical questions stated above and provide adequate results for calculation of effect sizes or odds ratios where applicable. Data Extraction: We calculated odds ratios with 95% confidence intervals for studies assessing postural control as a risk factor for lateral ankle sprains. Effect sizes were estimated with the Cohen d and associated 95% confidence intervals for comparisons of postural control performance between healthy and injured groups, or healthy and injured limbs, respectively. Data Synthesis: Poor postural control is most likely associated with an increased risk of sustaining an acute ankle sprain. Postural control is impaired after acute lateral ankle sprain, with deficits identified in both the injured and uninjured sides compared with controls. Although chronic ankle instability has been purported to be associated with altered postural control, these impairments have not been detected consistently with the use of traditional instrumented measures. Conclusions: Instrumented postural control testing on stable force plates is better at identifying deficits that are associated with an increased risk of ankle sprain and that occur after acute ankle sprains than at detecting deficits related to chronic ankle instability.

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Prevalence and Risk Factors of Ankle Sprain Among Male Soccer Players in Tabuk, Saudi Arabia: A Cross-Sectional Study

The Open Sports Sciences Journal ◽

10.2174/1875399x02013010027 ◽

2020 ◽

Vol 13 (1) ◽

pp. 27-33

Author(s):

Hamad S. Al Amer ◽

Shahul Hameed Pakkir Mohamed

Keyword(s):

Risk Factors ◽

Saudi Arabia ◽

Physical Therapy ◽

Ankle Sprain ◽

Cross Sectional Study ◽

Soccer Players ◽

Ankle Sprains ◽

Sectional Study ◽

Cross Sectional ◽

Warm Up

Background: Ankle sprains are common among soccer players, and their risk factors are well documented in the literature. In Saudi Arabia, some healthcare and sport-related characteristics provide the necessity for investigating the prevalence and risk factors of ankle sprain in that region as well. Objective: To analyze the prevalence of lower limb injuries and risk factors of ankle sprains among male soccer players in Tabuk, Saudi Arabia. Methods: A cross-sectional study among 400 male soccer players from different sports clubs in Tabuk, Saudi Arabia was conducted. A self-structured questionnaire was used to collect data related to ankle sprains. Chi-square, Fisher’s exact tests, and unpaired t-tests were used to test the association between variables. Univariate logistic regression analysis was used to identify the risk factors. Results: Ankle sprains were the most prevalent, reported by 63.8%. Previous ankle injury, lack of stretching, lack of warm-up, and not wearing bracing were identified as significant risk factors. A total of 47.9% of players preferred to go to the hospital for treatment, 15.8% selected physical therapy, while 56% had no prior education regarding injury prevention. Conclusion: Ankle sprain is the most prevalent lower limb injury. Risk factors include previous ankle injuries, lack of stretching, lack of warm-up, and not wearing bracing. Players have little knowledge of physical therapy measures and lack of injury prevention education. Our findings suggest that increasing the awareness of injuries and proper physical therapy measures might assist in preventing recurrence of ankle sprains among male soccer players.

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Hip Abductor Muscle Strength Deficit as a Risk Factor for Inversion Ankle Sprain in Male College Soccer Players: A Prospective Cohort Study

Orthopaedic Journal of Sports Medicine ◽

10.1177/23259671211020287 ◽

2021 ◽

Vol 9 (7) ◽

pp. 232596712110202

Author(s):

Kohei Kawaguchi ◽

Shuji Taketomi ◽

Yuri Mizutani ◽

Hiroshi Inui ◽

Ryota Yamagami ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Cohort Study ◽

Muscle Strength ◽

Ankle Sprain ◽

Soccer Players ◽

Ankle Sprains ◽

Abductor Muscle ◽

Hip Abductor ◽

Abductor Strength

Background: Previous studies have attempted to determine whether certain risk factors can predict the occurrence of inversion ankle sprains in male collegiate soccer players. However, no consensus has been reached on the predictive risk factors of inversion ankle sprain in this population. Purpose: To identify risk factors for inversion ankle sprains among male collegiate soccer players. Study Design: Cohort study; Level of evidence, 2. Methods: Included were 145 male collegiate soccer players in Japan who were assessed during a preseason medical checkup for potential risk factors of inversion ankle sprain. The preseason assessment included anthropometric measurements, joint laxity and flexibility, muscle flexibility, muscle strength, and balance ability, with a total of 33 variables. The participants were monitored during the 2019 season for inversion ankle sprains as diagnosed by physicians. Results: A total of 31 inversion ankle sprains in 31 players (21.4%) occurred during the season. Only the measured isometric hip abductor strength was significantly lower in injured players as compared with uninjured players. Logistic regression analysis revealed measured hip abductor muscle strength deficit as a significant risk factor for inversion ankle sprain (odds ratio, 0.978 [95% CI, 0.976-0.999]; P = .05). Conclusion: Hip abductor strength deficit was a risk factor for inversion ankle sprain in the study population. This finding could be useful for the prevention of inversion ankle sprains in male collegiate soccer players.

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Hip Strength as an Intrinsic Risk Factor for Lateral Ankle Sprains in Youth Soccer Players: A 3-Season Prospective Study

The American Journal of Sports Medicine ◽

10.1177/0363546516672650 ◽

2016 ◽

Vol 45 (2) ◽

pp. 410-416 ◽

Cited By ~ 27

Author(s):

Roel De Ridder ◽

Erik Witvrouw ◽

Mieke Dolphens ◽

Philip Roosen ◽

Ans Van Ginckel

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Muscle Strength ◽

Prospective Study ◽

Soccer Players ◽

Ankle Sprains ◽

Lateral Ankle Sprain ◽

Lateral Ankle ◽

Youth Soccer ◽

Hip Muscle

Background: Numerous epidemiological studies have emphasized the burden of lateral ankle sprains in youth soccer players. However, no prospective study has identified intrinsic physical and modifiable risk factors for these injuries in this particular population. Although injury prevention programs in soccer incorporate proximal hip and core stability exercises, it is striking that the relationship between impaired proximal hip function and ankle sprains has not yet been prospectively investigated in youth soccer players. Hypothesis: This prospective study aimed to examine whether hip muscle strength is a risk factor for sustaining a lateral ankle sprain in youth soccer players. We hypothesized that decreased hip muscle strength would predispose youth soccer players to an increased risk of lateral ankle sprains. Study Design: Case-control study; Level of evidence, 3. Methods: This study included a total of 133 male youth soccer players (age divisions U11-U17) for analysis. At the beginning of the season, anthropometric characteristics were collected and hip muscle strength was assessed using a handheld dynamometer. Injury registration was performed by the team medical staff during 3 consecutive seasons. A principal-component, multivariate Cox regression analysis was performed to identify potential risk factors for sustaining a lateral ankle sprain. Results: Twelve participants (18% of all reported injuries) sustained a lateral ankle sprain (0.36 per 1000 athletic-exposure hours). After adjustment for body size dependencies and other hip muscle forces, an increase in hip muscle extension force was associated with a significant decrease in the hazard of the injury (hazard ratio, 0.3; 95% confidence interval, 0.1-0.9; P = .028). No other study variable could be identified as a risk factor for lateral ankle sprains. Conclusion: Reduced hip extension muscle strength is an independent risk factor for lateral ankle sprains in male youth soccer players. Other hip muscle strength outcomes were not identified as risk factors. Replication in larger samples with more injured cases is warranted to further ascertain the importance of this risk factor.

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Nasal symptoms increase the risk of snoring and snoring increases the risk of nasal symptoms. A longitudinal population study

Sleep And Breathing ◽

10.1007/s11325-020-02287-8 ◽

2021 ◽

Author(s):

Maria Värendh ◽

Christer Janson ◽

Caroline Bengtsson ◽

Johan Hellgren ◽

Mathias Holm ◽

...

Keyword(s):

Risk Factors ◽

Respiratory Health ◽

Smoking Status ◽

Northern Europe ◽

Nasal Breathing ◽

Nasal Symptoms ◽

Increased Risk ◽

Study Population ◽

Independent Risk Factors

Abstract Purpose Humans have a preference for nasal breathing during sleep. This 10-year prospective study aimed to determine if nasal symptoms can predict snoring and also if snoring can predict development of nasal symptoms. The hypothesis proposed is that nasal symptoms affect the risk of snoring 10 years later, whereas snoring does not increase the risk of developing nasal symptoms. Methods In the cohort study, Respiratory Health in Northern Europe (RHINE), a random population from Denmark, Estonia, Iceland, Norway, and Sweden, born between 1945 and 1973, was investigated by postal questionnaires in 1999–2001 (RHINE II, baseline) and in 2010–2012 (RHINE III, follow-up). The study population consisted of the participants who had answered questions on nasal symptoms such as nasal obstruction, discharge, and sneezing, and also snoring both at baseline and at follow-up (n = 10,112). Results Nasal symptoms were frequent, reported by 48% of the entire population at baseline, with snoring reported by 24%. Nasal symptoms at baseline increased the risk of snoring at follow-up (adj. OR 1.38; 95% CI 1.22–1.58) after adjusting for age, sex, BMI change between baseline and follow-up, and smoking status. Snoring at baseline was associated with an increased risk of developing nasal symptoms at follow-up (adj. OR 1.22; 95% CI 1.02–1.47). Conclusion Nasal symptoms are independent risk factors for development of snoring 10 years later, and surprisingly, snoring is a risk factor for the development of nasal symptoms.

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Cumulative incidence and risk factors for radiation induced leukoencephalopathy in high grade glioma long term survivors

Scientific Reports ◽

10.1038/s41598-021-89216-1 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Robert Terziev ◽

Dimitri Psimaras ◽

Yannick Marie ◽

Loic Feuvret ◽

Giulia Berzero ◽

...

Keyword(s):

Risk Factors ◽

Cumulative Incidence ◽

High Grade Glioma ◽

High Grade ◽

Nucleotide Polymorphisms ◽

Increased Risk ◽

Radiation Induced ◽

Long Term Survivors

AbstractThe incidence and risk factors associated with radiation-induced leukoencephalopathy (RIL) in long-term survivors of high-grade glioma (HGG) are still poorly investigated. We performed a retrospective research in our institutional database for patients with supratentorial HGG treated with focal radiotherapy, having a progression-free overall survival > 30 months and available germline DNA. We reviewed MRI scans for signs of leukoencephalopathy on T2/FLAIR sequences, and medical records for information on cerebrovascular risk factors and neurological symptoms. We investigated a panel of candidate single nucleotide polymorphisms (SNPs) to assess genetic risk. Eighty-one HGG patients (18 grade IV and 63 grade III, 50M/31F) were included in the study. The median age at the time of radiotherapy was 48 years old (range 18–69). The median follow-up after the completion of radiotherapy was 79 months. A total of 44 patients (44/81, 54.3%) developed RIL during follow-up. Twenty-nine of the 44 patients developed consistent symptoms such as subcortical dementia (n = 28), gait disturbances (n = 12), and urinary incontinence (n = 9). The cumulative incidence of RIL was 21% at 12 months, 42% at 36 months, and 48% at 60 months. Age > 60 years, smoking, and the germline SNP rs2120825 (PPARg locus) were associated with an increased risk of RIL. Our study identified potential risk factors for the development of RIL (age, smoking, and the germline SNP rs2120825) and established the rationale for testing PPARg agonists in the prevention and management of late-delayed radiation-induced neurotoxicity.

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Predictive Factors of Recovery after an Acute Lateral Ankle Sprain: A Longitudinal Study

Sports ◽

10.3390/sports9030041 ◽

2021 ◽

Vol 9 (3) ◽

pp. 41

Author(s):

Philippe Terrier ◽

Sébastien Piotton ◽

Ilona M. Punt ◽

Jean-Luc Ziltener ◽

Lara Allet

Keyword(s):

Ankle Sprain ◽

Strength Function ◽

Selection Procedure ◽

Ankle Sprains ◽

Lateral Ankle Sprain ◽

Lateral Ankle ◽

Functional Scores ◽

Logistic Regressions ◽

Poor Outcomes ◽

Clinical Measures

A prominent feature of ankle sprains is their variable clinical course. The difficulty of providing a reliable early prognosis may be responsible for the substantial rate of poor outcomes after an ankle sprain. The aim of the present study was to evaluate the prognostic value of objective clinical measures, pain, and functional scores for ankle sprain recovery. Fifty-two participants suffering from lateral ankle sprain were included. Sprain status was assessed four weeks following injury and included evaluations of ankle range of motion, strength, function, and pain. Seven months following injury, a second assessment classified the patients into recovered and non-recovered groups using ankle ability measures. Following a predictor pre-selection procedure, logistic regressions evaluated the association between the four-week predictors and the seven-month recovery status. Twenty-seven participants (52%) fully recovered and 25 did not (48%). The results of the logistic regressions showed that walking pain was negatively associated with the probability of recovering at seven months (odds ratio: 0.71, 95% CI: 0.53–0.95). Pain four weeks after ankle sprain had relevant predictive value for long-term recovery. Special attention should be paid to patients reporting persistent pain while walking four weeks following sprain to reduce the risk of chronicity.

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Stroke in hemodialysis patients randomized to different intravenous iron strategies: a prespecified analysis from the PIVOTAL trial

Kidney360 ◽

10.34067/kid.0004272021 ◽

2021 ◽

pp. 10.34067/KID.0004272021

Author(s):

Patrick B. Mark ◽

Pardeep S. Jhund ◽

Matthew R. Walters ◽

Mark C. Petrie ◽

Albert Power ◽

...

Keyword(s):

Risk Factors ◽

Stroke Risk ◽

Controlled Trial ◽

Intravenous Iron ◽

Hemodialysis Patients ◽

High Dose ◽

Pivotal Trial ◽

Increased Risk ◽

Iv Iron

Background: People with kidney failure treated with hemodialysis (HD) are at increased risk of stroke compared to similarly aged people with normal kidney function. One concern is that treatment of renal anemia might increase stroke risk. We studied risk factors for stroke in a prespecified secondary analysis of a randomized controlled trial of intravenous iron treatment strategies in HD. Methods: We analyzed data from the Proactive IV IrOn Therapy in HaemodiALysis Patients (PIVOTAL) trial focusing on variables associated with risk of stroke. The trial randomized 2,141 adults, who had started hemodialysis <12 months earlier and who were receiving an erythropoiesis-stimulating agent (ESA), to high-dose IV iron administered proactively or low-dose IV iron administered reactively in a 1:1 ratio. Possible stroke events were independently adjudicated. We performed analyses to identify variables associated with stroke during follow-up and assessed survival following stroke. Results: During a median 2.1 years follow-up, 69 (3.2%) patients experienced a first post randomization stroke. 57 (82.6%) were ischemic strokes and 12 (17.4%) hemorrhagic strokes. There were 34 post randomization strokes in the proactive arm and 35 in the reactive arm (hazard ratio (95% confidence interval): 0.90 (0.56, 1.44), p=0.66). In multivariable models, female gender, diabetes, history of prior stroke at baseline, higher baseline systolic blood pressure, lower serum albumin and higher C-reactive protein were independently associated with stroke events during follow up. Hemoglobin, total iron or ESA dose were not associated with risk of stroke. 58% of patients with a stroke event died during follow-up, compared to 23% without a stroke. Conclusions: In hemodialysis patients, stroke risk is broadly associated with risk factors previously described to increase cardiovascular risk in this population. Proactive intravenous iron does not increase stroke risk.

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Community prevalence of SARS-CoV-2 in England: Results from the ONS Coronavirus Infection Survey Pilot

10.1101/2020.07.06.20147348 ◽

2020 ◽

Cited By ~ 4

Author(s):

Koen B Pouwels ◽

Thomas House ◽

Julie V Robotham ◽

Paul Birrell ◽

Andrew B Gelman ◽

...

Keyword(s):

Risk Factors ◽

Credible Interval ◽

Control Measures ◽

Cross Sectional ◽

Direct Patient Contact ◽

Increased Risk ◽

Potential Risk Factors ◽

Coronavirus Infection ◽

Over Time

Objective: To estimate the percentage of individuals infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) over time in the community in England and to quantify risk factors. Design: Repeated cross-sectional surveys of population-representative households with longitudinal follow-up if consent given. Setting: England. Participants: 34,992 Individuals aged 2 years and over from 16,722 private residential households. Data were collected in a pilot phase of the survey between 26 April and 28 June 2020. Main outcome measures: Percentage of individuals in the community testing positive for SARS-CoV-2 RNA using throat and nose swabs. Individuals were asked about any symptoms and potential risk factors. Results: The percentage of people in private-residential households testing positive for SARS-CoV-2 reduced from 0.32% (95% credible interval (CrI) 0.19% to 0.52%) on 26 April to 0.08% (95% CrI 0.05% to 0.12%) on 28 June, although the prevalence stabilised near the end of the pilot. Factors associated with an increased risk of testing positive included having a job with direct patient contact (relative exposure (RE) 4.06, 95% CrI 2.42 to 6.77)), working outside the home (RE 2.49, 95% CrI 1.39 to 4.45), and having had contact with a hospital (RE 2.20, 95% CrI 1.09 to 4.16 for having been to a hospital individually and RE 1.95, 95% CrI 0.81 to 4.09 for a household member having been to a hospital). In 133 visits where individuals tested positive, 82 (61%, 95% CrI 53% to 69%) reported no symptoms, stably over time. Conclusion: The percentage of SARS-CoV-2 positive individuals declined between 26 April and 28 June 2020. Positive tests commonly occurred without symptoms being reported. Working outside your home was an important risk factor, indicating that continued monitoring for SARS-CoV-2 in the community will be essential for early detection of increases in infections following return to work and other relaxations of control measures.

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Perioperative changes of response to antiplatelet medication in vascular surgery patients

PLoS ONE ◽

10.1371/journal.pone.0244330 ◽

2020 ◽

Vol 15 (12) ◽

pp. e0244330

Author(s):

Thomas Hummel ◽

Saskia Hannah Meves ◽

Andreas Breuer-Kaiser ◽

Jan-Ole Düsterwald ◽

Dominic Mühlberger ◽

...

Keyword(s):

Risk Factors ◽

Platelet Count ◽

Vascular Surgery ◽

Reactive Protein ◽

Antiplatelet Medication ◽

Impedance Aggregometry ◽

Increased Risk ◽

Potential Risk Factors ◽

Artery Disease

Introduction Reduced antiplatelet activity of aspirin (ALR) or clopidogrel (CLR) is associated with an increased risk of thromboembolic events. The reported prevalence data for low-responders vary widely and there have been few investigations in vascular surgery patients even though they are at high risk for thromb-embolic complications. The aim of this prospective observational monocentric study was to elucidate possible changes in ALR or CLR after common vascular procedures. Methods Activity of aspirin and clopidogrel was measured by impedance aggregometry using a multiple electrode aggregometer (Multiplate®). Possible risk factors for ALR or CLR were identified by demographical, clinical data and laboratory parameters. In addition, a follow-up aggregometry was performed after completion of the vascular procedure to identify changes in antiplatelet response. Results A total of 176 patients taking antiplatelet medications aspirin and/or clopidogrel with peripheral artery disease (PAD) and/or carotid stenosis (CS) were included in the study. The prevalence of ALR was 13.1% and the prevalence of CLR was 32% in the aggregometry before vascular treatment. Potential risk factors identified in the aspirin group were concomitant insulin medication (p = 0.0006) and elevated C-reactive protein (CRP) (p = 0.0021). The overall ALR increased significantly postoperatively to 27.5% (p = 0.0006); however, there was no significant change in CLR that was detected. In a subgroup analysis elevation of the platelet count was associated with a post-procedure increase of ALR incidence. Conclusion The incidence of ALR in vascular surgery patients increases after vascular procedures. An elevated platelet count was detected as a risk factor. Further studies are necessary to analyse this potential influence on patency rates of vascular reconstructions.

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