scholarly journals Injury Risk Associated with Sports Specialization in Youth

2019 ◽  
Vol 7 (7_suppl5) ◽  
pp. 2325967119S0039
Author(s):  
Mininder S. Kocher ◽  
Alison E. Field ◽  
Frances Tepolt
Keyword(s):  
Physical Activity ◽  
Injury Risk ◽  
Cruciate Ligament ◽  
The United States ◽  
Growing Up ◽  
Sports Activity ◽  
Risk Of Injury ◽  
Increased Risk ◽  
Anterior Cruciate ◽  
Using Data

Objectives: Sports specialization has become increasingly common among youth. Our goal was to examine the independent prospective associations of sports specialization and volume of activity with injury risk in youth. Methods: A prospective analysis in 2018 using data collected from 10,138 youth in the Growing Up Today Study, a prospective cohort study of youth throughout the United States, and their mothers. Activity was assessed via questionnaires in 1997, 1998, 1999 and 2001. Sports specialization was defined as engaging in one sport in the fall, winter, and spring. Injury history was provided by participants’ mothers via questionnaire in 2004. The outcome was incident stress fracture, tendinitis, chondromalacia patella or anterior cruciate ligament tear. Results: Females who engaged in sports specialization were at increased risk of injury (females: hazard ratio (HR)=1.31, 95% confidence interval (CI) 1.07 -1.61), but risk varied by sport. In both genders sports specialization was associated with greater volume of physical activity (p<0.0001). Total hours/week of vigorous activity was predictive of developing injury (males: HR=1.04, 95% CI 1.02 -1.06; females: HR=1.06, 95% CI 1.05 -1.08). Among the females even those engaging in 3-3.9 hours per week less than their age were at a significantly increased risk of injury (HR=1.93, 95% CI 1.34-2.77). In males there was not a clear pattern of risk. Conclusion: Sports specialization is associated with higher volume of vigorous sports activity and increased risk of injury. Parents, coaches, and medical providers need to be made aware of the volume threshold above which physical activity is excessive.

scholarly journals Injury Risk Associated With Sports Specialization and Activity Volume in Youth

2019 ◽  
Vol 7 (9) ◽  
pp. 232596711987012 ◽  
Author(s):  
Alison E. Field ◽  
Frances A. Tepolt ◽  
Daniel S. Yang ◽  
Mininder S. Kocher
Keyword(s):  
Physical Activity ◽  
Cohort Study ◽  
Injury Risk ◽  
Cruciate Ligament ◽  
The United States ◽  
Level Of Evidence ◽  
Sports Activity ◽  
Risk Of Injury ◽  
Increased Risk ◽  
Anterior Cruciate

Background: Sports specialization has become increasingly common among youth. Purpose/Hypothesis: To investigate the relative importance of specialization vs volume of activity in increasing risk of injury. Hypotheses were that specialization increases the risk of injury and that risk varies by sport. Study Design: Cohort study; Level of evidence, 2. Methods: A prospective analysis was conducted with data collected from 10,138 youth in the Growing Up Today Study—a prospective cohort study of youth throughout the United States—and their mothers. Activity was assessed via questionnaires in 1997, 1998, 1999, and 2001. Sports specialization was defined as engaging in a single sport in the fall, winter, and spring. Injury history was provided by participants’ mothers via questionnaire in 2004. The outcome was incident stress fracture, tendinitis, chondromalacia patella, anterior cruciate ligament tear, or osteochondritis dissecans or osteochondral defect. Results: Females who engaged in sports specialization were at increased risk of injury (hazard ratio [HR], 1.31; 95% CI, 1.07-1.61), but risk varied by sport. Sports specialization was associated with greater volume of physical activity in both sexes ( P < .0001). Total hours per week of vigorous activity was predictive of developing injury, regardless of what other variables were included in the statistical model (males: HR, 1.04; 95% CI, 1.02-1.06; females: HR, 1.06; 95% CI, 1.05-1.08). Among females, even those engaging in 3 to 3.9 hours per week less than their age were at a significantly increased risk of injury (HR, 1.93; 95% CI, 1.34-2.77). In males, there was no clear pattern of risk. Conclusion: Sports specialization is associated with a greater volume of vigorous sports activity and increased risk of injury. Parents, coaches, and medical providers need to be made aware of the volume threshold above which physical activity is excessive.

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 Electromyographic Assessment of Anterior Cruciate Ligament Injury Risk in Male Tennis Players: Which Role for Visual Input? A Proof-of-Concept Study

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 997
Author(s):  
Alessandro de Sire ◽  
Nicola Marotta ◽  
Andrea Demeco ◽  
Lucrezia Moggio ◽  
Pasquale Paola ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Injury Risk ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Visual Input ◽  
Proof Of Concept ◽  
Tennis Players ◽  
Concept Study ◽  
Acl Injury Risk ◽  
Anterior Cruciate

Anterior cruciate ligament (ACL) injury incidence is often underestimated in tennis players, who are considered as subjects conventionally less prone to knee injuries. However, evaluation of the preactivation of knee stabilizer muscles by surface electromyography (sEMG) showed to be a predictive value in the assessment of the risk of ACL injury. Therefore, this proof-of-concept study aimed at evaluating the role of visual input on the thigh muscle preactivation through sEMG to reduce ACL injury risk in tennis players. We recruited male, adult, semiprofessional tennis players from July to August 2020. They were asked to drop with the dominant lower limb from a step, to evaluate—based on dynamic valgus stress—the preactivation time of the rectus femoris (RF), vastus medialis, biceps femoris, and medial hamstrings (MH), through sEMG. To highlight the influence of visual inputs, the athletes performed the test blindfolded and not blindfolded on both clay and grass surfaces. We included 20 semiprofessional male players, with a mean age 20.3 ± 4.8 years; results showed significant early muscle activation when the subject lacked visual input, but also when faced with a less-safe surface such as clay over grass. Considering the posteromedial–anterolateral relationship (MH/RF ratio), tennis players showed a significant higher MH/RF ratio if blindfolded (22.0 vs. 17.0% not blindfolded; p < 0.01) and percentage of falling on clay (17.0% vs. 14.0% in grass; p < 0.01). This proof-of-principle study suggests that in case of absence of visual input or falling on a surface considered unsafe (clay), neuro-activation would tend to protect the anterior stress of the knee. Thus, the sEMG might play a crucial role in planning adequate athletic preparation for semiprofessional male athletes in terms of reduction of ACL injury risk.

scholarly journals The Relationship between Dynamic Balance and Jumping Tests among Adolescent Amateur Rugby Players. A Preliminary Study

2021 ◽  
Vol 18 (1) ◽  
pp. 312
Author(s):  
Bartosz Wilczyński ◽  
Jakub Hinca ◽  
Daniel Ślęzak ◽  
Katarzyna Zorena
Keyword(s):  
Injury Risk ◽  
Dynamic Balance ◽  
Study Data ◽  
Balance Test ◽  
Risk Of Injury ◽  
Counter Movement Jump ◽  
Increased Risk ◽  
Positive Correlations ◽  
The Relationship ◽  
Rugby Players

Rugby is a demanding contact sport. In light of research, poor balance, reduced jumping ability, muscle strength, and incorrect landing patterns might contribute to the increased risk of injury in athletes. Investigating the relationship between tests assessing these abilities might not only allow for the skillful programming of preventive training but also helps in assessing the risk of injury to athletes. Thus, the main purpose of this study was to investigate the relationship between dynamic balance, vertical and horizontal jumps, and jump-landings movement patterns. Thirty-one healthy amateur adolescent rugby players (age: 14.3 ± 1.6 years, height 171.4 ± 9.7 cm, body mass 80 ± 26 kg) participated in the study. Data were collected by the Y-balance Test (YBT), Counter Movement Jump (CMJ), Single Leg Hop for Distance (SLHD), and Landing Error Score System (LESS). Significant positive correlations were found between SLHD both legs (SLHDb) and YBT Composite both legs (COMb) (r = 0.51, p = 0.0037) and between SLHDb and CMJ (r = 0.72, p < 0.0001). A relationship was also observed between the CMJ and YBT COMb test (r = 0.51, p = 0.006). Moderate positive correlations were found between the dominant legs in SLHD and the posterolateral (r = 0.40, p = 0.027), posteromedial (r = 0.43, p = 0.014), and composite (r = 0.48, p = 0.006) directions of the YBT. These results indicate that variables that are dependent on each other can support in the assessment of injury-risk and in enhancing sports performance of young athletes.

Assessing Physical Activity After ACL Injury: Moving Beyond Return to Sport

2021 ◽  
pp. 194173812110253
Author(s):  
Christopher Kuenze ◽  
Katherine Collins ◽  
Karin Allor Pfeiffer ◽  
Caroline Lisee
Keyword(s):  
Physical Activity ◽  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Young Patients ◽  
Return To Sport ◽  
Acl Injury ◽  
Noncommunicable Diseases ◽  
Successful Recovery ◽  
Patient Reported ◽  
Anterior Cruciate

Context: Return to sport is widely utilized by sports medicine researchers and clinicians as a primary outcome of interest for successful recovery when working with young patients who have undergone anterior cruciate ligament (ACL) reconstruction (ACLR). While return-to-sport outcomes are effective at tracking progress post-ACLR, they are limited because they do not necessarily capture physical activity (PA) engagement, which is important to maintain knee joint health and reduce the risk of noncommunicable diseases. Therefore, there is a critical need (1) to describe current PA participation and measurement recommendations; (2) to appraise common PA measurement approaches, including patient-reported outcomes and device-based methodologies; and (3) to provide clinical recommendations for future evaluation. Evidence Acquisition: Reports of patient-reported or device-based PA in patients with ACL injury were acquired and summarized based on a PubMed search (2000 through July 2020). Search terms included physical activity OR activity AND anterior cruciate ligament OR ACL. Study Design: Clinical review. Level of Evidence: Level 5. Results: We highlight that (1) individuals with ACLR are 2.36 times less likely to meet the US Department of Health and Human Services PA recommendations even when reporting successful return to sport, (2) common patient-reported PA assessments have significant limitations in the data that can be derived, and (3) alternative patient-reported and device-based assessments may provide improved assessment of PA in this patient population. Conclusion: Clinicians and researchers have relied on return to sport status or self-reported PA participation via surveys. These approaches are not consistent with current recommendations for PA assessment and do not allow for comparison with contemporary PA recommendations or guidelines. Return to sport, patient-reported outcome measures, and device-based assessment approaches should be used in complementary manners to comprehensively assess PA participation after ACLR. However, appropriate techniques should be used when assessing PA in adult and adolescent populations.

scholarly journals Protection Against Spikes in Workload With Aerobic Fitness and Playing Experience: The Role of the Acute:Chronic Workload Ratio on Injury Risk in Elite Gaelic Football

2017 ◽  
Vol 12 (3) ◽  
pp. 393-401 ◽  
Author(s):  
Shane Malone ◽  
Mark Roe ◽  
Dominic A. Doran ◽  
Tim J. Gabbett ◽  
Kieran D. Collins
Keyword(s):  
Aerobic Fitness ◽  
Injury Risk ◽  
Perceived Exertion ◽  
Reference Group ◽  
Time Trial ◽  
Rating Of Perceived Exertion ◽  
Football Players ◽  
Risk Of Injury ◽  
Increased Risk ◽  
Injury Protection

Purpose:To examine the association between combined session rating of perceived exertion (RPE) workload measures and injury risk in elite Gaelic footballers.Methods:Thirty-seven elite Gaelic footballers (mean ± SD age 24.2 ± 2.9 y) from 1 elite squad were involved in a single-season study. Weekly workload (session RPE multiplied by duration) and all time-loss injuries (including subsequent-wk injuries) were recorded during the period. Rolling weekly sums and wk-to-wk changes in workload were measured, enabling the calculation of the acute:chronic workload ratio by dividing acute workload (ie, 1-weekly workload) by chronic workload (ie, rolling-average 4-weekly workload). Workload measures were then modeled against data for all injuries sustained using a logistic-regression model. Odds ratios (ORs) were reported against a reference group.Results:High 1-weekly workloads (≥2770 arbitrary units [AU], OR = 1.63–6.75) were associated with significantly higher risk of injury than in a low-training-load reference group (<1250 AU). When exposed to spikes in workload (acute:chronic workload ratio >1.5), players with 1 y experience had a higher risk of injury (OR = 2.22) and players with 2–3 (OR = 0.20) and 4–6 y (OR = 0.24) of experience had a lower risk of injury. Players with poorer aerobic fitness (estimated from a 1-km time trial) had a higher injury risk than those with higher aerobic fitness (OR = 1.50–2.50). An acute:chronic workload ratio of (≥2.0) demonstrated the greatest risk of injury.Conclusions:These findings highlight an increased risk of injury for elite Gaelic football players with high (>2.0) acute:chronic workload ratios and high weekly workloads. A high aerobic capacity and playing experience appears to offer injury protection against rapid changes in workload and high acute:chronic workload ratios. Moderate workloads, coupled with moderate to high changes in the acute:chronic workload ratio, appear to be protective for Gaelic football players.

Twenty-Year Outcomes After Anterior Cruciate Ligament Reconstruction: A Systematic Review of Prospectively Collected Data

2021 ◽  
pp. 036354652110273
Author(s):  
Joshua S. Everhart ◽  
Sercan Yalcin ◽  
Kurt P. Spindler
Keyword(s):  
Systematic Review ◽  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Knee Function ◽  
Increased Risk ◽  
Patient Reported ◽  
The Mean ◽  
Anterior Cruciate

Background: Several long-term (≥20 years) follow-up studies after anterior cruciate ligament (ACL) reconstruction have been published in recent years, allowing for a systematic evaluation of outcomes. Purpose: To summarize outcomes at ≥20 years after ACL reconstruction and identify patient and surgical factors that affect these results. Study Design: Systematic review; Level of evidence, 4. Methods: Prospective studies of primary ACL reconstructions with hamstring or bone–patellar tendon—bone (BTB) autograft via an arthroscopic or a mini-open technique and with a mean follow-up of ≥20 years were identified. When possible, the mean scores for each outcome measure were calculated. Factors identified in individual studies as predictive of outcomes were described. Results: Five studies met the inclusion and exclusion criteria with a total of 2012 patients. The pooled mean follow-up for patient-reported outcome measures was 44.2% (range, 29.6%-92.7%) and in-person evaluation was 33.2% (range, 29.6%-48.9%). Four studies (n = 584) reported graft tears at a mean rate of 11.8% (range, 2%-18.5%) and 4 studies (n = 773) reported a contralateral ACL injury rate of 12.2% (range, 5.8%-30%). Repeat non-ACL arthroscopic surgery (4 studies; n = 177) to the ipsilateral knee occurred in 10.4% (range, 9.5%-18.3%) and knee arthroplasty (1 study; n = 217) in 5%. The pooled mean of the International Knee Documentation Committee subjective knee function (IKDC) score was 79.1 (SD, 21.8 [3 studies; n = 644]). In 2 studies (n?= 221), 57.5% of patients continued to participate in strenuous activities. The IKDC-objective score was normal or nearly normal in 82.3% (n = 496; 3 studies), with low rates of clinically significant residual laxity. Moderate-severe radiographic osteoarthritis (OA) (IKDC grade C or D) was present in 25.9% of patients (n = 605; 3 studies). Medial meniscectomy is associated with increased risk of radiographic OA. Radiographic OA severity is associated with worse patient-reported knee function, but the association with knee pain is unclear. Conclusion: Currently available prospective evidence for ACL reconstruction with hamstring or BTB autograft provides several insights into outcomes at 20 years. The rates of follow-up at 20 years range from 30% to 93%. IKDC-objective scores were normal or nearly normal in 82% and the mean IKDC-subjective score was 79 points.

Diagnostic of Injury Risk in the Anterior Cruciate Ligament Based On Shape Context Description of the Intercondylar Notch Curvature

2021 ◽  
Author(s):  
Joao Paulo Dias ◽  
Ariful Bhuiyan ◽  
Nabila Shamim
Keyword(s):  
Anterior Cruciate Ligament ◽  
Injury Risk ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
False Positives ◽  
Intercondylar Notch ◽  
Mr Images ◽  
Shape Context ◽  
Similarity Factor ◽  
Anterior Cruciate

Abstract An estimated number of 300,000 new anterior cruciate ligament (ACL) injuries occur each year in the United States. Although several magnetic resonance (MR) imaging-based ACL diagnostics methods have already been proposed in the literature, most of them are based on machine learning or deep learning strategies, which are computationally expensive. In this paper, we propose a diagnostics framework for the risk of injury in the anterior cruciate ligament (ACL) based on the application of the inner-distance shape context (IDSC) to describe the curvature of the intercondylar notch from MR images. First, the contours of the intercondylar notch curvature from 91 MR images of the distal end of the femur (70 healthy and 21 with confirmed ACL injury) were extracted manually using standard image processing tools. Next, the IDSC was applied to calculate the similarity factor between the extracted contours and reference standard curvatures. Finally, probability density functions of the similarity factor data were obtained through parametric statistical inference, and the accuracy of the ACL injury risk diagnostics framework was assessed using receiver operating characteristic analysis (ROC). The overall results for the area under the curve (AUC) showed that method reached a maximum accuracy of about 66%. Furthermore, the sensitivity and specificity results showed that an optimum discrimination threshold value for the similarity factor can be pursued that minimizes the incidence of false positives and false positives simultaneously.

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