scholarly journals The Calculation, Thresholds and Reporting of Inter-Limb Strength Asymmetry: A Systematic Review

2021 ◽  
pp. 594-617
Author(s):  
Amy O. Parkinson ◽  
Charlotte L. Apps ◽  
John G. Morris ◽  
Cleveland T. Barnett ◽  
Martin G. C. Lewis
Keyword(s):  
Systematic Review ◽  
Injury Risk ◽  
Asymmetry Index ◽  
Normative Values ◽  
Original Research ◽  
Approximate Symmetry ◽  
Scientific Databases ◽  
Strength Asymmetry ◽  
Limb Asymmetry ◽  
And Performance

The prevalence of inter-limb strength differences is well documented in the literature however, there are inconsistencies related to measurement and reporting, and the normative values and effects associated with inter-limb asymmetry. Therefore, the aims of this systematic review were to: 1) assess the appropriateness of existing indices for the calculation of asymmetry, 2) interrogate the evidence basis for literature reported thresholds used to define asymmetry and 3) summarise normative levels of inter-limb strength asymmetry and their effects on injury and performance. To conduct this systematic review, scientific databases (PubMed, Scopus, SPORTDiscus and Web of Science) were searched and a total of 3,594 articles were retrieved and assessed for eligibility and article quality. The robustness of each identified asymmetry index was assessed, and the evidence-basis of the identified asymmetry thresholds was appraised retrospectively using the references provided. Fifty-three articles were included in this review. Only four of the twelve identified indices were unaffected by the limitations associated with selecting a reference limb. Eighteen articles applied a threshold to original research to identify “abnormal” asymmetry, fifteen of which utilised a threshold between 10-15%, yet this threshold was not always supported by appropriate evidence. Asymmetry scores ranged between and within populations from approximate symmetry to asymmetries larger than 15%. When reporting the effects of strength asymmetries, increased injury risk and detriments to performance were often associated with larger asymmetry, however the evidence was inconsistent. Limitations of asymmetry indices should be recognised, particularly those that require selection of a reference limb. Failure to reference the origin of the evidence for an asymmetry threshold reinforces doubt over the use of arbitrary thresholds, such as 10-15%. Therefore, an individual approach to defining asymmetry may be necessary to refine robust calculation methods and to establish appropriate thresholds across various samples and methodologies that enable appropriate conclusions to be drawn.

Integrating women into combat roles: comparing the UK Armed Forces and Israeli Defense Forces to understand where lessons can be learnt

2020 ◽  
pp. bmjmilitary-2020-001500
Author(s):  
Anne Fieldhouse ◽  
T J O'Leary
Keyword(s):  
Health Risks ◽  
Injury Risk ◽  
Armed Forces ◽  
Original Research ◽  
Employed Women ◽  
Research Findings ◽  
Physiological Studies ◽  
And Performance ◽  
The Uk

In October 2018, women became eligible to serve in all roles in the UK Armed Forces. The Israeli Defense Forces (IDF) have employed women in limited ground close combat (GCC) roles since 1995. Integration of women into some IDF combat units has improved our understanding of injury risk for servicewomen. While the research findings from physiological studies on women in IDF GCC roles helped inform the integration of women into UK GCC roles, the applicability of the data is limited by the differences between Israeli and UK approaches to recruitment, training and operational deployability of servicewomen. Women in IDF combat roles do, therefore, not provide a good model on the health and performance implications for women in UK Armed Forces combat roles. Further original research to better understand and develop mitigations against any health risks facing UK servicewomen in GCC roles is warranted.

scholarly journals The Influence of Exercise-Induced Fatigue on Inter-Limb Asymmetries: a Systematic Review

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Jessica Heil ◽  
Florian Loffing ◽  
Dirk Büsch
Keyword(s):  
Systematic Review ◽  
Injury Risk ◽  
Cruciate Ligament ◽  
Physical Load ◽  
Future Research ◽  
Before And After ◽  
Isokinetic Strength Testing ◽  
Anterior Cruciate ◽  
Limb Asymmetry ◽  
Exercise Induced

Abstract Background Non-contact injuries such as anterior cruciate ligament ruptures often occur during physical load toward the end of a match. This is ascribed to emerging processes due to exercise-induced fatigue. Moreover, non-contact injuries often occur during dynamic actions such as landing or cutting movements. Inter-limb asymmetries are suggested as one possible cause for those injuries based on findings indicating that asymmetries between limbs are associated with a higher injury risk. Hence, assessing inter-limb asymmetry during physical load in the condition of exercise-induced fatigue is warranted to identify potentially relevant precursors for non-contact injuries. Objective The objective of this study was to overview the current state of evidence concerning the influence of exercise-induced fatigue on inter-limb asymmetries through a systematic review. Methods A systematic literature search was conducted using the databases Web of Science, Scopus, PubMed, SURF, and SPONET to identify studies that assessed inter-limb asymmetries of healthy people, calculated with an asymmetry equation, before and after, or during a loading protocol. Results Thirteen studies were included in the systematic review. The loading protocols involved running, race walking, jumping, squatting, soccer, rowing, and combinations of different exercises. Moreover, different tasks/procedures were used to assess inter-limb asymmetries, e.g., squats, single-leg countermovement jumps, gait analysis, or isokinetic strength testing. The results seem to depend on the implemented loading protocol, the tasks/procedures, and the measured parameters. Conclusions Future research needs more systematization and consistency, assessing the effect of exercise-induced fatigue on inter-limb asymmetries. Moreover, the emergence of inter-limb asymmetries should be regarded in the context of sport-specific movements/tasks. Testing before, after, and during a physical loading protocol is advisable to consider the influence of exercise-induced fatigue on sport-specific tasks and to identify the possible mechanisms underlying load-dependent inter-limb asymmetries with regard to risk of non-contact injury.

scholarly journals Current Approaches to the Use of Artificial Intelligence for Injury Risk Assessment and Performance Prediction in Team Sports: a Systematic Review

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
João Gustavo Claudino ◽  
Daniel de Oliveira Capanema ◽  
Thiago Vieira de Souza ◽  
Julio Cerca Serrão ◽  
Adriano C. Machado Pereira ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Systematic Review ◽  
Risk Assessment ◽  
Performance Prediction ◽  
Injury Risk ◽  
Team Sports ◽  
And Performance

scholarly journals Evaluating the Implementation of Injury Prevention Strategies in Rugby Union and League: A Systematic Review using the RE-AIM Framework

2020 ◽  
Author(s):  
Craig Barden ◽  
Sheree Bekker ◽  
James Craig Brown ◽  
Keith A Stokes ◽  
Carly D. McKay
Keyword(s):  
Systematic Review ◽  
Injury Prevention ◽  
Injury Risk ◽  
English Language ◽  
Journal Article ◽  
Rugby Union ◽  
Research Field ◽  
Original Research ◽  
Inclusion Criteria ◽  
Prevention Strategies

AbstractRugby (union and league) has come under intense scrutiny due to its injury risk. Various interventions have been introduced to protect players from injury, with many deemed efficacious and advocated for use across various worldwide contexts. However, their implementation is less clear. The objective of this systematic review was to determine whether injury prevention interventions in rugby have evaluated their ‘reach’, ‘effectiveness’, ‘adoption’, ‘implementation’ and ‘maintenance’ as per the RE-AIM Multi-Dimension Item Checklist. Six electronic databases were searched in November 2019. Inclusion criteria included: English language, peer-reviewed journal article, original research, field-based rugby code, prospective intervention. Of the 4253 studies identified, 74 met the full inclusion criteria. Protective equipment, predominately mouthguards, was the intervention of interest in 44 studies. Other interventions included multimodal national injury prevention programmes, law changes and neuromuscular training programmes. ‘Effectiveness’ was the highest scoring RE-AIM dimension (55%), followed by ‘reach’ (26%). All other RE-AIM dimensions scored below 20%. Research currently focuses on determining intervention ‘effectiveness’. For injury prevention strategies to have their desired impact, there must be a shift to address all determinants associated with implementation. Consideration should be given to how this can be achieved by adopting specific reporting checklists, research frameworks and study designs.

Does lower-limb asymmetry increase injury risk in sport? A systematic review

2021 ◽  
Vol 49 ◽  
pp. 204-213
Author(s):  
Mark Helme ◽  
Jason Tee ◽  
Stacey Emmonds ◽  
Chris Low
Keyword(s):  
Systematic Review ◽  
Lower Limb ◽  
Injury Risk ◽  
Limb Asymmetry

scholarly journals Perceptual–Cognitive Function and Unplanned Athletic Movement Task Performance: A Systematic Review

2020 ◽  
Vol 17 (20) ◽  
pp. 7481
Author(s):  
Jan Wilke ◽  
David Groneberg ◽  
Winfried Banzer ◽  
Florian Giesche
Keyword(s):  
Systematic Review ◽  
Cognitive Function ◽  
Task Performance ◽  
Lower Limb ◽  
Injury Risk ◽  
Future Research ◽  
Functional Safety ◽  
Study Quality ◽  
And Performance ◽  
Cutting Direction

The performance of choice-reaction tasks during athletic movement has been demonstrated to evoke unfavorable biomechanics in the lower limb. However, the mechanism of this observation is unknown. We conducted a systematic review examining the association between (1) the biomechanical and functional safety of unplanned sports-related movements (e.g., jumps/runs with a spontaneously indicated landing leg/cutting direction) and (2) markers of perceptual–cognitive function (PCF). A literature search in three databases (PubMed, ScienceDirect and Google Scholar) identified five relevant articles. The study quality, rated by means of a modified Downs and Black checklist, was moderate to high (average: 13/16 points). Four of five papers, in at least one parameter, found either an association of PCF with task safety or significantly reduced task safety in low vs. high PCF performers. However, as (a) the outcomes, populations and statistical methods of the included trials were highly heterogeneous and (b) only two out of five studies had an adequate control condition (pre-planned movement task), the evidence was classified as conflicting. In summary, PCF may represent a factor affecting injury risk and performance during unplanned sports-related movements, but future research strengthening the evidence for this association is warranted.

Socioeconomic and Demographic Statuses as Determinants of Adherence to Antiretroviral Treatment in HIV Infected Patients: A Systematic Review of the Literature

2019 ◽  
Vol 17 (3) ◽  
pp. 161-172 ◽  
Author(s):  
Nuredin Nassir Azmach ◽  
Temam Abrar Hamza ◽  
Awel Abdella Husen
Keyword(s):  
Systematic Review ◽  
Occupational Status ◽  
Original Research ◽  
Positive Trend ◽  
Hiv Patients ◽  
Aids Patients ◽  
Pubmed Database ◽  
Education And Employment ◽  
Socio Economic Factors ◽  
Hiv Aids

Background: Socioeconomic and demographic statuses are associated with adherence to the treatment of patients with several chronic diseases. However, there is a controversy regarding their impact on adherence among HIV/AIDS patients. Thus, we performed a systematic review of the evidence regarding the association of socioeconomic and demographic statuses with adherence to antiretroviral therapy (ART) among HIV/AIDS patients. Methods: The PubMed database was used to search and identify studies concerning about socioeconomic and demographic statuses and HIV/AIDS patients. Data were collected on the association between adherence to ART and varies determinants factors of socioeconomic (income, education, and employment/occupation) and socio-demographic (sex and age). Findings: From 393 potentially-relevant articles initially identified, 35 original studies were reviewed in detail, which contained data that were helpful in evaluating the association between socioeconomic/ demographic statuses and adherence to ART among HIV patients. Two original research study has specifically focused on the possible association between socioeconomic status and adherence to ART. Income, level of education, and employment/occupational status were significantly and positively associated with the level of adherence in 7 studies (36.8%), 7 studies (28.0%), and 4 studies (23.5%) respectively out of 19, 25, and 17 studies reviewed. Sex (being male), and age (per year increasing) were significantly and positively associated with the level of adherence in 5 studies (14.3%), and 9 studies (25.7%) respectively out of 35 studies reviewed. However, the determinant of socioeconomic and demographic statuses was not found to be significantly associated with adherence in studies related to income 9(47.4%), education 17(68.0%), employment/ occupational 10(58.8%), sex 27(77.1%), and age 25(71.4%). Conclusion: The majority of the reviewed studies reported that there is no association between socio- demographic and economic variables and adherence to therapy. Whereas, some studies show that age of HIV patients (per year increasing) and sex (being male) were positively associated with adherence to ART. Among socio-economic factors, the available evidence does not provide conclusive support for the existence of a clear association with adherence to ART among HIV patients. There seems to be a positive trend between socioeconomic factors and adherence to ART in some of the reviewed studies.

scholarly journals Biomarkers predictive of treatment response in psoriasis and psoriatic arthritis: a systematic review

2021 ◽  
Vol 13 ◽  
pp. 1759720X2110140
Author(s):  
Conor Magee ◽  
Hannah Jethwa ◽  
Oliver M. FitzGerald ◽  
Deepak R. Jadon
Keyword(s):  
Systematic Review ◽  
Psoriatic Arthritis ◽  
Treatment Response ◽  
Unmet Need ◽  
Response To Treatment ◽  
Cochrane Library ◽  
Original Research ◽  
Eligibility Criteria ◽  
Psoriatic Disease ◽  
Subsequent Response

Aims: The ability to predict response to treatment remains a key unmet need in psoriatic disease. We conducted a systematic review of studies relating to biomarkers associated with response to treatment in either psoriasis vulgaris (PsV) or psoriatic arthritis (PsA). Methods: A search was conducted in PubMed, Embase and the Cochrane library from their inception to 2 September 2020, and conference proceedings from four major rheumatology conferences. Original research articles studying pre-treatment biomarker levels associated with subsequent response to pharmacologic treatment in either PsV or PsA were included. Results: A total of 765 articles were retrieved and after review, 44 articles (22 relating to PsV and 22 to PsA) met the systematic review’s eligibility criteria. One study examined the response to methotrexate, one the response to tofacitinib and all the other studies to biologic disease-modifying antirheumatic drugs (DMARDs). Whilst several studies examined the HLA-C*06 allele in PsV, the results were conflicting. Interleukin (IL)-12 serum levels and polymorphisms in the IL-12B gene show promise as biomarkers of treatment response in PsV. Most, but not all, studies found that higher baseline levels of C-reactive protein (CRP) were associated with a better clinical response to treatment in patients with PsA. Conclusion: Several studies have identified biomarkers associated with subsequent response to treatment in psoriatic disease. However, due to the different types of biomarkers, treatments and outcome measures used, firm conclusions cannot be drawn. Further validation is needed before any of these biomarkers translate to clinical practice.

scholarly journals Blending Indigenous Sharing Circle and Western Focus Group Methodologies for the Study of Indigenous Children’s Health: A Systematic Review

2021 ◽  
Vol 20 ◽  
pp. 160940692110151
Author(s):  
Sarah C. Hunt ◽  
Nancy L. Young
Keyword(s):  
Systematic Review ◽  
Focus Group ◽  
Focus Groups ◽  
Qualitative Content Analysis ◽  
Children's Health ◽  
Children’S Health ◽  
Community Advisory Board ◽  
Original Research ◽  
Research Approach ◽  
Sharing Circles

The primary objective of this systematic review was to investigate how Western focus groups and Indigenous sharing circles have been blended for the study of Indigenous children’s health. The secondary objective of this study was to propose recommendations for adapting focus groups to include elements of sharing circles. This systematic review was conducted using a systematic search of original research articles published between 2009 and 2020 that (a) focused on North American Indigenous children’s health and (b) used group-based qualitative methods including focus groups and sharing circles. Each of the articles was screened for relevance and quality. The methods sections were reviewed, subjected to qualitative content analysis, and codes were analyzed to identify common themes and synthesize results. We identified 29 articles, most of which followed a community-based participatory research approach. In these publications, most included a community advisory board, ethics approval was obtained, and in some cases, community members were included as research assistants. There was evidence that sharing circles and focus group methods had been blended in the recent Indigenous children’s health literature. This was particularly apparent in the authors’ approaches to recruitment, location, facilitation techniques, question format and reimbursement. Several groups have published results that describe approaches that successfully incorporated aspects of Indigenous sharing circles into Western focus groups, thus establishing a research method that is culturally safe and appropriate for the study of Indigenous children’s health.

988 The Prevalence and Incidence of Gender Bias and Sexual Discrimination in Orthopaedics, and Mitigating Strategies: A Systematic Review

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
A Elbayouk ◽  
U Halim ◽  
A Ali ◽  
S Javed ◽  
C Cullen
Keyword(s):  
Systematic Review ◽  
Gender Bias ◽  
Role Models ◽  
Educational Interventions ◽  
Original Research ◽  
Sexual Discrimination ◽  
Orthopaedic Training ◽  
Orthopaedic Community ◽  
Training Programmes ◽  
The Impact

Abstract Background The aim of this systematic review was to outline the prevalence and impact of Gender bias and sexual discrimination (GBSD) in orthopaedics, and to investigate interventions countering such behaviours. Method Original research papers pertaining to the prevalence and impact of gender bias or sexual discrimination, or mitigating strategies in orthopaedics, were suitable for inclusion. PRISMA guidelines were adhered to in this review. Results Of 570 papers, 27 were eligible for inclusion. A total of 13 papers discussed the prevalence of GBSD, whilst 13 related to the impact of these behaviours, and 6 discussed mitigating strategies. GBSD were found to be prevalent in the orthopaedic workplace, with all sources showing females to be the victims. The impact of GBSD includes poor workforce representation, lower salaries, barriers to career progression, and reduced academic output for females in orthopaedics. Mitigating strategies in the literature are focussed on encouraging females to apply for orthopaedic training programmes, by providing female role models, mentors, and educational interventions. Conclusions GBSD are highly prevalent in orthopaedic surgery, impacting females at all stages of their careers. Mitigating strategies have been tested but are limited in their scope. As such, the orthopaedic community as a whole is obliged to do more to tackle GBSD.

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