Prescribed footwear and orthoses are not prophylactic in preventing lower extremity injuries in military tactical athletes: a systematic review with meta-analysis

IntroductionMilitary members are exposed to high cumulative physical loads that frequently lead to injury. Prescribed footwear and orthoses have been used to prevent injury. The purpose of this systematic review with meta-analysis was to assess if prescribed prophylactic footwear or foot orthoses reduced the risk of lower extremity injury in military tactical athletes.MethodsMEDLINE, Embase, Web of Science, Cumulative Index to Nursing and Allied Health Literature, SportDiscus, and Defense Technical Information Center databases were searched for randomised controlled trials published at any time that compared foot orthoses or prescribed footwear (to include shock-absorbing insoles and socks) with a placebo intervention or a no-treatment control. Methodological quality was assessed and the number of injuries, population at risk and duration of the study epoch were extracted and relative risk (RR) calculated. An omnibus meta-analysis was performed assessing all prescribed footwear and orthoses intervention studies, with subgroup analyses conducted on studies with similar interventions (ie, basketball athletic shoes, athletic shoes (prescribed by foot type), foot orthoses, shock-absorbing insoles, socks, tropical combat boots).ResultsOf 1673 studies identified, 22 were included. Three of eight studies that employed orthoses demonstrated significantly reduced overuse injuries compared with no-treatment controls (RR range: 0.34–0.68); one study showed neoprene insoles significantly decreased overuse injuries (RR: 0.75). There were no other significant effects in the individual studies and no protective effects observed in the omnibus meta-analysis or in the component subanalyses.ConclusionsPrescribed footwear and orthoses do not appear to have a prophylactic effect on lower quarter musculoskeletal injuries in military members and cannot be recommended at this time.

Evaluation and management of wilderness injuries and acute illness in Iceland during the years 2017-2018

INTRODUCTION: In Iceland, wilderness search and rescue services are provided by volunteer members of the Icelandic association for search and rescue (ICE-SAR). The rescue teams respond to about 1200 calls every year, with a significant proportion of them involving injured and sick individuals. No previous studies have been done on the service provided by ICE-SAR teams. The aim of this study was to obtain information about the health services provided by ICE-SAR in Iceland. MATERIAL AND METHODS: Data was obtained from the ICE-SAR‘s and the National emergency call service‘s (112) databases. Cases that occurred during the years 2017 and 2018 that required transfer and treatment at a health clinic or hospital were included in the study. All cases with no involvement of sick or injured and minor injuries managed on scene without tranport were excluded. Treatment on scene and during transport and preliminary diagnosis made by ICE-SAR teams was reviewed. The medical report at each treating medical facility in Iceland was reviewed for treatment provided and final diagnosis. RESULTS: A total of 189 operations with 239 individuals were included in the study. A majority of the operations were recorded in the South region of Iceland. The average age of individuals was 44,4 years, just over half of cases involving men. Accidents accounted for 86% of all cases where the most common incident was a fall resulting in lower extremity injury. Cardiac disease was the most common cause for acute medical illness. On-scene treatment and use of equipment was not recorded in over 70% of cases. CONCLUSION: The ICE-SAR teams provide health care on regular basis, most commonly after accidents involving the lower extremities. Illness treated by the ICE-SAR volunteers most commonly involves cardiac symptoms. Documentation of on-site treatment and equipment use is incomplete.

Increased Lower Extremity Injury Risk Associated With Player Load and Distance in Collegiate Women’s Soccer

Background: There is limited research regarding the impact of workload on injury risk specific to women’s soccer. Wearable global positioning system (GPS) units can track workload metrics such as total distance traveled and player load during games and training sessions. These metrics can be useful in predicting injury risk. Purpose: To examine the relationship between injury risk and player workload as collected from wearable GPS units in National Collegiate Athletic Association (NCAA) Division I women’s soccer players. Study Design: Case-control study; Level of evidence, 3. Methods: Lower extremity injury incidence and GPS workload data (player load, total distance, and high-speed distance) for 65 NCAA Division I women’s soccer players were collected over 3 seasons. Accumulated 1-, 2-, 3-, and 4-week loads and acute-to-chronic workload ratios (ACWR) were classified into discrete ranges by z-scores. ACWR was calculated using rolling averages and exponentially weighted moving averages (EWMA) models. Binary logistic regression models were used to compare the 7:28 rolling average and EWMA ACWRs between injured and noninjured players for all GPS/accelerometer variables. The prior 1-, 2-, 3-, and 4-week accumulated loads for all GPS/accelerometer variables were compared between the injured and uninjured cohorts using 2-sample t tests. Results: There were a total of 53 lower extremity injuries that resulted in lost time recorded (5.76/1000 hours “on-legs” exposure time; 34 noncontact and 19 contact injuries). The prior 2-week (7242 vs 6613 m/s2; P = .02), 3-week (10,533 vs 9718 m/s2; P = .02), and 4-week (13,819 vs 12,892 m/s2; P = .04) accumulated player loads and 2-week (62.40 vs 57.25 km; P = .04), 3-week (90.97 vs 84.10 km; P = .03), and 4-week (119.31 vs 111.38 km; P = .05) accumulated total distances were significantly higher for injured players compared with noninjured players during the same time frames. There were no significant differences in player load, total distance, or high-speed distance ACWR between injured and noninjured players for both the rolling averages and EWMA calculations. Conclusion: Higher accumulated player load and total distance, but not ACWR, were associated with injury in women’s soccer players.

Simulation Analysis of Foot Force in Athletes’ Training Process Based on Sports Biomechanics

Objectives: With the rapid development of sports biomechanics, a new frontier discipline, the modeling and Simulation of human motion, as one of the cutting-edge research topics of sports biomechanics, is receiving more and more attention.. Methods: Based on this, this paper provides theoretical support for the analysis and research of foot stress in the process of training and applies it to guiding practice by using the analysis technology based on sports biomechanics and the method of foot pressure and simulation modeling and analysis system. Results: The results of the study showed that the injury of the athletes in the lower limbs accounted for about 46.7%, followed by the injury of the upper limbs and the injury of the trunk. In the lower extremity injury, the most common part of the foot joint is about 28.1%. Conclusion: Studies have shown that the changes in the force of the athlete’s foot after fatigue have not had the good stability before, the duration of each stage of the completion of the movement is changing, and the control of the ankle joint is decreasing, which greatly increases the foot joint. The possibility of injury.

The Effectiveness of Neuromuscular Warmups for Lower Extremity Injury Prevention in Basketball: A Systematic Review

Background Neuromuscular warmups have gained increasing attention as a means of preventing sports-related injuries, but data on effectiveness in basketball are sparse. The objective of this systematic review was to evaluate evidence of the effectiveness of neuromuscular warmup-based strategies for preventing lower extremity injuries among basketball athletes. Methods PubMed and Cochrane Library databases were searched in February 2019. Studies were included if they were English-language randomized controlled, non-randomized comparative, or prospective cohort trials, tested neuromuscular and/or balance-focused warmup interventions among basketball players, and assessed at least one type of lower extremity injury as a primary outcome. Criteria developed by the USPSTF were used to appraise study quality, and GRADE was used to appraise the body of evidence for each outcome. Due to heterogeneity in the included studies, meta-analyses could not be performed. Results In total, 825 titles and abstracts were identified. Of the 13 studies which met inclusion criteria for this review, five were balance interventions (3 randomized controlled trials) and eight were multicomponent interventions involving multiple categories of dynamic neuromuscular warmup (5 randomized controlled trials). Authors of four of the studies were contacted to obtain outcome data specific to basketball athletes. Basketball specific results from the studies suggest significant protective effects for the following lower extremity injuries: ankle injuries (significant in 4 out of the 9 studies that assessed this outcome); ACL injuries (2 of 4 studies); knee injuries generally (1 of 5 studies); and overall lower extremity injuries (5 of 7 studies). All but one of the non-significant results were directionally favorable. Evidence was moderate for the effect of multicomponent interventions on lower extremity injuries generally. For all other outcomes, and for balance-based interventions, the quality of evidence was rated as low. Conclusion Overall, the evidence is supportive of neuromuscular warmups for lower extremity injury prevention among basketball players. However, most studies are underpowered, some used lower-quality research study designs, and outcome and exposure definitions varied. Due to the nature of the study designs, effects could not be attributed to specific intervention components. More research is needed to identify the most effective bundle of warmup activities.

The relationship between y balance performance and hip strength in recreationally trained women

This study set one´s sight on the relationship between lower quarter y balance test (YBT-LQ) score with hip isometric strength with recreationally resistance-trained women. Utilizing dynamic balance as a screening tool for lower extremity injury risk has been proposed as a potential solution in injury prevention and injury assessment. A convenience sample of twenty young college females (22.3 ± 2.1 years) with a background in regular strength or plyometric training volunteered to participate in this study. The scores of YBT-LQ for each direction were calculated. A hand-held dynamometer was used to measure the maximum voluntary isometric strength of each participant´s unilateral hip extensors, flexors, adductors, abductors, internal and external rotation muscles. Significant lower normalized score was noted for the dominant limb (81.2 ± 11.7) when compared to non-dominant limb (83.6 ± 12.4) for anterior distance. For the composite score of YBT-LQ, a weak association was noted for hip extension and internal rotation, and moderate association was observed for hip flexion, adduction, and abduction. On the other hand, a strong association was observed between hip external rotators strength (r =0.516). Thus, the main finding of the current study was the strong association observed between hip external rotators strength and composite score of YBT-LQ.