Accuracy and Reliability of Examiners’ Observations of Pre-Practice Warm-Up and FIFA 11+ Injury Prevention Program Exercises

Background: The Fédération Internationale de Football Association (FIFA) 11+ is an injury prevention program that decreases the incidence of lower extremity injuries. The purpose of the current study was to understand what specific exercises prevented injury from occurring. We thus developed and tested a form to identify these exercises. We hypothesize that trained examiners could accurately and reliably use this form to identify and record individual exercises performed during preparticipation warm-up. Methods: A repeated-measures study design was used in this investigation. After observing five prepractice warm-up videos obtained from multiple high schools, 11 examiners observed and recorded performed exercises at two different times. The videos included four soccer teams and one American football team. Accuracy, interexaminer reliability, and intraexaminer reliability were assessed. Sensitivity, specificity, accuracy, and percent agreement with a FIFA 11+ expert were measured for each exercise component. Results: The intraclass correlation coefficients between examiners and individually ranged from 0.22 to 1.00 and 0.58 to 1.00, respectively. Reliability was lowest for exercises with similar movements. The percent agreement across all examiners for individual exercises ranged from 20% to 100%. Additionally, the percent agreement between each examiner and the “gold standard” examiner was high (range, 69.6% to 90.4%). For exercises with similar movements, accuracy and reliability were considerably improved (97%) when combined into one category. Conclusion: We determined that trained examiners with different backgrounds and experience can make accurate and reliable observations of most exercises observed in warm-up programs. Using the proposed form, researchers can accurately record exercises and perform quality and fidelity assessments of warm-up exercise routines

Sport-Related Injuries in Canadian Interuniversity Athletics: A Descriptive Epidemiologic Analysis of Knee Injuries, 2014-2017

The purpose of this study was to identify and establish the extent of sport-related injury in Canadian university varsity athletics, focusing on knee injury and significant sport injury. Of the SRIs reported, 20% were significant in nature and 23.2% were knee injuries. A larger percentage of knee SRIs were significant compared non-knee SRIs. Those suffering a knee injury were 4.5 times more likely to suffer a significant injury than those afflicted with non-knee injuries. Mens volleyball athletes are two times more likely to suffer a knee injury, once controlled for sport group. Once controlled for sport, mens hockey athletes are 2.3 times more likely to suffer a significant injury than any other sport (Table 4). Mens basketball has the highest rate of injury (3.32 per athlete) during this reporting period and football has the highest rate of significant knee injury at 0.27 per athlete (Table 1)

Controlled ecological evaluation of an implemented exercise-training programme to prevent lower limb injuries in sport: Population-level trends in hospital-treated injuries

Objective: Exercise-training programmes have reduced lower limb injuries in trials, but their population-level effectiveness has not been reported in implementation trials. This study aimed to demonstrate that routinely collected hospital data can be used to evaluate population-level programme effectiveness. Method: A controlled ecological design was used to evaluate the effect of FootyFirst, an exercise-training programme, on the number of hospital-treated lower limb injuries sustained by males aged 16–50 years while participating in community-level Australian Football. FootyFirst was implemented with ‘support’ (FootyFirst+S) or ‘without support’ (FootyFirst+NS) in different geographic regions of Victoria, Australia: 22 clubs in region 1: FootyFirst+S in 2012/2013; 25 clubs in region 2: FootyFirst+NS in 2012/2013; 31 clubs region 3: control in 2012, FootyFirst+S in 2013. Interrupted time-series analysis compared injury counts across regions and against trends in the rest of Victoria. Results: After 1 year of FootyFirst+S, there was a non-statistically significant decline in the number of lower limb injuries in region 1 (2012) and region 3 (2013); this was not maintained after 2 years in region 1. Compared with before FootyFirst in 2006–2011, injury count changes at the end of 2013 were: region 1: 20.0% reduction (after 2 years support); region 2: 21.5% increase (after 2 years without support); region 3: 21.8% increase (after first year no programme, second year programme with support); rest of Victoria: 12.6% increase. Conclusion: Ecological analyses using routinely collected hospital data show promise as the basis of population-level programme evaluation. The implementation and sustainability of sports injury prevention programmes at the population-level remains challenging

Effect of sand on landing knee valgus during single leg land and drop jump tasks: Possible implications for ACL injury prevention and rehabilitation.

Context: Despite significant emphasis on Anterior Cruciate Ligament (ACL) injury prevention, injury rates continue to rise and re-injury is common. Interventions to reduce injury have included resistance, balance and jump training elements. The use of sand-based jump training has been postulated as an effective treatment. However, evidence on landing mechanics is limited. Objective: To determine potential differences in landing strategies and subsequent landing knee valgus when performing single leg landing (SLL) and drop jump (DJ) tasks onto sand and land, and compare between both male and female populations. Design: A randomised repeated measures crossover design. Setting: University Laboratory. Participants: 31 participants (20 males, 11 females) from a university population. Interventions: All participants completed DJ and SLL tasks on both sand and land surfaces. Main Outcome Measures: 2-dimensional Frontal Plane Projection Angle (FPPA) of knee valgus was measured in both the DJ and SLL tasks (right and left) for both sand and land conditions. Results: FPPA was lower (moderate to large effect) for SLL in sand compared to land in both legs (Left: 4.3⁰ ±2.8⁰; Right: 4.1⁰ ±3.8⁰) for females. However, effects were unclear (Left: -0.7⁰ ±2.2⁰) and trivial for males (Right: -1.1⁰ ±1.9⁰). FPPA differences for males and females performing DJ were unclear, thus more data is required. Differences in FPPA (land vs sand) with respect to grouping (sex) for both SLL (Left: 4.9⁰ ±3.0⁰) and (Right: 5.1⁰ ±4.0⁰) were both very likely higher small/ possibly moderate for females compared to males

Acute Effects of ACL Injury-Prevention Warm-Up and Soccer-Specific Fatigue Protocol on Dynamic Knee Valgus in Youth Male Soccer Players

Childhood anterior cruciate ligament (ACL) injuries—which can pose a major risk to a child’s sporting career—have been on the rise in the last few decades. Dynamic knee valgus (DKV) has been linked to an increased risk of ACL injury. Therefore, the aim of this study was to analyze the acute effects of an ACL injury prevention protocol (ACL-IPP) and a soccer-specific fatigue protocol (SSFP) on DKV in youth male soccer players. The research hypothesis was that DKV would be reduced by the ACL-IPP and increased by the SSFP. Eighteen youth male soccer players were divided according to baseline DKV. Those with moderate or large DKV performed a neuromuscular training protocol based on activation of the abductor and external rotator hip muscles. Those with little or no DKV performed a soccer-specific fatigue protocol. DKV was assessed using the single-leg squat pre- and post-protocols in both legs. The ACL-IPP significantly decreased DKV during single-leg squat (p < 0.01, effect size = 1.39), while the SSFP significantly increased baseline DKV in the dominant leg during single-leg squat (p = 0.012; effect size = 1.74). In conclusion, the ACL-IPP appears to acutely reduce the DKV in youth male soccer players, and the SSFP seems to acutely increase the DKV in those players who showed a light or no DKV in a non-fatigue situation. By using the SSFP, it may be possible to determine which players would benefit from injury prevention programs due to increased DKV during game scenarios, while hip abductor and external rotator neuromuscular training may be beneficial for players who have moderate and severe DKV during single-leg squat under non-fatigued scenarios

Is knee neuromuscular activity related to anterior cruciate ligament injury risk? A pilot study.

BACKGROUND: There is limited evidence on neuromuscular risk factors for anterior cruciate ligament (ACL) injuries, with most work mainly focusing on hamstrings and quadriceps muscle strength. This prospective pilot study explored if neuromuscular activation patterns of the quadriceps and hamstrings during a drop vertical jump influence ACL injury risk. METHODS: Forty-six female athletes performed a drop vertical jump at baseline. Injuries were monitored throughout a one-year follow-up. Neuromuscular activation patterns of the vastus medialis, vastus lateralis, hamstrings medialis and hamstrings lateralis, and selected landing kinematic and kinetic profiles (knee flexion, knee abduction and hip flexion angles, and knee abduction moments), were compared between athletes who sustained a non-contact ACL injury and those who remained injury free. Electromyogram vector fields were created to represent neuromuscular activation patterns of muscle pairs around the knee joint rather than only considering individual muscle activations, and compared using Statistical Parametric Mapping. RESULTS: Four athletes sustained an ACL injury. Significantly greater {hamstrings medials, hamstrings lateralis}, {vastus lateralis, hamstrings lateralis} and {hamstrings lateralis, vastus medialis} activations, mainly due to greater hamstrings lateralis activation, were found in the injured group around peak loading and just before take-off (P < 0.001). No group differences were found in knee flexion, knee abduction and hip flexion angles, or knee abduction moments. CONCLUSIONS: This pilot study revealed initial evidence that athletes already showed altered neuromuscular activation patterns prior to sustaining an ACL injury, namely increased lateral and posterior muscle activations

L'influenza del genere nella prevenzione delle lesioni legamentose di ginocchio negli sport ad alto rischio. Revisione sistematica della letteratura

Introduzione: l’infortunio al ginocchio è una delle piaghe che maggiormente colpisce il mondo sportivo. Specialmente sono più esposte le donne a questo rischio rispetto agli uomini. I problemi di questo infortunio oltre ad essere immediati risultano anche futuri(rischio di osteoartrosi). La prevenzione quindi in infortuni del genere risulta fondamentale. Lo scopo di questa ricerca è di valutare l’efficacia di interventi preventivi sull’infortunio al ginocchio e l’influenza del genere nella loro efficacia. Materiali e metodi: una ricerca bibliografica è stata compiuta usando Pubmed, PEDro, Cochrane e Cinahl /SPORTDiscuss. Le principali parole chiave usate sono state: prevention, knee injury, acl injury e sport. I criteri di inclusione utilizzati sono stati: solo RCT, programmi preventivi solo su uomini o solo su donne, riportata incidenza degli infortuni al ginocchio o al LCA. Per valutare il rischio di bias è stata usata la PEDro scale. Risultati: 10 articoli sono stati trovati che rispondevano ai criteri di eleggibilità. Tra quelli trovati 8 studi riducono l’incidenza del numero di infortuni al ginocchio, 3 riportano variazioni statisticamente significative. Dei 10 studi, 5 erano sulle donne e 3 sugli uomini. Il rischio di bias calcolato con la PEDro score ha dato un punteggio medio di 5.6. Conclusione: da questo studio si capisce come gli interventi preventivi sul ginocchio abbiano efficacia. Il genere non influenza la loro efficacia. È compito del fisioterapista soprattutto nella popolazione più a rischio(ragazze tra i 14-18 anni) implementare ed educare le atlete agli esercizi di prevenzione. Limite di questo studio è stato soprattutto avere eterogeneità negli interventi utilizzati. Ulteriori ricerche serviranno per definire l’influenza del genere soprattutto nella prevenzione degli infortuni da non contatto. Sarà importante aprire il mondo sportivo a questi scenari sulla prevenzione

Anterior cruciate ligament structure and function. Injuries and prevention plan

38 p. : il. -- Bibliogr.: p. 30-38The main goal of this revision is to make a proposal of a prevention plan for non-contact Anterior Cruciate Ligament (ACL) injuries in soccer players. In order to achieve this, the first thing to do is to analyse the current evidence around the ACL from its anatomy and structure to its injuries, deepening in the injury mechanisms and risk factors. Additionally, a revision of the current knowledge about prevention protocols and exercises should be also done. After having reviewed the most important evidence and bearing in mind the factors that might affect the schedule of the programme, the proposed intervention plan may be useful to soccer players to reduce the risk of sustaining a non-contact ACL injury during both practice and competition. With the aim of developing an evidence-based protocol, the training components and the specific exercises are supported on the analysed studies as well