Strength training for physical performance and injury prevention in sports. Individualised and supervised training for female athletes.

The overall purpose of this thesis was to obtain knowledge about individualised, supervised strength and conditioning programmes for physical performance and injury prevention in female athletes. Data are presented both on the influence of individualisation and supervision during resistance training for physical performance and injury prevention and on the athletes’ experience of resistance training and the role of the physical coach. Data are also presented on physical performance testing and injury prevalence and preventive action in female volleyball. Study I: The purpose of this study was to examine the prevalence of injury and the extent of preventive action in elite Swedish volleyball players. Injuries to players in the elite male and female Swedish division, during the 2002-2003 season, were registered using a questionnaire. Of the 158 volleyball players, a total of 82 players (52%) reported 121 injuries, during a total exposure time of 24,632 h. The majority of the injuries were located in the ankle, knee and back. Most injuries were classified as being of minor severity. Although most players took part in some kind of preventive action, one in every two players incurred an injury during the season, which indicates that the risk of suffering an injury in elite volleyball is relatively high. Study II: The purpose of Study II was to evaluate the test-retest reliability of sit-ups and push-ups and to investigate performance differences in muscular endurance (maximum number of repetitions) and power (timed; maximum number of repetitions in 30 s) in young women and men. Thirty-eight women and 25 men (age18-35) participated in the study. Thirteen female participants performed two test sessions of each test using a test-retest design. A high level of reliability was noted for both the sit-up and the push-up tests. There were no significant differences between the men and the women in the sit-up test, whereas the men performed significantly more push-ups than the women. Study III: The purpose of Study III was to evaluate the effects of a 26-week individualised and supervised strength and injury-prevention programme on performance enhancement. Young female volleyball players completed resistance training with either a supervised, individualised training programme (experimental group; n=10) or an unsupervised, non-individualised training programme (control group; n=17). Exposure and injury data were collected during the 2006-2007 season (baseline) and the 26-week programme with physical performance testing was carried out during the 2007-2008 season. After the intervention, the experimental group had improved significantly more (p<0.05) than the control group in the squat, barbell bench press, push-ups and sit-ups. Individualisation and supervision of resistance training seem to improve greater training adherence and strength gains compared with non-individualised and unsupervised training. Study IV: The purpose of Study IV was to explore and describe volleyball players’ experience of an individualised, supervised strength-training programme aiming at physical performance and injury prevention. The purpose was also to use the players’ observations to obtain an understanding of the role of a physical coach. The study comprised nine participants (mean age 19 years) who had been involved as the experimental group in Study III. Data were collected using semi-structured interviews and were analysed using qualitative conventional content analysis. Three overarching themes describing the content of the text emerged: 1) being in an enjoyable, relaxed situation, 2) interaction between coach and athlete and 3) mental and physical achievements. Conclusions: Individualisation and supervision appear to be of importance for compliance, strength gains and athletic performance, during strength training. From the female team athletes’ perspective, the willingness to perform strength training is dependent on team spirit, individual goal-setting and bonding with the coach. Strength training, on the one hand, could be used to improve self-esteem among young females. On the other hand, when designing strength-training intervention studies, it is important to be aware of the fear and feeling of uncertainty that may exist among the participants when it comes to strength training

The Incidence and Prevalence of Ankle Sprain Injury: A Systematic Review and Meta-Analysis of Prospective Epidemiological Studies

Background: Ankle sprain is one of the most common musculoskeletal injuries, yet a contemporary review and meta-analysis of prospective epidemiological studies investigating ankle sprain does not exist. Objective: Our aim is to provide an up-to-date account of the incidence rate and prevalence period of ankle sprain injury unlimited by timeframe or context activity. Methods: We conducted a systematic review and meta-analyses of English articles using relevant computerised databases. Search terms included Medical Search Headings for the ankle joint, injury and epidemiology. The following inclusion criteria were used: the study must report epidemiology findings of injuries sustained in an observed sample; the study must report ankle sprain injury with either incidence rate or prevalence period among the surveyed sample, or provide sufficient data from which these figures could be calculated; the study design must be prospective. Independent extraction of articles was performed by two authors using pre-determined data fields. Results: One-hundred and eighty-one prospective epidemiology studies from 144 separate papers were included. The average rating of all the included studies was 6.67/11, based on an adapted version of the STROBE (STrengthening the Reporting of OBservational studies in Epidemiology) guidelines for rating observational studies. 116 studies were considered high quality and 65 were considered low quality. The main findings of the meta-analysis demonstrated a higher incidence of ankle sprain in females compared with males (13.6 vs 6.94 per 1,000 exposures), in children compared with adolescents (2.85 vs 1.94 per 1,000 exposures) and adolescents compared with adults (1.94 vs 0.72 per 1,000 exposures). The sport category with the highest incidence of ankle sprain was indoor/court sports, with a cumulative incidence rate of 7 per 1,000 exposures or 1.37 per 1,000 athlete exposures and 4.9 per 1,000 h. Low-quality studies tended to underestimate the incidence of ankle sprain when compared with high-quality studies (0.54 vs 11.55 per 1,000 exposures). Ankle sprain prevalence period estimates were similar across sub-groups. Lateral ankle sprain was the most commonly observed type of ankle sprain. Conclusions: Females were at a higher risk of sustaining an ankle sprain compared with males and children compared with adolescents and adults, with indoor and court sports the highest risk activity. Studies at a greater risk of bias were more likely to underestimate the risk of ankle sprain. Participants were at a significantly higher risk of sustaining a lateral ankle sprain compared with syndesmotic and medial ankle sprains.Health Research Boar