Adherence to an injury prevention program in male amateur football players is affected by players’ age, experience and perceptions

OBJECTIVES : Adherence to injury prevention programmes in football remains low, which is thought to drastically reduce the effects of injury prevention programmes. Reasons why (medical) staff and players implement injury prevention programmes, have been investigated, but player’s characteristics and perceptions about these programmes might influence their adherence. Therefore, this study investigated the relationships between player’s characteristics and adherence and between player’s perceptions and adherence following an implemented injury prevention programme. METHODS : Data from 98 of 221 football players from the intervention group of a cluster randomised controlled trial concerning hamstring injury prevention were analysed. RESULTS : Adherence was better among older and more experienced football players, and players considered the programme more useful, less intense, more functional and less time-consuming. Previous hamstring injuries, educational level, the programme’s difficulty and intention to continue the exercises were not significantly associated with adherence. CONCLUSION : These player’s characteristics and perceptions should be considered when implementing injury prevention programmes.https://bmjopensem.bmj.comhj2022Sports Medicin

Sports injuries and illnesses during the European Youth Olympic Festival 2013

BACKGROUND: The European Youth Olympic Festival (EYOF) is a biennial sporting event of nine Olympic Summer Sports for talented athletes, aged 13-18 years, from all over Europe. OBJECTIVE: To analyse the injuries and illnesses that occurred during the multisport event (14-19 July 2013), with the long-term aim of enabling international sports federations, the National Olympic Committees, and the European Olympic Committee to improve protection of athletes' health in youth. METHODS: Daily occurrence or non-occurrence of injuries and illnesses was recorded by using the IOC injury and illness surveillance system for multisport events. All National Olympic Committee physicians and healthcare providers and physicians of the Local Organizing Committee were invited to participate. RESULTS: In total, 2272 athletes from 49 countries took part in the EYOF 2013. During the five competition days of EYOF, 207 injuries and 46 illnesses were reported, resulting in an incidence of 91.1 injuries and 20.2 illnesses per 1000 athletes. Almost 10% of the athletes sustained at least one injury or illness. CONCLUSIONS: This study is the first multisport surveillance study on injuries and illnesses during the EYOF or any other summer Games organised for youth elite athletes. The data form the basis for further research on risk factors and injury mechanisms for this cohort. This research is needed to gain more knowledge and finally to implement effective injury and illness prevention measures

Symptoms of Common Mental Disorders in Professional Football (Soccer) Across Five European Countries

Evidence on the prevalence of symptoms related to distress, anxiety/depression or substance abuse/dependence, – typically referred to as symptoms of common mental disorders (CMD) – is lacking in European professional football (soccer). The aims of the present study were to investigate the prevalence of symptoms related to CMD (distress, anxiety/depression, sleeping disturbance, adverse alcohol behaviour, and adverse nutrition behaviour) in professional footballers from five European countries, and to explore associations of the outcome measures under study with life events and career dissatisfaction. A cross-sectional design was used. Questionnaires were distributed among professional footballers by the national players’ unions in Finland, France, Norway, Spain and Sweden. The highest prevalence of symptoms related to common mental disorders were 18% for distress (Sweden), 43% for anxiety/depression (Norway), 33% for sleeping disturbance (Spain), 17% for adverse alcohol behaviour (Finland), and 74% for adverse nutrition behaviour (Norway). In Finland, France and Sweden, both life events and career dissatisfaction were associated with distress, anxiety/depression, adverse alcohol behaviour, and adverse nutrition behaviour. Results suggest the need for self-awareness in professional football about common mental disorders and a multidisciplinary approach by the medical team

Alfredson versus Silbernagel exercise therapy in chronic midportion Achilles tendinopathy : Study protocol for a randomized controlled trial

Background: Midportion Achilles tendinopathy (AT) is a common overuse injury, usually requiring several months of rehabilitation. Exercise therapy of the ankle plantar flexors (i.e. tendon loading) is considered crucial during conservative rehabilitation. Alfredson's isolated eccentric and Silbernagel's combined concentric-eccentric exercise programs have both shown beneficial results, but it is unknown whether any of these programs is superior for use in clinical practice. Therefore, the primary objective of this study is to compare the effectiveness of both programs on clinical symptoms. Secondary objectives are to compare the effectiveness of both programs on quality of life and functional outcome measures, to investigate the prognostic value of baseline characteristics, to investigate differences in cost-effectiveness. Methods/Design: Eighty-six recreational athletes (21-60 years of age) with unilateral chronic midportion AT (i.e. ≥ 3 months) will be included in this multicenter assessor blinded randomized controlled trial. They will be randomly allocated to either a group performing the Alfredson isolated eccentric training program (n = 43), or a group performing the Silbernagel combined concentric-eccentric program (n = 43). In the Alfredson group, participants will perform eccentric heel-drops on their injured side, twice daily for 12 weeks, whereas in the Silbernagel group, participants perform various concentric-eccentric heel-raise exercises, once daily for 12 weeks. Primary outcome measure will be the Victorian Institute of Sport Assessment - Achilles (VISA-A) questionnaire. Secondary outcomes will be a visual analogue scale (VAS) for pain during daily activities and sports, duration of morning stiffness, global perceived effect, the 12-item Short Form Health Survey and the Euroqol instrument, and functional performance measured with the heel-raise test and the countermovement jump. Additionally, alongside the RCT, a cost-effectiveness analysis will be performed. Assessments will be performed at baseline and after 12, 26, and 52 weeks. Discussion: This study is the first to directly compare the Alfredson and the Silbernagel exercise program in a randomized trial. The results can further enlarge the evidence base for choosing the most appropriate exercise program for patients with midportion AT. Trial registration: Dutch Trial register: NTR5638. Date of registration: 7 January 2016

E-coaching : New future for cardiac rehabilitation? A systematic review

Objective: To provide an evidence-based overview of the effectiveness of e-coaching as a cardiac rehabilitation program (CRP). Methods: Pubmed, Embase, PEDro and CINAHL were searched to identify relevant RCTs. The e-coaching programs were divided into basic or complex depending on their content. Two reviewers independently assessed the methodological quality and extracted the data. A best-evidence synthesis was used to summarize the results. Results: 19 RCTs were included. Detailed descriptions of the e-coaching programs were lacking. Complex e-coaching was more effective than usual-care for physical capacity (moderate evidence for short-, and mid-term; strong evidence for long-term), for clinical status (limited evidence for short- and mid-term; moderate evidence for the long-term), and for psychosocial health (moderate evidence for short-term; strong evidence for mid-, and long-term). For basic e-coaching only limited or no evidence for effectiveness was found. Conclusion: Promising results were found for the effectiveness of complex e-coaching as a CRP to improve a patients' physical capacity, clinical status and psychosocial health. Practice implications: The content of the e-coaching programs were not clearly described. This makes it difficult to identify which components of e-coaching are most effective and should be further developed to deliver the most optimal care for cardiac rehabilitation patients

E-coaching : New future for cardiac rehabilitation? A systematic review

Objective: To provide an evidence-based overview of the effectiveness of e-coaching as a cardiac rehabilitation program (CRP). Methods: Pubmed, Embase, PEDro and CINAHL were searched to identify relevant RCTs. The e-coaching programs were divided into basic or complex depending on their content. Two reviewers independently assessed the methodological quality and extracted the data. A best-evidence synthesis was used to summarize the results. Results: 19 RCTs were included. Detailed descriptions of the e-coaching programs were lacking. Complex e-coaching was more effective than usual-care for physical capacity (moderate evidence for short-, and mid-term; strong evidence for long-term), for clinical status (limited evidence for short- and mid-term; moderate evidence for the long-term), and for psychosocial health (moderate evidence for short-term; strong evidence for mid-, and long-term). For basic e-coaching only limited or no evidence for effectiveness was found. Conclusion: Promising results were found for the effectiveness of complex e-coaching as a CRP to improve a patients' physical capacity, clinical status and psychosocial health. Practice implications: The content of the e-coaching programs were not clearly described. This makes it difficult to identify which components of e-coaching are most effective and should be further developed to deliver the most optimal care for cardiac rehabilitation patients

Return to Sport in Athletes with Midportion Achilles Tendinopathy : A Qualitative Systematic Review Regarding Definitions and Criteria

Background: Midportion Achilles tendinopathy (AT) can cause long-term absence from sports participation, and shows high recurrence rates. It is important that the decision to return to sport (RTS) is made carefully, based on sharply delimited criteria. Lack of a well-defined definition and criteria hampers the decision to RTS among athletes with AT, and impedes comparison of RTS rates between different studies. Objective: The aim of this study was to systematically review the literature for definitions of, and criteria for, RTS in AT research. Study Design: Qualitative systematic review. Methods: The PubMed, EMBASE, Cochrane, CINAHL, PEDro, and Scopus electronic databases were searched for articles that reported on the effect of a physiotherapeutic intervention for midportion AT. Article selection was independently performed by two researchers. Qualitative content analysis was used to analyze the included studies and extract definitions of, and criteria for, RTS. Results: Thirty-five studies were included in the content analysis, showing large variety in both the definitions and criteria. Thirty-two studies reported a definition of RTS, but only 19 studies described the criteria for RTS. The content analysis revealed that ‘reaching pre-injury activity/sports level, with the ability to perform training and matches without limitations’, ‘absence of pain’, and ‘recovery’ were the main content categories used to define RTS. Regarding the criteria for RTS, eight different content categories were defined: (1) ‘level of pain’; (2) ‘level of functional recovery’; (3) ‘recovery of muscle strength’; (4) ‘recovery of range of motion’; (5) ‘level of endurance of the involved limb’; (6) ‘medical advice’; (7) ‘psychosocial factors’; and (8) ‘anatomical/physiological properties of the musculotendinous complex’. Many criteria were not clearly operationalized and lacked specific information. Conclusions: This systematic review shows that RTS may be defined according to the pre-injury level of sports (including both training and matches), but also with terms related to the absence of pain and recovery. Multiple criteria for RTS were found, which were all related to level of pain, level of functional recovery, muscular strength, range of motion, endurance, medical advice, psychosocial factors, or anatomical/physiological properties of the Achilles tendon. For most of the criteria we identified, no clear operationalization was given, which limits their validity and practical usability. Further research on how RTS after midportion AT should be defined, and which criteria should be used, is warranted. PROSPERO Registration Number: CRD42017062518

Feasibility of Exercise Training in Cancer Patients Scheduled for Elective Gastrointestinal Surgery

Background/Aims: This study examines the feasibility of a preoperative exercise program to improve the physical fitness of a patient before gastrointestinal surgery. Methods: An outpatient exercise program was developed to increase preoperative aerobic capacity, peripheral muscle endurance and respiratory scheduled within 2 weeks. Results: The 115 participants followed on average 5.7 (3.5) training sessions. Adherence to the exercise program was high: 82% of muscle function in patients with pancreatic, liver, intestinal, gastric or esophageal cancer. During a consult at the outpatient clinic, patients were invited to participate in the exercise program when their surgery was not the planned training sessions were attended, and no adverse events occurred. Mixed model analyses showed a significant increase of maximal inspiratory muscle strength (84.1-104.7 cm H2O; p = 0.00) and inspiratory muscle endurance (35.0-39.5 cm H2O; p = 0.00). No significant changes were found in aerobic capacity and peripheral muscle strength. Conclusion: This exercise program in patients awaiting oncological surgery is feasible in terms of participation and adherence. Inspiratory muscle function improved significantly as a result of inspiratory muscle training. The exercise program however failed to result in improved aerobic capacity and peripheral muscle strength, probably due to the limited number of training sessions as a result of the restricted time interval between screening and surgery.</p