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Doha agreement meeting on terminology and definitions in groin pain in athletes.

ABSTRACT: BACKGROUND:Heterogeneous taxonomy of groin injuries in athletes adds confusion to this complicated area. AIM:The 'Doha agreement meeting on terminology and definitions in groin pain in athletes' was convened to attempt to resolve this problem. Our aim was to agree on a standard terminology, along with accompanying definitions. METHODS:A one-day agreement meeting was held on 4 November 2014. Twenty-four international experts from 14 different countries participated. Systematic reviews were performed to give an up-to-date synthesis of the current evidence on major topics concerning groin pain in athletes. All members participated in a Delphi questionnaire prior to the meeting. RESULTS:Unanimous agreement was reached on the following terminology. The classification system has three major subheadings of groin pain in athletes: 1. Defined clinical entities for groin pain: Adductor-related, iliopsoas-related, inguinal-related and pubic-related groin pain. 2. Hip-related groin pain. 3. Other causes of groin pain in athletes. The definitions are included in this paper. CONCLUSIONS:The Doha agreement meeting on terminology and definitions in groin pain in athletes reached a consensus on a clinically based taxonomy using three major categories. These definitions and terminology are based on history and physical examination to categorise athletes, making it simple and suitable for both clinical practice and research.

SUBMITTER: Weir A

PROVIDER: S-EPMC4484366 | biostudies-literature | 2015 Jun

REPOSITORIES: biostudies-literature

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Doha agreement meeting on terminology and definitions in groin pain in athletes.

Weir Adam A Brukner Peter P Delahunt Eamonn E Ekstrand Jan J Griffin Damian D Khan Karim M KM Lovell Greg G Meyers William C WC Muschaweck Ulrike U Orchard John J Paajanen Hannu H Philippon Marc M Reboul Gilles G Robinson Philip P Schache Anthony G AG Schilders Ernest E Serner Andreas A Silvers Holly H Thorborg Kristian K Tyler Timothy T Verrall Geoffrey G de Vos Robert-Jan RJ Vuckovic Zarko Z Hölmich Per P

British journal of sports medicine 20150601 12

<h4>Background</h4>Heterogeneous taxonomy of groin injuries in athletes adds confusion to this complicated area.<h4>Aim</h4>The 'Doha agreement meeting on terminology and definitions in groin pain in athletes' was convened to attempt to resolve this problem. Our aim was to agree on a standard terminology, along with accompanying definitions.<h4>Methods</h4>A one-day agreement meeting was held on 4 November 2014. Twenty-four international experts from 14 different countries participated. Systemat ...[more]

PMID: 26031643

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Project description:BackgroundGroin pain in athletes is frequent and many different treatment options have been proposed. The current level of evidence for the efficacy of these treatments is unknown.ObjectiveSystematically review the literature on the efficacy of treatments for groin pain in athletes.MethodsNine medical databases were searched in May 2014.Inclusion criteriatreatment studies in athletes with groin pain; randomised controlled trials, controlled clinical trials or case series; n>10; outcome measures describing number of recovered athletes, patient satisfaction, pain scores or functional outcome scores. One author screened search results, and two authors independently assessed study quality. A best evidence synthesis was performed. Relationships between quality score and outcomes were evaluated. Review registration number CRD42014010262.Results72 studies were included for quality analysis. Four studies were high quality. There is moderate evidence that, for adductor-related groin pain, active exercises compared with passive treatments improve success, multimodal treatment with a manual therapy technique shortens the time to return to sports compared with active exercises and adductor tenotomy improves treatment success over time. There is moderate evidence that for athletes with sportsman's hernia, surgery results in better treatment success then conservative treatment. There was a moderate and inverse correlation between study quality and treatment success (p<0.001, r=-0.41), but not between study quality and publication year (p=0.09, r=0.20).ConclusionsOnly 6% of publications were high quality. Low-quality studies showed significantly higher treatment success and study quality has not improved since 1985. There is moderate evidence for the efficacy of conservative treatment (active exercises and multimodal treatments) and for surgery in patients with adductor-related groin pain. There is moderate evidence for efficacy of surgical treatment in sportsman's hernia.

Project description:BackgroundAthletic groin pain (AGP) can lead to altered movement patterns during rapid deceleration and acceleration. However, the effect of AGP on movement variability and loading patterns during such actions remains less clear.PurposeTo investigate, using a continuous lateral hurdle hop task, how movement variability and magnitude measures of 3-dimensional (3D) kinematic, kinetic, and vertical ground-reaction force (vGRF) variables are (1) affected by AGP (AGP vs uninjured controls [CON]) and (2) changed after successful rehabilitation (AGP prerehabilitation vs AGP postrehabilitation vs CON).Study designControlled laboratory study.MethodsA total of 36 athletes diagnosed with AGP and 36 uninjured CON athletes matched on age (18-35 years), level (subelite), and type of sports played (multidirectional field sport) performed a continuous lateral hurdle hop test that involved 10 side-to-side hops over a 15-cm hurdle. The 3D joint kinematic, kinetic, and vGRF variables (total, eccentric, and concentric; ground contact time, peak force, and impulse; and eccentric rate of force development) were examined. The AGP and CON groups were tested at baseline, and the AGP group was retested after participants successfully completed a standardized, exercise-based rehabilitation program targeting intersegmental control.ResultsThere were no differences in baseline characteristics between the AGP (mean ± SD: age, 27.5 ± 4.8 years; height, 179.8 ± 6.3 cm; mass, 80.3 ± 7.1 kg) and CON (mean ± SD: age, 24.1 ± 4.5 years; height, 181.0 ± 5.8 cm; mass, 80.4 ± 8.2 kg) groups. At baseline, athletes with AGP demonstrated altered loading patterns in the vGRF (longer ground contact times, reduced peak force, and reduced rate of force development) compared with CON athletes, while no significant difference in any movement variability variables was evident. After rehabilitation, the athletes with AGP demonstrated significant changes in transverse and coronal plane hip and trunk kinematics, with no significant differences in vGRF variables compared with the CON group.ConclusionThe differences in baseline vGRF measures between the AGP and CON groups were no longer evident after athletes with AGP underwent rehabilitation. No differences in movement variability were evident between the AGP and CON groups, either before or after rehabilitation.Clinical relevanceRehabilitation programs should consider targeting intersegmental hip and trunk movement patterns to positively influence loading patterns in athletes with AGP.

Project description:BackgroundAthletes competing in sports that require running, changes in direction, repetitive kicking and physical contact are at a relatively higher risk of experiencing episodes of athletic groin pain. To date, there has been no systematic review that aims to inform clinicians about the best available evidence on features of exercise interventions for groin pain in athletes. The primary aim of this systematic review was to evaluate the available evidence on the effectiveness of exercise therapy for groin pain in athletes. The secondary aim of this review was to identify the key features of exercise interventions used in the management of groin pain in an athletic population.MethodsMEDLINE, CINAHL, PubMed, SPORTSDiscus, Embase, AMED, Ovid, PEDro, Cochrane Controlled Trials Register and Google Scholar databases were electronically searched. Data relating to research design, sample population, type of sport and exercise intervention was extracted. The methodological evaluation of included studies was conducted by using a modified quantitative critical appraisal tool.ResultsThe search strategy identified 468 studies, 12 of which were potentially relevant. Ultimately five studies were included in this review. Overall the quality of primary research literature was moderate, with only one randomised controlled trial identified. All included studies provided evidence that an exercise intervention may lead to favourable outcomes in terms of return to sport. Four of the five studies reviewed included a strengthening component and most utilised functional, standing positions similar to those required by their sport. No study appropriately reported the intensity of their exercise interventions. Duration of intervention ranged from 3.8 weeks to 16 weeks. All five studies reported the use of one or more co-intervention.ConclusionBest available evidence to date, with its limitations, continues to support common clinical practice of exercise therapy as a key component of rehabilitation for groin pain in athletes. Overall, the available evidence suggests that exercise, particularly strengthening exercise of the hip and abdominal musculature could be an effective intervention for athletes with groin pain. Literature provides foundational evidence that this may need to be in the form of progressive exercises (static to functional) and performed through range. There is currently no clear evidence regarding the most effective intensity and frequency of exercise, because of a lack of reporting in the primary literature.

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Doha agreement meeting on terminology and definitions in groin pain in athletes.

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Doha agreement meeting on terminology and definitions in groin pain in athletes.

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