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Whole-Body Reactive Agility Metrics to Identify Football Players With a Core and Lower Extremity Injury Risk

ABSTRACT: Clinical prediction models are useful in addressing several orthopedic conditions with various cohorts. American football provides a good population for attempting to predict injuries due to their relatively high injury rate. Physical performance can be assessed a variety of ways using an assortment of different tests to assess a diverse set of metrics, which may include reaction time, speed, acceleration, and deceleration. Asymmetry, the difference between right and left performance has been identified as a possible risk factor for injury. The purpose of this study was to determine the whole-body reactive agility metrics that would identify Division I football players who were at elevated risk for core, and lower extremity injuries (CLEI). This cohort study utilized 177 Division I football players with a total of 57 CLEI suffered who were baseline tested prior to the season. Single-task and dual-task whole-body reactive agility movements in lateral and diagonal direction reacting to virtual reality targets were analyzed separately. Receiver operator characteristic (ROC) analyses narrowed the 34 original predictor variables to five variables. Logistic regression analysis determined the three strongest predictors of CLEI for this cohort to be: lateral agility acceleration asymmetry, lateral flanker deceleration asymmetry, and diagonal agility reaction time average. Univariable analysis found odds ratios to range from 1.98 to 2.75 for these predictors of CLEI. ROC analysis had an area under the curve of 0.702 for any combination of two or more risk factors produced an odds ratio of 5.5 for risk of CLEI. These results suggest an asymmetry of 8–15% on two of the identified metrics or a slowed reaction time of ≥0.787 s places someone at increased risk of injury. Sixty-three percent (36/57) of the players who sustained an injury had ≥2 positive predictors In spite of the recognized limitation, these finding support the belief that whole-body reactive agility performance can identify Division I football players who are at elevated risk for CLEI.

SUBMITTER: Bruce S

PROVIDER: S-EPMC8564038 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:Reactive agility (RAG) and change of direction speed (CODS) are important determinants of success in football (soccer), but there is an evident lack of information on reliable and valid football-specific testing procedures which will be applicable in defining sport-specific RAG and CODS in youth players. This study evaluated reliability and construct validity of newly developed tests of football-specific RAG (FS_RAG) and CODS (FS_CODS), which involved the ball kicking football technique. Additionally, factors associated with FS_RAG and FS_CODS were evaluated. The participants were youth football players (n = 59; age: 13.40 ± 1.25 years) divided according to their age into U13 (11-12 years of age; n = 29), and U15 (13-14 years of age; n = 30) categories. Additionally, performance levels (starters [first-team] vs. non-starters [substitutes]) were observed in each age category. The dependent variables were newly developed FS_RAG and FS_CODS tests. The independent variables were sprinting capacities over 10 and 20 meters (S10M, S20M), countermovement jump (CMJ), the reactive strength index (RSI), and a generic CODS test of 20 yards (20Y). The newly developed FS_CODS and FS_RAG were observed as dependent variables. Results showed appropriate intra-testing and inter-testing reliability of the FS_RAG and FS_CODS, with somewhat better reliability of the FS_CODS (ICC=0.82 and 0.79, respectively). Additionally, better reliability was evidenced in U15 than in U13 (ICC: 0.82-0.85, and 0.78-0.80 for U15 and U13, respectively). Independent samples t-test indicated significant differences between U13 and U15 in S10 (t-test: 3.57, p < 0.001), S20M (t-test: 3.13, p < 0.001), 20Y (t-test: 4.89, p < 0.001), FS_RAG (t-test: 3.96, p < 0.001), and FS_CODS (t-test: 6.42, p < 0.001), with better performance in U15. Starters outperformed non-starters in most capacities among U13, but only in FS_RAG among U15 (t-test: 1.56, p < 0.05). Multiple regression calculations indicated nonsignificant association between independent and dependent variables in U13 (FS_CODS: 19%, FS_RAG: 21% of the explained variance, both p > 0.05), but independent variables explained significant proportion of both dependent variables in U15 (FS_CODS: 35%, FS_RAG: 33% explained variance, both p < 0.05). The study confirmed the applicability of newly developed tests in distinguishing studied age categories of players. Results indicate that superiority in all studied fitness capacities is translated into performance level in U13. Meanwhile, FS_RAG seems to be important determinant of quality in U15.

Project description:BackgroundStroboscopic training is based on an exercise with intermittent visual stimuli that force a greater demand on the visuomotor processing for improving performance under normal vision. While the stroboscopic effect is used as an effective tool to improve information processing in general perceptual-cognitive tasks, there is still a lack of research focused on identifying training protocols for sport-specific settings. Therefore, we aimed at assessing the effects of in-situ stroboscopic training on visual, visuomotor and reactive agility in young volleyball players.MethodsFifty young volleyball athletes (26 males and 24 females; mean age, 16.5 ± 0.6 years) participated in this study and were each divided randomly into an experimental group and a control group, who then both performed identical volleyball-specific tasks, with the experimental group under stroboscopic influence. The participants were evaluated three times using laboratory based tests for simple and complex reaction speed, sensory sensitivity and saccade dynamics; before the after the 6-week-long training (short-term effect) and 4 weeks later (long-term effect). In addition, a field test investigated the effects of the training on reactive agility.ResultsA significant TIME vs GROUP effect was observed for (1) simple motor time (p = 0.020, ηp2 = 0.08), with improvement in the stroboscopic group in the post-test and retention test (p = 0.003, d = 0.42 and p = 0.027, d = 0.35, respectively); (2) complex reaction speed (p < 0.001, ηp2 = 0.22), with a large post-test effect in the stroboscopic group (p < 0.001, d = 0.87) and a small effect in the non-stroboscopic group (p = 0.010, d = 0.31); (3) saccade dynamics (p = 0.011, ηp2 = 0.09), with post-hoc tests in the stroboscopic group not reaching significance (p = 0.083, d = 0.54); and (4) reactive agility (p = 0.039, ηp2 = 0.07), with a post-test improvement in the stroboscopic group (p = 0.017, d = 0.49). Neither sensory sensitivity nor simple reaction time was statistically significantly affected as a result of the training (p > 0.05). A significant TIME vs GENDER effect was observed for saccadic dynamics (p = 0.003, ηp2 = 0.226) and reactive agility (p = 0.004, ηp2 = 0.213), with stronger performance gains in the females.ConclusionsThere was a larger effectiveness from the 6-week volleyball-specific training in the stroboscopic group compared to the non-stroboscopic group. The stroboscopic training resulted in significant improvements on most measures (three of five) of visual and visuomotor function with more marked enhancement in visuomotor than in sensory processing. Also, the stroboscopic intervention improved reactive agility, with more pronounced performance gains for short-term compared to the long-term changes. Gender differences in response to the stroboscopic training are inconclusive, therefore our findings do not offer a clear consensus.

Project description:In vehicle dynamics, it is commonly understood that there is an inverse relationship between stability and maneuverability. However, animal studies have found that stability and maneuverability can coincide. In this study, we examine humans running a reactive agility obstacle and consider the relationship between observational perceived agility and balance, as well as the relationship between quantified surrogates of agility and balance. Recreational athletes (n = 18) completed the agility task while wearing inertial measurement units (IMUs) on their body. The task was also video-recorded. An observational study was completed by a separate group of adults (n = 33) that were asked to view the videos and score each athlete on a Likert scale for balance and for agility. The data from the body-worn IMUs were used to estimate quantified surrogate measures for agility and balance, and to assess if the relationship between the quantified agility and balance was in the same direction as the perceived relationship from the Likert scale responses. Results indicate that athletes that were given a higher Likert agility score were also given a higher balance score (rs = 0.75,p < 0.001). Quantitative surrogates of agility and balance also showed this same relationship. Additional insights on technique for this reactive agility task were informed by the quantitative surrogates. We observed the importance of stepping technique in achieving the faster completion times. The fast performing athletes spent a greater proportion of the task in double support and lower overall time in single support indicating increased periods of static stability. The fast performing athletes did not have a higher body speed, but performed the task with a more efficient technique, using foot placement to enable heading changes, and thus may have had a more efficient path. Similar to animal studies, people use technique to enable agile strategies while also enabling increased balance across the task.

Project description:BackgroundIndirect muscle injuries (IMIs) are a considerable burden to elite football (soccer) teams, and prevention of these injuries offers many benefits. Preseason medical, musculoskeletal and performance screening (termed periodic health examination (PHE)) can be used to help determine players at risk of injuries such as IMIs, where identification of PHE-derived prognostic factors (PF) may inform IMI prevention strategies. Furthermore, using several PFs in combination within a multivariable prognostic model may allow individualised IMI risk estimation and specific targeting of prevention strategies, based upon an individual's PF profile. No such models have been developed in elite football and the current IMI prognostic factor evidence is limited. This study aims to (1) develop and internally validate a prognostic model for individualised IMI risk prediction within a season in elite footballers, using the extent of the prognostic evidence and clinical reasoning; and (2) explore potential PHE-derived PFs associated with IMI outcomes in elite footballers, using available PHE data from a professional team.MethodsThis is a protocol for a retrospective cohort study. PHE and injury data were routinely collected over 5 seasons (1 July 2013 to 19 May 2018), from a population of elite male players aged 16-40 years old. Of 60 candidate PFs, 15 were excluded. Twelve variables (derived from 10 PFs) will be included in model development that were identified from a systematic review, missing data assessment, measurement reliability evaluation and clinical reasoning. A full multivariable logistic regression model will be fitted, to ensure adjustment before backward elimination. The performance and internal validation of the model will be assessed. The remaining 35 candidate PFs are eligible for further exploration, using univariable logistic regression to obtain unadjusted risk estimates. Exploratory PFs will also be incorporated into multivariable logistic regression models to determine risk estimates whilst adjusting for age, height and body weight.DiscussionThis study will offer insights into clinical usefulness of a model to predict IMI risk in elite football and highlight the practicalities of model development in this setting. Further exploration may identify other relevant PFs for future confirmatory studies and model updating, or influence future injury prevention research.

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Whole-Body Reactive Agility Metrics to Identify Football Players With a Core and Lower Extremity Injury Risk

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