Study protocol for a prospective cohort study identifying risk factors for sport injury in adolescent female football players: the Karolinska football Injury Cohort (KIC).
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ABSTRACT: Introduction
Football is a popular sport among young females worldwide, but studies concerning injuries in female players are scarce compared with male players. The aim of this study is to identify risk factors for injury in adolescent female football players.Methods and analysis
The Karolinska football Injury Cohort (KIC) is an ongoing longitudinal study that will include approximately 400 female football academy players 12-19 years old in Sweden. A detailed questionnaire regarding demographics, health status, lifestyle, stress, socioeconomic factors, psychosocial factors and various football-related factors are completed at baseline and after 1 year. Clinical tests measuring strength, mobility, neuromuscular control of the lower extremity, trunk and neck are carried out at baseline. Players are followed prospectively with weekly emails regarding exposure to football and other physical activity, health issues (such as stress, recovery, etc), pain, performance and injuries via the Oslo Sports Trauma Research Center Overuse Injury Questionnaire (OSTRC-O). Players who report a substantial injury in the OSTRC-O, that is, not being able to participate in football activities, or have reduced their training volume performance to a moderate or major degree, are contacted for full injury documentation. In addition to player data, academy coaches also complete a baseline questionnaire regarding coach experience and education.Ethics and dissemination
The study was approved by the Regional Ethical Review Authority at Karolinska Institutet, Stockholm, Sweden (2016/1251-31/4). All participating players and their legal guardians give their written informed consent. The study will be reported in accordance with the Strengthening the Reporting of Observational studies in Epidemiology. The results will be published in peer-reviewed academic journals and disseminated to the Swedish football movement through stakeholders and media.
SUBMITTER: Tranaeus U
PROVIDER: S-EPMC8756291 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:ObjectiveTo evaluate the effectiveness of neuromuscular training in reducing the rate of acute knee injury in adolescent female football players.DesignStratified cluster randomised controlled trial with clubs as the unit of randomisation.Setting230 Swedish football clubs (121 in the intervention group, 109 in the control group) were followed for one season (2009, seven months).Participants4564 players aged 12-17 years (2479 in the intervention group, 2085 in the control group) completed the study.Intervention15 minute neuromuscular warm-up programme (targeting core stability, balance, and proper knee alignment) to be carried out twice a week throughout the season.Main outcome measuresThe primary outcome was rate of anterior cruciate ligament injury; secondary outcomes were rates of severe knee injury (>4 weeks' absence) and any acute knee injury.ResultsSeven players (0.28%) in the intervention group, and 14 (0.67%) in the control group had an anterior cruciate ligament injury. By Cox regression analysis according to intention to treat, a 64% reduction in the rate of anterior cruciate ligament injury was seen in the intervention group (rate ratio 0.36, 95% confidence interval 0.15 to 0.85). The absolute rate difference was -0.07 (95% confidence interval -0.13 to 0.001) per 1000 playing hours in favour of the intervention group. No significant rate reductions were seen for secondary outcomes.ConclusionsA neuromuscular warm-up programme significantly reduced the rate of anterior cruciate ligament injury in adolescent female football players. However, the absolute rate difference did not reach statistical significance, possibly owing to the small number of events.Trial registrationClinical trials NCT00894595.
| S-EPMC3342926 | biostudies-literature
Project description:BackgroundA comprehensive examination of the sport-specific activities performed around the time of injury is important to hypothesise injury mechanisms, develop prevention strategies, improve management, and inform future investigations. The aim of this systematic review is to summarise the current literature describing the activities performed around the time of injury in football (soccer).MethodsA systematic search was carried out in PubMed, Web of Science, SPORTDiscus, and OpenGrey. Studies were included if participants were football players aged > 13 years old and the activities performed at the time of injury were reported together with the total number of injuries. Risk of bias was assessed using an adapted version of checklists developed for prevalence studies. The activities reported by the studies were grouped to account for inconsistent reporting, and the proportion of each injury activity was calculated. Data were not meta-analysed due to high heterogeneity of methods and classification criteria.ResultsWe included 64 studies reporting on 56,740 injuries in total. ACL injures were analysed by 12 studies, ankle/foot and knee injuries were analysed by five studies, thigh injuries were analysed by four studies, hip/groin injuries were analysed by three studies, and hamstring injuries were analysed by two studies. Five studies analysed more than one type of injury and 38 studies did not specify the type of injuries analysed. Running and kicking were the predominant activities leading to thigh and hamstring injuries. Changing direction and kicking were the predominant activities leading to hip and groin injuries and duels were the predominant activities leading to ankle injuries. Duels and pressing seem the predominant activities leading to ACL injuries, while results for other knee and general injuries were inconsistent.ConclusionsA qualitative summary of the activities performed at the time of injury has been reported. The results need to be interpreted carefully due to the risk of bias observed in the included studies. If we are to meaningfully progress our knowledge in this area, it is paramount that future research uses consistent methods to record and classify injuries and activities leading up to and performed at the time of injury.RegistrationThe protocol of this systematic review was registered at the Open Science Framework ( https://doi.org/10.17605/OSF.IO/U96KV ).
| S-EPMC9807506 | biostudies-literature
Project description:Concussions, both single and repetitive, cause brain and body alterations in athletes during contact sports. The role of the brain-gut connection and changes in the microbiota have not been well established after sports-related concussions or repetitive subconcussive impacts. We recruited 33 Division I Collegiate football players and collected blood, stool, and saliva samples at three time points throughout the athletic season: mid-season, following the last competitive game (post-season), and after a resting period in the off-season. Additional samples were collected from four athletes that suffered from a concussion. 16S rRNA sequencing of the gut microbiome revealed a decrease in abundance for two bacterial species, Eubacterium rectale, and Anaerostipes hadrus, after a diagnosed concussion. No significant differences were found regarding the salivary microbiome. Serum biomarker analysis shows an increase in GFAP blood levels in athletes during the competitive season. Additionally, S100β and SAA blood levels were positively correlated with the abundance of Eubacterium rectale species among the group of athletes that did not suffer a diagnosed concussion during the sports season. These findings provide initial evidence that detecting changes in the gut microbiome may help to improve concussion diagnosis following head injury.
| S-EPMC8914332 | biostudies-literature
Project description:Knee injuries in football are common regardless of age, gender or playing level, but adolescent females seem to have the highest risk. The consequences after severe knee injury, for example anterior cruciate ligament (ACL) injury, are well-known, but less is known about knee injury prevention. We have designed a cluster randomized controlled trial (RCT) to evaluate the effect of a warm-up program aimed at preventing acute knee injury in adolescent female football.In this cluster randomized trial 516 teams (309 clusters) in eight regional football districts in Sweden with female players aged 13-17 years were randomized into an intervention group (260 teams) or a control group (256 teams). The teams in the intervention group were instructed to do a structured warm-up program at two training sessions per week throughout the 2009 competitive season (April to October) and those in the control group were informed to train and play as usual. Sixty-eight sports physical therapists are assigned to the clubs to assist both groups in data collection and to examine the players' acute knee injuries during the study period. Three different forms are used in the trial: (1) baseline player data form collected at the start of the trial, (2) computer-based registration form collected every month, on which one of the coaches/team leaders documents individual player exposure, and (3) injury report form on which the study therapists report acute knee injuries resulting in time loss from training or match play. The primary outcome is the incidence of ACL injury and the secondary outcomes are the incidence of any acute knee injury (except contusion) and incidence of severe knee injury (defined as injury resulting in absence of more than 4 weeks). Outcome measures are assessed after the end of the 2009 season.Prevention of knee injury is beneficial for players, clubs, insurance companies, and society. If the warm-up program is proven to be effective in reducing the incidence of knee injury, it can have a major impact by reducing the future knee injury burden in female football as well as the negative long-term disabilities associated with knee injury.NCT00894595.
| S-EPMC2711921 | biostudies-literature
Project description:PURPOSE:To examine differences between men and women football players in clinically feasible jumping measures. METHODS:Female football players (N?=?46, ages 16-25) were matched based on age, training frequency, and playing position with 46 male players. All players performed the tuck jump and drop vertical jump (DVJ). DVJ was assessed quantitatively for valgus knee motion and probability of a high peak knee abduction moment (pKAM), as well as sagittal plane hip, knee, and ankle angles, and qualitatively with visual assessment of the player's knees upon landing; graded as good, reduced, or poor control. RESULT:Women had higher total tuck jump scores (5?±?2) (more technique flaws), than men (3?±?2, P?<?0.01). The quantitative analysis of the DVJ found that men had greater asymmetries between limbs, but women landed bilaterally in more knee valgus (interaction P?=?0.04, main effect of sex P?=?0.02). There was no difference in pKAM (interaction n.s.). Women also landed in less hip flexion (P?=?0.01) and ankle dorsiflexion (P?=?0.01) than men. The qualitative DVJ analysis found that more women (48%) had poor knee control compared to men (11%, P?<?0.01). CONCLUSIONS:The results indicate that women perform worse on the tuck jump assessment than men. The results support previous findings that women land in more knee valgus than men, but also found that men may have larger asymmetries in knee valgus. These results from clinically feasible measures provide some suggestions for clinicians to consider during ACL reconstruction rehabilitation to enhance performance.
| S-EPMC6994508 | biostudies-literature
Project description:PurposeTo describe the injury prevalence, injury pattern, and potential baseline risk factors for injuries in male and female adolescent and adult amateur football players.MethodsThis prospective study followed adolescent and adult amateur football players over one season March-October 2020. The study was completed by 462 players (130 men, age 20.0 ± 5.7, 14-46 years) who answered a baseline survey and a weekly web survey during the season. A total of 1456 weekly surveys were registered from males and 5041 from females. Injuries were recorded with the Oslo Sports Trauma Research Center Overuse Injury Questionnaire (OSTRC-O2). Potential baseline risk factors (age, performance of strength/conditioning training, participation in other sports, perceived importance of sporting success, self-rated training and match load, perceived balance between training/match load and recovery, previous/present injury at start of season, and injury beliefs) and their association with injury were analysed with Poisson regressions within each sex.ResultsMales reported 95 injuries (262 injury weeks, weekly prevalence 18.0% (95% CI 16.1-20.1)) and females 350 injuries (1206 injury weeks, weekly prevalence 23.9% (95% CI 22.8-25.1)). Gradual-onset injuries accounted for 57% of the injuries in males and 66% in females. For males, substantial injuries were most common in the hip/groin (weekly prevalence 3.8%), ankle (2.1%), posterior thigh (2.0%), and knee (2.0%); and for females, in the knee (4.3%), ankle (2.5%), and lower leg/Achilles tendon (2.0%). Significant risk factors for injury were higher age (rate ratio males 1.05 per year increase (95% CI 1.02-1.08), females 1.03 (95% CI 1.01-1.05)), and present injury at baseline (males 1.92 (95% CI 1.27-2.89), females 1.58 (95% CI 1.19-2.09)).ConclusionAt any given week, almost one in five male and one in four female amateur football players reported new or ongoing injuries. Hip/groin injuries were more frequent in males, while female players had a higher prevalence of knee injuries. Older players and those with an existing injury at the start of the season were more prone to new injury during the season. Rehabilitation of pre-season injury and complaints are key to reduce the injury burden in amateur football.Level of evidenceLevel II. Trial registration number NCT04272047, Clinical trials.
| S-EPMC10471640 | biostudies-literature
Project description:IntroductionSport-related concussion is one of the most common injuries in adolescent rugby players with evidence of prolonged recovery in some concussed athletes. Concussion is a complex pathophysiological process that can affect a variety of subsystems with multifactorial presentation. Most research on adolescents recovery after concussion focuses on neurocognitive functioning and symptom outcomes over the short term. There is a need to explore concussion recovery over time across multiple subsystems in adolescent rugby players.Methods and analysisThis prospective study will use sensorimotor and oculomotor outcomes in adolescent male and female rugby players aged 16-18 years. Players will be recruited from school or club rugby teams across the province of Ulster. Baseline assessment will be undertaken at the start of the playing season and will include questionnaires, Quantified Y Balance Test and Pupillary Light Reflex. Players who sustain a concussive event will be reassessed on all outcomes at 3 days, 7 days, 14 days, 23 days, 90 days, 180 days and 365 days postconcussion. For serial outcome data, we will examine response curves for each participant and make comparisons between known groups. We will use logistic regression to explore any association between demographic variables and recovery. The strength of the predictive model will be determined using R2, p values and ORs, with 95% CIs.Ethics and disseminationEthical approval has been granted for this study from Ulster University Research Ethics Committee (REC/14/0060). This study will be published in an open-access research journal on completion.Trial registration numberACTRN12622000931774p.
| S-EPMC10401252 | biostudies-literature
Project description:ImportancePilot studies that involved early imaging of the 18 kDa translocator protein (TSPO) using positron emission tomography (PET) indicated high levels of TSPO in the brains of active or former National Football League (NFL) players. If validated further in larger studies, those findings may have implications for athletes involved in collision sport.ObjectiveTo test for higher TSPO that marks brain injury and repair in a relatively large, unique cohort of former NFL players compared with former elite, noncollision sport athletes.Design, setting, and participantsThis cross-sectional study used carbon 11-labeled N,N-diethyl-2-(4-methoxyphenyl)-5,7-dimethylpyrazolo[1,5-a]pyrimidine-3-acetamide positron emission tomography ([11C]DPA-713 PET) data from former NFL players within 12 years of last participation in the NFL and elite noncollision sport athletes from across the US. Participants were enrolled between April 2018 and February 2023.Main outcomes and measuresRegional [11C]DPA-713 total distribution volume from [11C]DPA-713 PET that is a measure of regional brain TSPO; regional brain volumes on magnetic resonance imaging; neuropsychological performance, including attention, executive function, and memory domains.ResultsThis study included 27 former NFL players and 27 former elite, noncollision sport athletes. Regional TSPO levels were higher in former NFL players compared with former elite, noncollision sport athletes (unstandardized β coefficient, 1.08; SE, 0.22; 95% CI, 0.65 to 1.52; P < .001). The magnitude of the group difference depended on region, with largest group differences in TSPO in cingulate and frontal cortices as well as hippocampus. Compared with noncollision sport athletes, former NFL players performed worse in learning (mean difference [MD], -0.70; 95% CI, -1.14 to -0.25; P = .003) and memory (MD, -0.77; 95% CI, -1.24 to -0.30; P = .002), with no correlation between total gray matter TSPO and these cognitive domains.Conclusions and relevanceIn this cross-sectional study using [11C]DPA-713 PET, higher brain TSPO was found in former NFL players compared with noncollision sport athletes. This finding is consistent with neuroimmune activation even after cessation of NFL play. Future longitudinal [11C]DPA-713 PET and neuropsychological testing promises to inform whether neuroimmune-modulating therapy may be warranted.
| S-EPMC10616723 | biostudies-literature
Project description:This observational study aimed to analyze external training load in highly trained female football players, comparing starters and non-starters across various cycle lengths and training days.MethodExternal training load [duration, total distance [TD], high-speed running distance [HSRD], sprint distance [SpD], and acceleration- and deceleration distance [AccDecdist] from 100 female football players (22.3 ± 3.7 years of age) in the Norwegian premier division were collected over two seasons using STATSports APEX. This resulted in a final dataset totaling 10498 observations after multiple imputation of missing data. Microcycle length was categorized based on the number of days between matches (2 to 7 days apart), while training days were categorized relative to match day (MD, MD+1, MD+2, MD-5, MD-4, MD-3, MD-2, MD-1). Linear mixed modeling was used to assess differences between days, and starters vs. non-starters.ResultsIn longer cycle lengths (5-7 days between matches), the middle of the week (usually MD-4 or MD-3) consistently exhibited the highest external training load (~21-79% of MD TD, MD HSRD, MD SpD, and MD AccDecdist); though, with the exception of duration (~108-120% of MD duration), it remained lower than MD. External training load was lowest on MD+2 and MD-1 (~1-37% of MD TD, MD HSRD, MD SpD, MD AccDecdist, and ~73-88% of MD peak speed). Non-starters displayed higher loads (~137-400% of starter TD, HSRD, SpD, AccDecdist) on MD+2 in cycles with 3 to 7 days between matches, with non-significant differences (~76-116%) on other training days.ConclusionLoading patterns resemble a pyramid or skewed pyramid during longer cycle lengths (5-7 days), with higher training loads towards the middle compared to the start and the end of the cycle. Non-starters displayed slightly higher loads on MD+2, with no significant load differentiation from MD-5 onwards.
| S-EPMC10977714 | biostudies-literature
Project description:BackgroundRegular injury prevention training is not only effective in reducing sports injury rates, but also in improving neuromuscular and performance-related variables. However, it is currently unknown if this effect can be modified by varying the training dosage.ObjectiveTo compare the effects of two injury prevention programmes with a different training duration on neuromuscular control and functional performance in adolescent football players.Methods342 (15.4 ± 1.7 years) male football players from 18 teams were initially included. The teams were cluster-randomized into two intervention groups. Both groups performed an injury prevention program twice a week during one football season (10 months) using the same exercises but a different duration. One intervention group (INT10, n = 175) performed the program for 10 min, while the other intervention group (INT20, n = 167) for 20 min. At the beginning and end of the season, balance control (Balance Error Scoring System = BESS), jump performance (Squat Jump, Countermovement Jump) and flexibility (Sit and Reach Test, ankle flexibility, hip flexibility) tests were performed. For the final analysis, nine teams with 104 players were considered.ResultsSignificant group by time interactions were found for the sit and reach test (p < 0.001) and ankle flexibility (p < 0.001) with higher improvements in the INT20 group. Improvements over the period of one season but no group differences were found for the BESS, Squat Jump and hip flexibility.ConclusionWithin a single training session, performing structured neuromuscular training with a longer duration is more effective than a shorter duration for improving lower extremity flexibility.
| S-EPMC7593709 | biostudies-literature