Maarten Barendrecht

Background. Injury risk is high in Physical Education Teacher Education (PETE) students. Insights into specific injury locations per sex, setting, sports, and curriculum year are needed to develop preventive measures. Purpose. To compare injury distributions by body locations in PETE students and how these distributions differ by sex, type, onset, curriculum year, settings, or sports. Methods. In a historical cohort study over 14 years, data from 2899 students (male 76.2%, n = 1947) enlisted in the first three years of a PETE curriculum were analysed. Injuries reported at the institution's medical facility were categorised per sex, body location, onset, type, setting, sports, and curriculum year. Results. Forty-three percent (n = 1247) of all students (female 54.9%, n = 523, male 37.2%, and n = 429) reported a total of 2129 injuries (freshmen 56.4%; 2nd year 28.2%; 3rd year 15.5%). The most prevalent sudden onset injury locations (63.4% of all injuries) were the ankle (32.5%) and knee (16.6). The most prevalent gradual onset injuries were the lower leg (27.8%) and knee (25.2%). Joint/ligament injuries (45.8%) and muscle/tendon injuries (23.4%) were the most prevalent injury types. Proportions for injury locations and injury types differed significantly between curriculum years. Injury prevalence per setting and sport differed significantly between the sexes. Injury locations differed significantly between sports and between the sexes per sport. Conclusion. A differential approach per injury location, onset, type, sex, setting, sports, and curriculum year is needed to develop adequate preventive measures in PETE studies. The engagement of precurricular, intracurricular, and extracurricular stakeholders is needed in the development of these measures.

Objectives: To investigate the influence of sports/activity types and their distribution over the curriculum years on intracurricular injury risk differences between curriculum years and sexes in Physical Education Teacher Education (PETE) studies. Methods: In a cohort study over 14 years (2000–2014), injuries reported at the medical facility of a Dutch vocational institute by PETE students who completed their full curriculum were registered. Intracurricular injury rates (IR) per 1000 hours and 95% CIs were calculated per sport, sex and curriculum year and compared with injury rate ratios (RR) and 95% CI. Exposure times per sports category per curriculum year were compared with the χ² test. Results: Intracurricular IR was highest for gymnastics, team ball sports and track and field (0.76–1.23, 95% CI 0.65 to 1.45). IRs were higher for female compared with male students (RR 2.38, 95% CI 1.97 to 2.87). Comparisons for all individual sports and for all three curriculum years showed the same pattern. IR for the first year was higher than for the second (RR 1.79, 95% CI 1.45 to 2.21) and third year (RR 2.74, 95% CI 2.13 to 3.54) with similar patterns for all sports categories. Over the curriculum years, exposure time distributions per sport showed small differences (p<0.001, Cramer’s V=0.07). Conclusion: Curriculum year, sex and sports types are risk factors to be independently targeted for preventive and rehabilitative measures in PETE studies. The nature and aetiology of injuries in mixed sports, and the adaption to increased loads in first-year and female PETE students, need further investigation.

Background: Basketball is played by the youth worldwide, and various injuries occur in youth basketball. There is currently no overview of the incidence, the risk factors and preventive measures of musculoskeletal injuries among youth basketball players. Objective: This systematic review describes the most common injuries among youth basketball players. The most common risk factors and various preventive measures and interventions have also been reported and discussed. Methods: Search strategies were built based on groups of keywords, namely ‘injury’, ‘youth basketball’, and ‘cohort’. Search strategies were entered into Medline and SPORTDiscus. Titles, abstracts and full text articles were screened by two researchers. Data from the included articles were extracted by one researcher and checked by another researcher. Results: Twenty-seven studies showed that the overall injury rate ranged from 2.64 to 3.83 per 1 000 hours of exposure. Ankle- (22%-37%) and knee injuries (5%-41%) were the most common injuries. Risk factors for knee injuries included ankle dorsiflexion with a range less than 36.5 degrees and female athletes with greater hip abduction strength. High variations of postural sway corresponded to occurrences of ankle injuries (p=0.01, OR =1.22; p<0.001, OR =1.22). A core intervention (rate = 4.99/1 000 athlete exposure (AEs)) focused on the trunk and lower extremity led to a reduction in injuries compared to a sham intervention (rate =7.72/1 000 AEs) (p=0.02). Wearing a McDavid Ultralight 195 brace reduced ankle injuries compared to the controls (HR 0.30; 95 % CI 0.17 0.90; p=0.03). Conclusion: Ankle and knee injuries are the most common injuries among youth basketball players. Poor postural control, reduced ankle dorsiflexion and high hip abduction strength are the main risk factors. A neuromuscular warm-up, in combination with strength and stability exercises, seems to be the best training method to prevent injuries. Ankle injuries can be reduced by wearing a lace-up ankle brace.

The aim of this study was to determine sport‐related injury mechanisms in physical education teacher education (PETE) students. This prospective cohort study (40 weeks) in first‐year PETE students obtained self‐reported characteristics of injuries (body part, injury setting, injury mechanism, and movements related to the cause of injury). Students (N = 759) from the academic years of 2015‐2016, 2016‐2017, and 2017‐2018 participated in this study. Descriptive data analysis was conducted on the injury characteristics. In total, 896 injuries were registered by 489 (64%) students. Large proportions of the injuries resulted from both non‐contact (N = 496, 56%) and contact (N = 381, 42%) mechanisms. The most common injury mechanism was gradual onset non‐contact (N = 275, 31%). High proportions of non‐contact injuries were found in curricular practices (N = 120, 44%) and extra‐curricular practices (N = 30, 38%). Injuries during extra‐curricular games were mainly contact related (N = 133, 81%). Furthermore, injury onset was most commonly associated with a landing (N = 179, 29%), a fall (N = 158, 25%), and an explosive movement (N = 114, 18%). The most common injury mechanism was gradual onset non‐contact. For practices (curricular and extra‐curricular) and extra‐curricular games, the most common injury mechanism was, respectively, non‐contact and contact with an person. Furthermore, injuries were most commonly associated with landings, falls, and explosive movements.

Aim: Study concurrent validity of a new sensor-based 3D motion capture (MoCap) tool to register knee, hip and spine joint angles during the single leg squat. Design: Cross-sectional. Setting: University laboratory. Participants: Forty-four physically active (Tegner ≥ 5) subjects (age 22.8 (±3.3)) Main outcome measures: Sagittal and frontal plane trunk, hip and knee angles at peak knee flexion. The sensor-based system consisted of 4 active (triaxial accelerometric, gyroscopic and geomagnetic) sensors wirelessly connected with an iPad. A conventional passive tracking 3D MoCap (OptiTrack) system served as gold standard. Results: All sagittal plane measurement correlations observed were very strong for the knee and hip (r = 0.929–0.988, p < 0.001). For sagittal plane spine assessment, the correlations were moderate (r = 0.708–0.728, p < 0.001). Frontal plane measurement correlations were moderate in size for the hip (ρ = 0.646–0.818, p < 0.001) and spine (ρ = 0.613–0.827, p < 0.001). Conclusions: The 3-D MoCap tool has good to excellent criterion validity for sagittal and frontal plane angles occurring in the knee, hip and spine during the single leg squat. This allows bringing this type of easily accessible MoCap technology outside laboratory settings.

The relationship between injury risk (IR) in age groups and periods around peak height velocity (PHV) remains unclear. PHV is defined as the moment of the largest increase in body height. To investigate injury risk and injury burden as functions of growth velocity (periods around PHV) and chronological age groupings (under 12 years [U12] to U19) in talented youth male soccer players. Cohort study; Level of evidence, 2. A total of 170 players from the youth academy of a Dutch soccer club (highest professional league: Eredivisie) were observed for 1 to 3 seasons. Injuries, exposure, PHV age, and chronological age were registered. The injury incidence density (IID) and injury burden per 1000 hours of soccer participation, with 95% CIs, were calculated for 5 PHV periods and 7 age groups. These were compared with the overall cohort results using incidence ratios (IRs) and burden ratios (BRs) with 95% CIs. The mean age at PHV was 14.4 ± 0.65 years (range, 12.8-16.5 years). The mean IID for the total cohort was 8.34 injuries per 1000 hours (95% CI, 7.71-9.02). Compared with the overall mean, a significantly higher IID was found for PHV period 4+5 (IR, 1.31 [95% CI, 1.00-1.71]; P = .049) and for the U15 group (IR, 1.49 [95% CI, 1.24-1.79]; P < .001). The overall injury burden was 58.37 injury days per 1000 hours (95% CI, 56.66-60.13). In PHV period 4+5, the injury burden was significantly higher (BR, 1.53 [95% CI, 1.39-1.68]; P < .001) when compared with the overall mean. Also, compared with the overall mean, the injury burden was higher in the U16 (BR, 1.48 [95% CI, 1.39-1.58]; P < .001), U15 (BR, 1.28 [95% CI, 1.19-1.38]; P < .001), and U17 groups (BR, 1.21 [95% CI, 1.13-1.31]; P < .001). Talented young soccer players were more prone to injuries during the 6 months after PHV (31% above overall mean) as well as in the U15 group (49% above overall mean). Based on the higher injury burden in the U16 (48%), U15 (28%), and U17 (21%) groups, we suggest that research on injury risk factors and preventive measures should primarily target these age groups. Additional interventions based on PHV may be of limited value from a screening perspective. Further research is needed on the interaction between age groups and PHV periods.

Objectives: To study the clinical course including return to sport success rates of football players with adductor-related groin pain (ARGP) after manual therapy of the adductor muscles. Design: Prospective case series. Methods: Thirty-four football players with ARGP with median pre-injury Tegner scores of 9 (IQR 25–75: 9–9) were treated with manual therapy of the adductor muscles. Main outcome measures were numeric pain rating scale (NPRS), Hip and Groin Outcome Score (HAGOS) and global perceived effect (GPE) for treatment and patient satisfaction at 2, 6 and 12 weeks. Return to sport was documented. Results: Pain during (NPRS 7 (6–8) and after (NPRS 8 (6–8) sports decreased to NPRS 1 (0.2–3) and 1 (0.8–3), respectively (p < 0.001). Within 2 weeks 82% of the players returned to pre-injury playing levels with improved (p < 0.001) HAGOS subscale scores. Eighty-five percent reported clinically relevant improvement, 82% reported to be satisfied. At 12 weeks, 88% had returned to pre-injury playing levels. HAGOS showed symptoms were still present. Conclusion: Early return to sport seems possible and safe after manual therapy of the adductor muscles in football players with ARGP in the short term. While the majority of injured football players return to sport within two weeks, caution is advised regarding effectiveness as hip and groin symptoms were still present and no control groups were available.