| 1. |
- Atroshi, Isam, et al.
(författare)
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Costs for collagenase injections compared with fasciectomy in the treatment of Dupuytren's contracture: a retrospective cohort study
- 2014
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 4:1, s. 004166-004166
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To compare collagenase injections and surgery (fasciectomy) for Dupuytren's contracture (DC) regarding actual total direct treatment costs and short-term outcomes. Design: Retrospective cohort study. Setting: Orthopaedic department of a regional hospital in Sweden. Participants: Patients aged 65 years or older with previously untreated DC of 30 degrees or greater in the metacarpophalangeal (MCP) and/or proximal interphalangeal (PIP) joints of the small, ring or middle finger. The collagenase group comprised 16 consecutive patients treated during the first 6 months following the introduction of collagenase as treatment for DC at the study centre. The controls were 16 patients randomly selected among those operated on with fasciectomy at the same centre during the preceding 3 years. Interventions: Treatment with collagenase was given during two standard outpatient clinic visits (injection of 0.9 mg, distributed at multiple sites in a palpable cord, and next-day finger extension under local anaesthesia) followed by night-time splinting. Fasciectomy was carried out in the operating room (day surgery) under general or regional anaesthesia using standard technique, followed by therapy and splinting. Primary and secondary outcome measures: Actual total direct costs (salaries of all medical personnel involved in care, medications, materials and other relevant costs), and total MCP and PIP extension deficit (degrees) measured by hand therapists at 612 weeks after the treatment. Results: Collagenase injection required fewer hospital outpatient visits to a therapist and nurse than fasciectomy. Total treatment cost for collagenase injection was US$1418.04 and for fasciectomy US $2102.56. The post-treatment median (IQR) total extension deficit was 10 (0-30) for the collagenase group and 10 (0-34) for the fasciectomy group. Conclusions: Treatment of DC with one collagenase injection costs 33% less than fasciectomy with equivalent efficacy at 6 weeks regarding reduction in contracture.
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| 2. |
- Bengtsson, Hakan, et al.
(författare)
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Match Injury Rates in Professional Soccer Vary With Match Result, Match Venue, and Type of Competition
- 2013
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Ingår i: American Journal of Sports Medicine. - : SAGE Publications (UK and US): No SAGE Choice. - 0363-5465 .- 1552-3365. ; 41:7, s. 1505-1510
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Tidskriftsartikel (refereegranskat)abstract
- Background: Player activities in soccer matches are influenced by the match result and match venue. It is not known whether injury rates are influenced by these factors. Purpose: To investigate whether there are associations between injury rates and the match result, venue, and type of competition in male soccer. Study Design: Cohort study; Level of evidence, 3. Methods: Twenty-six professional clubs from 10 countries were followed prospectively during 9 seasons (2001-2002 to 2009-2010). All matches, and injuries occurring in these matches, were registered by the teams medical staff. An injury was registered if it resulted in player absence from training or matches. Information about match result, venue, and type of competition for all reported matches was gathered by the authors from online databases. Injury rates in matches with varying match characteristics were compared by use of generalized estimating equations. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Results: A total of 2738 injuries during 6010 matches were registered. There were no associations between odds of 1 injury occurrence and match result or type of competition, whereas the odds were decreased in matches played away compared with home matches (OR, 0.89; 95% CI, 0.80-0.99). The odds of 2 or more injury occurrences in a match were increased in matches resulting in a draw (OR, 1.39; 95% CI, 1.15-1.69) or loss (OR, 1.66; 95% CI, 1.38-1.98) compared with matches won and were decreased in other cup matches compared with league matches (OR, 0.57; 95% CI, 0.39-0.84) and in matches played away compared with home matches (OR, 0.70; 95% CI, 0.60-0.82). Finally, injuries with more than 1 weeks absence occurred more frequently in Champions League matches compared with league matches both for matches with 1 injury (OR, 1.26; 95% CI, 1.09-1.45) and matches with 2 or more injuries (OR, 1.57; 95% CI, 1.13-2.20). Conclusion: The odds of 2 or more injury occurrences in professional soccer were higher in matches resulting in a loss or a draw compared with a win, whereas the odds of injury occurrences were lower in matches played away compared with home matches. The rate of moderate and severe injuries increased with the importance of the match.
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| 3. |
- Ekstrand, Jan, et al.
(författare)
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Epidemiology of Muscle Injuries in Professional Football (Soccer)
- 2011
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Ingår i: American Journal of Sports Medicine. - : Sage. - 0363-5465 .- 1552-3365. ; 39:6, s. 1226-1232
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Tidskriftsartikel (refereegranskat)abstract
- Background: Muscle injuries constitute a large percentage of all injuries in football. Purpose: To investigate the incidence and nature of muscle injuries in male professional footballers. Study Design: Cohort study; Level of evidence, 2. Methods: Fifty-one football teams, comprising 2299 players, were followed prospectively during the years 2001 to 2009. Team medical staff recorded individual player exposure and time-loss injuries. The first-team squads of 24 clubs selected by the Union of European Football Associations as belonging to the best European teams, 15 teams of the Swedish First League, and another 15 European teams playing their home matches on artificial turf pitches were included. A muscle injury was defined as “a traumatic distraction or overuse injury to the muscle leading to a player being unable to fully participate in training or match play.” Results: In total, 2908 muscle injuries were registered. On average, a player sustained 0.6 muscle injuries per season. A squad of 25 players can thus expect about 15 muscle injuries per season. Muscle injuries constituted 31% of all injuries and caused 27% of the total injury absence. Ninety-two percent of all muscle injuries affected the 4 major muscle groups of the lower limbs: hamstrings (37%), adductors (23%), quadriceps (19%), and calf muscles (13%). Sixteen percent of the muscle injuries were reinjuries. These reinjuries caused significantly longer absences than did index injuries. The incidence of muscle injury increased with age. When separated into different muscle groups, however, an increased incidence with age was found only for calf muscle injuries and not for hamstring, quadriceps, or hip/groin strains. Conclusion: Muscle injuries are a substantial problem for players and their clubs. They constitute almost one third of all time-loss injuries in men’s professional football, and 92% of all injuries affect the 4 big muscle groups in the lower limbs.
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| 4. |
- Ekstrand, Jan, et al.
(författare)
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Fewer ligament injuries but no preventive effect on muscle injuries and severe injuries: an 11-year follow-up of the UEFA Champions League injury study
- 2013
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Ingår i: British Journal of Sports Medicine. - : BMJ Publishing Group. - 0306-3674 .- 1473-0480. ; 47:12, s. 732-
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Tidskriftsartikel (refereegranskat)abstract
- Background less thanbrgreater than less thanbrgreater thanLimited information is available on the variation in injury rates over multiple seasons of professional football. less thanbrgreater than less thanbrgreater thanAim less thanbrgreater than less thanbrgreater thanTo analyse time-trends in injury characteristics of male professional football players over 11 consecutive seasons. less thanbrgreater than less thanbrgreater thanMethods less thanbrgreater than less thanbrgreater thanA total of 1743 players comprising 27 teams from 10 countries were followed prospectively between 2001 and 2012. Team medical staff recorded individual player exposure and time loss injuries. less thanbrgreater than less thanbrgreater thanResults less thanbrgreater than less thanbrgreater thanA total of 8029 time loss injuries were recorded. The match unavailability due to injury was 14% and constant over the study period. On average, a player sustained two injuries per season, resulting in approximately 50 injuries per team and season. The ligament injury rate decreased during the study period (R-2=0.608, b=-0.040, 95% CI -0.065 to -0.016, p=0.005), whereas the rate of muscle injury (R-2=0.228, b=-0.013, 95% CI -0.032 to 0.005, p=0.138) and severe injury (R-2=0.141, b=0.015, 95% CI -0.013 to 0.043, p=0.255) did not change over the study period. In addition, no changes in injury rates over the 11-year period were found for either training (R-2=0.000, b=0.000, 95% CI -0.035 to 0.034, p=0.988) or match play (R-2=0.282, b=-0.015, 95% CI -0.032 to 0.003, p=0.093). less thanbrgreater than less thanbrgreater thanConclusions less thanbrgreater than less thanbrgreater thanThe injury rate has decreased for ligament injuries over the last 11years, but overall training, match injury rates and the rates of muscle injury and severe injury remain high.
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| 5. |
- Ekstrand, Jan, et al.
(författare)
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Hamstring muscle injuries in professional football: the correlation of MRI findings with return to play
- 2012
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Ingår i: British Journal of Sports Medicine. - : BMJ Publishing Group. - 0306-3674 .- 1473-0480. ; 46:2, s. 112-117
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Tidskriftsartikel (refereegranskat)abstract
- Background Hamstring injury is the single most common injury in professional football. MRI is commonly used to confirm the diagnosis and provide a prognosis of lay-off time. less thanbrgreater than less thanbrgreater thanObjective To evaluate the use of MRI as a prognostic tool for lay-off after hamstring injuries in professional football players and to study the association between MRI findings and injury circumstances. less thanbrgreater than less thanbrgreater thanMethods Prospective cohort study where 23 European professional teams, were followed between 2007 and 2011. Team medical staffs recorded individual player exposure and time-loss injuries. Radiological grading was performed using a modified Peetrons classification into four grades where grades 2 and 3 represent fibre disruption. less thanbrgreater than less thanbrgreater thanResults In total, 516 hamstring injuries occurred and 58% of these were examined by MRI. Thirteen per cent were grade 0 injuries, 57% grade 1, 27% of grade 2 and 3% of grade 3. Grade 0 and 1 injuries accounted for 56% (2141/3830 days) of the total lay-off. The layoff time differed between all four radiological grades of injury (8 +/- 3, 17 +/- 10, 22 +/- 11 and 73 +/- 60 days, p andlt; 0.0001). Eighty-three per cent of injuries affected the biceps femoris while 11% and 5% occurred to the semimembranosus and semitendinosus, respectively. Re-injuries (N=34/207) constituted 16% of injuries. All re-injuries occurred to the biceps femoris. less thanbrgreater than less thanbrgreater thanConclusion MRI can be helpful in verifying the diagnosis of a hamstring injury and to prognosticate layoff time. Radiological grading is associated with lay-off times after injury. Seventy per cent of hamstring injuries seen in professional football are of radiological grade 0 or 1, meaning no signs of fibre disruption on MRI, but still cause the majority of absence days.
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| 6. |
- Ekstrand, Jan, et al.
(författare)
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Injury incidence and injury patterns in professional football - the UEFA injury study
- 2011
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Ingår i: British journal of sports medicine. - : BMJ. - 1473-0480 .- 0306-3674. ; 45:7, s. 553-558
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To study the injury characteristics in professional football and to follow the variation of injury incidence during a match, during a season and over consecutive seasons. DESIGN: Prospective cohort study where teams were followed for seven consecutive seasons. Team medical staff recorded individual player exposure and time-loss injuries from 2001 to 2008. SETTING: European professional men's football. PARTICIPANTS: The first team squads of 23 teams selected by UEFA as belonging to the 50 best European teams. Main outcome measurement: Injury incidence. RESULTS: 4,483 injuries occurred during 566,000 hours of exposure, giving an injury incidence of 8.0 injuries/1,000 hours. The injury incidence during matches was higher than in training (27.5 v 4.1, p<0.0001). A player sustained on average 2.0 injuries per season and a team with typically 25 players can thus expect about 50 injuries each season. The single most common injury subtype was thigh strain, representing 17% of all injuries. Re-injuries constituted 12% of all injuries and they caused longer absences than non re-injuries (24 v 18 days, p<0.0001). The incidence of match injuries showed an increasing injury tendency over time in both the first and second halves (p<0.0001). Traumatic injuries and hamstring strains were more frequent during the competitive season, while overuse injuries were common during the pre-season. Training and match injury incidences were stable over the period with no significant differences between seasons. CONCLUSIONS: The training and match injury incidences were stable over seven seasons. The risk of injury increased with time in each half of matches.
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| 7. |
- Ekstrand, Jan, et al.
(författare)
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Upper extremity injuries in male elite football players
- 2013
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Ingår i: Knee Surgery, Sports Traumatology, Arthroscopy. - : Springer Verlag (Germany). - 0942-2056 .- 1433-7347. ; 21:7, s. 1626-1632
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Tidskriftsartikel (refereegranskat)abstract
- To investigate the epidemiology of upper extremity injuries in male elite football players and to describe their characteristics, incidence and lay-off times. less thanbrgreater than less thanbrgreater thanBetween 2001 and 2011, 57 male European elite football teams (2,914 players and 6,215 player seasons) were followed prospectively. Time-loss injuries and exposure to training and matches were recorded on individual basis. less thanbrgreater than less thanbrgreater thanIn total, 11,750 injuries were recorded, 355 (3 %) of those affected the upper extremities giving an incidence of 0.23 injuries/1,000 h of football. The incidence in match play was almost 7 times higher than in training (0.83 vs. 0.12 injuries/1,000 h, rate ratio 6.7, 95 % confidence interval 5.5-8.3). As much as 32 % of traumatic match injuries occurred as a result of foul play situations. Goalkeepers had a significantly higher incidence of upper extremity injuries compared to outfield players (0.80 vs. 0.16 injuries/1,000 h, rate ratio 5.0, 95 % confidence interval 4.0-6.2). The average absence due to an upper extremity injury was 23 +/- A 34 days. less thanbrgreater than less thanbrgreater thanUpper extremity injuries are uncommon among male elite football players. Goalkeepers, however, are prone to upper extremity injury, with a five times higher incidence compared to outfield players. less thanbrgreater than less thanbrgreater thanII.
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| 8. |
- Hägglund, Martin, et al.
(författare)
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Injuries affect team performance negatively in professional football : an 11-year follow-up of the UEFA Champions League injury study
- 2013
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Ingår i: British Journal of Sports Medicine. - : BMJ Publishing Group. - 0306-3674 .- 1473-0480. ; 47:12, s. 738-742
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Tidskriftsartikel (refereegranskat)abstract
- Background The influence of injuries on team performance in football has only been scarcely investigated.Aim To study the association between injury rates and team performance in the domestic league play, and in European cups, in male professional football.Methods 24 football teams from nine European countries were followed prospectively for 11 seasons (2001–2012), including 155 team-seasons. Individual training and match exposure and time-loss injuries were registered. To analyse the effect of injury rates on performance, a Generalised Estimating Equation was used to fit a linear regression on team-level data. Each team's season injury rate and performance were evaluated using its own preceding season data for comparison in the analyses.Results 7792 injuries were reported during 1 026 104 exposure hours. The total injury incidence was 7.7 injuries/1000 h, injury burden 130 injury days lost/1000 h and player match availability 86%. Lower injury burden (p=0.011) and higher match availability (p=0.031) were associated with higher final league ranking. Similarly, lower injury incidence (p=0.035), lower injury burden (p<0.001) and higher match availability (p<0.001) were associated with increased points per league match. Finally, lower injury burden (p=0.043) and higher match availability (p=0.048) were associated with an increase in the Union of European Football Association (UEFA) Season Club Coefficient, reflecting success in the UEFA Champions League or Europa League.Conclusions Injuries had a significant influence on performance in the league play and in European cups in male professional football. The findings stress the importance of injury prevention to increase a team's chances of success.
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| 9. |
- Hägglund, Martin, et al.
(författare)
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Risk Factors for Lower Extremity Muscle Injury in Professional Soccer : The UEFA Injury Study
- 2013
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Ingår i: American Journal of Sports Medicine. - : Sage Publications. - 0363-5465 .- 1552-3365. ; 41:2, s. 327-335
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Tidskriftsartikel (refereegranskat)abstract
- Background: Muscle injury is the most common injury type in professional soccer players. Despite this, risk factors for common lower extremity injuries remain elusive.Purpose: To evaluate the effects of various player- and match-related risk factors on the occurrence of lower extremity muscle injury in male professional soccer.Study Design: Cohort study; Level of evidence, 2.Methods: Between 2001 and 2010, 26 soccer clubs (1401 players) from 10 European countries participated in the study. Individual player exposure and time loss muscle injuries in the lower extremity were registered prospectively by the club medical staffs during 9 consecutive seasons. Hazard ratios (HRs) were calculated for player-related factors from simple and multiple Cox regression, and odds ratios (ORs) were calculated for match-related variables from simple and multiple logistic regression, presented with 95% confidence intervals (CIs).Results: There were 2123 muscle injuries documented in the major lower extremity muscle groups: adductors (n = 523), hamstrings (n = 900), quadriceps (n = 394), and calf (n = 306). Injuries to the adductors (56%; P = .015) and quadriceps (63%; P< .001) were more frequent in the kicking leg. Multiple analysis indicated that having a previous identical injury in the preceding season increased injury rates significantly for adductor (HR, 1.40; 95% CI, 1.00-1.96), hamstring (HR, 1.40; 95% CI, 1.12-1.75), quadriceps (HR, 3.10; 95% CI, 2.21-4.36), and calf injuries (HR, 2.33; 95% CI, 1.52-3.57). Older players (above mean age) had an almost 2-fold increased rate of calf injury (HR, 1.93; 95% CI, 1.38-2.71), but no association was found in other muscle groups. Goalkeepers had reduced injury rates in all 4 muscle groups. Match play on away ground was associated with reduced rates of adductor (OR, 0.56; 95% CI, 0.43-0.73) and hamstring injuries (OR, 0.76; 95% CI, 0.63-0.92). Quadriceps injuries were more frequent during preseason, whereas adductor, hamstring, and calf injury rates increased during the competitive season.Conclusion: Intrinsic factors found to increase muscle injury rates in professional soccer were previous injury, older age, and kicking leg. Injury rates varied during different parts of the season and also depending on match location.
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| 10. |
- Hägglund, Martin, et al.
(författare)
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Superior compliance with a neuromuscular training programme is associated with fewer ACL injuries and fewer acute knee injuries in female adolescent football players: secondary analysis of an RCT
- 2013
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Ingår i: British Journal of Sports Medicine. - : BMJ Publishing Group. - 0306-3674 .- 1473-0480. ; 47:15, s. 974-979
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Tidskriftsartikel (refereegranskat)abstract
- Background Little is known about the influence of compliance with neuromuscular training (NMT) on the knee injury rate in football.Aim To evaluate team and player compliance with an NMT programme in adolescent female football and to study the association between compliance and acute knee injury rates.Methods Prospective cohort study based on a cluster randomised controlled trial on players aged 12–17 years with 184 intervention teams (2471 players) and 157 control teams (2085 players). Exposure and acute time loss knee injuries were recorded. Team and player compliance was recorded by the coaches on a player attendance form. The intervention group was divided into tertiles of compliance. Injury rates were compared by calculating rate ratios (RRs) and 95% CIs using exact Poisson tests with the low-compliance tertile as reference. Seasonal compliance trends were analysed using linear regression.Results Players in the high-compliance tertile had an 88% reduction in the anterior cruciate ligament (ACL) injury rate (RR 0.12, 95% CI 0.01 to 0.85), whereas the rate in the control group players was not significantly different from those in the low-compliance tertile (RR 0.77, 95% CI 0.27 to 2.21). A significant deterioration occurred in team (b=−3.0% per month, 95% CI −5.2 to −0.8) and player (b=−5.0% per month, 95% CI −7.1 to −2.9) compliance over the season.Conclusions Players with high compliance with the NMT programme had significantly reduced ACL injury rate compared with players with low compliance. Significant deterioration in team and player compliance occurred over the season.
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| 11. |
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| 12. |
- Hägglund, Martin, et al.
(författare)
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VM ökar skaderisken
- 2014
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Ingår i: Svensk Idrottsforskning. - Stockholm : Centrum för idrottsforskning. - 1103-4629. ; :2, s. 6-9
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Tidskriftsartikel (refereegranskat)abstract
- Colombias Falcao är skadad och missar VM. Samma öde drabbade flera stjärnor redan före avresan till Brasilien. En hög skaderisk i mästerskap innebär sannolikt att fler får åka hem innan turneringen är över. Det visar 13 års erfarenhet av skadestudier inom europeisk toppfotboll. Sedan år 2001 har 27 olika fotbollslag från tio professionella ligor i Europa deltagit i den så kallade UEFA Elite Club Injury Study (2).Det medicinska teamet i varje lag, oftast läkare och fysioterapeuter, rapporterar på månadsbasis in tränings och matchtid för samtliga spelare i A-truppen samt information om de skador som har inträffat. För studien registreras de skador som skett i samband med träning eller match och som innebär att spelaren avbryter eller tvingas avstå från kommande träning eller match, så kallade frånvaroskador. Till dags dato har över 10 000 skador registrerats under drygt en miljon tränings- och matchtimmar. Det är troligen världens största skadedatabas inom elitfotboll.FaktaSedan år 2001 har Football Research Group i Linköping bedrivit skadestudier inom elitfotboll i samarbete med Europeiska fotbollförbundet (Uefa) och nationella förbund och organisationer, till exempel Svenska Fotbollförbundet och engelska Premier League (1). I ett temanummer om fotbollsmedicin i tidskriften British Journal of Sports Medicine i augusti 2013 presenterade gruppen flera studier från det pågående forskningsprojektet. Den här artikeln sammanfattar några av studierna och lärdomar som vi kan ta med oss under VM-slutspelet i Brasilien.
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| 13. |
- Johnson, Urban, 1961-, et al.
(författare)
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Towards removing performance barriers : Prediction of burnout in female elite soccer players
- 2013
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Ingår i: International Week of Sport Psychology FEPSAC. ; , s. 24-24
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Konferensbidrag (refereegranskat)abstract
- Based on the study by Stambulova and Johnson* from 2010 it is reported that applied sport psychology (ASP) literature reveals several publications on reflective practice and professional philosophies. Still, few studies focus how novice consultants make the first steps in their careers. The objective of this lecture is to discuss lessons learned by students during their one-year ASP education and supervised practice in Sweden. In total thirty-seven ASP students took part in the study. Information was gathered from the students' final reports on their six-month interventions with athlete clients. Four categories were created named professional tools, consultant & client relationship, learning process and experiences, and professional philosophy and organized into three levels reflecting the students' learning process with the shifts from analysis to synthesis and from concrete to more generalized and strategic lessons learned. In the lecture results are discussed using career development, scientist-practitioner and cultural sport psychology perspectives.
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| 14. |
- Kragh, Annika M, et al.
(författare)
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Bleeding and first-year mortality following hip fracture surgery and preoperative use of low-dose acetylsalicylic acid: an observational cohort study
- 2011
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Ingår i: BMC Musculoskeletal Disorders. - : BioMed Central. - 1471-2474. ; 12:254
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Tidskriftsartikel (refereegranskat)abstract
- Background: Hip fracture is associated with high mortality. Cardiovascular disease and other comorbidities requiring long-term anticoagulant medication are common in these mostly elderly patients. The objective of our observational cohort study of patients undergoing surgery for hip fracture was to study the association between preoperative use of low-dose acetylsalicylic acid (LdAA) and intraoperative blood loss, blood transfusion and first-year all-cause mortality. less thanbrgreater than less thanbrgreater thanMethods: An observational cohort study was conducted on patients with hip fracture (cervical requiring hemiarthroplasty or pertrochanteric or subtrochanteric requiring internal fixation) participating in a randomized trial that found lack of efficacy of a compression bandage in reducing postoperative bleeding. The participants were 255 patients (andgt;= 50 years) of whom 118 (46%) were using LdAA (defined as andlt;= 320 mg daily) preoperatively. Bleeding variables in patients with and without LdAA treatment at time of fracture were measured and blood transfusions given were compared using logistic regression. The association between first-year mortality and preoperative use of LdAA was analyzed with Cox regression adjusting for age, sex, type of fracture, baseline renal dysfunction and baseline cardiovascular and/or cerebrovascular disease. less thanbrgreater than less thanbrgreater thanResults: Blood transfusions were given postoperatively to 74 (62.7%) LdAA-treated and 76 (54%) non-treated patients; the adjusted odds ratio was 1.8 (95% CI 1.04 to 3.3). First-year mortality was significantly higher in LdAA-treated patients; the adjusted hazard ratio (HR) was 2.35 (95% CI 1.23 to 4.49). The mortality was also higher with baseline cardiovascular and/or cerebrovascular disease, adjusted HR 2.78 (95% CI 1.31 to 5.88). Patients treated with LdAA preoperatively were significantly more likely to suffer thromboembolic events (5.7% vs. 0.7%, P = 0.03). less thanbrgreater than less thanbrgreater thanConclusions: In patients with hip fracture (cervical treated with hemiarthroplasty or pertrochanteric or subtrochanteric treated with internal fixation) preoperative use of low-dose acetylsalicylic acid was associated with significantly increased need for postoperative blood transfusions and significantly higher all-cause mortality during one year after surgery.
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| 15. |
- Kristenson, Karolina, et al.
(författare)
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Lower Injury Rates for Newcomers to Professional Soccer : a Prospective Cohort Study over Nine Consecutive Seasons
- 2013
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Ingår i: American Journal of Sports Medicine. - : SAGE Publications. - 0363-5465 .- 1552-3365. ; 41:6, s. 1419-1425
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Tidskriftsartikel (refereegranskat)abstract
- Background: No study has investigated whether newcomers to professional soccer have a different injury rate than established players. Purpose: The primary objective was to investigate whether being a newcomer to professional soccer influences injury rates. The secondary objective was to evaluate whether playing position and player age influence injury rates. Study Design: Cohort study; Level of evidence, 2. Methods: Twenty-six soccer clubs, with 1401 players, were followed prospectively over 9 consecutive seasons between 2001 and 2010. Club medical staff recorded time-loss injuries and soccer exposure on an individual level. Cox regression analyses were used to evaluate associations between time-loss injuries and time in professional soccer, playing position, and age. Results: In total, 6140 injuries and 797,389 hours of exposure were registered. A decreased general injury rate was observed for newcomers (n = 116) compared with established players (n = 3091) (hazard ratio [HR], 0.77; 95% confidence interval [CI], 0.61-0.99). In contrast, newcomers had a higher rate of fractures (rate ratio [RR], 1.77; 95% CI, 1.05-2.97), especially stress-related bone injuries (RR, 2.68; 95% CI, 1.08-6.69). Using goalkeepers as a reference, all outfield playing positions had significantly higher adjusted injury rates: defenders with an HR of 1.91 (95% CI, 1.64-2.24), midfielders with an HR of 1.78 (95% CI, 1.53-2.07), and forwards with an HR of 1.82 (95% CI, 1.55-2.14). Using players aged ≤21 years as a reference, the overall adjusted injury rate increased with age, with a peak injury rate among players aged 29 to 30 years (HR, 1.44; 95% CI, 1.24-1.68). Conclusion: Newcomers to professional soccer had a lower general injury rate than established players but a higher rate of stress-related bone injuries. Being a goalkeeper was associated with lower injury rates than all outfield playing positions. Injury rates increased with age, a pattern that persisted after adjusting for playing position and match exposure.
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| 16. |
- Kristenson, Karolina, et al.
(författare)
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The Nordic Football Injury Audit : higher injury rates for professional football clubs with third-generation artificial turf at their home venue
- 2013
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Ingår i: British Journal of Sports Medicine. - : BMJ Publishing Group. - 0306-3674 .- 1473-0480. ; 47:12, s. 775-781
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Tidskriftsartikel (refereegranskat)abstract
- Background Previously, no difference in acute injury rate has been found when playing football on artificial turf (AT) compared with natural grass (NG).Aim To compare acute injury rates in professional football played on AT and NG at the individual player level; and to compare, at club level, acute and overuse injury rates between clubs that have AT at their home venue (AT clubs) and clubs that have NG (NG clubs).Methods 32 clubs (AT, n=11; NG, n=21) in the male Swedish and Norwegian premier leagues were followed prospectively during the 2010 and 2011 seasons. Injury rate was expressed as the number of time loss injuries/1000 h and compared with rate ratio (RR) and 99% CI.Results No statistically significant differences were found in acute injury rates on AT compared with NG during match play (RR 0.98, 99% CI 0.79 to 1.22) or training (RR 1.14, 99% CI 0.86 to 1.50) when analysing at the individual player level. When analysing at the club level, however, AT clubs had a significantly higher acute training injury rate (RR 1.31, 99% CI 1.04 to 1.63) and overuse injury rate (RR 1.38, 99% CI 1.14 to 1.65) compared with NG clubs.Conclusions At the individual player level, no significant differences were found in acute injury rates when playing on AT compared with NG. However, clubs with AT at their home venue had higher rates of acute training injuries and overuse injuries compared with clubs that played home matches on NG.
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| 17. |
- Lindblom, Hanna, et al.
(författare)
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Implementation of a neuromuscular training programme in female adolescent football : 3-year follow-up study after a randomised controlled trial
- 2014
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Ingår i: British Journal of Sports Medicine. - : B M J Group. - 0306-3674 .- 1473-0480. ; 48:19, s. 1425-1430
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Neuromuscular training (NMT) has been shown to reduce anterior cruciate ligament injury rates in highly structured clinical trials. However, there is a paucity of studies that evaluate implementation of NMT programmes in sports.AIM: To evaluate the implementation of an NMT programme in female adolescent football 3 years after a randomised controlled trial (RCT).METHODS: Cross-sectional follow-up after an RCT using the Reach, Effectiveness, Adoption, Implementation, and Maintenance Sports Setting Matrix (RE-AIM SSM) framework. Questionnaires were sent to the Swedish Football Association (FA), to eight district FAs and coaches (n=303) that participated in the RCT in 2009, and coaches who did not participate in the RCT but were coaching female adolescent football teams during the 2012 season (n=496).RESULTS: Response rates were 100% among the FAs, 57% among trial coaches and 36% among currently active coaches. The reach of the intervention was high, 99% of trial coaches (control group) and 91% of current coaches were familiar with the programme. The adoption rate was 74% among current coaches, but programme modifications were common among coaches. No district FA had formal policies regarding implementation, and 87% of current coaches reported no club routines for programme use. Maintenance was fairly high; 82% of trial coaches from the intervention group and 68% from the control group still used the programme.CONCLUSIONS: Reach and adoption of the programme was high among coaches. However, this study identified low programme fidelity and lack of formal policies for its implementation and use in clubs and district FAs.
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| 18. |
- Lindblom, Hanna, et al.
(författare)
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No effect on performance tests from a neuromuscular warm-up programme in youth female football: a randomised controlled trial
- 2012
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Ingår i: Knee Surgery, Sports Traumatology, Arthroscopy. - : Springer Verlag (Germany). - 0942-2056 .- 1433-7347. ; 20:10, s. 2116-2123
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Tidskriftsartikel (refereegranskat)abstract
- The objective of the present randomised controlled trial was to study the effect of a neuromuscular warm-up programme on performance tests in youth female football. less thanbrgreater than less thanbrgreater thanFour youth female football teams with players aged 12-16 years were randomised into an intervention group and control group. The intervention was a 15-min neuromuscular warm-up programme carried out twice a week during the 11-week study period. Baseline and follow-up measurements of performance were made indoors and included the star excursion balance test, a countermovement jump test, a triple-hop for distance test, a modified Illinois agility test, and 10- and 20-m sprint tests. less thanbrgreater than less thanbrgreater thanFifty-two players (intervention 28; control 24) took part in baseline measurements, and after dropout, 41 players (intervention 23; control 18) were included for analysis. Minor positive changes were seen in the control group compared to the intervention group for a sub-score of the star excursion balance test (P andlt; 0.05) and in the modified Illinois agility test (P andlt; 0.05). No improvement was seen in the intervention group from baseline to follow-up. less thanbrgreater than less thanbrgreater thanThe study showed that a neuromuscular warm-up programme carried out during 11 weeks did not improve performance in youth female football. This could indicate that the programme does not contain sufficient stimulus to improve performance. A low player attendance at training sessions, and low specificity between exercises in the warm-up programme and the evaluated performance tests may also contribute to the lack of effect. less thanbrgreater than less thanbrgreater thanI.
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| 19. |
- Lundblad, Matilda, et al.
(författare)
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The UEFA injury study: 11-year data concerning 346 MCL injuries and time to return to play
- 2013
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Ingår i: British Journal of Sports Medicine. - : BMJ Publishing Group. - 0306-3674 .- 1473-0480. ; 47:12, s. 759-
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Tidskriftsartikel (refereegranskat)abstract
- Background Medial collateral ligament (MCL) injury is the most common knee ligament injury in professional football. less thanbrgreater than less thanbrgreater thanAim To investigate the rate and circumstances of MCL injuries and development over the past decade. less thanbrgreater than less thanbrgreater thanMethods Prospective cohort study, in which 27 professional European teams were followed over 11 seasons (2001/2002 to 2011/2012). Team medical staffs recorded player exposure and time loss injuries. MCL injuries were classified into four severity categories. Injury rate was defined as the number of injuries per 1000 player-hours. less thanbrgreater than less thanbrgreater thanResults 346 MCL injuries occurred during 1057 201 h (rate 0.33/1000 h). The match injury rate was nine times higher than the training injury rate (1.31 vs 0.14/1000 h, rate ratio 9.3, 95% CI 7.5 to 11.6, pandlt;0.001). There was a significant average annual decrease of approximately 7% (p=0.023). The average lay-off was 23 days, and there was no difference in median lay-off between index injuries and reinjuries (18 vs 13, p=0.20). Almost 70% of all MCL injuries were contact-related, and there was no difference in median lay-off between contact and non-contact injuries (16 vs 16, p=0.74). less thanbrgreater than less thanbrgreater thanConclusions This largest series of MCL injuries in professional football suggests that the time loss from football for MCL injury is 23 days. Also, the MCL injury rate decreased significantly during the 11-year study period.
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| 20. |
- Nilsson, Michael, et al.
(författare)
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Head and Neck Injuries in Professional Soccer
- 2013
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Ingår i: Clinical Journal of Sports Medicine. - : Lippincott Williams & Wilkins. - 1050-642X .- 1536-3724. ; 23:4, s. 255-260
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate the rate of and risk factors for head and neck injury in male soccer.Design: Prospective cohort study.Setting: Professional soccer.Participants: Twenty-six European teams between 2001/2002 and 2009/2010.Assessment of Risk Factors: Simple and multiple risk factor analyses were evaluated using Cox regression for player-related variables and logistic regression for match-related variables.Main Outcome Measures: Injury rate (number of time loss injuries per 1000 hours).Results: A total of 136 head and neck injuries were recorded (2.2% of all injuries). The head and neck injury rate was 0.17 (0.06 concussions) per 1000 hours. There was a 20-fold higher rate of head and neck injury during match play compared with training (rate ratio [RR], 20.2; 95% confidence interval [CI], 13.3-30.6) and a 78-fold higher rate of concussions (RR, 78.5; 95% CI, 24.4-252.5). Mean layoff for concussion was 10.5 days, but 27% of the concussed players returned to play within 5 days. Defender was the only significant player-related risk factor for head and neck injuries in the multiple analysis (RR, 1.8; 95% CI, 1.0-3.1), whereas no significant variables were identified for concussions.Conclusions: Head and neck injuries were relatively uncommon in professional soccer. Defender was the playing position most at risk. More than one-quarter of the concussed players returned to play before what is recommended in the consensus statements by the major sports governing bodies.
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| 21. |
- Orchard, John W, et al.
(författare)
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Comparison of injury incidences between football teams playing in different climatic regions
- 2013
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Ingår i: Open Access Journal of Sports Medicine. - : Dove Medical Press. - 1179-1543. ; 4, s. 251-260
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Tidskriftsartikel (refereegranskat)abstract
- Australian Football League (AFL) teams in northern (warmer) areas generally have higher rates of injury than those in southern (cooler) areas. Conversely, in soccer (football) in Europe, teams in northern (cooler) areas have higher rates of injury than those in southern (warmer) areas, with an exception being knee anterior cruciate ligament (ACL) injuries, which are more common in the southern (warmer) parts of Europe. This study examined relative injury incidence in the AFL comparing 9,477 injuries over 229,827 player-weeks from 1999-2012. There was a slightly higher injury incidence for teams from warmer parts of Australia (relative risk [RR] 1.05, 95% confidence interval [CI] 1.01-1.10) with quadriceps strains (RR 1.32, 95% CI 1.10-1.58), knee cartilage injuries (RR 1.42, 95% CI 1.16-1.74), and ankle sprains (RR 1.17, 95% CI 1.00-1.37) all being more likely in warmer region teams. Achilles injuries followed a reverse pattern, tending to be more common in cooler region teams (RR 0.70, 95% CI 0.47-1.03). In conclusion, common findings from the AFL and European soccer are that ankle sprains and ACL injuries are generally more likely in teams playing in warmer climate zones, whereas Achilles tendinopathy may be more likely in teams playing in cooler zones. These injuries may have climate or surface risk factors (possibly related to types and structure of grass and shoe-surface traction) that are universal across different football codes.
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| 22. |
- Waldén, Markus, et al.
(författare)
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Anterior cruciate ligament injury in elite football : a prospective three-cohort study.
- 2011
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Ingår i: Knee Surgery, Sports Traumatology, Arthroscopy. - : Springer. - 0942-2056 .- 1433-7347. ; 19:1, s. 11-19
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Tidskriftsartikel (refereegranskat)abstract
- Anterior cruciate ligament (ACL) injury causes long lay-off time and is often complicated with subsequent new knee injury and osteoarthritis. Female gender is associated with an increased ACL injury risk, but few studies have adjusted for gender-related differences in age although female players are often younger when sustaining their ACL injury. The objective of this three-cohort study was to describe ACL injury characteristics in teams from the Swedish men's and women's first leagues and from several European men's professional first leagues. Over a varying number of seasons from 2001 to 2009, 57 clubs (2,329 players) were followed prospectively and during this period 78 ACL injuries occurred (five partial). Mean age at ACL injury was lower in women compared to men (20.6 ± 2.2 vs. 25.2 ± 4.5 years, P = 0.0002). Using a Cox regression, the female-to-male hazard ratio (HR) was 2.6 (95% CI 1.4-4.6) in all three cohorts studied and 2.6 (95% CI 1.3-5.3) in the Swedish cohorts; adjusted for age, the HR was reduced to 2.4 (95% CI 1.3-4.2) and 2.1 (95% CI 1.0-4.2), respectively. Match play was associated with a higher ACL injury risk with a match-to-training ratio of 20.8 (95% CI 12.4-34.8) and 45 ACL injuries (58%) occurred due to non-contact mechanisms. Hamstrings grafts were used more often in Sweden than in Europe (67 vs. 34%, P = 0.028), and there were no differences in time to return to play after ACL reconstruction between the cohorts or different grafts. In conclusion, this study showed that the ACL injury incidence in female elite footballers was more than doubled compared to their male counterparts, but also that they were significantly younger at ACL injury than males. These findings suggest that future preventive research primarily should address the young female football player.
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| 23. |
- Waldén, Markus, et al.
(författare)
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Prevention of acute knee injuries in adolescent female football players: cluster randomised controlled trial
- 2012
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Ingår i: The BMJ. - : BMJ Publishing Group: BMJ. - 1756-1833. ; 344
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Tidskriftsartikel (refereegranskat)abstract
- Objective To evaluate the effectiveness of neuromuscular training in reducing the rate of acute knee injury in adolescent female football players. less thanbrgreater than less thanbrgreater thanDesign Stratified cluster randomised controlled trial with clubs as the unit of randomisation. less thanbrgreater than less thanbrgreater thanSetting 230 Swedish football clubs (121 in the intervention group, 109 in the control group) were followed for one season (2009, seven months). less thanbrgreater than less thanbrgreater thanParticipants 4564 players aged 12-17 years (2479 in the intervention group, 2085 in the control group) completed the study. Intervention 15 minute neuromuscular warm-up programme (targeting core stability, balance, and proper knee alignment) to be carried out twice a week throughout the season. less thanbrgreater than less thanbrgreater thanMain outcome measures The primary outcome was rate of anterior cruciate ligament injury; secondary outcomes were rates of severe knee injury (andgt;4 weeks absence) and any acute knee injury. less thanbrgreater than less thanbrgreater thanResults Seven 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. less thanbrgreater than less thanbrgreater thanConclusions A 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.
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| 24. |
- Waldén, Markus, et al.
(författare)
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Regional differences in injury incidence in European professional football
- 2013
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Ingår i: Scandinavian Journal of Medicine and Science in Sports. - : Wiley-Blackwell. - 0905-7188 .- 1600-0838. ; 23:4, s. 424-430
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this study was to investigate regional differences in injury incidence in men's professional football in Europe. A nine-season prospective cohort study was carried out between 2001–2002 and 2009–2010 involving 1357 players in 25 teams from nine countries. Teams were categorized into different regions according to the Köppen–Geiger climate classification system. Teams from the northern parts of Europe (n = 20) had higher incidences of injury overall [rate ratio 1.12, 95% confidence interval (CI) 1.06 to 1.20], training injury (rate ratio 1.16, 95% CI 1.05 to 1.27), and severe injury (rate ratio 1.29, 95% CI 1.10 to 1.52), all statistically significant, compared to teams from more southern parts (n = 5). In contrast, the anterior cruciate ligament injury incidence was lower in the northern European teams with a statistically significant difference (rate ratio 0.43, 95% CI 0.25 to 0.77), especially for noncontact anterior cruciate ligament injury (rate ratio 0.19, 95% CI 0.09 to 0.39). In conclusion, this study suggests that there are regional differences in injury incidence of European professional football. However, further studies are needed to identify the underlying causes.
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| 25. |
- Waldén, Markus, et al.
(författare)
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Republished research: Prevention of acute knee injuries in adolescent female football players : cluster randomised controlled trial
- 2012
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Ingår i: British Journal of Sports Medicine. - : BMJ Publishing Group. - 0306-3674 .- 1473-0480. ; 46:13, s. 904-
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Tidskriftsartikel (refereegranskat)abstract
- Study question Does a neuromuscular warm-up programme reduce the rate of anterior cruciate ligament injury in adolescent female football players? Summary answer The neuromuscular warm-up programme reduced the overall rate of anterior cruciate ligament injury by 64%.What is known and what this paper adds Knee injuries are common in football regardless of the playing level, and adolescent female players are more susceptible to anterior cruciate ligament injury than their male counterparts. Almost two thirds of anterior cruciate ligament injuries in adolescent female football players can be prevented with a 15 minute neuromuscular warm-up programme.
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| 26. |
- Waldén, Markus, et al.
(författare)
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The epidemiology of anterior cruciate ligament injury in football (soccer) : a review of the literature from a gender-related perspective.
- 2011
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Ingår i: Knee Surgery, Sports Traumatology, Arthroscopy. - : Springer. - 0942-2056 .- 1433-7347. ; 19:1, s. 3-10
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Forskningsöversikt (refereegranskat)abstract
- Football (soccer), the most popular sport worldwide, is associated with a high injury risk, and the knee joint is often affected. Several studies have found female players to be more susceptible to knee injury, anterior cruciate ligament (ACL) injury in particular, compared to their male counterparts. There is, however, some controversy regarding the magnitude of this risk increase and a few studies have found no differences. The influence of age and activity type on gender-related differences in injury risk is only scarcely investigated. In this paper, the literature reporting gender-specific ACL injury risk in football is reviewed. A literature search yielded 33 relevant articles that were included for review. These show that female players have a 2-3 times higher ACL injury risk compared to their male counterparts. Females also tend to sustain their ACL injury at a younger age than males, and a limiting factor in the existing literature is that age is not adjusted for in comparisons of ACL injury risk between genders. Furthermore, the risk increase in females is primarily evident during match play, but type of exposure is also rarely adjusted for. Finally, the studies included in this review share important methodological limitations that are discussed as a starting point for future research in the field.
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| 27. |
- Waldén, Markus, et al.
(författare)
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Time-trends and circumstances surrounding ankle injuries in men's professional football : an 11-year follow-up of the UEFA Champions League injury study
- 2013
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Ingår i: British Journal of Sports Medicine. - : BMJ Publishing Group. - 0306-3674 .- 1473-0480. ; 47:12, s. 748-753
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Tidskriftsartikel (refereegranskat)abstract
- Background Ankle injury is common in football, but the circumstances surrounding them are not well characterised.Aim To investigate the rates, especially time-trends, and circumstances of ankle injuries in male professional football.Methods 27 European clubs with 1743 players were followed prospectively between 2001/2002 and 2011/2012. Time loss injuries and individual-player exposure during training sessions and matches were recorded. Injury rate was defined as the number of injuries/1000 h.Results A total of 1080 ankle injuries were recorded (13% of all injuries) with lateral ligament ankle sprain being the most common injury subtype (51% of all ankle injuries). The rates of ankle injury and ankle sprain were 1/1000 h and 0.7/1000 h, respectively. The ankle sprain rate declined slightly over time during the 11-year study period (on average 3.1%/season) with a statistically significant seasonal trend (p=0.041). Foul play according to the referee was involved in 40% of the match-related ankle sprains. Syndesmotic sprains and ankle impingement were uncommon causes of time loss (3% each of all ankle injuries).Conclusions Lateral ligament ankle sprain constituted half of all ankle injuries in male professional football, whereas ankle impingement syndromes were uncommon. The ankle sprain rate decreased slightly over time, but many ankle sprains were associated with foul play. Our data extend the body of literature that provides football policy makers with a foundation to review existing rules and their enforcement.
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