| 1. |
- Filbay, Stephanie R., et al.
(author)
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The Swedish version of the Anterior Cruciate Ligament Quality Of Life measure (ACL-QOL) : translation and measurement properties
- 2023
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In: Quality of Life Research. - : Springer. - 0962-9343 .- 1573-2649. ; 32:2, s. 593-604
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Journal article (peer-reviewed)abstract
- Purpose To translate the ACL-QOL from English to Swedish and evaluate measurement properties for use after surgical and non-surgical management of anterior cruciate ligament (ACL) injury. Methods The ACL-QOL was translated from English to Swedish and data were pooled from 13 cohorts to enable a comprehensive evaluation of measurement properties in line with COSMIN guidelines. We evaluated internal consistency, test-re-test reliability, measurement error, structural validity [confirmatory factor analysis (CFA)], construct validity and responsiveness (hypothesis testing), and floor/ceiling effects. Results were stratified by time since injury (<= 1.5 years; 2-10 years, 15-25 years; > 30 years) and ACL management strategy [surgical (n = 1163), non-surgical (n = 570)]. Results The Swedish ACL-QOL had sufficient internal consistency (total and domain scores) for use in surgically managed (Cronbachs alpha >= 0.744) and non-surgically managed (>= 0.770) ACL-injured individuals at all time-points. Test-re-test reliability was sufficient [intraclass correlation coefficients: all domains > 0.80, total score 0.93 (95% CI 0.86-0.96)]. The standard error of measurement was 5.6 for the total score and ranged from 7.0 to 10.3 for each domain. CFA indicated sufficient SRMR values when using the total score or five domains; however, CFI and RMSEA values did not meet cut-offs for good model fit. Hypothesis testing indicated sufficient construct validity and responsiveness. Floor effects were negligible and ceiling effects were negligible or minor. Conclusion The Swedish version of the ACL-QOL has sufficient internal consistency, test-re-test reliability, construct validity and responsiveness, for use in people with ACL injury managed with or without ACL surgery. Model fit could be improved and investigation into the source of misfit is warranted.
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| 2. |
- Lindblom, Hanna, 1984-, et al.
(author)
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Extended Knee Control programme lowers weekly hamstring, knee and ankle injury prevalence compared with an adductor strength programme or self-selected injury prevention exercises in adolescent and adult amateur football players : a two-armed cluster-randomised trial with an additional comparison arm
- 2023
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In: British Journal of Sports Medicine. - : BMJ Publishing Group. - 0306-3674 .- 1473-0480. ; 57:2, s. 83-90
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Journal article (peer-reviewed)abstract
- Objective To evaluate the preventive efficacy of an extended version of the Knee Control injury prevention exercise programme (IPEP) compared with an adductor strength programme and to a comparison group using a self-selected IPEP in amateur adolescent and adult male and female football players. Methods Two-armed cluster-randomised trial with an additional non-randomised arm. All 251 amateur teams (players 14-46 years) in one regional football district were approached. Teams meeting inclusion criteria were randomised to (1) extended Knee Control or (2) an adductor strength programme. Teams already using an IPEP were allocated to a comparison group and received no new intervention. Players responded to weekly questionnaires about football exposures and injuries during a 7-month season. Results Seventeen teams in the extended Knee Control, 12 in the adductor and 17 in the comparison group participated, with 502 players. For the primary outcomes, no difference in injury incidence in three lower-limb injury locations combined (hamstring, knee and ankle) was seen between extended Knee Control and the adductor group, whereas extended Knee Control had 29% lower incidence than the comparison group (incidence rate ratio 0.71, 95% CI 0.52 to 0.98). No between-group differences in groin injury incidence were seen. The weekly injury prevalence rates in the three lower limb locations combined (hamstring, knee and ankle) were 17% lower (prevalence rate ratio (PRR) 0.83, 95% CI 0.69 to 1.00) and 26% lower (PRR 0.74, 95% CI 0.63 to 0.87) in extended Knee Control compared with the adductor and comparison groups, respectively. Conclusion No difference in injury incidence was seen between the extended Knee Control and the adductor programme whereas extended Knee Control reduced injury incidence by nearly one-third compared with a self-selected IPEP. Players in extended Knee Control had lower injury prevalence compared with an adductor or self-selected IPEP.
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| 3. |
- Lindblom, Hanna, et al.
(author)
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Implementation of the injury prevention exercise programme Knee Control plus : a cross-sectional study after dissemination efforts within a football district
- 2023
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In: Injury Prevention. - : BMJ PUBLISHING GROUP. - 1353-8047 .- 1475-5785. ; 29:5, s. 399-406
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Journal article (peer-reviewed)abstract
- BackgroundThe Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework can be used for evaluation of implementation initiatives in sports injury prevention. The aim was to evaluate the implementation of the injury prevention exercise programme Knee Control+ among amateur clubs and coaches in one regional football district using all five dimensions of the RE-AIM framework. MethodsDissemination of Knee Control+ during the 2021 season with information and webinars within one regional football district. This was followed by a cross-sectional study with questionnaires to club personnel and coaches after the season. ResultsThe reach of Knee Control+ was fair to high, 83% of club personnel and 66% of coaches knew about the programme. 41% of club personnel and 51% of coaches had adopted it. Perceived programme effectiveness was high (6 on a 1-7 Likert scale) among coaches. Regarding implementation and maintenance, 27% of club personnel had informed coaches about Knee Control+ and 57% planned to inform coaches. The coaches had implemented the programme mainly as recommended, but half used the programme once per week or less. Intention to maintain use of the programme was high (7 on a 1-7 Likert scale) among coaches. ConclusionThe reach of Knee Control+ was fair to high, and adoption was fair in clubs, but there was a lack of policies for preventive training. Active strategies probably need to accompany dissemination of programme material. Reach, perceived effectiveness, adoption, implementation and planned maintenance were positive among coaches, but further studies are needed to analyse long-term maintenance.
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| 4. |
- Lindblom, Hanna, et al.
(author)
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Intra- and interrater reliability of subjective assessment of the drop vertical jump and tuck jump in youth athletes
- 2021
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In: Physical Therapy in Sport. - : CHURCHILL LIVINGSTONE. - 1466-853X .- 1873-1600. ; 47, s. 156-164
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Journal article (peer-reviewed)abstract
- Objectives: To investigate intra- and interrater reliability of the subjective assessments of filmed DVJ and TJA in youth male and female soccer players and to compare subjective assessment of the DVJ with two-dimensional movement analysis. Design: Cross-sectional study. Participants: 115 soccer players (66 boys, 49 girls) mean age 14 +/- 1 (range 13-16) years. Main outcome measures: Knee control during landing phase of DVJ was assessed using a 3-graded scoring scale. TJA was assessed according to ten criteria using a dichotomous grading scale. Subjective assessment of DVJ was compared with calculation of normalized knee separation distance (NKSD). Results: Intrarater reliability for DVJ was substantial to almost perfect (kappa 0.72 rater 1; 0.85 rater 2). Interrater reliability was substantial to almost perfect (kappa from 0.68 to 0.83). The TJA total score intrarater reliability was ICC 0.59 for rater 1 and 0.90 for rater 2. Interrater reliability ranged from ICC 0.51 to 0.60. There were between-group differences in mean NKSD during DVJ for players rated as 0, 1 and 2, but within-group variability was large. Conclusion: Assessment of DVJ and TJA in youth athletes was rater dependent. Players with subjectively assessed reduced or poor knee control had smaller normalized knee separation distance in DVJ. (C) 2020 The Authors. Published by Elsevier Ltd.
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| 5. |
- Perera, Nirmala, et al.
(author)
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Illness prevalence and symptoms in youth floorball players : a one-season prospective cohort study involving 471 players
- 2021
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In: BMJ Open. - : BMJ Publishing Group. - 2044-6055. ; 11:12
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Journal article (peer-reviewed)abstract
- Objective To describe weekly illness prevalence and illness symptoms by sex in youth floorball players during one season. Design Prospective cohort study. Setting Players who were registered to play community level floorball during the 2017-2018 season (26 weeks) in two provinces in southern Sweden. Participants 471 youth players aged 12-17 years. Mean (SD) age for 329 male players 13.3 (1.0) years and 142 female players 13.7 (1.5) years. Primary and secondary outcome measures Weekly self-reported illness prevalence and illness symptoms according to the 2020 International Olympic Committees consensus recommendations. Results 61% of youth floorball players reported at least one illness week during the season, with an average weekly illness prevalence of 12% (95% Cl 10.8% to 12.3%). The prevalence was slightly higher among females (13%, 95% CI 11.6% to 14.3%) than males (11%, 95% Cl 9.9% to 11.7%), prevalence rate ratio 1.20 (95% CI 1.05 to 1.37, p=0.009). In total, 49% (53% male, 43% female) of illness reports indicated that the player could not participate in floorball (time loss), with a mean (SD) absence of 2.0 (1.7) days per illness week. Fever (30%), sore throat (16%) and cough (14%) were the most common symptoms. Female players more often reported difficulty in breathing/tight airways and fainting, and male players more often reported coughing, feeling tired/ feverish and headache. Illness prevalence was highest in the peak winter months (late January/February) reaching 15%-18% during this period. Conclusions Our novel findings of the illness prevalence and symptoms in youth floorball may help direct prevention strategies. Athletes, coaches, parents and support personnel need to be educated about risk mitigation strategies.
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| 6. |
- Sonesson (fd Tagesson), Sofi, 1977-, et al.
(author)
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Rehabilitation after ACL injury and reconstruction from the patients perspective
- 2022
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In: Physical Therapy in Sport. - : Elsevier. - 1466-853X .- 1873-1600. ; 53, s. 158-165
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Journal article (peer-reviewed)abstract
- Objectives: To describe and compare patients appraisal of the rehabilitation and adherence to the rehabilitation program after acute ACL injury treated with (ACLR) or without (non-ACLR) reconstruction.Design: Prospective cohort study.Participants: 275 patients (143 females; mean age 25 +/- 7 years) with acute ACL injury, of whom 166 patients had ACLR within 24 months.Main outcome: Adherence to rehabilitation was assessed using the modified Sports Injury Rehabilitation Adherence Scale (SIRAS).Results: Appraisal of rehabilitation was higher in the post-ACLR group compared to the non-ACLR group at 3 months (91% compared to 70% scored rehabilitation as necessary, p = 0.025) and at 6 months (87% compared to 70% scored it as necessary, p = 0.017). SIRAS score did not differ between 3 and 6 months for the non-ACLR group (median (IQR) 13 (2) vs 13 (2)) or the post-ACLR group (14 (1) vs 14 (2), p>0.05). The post-ACLR group had a higher SIRAS score than the non-ACLR group at 3 and 6 months (p ≤0.001).Conclusion: Patients treated with ACLR reported valuing their rehabilitation more and rated greater adherence to the rehabilitation programme than non-surgically treated patients. As rehabilitation is essential for good knee function, strategies to improve adherence after non-ACLR treatment should be implemented.
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| 7. |
- Sonesson, Sofi, 1977-, et al.
(author)
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Accelerometer-assessed physical activity patterns during the first two years after a non-surgically treated ACL injury
- 2023
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In: Physical Therapy in Sport. - : CHURCHILL LIVINGSTONE. - 1466-853X .- 1873-1600. ; 64, s. 123-132
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Journal article (peer-reviewed)abstract
- Objectives: To describe physical activity patterns and analyze changes during the first two years after a non-surgically treated ACL injury, and to assess correlations between accelerometer-assessed physical activity and self-reported knee function and knee-related quality of life.Design: Prospective cohort study.Participants: 128 patients (61 females, 25.2 +/- 7.1 years) with acute ACL injuryMain outcome measures: Physical activity patterns were measured with accelerometry. Self-reported knee function was assessed using the International Knee Documentation Committee Subjective Knee Form, and knee-related quality of life was assessed using the Anterior Cruciate Ligament Quality of Life questionnaire.Results: Moderate to vigorous physical activity (MVPA) and steps per day increased from baseline to 3 months (p < .001), with no further increase from 3 to 24 months (p > .05). Time in MVPA did not correlate to patient reported outcome measures at 3, 6, 12, or 24 months (p > .05).Conclusions: Physical activity increased from acute phase to 3 months after non-surgically treated ACL injury, but almost one in four patients did not reach recommended levels of physical activity. Physical activity did not correlate with knee function or quality of life. Patients may need improved support to return to physical activity after ACL injury.
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| 8. |
- Sonesson, Sofi, 1977-, et al.
(author)
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Bilateral changes in knee joint laxity during the first year after non-surgically treated anterior cruciate ligament injury.
- 2022
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In: Physical Therapy in Sport. - Edinburgh : Churchill Livingstone. - 1466-853X .- 1873-1600. ; 58, s. 173-181
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Journal article (peer-reviewed)abstract
- OBJECTIVES: Analyse changes in knee laxity between 3, 6, 12 and 24 months after non-surgically treated ACL injury and to analyse associations between knee laxity and knee function, self-reported knee stability, ACL-Return to Sport after Injury (ACL-RSI), fear and confidence at different timepoints during recovery.DESIGN: Prospective cohort study.PARTICIPANTS: 125 patients (67 males, mean age 25.0 ± 7.0 years) with acute ACL injury.MAIN OUTCOME: Laxity was measured using KT-1000 arthrometer. Self-reported knee function was assessed using the International Knee Documentation Committee Subjective Knee Form (IKDC-SKF). Confidence and fear were assessed with questions from the ACL-RSI scale. Subjectively knee stability was assessed using SANE.RESULTS: Knee laxity increased bilaterally from 3 to 12 months, and in the non-involved knee from 3 to 24 months (p˂0.05), although mean change was below 1 mm. Side-to-side difference in knee laxity was correlated with IKDC-SKF (r = -0.283) and knee stability in rehabilitation/sport activities (r = -0.315) at 6 months, but not with confidence/fear.CONCLUSION: Knee laxity increased bilaterally during the first year after non-surgically treated ACL injury, though, the mean change in knee laxity was below 1 mm and the clinical significance is unknown. Knee laxity was weakly associated with knee function and perceived knee stability.LEVEL OF EVIDENCE: Level II TRIAL REGISTRATION: NCT02931084.
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| 9. |
- Sonesson, Sofi, et al.
(author)
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Early knee status affects self-reported knee function 1 year after non-surgically treated anterior cruciate ligament injury
- 2021
-
In: Physical Therapy in Sport. - : Churchill Livingstone. - 1466-853X .- 1873-1600. ; 50, s. 173-183
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Journal article (peer-reviewed)abstract
- Objectives: The primary aim was to assess impact of early knee status on self-reported knee function at 3 and 12 months and on quadriceps strength at 12 months after non-surgically treated ACL injury. The secondary aim was to describe the recovery of muscle strength during the first year after the injury. Design: Prospective cohort study. Participants: 70 patients (42 males; mean age 27 +/- 7 years) with acute ACL injury. Main outcome: Knee symptoms, knee function and sporting activities were assessed with the International Knee Documentation Committee Subjective Knee Form (IKDC-SKF). Muscle strength was assessed with an isokinetic dynamometer. Clinical assessment performed at baseline was used to evaluate early knee status. Results: Global knee function, knee joint stability during ADL, gait pattern and one-legged squat assessed in mean 2 weeks after injury hadimpact on self-reported knee function at 3 and 12 months (r(2) 0.105-0.267). Mean limb symmetry index (LSI) of muscle strength and jump performance were 91-98% at 12 months. Conclusion: Early knee symptoms affect self-reported knee function at 3 and 12 months, while other factors are important for gaining muscle strength. Muscle strength recovered during the first year after ACL injury and reached mean LSI above 90%. (C) 2021 The Authors. Published by Elsevier Ltd.
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| 10. |
- Sonesson, Sofi, 1977-, et al.
(author)
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Higher age and present injury at the start of the season are risk factors for in-season injury in amateur male and female football players-a prospective cohort study
- 2023
-
In: Knee Surgery, Sports Traumatology, Arthroscopy. - : SPRINGER. - 0942-2056 .- 1433-7347. ; 31, s. 4618-4630
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Journal article (peer-reviewed)abstract
- 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 & PLUSMN; 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.
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| 11. |
- Sonesson, Sofi, et al.
(author)
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Knee Arthroscopic Surgery in Middle-Aged Patients With Meniscal Symptoms : A 5-Year Follow-up of a Prospective, Randomized Study
- 2020
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In: The Orthopaedic Journal of Sports Medicine. - : Sage Publications. - 2325-9671. ; 8:1
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Journal article (peer-reviewed)abstract
- Background:Arthroscopic meniscal surgery is a common orthopaedic procedure in middle-aged patients, but the efficacy of this procedure has been questioned. In this study, we followed up the only randomized controlled trial that has shown a 1-year benefit from knee arthroscopic surgery with an exercise program compared with an exercise program alone.Purpose:To (1) evaluate whether knee arthroscopic surgery combined with an exercise program provided an additional 5-year benefit compared with an exercise program alone in middle-aged patients with meniscal symptoms, (2) determine whether baseline mechanical symptoms affected the outcome, and (3) compare radiographic changes between treatment groups.Study Design:Randomized controlled trial; Level of evidence, 1.Methods:Of 179 eligible patients aged 45 to 64 years, 150 were randomized to either a 3-month exercise program (nonsurgery group) or to the same exercise program plus knee arthroscopic surgery (surgery group) within 4 weeks. Radiographs were assessed, according to the Kellgren-Lawrence grade, at baseline and at the 5-year follow-up. The primary outcome was the change in Knee injury and Osteoarthritis Outcome Score (KOOS)–Pain (KOOSPAIN) subscore from baseline to the 5-year follow-up. We performed an as-treated analysis.Results:A total of 102 patients completed the 5-year questionnaire. At the 5-year follow-up, both groups had significant improvement in KOOSPAIN subscores, although there was no significant change from the 3-year scores. There was no between-group difference in the change in the KOOSPAIN subscore from baseline to 5 years (3.2 points [95% CI, –6.1 to 12.4]; adjusted P = .403). In the surgery group, improvement was greater in patients without mechanical symptoms than in those with mechanical symptoms (mean difference, 18.4 points [95% CI, 8.7 to 28.1]; P < .001). Radiographic deterioration occurred in 60% of patients in the surgery group and 37% of those in the nonsurgery group (P = .060).Conclusion:Knee arthroscopic surgery combined with an exercise program provided no additional long-term benefit after 5 years compared with the exercise program alone in middle-aged patients with meniscal symptoms. Surgical outcomes were better in patients without mechanical symptoms than in patients with mechanical symptoms during the preoperative period. Radiographic changes did not differ between treatment groups.Registration:NCT01288768 (ClinicalTrials.gov identifier).
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| 12. |
- Sonesson, Sofi, et al.
(author)
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Low correlation between functional performance and patient reported outcome measures in individuals with non-surgically treated ACL injury.
- 2021
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In: Physical Therapy in Sport. - EDINBURGH SCOTLAND : Elsevier BV. - 1466-853X .- 1873-1600. ; 47, s. 185-192
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Journal article (peer-reviewed)abstract
- OBJECTIVE: Describe a consecutive cohort of people with a non-surgically treated ACL injury and evaluate correlations between functional performance and patient reported outcome measures (PROMs).DESIGN: Cross-sectional.PARTICIPANTS: Sixty-eight individuals (38 males, 18-45 years old) 2-5 years after ACL injury.MAIN OUTCOME MEASURES: Tegner Activity Scale, International Knee Documentation Committee Subjective Knee Form (IKDC-SKF), Anterior Cruciate Ligament Return to Sport after Injury scale (ACL-RSI) and ACL-Quality of Life (ACL-QoL) were completed. Functional performance was assessed using 4 hop tests and a squat test.RESULTS: Mean IKDC-SKF score was 72 ± 17 and mean LSI on performance tests were above 90%. Tegner Activity Scale was reduced from median 8 pre-injury to 5 at follow up. Satisfaction with activity level was median 7 on a 10-point ordinal scale. Correlations were moderate to strong (r = 0.552-0.856) between PROMs, negligible to weak (r = 0.003-0.403) between performance tests and PROMs and negligible to moderate (r = 0.142-0.683) between performance tests.CONCLUSION: Functional performance had negligible or weak correlation to PROMs, which indicates the need for multi-modal assessment strategies. Activity level was reduced 2-5 years after a non-surgically treated ACL injury, but most patients were able to resume physical activity at a sufficient level to maintain health and displayed symmetrical functional performance.LEVEL OF EVIDENCE: Retrospective cohort study, Level III.
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| 13. |
- Sonesson, Sofi, 1977-, et al.
(author)
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Neuromuscular control and hop performance in youth and adult male and female football players
- 2022
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In: Physical Therapy in Sport. - : Churchill Livingstone. - 1466-853X .- 1873-1600. ; 55, s. 189-195
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Journal article (peer-reviewed)abstract
- Objectives: To compare neuromuscular control and hop performance between youth and adult male and female football players. Design: Cross-sectional study. Participants: 119 youth players (13-16 years; 68 males) and 88 adult players (17-26 years; 44 males). Main outcome measures: Neuromuscular control assessed with drop vertical jump (DVJ) and tuck jump assessment (TJA). Hop performance assessed with single-leg hop for distance and side hop. Results: Adult females had smaller normalized knee separation distances (NKSD) during DVJ at initial contact (77.9 +/- 18.5 vs. 86.1 +/- 11.0, p = 0.010) and at maximum knee flexion (59.7 +/- 23.4 vs.74.1 +/- 18.1, p = 0.001) compared to youth females. TJA revealed more technique errors in youths compared to adults (males 10 (8-11) vs. 8 (7-10); females 11 (9-12) vs. 9 (8-11), p < 0.05). Youths demonstrated inferior hop performance (males single-leg hop 142 +/- 18 vs. 163 +/- 17, side hop 41 +/- 12 vs. 52 +/- 12, p < 0.001; females side hop 32 +/- 10 vs. 38 +/- 14, p < 0.05). Conclusions: Youth players demonstrated reduced neuromuscular control during TJA and inferior hop performance compared to adult players. Adult female players demonstrated greater knee valgus during DVJ compared to youth female players.
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| 14. |
- Sonesson, Sofi, et al.
(author)
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Performance on sprint, agility and jump tests have moderate to strong correlations in youth football players but performance tests are weakly correlated to neuromuscular control tests
- 2021
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In: Knee Surgery, Sports Traumatology, Arthroscopy. - : SPRINGER. - 0942-2056 .- 1433-7347. ; 29, s. 1659-1669
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Journal article (peer-reviewed)abstract
- Purpose This study aimed at evaluating the correlation between seven different performance tests and two neuromuscular control tests in youth football players and to evaluate the influence of sex and age groups on test results. Methods One-hundred and fifteen football players (66 boys, 49 girls) mean age 14 +/- 0.7 (range 13-16) years from youth teams were tested at the start of the second half of the competitive season. A test battery including agility t-test, 505 agility test, single-leg hop for distance test, side-hop test, countermovement jump test, 10-m sprint test, 20-m sprint test, tuck jump assessment (TJA) and drop vertical jump (DVJ) was completed. Results Correlations between the seven different performance tests of agility, jump and sprint ability were generally moderate to strong (r = 0.534-0.971). DVJ did not correlate with the performance tests (rho = 0.004 to - 0.101) or with TJA total score (rho = 0.127). There were weak to moderate correlations between TJA total score and the performance tests (r = - 0.323-0.523). Boys performed better than girls in all performance tests (p 0.001) and in TJA total score (p = 0.002). In boys, older players performed better than younger players in the majority of the tests, while there was no clear age influence among girls. Conclusion Sprint performance was moderately to strongly correlated with agility and jump performance, and performance tests were weakly to moderately correlated to TJA, while DVJ did not correlate with the other tests. Boys performed better than girls on performance tests and TJA. An age effect on performance was evident in boys but not in girls.
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| 15. |
- Sonesson, Sofi, 1977-, et al.
(author)
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Risk factors for injury and illness in youth floorball players- A prospective cohort study
- 2023
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In: Physical Therapy in Sport. - : CHURCHILL LIVINGSTONE. - 1466-853X .- 1873-1600. ; 59, s. 92-102
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Journal article (peer-reviewed)abstract
- Objectives: To investigate risk factors for injury and illness in female and male youth floorball players (12-17 years) during a 26-week floorball season. Design: Prospective cohort study. Setting: Recreational youth sport. Participants: 471 players (142 females) 12-17 years. Main outcome measures: Weekly survey including questions about stress, sleep quality, well-being, sport exposure and average weekly rating of perceived exertion (RPE). Acute:chronic workload ratio (ACWR) was calculated. The Oslo Sports Trauma Research Center questionnaire on health problems was used. Predictors of new injury and illness were examined using multi-level logistic regression models with weekly measures nested within individuals. Results: Higher stress, poorer sleep quality and well-being increased the odds of a new injury in the subsequent week by 8% (2.0-13.5%), 10% (4.2-15.9%) and 8% (2.4-13.5%) per 1 unit increase. Higher stress, and poorer well-being increased the odds of illness by 8% (2.6-12.6%), and 12% (7.2-16.6%). ACWR below 0.8 or above 1.3 increased the odds of illness by 34% (4.9-70.8%). Conclusions: Perceived stress, well-being, and sleep quality were associated with injury and illness occurrence in the subsequent week. ACWR outside the range 0.8-1.3 was associated with illness the subsequent week. Trial registration: Clinical Trials registration NCT03309904. (c) 2022 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
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| 16. |
- Tigerstrand Grevnerts, Hanna, et al.
(author)
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Decision Making for Treatment After ACL Injury From an Orthopaedic Surgeon and Patient Perspective: Results From the NACOX Study
- 2021
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In: The Orthopaedic Journal of Sports Medicine. - : Sage Publications. - 2325-9671. ; 9:4
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Journal article (peer-reviewed)abstract
- Background: In the treatment of anterior cruciate ligament (ACL) injuries, there is little evidence of when and why a decision for ACL reconstruction (ACLR) or nonoperative treatment (non-ACLR) is made. Purpose: To (1) describe the key characteristics of ACL injury treatment decisions and (2) compare patient-reported knee instability, function, and preinjury activity level between patients with non-ACLR and ACLR treatment decisions. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 216 patients with acute ACL injury were evaluated during the first year after injury. The treatment decision was non-ACLR in 73 patients and ACLR in 143. Reasons guiding treatment decision were obtained from medical charts and questionnaires to patients and orthopaedic surgeons. Patient-reported instability and function were obtained via questionnaires and compared between patients with non-ACLR and ACLR treatment decisions. The ACLR treatment group was classified retrospectively by decision phase: acute phase (decision made between injury day and 31 days after injury), subacute phase (decision made between 32 days and up to 5 months after injury), and late phase (decision made 5-12 months after injury). Data were evaluated using descriptive statistics, and group comparisons were made using parametric or nonparametric tests as appropriate. Results: The main reasons for a non-ACLR treatment decision were no knee instability and no problems with knee function. The main reasons for an ACLR treatment decision were high activity demands and knee instability. Patients in the non-ACLR group were significantly older (P = .031) and had a lower preinjury activity level than did those in the acute-phase (P < .01) and subacute-phase (P = .006) ACLR decision groups. There were no differences in patient-reported instability and function between treatment decision groups at baseline, 4 weeks after injury, or 3 months after injury. Conclusion: Activity demands, not patient-reported knee instability, may be the most important factor in the decision-making process for treatment after ACL injury. We suggest a decision-making algorithm for patients with ACL injuries and no high activity demands; waiting for >3 months can help distinguish those who need surgical intervention from those who can undergo nonoperative management.
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| 17. |
- Tigerstrand Grevnerts, Hanna, et al.
(author)
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PATIENTS FOCUS ON PERFORMANCE OF PHYSICAL ACTIVITY, KNEE STABILITY AND ADVICE FROM CLINICIANS WHEN MAKING DECISIONS CONCERNING THE TREATMENT OF THEIR ANTERIOR CRUCIATE LIGAMENT INJURY
- 2020
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In: INTERNATIONAL JOURNAL OF SPORTS PHYSICAL THERAPY. - : AMER PHYSICAL THERAPY ASSOC. - 2159-2896. ; 15:3, s. 441-450
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Journal article (peer-reviewed)abstract
- Background: When deciding medical treatment, patients perspectives are important. There is limited knowledge about patients views when choosing non-operative treatment or anterior cruciate ligament (ACL) reconstruction (ACLR) after ACL injury. Purpose: To describe reasons that influenced patients decisions for non-operative treatment or ACLR after ACL injury. Study Design: Cross-sectional study. Methods: This study recruited a total of 223 patients (50% men), aged 28 +/- 8 years who had sustained ACL injury, either unilateral or bilateral. Subjects were, at different time points after injury, asked to fill out a questionnaire about their choice of treatment, where an ACLR treatment decision was made, some responded before and some after the ACLR treatment. A rating of the strength of 10 predetermined reasons in their choice of treatment graded as 0 (no reason) to 3 (very strong reason), was done. Results: Patients with unilateral ACL injury treated with ACLR (110 patients) rated "inability to perform physical activity at the same level as before the injury due to impaired knee function" (96%), "fear of increased symptoms during activity" (87%) and "giving way episodes" (83%) as strong or very strong reasons in their treatment decision. Patients with bilateral ACL injury treated with ACLR (109 knees) rated similar reasons as patients with unilateral ACLR and also "low confidence in the ability to perform at the preinjury activity level without ACLR" (80%) as strong or very strong reasons. Patients with unilateral ACL injury treated non-operatively (96 patients) rated "advice from clinician" (69%) as a strong or very strong reason. Patients with bilateral ACL injury treated non-operatively (25 knees) rated "absence of giving way episodes" (62%), and "no feeling of instability" (62%) as strong or very strong reasons. Conclusion: Inability to perform physical activity, fear of increased symptoms, and giving way episodes were reasons that patients with ACL injury considered when making decisions about ACLR. When choosing non-operative treatment, patients considered the absence of instability or giving way symptoms, being able to perform physical activity, and advice from clinicians.
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| 18. |
- Torvaldsson, Kalle, et al.
(author)
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Swedish Olympic athletes report one injury insurance claim every second year: a 22-year insurance registry-based cohort study.
- 2023
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In: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. - : SPRINGER. - 0942-2056 .- 1433-7347. ; 31:10, s. 4607-4617
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Journal article (peer-reviewed)abstract
- To describe injury incidence, time trends in injury incidence, and injury characteristics among Swedish Olympic athletes over 22years based on insurance data, as a first step to inform injury preventive measures among Olympic athletes.The cohort comprised 762 elite athletes (54% males; age 26.5±5.9years) in 38 sports in the Swedish Olympic Committee support program 'Top and Talent' between 1999 and 2020, with total 3427 athlete-years included. Acute and gradual onset injuries were reported to the insurance registry by the athletes' medical staff.A total of 1635 injuries in 468 athletes were registered. The overall injury incidence was 47.7 injuries/100 athlete-years (one injury per athlete every second year). An increasing trend in injury incidence was observed in the first decade 2001 to 2010 (annual change 6.0%, 95% CI 3.3-8.8%), while in the second decade 2011 to 2020 no change was evident (0.4%, 95% CI -1.9 to 2.7%). Gymnastics, tennis, and athletics had the highest incidence (100.0, 99.3, and 93.4 injuries/100 athlete-years, respectively). Among sport categories, mixed and power sports had the highest incidence (72.8 and 69.5 injuries/100 athlete-years, respectively). Higher incidences were seen in the younger age groups (≤25years) in mixed and skill sports. The injury incidence was comparable between male and female athletes, and summer and winter sports. Most injuries occurred in the lower limb, and specifically the knee (24%), foot/ankle (15%) and spine/pelvis (13%).The results on injury patterns in different sports and age groups may guide preventive focus for health and performance teams working with Olympic athletes.II.
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| 19. |
- Wezenberg, Daphne, et al.
(author)
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Prevalence and intensity of pain in male and female amateur football players: A prospective cohort study
- 2024
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In: Journal of Science and Medicine in Sport. - : ELSEVIER SCI LTD. - 1440-2440 .- 1878-1861. ; 27:4, s. 222-227
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Journal article (peer-reviewed)abstract
- Objectives: To determine the prevalence and intensity of pain due to a football-related injury during activities of daily living and during training and/or match play in both male and female and youth and adult amateur players. Design: A prospective cohort study involving amateur football players. Methods: Players (n = 502, median age 18 years, range 14-46) responded to weekly questionnaires during one season, including the Oslo Sports Trauma Research Center Overuse Injury Questionnaire. Weekly pain prevalence and pain intensity (measured on the numeric rating scale [range 0-10]) during activities of daily living and while playing football were determined. Results: A total of 6601 weekly questionnaires were collected (response rate 63.7 %). Average weekly pain prevalence during activities of daily living was 17.2 % for all players, and 15.7 % among players who participated in training and/or match play. Pain prevalence during training and/or match play was 18.3 % with an average pain intensity of 4.0. In 21.3 % of cases the recorded pain intensity was >5. Sex, age, and mode of injury onset (sudden or gradual) were not significant predictors of pain intensity. Conclusion: At a given week, one in six football players experiences pain during activities of daily living from a football-related injury. Almost one in five players reports pain while playing football, of whom >20% report a pain intensity above 5. Oftentimes, injury-related pain present while playing football transcends to activities of daily living. This warrants further monitoring and adequate management of pain within amateur football. (c) 2024 The Authors. Published by Elsevier Ltd on behalf of Sports Medicine Australia. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
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| 20. |
- Åkerlund, Ida, et al.
(author)
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Forty-five per cent lower acute injury incidence but no effect on overuse injury prevalence in youth floorball players (aged 12-17 years) who used an injury prevention exercise programme: two-armed parallel-group cluster randomised controlled trial
- 2020
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In: British Journal of Sports Medicine. - : BMJ PUBLISHING GROUP. - 0306-3674 .- 1473-0480. ; 54:17, s. 1028-
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Journal article (peer-reviewed)abstract
- Objective To study whether an injury prevention exercise programme would reduce the number of injuries in youth floorball players. Methods 81 youth community level floorball teams (48 clusters=clubs) with female and male players (12-17 years) were cluster-randomised into an intervention or control group. Intervention group coaches were instructed to use the Swedish Knee Control programme and a standard running warm-up before every training session, and the running warm-up before every match, during the season. Control teams continued usual training. Teams were followed during the 2017/2018 competitive season (26 weeks). Player exposure to floorball and occurrence of acute and overuse injuries were reported weekly via a web-based player survey using the Oslo Sports Trauma Research Centre Questionnaire. Results 17 clusters (301 players) in the intervention group and 12 clusters (170 players) in the control group were included for analyses. There were 349 unique injuries in 222 players. The intervention group had a 35% lower incidence of injuries overall than the control group (adjusted incidence rate ratio (IRR) 0.65, 95% CI 0.52 to 0.81). The absolute risk reduction was 6.6% (95% CI 3.2 to 10.0), and the number needed to treat was 152 hours of floorball exposure (95% CI 100 to 316). Intervention group teams had a 45% lower incidence of acute injuries (adjusted IRR 0.55, 95% CI 0.37 to 0.83). There was no difference in the prevalence of overuse injuries (adjusted prevalence rate ratio 0.96, 95% CI 0.73 to 1.26). Conclusion The Knee Control injury prevention programme reduced acute injuries in youth floorball players; there was no effect on overuse injuries.
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| 21. |
- Åkerlund, Ida, et al.
(author)
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High compliance with the injury prevention exercise programme Knee Control is associated with a greater injury preventive effect in male, but not in female, youth floorball players
- 2022
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In: Knee Surgery, Sports Traumatology, Arthroscopy. - : Springer. - 0942-2056 .- 1433-7347. ; 30:4, s. 1480-1490
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Journal article (peer-reviewed)abstract
- Purpose Evaluate team and player compliance with the Knee Control injury prevention exercise programme, study the association between player compliance and injury rates, and compare coach demographics, baseline prevention expectancies, and programme utilisation between teams with high and low compliance. Methods Prospective one-season cohort study based on a cluster randomised controlled trial on 301 (107 female) floorball players aged 12-17 years. Floorball exposure and injuries were self-reported weekly by players using the Oslo Sports Trauma Research Center questionnaire. Team and player compliance to Knee Control was reported monthly by coaches. Additionally, coaches answered pre- and post-season surveys. Teams were divided into a high (>= 80%) or low (< 80%) compliance group based on their use of Knee Control during the season. Players were divided into three compliance groups based on their average weekly number of Knee Control sessions; high (>= 2 sessions), intermediate (>= 1 to < 2 sessions), and low dose (< 1 session). Results Mean team compliance for the high and low compliance groups were 95% (range 82-100) and 50% (range 13-66), respectively. Mean +/- SD weekly Knee Control dose in the three player compliance groups were 2.4 +/- 0.3, 1.4 +/- 0.3, and 0.7 +/- 0.3 sessions, respectively. There were no differences in total injury incidence between the player compliance groups, but players in the high-dose group had a 35% lower prevalence of injuries overall [adjusted prevalence rate ratio (PRR) 0.65, 95% CI 0.48-0.89] and 60% lower prevalence of substantial injuries (adjusted PRR 0.40, 95% CI 0.26-0.61) compared with the low-dose group. Male players in the high-dose group had consistently lower injury incidence and prevalence, while no between compliance group differences were seen in female players. There were no differences in sex, years of coaching experience, or baseline prevention expectancies in general between coaches for teams in the high vs. low compliance groups, but teams in the high compliance group had a better utilisation fidelity. Conclusion There was a clear dose-response relationship between more frequent Knee Control use and lower injury rates in male floorball players, but not in female players. Teams with higher compliance also showed a better utilisation fidelity with the programme.
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| 22. |
- Åkerlund, Ida, 1986-
(author)
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Injury Prevention in Youth Male and Female Floorball Players : Effects, Compliance, and Experiences of the Knee Control Programme
- 2024
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Doctoral thesis (other academic/artistic)abstract
- Background: Floorball is one of the most popular team ball sports in Northern Europe, particularly among youths. The injury incidence is high, as is the case in other pivoting youth team ball sports, such as football. The injury prevention exercise programme (IPEP) Knee Control is developed to reduce injuries in team ball sports. Though, programme effects and implementation factors in floorball has not been evaluated.The overall aim of this thesis was to evaluate the effects of the Knee Control IPEP and explore players’ and coaches’ experiences of using Knee Control in youth floorball.Methods: Study A was a cluster-randomised controlled trial (RCT) evaluating the effects of Knee Control in reducing floorball injuries. The RCT comprised of 48 clusters (clubs) with male and female floorball players (12–17 years) on the community level who were randomised into either an intervention or control group. Seventeen clusters (31 teams with 301 players) in the intervention group and 12 clusters (16 teams with 170 players) in the control group were included for analyses. During a pre-season implementation workshop, the intervention group coaches were instructed to use Knee Control and a standard running warm-up before every training session during the season. Control teams continued usual training. Teams were followed during a competitive season (26 weeks). Player exposure to floorball and occurrence of acute and gradual onset injuries were reported weekly via a web-based player survey using the Oslo Sports Trauma Research Centre overuse injury questionnaire. Team and player compliance to Knee Control was reported monthly by coaches. Players were divided into three compliance groups based on their average weekly number of Knee Control sessions: high (≥2 sessions), intermediate (≥1 to <2 sessions), and low dose (<1 session). Additionally, players and coaches in the intervention group answered a post-season survey on experiences using Knee Control.Study B was a qualitative study exploring facilitators and barriers of Knee Control use and how to overcome the barriers. Semi-structured focus group discussions, six with players (11–17 years old, n =42), and two with coaches (n =12) were conducted.Results: In Study A, the intervention group had a 35% lower incidence rate of injuries overall (adjusted incidence rate ratio (IRR), 0.65; 95% confidence interval (CI), 0.52– 0.81) and 45% lower incidence of acute injuries (adjusted IRR, 0.55; 95% CI, 0.37–0.83) than the control group. There was no difference in the prevalence of gradual onset injuries. Male players in the high dose group had consistently lower injury incidence and prevalence compared to the low dose group, while no differences between the three compliance groups were seen in female players. Common facilitators of Knee Control use among coaches were support and education for coaches and high player motivation, and common barriers were that injury prevention training was time-consuming, a lack of space to execute the exercises, and a lack of player motivation. Players and coaches who intended to maintain use of Knee Control had higher belief in their ability to use Knee Control.Study B showed that player-perceived improved performance and making preventive training a natural part of floorball could be promoting factors for IPEP use. Promoting factors for coaches were described as support from the federation and club and collaboration with other coaches. To overcome barriers, players and coaches gave examples of how to adapt and progress the preventive training to the team by starting at an early age and keeping it simple.Conclusions: Knee Control was effective in preventing injuries, especially acute injuries, in Swedish youth floorball players. Male players had a clear dose-response relationship between Knee Control dose and injury rate reduction. Players found the Knee Control exercises necessary for injury prevention, but perceived them as boring, while coaches felt uncertain of their competence to use Knee Control and wished for support. Ideas on how to overcome barriers for IPEP use were to create a good structure and routines for preventive training, and to tailor the preventive training to the team, thus increasing player motivation.
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| 23. |
- Åkerlund, Ida, et al.
(author)
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Perceptions, facilitators, and barriers regarding use of the injury prevention exercise programme Knee Control among players and coaches in youth floorball: a cross-sectional survey study
- 2023
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In: BMC SPORTS SCIENCE MEDICINE AND REHABILITATION. - : BMC. - 2052-1847. ; 15:1
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Journal article (peer-reviewed)abstract
- BackgroundYouth participation in team ball sports is associated with a risk of both acute and gradual onset injuries but today there are several efficacious injury prevention exercise programmes (IPEPs). However, there is limited research about how to implement those programmes and the perceived barriers and facilitators among end-users.ObjectiveTo investigate perceptions of the IPEP Knee Control and facilitators and barriers to programme use among coaches and youth floorball players, and explore factors associated with planned maintenance of Knee Control.MethodsThis cross-sectional study is a sub-analysis of data from the intervention group of a cluster randomised controlled trial. Perceptions about Knee Control and facilitators and barriers to programme use were evaluated with surveys pre-intervention and post-season. 246 youth floorball players aged 12-17 years, and 35 coaches that reported no use of IPEPs during the preceding year were included. Descriptive statistics and univariate and multivariate ordinal logistic regression models were undertaken with the dependent variables: coaches planned maintenance and players opinions of maintenance of Knee Control. Independent variables were perceptions, facilitators and barriers regarding use of Knee Control and other potential influencing factors.Results88% of the players believed that Knee Control can reduce injury risk. Common facilitators to Knee Control use among coaches were support, education and high player motivation, and common barriers were that injury prevention training was time-consuming, lack of space to execute the exercises and lack of player motivation. Players who planned to maintain use of Knee Control had higher outcome expectancies and belief in ones ability to use Knee Control (action self-efficacy). Coaches who planned to maintain Knee Control had higher action self-efficacy and to a lesser extent considered that Knee Control takes too much time.ConclusionsSupport, education, and high player motivation are key facilitators, while lack of time and space for injury prevention training and boring exercises are key barriers for coaches and players to use Knee Control. High action self-efficacy among coaches and players seems to be a prerequisite for maintained use of IPEPs.
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