Journal of Orthopaedic and Sports Physical Therapy

Scientific injury data in men’s professional team handball injuries are rare and even less scientific information exists on injury prevention. In 2011, Germany’s national second team handball league was restructured by merging the existing two regional leagues into one league. This study evaluates the injury patterns in professional team handball and compares the injury rates between the first and second league before and after the restructure. All players of Germany’s national first and second men’s team handball leagues have mandatory trauma insurance with the same insurance company. This retrospective cohort study analysed the injury data of three consecutive seasons 2010–2013 using standardized injury definitions. 1194 professional team handball players were included in this study. The majority of severe injuries affected the lower extremities, shoulders, and hands. The average injury incidence significantly differed between the first (4.9 injuries per 1000 h) and the second league (3.9 per 1000 h, p < 0.01). The injury incidence in the restructured second league had increased from 3.7 to 4.1 per 1000 h (p < 0.01) and prevalence from 67.1 to 79.3% (p < 0.001), thus almost to the same levels of the first league. The second league showed more time-loss injuries at all severity levels. This study yielded a high injury incidence after the restructure of the national second team handball league and presents details on prevalence, incidence, and patterns of injury in professional men’s team handball. This study is an important basis for developing injury prevention strategies that should focus on the shoulders, hands, and lower extremities and on reducing the number of matches and travel burden. III.

Increased injury rates after the restructure of Germany's national second league of team handball.

Pre-season screening is well established within the sporting arena, and aims to enhance performance and reduce injury risk. With the increasing need to identify potential injury with greater accuracy, a new risk assessment process has been produced; The Performance Matrix (battery of movement control tests). As with any new method of objective testing, it is fundamental to establish whether the same results can be reproduced between examiners and by the same examiner on consecutive occasions. This study aimed to determine the intra-rater test re-test and inter-rater reliability of tests from a component of The Performance Matrix, The Foundation Matrix. Twenty participants were screened by two experienced musculoskeletal therapists using nine tests to assess the ability to control movement during specific tasks. Movement evaluation criteria for each test were rated as pass or fail. The therapists observed participants real-time and tests were recorded on video to enable repeated ratings four months later to examine intra-rater reliability (videos rated two weeks apart). Overall test percentage agreement was 87% for inter-rater reliability; 98% Rater 1, 94% Rater 2 for test re-test reliability; and 75% for real-time versus video. Intraclass-correlation coefficients (ICCs) were excellent between raters (0.81) and within raters (Rater 1, 0.96; Rater 2, 0.88) but poor for real-time versus video (0.23). Reliability for individual components of each test was more variable: inter-rater, 68-100%; intra-rater, 88-100% Rater 1, 75-100% Rater 2; and real-time versus video 31-100%. Cohen’s Kappa values for inter-rater reliability were 0.0-1.0; intra-rater 0.6-1.0 for Rater 1; -0.1-1.0 for Rater 2; and -0.1-1 for real-time versus video. It is concluded that both inter and intra-rater reliability of tests in The Foundation Matrix are acceptable when rated by experienced therapists. Recommendations are made for modifying some of the criteria to improve reliability where excellence was not reached.

http://www.jssm.org/hfpdf.php?volume=14&issue=2&page=427

Intra and inter-rater reliability of screening for movement impairments: movement control tests from the foundation matrix.

Handball is a team sport in which players are exposed to high physical conditioning requirements and several contacts and collisions, so they must face various musculoskeletal injuries throughout their career. The aim of this study was to summarize the characteristics of handball injuries both in training and in competition contexts, differentiating by gender and age. A systematic review was conducted and a total of 15 studies (33 cohorts) met the inclusion criteria. Higher injury incidence was reported during matches compared to training sessions in all groups (i.e., male and female senior and youth players), with male senior players presenting the greatest values. Lower extremities were more frequently injured, being contusions and sprains the most common type of injuries. Females reported more serious injuries than males, who presented a higher percentage of acute injuries caused by direct contact, while in female players these injuries were not caused by direct contact actions. Wings and backs presented the highest injury incidence; additionally, players registered higher match incidence during international championships compared to national leagues. Due to the differences in the injury profile of handball players, specific preventive strategies should be implemented for each group to optimize the injury prevention process.

https://www.mdpi.com/1660-4601/17/11/3925/pdf

Injury Profile of Male and Female Senior and Youth Handball Players: A Systematic Review

Cardiovascular fitness and health effects of various types of team sports for adult and elderly inactive individuals - a brief narrative review.

Objective:To examine the incidence, type, location, and severity of injuries in Icelandic elite male handball players and compare across factors like physical characteristics and playing position.Design:Prospective cohort study.Setting:The latter part of the preseason and the competitive season of I

Injury pattern in Icelandic elite male handball players

Characteristics of functional movement screening testing in elite handball players: Indicative data from the 9.

Background Injuries are common in handball, but little is known about their risk factors. One potential screening test to identify player at risk is the Nine Test Screening Battery (NTSB). Objective To test the intra-rater reliability of the NTSB and compare the results from NTSB between subgroups in the cohort. Design Test-retest design used for the intra-rater reliability test of NTSB. Experimental design used for testing senior and national team players. Setting Icelandic male handball players. Participants A total of 50 junior players from 5 clubs participated in the intra-rater reliability test. Also, 115 seniorplayers from 13 of 16 teams in the two highest divisions in Iceland and 26 Icelandic national team players (8 playing abroad), participated. Main outcome of measurement Intra-rater reliability of NTSB. Difference in NTSB scores between subgroups. Results There was a strong intra-rater correlation between the test-retest sessions, ICC: 0.95 T1: 21.6±3.5 (95% CI: 20.7–22.6), T2: 22.0±3.4 (95% CI: 21.0–22.9). The retest had significantly higher total score than the first test (P=.041), indicating some learning effect. No difference was found in total score of NTSB between teams, level of play or different age and height groups. However, goalkeepers had higher total score than other players (P=.001). Observing NTSB separately, junior players had significantly less core stability than senior and national team players (tests 5-7, P≤.006) and more mobility in trunk and shoulders (tests 8-9, P Conclusions NTSB seems to be reliable in test-retest, but some learning effect was noticed. Junior players showed less core stability and more trunk and shoulder mobility than senior players.

Nine test screening battery – intra-rater reliability and screening on icelandic male handball players

Many handball studies have reported injuries that cause absence from participation. In this prospective cohort study on elite Icelandic male players, the aim was to examine the prevalence of overuse problems in low back, knee, and shoulder. Sixteen Icelandic teams were invited. Thirteen teams agreed to participate. The OSTRC overuse questionnaire was distributed every second week during 32‐week period. In addition, the 9+ Screening Test was performed on 130 players. In total, 229 players participated with a weekly average response rate of 72%. The average weekly prevalence for shoulder was 28% (95% CI 25% to 31%), for knee 33% (95% CI 30% to 36%), and for low back 32% (95% CI 29% to 35%). Substantial problems were 10% (95% CI 9% to 11%) in shoulder and knee and 11% (95%CI 10% to 12%) in low back. Only 1% (95% CI 1% to 2%) of the overuse problems caused time loss from participation. In total, 61% of the players played with at least one overuse problem and 25% with one affecting their performance. There was no association between the 9+ Screening Test score and overuse problems among Icelandic male handball players.

No relationship between a movement screening test and risk of overuse problems in low back, shoulder and knee in elite handball players ‐ A prospective cohort study

Elis Thor Rafnsson

Papers

Injury pattern in Icelandic elite male handball players

Characteristics of functional movement screening testing in elite handball players: Indicative data from the 9.

Nine test screening battery – intra-rater reliability and screening on icelandic male handball players

No relationship between a movement screening test and risk of overuse problems in low back, shoulder and knee in elite handball players ‐ A prospective cohort study

Association between training load, intensity, and overuse problems during pre-season in Icelandic male handball