Prospective Cohort Study

SUMMARYACSM Position Stand on The Recommended Quantity and Quality of Exercise for Developing and Maintaining Cardiorespiratory and Muscular Fitness, and Flexibility in Adults. Med. Sci. Sports Exerc., Vol. 30, No. 6, pp. 975-991, 1998. The combination of frequency, intensity, and duration of chr

http://myweb.facstaff.wwu.edu/chalmers/pdfs/acsm position stand - quantity and quality of exercise.pdf

ACSM Position Stand: The Recommended Quantity and Quality of Exercise for Developing and Maintaining Cardiorespiratory and Muscular Fitness, and Flexibility in Healthy Adults

This review covers the toxicology of mercury and its compounds. Special attention is paid to those forms of mercury of current public health concern. Human exposure to the vapor of metallic mercury dates back to antiquity but continues today in occupational settings and from dental amalgam. Health risks from methylmercury in edible tissues of fish have been the subject of several large epidemiological investigations and continue to be the subject of intense debate. Ethylmercury in the form of a preservative, thimerosal, added to certain vaccines, is the most recent form of mercury that has become a public health concern. The review leads to general discussion of evolutionary aspects of mercury, protective and toxic mechanisms, and ends on a note that mercury is still an "element of mystery."

The Toxicology of Mercury and Its Chemical Compounds

Notwithstanding the healthy influence of sporting activities on risk factors, in particular those of cardiovascular disease, it is becoming increasingly apparent that sports can present a danger to health in the form of sports injuries. The extent of the sports injury problem calls for preventative action based on the results of epidemiological research. For the interpretation of these facts uniform definitions are needed and limitations of research designs should be known. Measures to prevent sports injuries form part of what is called the 'sequence of prevention'. Firstly the extent of the sports injury problem must be identified and described. Secondly the factors and mechanisms which play a part in the occurrence of sports injuries have to be identified. The third step is to introduce measures that are likely to reduce the future risk and/or severity of sports injuries. This measure should be based on the aetiological factors and the mechanism as identified in the second step. Finally the effect of the measures must be evaluated by repeating the first step. In this review some aspects of the first and second step of the sequence of prevention are discussed. The extent of the sports injury problem is often described by injury incidence and by indicators of the severity of sports injuries. Sports injury incidence should preferably be expressed as the number of sports injuries per exposure time (e.g. per 1000 hours of sports participation) in order to facilitate the comparability of research results. However, one should realise that the outcome of research applying this definition of sports injury incidence is highly dependent on the definitions of 'sports injury' and 'sports participation'. The outcome of such research also depends on the applied research design and research methodology. The incidence of sports injuries depends on: the method used to count injuries (e.g. prospective vs retrospective); the method used to establish the population at risk; and on the representativeness of the sample. Severity of sports injuries can be described on the basis of 6 criteria: the nature of the sports injury; the duration and nature of treatment; sporting time lost; working time lost; permanent damage; and cost. Here also uniform definitions are important and necessary in order to enhance the comparability of research data. In the second step of the 'sequence of prevention' the aetiological factors that play a role in the occurrence of a sports injury have to be identified by epidemiological studies. Epidemiological research on the aetiology of sports injuries requires a conceptual model.(ABSTRACT TRUNCATED AT 400 WORDS)

Incidence, Severity, Aetiology and Prevention of Sports Injuries A Review of Concepts

Objective
To determine the prevalence of radiographic knee osteoarthritis (OA) as well as knee-related symptoms and functional limitations in female soccer players 12 years after an anterior cruciate ligament (ACL) injury.

Methods
Female soccer players who sustained an ACL injury 12 years earlier were examined with standardized weight-bearing knee radiography and 2 self-administered patient questionnaires, the Knee Injury and Osteoarthritis Outcome Score questionnaire and the Short Form 36-item health survey. Joint space narrowing and osteophytes were graded according to the radiographic atlas of the Osteoarthritis Research Society International. The cutoff value to define radiographic knee OA approximated a Kellgren/Lawrence grade of 2.

Results
Of the available cohort of 103 female soccer players, 84 (82%) answered the questionnaires and 67 (65%) consented to undergo knee radiography. The mean age at assessment was 31 years (range 26–40 years) and mean body mass index was 23 kg/m2 (range 18–40 kg/m2). Fifty-five women (82%) had radiographic changes in their index knee, and 34 (51%) fulfilled the criterion for radiographic knee OA. Of the subjects answering the questionnaires, 63 (75%) reported having symptoms affecting their knee-related quality of life, and 28 (42%) were considered to have symptomatic radiographic knee OA. Slightly more than 60% of the players had undergone reconstructive surgery of the ACL. Using multivariate analyses, surgical reconstruction was found to have no significant influence on knee symptoms.

Conclusion
A very high prevalence of radiographic knee OA, pain, and functional limitations was observed in young women who sustained an ACL tear during soccer play 12 years earlier. These findings constitute a strong rationale to direct increased efforts toward prevention and better treatment of knee injury.

https://onlinelibrary.wiley.com/doi/pdf/10.1002/art.20589

High prevalence of knee osteoarthritis, pain, and functional limitations in female soccer players twelve years after anterior cruciate ligament injury.

Replacement of Dental Restorations in Patients With Subjective Health Impairment Has Limited Effect on Self-reported Changes of Health

Objectives The primary objective was to study the reach, effectiveness, adoption, implementation and maintenance of the Nordic Hamstring Exercise (NHE) programme in women’s elite teams in Europe in the 2020–21 season. The secondary objective was to compare hamstring injury rates between teams that used the NHE programme regularly in team training and teams that did not. Methods Eleven teams participating in the Women’s Elite Club Injury Study during the 2020–21 season provided data about injury rates and the implementation of the NHE programme. Results One team (9%) used the full original NHE programme, and four teams used the programme in the team training during parts of the season (team training group, n=5). Five teams did not use the NHE, or used it only sporadically for individual players, and one team used NHE only for players with a previous or current hamstring injury (no team training group, n=6). The team training group had a lower incidence of hamstring injuries during match-play (1.4 vs 4.0, p=0.028) than the non-team training group while no difference between groups was shown for the hamstring injury incidence in training (0.6 vs 0.7, p=0.502). Conclusion A low adoption of the NHE programme was reported during the 2020–21 season. However, teams that used NHE for the whole team or most players had a lower hamstring injury incidence at match-play than teams that did not use the NHE or used it for individual players only.

/pdf/low-adoption-in-womens-professional-football-teams-that-used-1lagva4u.pdf

Low adoption in women’s professional football: teams that used the Nordic Hamstring Exercise in the team training had fewer match hamstring injuries

Although athletic muscle injuries are very frequent, a consistent and comprehensive classification system as well as a clear terminology were so far missing. In order to facilitate effective communication among medical practitioners and to support the development of systematic treatment strategies, we developed practical and systematic definitions of muscle injuries as well as a new and comprehensive classification system, both based on an international consensus meeting.

Terminology and Classification of Athletic Muscle Injuries

To describe the perceived importance of suggested hamstring injury risk factors according to chief medical officers (CMOs) of European women's professional football clubs. A secondary objective was to compare if these perceptions differed between teams with a lower-than-average and higher-than-average hamstring injury burden.The CMOs of eleven European professional women's football clubs were initially asked to suggest modifiable risk factors for hamstring injury. These risk factors were rated in according with their perceived importance on a 5-graded Likert scale. Participating teams were divided in two groups depending on their hamstring injury burden during the 2020/21 season. The LOW group consisted of six teams that had a lower-than-average hamstring injury burden. The HIGH group consisted of five teams that had a higher-than-average hamstring injury burden.Twenty-one risk factors were suggested, most of which were extrinsic in nature, hence associated with the coaching staff, the team or the club organization rather than with the players themselves. The risk factors with the highest average importance were: "lack of communication between medical staff and coaching staff" and "load on players" (each with a weighted average of 3.9), followed by "lack of regular exposure to high-speed football actions during training" and "playing matches 2-3 times a week" (weighted average of 3.8 and 3.7). Differently from the LOW group, the HIGH group perceived the coaching factors (style of coach leadership, training/exercise surveillance by coaching staff) as more important.In accordance to the eleven CMOs recruited in this study, most risk factors for hamstring injuries are extrinsic in nature and associated with the club, the team, and the coaching staff, and not the players themselves.Level III. 

/pdf/most-modifiable-risk-factors-for-hamstring-muscle-injury-in-3o8bvirf.pdf

Most modifiable risk factors for hamstring muscle injury in women’s elite football are extrinsic and associated with the club, the team, and the coaching staff and not the players themselves: the UEFA Women’s Elite Club Injury Study

Jan Ekstrand

Papers

Replacement of Dental Restorations in Patients With Subjective Health Impairment Has Limited Effect on Self-reported Changes of Health

Low adoption in women’s professional football: teams that used the Nordic Hamstring Exercise in the team training had fewer match hamstring injuries

Terminology and Classification of Athletic Muscle Injuries

Most modifiable risk factors for hamstring muscle injury in women’s elite football are extrinsic and associated with the club, the team, and the coaching staff and not the players themselves: the UEFA Women’s Elite Club Injury Study