Journal Article•
Injuries and training recommendations in elite rhythmic gymnastics
TL;DR: Injuries in rhythmic gymnastics may be reduced by increasing the amount of time spent stretching per day (at least 40 minutes), and limiting conditioning to a maximum of 6 hours per week.
Abstract: Objective: To identify risk factors for injury in rhythmic sportive gymnastics and to provide recommendations for reducing the risk of injury. Methods: A one-year retrospective survey of injuries in twenty national-level rhythmic gymnasts (ages 14.8 to 18.8 years; mean age 17.1 years). Hours of rhythmic gymnastics (RG) training per week, minutes of stretching per day, and hours of conditioning per week, were analyzed as potential risk factors for injury. Main outcome measures were injuries that required time off, major injuries (at least 7 days off), injuries to muscle-tendon units, and fractures. Results: Thirteen (65%) of 20 gymnasts sustained timeloss injuries, and 4 gymnasts (20%) reported major injuries. Seventeen (85%) gymnasts reported muscle-tendon unit injuries and 5 (25%) suffered fractures. Sixteen (80%) of the gymnasts reported back pain or stress fractures of the back, 8 of whom required time off training. One gymnast (5%) incurred a concussion. Logistic regression indicated that rhythmic gymnastics training and stretching were associated with muscle-tendon unit injury. On multivariate analysis, stretching was found to be the only independent predictor of muscle-tendon unit injuries with each additional minute lowering the risk by approximately 10% (p ≤ 0.01). Conditioning and stretching were both independent predictors of fractures. The risk of fracture was estimated to increase by over 60% for each additional hour of weekly conditioning (odds ratio = 1.62; p = 0.03) and decrease by almost 20% for each additional minute of daily stretching (odds ratio = 0.81; p = 0.04). None of the variables studied were predictive of back pain or injury. Conclusions: Injuries in rhythmic gymnastics may be reduced by increasing the amount of time spent stretching per day (at least 40 minutes), and limiting conditioning to a maximum of 6 hours per week.
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TL;DR: Overuse injuries were common among Norwegian rhythmic gymnasts and Gymnasts who were not menstruating had higher substantial injury risk and younger gymnasts had higher all-injury risk.
Abstract: Objectives Rhythmic gymnastics is an Olympic sport that demands high training volume from early age. We investigated the extent of, and risk factors for, injuries among competitive Norwegian rhythmic gymnasts. Methods One hundred and seven of 133 (80.5%) female rhythmic gymnasts (mean age: 14.5 years (SD 1.6), mean body mass index: 18.9 (SD 2.2)) participated. All gymnasts completed a baseline questionnaire and the ‘Triad-Specific Self-Report Questionnaire’. Injuries, illnesses and training hours were recorded prospectively for 15 weeks during preseason using the ‘Oslo Sports Trauma Research Center Questionnaire on Health Problems’ (OSTRC-H2). Results Response rate to OSTRC-H2 was 97%. Mean overuse and acute injury prevalence were 37% (95% CI: 36% to 39%) and 5% (95% CI: 4% to 6%), respectively. Incidence was 4.2 overuse injuries (95% CI: 3.6 to 4.9) and 1.0 acute injuries (95% CI: 0.5 to 1.6) per gymnast per year. Overuse injuries in knees, lower back and hip/groin represented the greatest burdens. Previous injury increased the odds of injury (OR 30.38, (95% CI: 5.04 to 183.25)), while increased age (OR 0.61 per year, (95% CI: 0.39 to 0.97)) and presence of menarche (OR: 0.20, (95% CI: 0.06 to 0.71)) reduced the odds of all injuries and substantial injuries, respectively. Conclusions Overuse injuries were common among Norwegian rhythmic gymnasts. Younger gymnasts had higher all-injury risk. Gymnasts who were not menstruating had higher substantial injury risk. Injury prevention interventions should start at an early age and focus on preventing knee, lower back and hip/groin injuries.
16 citations
TL;DR: This trial analyzes the largest cohort of elRG to date and concludes that intensive training in RG is a significant factor causing more and stronger pain than in a CG.
Abstract: Rhythmic gymnastics (RG) unites aesthetic, ballet-like motion, and all aspects of gymnastics To reach elite level, girls begin at early age the intensive training To date it is unclear if such demanding training influences the incidence and intensity of painful overuse injuries The purpose of this study is to analyze anatomical painful regions and pain intensity in elite level rhythmic gymnasts (elRG) and compare results with an age-matched control group (CG) This prospective field study was carried out at the European Championship in RG 2013 (218 participating athletes, Vienna, Austria) Volunteering athletes were interviewed according to a preformed questionnaire As CG secondary school pupils without any competitive sports experience were analyzed accordingly Overall, 243 young females (144 elRG/66 % of all participants and 99 CG) were observed ElRGs were significantly (s) smaller, lighter, and had s stronger pain (p < 0001) A total of 72 % of athletes reported to have at least one painful body region compared with 52 % of CG (p < 0001) ElRG had nearly three times more serious injuries than the CG In all 23 % off all elRG reported to have had no access to professional medical care ElRGs were s more frequently (25 vs 9 %) affected at the lumbar spine and the ankle joint (174 vs 7 %) To our knowledge, this trial analyzes the largest cohort of elRG to date Hence, it is clearly alluded that intensive training in RG is a significant factor causing more and stronger pain than in a CG
7 citations
TL;DR: The Mézières method treatment performed on athletes with low back pain has caused positive effects on all the outcomes analyzed compared with the ones of control group.
Abstract: Context One of the main reasons why athletes with a high physical condition suffer from low back pain disease is because they often participate in sports that involve disc compression movements during flexion, lifting loads, or torsion movement. Objectives This study aims to examine the effectiveness of the postural treatment of the Mezieres method on elite rhythmic gymnastics athletes with low back pain. Design Double-blind, randomized, controlled trial. Setting The sports hall of "Puente Tocinos," Murcia, Spain. Participants Ninety gymnastics athletes were randomized into 2 parallel groups (intervention: n = 39; control: n = 51), of whom 98.9% were women (women = 89; man = 1). Intervention The Mezieres method postural therapy was implemented. It lasted about 60 minutes in repeated sessions of 2 to 3 meetings per week by counting in overall 60 sessions during a 24-week period. Main outcome measures Visual analog scale of pain, sit and reach flexibility test, Runtastic (pedometer performance android application), Roland-Morris Questionnaire for the physical disability, and the Health Status Questionnaire were used. Results The univariate analysis of variance and independent sample t test revealed a significant improvement in the intervention group concerning the visual analog scale pain assessment scale (P 0.8) compared with the control one. The same situation persists even for Roland-Morris Questionnaire (P 0.8). Conclusion The Mezieres method treatment performed on athletes with low back pain has caused positive effects on all the outcomes analyzed compared with the ones of control group.
5 citations
TL;DR: In this paper, the authors determine and compare the rate of use of body movement difficulties and elements with or without back band of the trunk or large hip extension of gymnasts who participated in a competition.
Abstract: The aim of this study is to determine and compare the rate of use of body movement difficulties and elements with or without back band of the trunk or large hip extension of gymnasts who participat...
4 citations
Cites background from "Injuries and training recommendatio..."
...The injuries to the spine are more commonly chronic or overuse injuries, and it has been reported that elite rhythmic gymnasts were affected by pain especially in the lumbar spine with incidence reports 72% (Sabeti et al., 2015), 80% (Zetaruk et al., 2006) or 86% (Hutchinson, 1999)....
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...Furthermore, intensive trainings are potential risk factors for overuse injuries with many of the techniques requiring repetitive, ballistic, extreme hyperextension of the spine in rhythmic gymnasts (Zetaruk et al., 2006)....
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...Progressive planning of the type, content and progression of training loads also relevant to minimise injury risk and optimise performance (Zetaruk et al., 2006)....
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...Despite the risk of overload and injury in rhythmic gymnasts (Zetaruk et al., 2006), the new changes in rules may have increased this risk even more....
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TL;DR: In this article, the authors analyzed the relationship between the technical penalties obtained in the execution of an isolated gymnastics element, the competitive level of the gymnasts, their anthropometric characteristics, and the most important temporal and angular variables analyzed in this skill.
Abstract: The aim of this study was to analyze the relationship between the following aspects: the technical penalties obtained in the execution of an isolated gymnastics element, the competitive level of the gymnasts, their anthropometric characteristics, and the most important temporal and angular variables analyzed in this skill. Twenty nine gymnasts (aged 17.1 ± 3.1 years) from different competition levels were selected. Three coaches evaluated the execution through an adaptation of the Code of Points. Significant direct and indirect associations were observed (p < 0.05): low adiposity index (rho = 0.643), take-off total time (rho = 0.619), flight total time (rho = - 0.596), maximum range of motion of the hips (rho = - 0.902), and maximum extension of ankles (rho = - 0.738). The assessment of penalties as well as the use of competitive level and Split Leap as specific tests, have demonstrated to be useful tools for evaluating performance. Key words: rhythmic gymnastics, photogrammetry, performance
3 citations
References
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Book•
01 Jan 1989
TL;DR: Hosmer and Lemeshow as discussed by the authors provide an accessible introduction to the logistic regression model while incorporating advances of the last decade, including a variety of software packages for the analysis of data sets.
Abstract: From the reviews of the First Edition. "An interesting, useful, and well-written book on logistic regression models... Hosmer and Lemeshow have used very little mathematics, have presented difficult concepts heuristically and through illustrative examples, and have included references."- Choice "Well written, clearly organized, and comprehensive... the authors carefully walk the reader through the estimation of interpretation of coefficients from a wide variety of logistic regression models . . . their careful explication of the quantitative re-expression of coefficients from these various models is excellent." - Contemporary Sociology "An extremely well-written book that will certainly prove an invaluable acquisition to the practicing statistician who finds other literature on analysis of discrete data hard to follow or heavily theoretical."-The Statistician In this revised and updated edition of their popular book, David Hosmer and Stanley Lemeshow continue to provide an amazingly accessible introduction to the logistic regression model while incorporating advances of the last decade, including a variety of software packages for the analysis of data sets. Hosmer and Lemeshow extend the discussion from biostatistics and epidemiology to cutting-edge applications in data mining and machine learning, guiding readers step-by-step through the use of modeling techniques for dichotomous data in diverse fields. Ample new topics and expanded discussions of existing material are accompanied by a wealth of real-world examples-with extensive data sets available over the Internet.
35,847 citations
TL;DR: Applied Logistic Regression, Third Edition provides an easily accessible introduction to the logistic regression model and highlights the power of this model by examining the relationship between a dichotomous outcome and a set of covariables.
Abstract: \"A new edition of the definitive guide to logistic regression modeling for health science and other applicationsThis thoroughly expanded Third Edition provides an easily accessible introduction to the logistic regression (LR) model and highlights the power of this model by examining the relationship between a dichotomous outcome and a set of covariables. Applied Logistic Regression, Third Edition emphasizes applications in the health sciences and handpicks topics that best suit the use of modern statistical software. The book provides readers with state-of-the-art techniques for building, interpreting, and assessing the performance of LR models. New and updated features include: A chapter on the analysis of correlated outcome data. A wealth of additional material for topics ranging from Bayesian methods to assessing model fit Rich data sets from real-world studies that demonstrate each method under discussion. Detailed examples and interpretation of the presented results as well as exercises throughout Applied Logistic Regression, Third Edition is a must-have guide for professionals and researchers who need to model nominal or ordinal scaled outcome variables in public health, medicine, and the social sciences as well as a wide range of other fields and disciplines\"--
30,190 citations
TL;DR: There is not sufficient evidence to endorse or discontinue routine stretching before or after exercise to prevent injury among competitive or recreational athletes and further research is urgently needed.
Abstract: THACKER, S. B., J. GILCHRIST, D. F. STROUP, and C. D. KIMSEY, JR. The Impact of Stretching on Sports Injury Risk: A Systematic Review of the Literature. Med. Sci. Sports Exerc., Vol. 36, No. 3, pp. 371–378, 2004. Purpose: We conducted a systematic review to assess the evidence for the effectiveness of stretching as a tool to prevent injuries in sports and to make recommendations for research and prevention. Methods: Without language limitations, we searched electronic data bases, including MEDLINE (1966 –2002), Current Contents (1997–2002), Biomedical Collection (1993–1999), the Cochrane Library, and SPORTDiscus, and then identified citations from papers retrieved and contacted experts in the field. Meta-analysis was limited to randomized trials or cohort studies for interventions that included stretching. Studies were excluded that lacked controls, in which stretching could not be assessed independently, or where studies did not include subjects in sporting or fitness activities. All articles were screened initially by one author. Six of 361 identified articles compared stretching with other methods to prevent injury. Data were abstracted by one author and then reviewed independently by three others. Data quality was assessed independently by three authors using a previously standardized instrument, and reviewers met to reconcile substantive differences in interpretation. We calculated weighted pooled odds ratios based on an intention-to-treat analysis as well as subgroup analyses by quality score and study design. Results: Stretching was not significantly associated with a reduction in total injuries (OR 0.93, CI 0.78 –1.11) and similar findings were seen in the subgroup analyses. Conclusion: There is not sufficient evidence to endorse or discontinue routine stretching before or after exercise to prevent injury among competitive or recreational athletes. Further research, especially well-conducted randomized controlled trials, is urgently needed to determine the proper role of stretching in sports. Key Words: ATHLETES, CONDITIONING, META-ANALYSIS, SYNTHESIS
538 citations
TL;DR: The basic science literature supports the epidemiologic evidence that stretching before exercise does not reduce the risk of injury and appears to mask muscle pain in humans.
Abstract: ObjectiveTo evaluate the clinical and basic science evidence surrounding the hypothesis that stretching immediately before exercise prevents injury.Data Sources and SelectionMEDLINE was searched using MEDLINE subject headings (MeSH) and textwords for English- and French-language articles related to
239 citations
TL;DR: The majority of cases of low back pain in adolescents respond to conservative therapy, and the final component of a young athletes’ back rehabilitation programme includes a long term stretching, and back and abdominal strengthening programme.
Abstract: Lumbar spine pain accounts for 5 to 8% of athletic injuries. Although back pain is not the most common injury, it is one of the most challenging for the sports physician to diagnose and treat. Factors predisposing the young athlete to back injury include the growth spurt, abrupt increases in training intensity or frequency, improper technique, unsuitable sports equipment, and leg-length inequality. Poor strength of the back extensor and abdominal musculature, and inflexibility of the lumbar spine, hamstrings and hip flexor muscles may contribute to chronic low back pain. Excessive lifting and twisting may produce sprains and strains, the most common cause of low back pain in adolescents. Blows to the spine may create contusions or fractures. Fractures in adolescents from severe trauma include compression fracture, comminuted fracture, fracture of the growth plate at the vertebral end plate, lumbar transverse process fracture, and a fracture of the spinous process. Athletes who participate in sports involving repeated and forceful hyperextension of the spine may suffer from lumbar facet syndrome, spondylolysis, or spondylolisthesis. The large sacroiliac joint is also prone to irritation. The signs and symptoms of disc herniation in adolescents may be more subtle than in adults. Disorders simulating athletic injury include tumours and inflammatory connective tissue disease. Often, however, a specific diagnosis cannot be made in the young athlete with a low back injury due to the lack of pain localisation and the anatomic complexity of the lumbar spine. A thorough history and physical examination are usually more productive in determining a diagnosis and guiding treatment than imaging techniques. Diagnostic tests may be considered, though, for the adolescent athlete whose back pain is severe, was caused by acute trauma, or fails to improve with conservative therapy after several weeks. Radiographs, bone scanning, computed tomography, and magnetic resonance imaging may help identify, or exclude serious pathology. Fortunately, the majority of cases of low back pain in adolescents respond to conservative therapy. Immediate treatment of an acute injury, such as a sprain or strain, includes cryotherapy, electrogalvanic stimulation, anti-inflammatory medications and gentle exercises. Prolonged bed rest should be avoided since atrophy may occur rapidly. Strong analgesics are also usually contraindicated, except for sleep, since they mask pain and may allow overvigorous activity. Early strengthening exercises include the Williams flexion exercises and/or McKenzie extension exercises. Both exercise motions may often be prescribed. Athletes with an acute disc herniation, however, should only perform extension exercises initially. Athletes with spondylolysis, spondylolisthesis and facet joint irritation should initially be limited to flexion exercises.(ABSTRACT TRUNCATED AT 400 WORDS)
210 citations