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Injuries and training recommendations in elite rhythmic gymnastics

TLDR
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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References
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Applied Logistic Regression

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.
Journal ArticleDOI

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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.
Journal ArticleDOI

The impact of stretching on sports injury risk: a systematic review of the literature.

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.
Journal ArticleDOI

Stretching before exercise does not reduce the risk of local muscle injury: a critical review of the clinical and basic science literature.

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.
Journal ArticleDOI

Low back pain in young athletes. A practical approach.

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.
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