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Kirk Krumrei, Molly Flanagan, Josh Bruner and Chris Durall

Clinical Scenario:

Injuries are somewhat commonplace in highly active populations. One strategy for reducing injuries is to identify individuals with an elevated injury risk before participation so that remediative interventions can be provided. Preparticipation screenings have traditionally entailed strength and flexibility measures thought to be indicative of inflated injury risk. Some researchers, however, have suggested that functional movements/tasks should be assessed to help identify individuals with a high risk of future injury. One assessment tool used for this purpose is the Functional Movement Screen (FMS). The FMS generates a numeric score based on performance attributes during 7 dynamic tasks; this score is purported to reflect future injury risk. Expanding interest in the FMS has led researchers to investigate how accurately it can identify individuals with an increased risk of injury.

Focused Clinical Question:

Can the Functional Movement Screen accurately identify highly active individuals with an elevated risk of injury?

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Ryan G. Timmins, Baubak Shamim, Paul J. Tofari, Jack T. Hickey and Donny M. Camera

attempt to balance performance improvement while minimizing injury risk. With these athletes, the prescription of resistance training interventions is rarely undertaken independent of aerobic conditioning. 10 For example, stationary cycling is used as part of an athlete’s combined concurrent training

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Carl G. Mattacola, Carolina Quintana, Jed Crots, Kimberly I. Tumlin and Stephanie Bonin

same location is reduced. Replacing an impacted helmet likely reduces a rider’s head injury risk when exposed to a subsequent head impact. References 1. Gibson T , Thai K , Saxon J , Pollock R . The effectiveness of safety equipment in horse racing falls . Paper presented at: International

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Francesco Campa, Federico Spiga and Stefania Toselli

.060582 19553225 10.1136/bjsm.2009.060582 6. Chorba RS , Chorba DJ , Bouillon LE , Overmyer CA , Landis JA . Use of a functional movement screening tool to determine injury risk in female collegiate athletes . N Am J Sports Phys Ther . 2010 ; 5 ( 2 ): 47 – 54 . PubMed ID: 21589661 21589661 7. Cook

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Jonathon R. Staples, Kevin A. Schafer, Matthew V. Smith, John Motley, Mark Halstead, Andrew Blackman, Amanda Haas, Karen Steger-May, Matthew J. Matava, Rick W. Wright and Robert H. Brophy

injury risk: a prospective biomechanical-epidemiologic study . Am J Sports Med . 2007 ; 35 ( 7 ): 1123 – 1130 . PubMed ID: 17468378 doi: 10.1177/0363546507301585 16. Nessler T , Denney L , Sampley J . ACL injury prevention: what does research tell us? Curr Rev Musculoskelet Med . 2017

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Matthew R. Rhea and Derek Bunker

Baseball demands speed, power, and quickness. To perform at a high level, and avoid injuries that are common among baseball players, an evaluation of current trends in strength and conditioning practices is helpful. Based on the demands of the sport and the injury risks, qualified strength and conditioning professionals can develop effective baseball-specific conditioning programs. This commentary briefly covers historical aspects of baseball conditioning, recent injury trends, current practices among elite baseball professionals, and provides suggestions for future improvements in training.

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Joseph J. Knapik, Keith G. Hauret, Sara Canada, Roberto Marin and Bruce Jones

Background:

Associations between physical activity and injuries have been previously examined using self-reports. The present investigation examined this association using objective measures of activity and injury.

Methods:

To quantify ambulatory activity, pedometers were worn daily by recruits in 10 Army Basic Combat Training companies during the 9-week training cycle. Injuries were obtained from a medical surveillance system, defined as traumatic or overuse events resulting in a medical care provider visit. A daily questionnaire documented whether or not recruits wore the pedometers and trained with their companies for the entire day.

Results:

Training companies were categorized by activity level into 3 groups with higher activity (HA, 17,948 ± 550 steps/day), 4 with moderate activity (MA, 16,346 ± 768 steps/day) and 3 with lower activity (LA, 14,772 ± 400 steps/day). Among men, the MA and HA groups were at 1.52 (95% confidence interval [95% CI] = 1.15−2.01) and 1.94 (95% CI = 1.46−2.61) times higher injury risk, respectively, compared with the LA group. Among women, the MA and HA groups were at 1.36 (95% CI = 1.07−1.73) and 1.53 (95% CI = 1.24−1.89) times higher injury risk, respectively, compared with low LA group. The relationships remained significant after considering physical characteristics and physical fitness.

Conclusions:

In consonance with previous self-report studies, higher physical activity was associated with higher injury risk.

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Andreas Ivarsson, Urban Johnson and Leslie Podlog

Context:

Athletes participating in sport are exposed to a high injury risk. Previous research has found a great number of risk factors (both physiological and psychological) that could increase injury risk.1 One limitation in previous studies is that few have considered the complex interaction between psychological factors in their research design.

Objective:

To study whether personality, stress, and coping predicted injury occurrence in an elite soccer population based on a hypothesized model.

Design:

Prospective.

Participants:

56 (n = 38 male, n = 18 female) Swedish Premiere League soccer players were selected based on convenience sampling.

Intervention:

Participants completed 4 questionnaires including the Swedish Universities Scales of Personality,2 Life Events Survey for Collegiate Athletes,3 and Brief COPE4 during the initial questionnaire administration. Subsequent to the first meeting, participants also completed the Hassle and Uplift Scale5 once per wk for a 13-wk period throughout the competitive season.

Main Outcome Measures:

A path analysis was conducted examining the influence of personality traits (ie, trait anxiety), state-level stressors (ie, negative-life-event stress and daily hassles), and coping on injury frequency.

Results:

Results of the path analysis indicated that trait anxiety, negative-life-event stress, and daily hassle were significant predictors of injury among professional soccer players, accounting for 24% of the variance.

Conclusion:

The findings highlight the need for athletes, coaches, and medical practitioners to attempt to reduce state-level stressors, especially daily hassles, in minimizing injury risk. Educating and training athletes and coaches in proactive stress-management techniques appears warranted.

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Gary B. Wilkerson, Kevin A. Simpson and Ryan A. Clark

Context:

Neurocognitive reaction time has been associated with musculoskeletal injury risk, but visuomotor reaction time (VMRT) derived from tests that present greater challenges to visual stimulus detection and motor response execution may have a stronger association.

Objective:

To assess VMRT as a predictor of injury and the extent to which improvement may result from VMRT training.

Design:

Cohort study.

Setting:

University athletic performance center.

Participants:

76 National Collegiate Athletic Association Division-I FCS football players (19.5 ± 1.4 y, 1.85 ± 0.06 m, 102.98 ± 19.06 kg).

Interventions:

Preparticipation and postseason assessments. A subset of players who exhibited slowest VMRT in relation to the cohort’s postseason median value participated in a 6-wk training program.

Main Outcome Measures:

Injury occurrence was related to preparticipation VMRT, which was represented by both number of target hits in 60 s and average elapsed time between hits (ms). Receiver operating characteristic analysis identified the optimum cut point for a binary injury risk classification. A nonparametric repeated-measures analysis of ranks procedure was used to compare posttraining VMRT values for slow players who completed at least half of the training sessions (n = 15) with those for untrained fast players (n = 27).

Results:

A preparticipation cut point of ≤85 hits (≥705 ms) discriminated injured from noninjured players with odds ratio = 2.30 (90% confidence interval, 1.05–5.06). Slow players who completed the training exhibited significant improvement in visuomotor performance compared with baseline (standardized response mean = 2.53), whereas untrained players exhibited a small performance decrement (group × trial interaction effect, L2 = 28.74; P < .001).

Conclusions:

Slow VMRT appears to be an important and modifiable injury risk factor for college football players. More research is needed to refine visuomotor reaction-time screening and training methods and to determine the extent to which improved performance values can reduce injury incidence.

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Michelle L. Weber, Kenneth C. Lam and Tamara C. Valovich McLeod

Clinical Question:

In youth and adolescent athletes, are jumping/plyometric exercises more effective than balance exercises in preventing sport-related injuries?

Objective:

The aim of this article is to examine the meta-analysis by Rössler et al.1 as it relates to the clinical question.

Conclusion:

Evidence in this meta-analysis suggests that injury prevention programs provide beneficial effects in injury reduction for youth and adolescent athletes. Prevention programs that contained jumping or plyometric exercises and were targeted toward females appeared to be especially beneficial for decreasing injury risk.