Background:
In soccer, although hamstring flexibility is thought to play a major role in preventing hamstring injuries, the relationship between hamstring flexibility and hamstring injuries remains ...unclear.
Purpose:
To investigate the relationship between hamstring flexibility and hamstring injuries in male amateur soccer players.
Study Design:
Case-control study; Level of evidence, 3.
Methods:
This study included 450 male first-class amateur soccer players (mean age, 24.5 years). Hamstring flexibility was measured by performing the sit-and-reach test (SRT). The relationship between hamstring flexibility and the occurrence of hamstring injuries in the following year, while adjusting for the possible confounding effects of age and previous hamstring injuries, was determined with a multivariate logistic regression analysis.
Results:
Of the 450 soccer players, 21.8% reported a hamstring injury in the previous year. The mean (±SD) baseline score for the SRT was 21.2 ± 9.2 cm. During the 1-year follow-up period, 23 participants (5.1%) suffered a hamstring injury. In the multivariate analysis, while adjusting for age and previous injuries, no significant relationship was found between hamstring flexibility and hamstring injuries (P = .493).
Conclusion:
In this group of soccer players, hamstring flexibility (measured with the SRT) was not related to hamstring injuries. Age and previous hamstring injuries as possible confounders did not appear to influence this relationship. Other etiological factors need to be examined to further elucidate the mechanism of hamstring injuries.
Background:
Although it has been suggested that generalized joint hypermobility (GJH) is a risk factor for injury in soccer players, it remains unclear whether this applies to elite female soccer ...players.
Purpose:
To investigate whether GJH is a risk factor for injury in elite female soccer players.
Study Design:
Cohort study; Level of evidence, 2.
Methods:
Elite female soccer players in the Netherlands were screened at the start of the 2014-2015 competitive season. GJH was assessed using the Beighton score. Soccer injuries and soccer exposure were registered throughout the entire season. Poisson regression was performed to calculate incidence risk ratios (IRRs) using different cutoff points of the Beighton score (≥3, ≥4, and ≥5) to indicate GJH.
Results:
Of the 114 players included in the study, 20 were classified as hypermobile (Beighton score ≥4). The mean (±SD) injury incidence per player was 8.40 ± 9.17 injuries/1000 hours of soccer, with no significant difference between hypermobile and nonhypermobile players. GJH was not a risk factor for injuries when using Beighton score cutoff points of ≥3 (IRR = 1.06 95% CI, 0.74-1.50; P = .762), ≥4 (IRR = 1.10 95% CI, 0.72-1.68; P = .662), or ≥5 (IRR = 1.15 95% CI, 0.68-1.95; P = .602). Similarly, GJH was not a significant risk factor for thigh, knee, or ankle injuries evaluated separately.
Conclusion:
This study indicates that GJH is not a risk factor for injuries in elite female soccer players, irrespective of Beighton score cutoff point. Hypermobile players at this elite level might have improved their active stability and/or used braces to compensate for joint laxity.
Abstract Objectives To investigate the economic burden of running-related injuries (RRI) occurred during the 6-week ‘Start-to-Run’ program of the Dutch Athletics Federation in 2013. Design ...Prospective cohort study. Methods This was a monetary cost analysis using the data prospectively gathered alongside the RRI registration in the NLstart2run study. RRI data were collected weekly. Cost diaries were applied two and six weeks after the RRI registration to collect data regarding healthcare utilisation (direct costs) and absenteeism from paid and unpaid work (indirect costs). RRI was defined as running-related pain that hampered running ability for three consecutive training sessions. Results From the 1696 participants included in the analysis, 185 reported a total of 272 RRIs. A total of 26.1% of the cost data (71 RRIs reported by 50 participants) were missing. Therefore, a multiple imputation procedure was performed. The economic burden (direct plus indirect costs) of RRIs was estimated at €83.22 (95% CI €50.42–€116.02) per RRI, and €13.35 (95% CI €7.07–€19.63) per participant. The direct cost per RRI was €56.93 (95% CI €42.05–€71.81) and the indirect cost per RRI was €26.29 (95% CI €0.00–€54.79). The indirect cost was higher for sudden onset RRIs than for gradual onset RRIs, with a mean difference of €33.92 (95% CI €17.96–€49.87). Conclusions Direct costs of RRIs were 2-fold higher than the indirect costs, and sudden onset RRIs presented higher costs than gradual onset RRIs. The results of this study are important to provide information to public health agencies and policymakers about the economic burden of RRIs in novice runners.
Background:
Alfredson isolated eccentric loading and Silbernagel concentric–eccentric loading have both shown beneficial effects on clinical symptoms in midportion Achilles tendinopathy (AT), but ...they have never been compared directly.
Purpose:
To test for differences in clinical effects at 1-year follow-up between Alfredson and Silbernagel loading in midportion AT.
Study Design:
Randomized controlled trial; Level of evidence, 2.
Methods:
A total of 40 recreational athletes were allocated to the Alfredson group (AG) or the Silbernagel group (SG). The primary outcome was the difference in the Victorian Institute of Sports Assessment–Achilles (VISA-A) at 1-year follow-up. Secondary outcomes were the visual analog scale for pain during activities of daily living (VAS-ADL) and sports activities (VAS–sports), the EuroQol 5 Dimensions instrument (EQ-5D), and global perceived effect score. Measurements were performed at baseline and 12-week, 26-week, and 1-year follow-up. Analysis was performed using a linear mixed-regression model with intervention (AG vs SG), time (12 weeks, 26 weeks, and 1 year postoperatively), and intervention-by-time interaction.
Results:
The VISA-A score improved for both AG and SG, from 60.7 ± 17.1 at baseline to 89.4 ± 13.0 at 1-year follow-up and from 59.8 ± 22.2 to 83.2 ± 22.4, respectively (P < .001 for both). Because the interaction term did not significantly improve the model, we reported a treatment effect without interaction term, indicating a constant difference at each follow-up. The linear mixed model with correction for baseline VISA-A and confounders revealed a nonsignificant treatment effect (2.4 95% CI, –8.5 to 13.3; P = .656). In addition, after adjustment for the respective baseline values and confounders, nonsignificant treatment effects were found for the VAS-ADL (–2.0 95% CI, –11.3 to 7.3; P = .665) and VAS-sports (1.3 95% CI, –12.8 to 15.3, P = .858). The EQ-5D subscales improved in both groups. After 1 year, significantly more SG participants considered themselves improved (77.3% SG vs 50.0% AG; P = .04).
Conclusion:
No differences in clinical effects were found between Alfredson and Silbernagel loading at up to 1-year follow-up. Both programs significantly improved clinical symptoms, and given their high adherence rates, offering either of them as a home-based program with limited supervision appears to be an effective treatment strategy for midportion AT.
Registration:
NTR5638 (Netherlands Trial Register number).
OBJECTIVE: In addition to known risk factors for musculoskeletal complaints in the general population, playing a musical instrument is an additional risk factor. In this pilot study, the prevalence ...of musculoskeletal complaints in student amateur musicians and their relation with playing
posture and playing time were evaluated. METHODS: A cross-sectional web-based survey among amateur musicians studying at a Dutch university. RESULTS: 162 amateur musicians were included in this pilot study (response rate 17.6%). 46.9% of these amateur musicians played with an elevated arm
position. Presence of complaints of the arm, neck and/or shoulder (CANS) was not statistically significantly related to arm position, except for complaints in the left shoulder with an elevated left arm position compared to neutral left arm position (OR 6.7, CI 95% 2.2-20.8) The number
of hours playing per week did not significantly contribute to CANS (OR 1.0, CI 95% 0.95-1.17). CONCLUSIONS: In this pilot study among student amateur musicians, the occurrence of CANS was not significantly related to arm position, except for musicians playing with an elevated left arm
position, which was associated with complaints of the left shoulder (OR 6.7). The number of hours playing per week did not significantly contribute to CANS in this group of musicians.
Pompe disease is an inherited metabolic, neuromuscular disorder. With the introduction of enzyme replacement therapy skeletal muscle and respiratory function can be stabilized or improved. Additional ...physiotherapy to advance physical functioning of patients might be beneficial, but evidence and guidelines are lacking.
In order to get an insight into current practices of referral and treatment, and perceived benefit, we performed a survey among 88 Dutch adult Pompe patients and 31 physiotherapists.
Sixty percent of patients were ever referred for physiotherapy, whereas currently less than 40% receive physiotherapy. Approximately 50% of patients were referred for loss of muscle strength; while 74% received muscle strengthening exercises, often combined with aerobic endurance training. In 47% of patients the intervention did not match the referral reason. More than two-thirds of patients and physiotherapists perceived physiotherapy as beneficial, and the majority highlighted the need for guidance.
Physiotherapeutic care can be improved by tailoring interventions to referral reasons and treatment objectives. More high quality studies are urgently needed to assess which interventions are most useful in this patient group.
► 41% of patients with Pompe disease were never referred for physiotherapy. ► More patients could be referred; evidence and guidelines are needed to support this. ► Treatment objective and intervention are often not in line with the referral reason. ► Tailoring intervention to referral reason and objective may improve physiotherapy care.
Commentaries Huisstede, Bionka MA; Hoogvliet, Peter
International journal of therapy and rehabilitation,
03/2011, Letnik:
18, Številka:
3
Journal Article
For the posterior interosseus nerve syndrome (PINS), no randomised controlled trials or controlled clinical trials about the effectiveness of interventions are available; only case series can be ...found. Although the validity of case series is inferior to controlled trials, they may provide valuable data about the efficacy of treatment options. Therefore, we systematically reviewed all available observational studies on treatment of PINS. A literature search and additional reference checking was done. On the basis of previous checklists, we constructed a quality assessment and rating system to analyse the included case series. Studies with less than 50% of the maximum points on the methodological quality assessment were excluded from the analysis. The results are summarised according to a rating system for the strength of the scientific evidence. Six eligible case series for this review were found. After the data extraction and methodological quality assessment, two higher quality studies that evaluated the effectiveness of surgical decompression of the PIN were included in the final analysis. There is a tendency for the effectiveness of surgical decompression of the PIN in patients with PINS. The effectiveness of a conservative treatment for PINS is unknown because no higher quality studies are available. Additional high-quality controlled studies are needed to assess the level of 'conclusive evidence' for surgical treatment. There is also a need for high-quality controlled trials into the effectiveness of conservative treatments for PINS.
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