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International Journal of Environmental... Aug 2022Handball is a team sport involving a great physical demand from its practitioners in which a high number of injuries occur, affecting individual and collective... (Review)
Review
Handball is a team sport involving a great physical demand from its practitioners in which a high number of injuries occur, affecting individual and collective performance. Knowledge of the injuries is of great importance for their prevention. The objective of the present study was to identify, locate and compare the most frequent injuries and injury mechanisms in handball practice. It was carried out following the Preferred Informed Item for Systematic Reviews and Meta-analysis (PRISMA) guidelines. The source of data collection was direct consultation of the PubMed and Medline databases. Several keywords were used for the documentary retrieval, and the quality of the studies that were selected was evaluated. Of the 707 studies retrieved, only 27 were considered appropriate for the review, and quality scores were obtained that ranged from 10 to 26 points, out of a maximum of 28. The most frequent injuries in handball players are located in the lower limbs (thigh, knee and ankle), and in the shoulder in the upper limbs. Regarding the playing position, the players who play over the 6-m line are the most affected by injuries, while the women players have a higher probability of injury. Most injuries occur during competition.
Topics: Athletic Injuries; Female; Humans; Knee Joint; Lower Extremity; Male; Shoulder; Sports
PubMed: 36078403
DOI: 10.3390/ijerph191710688 -
International Journal of Environmental... Jul 2022Patellofemoral pain syndrome (PFPS) is highly prevalent; it can cause severe pain and evolve into progressive functional loss, leading to difficulties performing daily... (Review)
Review
Patellofemoral pain syndrome (PFPS) is highly prevalent; it can cause severe pain and evolve into progressive functional loss, leading to difficulties performing daily tasks such as climbing and descending stairs and squatting. This systematic review aimed to find evidence, in the literature, of squat movements that can cause or worsen PFPS. This work was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, and its protocol was registered in PROSPERO (CRD42019128711). From the 6570 collected records, 37 were included. From these 37 articles, 27 present a causal relationship between knee flexion and PFPS, 8 describe a relationship, considering the greater existence of muscle contractions, and one article did not describe this relationship in its results. The main limitations stem from the fact that different studies used different evaluation parameters to compare the force exerted on the patellofemoral joint. Furthermore, most studies are focused on sports populations. After analysing the included works, it was concluded that all squat exercises can cause tension overload in the knee, especially with a knee flexion between 60° and 90° degrees. The main causal/worsening factors of PFPS symptoms are the knee translocation forward the toes (on the same body side) when flexing the knee, and the muscle imbalance between the thigh muscles.
Topics: Exercise Therapy; Humans; Knee; Knee Joint; Patellofemoral Pain Syndrome
PubMed: 35954598
DOI: 10.3390/ijerph19159241 -
Journal of Sport and Health Science Jan 2022Team-sport players have a particularly high injury risk. Although female sex is considered a risk factor, it is still unknown whether female and male team-sport players,... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Team-sport players have a particularly high injury risk. Although female sex is considered a risk factor, it is still unknown whether female and male team-sport players, in fact, differ in their injury rates. We aimed to compare injury rates between female and male players by systematically reviewing and meta-analyzing injury surveillance studies of both sexes in order to evaluate sex-specific differences in team-sport injuries.
METHODS
Studies that prospectively collected injury data for high-level female and male players (age ≥16 years) in basketball, field hockey, football (soccer), handball, rugby (union and sevens), and volleyball were included. Two reviewers (AZ and ALR) independently assessed study quality and extracted data for overall, match, training, and severe injuries (>28 days' time loss) as well as data regarding injury locations and types. Incidence rate ratios (IRRs) were pooled in a meta-analysis, and meta-regression analysis was performed when 10 or more studies were available.
RESULTS
Of 20 studies, 9 studies reported injury data from football, 3 studies from rugby, 3 studies from handball, 1 study from basketball, 1 study from field hockey, 2 studies from volleyball, and 1 study from basketball and field hockey. For overall injuries, the pooled IRR = 0.86 (95% confidence interval (95%CI): 0.76-0.98) indicated significantly more injuries in male than in female players. For injury location, the pooled IRR showed higher injury rates in male athletes than in female athletes for upper extremity, hip/groin, thigh, and foot injuries. Female players had a significantly higher rate of anterior cruciate ligament injuries (IRR = 2.15, 95%CI: 1.27-3.62) than male players. No significant sex-specific differences in IRR were found for match, training, severe injuries, concussions, or ankle sprains.
CONCLUSION
Our meta-analysis provides evidence for sex-specific differences in the injury rates in team sports. Further epidemiological studies including both sexes in sports other than football are needed in order to strengthen the evidence.
Topics: Adolescent; Female; Humans; Male; Athletic Injuries; Regression Analysis; Sex Characteristics; Team Sports; Soccer
PubMed: 34052518
DOI: 10.1016/j.jshs.2021.04.003 -
British Journal of Sports Medicine Dec 2018To perform a systematic review and meta-analysis identifying (1) potential modifiable risk factors and (2) associated modifiable factors for patellar tendinopathy in... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To perform a systematic review and meta-analysis identifying (1) potential modifiable risk factors and (2) associated modifiable factors for patellar tendinopathy in athletes.
DESIGN
A systematic review and meta-analysis was conducted. Risk of bias was assessed using the Newcastle-Ottawa Scale and grouped based on study design. Meta-analytic statistics were performed for items reported by five or more studies. A strength of evidence rating is provided for items not appropriate for meta-analysis.
DATA SOURCES
PubMed, Web of Science, Scopus and Cinahl were searched on 14 November 2017.
ELIGIBILITY CRITERIA
Quantitative, original research reporting potential modifiable risk factors or associated factors, comparing athletes with patellar tendinopathy with a group without the injury.
RESULTS
862 records were screened and 31 articles were included (6 prospective, 25 cross-sectional). There was a lack of strong evidence for any potential modifiable risk factor or associated factors. There was limited or conflicting evidence that decreased ankle dorsiflexion range of motion, decreased posterior thigh and quadriceps flexibility, greater volume of jump training, more volleyball sets played per week, greater countermovement jump (CMJ) height and greater activity volume are potential modifiable risk factors. Meta-analysis supported greater activity volume (Cohen's d=0.22, 95% CI 0.06 to 0.39, p=0.008), higher body weight (0.36, 0.17 to 0.55, p<0.001) and greater CMJ height (0.31, 0.07 to 0.56, p=0.01) as associated modifiable factors.
CONCLUSIONS
There is a lack of strong evidence for any potential modifiable risk factors or associated factors. Factors with lower levels of support may be of interest in designing prevention programmes but require further research in high-quality, prospective studies.
Topics: Ankle; Athletes; Basketball; Humans; Patellar Ligament; Quadriceps Muscle; Range of Motion, Articular; Risk Factors; Tendinopathy; Volleyball
PubMed: 30054341
DOI: 10.1136/bjsports-2017-099000 -
BMJ (Clinical Research Ed.) Sep 2020To quantify the association of indices of central obesity, including waist circumference, hip circumference, thigh circumference, waist-to-hip ratio, waist-to-height... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To quantify the association of indices of central obesity, including waist circumference, hip circumference, thigh circumference, waist-to-hip ratio, waist-to-height ratio, waist-to-thigh ratio, body adiposity index, and A body shape index, with the risk of all cause mortality in the general population, and to clarify the shape of the dose-response relations.
DESIGN
Systematic review and meta-analysis.
DATA SOURCES
PubMed and Scopus from inception to July 2019, and the reference lists of all related articles and reviews.
ELIGIBILITY CRITERIA FOR SELECTING STUDIES
Prospective cohort studies reporting the risk estimates of all cause mortality across at least three categories of indices of central fatness. Studies that reported continuous estimation of the associations were also included.
DATA SYNTHESIS
A random effects dose-response meta-analysis was conducted to assess linear trend estimations. A one stage linear mixed effects meta-analysis was used for estimating dose-response curves.
RESULTS
Of 98 745 studies screened, 1950 full texts were fully reviewed for eligibility. The final analyses consisted of 72 prospective cohort studies with 2 528 297 participants. The summary hazard ratios were as follows: waist circumference (10 cm, 3.94 inch increase): 1.11 (95% confidence interval 1.08 to 1.13, I=88%, n=50); hip circumference (10 cm, 3.94 inch increase): 0.90 (0.81 to 0.99, I=95%, n=9); thigh circumference (5 cm, 1.97 inch increase): 0.82 (0.75 to 0.89, I=54%, n=3); waist-to-hip ratio (0.1 unit increase): 1.20 (1.15 to 1.25, I=90%, n=31); waist-to-height ratio (0.1 unit increase): 1.24 (1.12 to 1.36, I=94%, n=11); waist-to-thigh ratio (0.1 unit increase): 1.21 (1.03 to 1.39, I=97%, n=2); body adiposity index (10% increase): 1.17 (1.00 to 1.33, I=75%, n=4); and A body shape index (0.005 unit increase): 1.15 (1.10 to 1.20, I=87%, n=9). Positive associations persisted after accounting for body mass index. A nearly J shaped association was found between waist circumference and waist-to-height ratio and the risk of all cause mortality in men and women. A positive monotonic association was observed for waist-to-hip ratio and A body shape index. The association was U shaped for body adiposity index.
CONCLUSIONS
Indices of central fatness including waist circumference, waist-to-hip ratio, waist-to-height ratio, waist-to-thigh ratio, body adiposity index, and A body shape index, independent of overall adiposity, were positively and significantly associated with a higher all cause mortality risk. Larger hip circumference and thigh circumference were associated with a lower risk. The results suggest that measures of central adiposity could be used with body mass index as a supplementary approach to determine the risk of premature death.
Topics: Body Mass Index; Humans; Obesity, Abdominal; Waist Circumference; Waist-Hip Ratio
PubMed: 32967840
DOI: 10.1136/bmj.m3324 -
Sports Health 2023Knee muscle atrophy and weakness are common impairments after anterior cruciate ligament (ACL) reconstruction. Blood flow restriction (BFR) training represents a new...
CONTEXT
Knee muscle atrophy and weakness are common impairments after anterior cruciate ligament (ACL) reconstruction. Blood flow restriction (BFR) training represents a new approach to treat such impairments. However, limited evidence currently exists to support this intervention in related patients.
OBJECTIVE
To appraise literature comparing the effects of BFR training with conventional therapy on knee muscle morphological and strength properties in ACL-reconstructed patients.
DATA SOURCES
PubMed, SPORTDiscus, CINAHL, and Cochrane Central Register databases were searched for relevant articles from January 1991 through April 2021.
STUDY SELECTION
Articles were minimum Level 3 evidence focusing on knee muscle morphologic as well as extensor and flexor strength outcomes in ACL-reconstructed patients of all graft types.
STUDY DESIGN
Systematic review.
LEVEL OF EVIDENCE
Level 2.
DATA EXTRACTION
Critical appraisal instruments (Downs and Black checklist, Cochrane Collaboration tool, ROBINS-1 tool) were used to evaluate study quality. We independently calculated effect sizes (ESs) (Cohen ) between groups in each study. The Strength of Recommendation Taxonomy grading scale was used for clinical recommendations.
RESULTS
Six articles (4 randomized control studies, 1 nonrandomized study, and 1 case-control study) met inclusion criteria. Exercises paired with BFR training included open kinetic chain, closed kinetic chain, and passive applications. Diverse assessments and time of intervention were observed across studies. ESs ranged from trivial to large in favor of BFR training for muscle morphological ( = 0.06 to 0.81) and strength assessments ( = -0.12 to 1.24) with CIs spanning zero.
CONCLUSION
At this time, grade B or inconsistent and limited-quality patient-oriented evidence exists to support using BFR training to improve or maintain thigh muscle size as well as knee extensor and flexor strength in ACL-reconstructed patients. ESs indicated no consistent clinically meaningful differences when compared with conventional therapy. Subsequent analyses should be repeated as new evidence emerges to update practice guidelines.
Topics: Humans; Anterior Cruciate Ligament Injuries; Blood Flow Restriction Therapy; Case-Control Studies; Exercise Therapy; Muscle, Skeletal; Muscle Strength
PubMed: 35130790
DOI: 10.1177/19417381211070834 -
Journal of Sports Science & Medicine Jun 2019The present systematic review aimed to analyze the activation of the muscles involved in the barbell hip thrust (BHT) and its transfer to sports activities that include...
The present systematic review aimed to analyze the activation of the muscles involved in the barbell hip thrust (BHT) and its transfer to sports activities that include horizontal displacement. A search of the current literature was performed using the PubMed, SPORTDiscuss, Scopus and Google Scholar databases. The inclusion criteria were: (a) descriptive studies, (b) physically trained participants, (c) analyzed muscle activation using normalized EMG signals or as a percentage of maximal voluntary isometric contraction (MVIC) and (d) acute or chronic transfer of the BHT to horizontal displacement activity. Twelve articles met the inclusion criteria and the following results were found: 1) neuromuscular activation: hip extensor muscles (gluteus maximus and biceps femoris) demonstrated greater activation in the BHT compared to the squat. The straight bar deadlift exercise demonstrated greater biceps femoris activation than BHT; 2) Regardless of the BHT variation and intensity used, the muscle excitation sequence is gluteus maximus, erector spinae, biceps femoris, semitendinosus, vastus lateralis, gluteus medius, vastus medialis and rectus femoris; 3) acute transfer: four studies demonstrated a significant improvement in sprinting activities after BHT exercise; 4) as for the chronic transfer: two studies demonstrated improvement of the sprint time, while other two studies failed to present such effect. We concluded that: a) the mechanics of BHT favors greater activation of the hip extensor muscles compared to more conventional exercises; b) regardless of the variation of BHT used, the muscle excitation sequence is gluteus maximus, erector spinae, hamstrings, and quadriceps femoris; c) the acute transfer of the post-activation potentiation of the BHT is significant, improving the sprinting time; and d) despite training with BHT submaximal loads can improve sprint times, further investigations are needed.
Topics: Biomechanical Phenomena; Buttocks; Hamstring Muscles; Hip; Humans; Isometric Contraction; Paraspinal Muscles; Posture; Quadriceps Muscle; Thigh; Weight Lifting
PubMed: 31191088
DOI: No ID Found -
The Journals of Gerontology. Series A,... Sep 2019There is increasing use of computed tomography (CT) in sarcopenia research using a wide variety of techniques. We performed a systematic review of the CT literature to...
BACKGROUND/OBJECTIVE
There is increasing use of computed tomography (CT) in sarcopenia research using a wide variety of techniques. We performed a systematic review of the CT literature to identify the differences between approaches used.
METHODS
A comprehensive search of PubMed from 1983 to 2017 was performed to identify studies that used CT muscle measurements to assess muscle mass and myosteatosis. The CT protocols were evaluated based on anatomic landmark(s), thresholding, muscle(s) segmented, key measurement (ie, muscle attenuation, cross-sectional area, volume), derived variables, and analysis software. From the described search, 657 articles were identified and 388 studies met inclusion criteria for this systematic review.
RESULTS
Muscle mass was more commonly assessed than myosteatosis (330 vs. 125). The most commonly assessed muscle or muscle groups were total abdominal wall musculature (142/330 and 49/125 for muscle mass and myosteatosis, respectively) and total thigh musculature (90/330 and 48/125). The most commonly used landmark in the abdomen was the L3 vertebra (123/142 and 45/49 for muscle mass and myosteatosis, respectively). Skeletal muscle index and intermuscular adipose tissue were the most commonly used measures of abdominal wall muscle mass (114/142) and myosteatosis (27/49), respectively. Cut points varied across studies. A significant majority of studies failed to report important CT technical parameters, such as use of intravenous contrast and slice thickness (94% and 63%, respectively).
CONCLUSIONS
There is considerable variation in the CT approaches used for the assessment of muscle mass and myosteatosis. There is a need to develop consensus for CT-based evaluation of sarcopenia and myosteatosis.
Topics: Adipose Tissue; Body Composition; Humans; Muscle, Skeletal; Sarcopenia; Tomography, X-Ray Computed
PubMed: 30726878
DOI: 10.1093/gerona/glz034 -
International Journal of Environmental... Feb 2021The hip flexor muscles are major contributors to lumbar spine stability. Tight hip flexors can lead to pain in the lumbar spine, and hence to an impairment in... (Meta-Analysis)
Meta-Analysis Review
The hip flexor muscles are major contributors to lumbar spine stability. Tight hip flexors can lead to pain in the lumbar spine, and hence to an impairment in performance. Moreover, sedentary behavior is a common problem and a major contributor to restricted hip extension flexibility. Stretching can be a tool to reduce muscle tightness and to overcome the aforementioned problems. Therefore, the purpose of this systematic review with meta-analysis was to determine the effects of a single hip flexor stretching exercise on performance parameters. The online search was performed in the following three databases: PubMed, Scopus, and Web of Science. Eight studies were included in this review with a total of 165 subjects (male: 111; female 54). In contrast to other muscle groups (e.g., plantar flexors), where 120 s of stretching likely decreases force production, it seems that isolated hip flexor stretching of up to 120 s has no effect or even a positive impact on performance-related parameters. A comparison of the effects on performance between the three defined stretch durations (30-90 s; 120 s; 270-480 s) revealed a significantly different change in performance ( = 0.02) between the studies with the lowest hip flexor stretch duration (30-90 s; weighted mean performance change: -0.12%; CI (95%): -0.49 to 0.41) and the studies with the highest hip flexor stretch duration (270-480 s; performance change: -3.59%; CI (95%): -5.92 to -2.04). Meta-analysis revealed a significant (but trivial) impairment in the highest hip flexor stretch duration of 270-480 s (SMD effect size = -0.19; CI (95%) -0.379 to 0.000; Z = -1.959; = 0.05; I = 0.62%), but not in the lowest stretch duration (30-90 s). This indicates a dose-response relationship in the hip flexor muscles. Although the evidence is based on a small number of studies, this information will be of great importance for both athletes and coaches.
Topics: Exercise; Female; Hip; Hip Joint; Humans; Male; Muscle, Skeletal; Thigh
PubMed: 33671271
DOI: 10.3390/ijerph18041936