ECSS Paris 2023: OP-MH08
INTRODUCTION: Hamstring strain injuries (HSI) remain a major concern in soccer. Yet existing prediction models fail to account for the multifactorial nature of injury risk. Key factors such as sprint kinematics, performance fatigability, and psychological influences have been largely overlooked. The aim of this study was to develop a parsimonious and multidisciplinary model to identify players at risk of HSI using a single preseason screening session. Additionally, we compared this model’s predictive accuracy to that of individual predictors. METHODS: A total of 120 male and female soccer players competing at regional and national levels underwent preseason assessments, including psychological, physiological, biomecanical, and behavioural variables. Injury occurrence was prospectively monitored throughout the competitive season. After variable selection, logistic regression with the Wald backward stepwise method was used to refine the model. The predictive abilities of the final model and individual variables were determined using the area under the receiver operating characteristic curve (AUC). RESULTS: Twenty-nine players sustained an HSI during the follow-up period. The final model included eight predictors: age, sex, HSI history, knee flexor performance fatigability, sprint performance (best sprint time and maximal theoretical velocity), perceived vulnerability to injury, and subjective norms regarding pain and fatigue in soccer. It demonstrated strong predictive accuracy (AUC = 0.82, sensitivity = 79%). No individual predictor, when considered independently, reached sufficient discriminative power (AUC ≤ 0.65). CONCLUSION: Assessing single risk predictors does not allow for accurate HSI prediction in soccer players. In contrast, our multidisciplinary model achieved high accuracy in identifying at-risk players. Parsimonious in its design, it highlights the interest of both multifactorial and multidisciplinary approach. Notably, knee flexor performance fatigability following repeated sprints emerged as a key predictor, emphasizing the role of fatigue in HSI occurrence. Additionaly, sprint performance and psychological variables significantly contributed to injury prediction, reinforcing the need for an integrated approach to injury prevention. If externally validated, the present model could serve as a valuable tool for injury prevention strategies. in soccer teams.
Read CV Enzo PIPONNIERECSS Paris 2023: OP-MH08
INTRODUCTION: Tackle injuries have the highest injury incidence, may cause the greatest number of days lost (severity) and carry a high injury burden. Moderate and severe injuries in particular may have financial, psychological and team performance implications. To develop effective injury prevention strategies, an understanding of how tackle injuries occur in their specific context is required. Video analysis has been shown to be a useful tool to understand injury mechanism during competition. Therefore, the purpose of this study was to analyse tackler and ball-carrier technical proficiency during moderate and severe contact injuries in professional rugby union and compare with non-injury event controls from the same player and from the same team. METHODS: Injury surveillance was conducted during The Currie Cup (South Africa’s annual premier domestic senior male professional level rugby union competition) between 2022 and 2023 as part of the SA Rugby Injury and Illness Surveillance and Prevention Project (SARIISPP). Using the SARIISPP injury surveillance data, video footage of injuries with a ‘moderate’ and ‘severe’ severity (≥8days’ time loss) were identified. Player-matched and team-matched non-injury events were also identified as controls. Technical proficiency for 46 (moderate and severe; ≥8 days lost) tackler and ball-carrier injuries and 182 matched non-injury events (90 own controls, 92 team controls) were examined using a standardised list of technical criteria. RESULTS: Mean technical proficiency scores for tackler front-on injury events was 10 (95% CI 9.2-11), and for side-on/behind injury events was 6.7 (95% CI 5.7-7.7), which was significantly different to their team controls 12 (95% CI 11-12, p=0.0053, ES=0.62, moderate) and 7.7 (95% CI 7.1-8.2, p=0.0696, ES=0.66, moderate), respectively. Side-on/behind injury events was also significantly different to their own controls 7.3 (95% CI 6.9-7.7, p=0.4755, ES=0.35, small). Mean technical proficiency scores for ball-carriers during front-on tackles was 6.7 (95% CI 5.9-7.5), which was significantly different to their team controls 8 (95% CI 7.5-8.4, p=0.0074, ES=0.62, moderate), and own controls 7.4 (95% CI 6.9-7.9, p=0.2223, ES=0.3, small). CONCLUSION: Both tackler front-on and side-on/behind tackler proficiency scores were lower than the team’s non-injury tackles. For the ball-carrier, only front-on tackle events had lower proficiency scores than the team’s non-injury tackles. By comparing technical proficiencies during injury events and matched controls, technique deficiencies exposing players to injury were highlighted. These highlighted deficiencies may inform injury prevention strategies and assist coaches in optimising training to reduce tackle injury risk.
Read CV Sharief HendricksECSS Paris 2023: OP-MH08
INTRODUCTION: The protective effect of shoe cushioning against running-related injuries has recently been demonstrated in a large, randomised trial including 800+ leisure-time runners. The underlying mechanism includes a decrease in loading rate and an increase in time to impact peak of the high-frequency signal in softer shoes. However, runners cannot easily assess these biomechanical factors when testing new running shoes. Alternatively, the comfort filter had previously been suggested as a new paradigm relating running shoes and injury risk, suggesting that runners should select a comfortable product according to this filter to reduce injury risk. Therefore, the objective of this study was to investigate whether the perception of cushioning and the overall appreciation of running shoes were associated with injury risk. METHODS: This is a secondary analysis of a randomized trial on the effect of shoe cushioning on injury risk. Running exposure and injury data were prospectively collected over 6 months. Healthy recreational runners were asked to fill in a questionnaire on 1) shoe cushioning perception at the heel, 2) ideal shoe cushioning level at the heel, and 3) global appreciation of the study shoe using numerical rating scales (score from min. 1 to max. 9). The difference between shoe cushioning perception and ideal shoe cushioning level was computed to reflect the difference between perceived and ideal cushioning. The variables related to perception were then categorised in tertiles. A Cox proportional hazards model was used to estimate adjusted hazard rate ratios (HR), taking right censoring and competing risks into account, and using hours of running as time scale. RESULTS: The analysis includes 527 participants (35.3% females, mean age (SD): 41.1 (10.2) years, and body mass index: 24.3 (3.1) kg.m-2). The participants ran 172,307 km over the follow-up, and 60 of them (11.4%) reported at least one running-related injury. Compared to the second tertile (ref; >3 to <6), those with low value for cushioning perception (≤3) had greater injury risk (HR [95%CI]: 2.51 [1.30; 4.86], while no difference was observed between the second tertile and those with high values (≥6; HR: 0.77 [0.29; 2.04]). Similarly, compared to the second tertile (ref; >-2 to ≤0), those with low values for perceived-ideal difference in cushioning (≤-2) had greater injury risk (HR [95%CI]: 2.00 [1.12; 3.57], while no difference was observed with those with high values (>0; HR: 0.81 [0.37; 1.79]). No significant association was found between global appreciation of the shoe and injury risk. CONCLUSION: The present study demonstrates that greater perceived shoe cushioning is associated with lower injury risk. Therefore, the study suggests that cushioning perception, and potentially comfort filter, may be a valuable approach for shoe selection to prevent running-related injuries, although the validity of this paradigm deserves further research and the causal pathway has yet to be explained.
Read CV Laurent MalisouxECSS Paris 2023: OP-MH08