Sportverletzung-Sportschaden最新文献

Background: In sports games, epidemiological data show that groin pain is relatively common and can lead to repeated loss of time. Consequently, it is essential to be aware of the evidence-based prevention strategies. The aim of this systematic review was to examine risk factors and prevention strategies for groin pain and to rank them based on their evidence in sports games.

Methods: The review was conducted according to the PRISMA guidelines, using a PICO-scheme in the PubMed, Web of Science and SPOLIT databases. We included all available intervention and observational studies on the influence of risk factors and prevention strategies on groin pain in sports games. The methodological quality and level of evidence was assessed using the PEDro-Scale and OCEBM model, respectively. Finally, the quantity, quality and level of evidence was used to rank each risk factor for its grade.

Results: Moderate evidence was found for four risk factors that significantly influence the risk of groin pain: male sex, previous groin pain, hip adductor strength and not participating in the FIFA 11+ Kids. Moreover, moderate evidence was found for the following non-significant risk factors: older age, body height and weight, higher BMI, body fat percentage, playing position, leg dominance, training exposure, reduced hip abduction, adduction, extension, flexion, and internal rotation-ROM, hip flexor strength, hip abductor, adductor, flexor and core strengthening with balance exercises, clinical hip mobility tests and physical capacities.

Conclusion: The identified risk factors can be considered when developing prevention strategies to reduce the risk of groin pain in sports games. Thereby, not only the significant, but also the non-significant risk factors should be considered for prioritisation.

Background: Ankle sprains are among the most common injuries in sports and can result in chronic ankle instability. In therapy and prevention, a sensorimotor training approach on the structures surrounding the ankle joint has proven to be effective. There is evidence that training the intrinsic foot muscles can also improve balance, for example.

Objective/aim: The aim of this narrative review is to present evidence regarding intrinsic foot muscles training in patients with ankle instability.

Methods: In January 2022, a systematic literature search was conducted in the databases PubMed, Cochrane Library, EBSCOhost, PEDro, SPONET and BISp-Surf and was complemented by a freehand search. We searched for meta-analyses, systematic reviews and intervention studies that examined the effects of a form of intrinsic foot muscle training on patients with ankle instability. The qualitative evaluation of the literature and evidence was based on the risk-of-bias tool (RoB tool) of the Cochrane Handbook and the GRADE system.

Main results: Five randomised controlled trials involving 150 participants were included. Four trials used the Short-Foot Exercise (SFE), one trial used the Towel-Curl Exercise (TCE) and a toe-training program. The results of three studies showed a significant positive effect (p<0,05) on self-reported instability. Significant positive effects (p<0.05) on balance were shown for the SFE and the toe-training program, although the inclusion of the SFE in a training program did not result in any benefits. One study found significant positive effects (p<0.05) of the SFE on somatosensory function. All three forms of training led to significant (p<0.05) improvements in functional aspects.

Conclusion: The results of this narrative review show positive effects of training the intrinsic foot muscles in patients with ankle instability on self-reported instability, balance, somatosensory function and on functional aspects. SFE and toe training seem to be effective forms of training and could be a useful addition to conventional therapy. However, the quality of evidence is too low and further research is needed to make a clear recommendation.

Although numerous studies have been performed, there are no clear findings providing a meaningful statement about how foot strike changes as a result of muscular fatigue. In studies on running fatigue, it is not possible to differentiate which kinematic or kinetic changes are a direct result of local muscle fatigue and varied speeds. This study aimed to investigate the effect of foot strike technique and localized muscle fatigue of the plantar and dorsal flexors on plantar pressure distribution and selected kinematic features of treadmill running. Twenty-six voluntary forefoot and rearfoot runners of similar age and body mass participated in the study. Each group completed two tests with a time interval of 3-7 days. The kinematic data was measured with the help of a three-dimensional measuring and analysis system while the volunteers ran on the treadmill. The fatigue protocol included an isometric maximal force test and an isokinetic endurance test. In order to check the differences, a variance analysis with repeated measurements was used. The strength values of the two groups of runners showed significant average differences in the plantar flexors in the endurance test and in the fatigue index for both the left and right legs. The results of the strength values are surprising because the plantar flexors of this group of runners should be well-trained due to the forefoot strike during regular running. In response to fatigue, the pressure maxima decreased under the exposed foot regions, i.e. under the forefoot at forefoot strike and under the heel at rearfoot strike. The two groups of runners differed in foot angle at foot-on with higher values measured in the forefoot runners. The larger foot angle of the forefoot runners improved shock absorption and can thus reduce the risk of injury.

Background: Postural control helps maintain upright posture and contributes to balance regulation. Increasing neuromuscular deficits in older subjects lead to a deterioration in postural control, which can be improved through neuromuscular training. Assuming that neuromuscular deficits occur at an early age, the postural abilities of 20 to 40 year olds were investigated. In addition, the influence of competitive sports on postural control was examined by including karate squad athletes.

Methods and material: For an age comparison, 123 age-homogeneous healthy people between 20 and 40 years were examined. 24 karate squad athletes were compared with the 20 -25 year old healthy subjects. A neuromuscular training device, the Human Body Equilibrium 360, was used to collect data.

Results: In the age comparison, there were no significant differences for all seven measurements. The study group was too young to detect deficits. However, some general findings could be published. In the two-legged stance, a significant increase in the fluctuations of the body centre of gravity after eye closure could be seen in all groups. The influence of footedness and handedness could be seen in the one-legged stance and the strength test. Gender-specific differences could be observed. The examination of karate squad athletes showed various training-specific adaptations. For example, karate athletes were better able to compensate for the loss of visual information. Karate athletes also showed a significantly wider gait pattern and a larger stability area. Athletes were able to shift their body centre of gravity further without getting out of balance.

Conclusion: The Huber 360 is only conditionally suitable as a rehabilitation and training device, due to the low discriminatory power of the tests in its entire range of applications, as significant differences between the groups are difficult to detect. Individual training specific adaptations through performance-oriented karate training are recognisable and underline the influence of training on postural control. In summary, the use of the Huber 360 to assess postural abilities in age comparisons and to distinguish training specific adaptations requires a differentiated and more selective use of the individual tests. Further studies with older patients with different diseases are planned.