Background. Youth around the globe place their shoulders at risk for injury when participating in... more Background. Youth around the globe place their shoulders at risk for injury when participating in sports. Shoulder injuries may vary in severity, produce the potential for time-loss from sport, and result in functional disability. We sought to explore sport-related shoulder injuries in youth by identifying injury rates, risk factors, injury mechanisms, and injury prevention strategies. Methods. All relevant full-text articles were identified by searching MEDLINE, EMBASE, CINAHL, Sport Discus, and the Cochrane Controlled Trials Registry. No date restrictions were used. All full-text studies reporting original research describing sport-related shoulder injury among female and/or male youth from 5 to 18 years old were included. Results. Of 3,889 studies screened, 97 described shoulder injury in youth sports. Shoulder injuries were identified in 24 unique sports. The median seasonal prevalence of shoulder injury was 10.9% (range 1.2–28.2%). The most common injury mechanisms identified w...
Neuromuscular exercises are essential components of successful sport injury prevention and rehabi... more Neuromuscular exercises are essential components of successful sport injury prevention and rehabilitation programs. Neuromuscular training (NMT) aims to improve neuromuscular control and functional joint stability, and above all, it aims to enhance or relearn sportspecific movement patterns and skills. Typically, NMT programs consist of strength training, balance exercises, jump training, and sportspecific exercises (such as running, change of direction technique, and agility drills). Neuromuscular training has been shown to be effective in injury prevention in youth and adult team sports.1,2 Across different team sports, regular NMT has reduced the occurrence of both acute and overuse musculoskeletal injuries. In addition, a recent study in youth rugby suggested that NMT can also decrease the risk of concussion.3 According to recent systematic reviews, the vast majority of sport injury prevention studies have focused on team sports.1,2,4 The most frequently studied sports are socce...
Journal of dance medicine & science : official publication of the International Association for Dance Medicine & Science, Jul 30, 2023
Introduction: Wearable technology (WT) has become common place in sport. Increased affordability ... more Introduction: Wearable technology (WT) has become common place in sport. Increased affordability has allowed WT to reach the wrists and bodies of grassroots and community athletes. While WT is commonly used by sport populations to monitor training load, the use of WT among dancers and dance teachers is unknown. Therefore, the purpose of this study is to explore the perspectives of dancers, dance teachers, and dance parents on using WT in the dance studio environment. Methods: Dancers (aged 14+), dance teachers (aged 18+), and dance parents (with a child <18 years registered in a dance program) were recruited from local dance studios (including those offering vocational programs and/or professional training opportunities), and dance retail stores. Participants provided informed consent/assent and completed a one-time online survey about their attitudes, self-efficacy, motivations, barriers, and current practices of using WT in the studio. Results: Sixty-seven participants (19 dancers, 32 dance teachers, and 16 dance parents) completed the survey. Attitudes toward using WT were similar across all groups (mean score range = 34-38/45). Thirteen dancers (68%), 29 teachers (91%), and 7 dance parents reporting on behalf of their children (47%) were permitted to use WT in the studio. Smartwatches were the most common WT used in the studio by dancers (7/9) and teachers (13/17), while dance parents reported that their children primarily used wristband activity trackers (3/4). Among all groups, the primary reason for using WT was to track personalized training data, with calories, total duration, and heart rate being the most important perceived metrics for improving dancing. Conclusion: Across all groups, attitudes toward WT were modest. Prevalence of WT use in the dance studio varied, with wrist-based gadgets being the most common. As WT research continues in dance populations, it will be important for future studies to consider studio permissions as well as participants’ existing WT use practices.
Objective: To describe shoulder-related injury rates (IRs), types, severity, mechanisms, and risk... more Objective: To describe shoulder-related injury rates (IRs), types, severity, mechanisms, and risk factors in youth ice hockey players during games and practices. Design: Secondary analysis of data from a 5-year prospective cohort study, Safe-to-Play (2013-2018). Setting: Canadian youth ice hockey. Participants: Overall, 6584 player-seasons (representing 4417 individual players) participated. During this period, 118 shoulder-related games and 12 practice injuries were reported. Assessment of Risk Factors: An exploratory multivariable mixed-effects Poisson regression model examined the risk factors of body checking policy, weight, biological sex, history of injury in the past 12 months, and level of play. Main Outcome Measures: Injury surveillance data were collected from 2013 to 2018. Injury rates with 95% confidence interval (CI) were estimated using Poisson regression. Results: The shoulder IR was 0.35 injuries/1000 game-hours (95% CI, 0.24-0.49). Two-thirds of game injuries (n = 80, 70%) resulted in >8 days of time-loss, and more than one-third (n = 44, 39%) resulted in >28 days of time-loss. An 83% lower rate of shoulder injury was associated with policy prohibiting body checking compared with leagues allowing body checking (incidence rate ratio [IRR], 0.17; 95% CI, 0.09-0.33). A higher shoulder IR was observed for those who reported any injury in the last 12-months compared with those with no history (IRR, 2.00; 95% CI, 1.33-3.01). Conclusions: Most shoulder injuries resulted in more than 1 week of time-loss. Risk factors for shoulder injury included participation in a body-checking league and recent history of injury. Further study of prevention strategies specific to the shoulder may merit further consideration in ice hockey.
Journal of dance medicine & science : official publication of the International Association for Dance Medicine & Science, Jun 6, 2023
Objectives: Pre-professional dance is high-risk, with injury incidence up to 4.7 injuries/1000 da... more Objectives: Pre-professional dance is high-risk, with injury incidence up to 4.7 injuries/1000 dance hours. Pre-season screening measures have been utilized to assess risk factors for dance-related injury, however normative values haven’t been established for a pre-professional ballet population. The purpose of this study was to establish normative values of ankle and hip joint range of motion (ROM), lumbopelvic control, and dynamic balance pre-season screening measures for pre-professional ballet dancers. Methods: 498 adolescent pre-professional ballet dancers [n = 219 junior division (194 female, 25 male; mean age: 12.9±0.9 year); n = 281 senior division (238 female, 41 male; mean age: 16.8±1.5 year)] participated in baseline screening tests across 5 seasons (2015-2019). Baseline measures took place at the beginning of each academic year: ankle ROM [dorsiflexion (deg); plantarflexion (PF) (deg)], total active turnout (TAT) (deg), lumbopelvic control [active straight leg raise (ASLR) (score); one leg standing test (OLS) (score)], and dynamic balance [unipedal balance (sec); Y-Balance Test (cm)]. Results: Percentiles for ankle dorsiflexion ranged from 28.2° (male senior division, 10th percentile) to 63.3° (female junior division, 100th percentile). For PF, percentiles ranged from 77.5 to 111.8° (male junior division, 10th percentile; male senior division, 100th percentile). Percentiles for TAT for all participants ranged between 121.1° and 131.0°. For the ASLR, the proportion of participants moving with compensation (pelvis shifting) was between 64.0% and 82.2%. For OLS, 19.7% to 56.1% of dancers had a positive score (hip hiking). Percentiles for dynamic balance ranged from 3.5 to 17.1 seconds (unipedal dynamic balance) and 75.8 to 103.3 cm (YBT composite reach score) across all groups. Conclusion: The establishment of normative values of pre-season screening measures among a pre-professional ballet population can be used to determine areas to target during training, recognize individuals with possible injury risk, and inform return to dance protocols following injury. Comparison with other dancer/athletic populations will also provide insight into the performance of dancers and identify areas in need of improvement.
The objective of this study was to examine the effect of a neuromuscular training (NMT) warm‐up o... more The objective of this study was to examine the effect of a neuromuscular training (NMT) warm‐up on the prevalence of overuse lower extremity (LE) injuries in children's football. Twenty Finnish U11‐U14 youth football clubs (n = 1409 players; females 280, males 1129; age range 9‐14) were randomized into intervention and control groups containing 10 clubs each (intervention: 44 teams, n = 676 players; control: 48 teams, n = 733 players). The intervention group performed a structured NMT warm‐up operated by team coaches for 20 weeks. The main outcome measure was the prevalence of football‐related overuse LE injuries and injuries were tracked via weekly text messages. The average weekly prevalence of overuse LE injuries was 11.6% (95% CI: 11.0%‐12.2%) in the intervention group and 11.3% (10.7%‐11.9%) in the control group. The most common anatomical locations were the knee (weekly prevalence 6.0% in the intervention group and 5.7% in the control group) and heel (2.4% and 2.6%). There was no difference in the prevalence of overuse LE injuries between the groups: odds ratio (OR) 1.01 (95% CI: 0.99‐1.03). In conclusion, NMT warm‐up was equal to standard practice warm‐up in preventing overuse LE injuries in children's football during a follow‐up of 20 weeks.
Sports Health: A Multidisciplinary Approach, Jan 17, 2022
Background:The identification of risk factors for sports injuries is essential before injury prev... more Background:The identification of risk factors for sports injuries is essential before injury prevention strategies can be planned.Hypothesis:Previous acute knee injury and lower perceived knee function measured by Knee injury and Osteoarthritis Outcome Score (KOOS) will increase the risk of acute knee injury in youth team-sports athletes.Study Design:Prospective cohort study.Level of Evidence:Level 3.Methods:At baseline, youth (≤21 years old) male and female basketball and floorball athletes completed a questionnaire on previous acute knee injuries and perceived knee function (KOOS). A total of 211 male and 183 female athletes were followed for an acute knee injury up to 3 years. Unadjusted and adjusted Cox regression models were used in risk factor analyses.Results:In male athletes, previous acute knee injury and lower KOOS Pain, Activities of Daily Living, Sport and Recreation, and knee-related Quality of Life subscale scores increased the risk of acute knee injury in the unadjusted analyses. Adjusted analyses for male injuries were not performed because of low number of acute knee injuries (n = 18). In female athletes, previous acute knee injury increased the risk of acute knee injury when adjusted for athletes’ age and body mass index (hazard ratio, 2.6 [95% CI, 1.3-5.2]). In female athletes, none of the KOOS subscale scores were associated with the increased risk of acute knee injury in the adjusted analyses.Conclusion:Previous acute knee injury was associated with the risk of new acute knee injury in youth male and female athletes. In youth male athletes, additionally, lower perceived knee function in 4 out of 5 KOOS subscale scores were associated with the increased risk of new acute knee injury.Clinical Relevance:The treatment and rehabilitation of the present acute knee injury and secondary prevention of reinjury should be emphasized in youth team-sports athletes.
Background. Youth around the globe place their shoulders at risk for injury when participating in... more Background. Youth around the globe place their shoulders at risk for injury when participating in sports. Shoulder injuries may vary in severity, produce the potential for time-loss from sport, and result in functional disability. We sought to explore sport-related shoulder injuries in youth by identifying injury rates, risk factors, injury mechanisms, and injury prevention strategies. Methods. All relevant full-text articles were identified by searching MEDLINE, EMBASE, CINAHL, Sport Discus, and the Cochrane Controlled Trials Registry. No date restrictions were used. All full-text studies reporting original research describing sport-related shoulder injury among female and/or male youth from 5 to 18 years old were included. Results. Of 3,889 studies screened, 97 described shoulder injury in youth sports. Shoulder injuries were identified in 24 unique sports. The median seasonal prevalence of shoulder injury was 10.9% (range 1.2–28.2%). The most common injury mechanisms identified w...
Neuromuscular exercises are essential components of successful sport injury prevention and rehabi... more Neuromuscular exercises are essential components of successful sport injury prevention and rehabilitation programs. Neuromuscular training (NMT) aims to improve neuromuscular control and functional joint stability, and above all, it aims to enhance or relearn sportspecific movement patterns and skills. Typically, NMT programs consist of strength training, balance exercises, jump training, and sportspecific exercises (such as running, change of direction technique, and agility drills). Neuromuscular training has been shown to be effective in injury prevention in youth and adult team sports.1,2 Across different team sports, regular NMT has reduced the occurrence of both acute and overuse musculoskeletal injuries. In addition, a recent study in youth rugby suggested that NMT can also decrease the risk of concussion.3 According to recent systematic reviews, the vast majority of sport injury prevention studies have focused on team sports.1,2,4 The most frequently studied sports are socce...
Journal of dance medicine & science : official publication of the International Association for Dance Medicine & Science, Jul 30, 2023
Introduction: Wearable technology (WT) has become common place in sport. Increased affordability ... more Introduction: Wearable technology (WT) has become common place in sport. Increased affordability has allowed WT to reach the wrists and bodies of grassroots and community athletes. While WT is commonly used by sport populations to monitor training load, the use of WT among dancers and dance teachers is unknown. Therefore, the purpose of this study is to explore the perspectives of dancers, dance teachers, and dance parents on using WT in the dance studio environment. Methods: Dancers (aged 14+), dance teachers (aged 18+), and dance parents (with a child <18 years registered in a dance program) were recruited from local dance studios (including those offering vocational programs and/or professional training opportunities), and dance retail stores. Participants provided informed consent/assent and completed a one-time online survey about their attitudes, self-efficacy, motivations, barriers, and current practices of using WT in the studio. Results: Sixty-seven participants (19 dancers, 32 dance teachers, and 16 dance parents) completed the survey. Attitudes toward using WT were similar across all groups (mean score range = 34-38/45). Thirteen dancers (68%), 29 teachers (91%), and 7 dance parents reporting on behalf of their children (47%) were permitted to use WT in the studio. Smartwatches were the most common WT used in the studio by dancers (7/9) and teachers (13/17), while dance parents reported that their children primarily used wristband activity trackers (3/4). Among all groups, the primary reason for using WT was to track personalized training data, with calories, total duration, and heart rate being the most important perceived metrics for improving dancing. Conclusion: Across all groups, attitudes toward WT were modest. Prevalence of WT use in the dance studio varied, with wrist-based gadgets being the most common. As WT research continues in dance populations, it will be important for future studies to consider studio permissions as well as participants’ existing WT use practices.
Objective: To describe shoulder-related injury rates (IRs), types, severity, mechanisms, and risk... more Objective: To describe shoulder-related injury rates (IRs), types, severity, mechanisms, and risk factors in youth ice hockey players during games and practices. Design: Secondary analysis of data from a 5-year prospective cohort study, Safe-to-Play (2013-2018). Setting: Canadian youth ice hockey. Participants: Overall, 6584 player-seasons (representing 4417 individual players) participated. During this period, 118 shoulder-related games and 12 practice injuries were reported. Assessment of Risk Factors: An exploratory multivariable mixed-effects Poisson regression model examined the risk factors of body checking policy, weight, biological sex, history of injury in the past 12 months, and level of play. Main Outcome Measures: Injury surveillance data were collected from 2013 to 2018. Injury rates with 95% confidence interval (CI) were estimated using Poisson regression. Results: The shoulder IR was 0.35 injuries/1000 game-hours (95% CI, 0.24-0.49). Two-thirds of game injuries (n = 80, 70%) resulted in >8 days of time-loss, and more than one-third (n = 44, 39%) resulted in >28 days of time-loss. An 83% lower rate of shoulder injury was associated with policy prohibiting body checking compared with leagues allowing body checking (incidence rate ratio [IRR], 0.17; 95% CI, 0.09-0.33). A higher shoulder IR was observed for those who reported any injury in the last 12-months compared with those with no history (IRR, 2.00; 95% CI, 1.33-3.01). Conclusions: Most shoulder injuries resulted in more than 1 week of time-loss. Risk factors for shoulder injury included participation in a body-checking league and recent history of injury. Further study of prevention strategies specific to the shoulder may merit further consideration in ice hockey.
Journal of dance medicine & science : official publication of the International Association for Dance Medicine & Science, Jun 6, 2023
Objectives: Pre-professional dance is high-risk, with injury incidence up to 4.7 injuries/1000 da... more Objectives: Pre-professional dance is high-risk, with injury incidence up to 4.7 injuries/1000 dance hours. Pre-season screening measures have been utilized to assess risk factors for dance-related injury, however normative values haven’t been established for a pre-professional ballet population. The purpose of this study was to establish normative values of ankle and hip joint range of motion (ROM), lumbopelvic control, and dynamic balance pre-season screening measures for pre-professional ballet dancers. Methods: 498 adolescent pre-professional ballet dancers [n = 219 junior division (194 female, 25 male; mean age: 12.9±0.9 year); n = 281 senior division (238 female, 41 male; mean age: 16.8±1.5 year)] participated in baseline screening tests across 5 seasons (2015-2019). Baseline measures took place at the beginning of each academic year: ankle ROM [dorsiflexion (deg); plantarflexion (PF) (deg)], total active turnout (TAT) (deg), lumbopelvic control [active straight leg raise (ASLR) (score); one leg standing test (OLS) (score)], and dynamic balance [unipedal balance (sec); Y-Balance Test (cm)]. Results: Percentiles for ankle dorsiflexion ranged from 28.2° (male senior division, 10th percentile) to 63.3° (female junior division, 100th percentile). For PF, percentiles ranged from 77.5 to 111.8° (male junior division, 10th percentile; male senior division, 100th percentile). Percentiles for TAT for all participants ranged between 121.1° and 131.0°. For the ASLR, the proportion of participants moving with compensation (pelvis shifting) was between 64.0% and 82.2%. For OLS, 19.7% to 56.1% of dancers had a positive score (hip hiking). Percentiles for dynamic balance ranged from 3.5 to 17.1 seconds (unipedal dynamic balance) and 75.8 to 103.3 cm (YBT composite reach score) across all groups. Conclusion: The establishment of normative values of pre-season screening measures among a pre-professional ballet population can be used to determine areas to target during training, recognize individuals with possible injury risk, and inform return to dance protocols following injury. Comparison with other dancer/athletic populations will also provide insight into the performance of dancers and identify areas in need of improvement.
The objective of this study was to examine the effect of a neuromuscular training (NMT) warm‐up o... more The objective of this study was to examine the effect of a neuromuscular training (NMT) warm‐up on the prevalence of overuse lower extremity (LE) injuries in children's football. Twenty Finnish U11‐U14 youth football clubs (n = 1409 players; females 280, males 1129; age range 9‐14) were randomized into intervention and control groups containing 10 clubs each (intervention: 44 teams, n = 676 players; control: 48 teams, n = 733 players). The intervention group performed a structured NMT warm‐up operated by team coaches for 20 weeks. The main outcome measure was the prevalence of football‐related overuse LE injuries and injuries were tracked via weekly text messages. The average weekly prevalence of overuse LE injuries was 11.6% (95% CI: 11.0%‐12.2%) in the intervention group and 11.3% (10.7%‐11.9%) in the control group. The most common anatomical locations were the knee (weekly prevalence 6.0% in the intervention group and 5.7% in the control group) and heel (2.4% and 2.6%). There was no difference in the prevalence of overuse LE injuries between the groups: odds ratio (OR) 1.01 (95% CI: 0.99‐1.03). In conclusion, NMT warm‐up was equal to standard practice warm‐up in preventing overuse LE injuries in children's football during a follow‐up of 20 weeks.
Sports Health: A Multidisciplinary Approach, Jan 17, 2022
Background:The identification of risk factors for sports injuries is essential before injury prev... more Background:The identification of risk factors for sports injuries is essential before injury prevention strategies can be planned.Hypothesis:Previous acute knee injury and lower perceived knee function measured by Knee injury and Osteoarthritis Outcome Score (KOOS) will increase the risk of acute knee injury in youth team-sports athletes.Study Design:Prospective cohort study.Level of Evidence:Level 3.Methods:At baseline, youth (≤21 years old) male and female basketball and floorball athletes completed a questionnaire on previous acute knee injuries and perceived knee function (KOOS). A total of 211 male and 183 female athletes were followed for an acute knee injury up to 3 years. Unadjusted and adjusted Cox regression models were used in risk factor analyses.Results:In male athletes, previous acute knee injury and lower KOOS Pain, Activities of Daily Living, Sport and Recreation, and knee-related Quality of Life subscale scores increased the risk of acute knee injury in the unadjusted analyses. Adjusted analyses for male injuries were not performed because of low number of acute knee injuries (n = 18). In female athletes, previous acute knee injury increased the risk of acute knee injury when adjusted for athletes’ age and body mass index (hazard ratio, 2.6 [95% CI, 1.3-5.2]). In female athletes, none of the KOOS subscale scores were associated with the increased risk of acute knee injury in the adjusted analyses.Conclusion:Previous acute knee injury was associated with the risk of new acute knee injury in youth male and female athletes. In youth male athletes, additionally, lower perceived knee function in 4 out of 5 KOOS subscale scores were associated with the increased risk of new acute knee injury.Clinical Relevance:The treatment and rehabilitation of the present acute knee injury and secondary prevention of reinjury should be emphasized in youth team-sports athletes.
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Papers by Kati Pasanen