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Background: Skydiving is the fastest nonmotorized sport; and consequently is not without risk. In the last decades, skydiving has become considerably safer but injuries and fatalities still occur. Incidents are reported to and administered by the Royal Netherlands Aeronautical Association (KNVvL). From 1995 to 2020, 2715 incidents were reported; of which 1503 resulted in injury and 26 in fatality. There is a need for more information available on the particular type, severity, and factors which contribute to skydiving-related injuries worldwide. This study aims to investigate patterns in occurrence rates, examine demographic and skydiving-related factors linked to injuries, and analyze the types and severity of injuries relating to these contributing factors. Methods: The Dutch KNVvL database – covering more than 25 years of data – was examined for contributing factors. An analysis of the severity and types of injury resulting from incidents over the last five years were matched with a search of hospital databases. Results: The rate of injuries pattern increases starting from 2016, with novice jumpers having the highest risk of injury. Most injuries occur during the landing phase. The lower extremities and the spine are most affected, with fractures being the most prevalent type of injury. More than half of the patients were admitted to hospital, with 10% requiring surgery, resulting in months of rehabilitation. Conclusion: This study is the first in the Netherlands, and only the second worldwide to analyze technical incident databases in combination with data from medical information systems. Skydiving accidents of experienced jumpers should be considered as 'high-energy trauma,' therefore treatment should follow standard trauma guidelines. In less experienced skydivers, it is critical to conduct a secondary survey to assess the extremities adequately. Clinicians should also pay attention to friction burns that can arise due to friction between the skin and skydive equipment, a phenomenom that is already known in road traffic accidents. [ABSTRACT FROM AUTHOR]

The 6th International Consensus Conference on Concussion in Sport, Amsterdam 2022, addressed sport-related concussion (SRC) in adults, adolescents, and children. We highlight the updated evidence-base and recommendations regarding SRC in children (5--12 years) and adolescents (13--18 years). Prevention strategies demonstrate lower SRC rates with mouthguard use, policy disallowing bodychecking in ice hockey, and neuromuscular training in adolescent rugby. The Sport Concussion Assessment Tools (SCAT) demonstrate robustness with the parent and child symptom scales, with the best diagnostic discrimination within the first 72 hours postinjury. Subacute evaluation (>72 hours) requires a multimodal tool incorporating symptom scales, balance measures, cognitive, oculomotor and vestibular, mental health, and sleep assessment, to which end the Sport Concussion Office Assessment Tools (SCOAT6 [131] and Child SCOAT6 [8--12]) were developed. Rather than strict rest, early return to light physical activity and reduced screen time facilitate recovery. Cervicovestibular rehabilitation is recommended for adolescents with dizziness, neck pain, and/or headaches for greater than 10 days. Active rehabilitation and collaborative care for adolescents with persisting symptoms for more than 30 days may decrease symptoms. No tests and measures other than standardized and validated symptom rating scales are valid for diagnosing persisting symptoms after concussion. Fluid and imaging biomarkers currently have limited clinical utility in diagnosing or assessing recovery from SRC. Improved paradigms for return to school were developed. The variable nature of disability and differences in evaluating para athletes and those of diverse ethnicity, sex, and gender are discussed, as are ethical considerations and future directions in pediatric SRC research. [ABSTRACT FROM AUTHOR]

Background: Physical tests are commonly used in patellar tendinopathy to aid the clinical diagnosis, assess the prognosis, and monitor treatment. However, it is still unknown whether these physical measures are associated with patient-reported outcomes after exercise therapy. Purpose: To identify the prognostic value of baseline physical test results and to determine the association between physical response after exercise therapy and clinical improvement over 24 weeks. Study Design: Case-control study; Level of evidence, 3. Methods: This study recruited 76 consecutive athletes with patellar tendinopathy who were randomized to 2 different programs of exercise therapy for 24 weeks. Athletes underwent a range of physical tests before and during exercise therapy (12 and 24 weeks), including isometric muscle strength (quadriceps and hip abductors), muscle flexibility (quadriceps, hamstrings, soleus, and gastrocnemius), vertical jump height, and visual analog scale (VAS) scores by palpation, after 3 jump trials, and after single-leg squat (VAS-SLS). The Victorian Institute of Sports Assessment–Patella (VISA-P) questionnaire was used as the primary patient-reported outcome. Linear mixed-effect models were used to assess the prognostic value of baseline physical tests. The change in VISA-P score was further dichotomized into clinical responsiveness (≥14 points) and nonresponsiveness (<14 points). Multiple linear and logistic regression models were performed to evaluate associations between physical response and clinical improvement. Results: Of the 76 included patients, 67 (88%) had complete follow-ups. The estimated mean VISA-P score increased by 23 points (95% CI, 19-28 points) after 24 weeks. No association was found between any baseline physical test results and a 24-week change in VISA-P score (all P interaction >.2, using the likelihood ratio test). Improvement in VAS-SLS after exercise therapy was not associated with VISA-P improvement after adjustment (β = −1.76; P =.01; Bonferroni-corrected P =.10; R 2 = 36.3%). No associations were found between changes in other physical test results and clinical improvement (all P >.05). Conclusion: In patients with patellar tendinopathy, physical test results including strength and flexibility in the lower limb, jump performance, and pain levels during pain-provoking tests were not identified as prognostic factors for patient-reported outcomes after exercise therapy. Similarly, changes in physical test results were not associated with changes in patient-reported outcomes after adjustments. These results do not support using physical test results to estimate prognosis or monitor treatment response. Registration: NCT02938143 (ClinicalTrials.gov identifier). [ABSTRACT FROM AUTHOR]

Key Points: Question: Which neurobiological, psychosocial, or behavioral pathways mediate the associations between physical activity and psychiatric symptoms in young people? Findings: This cohort study found that self-esteem mediated the association between sports participation in childhood and internalizing symptoms in adolescence. Meaning: Physical activity interventions carried out during childhood should consider self-esteem improvements as a channel to protect young people against the later emergence of internalizing problems. This cohort study evaluates neurobiological, psychosocial, and behavioral mechanisms potentially underlying associations between physical activity and psychiatric symptoms in children in the Netherlands. Importance: Understanding the mechanisms by which physical activity is associated with a lower risk of psychiatric symptoms may stimulate the identification of cost-efficient strategies for preventing and treating mental illness at early life stages. Objective: To examine neurobiological, psychosocial, and behavioral mechanisms that mediate associations of physical activity with psychiatric symptoms in youth by testing an integrated model. Design, setting, and participants: Generation R is an ongoing prospective population-based cohort study collecting data from fetal life until young adulthood in a multiethnic urban population in the Netherlands. Pregnant women living in Rotterdam with an expected delivery date between April 2002 and January 2006 were eligible for participation along with their children born during this time. Data were collected at a single research center in the Erasmus Medical Center Sophia Children's Hospital. For the current study, data were analyzed from 4216 children with complete data on both exposure and outcome at ages 6, 10, and 13 years. Data were analyzed from January 2021 to November 2022. Exposures: Physical activity was ascertained at age 6 years (visit 1) via parent report and included weekly frequency and duration of walking or cycling to or from school, physical education at school, outdoor play, swimming, and sports participation. Main Outcomes and Measures: Psychiatric symptoms (internalizing and externalizing symptoms) were assessed at age 6 years (visit 1) and at age 13 years (visit 3) using the Child Behavior Checklist. Several mechanisms were explored as mediators, measured at age 10 years (visit 2). Neurobiological mechanisms included total brain volume, white matter microstructure, and resting-state connectivity assessed using a 3-T magnetic resonance imaging scanner. Psychosocial mechanisms included self-esteem, body image, and friendship. Behavioral mechanisms included sleep quality, diet quality, and recreational screen time. Pearson correlations between physical activity measures and psychiatric symptoms were calculated, with false discovery rate correction applied to account for the number of tests performed. Mediation analyses were performed when a correlation (defined as false discovery rate P <.05) between exposure and outcome was observed and were adjusted for confounders. Results: Among the 4216 children included in this study, the mean (SD) age was 6.0 (0.4) years at visit 1, and 2115 participants (50.2%) were girls. More sports participation was associated with fewer internalizing symptoms (β for direct effect, −0.025; SE, 0.078; P =.03) but not externalizing symptoms. Self-esteem mediated the association between sports participation and internalizing symptoms (β for indirect effect, −0.009; SE, 0.018; P =.002). No evidence was found for associations between any other neurobiological, psychosocial, or behavioral variables. No association was found between other types of physical activity and psychiatric symptoms at these ages. Conclusions and Relevance: The integrated model presented in this cohort study evaluated potential mechanisms mediating associations between physical activity and psychiatric symptoms in youth. Self-esteem mediated an association between sports participation in childhood and internalizing symptoms in adolescence; other significant mediations were not observed. Further studies might explore whether larger effects are present in certain subgroups (eg, children at high risk of developing psychiatric symptoms), different ages, or structured sport-based physical activity interventions. [ABSTRACT FROM AUTHOR]

Objectives Up to 68% of field hockey players have experienced at least one orodental injury in their sport career. Therefore, the Royal Dutch Hockey Association (KNHB) made mouthguard use mandatory for field hockey players during competition and training from August 2015 onwards. This study evaluates the effects of the new regulations on mouthguard use and the occurrence of injuries in Dutch field hockey. Methods A 35-item online questionnaire about mouthguard use and orodental injuries was sent to 13 field hockey clubs in the Netherlands. Absolute numbers and percentages of mouthguard ownership, mouthguard use, number and type of injuries were assessed. The results were related to comparable data before mandatory mouthguard use. Associations of gender and training frequency with the number of injuries were analysed with logistic regression. Results In total, 1169 hockey players were included in the study and almost all owned a mouthguard (females:99.6%, males:93.7%), which significantly increased after implementation (p < 0.001). 90.6% of the respondents wore a mouthguard during matches and 70.1% during training. Of the 1169 players, 68(5.8%) experienced at least one orodental injury after the implementation with a total of 100 injuries. Injuries happened more often during matches (63.2%) than during training (36.8%). Lip cuts account for most of the injuries, the number of broken (p = 0.116) and knocked out teeth (p = 0.026) decreased. Conclusion Although mouthguard use already increased in recent years, the new regulations led to an additional increase and a successful change of attitude towards mouthguard use. Most importantly, the severity of orodental injuries decreased measurable. [ABSTRACT FROM AUTHOR]

Background Single-legged hop tests are frequently used in substantiating return to sport decisions following lower extremity injury. Evidence for using the non-injured leg as a reference for the injured leg in the return to sport decision-making at the criterion-based point of return to sport following lower extremity injury is lacking. Purpose To compare absolute values in single-legged hop tests between the non-injured leg of athletes returning to high-impact sports after lower extremity injury and the matched leg of healthy athletes. Study Design Cross-sectional study. Methods One hundred and sixty-nine athletes returning to high-impact sports after lower extremity injury and 169 matched healthy athletes executed five single-legged hop tests. Differences between athletes returning to high-impact sports after lower extremity injury and matched healthy athletes on five single-legged hop tests were analyzed using paired t-tests. Results There were no statistically significant differences between the non-injured leg of athletes returning to sport and the matched leg of healthy athletes. Effect sizes ranged from 0.05 to 0.14 indicating negligible effects. Conclusion Clinicians can use the non-injured leg as a reference for the injured leg in single-legged hop tests for deciding on return to high-impact sports after lower extremity injuries. Level of Evidence 3b [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to determine the effect of targeted eccentric calf muscle exercises compared to regular training on ankle dorsiflexion in healthy adolescent soccer players with a decreased ankle dorsiflexion.Methods: Male adolescent players (aged 14-21 years) from two professional soccer clubs were evaluated with the Weight Bearing Dorsiflexion Lunge Test (WBDLT) at baseline and after 12 weeks of this prospective controlled study. One club served as the control group and the other as the intervention group. Players with decreased ankle dorsiflexion (WBDLT) ≤ 10 cm) performed stretching and eccentric calf muscle exercises three times per week next to regular training in the intervention group, and performed only regular training in the control group. Primary outcome was the between-group difference in change in WBDLT between baseline and 12 weeks.Results: Of 107 eligible players, 47(44 %) had a decreased ankle dorsiflexion. The WBDLT (± standard deviation) increased in the intervention group from 7.1 (± 1.8) to 7.4 (± 2.4) cm (95 % Confidence Interval (CI)[-0.493 to 1.108], p = 0.381) and in the control group from 6.1 (± 2.4) to 8.2 (± 2.9) cm (95 % CI [1.313 to 2.659], p < 0.001). The difference in change of WBDLT between both groups was statistically significant (95 % CI [-2.742 to -0.510], p = 0.005).Conclusions: Targeted eccentric calf muscle exercises do not increase ankle dorsiflexion in healthy adolescent soccer players. Compared to regular training, eccentric exercises even resulted in a decreased calf muscle flexibility.Trial Registration: This trial was registered retrospectively on the 7th of September 2016 in The Netherlands Trial Register (ID number: 6044). [ABSTRACT FROM AUTHOR]

Introduction: Sports participation in children with hemophilia is generally considered to be associated with increased injury risk, which is generally considered highest in severe hemophilia. Aim: To assess sports participation according to age and severity in children with hemophilia and its association with sports injuries. Methods: In a retrospective single‐center study, sports participation, injuries, and bleeding data from three consecutive annual clinic visits were collected for young patients with hemophilia (PWH, aged 6‐18). Sports in categories 2.5 and 3 of 3 according to the National Hemophilia Foundation classification were considered high‐risk. Groups were compared using chi‐square testing. Results: 105 PWH (median age: 13(IQR 10‐14); 53% severe; bleeding rate: 1/y) were identified; three were unable to perform sports and were excluded. The majority of PWH (77%) played sports weekly, of which 80% high‐risk sports. Sports participation (median 3.0x/wk), and the proportion of injured PWH was similar in severe (42%) and non‐severe (33%) PWH. Sports injuries were rare (65% no injuries in 3 years, median 0/y (IQR 0‐1)). Annually, PWH did not report more injuries (15%) than age‐matched boys (28%). Sports injuries were not associated with frequency and type of sports. Discussion: This retrospective study showed high sports participation (including high‐risk sports) and low injury rates. Sports participation was similar across severities and injury rates were not higher than among the general population. Injuries were not associated with frequency or type of sports. A prospective study with objective assessment of sports participation and injuries is warranted to confirm these findings and avoid recall bias. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to determine whether there is a difference in the prevalence of tennis injuries between the four most common court surfaces in the Netherlands, including hard court, clay, sand-fill artificial grass and red-sand-fill artificial grass. Natural grass was not included in this study.Methods: This was a repeated cross-sectional study over 6 months, involving members of the Royal Netherlands Lawn Tennis Association (KNLTB). A monthly questionnaire was sent to a random sample of 20 000 KNLTB members, stratified by their club's playing surface. The questionnaire included questions on court surface, tennis exposure and physical complaints, using the Oslo Sports Trauma Research Centre questionnaire on health problems.Results: A total of 3656 (18%) of the 20 000 invited members completed at least one of the monthly questionnaires [mean age 49 years (15)]. A total of 4047 injuries were reported by 1957 respondents. Of these injuries, 3246 (80%) were overuse and 801 (20%) were acute. There were no statistically significant differences in injury prevalence between groups who played primarily on any one of the four court surfaces. However, players who played on multiple surfaces had a higher injury prevalence, particularly of overuse injuries, than those who primarily played on one court surface. Compared with the other court surfaces, there was a higher prevalence of lower limb overuse injuries when playing on hard court.Conclusion: There is no significant difference in the overall prevalence of injury on clay, hard court, sand-fill artificial grass and red-sand-fill artificial grass. [ABSTRACT FROM AUTHOR]

This study’s objective was to collect items from experienced sports physicians, relating to the presence and severity of overuse wrist injuries in young athletes, for developing a measurement instrument for signals of overuse wrist injury. Seven Dutch elite sports physicians involved in guidance and treatment of young athletes in wrist-loading sports (gymnastics, tennis, judo, field hockey, volleyball and rowing) participated in a focus group. They discussed signals and limitations related to overuse wrist injuries in young athletes. Data were coded and categorised into signals and limitations with subcategories, using an inductive approach. Of the resulting 61 signals and limitations in nineteen (sub)categories, 20 were considered important, forming a comprehensive item set for identifying overuse wrist injury in young athletes. Signals such as pain, “click”, crepitations, swelling and limited range of motion were marked useful for early identification of overuse wrist injury. Limitations in movement and performance were considered indicative of severe overuse injury but less relevant for initial injury identification. The focus group provided 17 important signals and 3 important limitations indicative of overuse wrist injury. These provide the basis for a valid measurement instrument for identifying overuse wrist injury in young athletes, with equal emphasis on pain and on other symptoms. [ABSTRACT FROM AUTHOR]

Injuries can have a major impact on the physical performance and academic career of physical education teacher education ( PETE) students. To investigate the injury problem, risk factors, and the impact of injuries on academic success, 252 PETE students were followed during their first semester. Risk factor analysis was conducted by means of logistic regression analysis with a differentiation for upper body, lower body, acute, overuse, and severe injuries. An incidence of 1.26 injuries/student/semester was found. Most injuries involved the lower body (61%), were new injuries (76%), occurred acutely (66%), and were sustained during curricular gymnastics (25%) or extracurricular soccer (28%). Significant risk factors for lower body acute injuries were age ( OR=2.14; P=.01), previous injury ( OR=2.23; P=.01), and an injury at the start of the year ( OR=2.56; P=.02). For lower body overuse injuries, gender ( OR=2.85; P=.02) and the interval shuttle run test score ( OR=2.44; P=.04) were significant risk factors. Previous injury ( OR=2.59; P=.04) and injury at the start of the year (upper body: OR=4.57; P=.02; lower body: OR=3.75; P<.01) were risk factors for severe injuries. Injury-related time loss was positively related to total academic success ( r=.20; P=.02) and success in theoretical courses ( r=.24; P=<.01). No association was found between time loss and academic success for sport courses. [ABSTRACT FROM AUTHOR]

The aim of the study was to determine the prevalence and comorbidity of symptoms of common mental disorders (distress, anxiety/depression, sleep disturbance, eating disorders, adverse alcohol use) among current and former Dutch elite athletes, and to explore the inference between potential risk indicators (severe injury, surgery, life events, sport career dissatisfaction, social support) and the outcomes measures under investigation. Cross-sectional analyses were conducted on baseline questionnaires from an ongoing prospective cohort study among 203 current and 282 former elite Dutch athletes (response rate: 28% among current athletes and 95% among former athletes). Based on validated scales, an electronic questionnaire was set up and distributed. Prevalence (4-week) ranged from 6% for adverse alcohol use to 45% for anxiety/depression among current elite athletes, and from 18% for distress to 29% for anxiety/depression among former elite athletes. A higher number of past severe injuries, higher number of past surgeries, higher number of recent life events, higher level of career dissatisfaction and lower level of social support were related to the occurrence of symptoms of common mental disorders among both current and former elite athletes. On average, the 4-week prevalence of common mental disorders as shown in our study among current and former Dutch elite athletes were similar to the ones found among athletes from other sports disciplines and does compare with the lifetime prevalence estimates in the general population of the Netherlands. [ABSTRACT FROM PUBLISHER]

Introduction: The objective of this study was to investigate the nature, management, and outcome of major injuries related to equestrian sports and to define the at-risk groups for serious and life-threatening injuries.Methods: We analyzed demographic, pre-hospital, clinical, and outcome data from an international population-based prospective trauma database (TraumaRegister DGU®). Patients with major injuries (Injury Severity Score [ISS] ≥9 points) related to equestrian sports activities were included (January 1, 1993, to December 31, 2012). Clinical and outcome parameters were stratified for four different types of injury mechanisms: fall from horse (FFH), horse-kick (HK), horse crush (HC), and carriage-related accidents (CRA). Participating countries included Germany, Austria, Switzerland, Finland, Slovenia, Belgium, Luxembourg, and The Netherlands. Statistical analyses were performed with SPSS (Version 22, IBM Inc., Armonk, NY).Results: The Database identified 122,000 documented patients, of whom 679 were equestrian incidents. Among these, the four major injury mechanisms were: FFH (n = 427), HK (n = 188), HC (n = 34), and the CRA (n = 30). Females were more likely to sustain FFH (75.5%, p < 0.001), leading to head injuries (n = 204, 47.8%) and spinal fractures (n = 109, 25.5%). HK injuries often resulted in facial fractures (29.3%, p < 0.001). Individuals sustaining HC injuries had a high risk for pelvic (32.4%, p < 0.001) and abdominal injuries (35.2%, p < 0.001). In contrast to the FFH cohort, the CRA cohort involved older males (57 ± 13 years), with chest (63.3% p = 0.001), and extremity injuries, resulting in significant injury severity (ISS 20.7 ± 10.6). In the CRA cohort, 16% were in haemorrhagic shock on scene, and also the highest in-hospital mortality (14.8%, p = 0.006) was observed.Conclusions: Young female riders are at risk from falling, horse-kicks, and crush-injuries. Older males in carriage-related accidents sustained the highest injury severity and mortality rate, and must specifically be targeted by future prevention initiatives. Level of evidence Descriptive Epidemiologic Study, Level II. [ABSTRACT FROM AUTHOR]

Purpose: The aim of the study was to develop a Dutch language version of the Foot and Ankle Ability Measure (FAAM) and evaluate its measurement properties according to the consensus-based standards for the selection of health measurement instruments (COSMIN) definitions.Methods: A forward-backward translation procedure was performed and subsequently the Dutch version of the FAAM was evaluated for its reliability and validity in 369 patients with a variety of foot and ankle complaints. The reliability was assessed by calculating the intraclass correlation coefficients (ICC, test-retest reliability), Cronbach's alpha (internal consistency), the standard error of measurement and the minimal detectable change (MDC). Additionally, this was done for athletes. The construct validity was assessed by the use of Spearman's correlation coefficient between FAAM domains and similar and contradictory domains of the Foot and Ankle Outcome Score, Short Form 36 and the Numeric Rating Scale for pain.Results: The ICC of the subscales ranged from 0.62 to 0.86. Cronbach's alpha's minimum was 0.97. At individual level, the MDC ranged from 23.9 to 44.7 and at group level from 2.77 to 4.32. In the subgroup of athletes, the reliability was higher. The hypothesized correlations of the construct validity were supported by an 80% confirmation rate.Conclusion: The Dutch version of the FAAM met adequate measurement properties, although the reliability is not optimal. The FAAM-Sport subscale is more useful in athletes and the FAAM-Sport % seems not to contribute. In athletes with various foot and ankle symptoms, the FAAM can be used for functional assessment and follow-up at group level. For the general population, the FAAM is less appropriate.Level Of Evidence: Diagnostic study, Level I. [ABSTRACT FROM AUTHOR]

The purpose of this study was to describe the prevalence, incidence and risk factors for climbing-related injuries of the upper extremities in recreational climbers. A total of 426 recreational climbers were recruited from indoor climbing halls. The baseline questionnaire included questions on potential risk factors for climbing injuries: personal factors, climbing-related factors and upper extremity injuries that had occurred in the previous 12 months. Follow-up questionnaires collected information on new injuries that occurred during the follow-up period. The incidence of climbing-related injuries during one-year follow-up was 42.4% with 13 injuries per 1 000h of climbing. The finger was the most frequently affected injury location (36.0%). The following risk factors were associated with the occurrence of upper extremity injuries: higher age (OR 1.03, 95%CI 1.01;1.05), performing a cooling-down (OR 2.02, 95%CI 1.28;3.18), climbing with campus board (OR 2.48, 95%CI 1.23;5.02), finger strength middle finger (OR 1.12, 95%CI 1.05;1.18) and previous injuries (OR 3.05, 95%CI 2.01 ;4.83). Climbing injuries of the upper body extremities are very common among recreational climbers in indoor halls and several risk factors can be identified that are related to a higher injury risk. [ABSTRACT FROM AUTHOR]

Background: Many runners suffer from injuries. No information on high-risk populations is available so far though. Objectives: The aims of this study were to systematically review injury proportions in different populations of runners and to compare injury locations between these populations. Data Sources: An electronic search with no date restrictions was conducted up to February 2014 in the PubMed, Embase, SPORTDiscus and Web of Science databases. The search was limited to original articles written in English. The reference lists of the included articles were checked for potentially relevant studies. Study Eligibility Criteria: Studies were eligible when the proportion of running injuries was reported and the participants belonged to one or more homogeneous populations of runners that were clearly described. Study selection was conducted by two independent reviewers, and disagreements were resolved in a consensus meeting. Study Appraisal and Synthesis Methods: Details of the study design, population of runners, sample size, injury definition, method of injury assessment, number of injuries and injury locations were extracted from the articles. The risk of bias was assessed with a scale consisting of eight items, which was specifically developed for studies focusing on musculoskeletal complaints. Results: A total of 86 articles were included in this review. Where possible, injury proportions were pooled for each identified population of runners, using a random-effects model. Injury proportions were affected by injury definitions and durations of follow-up. Large differences between populations existed. The number of medical-attention injuries during an event was small for most populations of runners, except for ultra-marathon runners, in which the pooled estimate was 65.6 %. Time-loss injury proportions between different populations of runners ranged from 3.2 % in cross-country runners to 84.9 % in novice runners. Overall, the proportions were highest among short-distance track runners and ultra-marathon runners. Limitations: The results were pooled by stratification of studies according to the population, injury definition and follow-up/recall period; however, heterogeneity was high. Conclusions: Large differences in injury proportions between different populations of runners existed. Injury proportions were affected by the duration of follow-up. A U-shaped pattern between the running distance and the time-loss injury proportion seemed to exist. Future prospective studies of injury surveillance are highly recommended to take running exposure and censoring into account. [ABSTRACT FROM AUTHOR]

Background: Connective tissue scar (fibrosis) is a common finding on magnetic resonance imaging (MRI) after recovery from acute hamstring injuries. Fibrosis has been suggested as a predisposing factor for reinjury, but evidence from clinical studies is lacking. Purpose/Hypothesis: The aim of this study was to examine the association between the presence of fibrosis on MRI at return to play after an acute hamstring injury and the risk of reinjury. The hypothesis was that fibrous tissue on MRI was associated with an increased reinjury risk. Study Design: Cohort study; Level of evidence, 3. Methods: Magnetic resonance images were obtained from 108 consecutive athletes with modified Peetrons classification grade 1 or 2 hamstring injuries within 5 days of injury and within 7 days of return to play. The presence and extent of abnormally low signal intensity in the intramuscular tissue on MRI, suggestive of fibrosis, were assessed on both T1- and T2-weighted images. Reinjuries were recorded over a 1-year follow-up period. The association between fibrosis and reinjury risk was analyzed with a Cox proportional hazards model. Results: The MRIs of the initial injury showed 45 (43%) grade 1 and 63 (57%) grade 2 injuries. Median time of return to play was 30 days (interquartile range [IQR], 22-42 days). At return to play, 41 athletes (38%) had fibrosis on MRI with a median longitudinal length of 5.8 cm (IQR, 3.3-12.5 cm) and a median volume of 1.5 cm3 (IQR, 1.5-3.9 cm3 ). In athletes with fibrosis, 24% (10/41) sustained a reinjury, and in the subjects without fibrosis, 24% (16/67) had a reinjury, resulting in a hazard ratio of 0.95 (95% CI, 0.43-2.1; P = .898). Conclusion: Fibrosis is commonly seen on MRI at return to play after grade 1 or 2 hamstring injuries but is not associated with reinjury risk. [ABSTRACT FROM AUTHOR]

Physical activity and sports participation are promoted to counteract the increased prevalence of overweight and obesity in children and young adults. Both high body mass index and physical activity level have been associated with an increased risk of sports injuries. The objective is to determine the relationship between sports injuries and overweight in sports participants (4-24 years), taking physical activity into account. Data were obtained from the 2006-2011 'Injuries and Physical Activity in the Netherlands' survey. Analyses were based on a representative sample of 3846 sports participants (4-24 years). Univariate and multiple logistic regression analyses were applied to investigate the association between sports injury and weight status. Of all the sports participants, 14.7% were overweight. Compared with normal-weight sports participants, the odds of sustaining a sports injury was 0.73 [confidence interval ( CI): 0.53-1.00, P = 0.050] for overweight sports participants; the odds for underweight sports participants was 0.80 ( CI: 0.56-1.15, P = 0.226). There is some evidence that overweight sports participants (4-24 years) do not have an increased injury risk compared with normal-weight sports participants, even when the level of physical activity is taken into account. Additional research is recommended regarding overweight people who start to participate in a physically active lifestyle. [ABSTRACT FROM AUTHOR]

Background Hamstring injuries are the most common muscle injury in male amateur soccer players and have a high rate of recurrence, often despite extensive treatment and long rehabilitation periods. Eccentric strength and flexibility are recognised as important modifiable risk factors, which have led to the development of eccentric hamstring exercises, such as the Nordic hamstring exercise. As the effectiveness of the Nordic hamstring exercise in reducing hamstring injuries has never been investigated in amateur soccer players, the aim of this study is to investigate the effect of this exercise on the incidence and severity of hamstring injuries in male amateur soccer players. An additional aim is to determine whether flexibility is associated with hamstring injuries. Study design Cluster-randomised controlled trial with soccer teams as the unit of cluster. Methods Dutch male amateur soccer players, aged 18–40 years, were allocated to an intervention or control group. Both study groups continued regular soccer training during 2013, but the intervention group additionally performed the Nordic hamstring exercise (25 sessions over 13 weeks). Primary outcomes are the incidence of initial and recurrent hamstring injury and injury severity. Secondary outcomes are hamstring-and lower-back flexibility and compliance. Compliance to the intervention protocol was also monitored. Discussion Eccentric hamstring strength exercises are hypothesised to reduce the incidence of hamstring injury among male amateur soccer players by 70%. The prevention of such injuries will be beneficial to soccer players, clubs, football associations, health insurance companies and society. [ABSTRACT FROM AUTHOR]

The article presents a cohort study to determine intertester reliability of the active knee extension test (AKET) and the passive knee extension test (PKET) in patients with acute hamstring injuries. It mentions that 50 consecutive athletes with acute hamstring injuries and who were confirmed with magnetic resonance imaging were included in this study. It concludes that both tests can be used to assess flexibility in injured hamstrings despite of discomfort and pain during testing.

STUDY DESIGN: Systematic review with meta- analysis. OBJECTIVES: To review and critically appraise the literature for factors that increase the risk for meniscal tears. BACKGROUND: Meniscal tears are an important cause of disability and time lost from work, and are associated with a 4-fold increase in the long-term risk of knee osteoarthritis. Knowledge of the risk factors that lead to meniscal tears can help to correctly diagnose knee injuries and is important to the development of prevention strategies for knee osteoarthritis. METHODS: A search of the Cochrane Database of Systematic Reviews, MEDLINE, and Embase, from 1950 to January 2012, and a hand search of reference lists of all initially selected studies, without restriction on language or date of publication, were conducted. Prospective, retrospective, and case-control studies that included individuals over 16 years of age, who had no previous meniscal injuries or surgeries, were selected. A meta-analysis for 17 risk factors was performed. Where considerable heterogeneity among studies was present or the data did not provide sufficient information to perform a meta-analysis, a qualitative synthesis was conducted. RESULTS: Eleven studies, with a total of 7358 participants, were selected for systematic review. Data were available for meta-analysis for 10 of the 11 studies. Qualitative analysis was conducted using data from 3 of the 11 studies. Results showed strong evidence that age (older than 60 years), gender (male), work-related kneeling and squatting, and climbing stairs (greater than 30 flights) were risk factors for degenerative meniscal tears. We also found strong evidence that playing soccer and playing rugby were strong risk factors for acute meniscal tears. Waiting longer than 12 months between the anterior cruciate ligament injury and reconstructive surgery was a strong risk factor for a medial meniscal tear but not for a lateral meniscal tear. • CONCLUSION: The literature indicates a number of risk factors leading to either degenerative or acute meniscal tears, with some of these factors being potentially modifiable. [ABSTRACT FROM AUTHOR]

Background: In The Netherlands, sports medicine physicians are involved in the care of about 8% of all sports injuries that occur each year. Some patients consult a sports physician directly, without being referred by a general practitioner. This study aims to determine how many patients consult a sports physician directly, and to explore differences in the profiles of these patients compared with those who are referred. Methods: This was an exploratory cross-sectional study in which all new patients presenting with an injury to a regional sports medical center during September 2010 were identified. The characteristics of patients who self-referred and those who were referred by other medical professionals were compared. Results: A total of 234 patients were included (mean age 33.7 years, 59.1% male). Most of the injuries occurred during soccer and running, particularly injuries of the knee and ankle. In this cohort, 39.3% of patients consulted a sports physician directly. These patients were significantly more often involved in individual sports, consulted a sports physician relatively rapidly after the onset of injury, and had received significantly less care before this new event from medical professionals compared with patients who were referred. Conclusion: In this study, 39.3% of patients with sports injuries consulted a sports physician directly without being referred by another medical professional. The profile of this group of patients differed from that of patients who were referred. The specific roles of general practitioners and sports physicians in medical sports care in The Netherlands needs to be defined further. [ABSTRACT FROM AUTHOR]

Patellar tendinopathy (PT) has a multifactorial etiology, and many possible risk factors have been described in the literature. The findings are conflicting, though, and most research has been conducted on elite athletes. The aim of the current study is to determine the risk factors for PT in a large representative sample of basketball and volleyball players. Separate risk factors for men and women, basketball and volleyball players, and athletes with unilateral and bilateral PT were identified. All basketball and volleyball players between ages 18 and 35 from the Dutch Basketball Association and the Dutch Volleyball Association were invited to complete an online questionnaire on knee complaints and risk factors for PT. The logistic regression analyses included 2224 subjects. The risk factors for PT were age, playing at the national level, being male and playing volleyball (compared with playing basketball). The risk factors for men and women were comparable. Among volleyball players, outside hitters and middle blockers/hitters had an increased risk compared with setters. For basketball players, no risk factors could be identified. No differences in the risk factors were found between athletes with unilateral and bilateral PT. These findings should be taken into account for prevention and rehabilitation purposes. [ABSTRACT FROM AUTHOR]

An osteochondral defect (OD) is a lesion involving the articular cartilage and the underlying subchondral bone. ODs of the talus can severely impact on the quality of life of patients, who are usually young and athletic. The primary treatment for ODs that are too small for fixation, consists of arthroscopic debridement and bone marrow stimulation. This article delineates levels of activity, determines times for return to activity and reviews the factors that affect rehabilitation after arthroscopic debridement and bone marrow stimulation of a talar OD. Articles for review were obtained from a search of the MEDLINE database up to January 2012 using the search headings 'osteochondral defects', 'bone marrow stimulation', 'sports/activity', 'rehabilitation', various other related factors and 'talus'. English-, Dutchand German-language studies were evaluated.The review revealed that there is no consensus in the existing literature about rehabilitation times or returnto-sports activity times, after treatment with bone marrow stimulation of ODs in the talus. Furthermore, scant research has been conducted on these issues. The literature also showed that potential factors that aid rehabilitation could include youth, lower body mass index, smaller OD size, mobilization and treatment with growth factors, platelet-rich plasma, biphosphonates, hyaluronic acid and pulse electromagnetic fields. However, most studies have been conducted in vitro or on animals. We propose a scheme, whereby returnto-sports activity is divided into four phases of increasing intensity: walking, jogging, return to non-contact sports (running without swerving) and return to contact sports (running with swerving and collision). We also recommend that research, conducted on actual sportsmen, of recovery times after treatment of talar ODs is warranted. [ABSTRACT FROM AUTHOR]

Background: Results of surgery for chronic exertional compartment syndrome (CECS) of the lower leg deep posterior compartment are inferior compared with other types of CECS. Factors predicting success after surgery are unknown. Purpose: To study the prognostic value of preoperative compartmental pressure curves in patients receiving surgery for deep posterior compartment CECS. Study Design: Case series; Level of evidence, 4. Methods: Intracompartmental pressures (ICPs) of patients with deep posterior lower leg CECS were obtained at 4 time points (ie, before, immediately after, and 1 and 5 minutes after a standard exercise challenge test). Area under the 4-point pressure curve was calculated. Patients received a questionnaire investigating residual symptoms after surgery. Results: A complete data set was available for 52 patients (men, n = 23; age, 33 6 14 years). They rated their 3-month postoperative clinical outcome as excellent (14%), good (38%), fair (35%), or poor (13%). Outcome at 3 months was related to the area under the preoperative 4-point pressure curve (excellent, 127 6 28; good, 113 6 25; fair, 100 6 22; and poor, 88 6 15; P = .005; odds ratio [OR], 1.04; 95% confidence interval [CI], 1.01-1.08). At the long-term follow-up (39 6 24 months), all 5 cardinal symptoms (pain, tight feeling, cramps, weakness, and diminished sensibility) were greatly attenuated (P \ .001) in the successfully operated group. Long-term success was 48%. Delay in diagnosis was related to poor outcome (P = .04). Correlations between pressures/area under the 4-point pressure curve and long-term outcome were not significant, however. Conclusion: Preoperative measured intracompartmental pressures obtained in rest and after a standard exercise test may predict success of surgery for deep posterior compartment CECS of the lower limb. Further standardizing of preoperative pressure protocols may confirm that compartmental pressure analysis has diagnostic as well as predictive properties. [ABSTRACT FROM AUTHOR]

Background: The prevalence of jumper’s knee among nonelite athletes from different sports is unknown.Purpose: This study was undertaken to determine the prevalence of jumper’s knee in nonelite athletes from different sports and to determine potential risk factors for jumper’s knee.Design: Cohort study (prevalence); Level of evidence, 2.Methods: The authors interviewed 891 male and female nonelite athletes from 7 popular sports in The Netherlands: basketball, volleyball, handball, korfball, soccer, field hockey, and track and field. Using a specially developed questionnaire, information was obtained about individual characteristics (age, height, and weight), training background, previous and actual knee problems, and the VISA-P (Victorian Institute of Sport Assessment–Patella) score.Results: The overall prevalence of current jumper’s knee was 8.5% (78 of 891 athletes), showing a significant difference between sports with different loading characteristics. Prevalence was highest among volleyball players (14.4%) and lowest among soccer players (2.5%); it was significantly higher among male athletes (51 of 502 [10.2%]) than female athletes (25 of 389 [6.4%]) (χ2 = 3.91, P = .048). The mean duration of symptoms was 18.9 months (standard deviation [SD], 21.6; median value, 12.0; range, 2.0-59.8). The mean VISA-P score of the athletes with jumper’s knee was 71.4 (SD, 13.8). Athletes with jumper’s knee were significantly younger, taller, and heavier than those without jumper’s knee.Conclusion: Prevalence of jumper’s knee is high among nonelite athletes and varies between 14.4% and 2.5% for different sports. Jumper’s knee is almost twice as common among male nonelite athletes compared with female athletes. Different sport-specific loading characteristics of the knee extensor apparatus, a younger age, a taller body stature, and higher body weight seem to be risk factors associated with patellar tendinopathy. [ABSTRACT FROM AUTHOR]

Amputation of a limb may have a negative impact on the psychological and physical well-being, mobility and social life of individuals with limb amputations. Participation in sports and/or regular physical activity has a positive effect on the above mentioned areas in able-bodied individuals. Data concerning participation in sports or regular physical activity together with its benefits and risks for individuals with limb amputations are scarce. No systematic review exists that addresses a wide range of outcomes such as biomechanics, cardiopulmonary function, psychology, sport participation and sport injuries. Therefore, the aim of this article is to systematically review the literature about individuals with limb amputations and sport participation. MEDLINE (PubMed), EMBASE, CINAHL® and SportDiscus® were searched without time or language restrictions using free text words and MeSH terms. The last search date was 31 March 2010. Books, internet sites and references of included papers were checked for papers relevant to the topic under review. Papers were included if the research topic concerned sports and a minimum of ten individuals with limb amputations were part of the study population. Papers were excluded if they included individuals with amputations of body parts other than upper or lower limbs or more distal than the wrist or ankle, or if they consisted of case reports, narrative reviews, books, notes or letters to the editor. Title, abstract and full-text assessments were performed by two independent observers following a list of preset criteria. Of the 3689 papers originally identified, 47 were included in the review. Most of the included studies were older than 10 years and had cross-sectional designs. Study participants were generally younger and often had more traumatic amputations than the general population of individuals with limb amputations. Heterogeneity in population characteristics, intervention types and main outcomes made data pooling impossible. In general, sports were associated with a beneficial effect on the cardiopulmonary system, psychological well-being, social reintegration and physical functioning. Younger individuals with unilateral transtibial amputations achieve better athletic performance and encounter fewer problems when participating in sports compared with older individuals with bilateral transfemoral amputations. Regardless of their amputation level, individuals with limb amputations participate in a wide range of recreational activities. The majority of them were not aware of the sport facilities in their area and were not informed about available recreational activities. Sport prosthetic devices were used mostly by competitive athletes. For football, the injury rate and pattern of the players with an amputation were similar to those of able-bodied players. Individuals with limb amputations appear to benefit both physically and psychologically from participation in sports and/or regular physical activity. Therefore, sports should be included in rehabilitation programmes, and individuals with limb amputations should be encouraged to pursue a physically active life following hospital discharge. [ABSTRACT FROM AUTHOR]

Background and aims: Approximately 16% of all sports injuries in the Netherlands are caused by outdoor soccer. A cluster-randomised controlled trial has been designed to investigate the effectiveness and cost-effectiveness of an injury prevention programme ('The11') for male amateur soccer players. The injury prevention programme The11, developed with the support of the World Football Association FIFA, aims to reduce the impact of intrinsic injury risk factors in soccer. Methods: Teams playing at first-class amateur level in two districts in the Netherlands are participating in the study. Teams in the intervention group were instructed to apply The11 during each practice session throughout the 2009--10 season. All participants of the control group continued their practice sessions as usual. All soccer-related injuries and related costs for each team were systematically reported online by a member of the medical staff. Player exposure to practice sessions and matches was reported weekly by the coaches. Also the use of The11 during the season after the intervention season will be monitored. Discussion: Our hypothesis is that integrating the The11 exercises in the warm-up for each practice session is effective in terms of injury incidence, injury severity, healthcare use, and its associated costs and/or absenteeism. Prevention of soccer injuries is expected to be beneficial to adult soccer players, soccer clubs, the Royal Dutch Football Association (KNVB), health insurance companies and society. [ABSTRACT FROM AUTHOR]

The article discusses research which evaluated whether a platelet-rich plasma (PRP) injection would improve outcome in chronic midportion Achilles tendinopathy. The stratified, block-randomized, double-blind, placebo-controlled trial was conducted at the Hague Medical Center in Leidschendam, the Netherlands between August 28, 2008 and January 29, 2009, with a follow-up through July 16, 2009. It enumerates the study's intervention and main outcome measures. Presented in details are the research findings.

To investigate whether sports injuries result in long-term disabilities and handicaps and to establish variables with a prognostic value for the occurrence of these long-term consequences. All patients older than 17 years of age and admitted to the University Hospital Groningen because of a sports injury were entered in the study. By filling in a questionnaire 1–4 years after the injury an inventory was made of the long-term consequences. Absenteeism from work and sports, experienced disabilities or handicaps and the Sickness Impact Profile 68 (SIP68). Out of 306 patients 229 (75%) returned a completed questionnaire. Sixty-seven per cent of the working population had been unfit for work up to one year, whereas 4% still had not resumed work. Absenteeism from sports was also considerable; nearly half of the population did not participate in sports for more than a year. Furthermore, 32% of the patients still experienced disability or handicap following the injury. This finding is in agreement with the results of the SIP68 (odds ratio 6.8; confidence interval (95% CI): 3.51–13.08). Two prognostic variables could be distinguished: 'gender' and 'type of sport'. Long-term consequences occur more often in women (p < 0.03) and with playing outdoor soccer, horse riding or skiing (p < 0.01). Sports injuries can lead to long-term disabilities and handicaps. The variables 'gender' and 'type of sport' were of prognostic significance. [ABSTRACT FROM AUTHOR]

Objective-To determine the type and number of injuries that occur during the training and practice of Muay Thai kick boxing and to compare the data obtained 1 with those from previous studies of karate and taekwondo. Methods-One to one interviews using a standard questionnaire on injuries incurred during training and practice of Muay Thai kick boxing were conducted at various gyms and competitions in the United Kingdom and a Muay Thai gala in Holland. Results-A total of 152 people were questioned, 132 men and 20 women. There were 19 beginners, 82 amateurs, and 51 professionals. Injuries to the lower extremities were the most common in all groups. Head injuries were the second most common in professionals and amateurs. Trunk injuries were the next most common in beginners. The difference in injury distribution among the three groups was significant (p &les; 0.01). Soft tissue trauma was the most common type of injury in the three groups. Fractures were the second most common in professionals, and in amateurs and beginners it was sprains and strains (p &les; 0.05). Annual injury rates were: beginners, 13.5/1000 participants; amateurs, 2.43/1000 participants; professionals, 2.79/1000 participants. For beginners, 7% of injuries resulted in seven or more days off training; for amateurs and professionals, these values were 4% and 5.8% respectively. Conclusions-The results are similar to those found for karate and taekwondo with regard to injury distribution, type, and rate. The percentage of injuries resulting in time off training is less. [ABSTRACT FROM AUTHOR]

Evaluates athletes with medial instability of the elbow due to insufficiency of the medial collateral ligament using valgus load radiography and magnetic resonance imaging in the Netherlands. Physical examination of the upper extremities; Immobilization of the elbow in an arm-cast; Grade of instability at radiography; Ulna nerve symptoms.

The article presents a case study of a 17-year old male athlete with popliteal artery entrapment syndrome type II revealed after his ingrown toenail extraction in Zwolle, Netherlands. Diagnosis with contrast angiography showed ischemic symptoms. Unfortunately, the syndrome resulted into serious morbidity that resulted in four-toe amputation. He was hospitalized for weeks and post-operative treatment included platelet inhibitor and leg cast to accelerate the healing time.

Objectives: To investigate the prognosis and possible prognostic factors of running-related injuries (RRIs) in novice runners., Design: Prospective cohort study., Methods: Participants of Start to Run, a 6-weeks course for novice runners in The Netherlands, were asked to participate in this study. Before the start of the course a baseline questionnaire, on demographics, physical activity and perceived health, was sent to runners willing to participate. The 26- or 52-weeks follow-up questionnaires assessed information on RRIs and their duration. Only participants that sustained a RRI during follow-up were included in the analyses. An injury duration of 10weeks or shorter was regarded as a relatively good prognosis, while an injury duration of more than 10weeks was defined as a poor prognosis. To determine the associations between baseline characteristics and injury prognosis and between injury location and injury prognosis, multivariable logistic regression analyses were performed., Results: 347 participants (48.8%) sustained an RRI during follow-up. The RRIs had an overall median duration of eight weeks (range: 1-52weeks). Participants with a previous RRI were more likely to have a poor prognosis (OR 2.31; 95%CI 1.12-4.79), while a calf injury showed a trend towards an association with a relatively good prognosis (OR 0.49; 95%CI 0.22-1.11)., Conclusions: The duration of RRIs in novice runners is relatively long, with only calf injuries being associated with a good prognosis. This emphasizes the need of injury prevention measures in novice runners and adequate support during and after an RRI, especially in runners with a previous injury., (Copyright © 2018 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.)

The article presents a study by researcher Delfino Barboza S. and others that analyzes injuries in Dutch elite field hockey players in order to frame steps to prevent injury, published in a 2018 issue of the journal "Scandinavian Journal of Medicine & Science in Sports."

Presents an abstract of the article 'Sports Injuries in School-Aged Children: An Epidemiologic Study,' by Frank J.G. Backs et al, published in a 1989 issue of the 'American Journal of Sports Medicine.'