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No research currently exists predicating a link between the injury-affiliated sensorimotor deficits of acute ankle sprain and those of chronic ankle instability during gait. This analysis evaluates participants with a 6-month history of ankle sprain injury to affirm this link. 69 participants wnh a 6-month history of acute first-time lateral ankle sprain were divided into subgroups ('chronic ankle instability' and 'coper') based on their self-reported disability and compared to 20 non-injured participants during a gait task. Lower extremity kinematic and kinetic data were collected from 200 ms pre- to 200 ms post-heel strike (period 1) and from 200 ms pre- to 200 ms post-toe off (period 2). The 'chronic ankle instability' subgroup (who reported greater disability) displayed increased knee flexion during period 1. During period 2, this subgroup exhibited greater total displacement at their ankle joint and greater extensor dominance at their knee. That many of these features are present, both in individuals with acute ankle sprain and those with chronic ankle instability may advocate a link between acute deficits and long-term outcome. Clinicians must be aware that the sensorimotor deficits of ankle sprain may persevere beyond the acute stage of injury and be cognizant of the capacity for impairments to pervade proximally. [ABSTRACT FROM AUTHOR]

Objective To examine whether people with recurrent ankle sprain, have specific physical and sensorimotor deficits. Design A systematic review of journal articles in English using electronic databases to September 2009. Included articles compared physical or sensorimotor measures in people with recurrent (>=2) ankle sprains and uninjured controls. Main outcome groups Outcome measures were grouped into: physical characteristics, strength, postural stability, proprioception, response to perturbation, biomechanics and functional tests. A meta-analysis was undertaken where comparable results within an outcome group were inconsistent. Results Fifty-five articles met the inclusion criteria. Compared with healthy controls, people with recurrent sprains demonstrated radiographic changes in the talus, changes in foot position during gait and prolonged time to stabilisation after a jump. There were no differences in ankle range of motion or functional test performance. Pooled results showed greater postural sway when standing with eyes closed (SMD=0.9, 95% CI 0.4 to 1.4) or on unstable surfaces (0.5, 0.1 to 1.0) and decreased concentric inversion strength (1.1, 0.2 to 2.1) but no difference in evertor strength, inversion joint position sense or peroneal latency in response to a perturbation. Conclusion There are specific impairments in people with recurrent ankle sprain but not necessarily in areas commonly investigated. [ABSTRACT FROM AUTHOR]

Background Groin injuries are a common occurrence in field based sports that have a high component of twisting and turning activities. The adductor squeeze test is commonly utilised, as a diagnostic and injury screening tool. Currently no reports exist in the published literature, which detail the level of activation of the adductor musculature and concomitant squeeze values during the test positions of the adductor squeeze test which are commonly utilised in a clinical setting. Objective The aim of the present study was to investigate the level of adductor musculature surface EMG (SEMG) activity and concomitant squeeze values in a healthy population of male Gaelic games athletes during performance of the adductor squeeze test in the three commonly utilised test positions (ie, 0°, 45°, and 90° of hip flexion). Setting University biomechanics laboratory. Participants 18 male Gaelic games players without any previous or current history of groin or hip injury. Main outcome measures Each participant performed three maximal effort repetitions of the adductor squeeze test in the positions of 0°, 45°, and 90° of hip flexion. Bilateral adductor SEMG activity and concomitant squeeze values quantified by a sphygmomanometer were recorded for each test. Repeated measures ANOVA was used to test for differences in the values obtained during each of the three test positions for both SEMG activity and squeeze values. Results The greatest amount of adductor muscle activity and squeeze values were observed in the 45° of hip flexion test position. Conclusion The results of the present study suggest that the adductor squeeze test performed in a position of 45° of hip flexion is the optimal test position for eliciting maximal adductor muscle activity and squeeze values. Therefore, the 45° of hip flexion test position can be recommended as the optimal test position for injury screening in non-pathological groups. [ABSTRACT FROM PUBLISHER]

Purpose: Exercise has been shown to reduce platelet reactivity and increase platelet sensitivity to prostacyclin, an endothelium-derived inhibitor of platelet activation, in middle-aged men and women. It is currently unknown if these beneficial effects can also be observed in young women and the intracellular mechanisms involved have not been identified. In this study, the feasibility of detecting changes in platelet reactivity, prostacyclin sensitivity and cAMP signalling were tested., Methods: 10 well-trained and 10 sedentary but healthy young women participated in this study. Responses of washed platelets to thrombin receptor activating peptide 6, the thromboxane A 2 receptor agonist U46619, and prostaglandin E 1 were measured by light transmission aggregometry. Expression levels of proteins in the cAMP pathway including phosphorylation of the vasodilator-stimulated phosphoprotein were analysed by western blotting., Results: There was no evidence of reduced basal reactivity in platelets from the well-trained group ( V ˙ O 2 max  = 51.1 ± 3.6 ml/kg/min) compared to the untrained group ( V ˙ O 2 max  = 31.1 ± 4.7 ml/kg/min). Platelets from the trained group showed evidence of greater sensitivity to the anti-aggregatory effects of prostaglandin E 1 . The slope of the aggregation curves indicated an overall faster rate of aggregation in the untrained group. Mean phosphorylation levels of vasodilator-stimulating phosphoprotein were consistently higher in the trained group, indicative of increased protein kinase A activity., Conclusion: Platelets from young women may exhibit an exercise-induced increase in sensitivity to prostacyclin leading to stimulation of the cAMP pathway. A larger study is warranted to explore this vasoprotective effect further., Competing Interests: Declarations. Conflict of interest: The authors have no competing interests to declare that are relevant to the content of this article. Ethical approval: The experimental protocol was approved by the Human Research Ethics Committee of University College Dublin (LS-21-74-ODonoghue-Smolenski). All participants provided written informed consent and experiments were conducted in accordance with the Declaration of Helsinki., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objective: This study reviewed the current state of machine learning (ML) research for the prediction of sports-related injuries. It aimed to chart the various approaches used and assess their efficacy, considering factors such as data heterogeneity, model specificity and contextual factors when developing predictive models., Design: Scoping review., Data Sources: PubMed, EMBASE, SportDiscus and IEEEXplore., Results: In total, 1241 studies were identified, 58 full texts were screened, and 38 relevant studies were reviewed and charted. Football (soccer) was the most commonly investigated sport. Area under the curve (AUC) was the most common means of model evaluation; it was reported in 71% of studies. In 60% of studies, tree-based solutions provided the highest statistical predictive performance. Random Forest and Extreme Gradient Boosting (XGBoost) were found to provide the highest performance for injury risk prediction. Logistic regression outperformed ML methods in 4 out of 12 studies. Three studies reported model performance of AUC>0.9, yet the clinical relevance is questionable., Conclusions: A variety of different ML models have been applied to the prediction of sports-related injuries. While several studies report strong predictive performance, their clinical utility can be limited, with wide prediction windows or broad definitions of injury. The efficacy of ML is hampered by small datasets and numerous methodological heterogeneities (cohort sizes, definition of injury and dependent variables), which were common across the reviewed studies., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Osteoarthritis (OA) is characterised by the failure of normal biological processes to repair following damage. Traditionally, OA was considered a "wear and tear" disorder; however, it is now a recognised inflammatory condition, preceded by molecular modifications. The aim of this study was to evaluate inflammatory markers among individuals with early knee OA (eKOA) and well-matched asymptomatic controls., Methods: Twenty six eKOA (females, n = 13; age = 60.2 ± 5.4 yrs, height = 1.73 ± 0.11 m, body mass = 77.8 ± 12.8 kg, body fat = 33.9 ± 8.5%) and twenty-three asymptomatic individuals (females, n = 14; age = 59.9 ± 5.5yrs, height = 1.71 ± 0.09 m, body mass = 72.6 ± 11.3 kg, body fat = 30.4 ± 8.2%) were recruited. The Timed Up and Go, and the 6 Minute Walk Tests evaluated physical function in addition to pain specific questionnaires (KOOS and ICOAP). Serum levels of IL-1α, IL-1β, IL-2, IL-4, IL-6, IL-8(CXCL8), IL-10, hsCRP and TNF-α were quantified using a multiplex assay via V-plex®Sector Imager 2400., Results: As hypothesised, only KOOS and EQ-5D-5L metrics differed between the groups for non-blood derived measures (p < 0.04). Only IL-6 was higher in eKOA (P = 0.02; 95% CI = 0.202; by 0.197 pg/mL; 34.5%). Among eKOA, IL-6 did not relate to severity of KOOS pain (P = 0.696, r = -0.088), but had a positive relationship with ICOAP consistent (r = 0.469, P = 0.045) rather than intermittent pain. There was a moderate correlation between 6MWD and IL-8 (r = 0.471, P = 0.012)., Conclusion: Our results illustrate the potential for IL-6 as a biomarker for eKOA, and introduce the proposition for particular consideration in those with consistent pain. Further, for the first time the present data showed greater walking distance in eKOA with lower circulating IL-8. Future work should seek to verify these results and further investigate IL-6 and IL-8 related molecular pathways in eKOA, and their potential relationships with consistent knee pain and physical function., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Abstract: O' Connor, C, Mc Intyre, M, Delahunt, E, and Thorborg, K. Maximum isometric hip adduction squeeze and abduction press strength values in men's rugby union players at select timepoints throughout a competitive season. J Strength Cond Res XX(X): 000-000, 2024-The purpose of this research was to report hip adduction and abduction strength values in men's rugby union players at select timepoints throughout a competitive season and to examine if differences exist between time of season and hip-testing positions. This cross-sectional repeated measures study design consisted of 15 male rugby union players competing at senior club level. Maximum isometric hip adduction and abduction strength were measured using a ForceFrame in 3 testing positions at specific timepoints: start of preseason (T1), start of competitive season (T2), mid-season period 1 (T3), and mid-season period 2 (T4). At group level, hip adduction strength (N·kg-1) increased from T1 to T2 in all testing positions, with significant increases observed in the 0° hip-flexion short-lever position (p = 0.048), and 45° hip-flexion position (p = 0.032). No significant changes occurred in hip abduction strength (N·kg-1). Hip adduction:abduction strength ratio increased from T1 to T2, with a significant increase observed in the 0° hip-flexion short-lever position (p = 0.008). At individual level, large variations from baseline strength (N·kg-1) were observed between timepoints for hip adduction strength, abduction strength, and adduction:abduction strength ratio. In conclusion, the present study shows increases in hip adduction strength and hip adduction:abduction strength ratio from the start of preseason to the beginning of the competitive season, with no other significant changes in hip strength observed throughout the season. Individual and frequent hip strength monitoring throughout the season and a more individualized exercise prescription approach may be needed for rugby union players, in addition to a more generalized focus on improving adductor and abductor strength., (Copyright © 2024 National Strength and Conditioning Association.)

Objectives: To report isometric hip adduction squeeze and abduction press strength values of elite-level youth male and female soccer players and examine if differences exist between sexes, and age-groups., Design: Cross-sectional cohort study., Setting: Elite youth soccer academy., Participants: 102 soccer players (n = 64; male, n = 38 female) competing in the national youth soccer leagues from under (U) 14-19 years of age level (U-14, U-15, U-17, U-19)., Main Outcome Measures: Isometric hip adduction and abduction strength values were measured with a ForceFrame in various testing positions., Results: Isometric hip adduction and abduction strength values are presented. Male U-17 and U-19 players demonstrated significantly greater (p < 0.05) absolute(N) and relative (N/kg) hip adduction and abduction strength than their female counterparts, with large (η 2  = 0.068-0.227) and medium-to-large (η 2  = 0.049-0.234) effect size, respectively. Significant differences in absolute strength, but not relative strength, were observed for hip adduction and abduction between male age-groups (U-14, U-15, U-17, U-19), with hip abduction strength differences only existing between U-14 and U-17 groups. No significant differences in hip strength were observed between U-17 and U-19 groups for female players., Conclusion: Male youth soccer players have higher absolute and relative hip adduction and abduction strength than females at the U-17 and U-19 level., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Competing Interests: Competing interests: None declared.

Context: Chronic ankle instability (CAI) is prevalent amongst individuals who sustain a lateral ankle sprain (LAS) injury. The persistent of the characteristic long-standing clinical symptoms of CAI maybe attributable to the lack of adoption of evidence-informed clinical guidelines., Objective: To investigate to what extent French-speaking physiotherapists implement the International Ankle Consortium Rehabilitation-Oriented-ASsessmenT (ROAST) framework when providing clinical care for individuals with an acute LAS injury., Design: Cross-sectional study., Setting: We created an online survey informed by a Delphi process of foot-ankle experts, and disseminated it to French-speaking physiotherapists in France, Switzerland, Quebec-Canada, Belgium, and Luxembourg., Patients or Other Participants: In total, 426 physiotherapists completed the online survey., Main Outcome Measure(s): The online survey comprised closed and open-ended questions organized in 5 sections: (1) participants' demographics, (2) participants' self-assessment expertise, (3) clinical diagnostic assessment (bones and ligaments), (4) clinical evaluation after an acute LAS injury (ROAST framework), and (5) CAI. The qualitative data from the open-ended questions was analyzed using best practice thematic analysis guidelines., Results: Only 6% of the respondents could name all Ottawa Ankle Rules criteria. Only 25% of the respondents cited or described "gold standard" tests from the literature to assess the integrity of the ankle lateral ligaments. Less than 25% of the respondents used some of the International Ankle Consortium ROAST recommended clinical evaluation outcome metrics to inform their clinical care for individuals with an acute LAS injury. In general, the respondents had a greater knowledge of the functional insufficiencies that associated with CAI when compared to the mechanical insufficiencies., Conclusion: A minority of French-speaking physiotherapists use the International Ankle Consortium ROAST recommended clinical evaluation outcome metrics to inform their clinical care for individuals with an acute LAS injury. This highlights the responsibility of the scientific community to better disseminate evidence-informed research to clinicians.

We aimed to determine whether the anatomical location (intramuscular tendon or T-Junction) of hamstring muscle injuries in professional men's rugby union associates with a prolonged time to return to full training and a higher rate of re-injury/subsequent injury. We reviewed the medical records of an Irish professional rugby union club to identify hamstring muscle injuries incurred across five seasons. Clinicians and players were not blinded to MRI results at the time of rehabilitation. A blinded musculoskeletal radiologist re-classified all included injuries (n = 91) according to the British Athletics Muscle Injury Classification framework. Players who sustained an injury with intramuscular tendon involvement required a longer time to return to full training compared to players who sustained an injury without intramuscular tendon involvement (78 days vs. 24 days). Players who sustained a biceps femoris injury with T-junction involvement did not require a longer time to return to full training compared to players who sustained a biceps femoris injury without T-junction involvement (29 days vs. 27 days). Injuries with either intramuscular tendon or T-junction involvement were not associated with an increased rate of re-injury/subsequent injury to the same limb (intramuscular tendon involvement - odds ratio = 0.96, T-junction involvement - odds ratio = 1.03). When a hamstring muscle injury involves the intramuscular tendon, the injured player and stakeholders should be made aware that a longer time to return to full training is likely required. T-junction involvement does not alter the expected clinical course of biceps femoris injuries., (© 2024 The Authors. Scandinavian Journal of Medicine & Science In Sports published by John Wiley & Sons Ltd.)

Objectives: The aim of our study was to explore the contextual factors that affect the implementation of football injury prevention initiatives and the provision of effective injury management in the Irish Women's National League (WNL)., Methods: We used a criterion-based purposive sampling approach to recruit coaches (n=7), players (n=17) and medical personnel (n=8) representing eight of the nine clubs in the WNL to participate in one-to-one semistructured interviews. Our study was located within an interpretivist, constructivist research paradigm. The interview data were analysed using reflexive thematic analysis., Results: The participants identified academic and work pressures, financial challenges, conflict with college football, inadequate facilities and gender inequity as being barriers to the implementation of injury prevention initiatives and the provision of effective injury management. Financial constraints within clubs were perceived to limit the provision of medical care and strength and conditioning (S&C) support and this was deemed to be associated with a heightened risk of injuries., Conclusion: Specific contextual factors were identified which curtail the implementation of injury prevention initiatives and the provision of effective injury management in elite-level women's club football in Ireland. Gender inequity was identified as one of the factors impacting the availability of high-quality medical care, S&C support, as well as access to training and match facilities. Our results provide new insights that could be used to inform the design and implementation of injury prevention and management initiatives for women football players in Ireland., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Objective: Joint stiffness results from the coupling of the nervous system and joint mechanics, and thus stiffness is a comprehensive representation of joint stability. It has been reported that moxibustion can alleviate general weakness and fatigue symptoms and subsequently may influence joint stiffness. This study investigated whether moxibustion could enhance knee joint stiffness in recreational athletes pre- and post-fatigue., Methods: Eighteen participants were randomized into intervention (5 males: 20.6 ± 1.5 yr; 4 females: 20.8 ± 1.5 yr) and control groups (5 males: 19.4 ± 0.9 yr; 4 females: 20.5 ± 0.6 yr). The intervention group received indirect moxibustion applied to acupoints ST36 (bilateral) and CV4 for 30 min every other day for 4 consecutive weeks. The control group maintained regular exercise without moxibustion. Peak torque (PT) of right knee extensor, relaxed and contracted muscle stiffness (MS) of vastus lateralis, and knee extensor musculoarticular stiffness (MAS) was assessed with an isokinetic dynamometer (IsoMed 2000), myometer, and free oscillation technique, respectively. Measurements were taken at three time points: pre-intervention, post-intervention/pre-fatigue, and post-fatigue., Results: MAS (P = 0.006) and PT (P = 0.007) in the intervention group increased more from pre-to post-intervention compared with the control group. Post-fatigue MAS (P = 0.016) and PT (P = 0.031) increased more in the intervention group than in the control group., Conclusion: Moxibustion enhanced PT and knee MAS, suggesting that this intervention could be used in injury prevention and benefit fatigue resistance in young recreational athletes., Competing Interests: The authors declare that they have no competing interests., (© 2023 Asia Pacific Knee, Arthroscopy and Sports Medicine Society. Published by Elsevier (Singapore) Pte Ltd.)

Hamstring strain injuries (HSI) are one of the most common sport-related injuries. They have a high injury burden and a high recurrence rate. The development of novel muscle injury grading systems has provided new insights into the possible impact of injury location on the time to return to play (TTRTP) and re-injury following HSI. In particular, injuries to the intramuscular tendon (IMT) may be present in up to 41% of all HSI and have been described as a 'serious thigh muscle strain'. Re-injury rates as high as 60% have been described in elite track and field athletes, as well as prolonged TTRTP. A systematic search was carried out using appropriate keywords to identify articles reporting on HSI involving the IMT in athletes. The primary aim was to determine whether IMT injuries warrant being classified as a distinct clinical entity with different expected outcomes to other hamstring muscle injuries. This narrative review summarises the existing evidence on: (1) the anatomy of the IMT and its response to injury; (2) the role of MRI and novel grading scales in IMT injury management (3) clinical assessment of IMT injuries, (4) TTRTP and re-injury rates across sports following IMT, (5) conservative rehabilitation and the role of specific 'IMT-oriented' strategies, and (6) indications for and approaches to surgery. The review found that important clinical outcomes such as re-injury rates and TTRTP vary across populations, cohorts and sports which suggest that outcomes are specific to the sporting context. Bespoke rehabilitation, tailored to IMT injury, has been shown to significantly reduce re-injuries in elite track and field athletes, without compromising TTRTP. Continued prospective studies across other sports and cohorts, are warranted to further establish relevant clinical findings, indications for surgical intervention and outcomes across other sporting cohorts., (© 2023. Springer Nature Switzerland AG.)

Background: To manage injuries effectively, players, head coaches, and medical personnel need to have excellent knowledge, attitudes, and behaviours in relation to the identification of risk factors for injuries, the implementation of injury prevention initiatives, as well as the implementation of effective injury management strategies. Understanding the injury context, whereby specific personal, environmental, and societal factors can influence the implementation of injury prevention initiatives and injury management strategies is critical to player welfare. To date, no qualitative research investigating the context of injuries, has been undertaken in elite-level women's football. The aim of our study was to explore the knowledge, attitudes, and behaviours of players, head coaches, and medical personnel in the Irish Women's National League (WNL) to injury prevention and injury management., Methods: We used qualitative research methods to explore the knowledge, attitudes, and behaviours of players, head coaches, and medical personnel in the Irish WNL to injury prevention and injury management. Semi-structured interviews were undertaken with 17 players, 8 medical personnel, and 7 head coaches in the Irish WNL. The data were analysed using thematic analysis. Our study is located within an interpretivist, constructivist research paradigm., Results: The participants had incomplete knowledge of common injuries in elite-level football, and many held beliefs about risk factors for injuries, such as menstrual cycle stage, which lacked evidence to support them. Jumping and landing exercises were commonly used to reduce the risk of injuries but evidence-based injury prevention exercises and programmes such as the Nordic hamstring curl, Copenhagen adduction exercise, and the FIFA 11+ were rarely mentioned. Overall, there was dissatisfaction amongst players with their medical care and strength and conditioning (S & C) support, with resultant inadequate communication between players, head coaches, and medical personnel., Conclusion: Poor quality and availability of medical care and S & C support were considered to be a major obstacle in the effective implementation of injury risk reduction strategies and successful return-to-sport practices. More original research is required in elite-level women's football to explore injury risk factors, injury prevention initiatives, and contextual return-to-sport strategies, so that players, head coaches, and medical personnel can use evidence that is both up-to-date and specific to their environment., (© 2023. The Author(s).)

Objective: To review the literature to establish overall, match and training injury incidence rates (IIRs) in senior (≥18 years of age) women's football (amateur club, elite club and international)., Design: Systematic review and meta-analysis of overall, match and training IIRs in senior women's football, stratified by injury location, type and severity., Data Sources: MEDLINE via PubMed; EMBASE via Ovid; CINAHL via EBSCO and Web of Science were searched from earliest record to July 2021., Eligibility Criteria for Selecting Studies: (1) football players participating in a senior women's football league (amateur club or elite club) or a senior women's international football tournament; (2) the study had to report IIRs or provide sufficient data from which this outcome metric could be calculated through standardised equations; (3) a full-text article published in a peer-reviewed journal before July 2021; (4) a prospective injury surveillance study and (5) case reports on single teams were ineligible., Results: 17 articles met the inclusion criteria; amateur club (n=2), elite club (n=10), international (n=5). Overall, match and training 'time-loss' IIRs are similar between senior women's elite club football and international football. 'Time-loss' training IIRs in senior women's elite club football and international football are approximately 6-7 times lower than their equivalent match IIRs. Overall 'time-loss' IIRs stratified by injury type in women's elite club football were 2.70/1000 hours (95% CI 1.12 to 6.50) for muscle and tendon, 2.62/1000 hours (95% CI 1.26 to 5.46) for joint and ligaments, and 0.76/1000 hours (95% CI 0.55 to 1.03) for contusions. Due to the differences in injury definitions, it was not possible to aggregate IIRs for amateur club football., Conclusion: Lower limb injuries incurred during matches are a substantial problem in senior women's football. The prevention of lower limb joint, ligament, muscle and tendon injuries should be a central focus of injury prevention interventions in senior women's amateur club, elite club and international football., Prospero Registration Number: CRD42020162895., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.)

The Doha agreement classification is used to classify groin pain in athletes. We evaluated the inter-examiner reliability of this classification system. We prospectively recruited 48 male athletes (66 symptomatic sides) with groin pain between 10-2017 and 03-2020 at a sports medicine hospital in Qatar. Two examiners (23 and 10 years of clinical experience) performed history taking, and a standardized clinical examination blinded to each other's findings. Examiners classified groin pain using the Doha agreement terminology (adductor-, inguinal-, iliopsoas-, pubic-, hip-related groin pain, or other causes of groin pain). Multiple entities were ranked in order of perceived clinical importance. Each side was classified separately for bilateral groin pain. Inter-examiner reliability was calculated using Cohen's Kappa statistic (κ). Inter-examiner reliability was slight to moderate for adductor- (κ = 0.40), inguinal- (κ = 0.44), iliopsoas- (κ = 0.57), and pubic-related groin pain (κ = 0.12), substantial for hip-related groin pain (κ = 0.62), and slight for "other causes of groin pain" (κ = 0.13). Ranking entities in order of perceived clinical importance improved inter-examiner reliability for adductor-, inguinal-, and iliopsoas-related groin pain (κ = 0.52-0.65), but not for pubic (κ = 0.12), hip (κ = 0.51), and "other causes of groin pain" (κ = 0.03). For participants with unilateral groin pain classified with a single entity (n = 7), there was 100% agreement between the two examiners. Inter-examiner reliability of the Doha agreement meeting classification system varied from slight to substantial, depending on the clinical entity. Agreement between examiners was perfect when athletes were classified with a single clinical entity of groin pain, but lower when athletes were classified with multiple clinical entities., (© 2022 The Authors. Scandinavian Journal of Medicine & Science In Sports published by John Wiley & Sons Ltd.)

Purpose: To determine whether differences exist in the architectural characteristics of the hamstring muscles of elite-level male and female rugby union players. Methods: Forty elite-level rugby union players (male n = 20, female n = 20) participated in this cross-sectional study. A sonographer acquired static ultrasound images using a 92 mm linear transducer to quantify ( via a semi-automated tracing software tool) the architectural characteristics (muscle length, fascicle length, pennation angle, and muscle thickness) of the biceps femoris long head and semimembranosus muscles of participants' left limb. Muscle length and muscle thickness of the biceps femoris short head and semitendinosus muscles of participants' left limb were also quantified. Bonferroni adjusted independent samples t-tests were performed to evaluate whether differences exist in the architectural characteristics of the hamstring muscles of elite-level male and female rugby union players. Results: There were no significant differences in fascicle length or pennation angle of the hamstring muscles of elite-level male and female rugby union players. Some significant differences in muscle thickness (biceps femoris short head, and semimembranosus) and muscle length (biceps femoris short head, biceps femoris long head, semitendinosus, and semimembranosus) were observed; in all cases the male players had thicker and longer muscles. Conclusion: At a group level, hamstring muscle fascicle length and pennation angle are unlikely to be a sex-specific intrinsic risk factor for Hamstring strain injuries., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Cronin, Foley, Cournane, De Vito, Kerin, Farrell and Delahunt.)

Objectives: The criterion validity of the sphygmomanometer was evaluated, relative to the Force Frame strength testing system. Test-retest reliability was assessed for both hip adduction and abduction strength., Design: Test-retest reliability study and criterion validity study., Participants: 50 asymptomatic, field-sport athletes., Main Outcome Measures: Maximal isometric hip adduction and abduction strength were measured. Interclass correlation coefficient(ICC 2,1 ) with confidence intervals were calculated to evaluate reliability of peak strength values. A Pearson product-moment correlation coefficient(r) was calculated to examine criterion validity of the sphygmomanometer as a measure of force when compared to the ForceFrame., Results: Intra-rater reliability for bilateral adduction testing using both ForceFrame and sphygmomanometer values revealed good-excellent reliability for both the 0° (ICC 2.1  = 0.87-0.90) and 45° (ICC 2.1  = 0.81-0.91) positions. ForceFrame values revealed good-excellent reliability for 0° abduction position and 45° abduction position. A good-moderate relationship (Pearson's r = 0.63) for 0° adduction position, and poor relationship (Pearson's r = 0.40) for 45° adduction position, were found between adduction squeeze values on ForceFrame and sphygmomanometer., Conclusion: Excellent reliability in hip adduction squeeze strength testing for both modes. However, there exists a 'good to moderate'-'fair' relationship between the Force Frame and sphygmomanometer., Competing Interests: Declaration of competing interest None declared., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Field hockey is played with sticks and a hard ball. It is fast-paced, with athletes playing together in close proximity. Athletes may be at increased risk of sustaining injuries through contact. The aim of this study was to investigate the epidemiological characteristics of contact injuries in field hockey. Data were collected during the 2017/2018 and 2018/2019 Irish Hockey League seasons. This study included two methods of data collection among male athletes: self-reported injuries and via those reported by the teams' physiotherapists. Injuries were defined as any physical complaint sustained during field hockey, supplemented by medical attention and time-loss injuries. Only contact injuries were included for analysis. Overall, 107 contact injuries were incurred, giving rise to an injury incidence rate of 3.1/1000 h, and accounting for 33.1% of all injuries. Athletes had an absolute risk of 0.372 of sustaining a contact injury. Contusions (48.6%) were the most common type of contact injury, while injuries to the head/face (20.6%) were the most frequently reported location. Contact injuries represent an important proportion of all injuries. Rule changes to mandate the use of personal protective equipment in field hockey may assist in reducing the absolute risk and severity of contact injuries in field hockey.

Purpose: To assess the intra-rater reliability of static wide field of view ultrasound to quantify the architectural characteristics of the hamstring muscles., Methods: Twenty amateur male athletes were recruited. Their left hamstring muscles were assessed using static wide field of view ultrasound on two separate occasions. Static ultrasound images were acquired by a single sonographer using a 92mm linear transducer. The architectural characteristics (muscle length, fascicle length, pennation angle and muscle thickness) from two distinct locations of the bicep femoris long head and semimembranosus were evaluated. Muscle length and thickness of the bicep femoris short head and semitendinosus muscle were also evaluated. Intraclass correlation coefficient analyses were performed to determine the intra-rater reliability of the performed measurements., Results: Both muscle (intraclass correlation coefficient = 0.99; standard error of measurement = 4.3 to 6.6mm) and fascicle (intraclass correlation coefficient = 0.92 to 0.98; standard error measurement = 1.1 to 2.4mm) length were measured with excellent intra-rater reliability. Muscle thickness was measured with excellent reliability (intraclass correlation coefficient = 0.9 to 0.96; standard error of measurement = 0.91mm to 1.4mm) for all hamstring muscles except for the proximal segments of the bicep femoris short head (intraclass correlation coefficient = 0.85; standard error of measurement = 0.84mm) and semitendinosus (intraclass correlation coefficient = 0.88; standard error of measurement = 0.82mm), which were measured with good reliability. Pennation angle was measured with good reliability (intraclass correlation coefficient = 0.77 to 0.87; standard error of measurement = 1 to 1.6°)., Conclusion: The architectural characteristics of the hamstring muscles of male amateur athletes can be reliably quantified using static wide field of view ultrasound., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2022 Cronin et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Objectives: The Irish Hockey League (IHL) introduced an eight-week winter break for the first time in the 2018/2019 season. We evaluated the effects of this eight-week break by comparing injury outcome metrics in the 2018/2019 (winter break) season and the 2017/2018 (no winter break) season., Design: Prospective cohort study., Methods: Each season was split into three distinct periods: period one consisted of the first nine weeks of each season; period two, weeks ten to 18; and period three, the final weeks. For the 2018/2019 season, the winter break was implemented in period two (weeks 10 to18). Relative risk with 95 % CI and injury incidence (1000h) were compared across the two seasons., Results: Overall, 173 and 150 injuries we incurred during the 2017/2018 (no winter break) and 2018/2019 (winter break season) seasons respectively. Compared to 2017/2018 season, total injury incidence rate, injury severity, and injury burden were all significantly higher in period three during the 2018/2019 season (i.e., following the winter break). Furthermore, injured athletes had a 2.5-times higher relative risk of sustaining an injury after the winter break. Relative risks of 15.3 and 21.4 were observed for lower back injuries and fractures after the winter break, when compared with no break., Conclusions: Although fewer injuries were incurred during the 2018/2019 season, significantly more injuries were sustained in the period after the implementation of the winter break when compared to the corresponding period during the 2017/2018 season., (Copyright © 2022 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.)

Objectives: Researchers have often struggled to successfully implement injury prevention strategies in real-world practice. This is despite such strategies proving successful in reducing overall injury incidence and burden. It has been hypothesised that this may be because the behavioural and contextual factors related to sports injury are not fully understood. Such factors stem from multiple key stakeholders, including the athlete. The primary aim of this study was to investigate athletes' knowledge and attitudes towards injury, injury reporting and prevention, as well as some of the barriers that may impact the future implementation of prevention strategies., Design: Qualitative; with semi-structured interviews following an interpretivist approach., Methods: Twenty-two field hockey athletes, playing in the top-tier Irish Hockey League were interviewed. Data were analysed using reflexive thematic analysis, with three general dimensions containing six higher-order themes., Results: The findings highlighted that athletes have a varied understanding of injury, which tends to improve with experience. The reporting of injuries by athletes to members of the coaching staff was relatively poor. This may be due to limited resources and supports available to athletes which also cause challenges to injury prevention., Conclusions: Future injury prevention strategies in field hockey need to account for athletes' varied understanding of what constitutes an injury. Furthermore, policy changes to influence potential barriers to injury may assist in preventing or reducing the number of injuries being sustained by athletes., (Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Introduction: Variable eligibility criteria across studies on plantar heel pain may result in compromising the generalisability of meta-analyses when heterogeneity is not accounted for. We aimed to explore: (i) heterogeneity of participant eligibility criteria in studies that have investigated plantar heel pain, and (ii) associations between key eligibility criteria and the characteristics of the participants included in the study., Methods: In this systematic review with narrative synthesis, we extracted participant eligibility criteria, and participants' age, body mass index (BMI), symptom duration and pain level from published studies on plantar heel pain. We performed a content analysis of criteria and aligned overarching criteria to the International Classification of Functioning, Disability and Health (ICF). We pooled studies that used the same thresholds for participant eligibility criteria into sub-groups. We also pooled and reported studies that did not have any eligibility criteria for the quantitative characteristics to use their data for reference values and pooled studies that did not have any eligibility criteria for the characteristics as reference., Results: Two hundred and fourteen articles were included. The most reported participant eligibility criteria (as aligned to the ICF) related to body structures/function and personal factors. Age, BMI, symptom duration and pain level were used with various ranges and/or thresholds across studies (age was reported in 23 different ways across 97 studies; BMI 7/13; symptom duration 14/100; and pain level 8/31). When eligibility criteria included thresholds close to the reference value of a participant characteristic, characteristics were associated with criteria (e.g., younger participants when an upper age threshold was used)., Conclusion: Participant eligibility criteria in studies on plantar heel pain vary widely; studies differed substantially in their use of quantitative thresholds. Participant characteristics of samples in studies were associated with the criteria used. This study emphasises a need for adjusting for participant heterogeneity in systematic reviews to improve their validity., (© 2022. The Author(s).)

Objectives: The mechanisms of hamstring strain injuries (HSIs) in professional Rugby Union are not well understood. The aim of this study was to describe the mechanisms of HSIs in male professional Rugby Union players using video analysis., Methods: All time-loss acute HSIs identified via retrospective analysis of the Leinster Rugby injury surveillance database across the 2015/2016 to 2017/2018 seasons were considered as potentially eligible for inclusion. Three chartered physiotherapists (analysts) independently assessed all videos with a consensus meeting convened to describe the injury mechanisms. The determination of the injury mechanisms was based on an inductive process informed by a critical review of HSI mechanism literature (including kinematics, kinetics and muscle activity). One of the analysts also developed a qualitative description of each injury mechanism., Results: Seventeen acute HSIs were included in this study. Twelve per cent of the injuries were sustained during training with the remainder sustained during match-play. One HSI occurred due to direct contact to the injured muscle. The remainder were classified as indirect contact (ie, contact to another body region) or non-contact. These HSIs were sustained during five distinct actions-'running' (47%), 'decelerating' (18%), 'kicking' (6%), during a 'tackle' (6%) and 'rucking' (18%). The most common biomechanical presentation of the injured limb was characterised by trunk flexion with concomitant active knee extension (76%). Fifty per cent of cases also involved ipsilateral trunk rotation., Conclusion: HSIs in this study of Rugby Union were sustained during a number of playing situations and not just during sprinting. We identified a number of injury mechanisms including: 'running', 'decelerating', 'kicking', 'tackle', 'rucking' and 'direct trauma'. Hamstring muscle lengthening, characterised by trunk flexion and relative knee extension, appears to be a fundamental characteristic of the mechanisms of acute HSIs in Rugby Union., Competing Interests: Competing interests: ED is an Associate Editor of the British Journal of Sports Medicine., (© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.)

Lateral ankle sprains are a commonly incurred injury in sports. They have a high recurrence rate and can lead to the development of persistent injury associated symptoms. We performed a quantitative synthesis of published case reports documenting the kinematics of acute lateral ankle sprains and episodes of 'giving-way' of the ankle joint to provide a comprehensive description of the mechanisms. A systematic literature search was conducted to screen records within MEDLINE® and EMBASE®. Additional strategies included manual search of specific journals, as well as contacting researchers in relevant communities to retrieve unpublished data. Twenty-four cases were included in the quantitative synthesis, 11 from individual case reports and 13 from four separate case series. Two authors independently reviewed all the articles and extracted ankle joint kinematic data. Excessive ankle inversion was the most pronounced kinematic pattern observed across all included cases, with a mean peak inversion angle of 67.5° (range 2.0 to 142) and a mean peak inversion velocity of 974°/s (range 468 to 1752). This was followed by internal rotation and plantar flexion, respectively. A homogeneous linear function revealed a mean inversion velocity across all cases of 337°/s (range 117 to 1400; R 2  = 0.78; p < 0.0001).

Objectives: To investigate (i) the presence of vestibular and oculomotor impairments and (ii) the self-perceived effects of concussion-associated dizziness on health-related quality of life among amateur athletes 6 months and 1 year following sport-related concussion compared with nonconcussed, control athletes., Design: Prospective, matched-cohort study., Setting: Clinical assessment laboratory., Participants: Amateur athletes who were diagnosed with sport-related concussion within 1 week of injury, and sex-, age-, and activity-matched nonconcussed, control athletes., Main Measures: Participants were evaluated 6 months and 1 year following sport-related concussion and enrollment in the longitudinal study using the Vestibular and Oculo-Motor Screening and the Dizziness Handicap Inventory. We performed multivariate analyses of variance and chi-square analyses to compare concussion and control group scores at each study assessment., Results: Forty-seven participants with concussion and 47 control participants completed the study. The concussion group reported similar mean symptom provocation scores on the Vestibular and Oculo-Motor Screening and exhibited a similar near-point convergence distance compared with the control group at the 6-month and 1-year study assessments. The concussion and control groups had similar perceptions of the effects of dizziness on their health-related quality of life at both study assessments., Conclusion: Meaningful differences in vestibular and oculomotor symptom provocation and self-perceived effects of dizziness on everyday life were not observed between concussed and nonconcussed, control athletes 6 months and 1 year following sport-related concussion., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Poor reporting of medical and healthcare systematic reviews is a problem from which the sports and exercise medicine, musculoskeletal rehabilitation, and sports science fields are not immune. Transparent, accurate and comprehensive systematic review reporting helps researchers replicate methods, readers understand what was done and why, and clinicians and policy-makers implement results in practice. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement and its accompanying Explanation and Elaboration document provide general reporting examples for systematic reviews of healthcare interventions. However, implementation guidance for sport and exercise medicine, musculoskeletal rehabilitation, and sports science does not exist. The Prisma in Exercise, Rehabilitation, Sport medicine and SporTs science (PERSiST) guidance attempts to address this problem. Nineteen content experts collaborated with three methods experts to identify examples of exemplary reporting in systematic reviews in sport and exercise medicine (including physical activity), musculoskeletal rehabilitation (including physiotherapy), and sports science, for each of the PRISMA 2020 Statement items. PERSiST aims to help: (1) systematic reviewers improve the transparency and reporting of systematic reviews and (2) journal editors and peer reviewers make informed decisions about systematic review reporting quality., Competing Interests: Competing interests: RA, MCA, FB, MC, SH, FMI, SM, MSR, GS, BV, JLW, MW and AAW declare they have no competing interests. CLA was a Deputy Editor (Systematic Reviews) for BJSM from 2016 to 2018. ED, HPD and AW are associate editors for BJSM. MCA was a member of the BJSM editorial board from 2008 to 2020. KMK was Editor-in-Chief of BJSM from 2008 to 2020. He holds no position with the BJSM or the BMJ Group at present (September 2021). DM is Chair of the PRISMA group, led the PRISMA 2009 statement and co-led the PRISMA 2020 statement. MJP co-led the PRISMA 2020 statement. ES was editor of BJSM from 2017 to 2020, and editor-in-chief of BMJ Open Sport & Exercise Medicine from 2019 to 2020. He is a senior adviser to BJSM (September 2021)., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

We investigated the pattern of injuries in elite-level women's football in Ireland, during a two-season prospective injury surveillance study in the Women's National League (WNL). Seven out of the eight clubs (271 players) in the WNL were followed prospectively during the 2018 and 2019 seasons. The injury incidence rate in matches (19.2/1000 h) was 7.5 times higher than in training (2.5/1000 h). Players, on average, sustained 0.69 injuries per season (266 injuries/383 player seasons), which equates to 15 time-loss injuries per season for a squad of 22 players. The majority of the injuries sustained by players were lower extremity injuries (85%), of which, 46% had a non-contact injury mechanism. Muscle, ligament, and contusion injuries were the most common injury types, while the ankle, knee, and thigh were the most commonly injured body sites. The most common injuries sustained over the two seasons were lateral ankle sprains (13.9%), hamstring strains (12.4%), knee meniscus/cartilage injuries (7.5%), adductor strains (6%), quadriceps strains (4.5%), and ankle contusions (4.5%). The injuries with the highest injury burden were ACL injuries (59 days lost/1000 h), knee meniscus/cartilage injuries (23/1000 h), lateral ankle sprains (21/1000 h), hamstring strains (12/1000 h), MCL sprains (11/1000 h), and quadriceps strains (11/1000 h). There were 8 ACL tears documented over the 2 seasons, which accounted for 28% of all time lost to injury with a mean days lost per injury of 247. We recommend that clubs in the WNL in Ireland should implement injury risk mitigation strategies, with a particular focus on injuries with a high injury burden., (© 2021 The Authors. Scandinavian Journal of Medicine & Science In Sports published by John Wiley & Sons Ltd.)

Hamstring strains are the most prevalent injury sustained by field-sport athletes. Insufficiencies in the architectural characteristics of the hamstring muscles can heighten an athlete's risk of incurring a hamstring strain. To evaluate the influence of hamstring muscle architectural characteristics (i. e., fascicle length, pennation angle, muscle thickness) on injury risk, it is necessary to precisely evaluate these characteristics. Considering this, our aim was to develop and evaluate the precision of a novel semi-automated tracing software to measure the architectural characteristics of the biceps femoris long head (the most commonly injured hamstring muscle) in B-mode ultrasound images. We acquired static sonograms of the biceps femoris long head from ten healthy male field-sport athletes. The architectural characteristics (fascicle length, pennation angle, and muscle thickness) of participants' biceps femoris long head were evaluated 10 times using the tracing software, with the specific purpose of determining its measurement precision. The tracing software precisely measured the architectural characteristics of the participants' biceps femoris long head: fascicle length (% CV: 0.64-1.12), pennation angle (% CV: 2.58-10.70), muscle thickness (% CV: 0.48-2.04) Our semi-automated skeletal muscle tracing algorithm precisely measures fascicle length, pennation angles, and muscle thickness of the biceps femoris long head in static B-mode ultrasound images., Competing Interests: The authors declare that they have no conflict of interest., (Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany.)

Objectives: To evaluate the adoption of and opinions on the Doha agreement meeting classification in groin pain in athletes., Design: Delphi survey and e-survey., Methods: A 2-round Delphi survey among the Doha agreement meeting expert group, and a separate international e-survey among clinicians who regularly assess athletes with groin pain. Clinical cases were presented, and participants provided their preferred terms for the diagnoses. All participants reported if they had adopted the Doha agreement meeting classification system in their practice. The Doha agreement meeting experts also shared opinions on amendments to the classification system, and reported their level of agreement with suggested statements., Results: In the Delphi survey, the Doha agreement meeting experts (n = 21) reported 8-11 different terms for their primary diagnosis of each presented case. The Doha agreement meeting terminology was used by 50-67% of these experts. In the international e-survey (n = 51), 12-15 different diagnostic terms were reported in each clinical case, and 43-55% of clinicians used the Doha agreement meeting terminology. Adoption of the Doha agreement classification system in practice was reported by 73-82% of the Doha agreement meeting experts and 57-69% of the clinicians in the international e-survey. The experts suggested 49 statements regarding amendments to the classification system. Seven of these reached >75% agreement or disagreement., Conclusions: Five years after publication, the majority of the Doha agreement expert group and independent international clinicians report adopting the Doha agreement meeting classification system. There is still considerable heterogeneity in diagnostic terminology when clinical cases are presented, and disagreement on statements related to amendments of the current classification system., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Objectives: To evaluate whether differences in physical characteristics (running-related and collision-related metrics) exist between four different professional rugby union competition levels., Design: We collected and retrospectively analysed microsensor technology data from players of two professional rugby union clubs that competed across four different competition levels: International rugby union, European Rugby Champions Cup, PRO14 club competition, and British and Irish Cup., Methods: Differences between competition levels were analysed using a one-way ANOVA test. The Tukey HSD test was completed to perform multiple pairwise-comparisons between the means of the competition levels and player positional groups., Results: Ten of the 12 microsensor technology derived physical characteristics were significantly different between competition levels. Collision load-, collisions-, and high metabolic load efforts-per minute all increased at higher competition levels. These differences were also noted across player positional groups., Conclusions: The physical characteristics of rugby union match-play differ across competitions levels. Our data suggest that professional rugby union players require specific physical preparation for different competition levels. In particular, players are likely to need specific preparation and recovery for the higher collision intensity observed at higher competition levels., (Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: Despite being the most commonly incurred sports injury with a high recurrence rate, there are no guidelines to inform return to sport (RTS) decisions following acute lateral ankle sprain injuries. We aimed to develop a list of assessment items to address this gap., Methods: We used a three-round Delphi survey approach to develop consensus of opinion among 155 globally diverse health professionals working in elite field or court sports. This involved surveys that were structured in question format with both closed-response and open-response options. We asked panellists to indicate their agreement about whether or not assessment items should support the RTS decision after an acute lateral ankle sprain injury. The second and third round surveys included quantitative and qualitative feedback from the previous round. We defined a priori consensus being reached at >70% agree or disagree responses., Results: Sixteen assessment items reached consensus to be included in the RTS decision after an acute lateral ankle sprain injury. They were mapped to five domains with 98% panellist agreement-PAASS: P ain (during sport participation and over the last 24 hours), A nkle impairments (range of motion; muscle strength, endurance and power), A thlete perception (perceived ankle confidence/reassurance and stability; psychological readiness), S ensorimotor control (proprioception; dynamic postural control/balance), S port/functional performance (hopping, jumping and agility; sport-specific drills; ability to complete a full training session)., Conclusion: Expert opinion indicated that pain severity, ankle impairments, sensorimotor control, athlete perception/readiness and sport/functional performance should be assessed to inform the RTS decision following an acute lateral ankle sprain injury., Trial Registration Number: ACTRN12619000522112., Competing Interests: Competing interests: KT, TB, OBAO, ED and EV are on the BJSM Editorial Board., (© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.)

Groin/hip injuries are prevalent in rugby union (RU). Assessment of hip muscle strength is important when designing bespoke injury prevention and rehabilitation programmes., Objective: The primary aim of this study was to determine normative values of hip muscle strength in elite-level RU players. A secondary aim of this study was to compare the Copenhagen Hip and Groin Outcome Score (HAGOS) between players with and without a history of groin/hip injury., Design: Cross-sectional cohort study., Setting: Professional RU club., Participants: 58 male professional RU players competing in the PRO14 league elite club level competition., Main Outcome Measures: Handheld dynamometry eccentric strength values of hip abduction (ABD), adduction (ADD), internal rotation (IR) and external rotation (ER), HAGOS., Results: Players' dominant (DOM) and non-dominant (NDOM) hip strength values were, 2.38 and 2.34 N m/kg for ABD, 2.79 and 2.71 N m/kg for ADD, 2.69 and 2.55 N m/kg for IR, and 2.65 and 2.54 N m/kg for ER. ADD:ABD strength ratio was 1.17 ± 0.26 for the DOM limb and 1.16 ± 0.24 for the NDOM limb. There was no clinically significant difference in strength between players' DOM and NDOM limbs. Players with a history of groin/hip injury scored lower on four of the HAGOS subscales (pain; symptoms; sport; quality of life) compared to those without a history of groin/hip injury., Conclusions: This study may help establish normative hip strength and HAGOS values for elite-level RU players. The results presented have important implications for the assessment of hip muscle strength and could provide clinical markers for return-to-play following injury., Competing Interests: Declaration of competing interest None declared., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Objective: Few studies have investigated injury incidence in field hockey. The aim of this systematic review was to determine the incidence and characteristics of injury in male field hockey athletes., Design: Prognosis systematic review with meta-analysis., Literature Search: MEDLINE via PubMed; EMBASE via Ovid; CINAHL via EBSCO; SPORTDiscus; and Web of Science were searched., Study Selection Criteria: Prospective studies and retrospective studies employing video analysis, written in English and published in peer-reviewed journals, expressing the incidence of injury in male field hockey athletes were included. Studies must have been of a duration of a minimum one season or one tournament. Studies were screened by two authors, assessing the eligibility of each record. Following selection of the studies, data were extracted by the two authors., Data Synthesis: Levels of heterogeneity were assessed in aggregate data using the I 2 statistic., Results: In total, 1722 records were identified. Twelve studies were included in the review. Injury incidence ranged from 4.5 to 57.9/1000h (I 2  = 98.5%). Nine studies were undertaken in tournament settings, with the remaining three conducted in club-based athletes in season-long settings. When a medical attention definition was used, there was a pooled incidence rate of 48.1/1000h, all in tournament studies. Contusions and muscle strains were the most frequently reported injury types, while the lower limb was the most common site of injury. Contact injuries were most common in tournament-based studies, while non-contact was more common in season-long studies., Conclusion: Prospective, season-long epidemiological studies investigating injury incidence in field hockey are lacking., Competing Interests: Declaration of competing interest None., (Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Objective: To prospectively investigate the condition-specific health-related quality of life (HRQoL) of athletes six months and one-year following sport-related concussion., Design: Prospective, longitudinal study., Setting: Clinical research centre at university school of public health., Participants: Amateur athletes who were diagnosed with sport-related concussion within one-week after presenting to a hospital emergency department were recruited along with sex-, age-, and activity-matched, non-concussed, control athletes. Concussion and control participants were assessed six months and one-year following sport-related concussion and study enrolment, respectively., Main Outcome Measures: Participants completed the Post-Concussion Symptom Scale and five condition-specific HRQoL patient-reported outcome measures - Headache Impact Test-6, Fatigue Severity Scale, Neck Disability Index, Generalised Anxiety Disorder-7, and Dizziness Handicap Inventory. We performed Frequentist and Bayesian mixed-design analyses of variance to compare the concussion group and control group at both assessments and quantify whether there was greater evidence in favour of the null hypothesis compared with the alternative hypothesis., Results: At six-month and one-year assessments, the concussion group (n = 47; male = 72%; mean (SD) age = 22.68 (5.07)) and the control group (n = 47; male = 72%; mean (SD) age = 23.81 (4.60)) reported similar clinical symptom severity scores and condition-specific HRQoL. The proportion of athletes in the concussion group with clinically-impaired scores was similar to the proportion of non-concussed athletes with clinically-impaired scores. At six-month and one-year assessments, there was moderate-to-very strong evidence that there was no difference between concussion and control participants' perceptions of the effects of headache, fatigue, neck pain, anxiety, and dizziness on HRQoL., Conclusion: There was moderate-to-very strong evidence in favour of no difference between the concussion and control groups on symptom severity scores and condition-specific HRQoL patient-reported outcome measures at six-month and one-year assessments. These results suggest that condition-specific HRQoL returns to the levels of non-concussed individuals within six months following sport-related concussion., Competing Interests: Declaration of competing interest The authors report no conflict of interest relating to the reported research study., (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)