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To investigate: (1) the injury epidemiology in an Australian academy; (2) how athletes transition through the high‐performance sport (HPS) pathway; and (3) why athletes leave this HPS program. This retrospective cohort study was conducted at an Australian HPS academy over a 4‐year period. Medical attention injuries were prospectively recorded. Injury incidence rates (IIR) and burden were calculated per 365 athlete‐days, according to sport, sex, and pathway level. Athlete pathway levels were mapped to the Foundations, Talent, Elite, and Mastery (FTEM) framework. Reasons for athletes transitioning out were reported. Four hundred and eighty‐one injuries were reported across 124 athletes at an IIR of 2.09 injuries per 365 athlete‐days (95% CI = 1.91–2.29). Most athletes (103, 83.1%) were injured at least once over the 4‐year period. IIRs increased (IRR = 1.17, 95% CI = 1.06–1.29, p = 0.001) as athletes progressed through the pathway. The most common reason for athlete attrition was deselection due to performance (n = 18), with 55.6% of these athletes sustaining an injury in the season prior to deselection. Injury burden was highest at E2 (119.5 days absence per 365 athlete‐days (95% CI = 62.18–229.67)) and lowest at T4 (30.47 days absence per 365 athlete‐days (95% CI = 21.98–42.24)). Injury occurrence is common across HPS, with IIRs increasing as athletes progressed to higher talent levels. Deselection due to poor performance was the main attrition factor, with more than half the deselected athletes impacted by injury prior to deselection. This study highlights an increased risk of deselection, following injury, and indicates the need for further development of prevention strategies targeting pathway athletes. [ABSTRACT FROM AUTHOR]

Purpose: Psychological stress is reported to be an important contributor to reduced sleep quality and quantity observed in elite athletes. The purpose of this study was to explore the association between psychological stress and sleep and to identify if specific aspects of sleep are disturbed. Methods: One hundred thirty-one elite athletes (mean [SD], male: n = 46, age 25.8 [4.1] y; female: n = 85, age 24.3 [3.9] y) from a range of sports completed a series of questionnaires in a 1-month period approximately 4 months before the 2016 Rio Olympic Games. Questionnaires included the Pittsburgh Sleep Quality Index; Recovery-Stress Questionnaire; Depression, Anxiety, and Stress Scale (DASS 21); and Perceived Stress Scale (PSS). Results: Regression analysis identified the PSS and DASS stress as the main variables associated with sleep. A PSS score of 6.5 or higher was associated with poor sleep. In addition, a PSS score lower than 6.5 combined with a DASS stress score higher than 4.5 was also associated with poor sleep. Univariate analyses on subcomponents of the Pittsburgh Sleep Quality Index confirmed that PSS is associated with lower sleep quality (t99 = 2.40, P =.018), increased sleep disturbances (t99 = 3.37, P =.001), and increased daytime dysfunction (t99 = 2.93, P =.004). DASS stress was associated with increased sleep latency (t94 = 2.73, P =.008), increased sleep disturbances (t94 = 2.25, P =.027), and increased daytime dysfunction (t94 = 3.58, P =.001). Conclusions: A higher stress state and higher perceived stress were associated with poorer sleep, in particular increased sleep disturbances and increased daytime dysfunction. Data suggest that relatively low levels of psychological stress are associated with poor sleep in elite athletes. [ABSTRACT FROM AUTHOR]

This study aimed to establish injury incidence rates (IIRs) and burden within an Australian male professional football club (n = 73) and to investigate longitudinal trends across five consecutive seasons (2016/17–2020/21). There was an overall IIR of 9.18 injuries per 1000 hours (h) (95% CI [7.89, 10.47]). The IIR was approximately seven times greater (rate ratio (RR): 6.85; 95% CI [5.13, 9.19]; p < 0.01) in matches (31.29 injuries per 1000 h; 95% CI [25.25, 37.33]) compared to training (4.49 injuries per 1000 h; 95% CI [3.51, 5.47]). The overall injury burden was 254.1 days lost per 1000 h (95% CI [220.9, 292.3]). Compared with the reference 2016/17 season, there were significant increases in minimal (RR: 6.94; 95% CI [1.27, 128.73]) and mild injuries (RR: 3.76; 95% CI [1.21, 16.39]) in season 2017/18 and decreases in moderate (RR: 0.40; 95% CI [0.19, 0.80]) and contact injuries (RR: 0.35; 95% CI [0.12, 0.90]) in season 2019/2020. Time-loss injury is common and represents a major burden in Australian male professional football, with injuries more frequently sustained during matches. Injury prevention practices should specifically be directed towards muscle/tendon and ligament injuries of the lower limb, particularly anterior cruciate ligament, ankle sprain and hamstring strain injuries. [ABSTRACT FROM AUTHOR]

The Low Energy Availability in Females Questionnaire (LEAF-Q) was validated to identify risk of the female athlete triad (triad) in female endurance athletes. This study explored the ability of the LEAF-Q to detect conditions related to low energy availability (LEA) in a mixed sport cohort of female athletes. Data included the LEAF-Q, SCOFF Questionnaire for disordered eating, dual-energy X-ray absorptiometry-derived body composition and bone mineral density, Mini International Neuropsychiatric Interview, blood pressure, and blood metabolic and reproductive hormones. Participants were grouped according to LEAF-Q score (≥8 or <8), and a comparison of means was undertaken. Sensitivity, specificity, and predictive values of the overall score and subscale scores were calculated in relation to the triad and biomarkers relevant to LEA. Fisher's exact test explored differences in prevalence of these conditions between groups. Seventy-five athletes (18–32 years) participated. Mean LEAF-Q score was 8.0 ± 4.2 (55% scored ≥8). Injury and menstrual function subscale scores identified low bone mineral density (100% sensitivity, 95% confidence interval [15.8%, 100%]) and menstrual dysfunction (80.0% sensitivity, 95% confidence interval [28.4%, 99.5%]), respectively. The gastrointestinal subscale did not detect surrogate markers of LEA. LEAF-Q score cannot be used to classify athletes as "high risk" of conditions related to LEA, nor can it be used as a surrogate diagnostic tool for LEA given the low specificity identified. Our study supports its use as a screening tool to rule out risk of LEA-related conditions or to create selective low-risk groups that do not need management as there were generally high negative predictive values (range 76.5–100%) for conditions related to LEA. [ABSTRACT FROM AUTHOR]

Objectives: To assess the effect of multiple high-risk-scenario (HRS) exposures on noncontact injury prediction in elite Australian footballers. Design: Retrospective cohort study. Methods: Sessional workload data (session rating of perceived exertion, global positioning system–derived distance, sprint distance, and maximum velocity) from 1 club (N = 60 players) over 3 seasons were collated; several established HRSs were also defined. Accumulated HRS sessional exposures were calculated retrospectively (previous 1–8 wk). Noncontact injury data were documented. Univariate and multivariate Poisson regression models determined injury incidence rate ratios (IRRs) while accounting for moderating effects (preseason workload volume and playing experience). Model performance was evaluated using receiver operating characteristics (area under curve). Results: Very low (0–8 sessions: IRR = 5.76; 95% confidence interval [CI], 1.69–19.66) and very high (>15 sessions: IRR = 4.70; 95% CI, 1.49–14.87) exposures to >85% of an individual's maximal velocity over the previous 8 wk were associated with greater injury risk compared with moderate exposures (11–12 sessions) and displayed the best model performance (area under curve = 0.64). A single session corresponding to a very low chronic load condition over the previous week for all workload variables was associated with increased injury risk, with sprint distance (IRR = 3.25; 95% CI, 1.95–5.40) providing the most accurate prediction model (area under curve = 0.63). Conclusions: Minimal exposure to high-velocity efforts (maximum speed exposure and sprint volume) was associated with the greatest injury risk. Being underloaded may be a mediator for noncontact injury in elite Australian football. Preseason workload and playing experience were not moderators of this effect. [ABSTRACT FROM AUTHOR]

In applied program settings, such as in natural environment control and education, performance evaluation is usually conducted by evaluators considering both self-comparison and comparison with peers. We have developed the performance outcome scoring template (POS-T) for assessments with high face-validity in these settings. POS-T puts achievements of individuals or groups in context, i.e. the resulting performance outcome score (POS) reflects a meaningful measure of performance magnitude with regards to internal and external comparisons. Development of a POS is performed in four steps supported by a statistical framework. Software is supplied for creation of scoring applications in different performance evaluation settings. We demonstrate the POS-T by evaluation of CO2 emissions reduction amongst 36 OECD member countries. [ABSTRACT FROM AUTHOR]

Sport science and medicine practitioners are interested in the relationships between training load, injury, and illness. The extent to which training preparedness is associated with workload‐related injury and illness risk is debated. Therefore, this study applied multi‐level mixed effect logistic regression to investigate time‐dependent (±7‐ and ±28‐day) relationships between training preparedness (fatigue, mood, motivation, soreness, stress, sleep duration, and quality), training load, injury, and illness in 536 elite and pre‐elite female netball athletes. Absolute risk (AR ± 95% CI) of sustaining an injury (0.98 ± 0.06%, n = 1122 injuries, N = 254 athletes) or illness (1.09 ± 0.10%, n = 2881, N = 432 athletes) was calculated. All training preparedness variables combined resulted in an absolute risk of 0.88%‐5.88% and 0.87%‐20% for injury and illness, respectively. Injury and illness had significant (P <.05) bidirectional (ie, both increased and decreased) associations with physical (soreness) and physiological (sleep duration and quality), while illness also had negative (mood, motivation) and positive (stress) associations with psychological training preparedness variables. Low sleep duration in the 48‐h period prior was associated (P =.005) with increased injury risk (OR = 0.91 ± 0.03; AR = 4.00%), while "very poor" sleep quality (OR = 0.59 ± 0.02; AR = 7.83%) or extremes of too little (<5 hours, OR = 1.01 ± 0.03; AR = 3.13%‐14.29%) and too much (>10 hours, OR = 1.01 ± 0.03; AR = 2.61%‐10.98%) sleep had bidirectional associations (P <.001) with an increased illness risk. Changes in training preparedness variables demonstrated bidirectional associations with injury and illness. These outcomes suggest that sport science and medicine practitioners should monitor sleep, physical, and psychological recovery status, to aid early detection and intervention regarding injury and illness symptomology. [ABSTRACT FROM AUTHOR]

An emerging method to measure muscle activation patterns is muscle functional magnetic resonance imaging (mfMRI), where preexercise and postexercise muscle metabolism differences indicate spatial muscle activation patterns. We evaluated studies employing mfMRI to determine activation patterns of lumbar or lower limb muscles following exercise in physically active adults. Electronic systematic searches were conducted until March 2020. All studies employing ≥1.5 Tesla MRI scanners to compare spatial muscle activation patterns at the level of or inferior to the first lumbar vertebra in healthy, active adults. Two authors independently assessed study eligibility before appraising methodological quality using a National Institutes of Health assessment tool. Because of heterogeneity, findings were synthesized without meta-analysis. Of the 1,946 studies identified, seven qualified for inclusion and pertained to hamstring (n = 5), quadriceps (n = 1) or extrinsic foot (n = 1) muscles. All included studies controlled for internal validity, with one employing assessor blinding. MRI physics and differing research questions explain study methodology heterogeneity. Significant mfMRI findings were: following Nordic exercise, hamstrings with previous trauma (strain or surgical autograft harvest) demonstrated reduced activation compared with unharmed contralateral muscles, and asymptomatic individuals preferentially activated semitendinosus; greater biceps femoris long head to semitendinosus ratios reported following 45° hip extension over Nordic exercise; greater rectus femoris activation occurred in “flywheel” over barbell squats. mfMRI parameters differ on the basis of individual research questions. Individual muscles show greater activation following specific exercises, suggesting exercise specificity may be important for rehabilitation, although evidence is limited to single cohort studies comparing interlimb differences preexercise versus postexercise. [ABSTRACT FROM AUTHOR]

Patellar tendinopathy (PT) is a leading cause of morbidity in jump‐landing athletes. Landing mechanics are identified as a factor associated with PT and/or patellar tendon abnormality. This study aimed to identify key jump‐landing variables associated with PT. Thirty‐six junior elite basketball players (men n = 18, women n = 18) were recruited from a Basketball Australia development camp. Three‐dimensional (3D) kinematic and ground reaction force (GRF) data during a stop‐jump task were collected as well as ultrasound scans of the patellar tendons and recall history of training load data. Mixed‐model factorial analyses of variance were used to determine any significant between‐group differences. Of the 23 participants included for statistical analyses, 11 had normal bilateral patellar tendons (controls) and eight reported PT (currently symptomatic); however, the four participants categorized as asymptomatic with patellar tendon abnormality on diagnostic imaging were excluded from statistical analyses due to their small sample size. Athletes with PT displayed a similar knee flexion angle at initial foot‐ground contact (IC) and hip extension strategy during a stop‐jump horizontal landing. Despite a similar kinematic technique, athletes with PT utilized a strategy of a longer stance duration phase from IC to peak force. This strategy did not lead to those athletes with PT decreasing their peak vertical GRF nor patellar tendon force during landing but enabled these athletes to land with a lower rate of loading (control 59.2 ± 39.3 vs. PT 29.4 ± 33.7 BW.s‐1). Athletes with PT still reported significantly reduced training volume (control 4.9 ± 1.8 vs PT 1.8 ± 1.1 sessions/wk; total training time/wk control 2.4 ± 1.0 vs PT 1.4 ± 1.1 h/wk). [ABSTRACT FROM AUTHOR]

Purpose: Habitual intense exercise may increase the incidence of upper respiratory symptoms (URS) in elite athletes. This study investigated whether immune gene expression could identify gene markers that discriminate athletes with a higher prevalence of URS. Methods: This cross-sectional analysis of elite Australian athletes from various sports investigated whether athletes retrospectively reporting URS for two days or more in a month (n=38), had an altered immune gene expression profile compared with asymptomatic athletes (n=33). Peripheral blood samples were collected during Olympic selection events with corresponding URS data collected for the one-month period before sampling. Digital immune gene expression analysis was undertaken using the NanoString PanCancer Immune Profiling panel. Results: Fifty immune genes were differentially expressed between the groups (p<0.05) and approximately 78% of these genes were more highly expressed in athletes reporting URS. Many of these genes were interferon-stimulated genes or genes involved in the Jak/Stat signalling pathway. Only interferon alpha inducible protein 27 (IFI27), an interferon stimulated gene involved in viral response, remained significantly higher in athletes reporting URS (log2 fold-difference=2.49, odds ratio 1.02 per unit increase; p<0.01) post-adjustment and discriminated athletes reporting URS from asymptomatic athletes with 78% accuracy. Conclusion: Expression of IFI27 could differentiate athletes reporting URS from asymptomatic athletes, a gene that is upregulated in the immune response to viral infection. Upregulation of viral signalling pathways provides novel information on the potential aetiology of URS in elite Olympic athletes. [ABSTRACT FROM AUTHOR]

Background: The risk of sustaining a subsequent injury is elevated in the weeks after return to play (RTP) from an index injury. However, little is known about the magnitude, duration, and nature by which subsequent injury risk is increased. Purpose: To quantify and describe the risk of injury in a 12-week period after RTP from an index injury in Australian football players. Study Design: Cohort study; Level of evidence, 2. Methods: Injury data were collected from 79 players over 5 years at 1 Australian Football League club. Injuries were classified with the Orchard Sports Injury Classification System and by side of the body. Furthermore, injury severity was classified as time loss (resulting in ≥1 matches being missed) or non–time loss (no matches missed). Subsequent injury was categorized with the SIC-2.0 model and applied to the data set via an automated script. The probability of a time loss subsequent injury was calculated for in-season index injuries for each week of a 12-week period after RTP via a mixed effect logistic regression model. Results: Subsequent injury risk was found to be highest in the week of RTP for both time loss injuries (9.4%) and non–time loss injuries (6.9%). Risk decreased with each week survived after RTP; however, it did not return to baseline risk of participation (3.6%). Conclusion: These findings demonstrate that athletes returning to play are at an increased risk of injury for a number of weeks, thus indicating the requirement for tertiary prevention strategies to ensure that they survive this period. [ABSTRACT FROM AUTHOR]

Background: Injuries are common in rugby sevens, but studies to date have been limited to short, noncontinuous periods and reporting of match injuries only. Purpose: To report the injury incidence rate (IIR), severity, and burden of injuries sustained by men and women in the Australian rugby sevens program and to provide the first longitudinal investigation of subsequent injury occurrence in rugby sevens looking beyond tournament injuries only. Study Design: Descriptive epidemiology study. Methods: Ninety international rugby sevens players (55 men and 35 women) were prospectively followed over 2 consecutive seasons (2015-2016 and 2016-2017). All medical attention injuries were reported irrespective of time loss. Individual exposure in terms of minutes, distance, and high-speed distance was captured for each player for matches and on-field training, with the use of global positioning system devices. The IIR and injury burden (IIR × days lost to injury) were calculated per 1000 player-hours, and descriptive analyses were performed. Results: Seventy-three players (81.1%) sustained 365 injuries at an IIR of 43.2 per 1000 player-hours (95% CI, 43.0-43.3). As compared with male players, female players experienced a lower IIR (incidence rate ratio, 0.91; 95% CI, 0.90-0.91). Female players also sustained a higher proportion of injuries to the trunk region (relative risk, 1.75; 95% CI, 1.28-2.40) but a lower number to the head/neck region (relative risk, 0.58; 95% CI, 0.37-0.93; P =.011). The majority (80.7%) of subsequent injuries were of a different site and nature than previous injuries. A trend toward a reduced number of days, participation time, distance, and high-speed distance completed before the next injury was observed after successive injury occurrence. Conclusion: Female players have a lower IIR than male players, with variation of injury profiles observed between sexes. With a surveillance period of 2 years, subsequent injuries account for the majority of injuries sustained in rugby sevens, and they are typically different from previous types of sustained injuries. After each successive injury, the risk profile for future injury occurrence appears to be altered, which warrants further investigation to inform injury prevention strategies in rugby sevens. [ABSTRACT FROM AUTHOR]

Background: Accounting for subsequent injuries is critical for sports injury epidemiology. The subsequent injury categorisation (SIC-1.0) model was developed to create a framework for accurate categorisation of subsequent injuries but its operationalisation has been challenging.Objectives: The objective of this study was to update the subsequent injury categorisation (SIC-1.0 to SIC-2.0) model to improve its utility and application to sports injury datasets, and to test its applicability to a sports injury dataset.Methods: The SIC-1.0 model was expanded to include two levels of categorisation describing how previous injuries relate to subsequent events. A data-driven classification level was established containing eight discrete injury categories identifiable without clinical input. A sequential classification level that sub-categorised the data-driven categories according to their level of clinical relatedness has 16 distinct subsequent injury types. Manual and automated SIC-2.0 model categorisation were applied to a prospective injury dataset collected for elite rugby sevens players over a 2-year period. Absolute agreement between the two coding methods was assessed.Results: An automated script for automatic data-driven categorisation and a flowchart for manual coding were developed for the SIC-2.0 model. The SIC-2.0 model was applied to 246 injuries sustained by 55 players (median four injuries, range 1-12), 46 (83.6%) of whom experienced more than one injury. The majority of subsequent injuries (78.7%) were sustained to a different site and were of a different nature. Absolute agreement between the manual coding and automated statistical script category allocation was 100%.Conclusions: The updated SIC-2.0 model provides a simple flowchart and automated electronic script to allow both an accurate and efficient method of categorising subsequent injury data in sport. [ABSTRACT FROM AUTHOR]

Objectives To evaluate strength and flexibility measures pre- and post- Australian Football (AF) competition to determine their potential utility as secondary prevention measures. Design Cohort study. Setting Semi-professional AF club. Participants Ten male AF athletes (mean ± SD; age, 21.3 ± 2.2 years; height, 186.1 ± 6.3 cm; weight, 83.5 ± 8.6 kg). Main Outcome Measures Maximal unilateral isometric knee flexion strength performed in 45 degrees of hip flexion and 30 degrees of knee flexion, flexibility measures of hip and knee extension and ankle dorsiflexion. All outcome measures were evaluated pre-match to determine baseline measurements and repeated acutely post-match and at 26, 50 and 74 h following. Comparisons were made between baseline measures and all other time points. Results Knee flexion strength was significantly reduced at a group level acutely (−122.8N, 95%CI −156.2 to −89.4, p  = 0.000) and at 26 h (−89.6N, 95%CI −122.9 to −56.2, p  = 0.000) following competition. Hamstring flexibility was significantly reduced at all time periods following competition (all p  < 0.05), however these values were not clinically meaningful. Conclusions Knowledge that unilateral isometric knee flexion strength returns to pre-competition levels by 50 h following match-play in AF athletes is valuable for planning recovery time frames and may inform implementation of secondary prevention strategies. [ABSTRACT FROM AUTHOR]

Objectives: The use of microsensor technologies to conduct research and implement interventions in sports and exercise medicine has increased recently. The objective of this paper was to determine the validity and reliability of the ViPerform as a measure of load compared to vertical ground reaction force (GRF) as measured by force plates.Design: Absolute reliability assessment, with concurrent validity.Methods: 10 professional triathletes ran 10 trials over force plates with the ViPerform mounted on the mid portion of the medial tibia. Calculated vertical ground reaction force data from the ViPerform was matched to the same stride on the force plate. Bland-Altman (BA) plot of comparative measure of agreement was used to assess the relationship between the calculated load from the accelerometer and the force plates. Reliability was calculated by intra-class correlation coefficients (ICC) with 95% confidence intervals.Results: BA plot indicates minimal agreement between the measures derived from the force plate and ViPerform, with variation at an individual participant plot level. Reliability was excellent (ICC=0.877; 95% CI=0.825-0.917) in calculating the same vertical GRF in a repeated trial. Standard error of measure (SEM) equalled 99.83 units (95% CI=82.10-119.09), which, in turn, gave a minimum detectable change (MDC) value of 276.72 units (95% CI=227.32-330.07).Conclusions: The ViPerform does not calculate absolute values of vertical GRF similar to those measured by a force plate. It does provide a valid and reliable calculation of an athlete's lower limb load at constant velocity. [ABSTRACT FROM AUTHOR]

Objectives: To assess the association between workload, subjective wellness, musculoskeletal screening measures and non-contact injury risk in elite Australian footballers.Design: Prospective cohort study.Methods: Across 4 seasons in 70 players from one club, cumulative weekly workloads (acute; 1 week, chronic; 2-, 3-, 4-week) and acute:chronic workload ratio's (ACWR: 1-week load/average 4-weekly load) for session-Rating of Perceived Exertion (sRPE) and GPS-derived distance and sprint distance were calculated. Wellness, screening and non-contact injury data were also documented. Univariate and multivariate regression models determined injury incidence rate ratios (IRR) while accounting for interaction/moderating effects. Receiver operating characteristics determined model predictive accuracy (area under curve: AUC).Results: Very low cumulative chronic (2-, 3-, 4- week) workloads were associated with the greatest injury risk (univariate IRR=1.71-2.16, 95% CI=1.10-4.52) in the subsequent week. In multivariate analysis, the interaction between a low chronic load and a very high distance (adj-IRR=2.60, 95% CI=1.07-6.34) or low sRPE ACWR (adj-IRR=2.52, 95% CI=1.01-6.29) was associated with increased injury risk. Subjectively reporting "yes" (vs. "no") for old lower limb pain and heavy non-football activity in the previous 7 days (multivariate adj-IRR=2.01-2.25, 95% CI=1.02-4.95) and playing experience (>9 years) (multivariate adj-IRR=2.05, 95% CI=1.03-4.06) was also associated with increased injury risk, but screening data were not. Predictive capacity of multivariate models was significantly better than univariate (AUCmultivariate=0.70, 95% CI 0.64-0.75; AUCunivariate range=0.51-0.60).Conclusions: Chronic load is an important moderating factor in the workload-injury relationship. Low chronic loads coupled with low or very high ACWR are associated with increased injury risk. [ABSTRACT FROM AUTHOR]

Background: Cost-benefit analyses have been proposed for determining acceptable risk of injury regarding training and competition participation. Currently, there is no best evidence synthesis of the literature evaluating the relationship between injury/illness and chance of success or failure.Objective: To evaluate the relationship between injury and/or illness and success and/or failure in athletic populations (individual and team sports).Methods: This review was prospectively registered (PROSPERO CRD42016036729) and a systematic electronic search was conducted in May 2016. Inclusion criterion was any study design describing the association between injury and/or illness and success or failure in athletic performance. Two independent authors screened search results, performed data extraction and assessed methodological quality and strength of evidence using a modified Downs and Black appraisal tool and a modified van Tulder method, respectively.Results: Of 10 546 titles identified, 14 satisfied the inclusion criteria and 7 had low risk of bias. Outcome measures associated with success and/or failure included: (1) availability of team members, (2) injury incidence, (3) injury burden, (4) squad utilisation and (5, 6) precompetition and in-competition injury. There was strong evidence that (1) increased availability of team members/athletes decreased the risk of failure and (2) precompetition and in-competition injuries were associated with increased risk of failure.Conclusions: Injuries have a detrimental impact on team and individual athletic success. Increased player availability improves chances of success. Conversely, injuries sustained both prior to and during competition may increase risk of failure. Injury prevention should therefore be a priority for maximising athletic performance. [ABSTRACT FROM AUTHOR]

Objectives: Illness can disrupt training and competition performance of athletes. Few studies have quantified the relative contribution of the known medical, behavioural and lifestyle risk factors.Design: Cross-sectional.Methods: Olympic athletes from 11 sports (n=221) were invited to complete questionnaires administered nine months before the Rio 2016 Olympic Games. These included the Depression, Anxiety and Stress Questionnaire (DASS-21), Perceived Stress Scale (PSS), Dispositional Resilience Scale (DRS), Recovery-Stress Questionnaire (REST-Q-52 item), Low Energy in Females Questionnaire (LEAF-Q), a modified Personal and Household Hygiene questionnaire, Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, and custom-made questionnaires on probiotic usage and travel. An illness (case) was defined as an event which limited training or competition for greater hours in the prior month. Odds ratios and attributable fractions in the population (AFP) were utilised for categorical variables with independent t-tests or Wilcoxon rank-sum for continuous variables.Results: Eighty-one athletes responded (male, n=26; female, n=55). There were 16 illness cases and 65 controls. Female athletes were at higher odds of illness (OR=9.4, 95%CI 1.3-410, p=0.01, AFP=0.84). Low energy availability (LEAF-Q score ≥8: OR=7.4, 95%CI 0.78-352, p=0.04, AFP=0.76), depression symptoms (DASS-21: depression score >4, OR=8.4, 95%CI 1.1-59, p<0.01; AFP=0.39) and higher perceived stress (PSS: 10-item, p=0.04) were significantly associated with illness.Conclusions: Female sex, low energy availability, and mental health are associated with sports incapacity (time loss) due to illness. Low energy availability had high attributable fractions in the population and stands out as a primary association with illness. [ABSTRACT FROM AUTHOR]

Objectives To report normative responses to the HAGOS questionnaire for Australian football players and to determine whether any of the HAGOS questionnaire sub scales can differentiate players with and without groin pain. Design Case-control. Setting Clinical setting. Participants Professional (n = 66) and semi-professional (n = 9) Australian football (AF) players with current groin pain (n = 16) and controls (n = 57) without current groin pain. Main outcome measure The HAGOS subscales were compared between players with and without groin pain using the Wilcoxon rank-sum test with effect sizes (ES) calculated. Floor and ceiling effects were examined. A post-hoc factor analysis was undertaken. Results Participants with current groin pain showed lower Physical Function of Daily Living (PFDL) and Physical Function in Sport and Recreation (PFSR) subscale scores (p < 0.05, ES: 0.77 and 0.90 respectively). Any groin pain (current and/or historical) lowered the Pain and Quality of Life (QOL) subscale scores (p < 0.05, ES: 0.38 and 0.72 respectively). Factor analysis showed 8 significant factors with one main factor identified representing items describing forceful activities (Eigenvalue = 18.02, Proportion = 0.49). Conclusions The HAGOS can distinguish AF players with current groin pain in the PFDL and PFSR subscales but not in the other four subscales. Any current or historical groin pain lowers scores on the QOL and Pain sub scales. Level of evidence Aetiology, Individual Case-Control Study, Level 3b [ABSTRACT FROM AUTHOR]

Objectives: To identify the most accurate method of predicting peak height velocity in adolescents.Design: Systematic review.Methods: A comprehensive literature search of six electronic databases and reference lists was conducted. Studies that met selection criteria of (1) observational longitudinal cohort study (2) reproducible method/s of predicting peak height velocity (3) minimum six-month follow-up (4) healthy male and/or female adolescent subjects, with the exception of participants with adolescent idiopathic scoliosis, were considered for review. Studies were screened using a modified quality assessment checklist, with only those scoring >50% included. The type of surrogate measure of peak height velocity, its reliability and ability to predict peak height velocity were extracted from the year or stage immediately preceding peak height velocity. We defined "predict" as when both the estimates of effect and 95% confidence intervals of the surrogate occurred prior to the actual age of PHV.Results: The nine included studies examined three anthropometric, three equation and four radiographic-based surrogates for PHV. Of these, the radiographic measures were reported to exhibit moderate to high intra- and inter-rater reliability. Three of the four radiographic surrogates predicted PHV. Two anthropometric measures also predicted PHV but reliability of the measures is unknown. All equation-based methods predicted the timing of PHV to occur later than it actually happened when applied in the year prior to expected PHV.Conclusions: In the year/stage immediately preceding peak height velocity, radiograph-based methods appear to be accurate and reliable surrogates. [ABSTRACT FROM AUTHOR]

Training loads contribute to sports injury risk but their mitigation has rarely been considered in a sports injury prevention framework. A key concept behind monitoring training loads for injury prevention is to screen for those at increased risk of injury so that workloads can be adjusted to minimise these risks. This review describes how advances in management of workload can be applied as a preventive measure. Primary prevention involves screening for preparticipation load risk factors, such as low training loads, prior to a training period or competition. Secondary prevention involves screening for workloads that are known to precede an injury developing so that modification can be undertaken to mitigate this risk. Tertiary prevention involves rehabilitation practices that include a graded return to training programme to reduce the risk of sustaining a subsequent injury. The association of training loads with injury incidence is now established. Prevention measures such as rule changes that affect the workload of an athlete are universal whereas those that address risk factors of an asymptomatic subgroup are more selective. Prevention measures, when implemented for asymptomatic individuals exhibiting possible injury risk factors, are indicated for an athlete at risk of developing a sports injury. Seven key indicated risks and associated prevention measures are proposed. [ABSTRACT FROM AUTHOR]