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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. Test-retest reliability study and criterion validity study. 50 asymptomatic, field-sport athletes. 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. 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. 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. • Sphygmomanometer is reliable when used for measuring hip adduction strength. • ForceFrame is reliable and valid when used for measuring hip strength. • Sphygmomanometer displays ceiling effects. • Sphygmomanometer may not be the most valid method of measuring hip strength. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Ultrasonic techniques are being developed to detect changes in cancellous bone caused by osteoporosis. The goal of this study was to test the relative in vivo performance of eight backscatter parameters developed over the last several years for ultrasonic bone assessment: apparent integrated backscatter (AIB), frequency slope of apparent backscatter (FSAB), frequency intercept of apparent backscatter (FIAB), normalized mean of the backscatter difference (nMBD), normalized slope of the backscatter difference (nSBD), normalized intercept of the backscatter difference (nIBD), normalized backscatter amplitude ratio (nBAR) and backscatter amplitude decay constant (BADC). Backscatter measurements were performed on the left and right femoral necks of 80 adult volunteers (age = 25 ± 11 y) using an imaging system equipped with a convex array transducer. For comparison, additional ultrasonic measurements were performed at the left and right heel using a commercially available heel-bone ultrasonometer that measured the stiffness index. Six of the eight backscatter parameters (all but nSBD and nIBD) exhibited similar and highly significant (p < 0.000001) left-right correlations (0.51 ≤ R ≤ 0.68), indicating sensitivity to naturally occurring variations in bone tissue. Left-right correlations for the stiffness index measured at the heel (R = 0.75) were not significantly better than those produced by AIB, FSAB and FIAB. The short-term precisions of AIB, nMBD, nBAR and BADC (7.8%-11.7%) were comparable to that of the stiffness index measured with the heel-bone ultrasonometer (7.5%). [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. Prognosis systematic review with meta-analysis. MEDLINE via PubMed; EMBASE via Ovid; CINAHL via EBSCO; SPORTDiscus; and Web of Science were searched. 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. Levels of heterogeneity were assessed in aggregate data using the I2 statistic. In total, 1722 records were identified. Twelve studies were included in the review. Injury incidence ranged from 4.5 to 57.9/1000h (I2 = 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. Prospective, season-long epidemiological studies investigating injury incidence in field hockey are lacking. • Studies investigating the incidence of injury in male field hockey athletes are lacking, and those that have been conducted display high levels of heterogeneity. • There are important differences in injury characteristics incurred by athletes in a tournament-setting and those incurred during a club-season. • Developing a consensus statement on data collection procedures is vital to reduce the levels of heterogeneity between studies. [ABSTRACT FROM AUTHOR]

Groin/hip injuries are prevalent in rugby union (RU). Assessment of hip muscle strength is important when designing bespoke injury prevention and rehabilitation programmes. 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. Cross-sectional cohort study. Professional RU club. 58 male professional RU players competing in the PRO14 league elite club level competition. Handheld dynamometry eccentric strength values of hip abduction (ABD), adduction (ADD), internal rotation (IR) and external rotation (ER), HAGOS. 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. 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. • This is the first study to report eccentric hip strength profiles in professional rugby union players. • There is no significant difference in hip strength between dominant and non-dominant limbs. • Players with a history of hip/groin injury score lower on HAGOS subscales compared to those without, despite being injury free. • Absolute hip strength values are different in rugby union players compared to players from other footballing codes. [ABSTRACT FROM AUTHOR]

To prospectively investigate the condition-specific health-related quality of life (HRQoL) of athletes six months and one-year following sport-related concussion. Prospective, longitudinal study. Clinical research centre at university school of public health. 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. 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. 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. 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. • At six months and one year, concussed athletes reported similar clinical symptoms and HRQoL versus non-concussed athletes. • The proportion of concussed athletes and control athletes with clinical HRQoL at six months and one year was similar. • These findings support prior work suggesting HRQoL normalises for most athletes within six months after sports concussion. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to compare the outcomes of open Latarjet (OL) in competitive athletes with primary shoulder instability versus those with recurrent instability versus those undergoing OL for failed prior instability surgery.Methods: A retrospective review of patients who underwent OL with a minimum of 24-month follow-up was performed. Additionally, these were pair-matched in a 1:2:1 ratio for age, gender, sport, level of preoperative play, and follow-up length for primary instability, recurrent instability and failed prior instability surgery. Return to sport, the level of return and the timing of return were assessed. Additionally, recurrence, Visual Analogue Scale for pain (VAS), Subjective Shoulder Value (SSV), Rowe score, Shoulder Instability-Return to Sport after Injury (SIRSI) score, satisfaction, and whether they would undergo the same surgery again were compared.Results: After pair-matching, a total of 200 patients were included, with a mean age of 22.7 years and a mean follow-up of 38.8 months. Overall, there was no significant difference in any of the clinical outcome scores (VAS, Rowe, SIRSI, SSV) used for the 3 groups (P > 0.05 for all). However, there was a significantly lower rate of return to play for those undergoing OL because of failed prior instability surgery (88% vs 91% vs 64%, P < 0.0001) and for return at the same or a higher level (66% vs 78% vs 56%, P = 0.02). There was no significant difference in the rate of recurrent instability among the 3 groups (6% vs 5% vs 6%, P = 0.95).Conclusion: OL results in excellent clinical outcomes and low recurrence rates for those with primary shoulder instability, those with recurrent instability and those undergoing OL for failed prior instability surgery. However, in those undergoing OL for failed prior stabilization surgery, there was a lower rate of return to play.Level Of Evidence: Level III: Retrospective Comparative Study. [ABSTRACT FROM AUTHOR]

Prostate biopsy data are critical for patient management. Guidelines focus of detailed criteria to ensure that these are precisely and reproducibly reported. However, conflicting recommendations by different expert groups have led to significant reporting variation that could negatively impact patient care. We describe a different approach focusing on optimising communication of histopathological parameters such as tumour extent and grade to the clinical team. Communication is crucial because clinicians usually do not view histological material and are dependent on the information included in the histopathology report. Precision could become less critical if the biopsy findings are effectively conveyed by the pathologist and correctly interpreted by the clinician. Strategies to effectively communicate the message in contentious scenarios such when a prostate needle biopsy set contains prostate cancer that is discontinuous, of borderline grade, of disparate grades or associated with intraductal carcinoma of the prostate are outlined. [ABSTRACT FROM AUTHOR]

Objectives: To estimate the times taken to receive clearance to return to sporting activity and to return to pre-injury level of sport competition following sport-related concussion, and to estimate the proportion of athletes who were participating at their pre-injury level of sport competition six months and one-year following sport-related concussion.Design: Prospective cohort study.Methods: Amateur, adult athletes (16-38 years old) were diagnosed with sport-related concussion at a university-affiliated hospital emergency department. Participants were assessed within one-week, upon medical clearance to return to sporting activity, two weeks following return to sporting activity, six months, and 12 months following sport-related concussion. We assessed sex-, age-, and activity-matched non-injured, control participants at matched time-points. Participants were asked during each study assessment whether they were participating in any sport, in a different sport than before their sport-related concussion, in the same sport but at a lower level of competition than before their sport-related concussion, or in the same sport at the same level of competition than before their sport-related concussion.Results: Fifty concussed participants and 50 non-injured, control participants completed the study. The median times taken to receive clearance to return to sporting activity and to return to pre-injury level of sport competition following sport-related concussion were 13 days (95%CI=12,16) and 31 days (95%CI=28,32), respectively. One-year following sport-related concussion, 52% of participants reported that they were no longer participating in the same sport and at the same level of competition as they were before their sport-related concussion, compared with only 24% of participants in the non-injured, control group (p=0.003).Conclusions: A greater percentage of athletes in the concussion group were not participating at their perceived pre-injury level of sport competition one-year following sport-related concussion compared with a non-injured control group. Factors that explain the lower proportion of amateur athletes participating at their pre-injury level of sport competition one-year after sport-related concussion are likely multifaceted and should be considered in future investigations. [ABSTRACT FROM AUTHOR]