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Objective: To provide consensus on how to plan, organize and implement exercise-based injury prevention program (IPP) in sports., Design: Delphi., Setting: LimeSurvey platform., Participants: Experienced sports physical therapists from the International Federation of Sports Physical Therapy member countries., Main Outcome Measures: Factors related to sports IPP planning, organization and implementation., Results: We included 305 participants from 32 countries. IPP planning should be based on an athlete's injury history, on pre-season screening results, and on injury rates (respectively, 98%, 92%, 89% agreement). In total 97% participants agreed that IPP organization should depend on the athlete's age, 93% on the competition level, and 93% on the availability of low-cost materials. It was agreed that IPP should mainly be implemented in warm-up sessions delivered by the head or strength/conditioning coach, with physical training sessions and individual physical therapy sessions (respectively, 94%, 92%, 90% agreement)., Conclusion: Strong consensus was reached on (1) IPP based on the athlete's injury history, pre-season screening and evidence-based sports-specific injury rates; (2) IPP organization based on the athlete's age, competition level, and the availability of low-cost materials and (3) IPP implementation focussing on warm-up sessions implemented by the strength/conditioning coach, and/or individual prevention sessions by the physical therapist., Competing Interests: Declaration of competing interest LDM, CR, CN, UB are on the IFSPT executive board. The other co-authors have none declared., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Objective: Unlike in neurological patient populations, the effects of Extended Reality within the context of sports medicine have rarely been studied. This systematic review was conducted to investigate the value of Extended Realty-assisted rehabilitation and injury prevention strategies on injury rehabilitation and prevention outcomes., Methods: PubMed and Web of Science databases were consulted. The search strategy consisted of the terms Virtual Reality (Intervention), rehabilitation and injury prevention (Outcome) and healthy athletes or athletes with a musculoskeletal sports injury (Population). After eligibility and Risk of Bias screening, ten articles were included. Risk of Bias analysis resulted in a level of evidence varying between C (three articles), B (six articles) and A2 (one article) scores., Results: Extended Reality was found to provide an added value for both sports injury prevention and rehabilitation outcomes. It particularly provides clinicians with the opportunity to address the underlying biomechanical risk profile for common sports injuries, allowing the athletes to train protective movement patterns more effectively., Conclusion: More large-scale high-quality prospective research is needed in order to determine whether Extended Reality-assisted therapy is superior to conventional therapy in sports rehabilitation and injury prevention circles with strong conclusive evidence., Competing Interests: Declaration of competing interest None declared., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Objective: To identify the role of sports physical therapists (PT) in the organization of injury registration and preseason assessment, applied in athletic organizations and sports teams of different gender and level world-wide., Design: cross-sectional study., Setting: LimeSurvey platform., Participants: Sports PTs working with athletes invited through International Federation of Sports Physical Therapy., Main Outcome Measures: injury registration and athlete's screening., Results: 414 sports PTs participated in this international survey (mean age of 37.66 (SD = 9.38) years). 340 participants indicated that the PT as the responsible for injury registration. Barriers to properly register injury throughout the season were indicated by 157 sports PT and 86 (54.77%) indicated a lack of time on their routine as the main factor. 93 participants (30.09%) indicated that they customize the prevention program based on the preseason assessment. Sports PTs who reported not performing a preseason assessment (92 participants - 22.22%) mainly indicated this to be consequence of lack of structure in the organization (44 participants - 47.82%)., Conclusion: The majority of the sports PTs participate on injury registration and perform preseason assessment in athletes. However, lack of time in their routine and structure in the organization were recognized as the most important barriers to organize these properly., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Objective: To identify the role of sports physical therapists (PT) in the injury prevention process and to compare the structure of preventive programs and associated (organization) policies applied in athletic organizations and sports teams of varying gender and level world-wide., Design: cross-sectional study., Setting: LimeSurvey platform., Participants: Sports PT working with athletes invited through the International Federation of Sports Physical Therapy., Main Outcome Measures: Sports injury prevention program (IPP) structure and implementation., Results: 414 participants fully participate in this survey study. Athlete's injury history (68.84%), the most common injuries within the sport modality (67.87%) and athlete's preseason screening results (64.01%) were most frequently used to customize IPPs. Warm-up (70.04%) and individually PT-guided exercise-therapy (70.04%) were the preferred methods to organize the prevention routine. The main barrier for IPP implementation was lack of time within the athlete's weekly training schedule (66.66%). The majority of the participants (72.84%) reported to evaluate the perception of IPP's effect by comparing current and preceding seasons' injury occurrences., Conclusion: These survey results are the first identifying contemporary sports injury prevention organization and implementation policies on an international level. This information might support the sports PT community in improving and standardizing IPP (implementation) strategies worldwide., Competing Interests: Declaration of competing interest The authors also declare that they do not have any conflict of interest., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Return to play (RTP) criteria after hamstring strain injuries (HSIs) help clinicians in deciding whether an athlete is ready to safely resume previous sport activities. Today, functional and sport-specific training tests are the gold standard in the decision-making process. These criteria lead to an average RTP time between 11 and 25 days after a grade 1 or 2 HSI. However, the high re-injury rates indicate a possible inadequacy of the current RTP criteria. A possible explanation for this could be the neglect of biological healing time. The present review shows that studies indicating time as a possible factor within the RTP-decision are very scarce. However, studies on biological muscle healing showed immature scar tissue and incomplete muscle healing at the average moment of RTP. Twenty-five percent of the re-injuries occur in the first week after RTP and at the exact same location as the index injury. This review supports the statement that functional recovery precedes the biological healing of the muscle. Based on basic science studies on biological muscle healing, we recommend a minimum period of 4 weeks before RTP after a grade 1 or 2 HSI. In conclusion, we advise a comprehensive RTP functional test battery with respect for the natural healing process. Before deciding RTP readiness, clinicians should reflect whether or not it is biologically possible for the injured tissue to have regained enough strength to withstand the sport-specific forces. In an attempt to reduce the detrimental injury-reinjury cycle, it is time to start considering (biological healing) time., (© 2021. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Background: With their unremittingly high incidence rate and detrimental functional repercussions, hamstring injuries remain a substantial problem in male soccer. Proximal neuromuscular control ("core stability") is considered to be of key importance in primary and secondary hamstring injury prevention, although scientific evidence and insights on the exact nature of the core-hamstring association are nonexistent at present., Hypothesis: The muscle activation pattern throughout the running cycle would not differ between participants based on injury occurrence during follow-up., Study Design: Case-control study; Level of evidence, 3., Methods: Sixty amateur soccer players participated in a multimuscle surface electromyography (sEMG) assessment during maximal acceleration to full-speed sprinting. Subsequently, hamstring injury occurrence was registered during a 1.5-season follow-up period. Hamstring, gluteal, and trunk muscle activity time series during the airborne and stance phases of acceleration were evaluated and statistically explored for a possible causal association with injury occurrence and absence from sport during follow-up., Results: Players who did not experience a hamstring injury during follow-up had significantly higher amounts of gluteal muscle activity during the front swing phase ( P = .027) and higher amounts of trunk muscle activity during the backswing phase of sprinting ( P = .042). In particular, the risk of sustaining a hamstring injury during follow-up lowered by 20% and 6%, with a 10% increment in normalized muscle activity of the gluteus maximus during the front swing and the trunk muscles during the backswing, respectively ( P < .024)., Conclusion: Muscle activity of the core unit during explosive running appeared to be associated with hamstring injury occurrence in male soccer players. Higher amounts of gluteal and trunk muscle activity during the airborne phases of sprinting were associated with a lower risk of hamstring injuries during follow-up. Hence, the present results provide a basis for improved, evidence-based rehabilitation and prevention, particularly focusing on increasing neuromuscular control of the gluteal and trunk muscles during sport-specific activities (eg, sprint drills, agility drills).

Objectives: The aim of this study was to investigate the association between SARS-CoV-2 infection and muscle strain injury in elite athletes.Methods: A prospective cohort study in three Belgian professional male football teams was performed during the first half of the 2020-2021 season (June 2020-January 2021). Injury data were collected using established surveillance methods. Assessment of SARS-CoV-2 infection was performed by a PCR test before each official game.Results: Of the 84 included participants, 22 were infected with SARS-CoV-2 and 14 players developed a muscle strain during the follow-up period. Cox's proportional hazards regression analyses demonstrated a significant association between SARS-CoV-2 infection and the development of muscle strain (HR 5.1; 95% CI 1.1 to 23.1; p=0.037), indicating an increased risk of developing muscle strains following SARS-CoV-2 infection. All athletes who sustained a muscle strain after infection were injured within the first month (15.71±11.74 days) after sports resumption and completed a longer time in quarantine (14.57±6.50 days) compared with the infected players who did not develop a muscle strain (11.18±5.25 days).Conclusion: This study reported a five times higher risk of developing a muscle strain after a SARS-CoV-2 infection in elite male football players. Although this association should be examined further, it is possible that short-term detraining effects due to quarantine, and potentially pathological effects of the SARS-CoV-2 infection are associated with a higher risk of muscle strain injury. [ABSTRACT FROM AUTHOR]