Search

Purpose: Schools provide opportunities for children to accumulate recommended daily moderate to vigorous physical activity (MVPA). This study aimed to determine physical activity (PA) across the school day among elementary school children in Qatar. Methods: This cross-sectional study recruited 181 Grade 1 (5.8 ± 0.4 years) and Grade 4 (9.0 ± 0.5 years) children. Participants wore wrist-based accelerometers for 5 days to assess school-based PA. MVPA during physical education, recess, and class time were compared across sex, grade, and body mass index using general linear models. Results: Only 39.0% of this cohort met the recommended 30 min of MVPA during school hours. Fewer girls (23.2%) than boys (58.1%) achieved the school-based PA guidelines (p < 0.001). The children engaged in 19.0 ± 12.3%, 19.3 ± 8.6%, and 6.2 ± 3.4% of the designated physical education, recess, and class time in MVPA, respectively. Conclusion: Elementary school children in Qatar engage in inadequate MVPA during the school day, especially girls. Enhancing PA opportunities during physical education and recess is crucial.

Background: This study aims to investigate the patient safety culture at a sports medicine hospital and explore the quality of healthcare and associated factors. Methods: In a cross-sectional study design, the Hospital Survey on Patient Safety Culture (HSOPC) tool was administered online among staff at a sports medicine hospital in Doha, Qatar. Out of 898 staff who received an email invitation, 504 participated (56.1%). Results: The results showed that 48.0% of the staff rated the patient safety grade as excellent and 37.5% as very good, totaling 85.5%. Factors associated with excellent or very good patient safety grades were management support OR 4.7 95% CI (1.8 to 12.3); team communication OR 3.0 95% CI (1.4 to 6.3), supervisor action supporting patient safety OR 3.5 95% CI (1.7 to 7.0) and other items related to work area such as working together: OR 3.0 95% CI (1.2 to 7.6), helping out busy areas OR 2.5 95% CI (1.1 to 5.5) and having good procedures and systems: OR 2.8 95% CI (1.4 to 5.8). Conclusions: Addressing management support, enhancing communication, and cohesive work within the work area facilitates a culture of trust that improves patient safety grades. [ABSTRACT FROM AUTHOR]

Objective: Investigate the incidence and burden of injuries by age group in youth football (soccer) academy players during four consecutive seasons.Methods: All injuries that caused time-loss or required medical attention (as per consensus definitions) were prospectively recorded in 551 youth football players from under 9 years to under 19 years. Injury incidence (II) and burden (IB) were calculated as number of injuries per squad season (s-s), as well as for type, location and age groups.Results: A total of 2204 injuries were recorded. 40% (n=882) required medical attention and 60% (n=1322) caused time-loss. The total time-loss was 25 034 days. A squad of 25 players sustained an average of 30 time-loss injuries (TLI) per s-s with an IB of 574 days lost per s-s. Compared with the other age groups, U-16 players had the highest TLI incidence per s-s (95% CI lower-upper): II= 59 (52 to 67); IB=992 days; (963 to 1022) and U-18 players had the greatest burden per s-s: II= 42.1 (36.1 to 49.1); IB= 1408 days (1373 to 1444). Across the cohort of players, contusions (II=7.7/s-s), sprains (II=4.9/s-s) and growth-related injuries (II=4.3/s-s) were the most common TLI. Meniscus/cartilage injuries had the greatest injury severity (95% CI lower-upper): II= 0.4 (0.3 to 0.7), IB= 73 days (22 to 181). The burden (95% CI lower-upper) of physeal fractures (II= 0.8; 0.6 to 1.2; IB= 58 days; 33 to 78) was double than non-physeal fractures.Summary: At this youth football academy, each squad of 25 players averaged 30 injuries per season which resulted in 574 days lost. The highest incidence of TLI occurred in under-16 players, while the highest IB occurred in under-18 players. [ABSTRACT FROM AUTHOR]

Background: The 9+ screening battery test consists of 11 tests to assess limitations in functional movement.Aim: To examine the association of the 9+ with lower extremity injuries and to identify a cut-off point to predict injury risk.Methods: Professional male football players in Qatar from 14 teams completed the 9+ at the beginning of the 2013/2014 and 2014/2015 seasons. Time-loss injuries and exposure in training and matches were registered prospectively by club medical staff during these seasons. Univariate and multivariate Cox regression analyses were used to calculate HR and 95% CI. Receiver operating characteristic (ROC) curves were calculated to determine sensitivity and specificity and identify the optimal cut-off point for risk assessment.Results: 362 players completed the 9+ and had injury and exposure registration. There were 526 injuries among 203 players (56.1%) during the two seasons; injuries to the thigh were the most frequent. There was no association between 9+ total score and the risk of lower extremity injuries (HR 1.02, 95% CI 0.99 to 1.05, p=0.13), even after adjusting for other risk factors in a multivariate analysis (HR 1.01, 95% CI 0.98 to 1.04, p=0.37). ROC curve analysis revealed an area under the curve of 0.48, and there was no cut-off point that distinguished injured from non-injured players.Conclusion: The 9+ was not associated with lower extremity injury, and it was no better than chance for distinguishing between injured and uninjured players. Therefore, the 9+ test cannot be recommended as an injury prediction tool in this population. [ABSTRACT FROM AUTHOR]

Background: Musculoskeletal hip/groin screening tests are commonly performed to detect at-risk individuals. Bony hip morphology is considered a potential intrinsic risk factor but has not been examined prospectively. Purpose: To evaluate the association between intrinsic risk factors identified from musculoskeletal and radiographic screening tests and hip/groin injuries leading to time loss from training and/or match play in professional male soccer players. Study Design: Prospective cohort study; Level of evidence, 2. Methods: Male professional soccer players, aged ≥ 18 years, underwent screening specific for hip/groin pain during 2 consecutive seasons of the Qatar Stars League. The screening battery included pain provocation, range of motion, and strength tests as well as a hip radiographic examination. The radiographic examination included an anteroposterior pelvic view and 45) Dunn view, with bony hip morphology determined using quantitative methods. Time-loss (≥1 day) hip/groin injuries and individual player exposure (training and match play) were recorded prospectively, and injuries were categorized as adductor-related, inguinalrelated, iliopsoas-related, pubic-related, or hip-related groin pain, or "other," as recommended in the Doha agreement. We calculated hazard ratios (HRs) from univariate and multivariate Cox regression models to assess the relationship between potential risk factors and hip/groin injuries. Results: There were 438 players, completing 609 player seasons, and 113 hip/groin injuries that met the criteria for inclusion, with 85 injuries categorized as adductor-related. The proportion of players with bony morphological variants was the following: cam, 71%; pincer, 5%; and acetabular dysplasia, 13%. Previous hip/groin injuries (HR, 1.8; 95% CI, 1.2-2.7) and eccentric adduction strength were associated with the risk of hip/groin injuries. Higher (>1 SD above the mean) than normal eccentric adduction strength was associated with an increased risk for all hip/groin injuries (HR, 1.6; 95% CI, 1.0-2.5). Lower (< 1 SD below the mean) than normal eccentric adduction strength was associated with an increased risk for adductor-related injuries (HR, 1.7; 95% CI, 1.0-3.0). No other musculoskeletal screening test or bony hip morphology variables were associated with the injury risk. Conclusion: Previous groin injuries and eccentric adduction strength were associated with the risk of groin injuries. However, these associations were not strong enough to identify an "at-risk" individual, and therefore, musculoskeletal screening tests were not useful to dictate individualized prevention strategies. Bony hip morphology was not associated with the risk of groin injuries. [ABSTRACT FROM AUTHOR]

Background: Lower extremity muscle strength tests are commonly used to screen for injury risk in professional soccer. However, there is limited evidence on the ability of such tests in predicting future injuries. Purpose: To examine the association between hip and thigh muscle strength and the risk of lower extremity injuries in professional male soccer players. Study Design: Case-control study; Level of evidence, 3. Methods: Professional male soccer players from 14 teams in Qatar underwent a comprehensive strength assessment at the beginning of the 2013/2014 and 2014/2015 seasons. Testing consisted of concentric and eccentric quadriceps and hamstring isokinetic peak torques, eccentric hip adduction and abduction forces, and bilateral isometric adductor force (squeeze test at 45°). Time-loss injuries and exposure in training and matches were registered prospectively by club medical staff throughout each season. Univariate and multivariate Cox regression analyses were used to calculate hazard ratios (HRs) with 95% CIs. Results: In total, 369 players completed all strength tests and had registered injury and exposure data. Of these, 206 players (55.8%) suffered 538 lower extremity injuries during the 2 seasons; acute muscle injuries were the most frequent. Of the 20 strength measures examined, greater quadriceps concentric peak torque at 300 deg/s (HR, 1.005 [95% CI, 1.00-1.01]; P = .037) was the only strength measure identified as significantly associated with a risk of lower extremity injuries in multivariate analysis. Greater quadriceps concentric peak torque at 60 deg/s (HR, 1.004 [95% CI, 1.00-1.01]; P = .026) was associated with the risk of overuse injuries, and greater bilateral adductor strength adjusted for body weight (HR, 0.75 [95% CI, 0.57-0.97; P = .032) was associated with a lower risk for any knee injury. Receiver operating characteristic curve analyses indicated poor predictive ability of the significant strength variables (area under the curve, 0.45-0.56). Conclusion: There was a weak association with the risk of lower extremity injuries for 2 strength variables: greater quadriceps concentric muscle strength at (1) high and (2) low speeds. These associations were too small to identify an "at-risk" player. Therefore, strength testing, as performed in the present study, cannot be recommended as a screening test to predict injuries in professional male soccer. [ABSTRACT FROM AUTHOR]

Background: Hamstring injuries remain prevalent across a number of professional sports. In football, the incidence has even increased by 4% per year at the Champions League level over the last decade. The role of muscle strength or strength ratios and their association with risk of hamstring injury remain restricted by small sample sizes and inconclusive results.Purpose: The purpose of this study is to identify risk factors for hamstring injury in professional football players in an adequately powered, prospective cohort study. Using both established (isokinetic) and novel (eccentric hamstring test device) measures of muscle strength, we aimed to investigate the relationship between these strength characteristics over the entire range of motion with risk of hamstring injury.Methods: All teams (n=18) eligible to compete in the premier football league in Qatar underwent a comprehensive strength assessment during their annual periodic health evaluation at Aspetar Orthopaedic and Sports Medicine Hospital in Doha, Qatar. Variables included isokinetic strength, Nordic hamstring exercise strength and dynamic hamstring: quadriceps ratios.Results: Of the 413 players included (68.2% of all league players), 66 suffered a hamstring injury over the two seasons. Only isokinetic quadriceps concentric at 300°/s (adjusted for bodyweight) was associated with risk of hamstring injury when considered categorically. Age, body mass and playing position were also associated with risk of hamstring injury. None of the other 23 strength variables examined were found to be associated with hamstring injury.Conclusion: The clinical value of isolated strength testing is limited, and its use in musculoskeletal screening to predict future hamstring injury is unfounded. [ABSTRACT FROM AUTHOR]

Background: Recent data from a self-administered questionnaire show that approximately 75% of school children in Qatar do not meet the daily recommended levels of physical activity (PA). Since children spend half of their waking hours in school, it is important to understand when and how much PA children accumulate during the school day. This study aimed to objectively assess school-time PA among elementary school children in Qatar and to determine association of PA with age, gender, body mass index (BMI) status, or day of the week.Methods: A cross-sectional epidemiological study was conducted in four randomly selected elementary schools in Qatar. Two classes representing grade 1 children (age 5) and grade 4 children (age 9) were randomly selected within each school. A total of 183 elementary school children (86 boys and 97 girls) ages 6-12 years participated in this study. PA was assessed using a three-axial accelerometer (ActiGraph® wGT3X-BT). Participants wore accelerometers on their non-dominant wrist at school (7:00 a.m. to 1:00 p.m.) for five consecutive school days during the week. A cutoff points of 818 counts per 5 s was classified as moderate-to-vigorous physical activity (MVPA).Results: The average duration of MVPA in our study was 28.2 ± 13.5 min per day. Only 39% of participated children reach the recommended school-based MVPA of 30 min or more per day. Students spent on average 58.1 ± 8.4% of school time on sedentary activities. MVPA of boys and girls was similar in age 5 while girls age 9 were less active (23.7 ± 1.5 min/day) than boys of the same age (42.7 ± 1.8 min/day), ES = 0.269, P < 0.001. Neither overweight children nor children at risk for being overweight showed any differences in physical activity parameters when compared to children of normal weight. Our results showed, percentage of MVPA on the first (7.7 ± 5.1%) and last (7.1 ± 4.1%) day of the week was generally lower compared to other weekdays (P < 0.001).Conclusion: This was the first study to objectively assess PA during school hours among elementary school-children in Qatar. This study found that many of school children do not perform sufficient time being physically active at school. All students in two age categories (age 5 and age 9) spend the majority of school time engaged in sedentary activities. The low participation of girls age 9 in MVPA is a cause for concern and need to be addressed. [ABSTRACT FROM AUTHOR]

A correction is presented to the article "Prevalence and Novel Risk Factors for Vitamin D Insufficiency in Elite Athletes: Systematic Review and Meta-Analysis" which appeared in the October 11, 2022 issue of the magazine.

Purpose: Adequate vitamin D (25(OH)D) is required to maintain good bone health, yet many athletes are 25(OH)D deficient. This study sought to examine the relation between serum 25(OH)D and measures of bone health (bone mineral density (BMD) and T-score) in an ethnically diverse athletic population. Methods: Nine hundred and fifty male athletes presented for precompetition medical assessment in our facility. An additional 436 individuals registered with a Qatari sporting federation (such as sailing, archery, shooting, bowling) but exercising <2 h·wk-1 were used as control population. There were 30 Asian, 242 Black African, 235 Caucasian, 491 from Gulf Cooperation Countries, 336 Middle Eastern, and 52 Persian participants. All individuals undertook bone densitometry and body composition analysis by dual-energy x-ray absorptiometry and serum 25(OH)D evaluation. Results: From 950 athletes, 17.5% demonstrated severe deficiency, 39.2% demonstrated deficiency, 24.5% demonstrated insufficiency, and 18.8% demonstrated sufficiency, compared with 436 controls, 25.9% of whom demonstrated severe deficiency, 46.3% demonstrated deficiency, 19.0% demonstrated insufficiency, and 8.7% demonstrated sufficiency. No athlete presented with a T-score suggestive of osteoporosis (-2.5 SD) or osteopenia (-1.0 SD) at hip total. After adjustment for age, anthropometry, ethnicity, and athletic participation, there was no association between 25(OH)D and any BMD and T-score at any site within athletes. African and Caucasian athletes present with greater (P < 0.05) BMD and T-scores at the spine, neck, and hip total than those of Asian, Gulf Cooperation Countries, Middle Eastern, and Persian ethnicities. Athletes participating in high-impact sports present with higher measures (P < 0.05) of bone health than control participants regardless of 25(OH)D status. Conclusions: There is no association between 25(OH)D and BMD and T-score for any site within male athletes after adjusting for age, ethnicity, and sporting participation. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this study was to investigate the effects of weather, rank, and home advantage on international football match results and scores in the Gulf Cooperation Council (GCC) region. Methods: Football matches (n = 2008) in six GCC countries were analyzed. To determine the weather influence on the likelihood of favorable outcome and goal difference, generalized linear model with a logit link function and multiple regression analysis were performed. Results: In the GCC region, home teams tend to have greater likelihood of a favorable outcome (P < 0.001) and higher goal difference (P < 0.001). Temperature difference was identified as a significant explanatory variable when used independently (P < 0.001) or after adjustment for home advantage and team ranking (P < 0.001). The likelihood of favorable outcome for GCC teams increases by 3% for every 1 -unit increase in temperature difference. After inclusion of interaction with opposition, this advantage remains significant only when playing against non-GCC opponents. While home advantage increased the odds of favorable outcome (P < 0.001) and goal difference (P < 0.001) after inclusion of interaction term, the likelihood of favorable outcome for a GCC team decreased (P < 0.001) when playing against a stronger opponent. Finally, the temperature and wet bulb globe temperature approximation were found as better indicators of the effect of environmental conditions than absolute and relative humidity or heat index on match outcomes. Conclusions: In GCC region, higher temperature increased the likelihood of a favorable outcome when playing against non-GCC teams. However, international ranking should be considered because an opponent with a higher rank reduced, but did not eliminate, the likelihood of a favorable outcome. [ABSTRACT FROM AUTHOR]

Coronavirus disease of 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has sparked a global pandemic with severe complications and high morbidity rate. Neurological symptoms in COVID-19 patients, and neurological sequelae post COVID-19 recovery have been extensively reported. Yet, neurological molecular signature and signaling pathways that are affected in the central nervous system (CNS) of COVID-19 severe patients remain still unknown and need to be identified. Plasma samples from 49 severe COVID-19 patients, 50 mild COVID-19 patients, and 40 healthy controls were subjected to Olink proteomics analysis of 184 CNS-enriched proteins. By using a multi-approach bioinformatics analysis, we identified a 34-neurological protein signature for COVID-19 severity and unveiled dysregulated neurological pathways in severe cases. Here, we identified a new neurological protein signature for severe COVID-19 that was validated in different independent cohorts using blood and postmortem brain samples and shown to correlate with neurological diseases and pharmacological drugs. This protein signature could potentially aid the development of prognostic and diagnostic tools for neurological complications in post-COVID-19 convalescent patients with long term neurological sequelae. • Neurological protein signature of severe COVID-19. • Validation of Qatar severe COVID-19 neurological protein signature in independent cohorts at protein and RNA levels. • Neurological proteins signature of severe COVID-19 corelates with Neurological diseases such as Nerve Injury, Parkinson's disease, Alzheimer's disease, Amyotrophic lateral sclerosis, and Schizophrenia. • Neurological proteins signature of severe COVID-19 corelates with pharmacological drugs such as risperidone. • The risk of developing chronic neurological diseases in post-severe COVID-19 patients. [ABSTRACT FROM AUTHOR]

Objective: To investigate whether fasting during Ramadan influences injury incidence in professional Muslim and non-Muslim footballers. Design: Prospective cohort study. Setting: Professional First Division League of Qatar. Participants: About 527 male football players (462 Muslim and 65 non-Muslim) from 7 league clubs (first year of data collection) and 8 clubs (second and third years). Interventions: Daily collection of training and match exposure from August 2008 until April 2011 by club medical staff. Injuries during training and match play were recorded on standardized injury cards. Main Outcome Measures: Injury incidence was calculated as number of injuries per hour exposed to risk, and expressed as rate per 1000 hours. The probability of injury for different Arabic months between Muslims and non-Muslims was calculated using Generalized Estimating Equations (GEEs). Results: There was no significant difference in total, match, and training injury incidence between the Ramadan and non-Ramadan periods. Non-Muslim footballers had a significantly higher injury incidence rate than Muslim footballers both during Ramadan (8.5 vs 4.0 injuries/1000 hours, P = 0.009) and non Ramadan (6.6 vs 4.9 injuries/1000 hours, P = 0.004) periods. The GEE analysis revealed that after adjusting for age and random factors (month and club), the probability of match injury among non-Muslims was the highest in Ramadan and the 2 consecutive following months (adjusted odds ratio of injury among non-Muslims compared with Muslims was 3.7 [95% confidence interval (CI), 1.7-7.9], P = 0.001 during Ramadan (ninth) month; 2.4 (95% CI, 1.1-4.9), P = 0.021 during 10th month; and 2.7 (95% CI, 1.2-5.8), P = 0.013 during 11th month). Finally, there was no change in injury patterns over the months of the Islamic calendar. Conclusions: Ramadan does not impact injury incidence for Muslim footballers in Qatar, suggesting the current adjustments and scheduling of football activities during Ramadan are sufficient. The increased match injury among non-Muslims during and 2 months post-Ramadan may suggest less effective coping strategies. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pandemic led to restrictions that prevented physical activity in public places. This study sought to conduct a comprehensive longitudinal analysis of how lockdown policies in an Arabian Gulf country influenced the patterns of physical activity during first wave., Methods: In a longitudinal study design, members of the ongoing "Step into health" community-based health promotion program who provided valid pedometer data from January to August 2020, covering pre, during and post-covid first wave period met the inclusion criteria., Results: 420 (76.7% men, 13.8% ≤40 years) were included in the study. Overall, significant decline in daily step counts was recorded (-1,130 ± SE302) after the implementation of lockdown policies ( p  < 0.001). When the restrictions were removed, the steps per day were still lower compared to pre-covid for men (-910 ± SE610, p  = 0.017) and among individuals with normal BMI (-1,304 ± SE409, p  = 0.004). The lockdown in Qatar did not significantly affect women and individuals with obesity who already had lower daily steps pre-covid., Discussion: The present study confirms immediate decline in daily steps imposed indirectly through the COVID-19 lockdown measures. Participants with higher physical activity levels pre-covid experienced significant decline in step count during and even after restrictions were uplifted., 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 © 2024 Al-Mohannadi, Farooq, Salman, Ghram, Al-Harahsheh, Majed, Sayegh and Cardinale.)

Background: South Asian workers have a greater predisposition to non-communicable diseases (NCDs) that is exacerbated by migration and length of residence in host countries. Aims: To examine the association between length of residence in Qatar with diagnosis of NCDs in male blue-collar workers. Methods: A retrospective investigation of the electronic health records (EHRs) of 119,581 clinical visits by 58,342 patients was conducted. Data included age, nationality and confirmed ICD-10 diagnosis. Based on duration of residence, the population was divided into groups: ≤6 months, 6-12 months, 1-≤2 years, 2-≤5 years, 5-≤6 years, >6 years. It was assumed that the group that had been resident in Qatar for ≤6 months represented diseases that had been acquired in their countries of origin. Results: South Asian (90%) patients presented with NCDs at a younger (mean ± SD age of 34.8 ± 9.0 years) age. Diabetes and hypertension were higher in those who had just arrived (<6 months' group), compared to the other durations of residence groups. Conversely, acute respiratory infections, as well as dermatitis and eczema, all increased, perhaps a consequence of shared living/working facilities. Only patients with diabetes and hypertension visited the clinic multiple times, and the cost of medication for these NCDs was affordable, relative to earnings. Discussion/Conclusions: Blue-collar workers were predominantly South Asian, from lower socioeconomic classes, with early onset chronic NCDs. Notably, residence in Qatar gave them better access to affordable, significantly subsidized healthcare, leading to effective management of these chronic conditions.

Objectives: Examine growth and maturation trends in dynamic balance using the anterior reach Y-Balance test, and its utility as an injury risk screening tool., Design: Cross sectional and prospective cohort., Setting: Elite male youth soccer players., Participants: 346 players grouped as pre, circa or post peak height velocity (PHV)., Main Outcome Measures: Pre-season anterior reach absolute and relative Y-Balance test scores and seasonal prospective lower extremity injury monitoring., Results: Absolute reach distances were greatest post-PHV (p < 0.05). Relative to leg length, pre-PHV achieved the highest scores and increased between-limb differences. Significant associations between injury and anterior reach scores were present in pre (OR: 0.94, CI: 0.91-0.98, p < 0.05) and circa-PHV (OR: 1.05, 95% CI: 1.05-1.10, p < 0.05). Increased age (OR: 1.49, 95% CI: 1.04-2.13, p < 0.05) and height (OR: 1.06, 95% CI: 0.99-1.13, p = 0.82) were risk factors post-PHV. No differences in injury occurrence were shown between players with absolute reach difference >4 cm in any group., Conclusions: Anterior reach scores increased injury risk, but associations were small and inconsistent. The Y-Balance should be used with caution as a screening tool in this cohort., Competing Interests: Declaration of competing interest Paul J. Read, Jon L. Oliver, Gregory D. Myer, PhD, Abdulaziz Farooq, Mark De Ste Croix, and Rhodri S. Lloyd confirm there are no conflicts of interest associated with any aspects or content of this manuscript., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Purpose: Assess the health status and heat preparation strategies of athletes competing in a World Cycling Championships held in hot ambient conditions (37°C, 25% relative humidity, wet-bulb-globe-temperature 27°C) and monitor the medical events arising during competition., Methods: 69 cyclists (~9% of the world championships participants) completed a pre-competition questionnaire. Illnesses and injuries encountered by the Athlete Medical Centre (AMC) were extracted from the race reports., Results: 22% of respondents reported illness symptoms in the 10 days preceding the Championships. 57% of respondents had previously experienced heat-related symptoms (cramping most commonly) while 17% had previously been diagnosed with exertional heat illness. 61% of the respondents had undergone some form of heat exposure prior to the Championships, with 38% acclimating for 5 to 30 days. In addition, several respondents declared to live in warm countries and all arrived in Qatar ~5 days prior to their event. 96% of the respondents used a pre-cooling strategy for the time trials and 74% did so before the road race (p<0.001), with ice vests being the most common. The AMC assessed 46 injuries and 26 illnesses in total, with three cyclists diagnosed with heat exhaustion., Conclusions: The prevalence of previous heat illness in elite cyclists calls for team and event organisation doctors to be trained on heat illness management, including early diagnosis and rapid on-site cooling. Some cyclists had been exposed to the heat prior to the Championships, but few had a dedicated plan, calling for additional education on the importance of heat acclimation. Pre-cooling was widely adopted., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.)

Objectives: To investigate the association of maturity status with injury incidence in Middle-Eastern youth athletes., Design: Prospective cohort study., Setting: Four consecutive seasons (2010-2014), Aspire Academy, Qatar., Participants: Male athletes (age range: 11-18 years) representing four disciplines enrolled and grouped into two categories: individual sports and racquet sports., Outcome Measures: Injury data collected over four seasons. Athletes' anthropometric characteristics assessed to calculate age at peak height velocity. Predicted mature heights (PMHs) collected and categorised into four quartiles. Athletes had wrist and hand radiographs for assessment of skeletal age (SA). Early and late maturers with an SA of >1 year older or younger than their chronological age (CA)., Results: For the sample (n=67) across all groups, 43 (64%) athletes had one or more injuries: total of 212 injuries, 4.9 injuries per athlete across study. Survival analysis of maturity status using SA found early maturing athletes had two-fold greater injury risk compared with late maturers (HR 2.04, 95% CI 1.15 to 3.61, p=0.015). PMH associated with injury risk (HR 1.05, 95% CI 1.01 to 1.08, p=0.006).Athletes in fourth quartile (≥184 cm) had up to two-fold injury risk (HR 2.41, 95% CI 1.42 to 4.08, p=0.001). Racquet and individual sports involved similar injury risk (HR 1.14, 95% CI 0.86 to 1.52, p=0.37)., Conclusion: SA early maturity and PMH gradient were significant predictors of injury in youths., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Hamstring injuries remain a significant injury burden in sports such as soccer that involve high-speed running. It has repeatedly been identified as the most common noncontact injury in elite male soccer, representing 12% of all injuries. As the incidence of hamstring injuries remains high, investigations are aimed at better understanding how to prevent hamstring injuries. Stretching to improve flexibility is commonly used in elite-level sports, but risk factor studies have reported contradicting results, leading to unclear conclusions regarding flexibility as a risk factor for hamstring injuries., Purpose: To investigate the association of lower limb flexibility with the risk of hamstring injuries in professional soccer players., Study Design: Cohort study; Level of evidence, 2., Methods: All teams (n = 18) eligible to compete in the premier soccer league in Qatar (Qatar Stars League [QSL]) underwent a comprehensive musculoskeletal assessment during their annual periodic health evaluation at Aspetar Orthopaedic and Sports Medicine Hospital in Doha, Qatar. Variables included passive knee extension and ankle dorsiflexion range of motion. A clustered multivariate Cox regression analysis was used to identify associations with the risk of hamstring injuries. Receiver operating characteristic (ROC) curves were calculated to determine sensitivity and specificity., Results: A total of 438 unique players (72.4% of all QSL players) competed for 601 player-seasons (148 players competed both seasons) and sustained 78 hamstring injuries. Passive knee extension range of motion (hazard ratio [HR], 0.97 [95% CI, 0.95-0.99]; P = .008) and ankle dorsiflexion range of motion (HR, 0.93 [95% CI, 0.88-0.99]; P = .02) were independently associated with the injury risk. The absolute differences between the injured and uninjured players were 1.8° and 1.4 cm, respectively, with small effect sizes ( d < 0.2). The ROC curve analyses showed an area under the curve of 0.52 for passive knee extension and 0.61 for ankle dorsiflexion, indicating failed to poor combined sensitivity and specificity of the 2 strength variables identified in the multivariate Cox regression analysis., Conclusion: This study identified deficits in passive hamstring and ankle dorsiflexion range of motion as weak risk factors for a hamstring injury. These findings have little clinical value in predicting the risk of future hamstring injuries, and test results must therefore be interpreted cautiously in athletic screening.

Background: Although the incidence of football injuries should relate to team success there is little empirical evidence., Objective: We investigated the relationship between injury incidence and team success in Qatar first-division football clubs., Methods: Using a prospective cohort study design, we captured exposure and injuries in Qatar male elite football for a season. Club performance was measured by total league points, ranking, goal scored, goals conceded and number of matches won, drawn or lost., Results: Lower injury incidence was strongly correlated with team ranking position (r=0.929, p=0.003), more games won (r=0.883, p=0.008), more goals scored (r=0.893, p=0.007), greater goal difference (r=0.821, p=0.003) and total points (r=0.929, p=0.003)., Conclusions: Lower incidence rate was strongly correlated with team success. Prevention of injuries may contribute to team success.