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Purpose: Non-ambulatory persons with cerebral palsy are prone to low bone mineral density. In ambulatory persons with cerebral palsy, bone mineral density deficits are expected to be small or absent, but a consensus conclusion is lacking. In this systematic review bone mineral density in ambulatory persons with cerebral palsy (Gross Motor Function Classification Scales I–III) was studied. Materials and methods: Medline, Embase, and Web of Science were searched. According to international guidelines, low bone mineral density was defined as Z-score ≤ −2.0. In addition, we focused on Z-score ≤ −1.0 because this may indicate a tendency towards low bone mineral density. Results: We included 16 studies, comprising 465 patients aged 1–65 years. Moderate and conflicting evidence for low bone mineral density (Z-score ≤ −2.0) was found for several body parts (total proximal femur, total body, distal femur, lumbar spine) in children with Gross Motor Function Classification Scales II and III. We found no evidence for low bone mineral density in children with Gross Motor Function Classification Scale I or adults, although there was a tendency towards low bone mineral density (Z-score ≤ −1.0) for several body parts. Conclusions: Although more high-quality research is needed, results indicate that deficits in bone mineral density are not restricted to non-ambulatory people with cerebral palsy. Although more high-quality research is needed, including adults and fracture risk assessment, the current study indicates that deficits in bone mineral density are not restricted to non-ambulatory people with CP. Health care professionals should be aware that optimal nutrition, supplements on indication, and an active lifestyle, preferably with weight-bearing activities, are important in ambulatory people with CP, also from a bone quality point-of-view. If indicated, medication and fall prevention training should be prescribed. [ABSTRACT FROM AUTHOR]

* OBJECTIVE: To describe the incidence, prevalence, and impact of running-related injuries (RRIs) and illness symptoms in half marathon and marathon runners during the 16-week period before the Utrecht Marathon. * METHODS: In this prospective cohort study, we used the Oslo Sports Trauma Research Center questionnaire to register RRIs and illness symptoms every 2 weeks during the 16-week study period. When an injury or illness occurred, questions were added regarding its nature. We calculated the incidence proportion (the number of new cases divided by the number of runners at risk) and the period prevalence (the number of existing and new cases within a 2-week period, divided by the total number of runners at risk during that period). * RESULTS: Of the 161 included runners, 9 out of 10 reported an RRI or illness symptom at some time during the study period. In any 2-week period, 5,6% to 14.8% of the runners reported a new RRI, and 6.3% to 13.8% of the runners reported a new illness symptom. The prevalence of RRIs ranged from 29.2% to 43.5%, and the prevalence of illness symptoms ranged from 28.3% to 71.2%. The most prevalent RRIs were in the lower leg (prevalence range, 5.4%-12.3%) and knee (prevalence range, 2.7%-9.3%). The most prevalent illness symptoms were rhinorrhea/sneezing (prevalence range, 3.9%-12,7%) and coughing (prevalence range, 3.9%-11.9%). The incidence and prevalence of illness symptoms peaked at the same time as the influenza-like illness epidemic of the winter of 2015-2016. *CONCLUSION: Nine out of every 10 runners reported an RRI or illness symptom in the lead-up to a half or full marathon, In any 2-week period, up to 1 in 7 runners reported a new RRI or illness symptom. [ABSTRACT FROM AUTHOR]

Background: Although the Nordic Hamstring Exercise (NHE) prevents hamstring injury in soccer players effectively, the annual incidence of these injuries still increases. This may be because of poor long‐term compliance with the program. Furthermore, the timing and amplitude of gluteal and core muscle activation seem to play an important role in hamstring injury prevention, the NHE program was not designed to improve activation of these muscles. Therefore, we propose plyometric training as an alternative to reduce hamstring injuries in soccer players. Purpose: To determine the preventive effect of the Bounding Exercise Program (BEP) on hamstring injury incidence and severity in adult male amateur soccer players. Study design: A cluster‐Randomized Controlled Trial. Methods: Thirty‐two soccer teams competing in the first‐class amateur league were cluster‐randomized into the intervention or control group. Both groups were instructed to perform their regular training program, and the intervention group additionally performed BEP. Information about player characteristics was gathered at baseline and exposure, hamstring injuries and BEP compliance were weekly registered during one season (2016‐2017). Results: The data of 400 players were analyzed. In total, 57 players sustained 65 hamstring injuries. The injury incidence was 1.12/1000 hours in the intervention group and 1.39/1000 hours in the control group. There were no statistically significant differences in hamstring injury incidence (OR = 0.89, 95% CI 0.46‐1.75) or severity between the groups (P > 0.48). Conclusion: In this large cluster‐randomized controlled trial, no evidence was found for plyometric training in its current form to reduce hamstring injuries in amateur soccer players. [ABSTRACT FROM AUTHOR]

There are three major questions about return to play (RTP) after hamstring injuries: How should RTP be defined? Which medical criteria should support the RTP decision? And who should make the RTP decision? The study aimed to provide a clear RTP definition and medical criteria for RTP and to clarify RTP consultation and responsibilities after hamstring injury. The study used the Delphi procedure. The results of a systematic review were used as a starting point for the Delphi procedure. Fifty-eight experts in the field of hamstring injury management selected by 28 FIFA Medical Centres of Excellence worldwide participated. Each Delphi round consisted of a questionnaire, an analysis and an anonymised feedback report. After four Delphi rounds, with more than 83% response for each round, consensus was achieved that RTP should be defined as 'the moment a player has received criteria-based medical clearance and is mentally ready for full availability for match selection and/or full training'. The experts reached consensus on the following criteria to support the RTP decision: medical staff clearance, absence of pain on palpation, absence of pain during strength and flexibility testing, absence of pain during/after functional testing, similar hamstring flexibility, performance on field testing, and psychological readiness. It was also agreed that RTP decisions should be based on shared decision-making, primarily via consultation with the athlete, sports physician, physiotherapist, fitness trainer and team coach. The consensus regarding aspects of RTP should provide clarity and facilitate the assessment of when RTP is appropriate after hamstring injury, so as to avoid or reduce the risk of injury recurrence because of a premature RTP. [ABSTRACT FROM AUTHOR]

OBJECTIVE: In addition to known risk factors for musculoskeletal complaints in the general population, playing a musical instrument is an additional risk factor. In this pilot study, the prevalence of musculoskeletal complaints in student amateur musicians and their relation with playing posture and playing time were evaluated. METHODS: A cross-sectional web-based survey among amateur musicians studying at a Dutch university. RESULTS: 162 amateur musicians were included in this pilot study (response rate 17.6%). 46.9% of these amateur musicians played with an elevated arm position. Presence of complaints of the arm, neck and/or shoulder (CANS) was not statistically significantly related to arm position, except for complaints in the left shoulder with an elevated left arm position compared to neutral left arm position (OR 6.7, CI 95% 2.2-20.8) The number of hours playing per week did not significantly contribute to CANS (OR 1.0, CI 95% 0.95-1.17). CONCLUSIONS: In this pilot study among student amateur musicians, the occurrence of CANS was not significantly related to arm position, except for musicians playing with an elevated left arm position, which was associated with complaints of the left shoulder (OR 6.7). The number of hours playing per week did not significantly contribute to CANS in this group of musicians [ABSTRACT FROM AUTHOR]