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Purpose To examine the associations between longitudinal physical activity (PA) patterns and the development of cardiometabolic risk factors from adolescence to young adulthood. Methods This cohort study encompassed 250 participants recruited from sports clubs and schools, and examined at mean age 15 and 19. Device-measured moderate-to-vigorous PA was grouped into five patterns (via a data-driven method, using inactivity maintainers as a reference). The outcomes were: glucose, insulin, homeostasis model assessment for insulin resistance (HOMA-IR), total cholesterol, HDL and LDL cholesterol, triglycerides, blood pressure, and body mass index (BMI). Linear growth curve models were applied with adjustment for sex, age, fruit/vegetable consumption, cigarette/snuff use, and change in the device wear-time. Results Insulin and BMI increased among decreasers from moderate to low PA (β for insulin 0.23, 95% CI 0.03–0.46; β for BMI 0.90; CI 0.02–1.78). The concentration of HDL cholesterol decreased (β −0.18, CI −0.31 to −0.05) and that of glucose increased (β 0.18, CI 0.02–0.35) among decreasers from high to moderate PA. By contrast, among increasers, blood pressure declined (systolic β −6.43, CI −12.16 to −0.70; diastolic β −6.72, CI −11.03 to −2.41). Conclusions Already during the transition to young adulthood, changes in PA are associated with changes in cardiometabolic risk factors. Favorable blood pressure changes were found among PA increasers. Unfavorable changes in BMI, insulin, glucose, and HDL cholesterol were found in groups with decreasing PA. The changes were dependent on the baseline PA and the magnitude of the PA decline. peerReviewed

Background Longitudinal studies demonstrate that physical activity (PA) declines on average from adolescence to early adulthood. However, some subgroups of adolescents increase activity while others decrease or maintain high or low activity. Determinants of change or maintenance of (in)activity may differ between subgroups and are valuable information for targeted health promotion. The purpose of this study was to identify PA patterns from adolescence to early adulthood, and also to explore how different activity domains and Sedentary Behaviour (SB) are associated with PA patterns. Methods The data of this observational cohort study (collected in 2013/2014 and 2017/2018) consisted of 254 Finns at age 15 and 19 participating the Health Promoting Sports Club study. K-means cluster analysis for longitudinal data was performed to identify participant clusters (patterns) based on their accelerometry-measured moderate-to-vigorous PA (MVPA). Associations of sports club participation (SC), active commuting (AC), and SB with PA patterns were examined by logistic regression analysis. Results (preliminary) Five MVPA patterns were identified: inactivity maintainers (n = 71), activity maintainers (n = 70), decreasers from moderate (to low) PA (n = 61), decreasers from high (to moderate) PA (n = 32), and increasers (n = 20). At age 15, SC participation (41-97%) and AC (47-75%) were common in all the patterns. By age 19, clear dropout from these activities was prevalent (SC participation mean 32%, AC 31-63%). Maintained SC participation was associated with a higher likelihood of belonging to the decreasers from high PA (OR = 11.2, CI = 1.4-90.0) and to the combined group of increasers and activity maintainers (OR = 3.6, CI = 1.8-7.4); also with a lower likelihood of being an inactivity maintainer (OR = 0.1, CI = 0.02-0.2). Dropout from SC was related to a higher likelihood of being a decreaser from high PA (OR = 10.9, CI = 1.3-90.7). Maintenance/adoption of AC was associated with a lower likelihood of being an inactivity maintainer (OR = 0.3, CI = 0.1-0.7). Decreased SB was related to a higher likelihood of belonging to the activity maintainers and increasers (OR = 0.96, CI = 0.93-0.98). Conclusions PA patterns diverge greatly over the transition to adulthood. Changes in SC participation, AC, and SB show different associations with diverging PA patterns. Hence, tailored PA promotion is recommended.

The aim of the present study was to identify profiles of elite athlete mental well- and ill-being and study how the profiles (i.e., subgroups of athletes) differed in sport-related demands and resources. A total of 259 Finnish elite athletes (n = 170 active and n = 89 retired) completed quantitative self-report inventories. Through cluster analysis, four profiles of mental well- and ill-being were identified. Profile 1 was overrepresented by retired, older, and male athletes, and characterized by good mental well-being. Profile 2 consisted mainly of active athletes who reported mild risk for alcohol abuse. Profile 3 consisted mainly of women who displayed possible presence of an eating disorder. Profile 4 was typical of young athletes with mental ill-being. The balance between sport-related demands and resources appeared to be the healthiest in Profile 1 and worst in Profile 4. The present findings are beneficial for those who work with and/or provide psychological support to athletes.

Background: Regardless of competitive athletes’ body image pressures, the role of competitive goals in sports on adolescents’ body perception has not been studied. We examined the factors associated with adolescents’ competitive goals in sports and body size perception, and the associations between adolescents’ competitive goals in sports and body size perception.Methods: The cross-sectional study included 475 goal-oriented sports club participants and 936 reference youths (aged 14–16 years) with self-reported data on health behaviours and accelerometer-measured physical activity. The multinomial logistic regression analysis was used to investigate the associations.Results: Adolescents with competitive goals in sports were more frequently satisfied with their body size than reference youths (68% vs 47%, p < 0.001 in girls; 74% vs 61%, p < 0.001 in boys). More than one-fourth of girls with competitive goals in sports perceived themselves as overweight, although only 7% of them were overweight. Adolescents with appearance/weight motives to exercise and poor perceived physical fitness had higher odds of perceived fatness. Additionally, BMI was positively associated with perceived fatness and negatively with perceived thinness. Having competitive goals in sports was not independently associated with perceived fatness or perceived thinness.Conclusions: Adolescents’ BMI, appearance/weight motives to exercise, and perceived physical fitness were more strongly associated with body size perception than their competitive goals in sports. However, body size dissatisfaction among girls with competitive goals in sports should be considered in organized sports.

Objectives The aim of this study was to investigate the association between pelvic kinematics during the standing knee lift (SKL) test and low back pain (LBP) in youth floorball and basketball players. Design A prospective cohort study. Setting Finnish elite youth floorball and basketball players. Participants Finnish elite youth female and male floorball and basketball players (n = 258, mean age 15.7 ± 1.8). Main outcome measures LBP resulting in time loss from practice and games was recorded over a 12-month period and verified by a study physician. Associations between LBP and sagittal plane pelvic tilt and frontal plane pelvic obliquity during the SKL test as measured at baseline were investigated. Individual training and game hours were recorded, and Cox’s proportional hazard models with mixed effects were used for the analysis. Results Cox analyses revealed that sagittal plane pelvic tilt and frontal plane pelvic obliquity were not associated with LBP in floorball and basketball players during the follow-up. The hazard ratios for pelvic tilt and pelvic obliquity ranged between 0.93 and 1.08 (95% CIs between 0.91 and 1.07 and 0.83 and 1.29), respectively. Conclusions Pelvic movement during the SKL test is not associated with future LBP in youth floorball and basketball players.

Objectives To investigate lower extremity muscle strength as risk factor for an acute ankle injury in youth athletes. Design Cohort study. Setting Basketball and floorball clubs. Participants 188 youth (≤21) male and 174 female athletes. Main outcome measures 1RM leg press, maximal concentric isokinetic quadriceps and hamstrings as well as maximal isometric hip abductor strength were measured and athletes were followed for an acute ankle injury up to three years. Cox regression models were used in statistical analyses. Results In males, greater 1RM leg press and maximal quadriceps strength increased the risk of any type of acute ankle injury (Hazard ratio [HR] for 1 SD increase, 1.63 [95% CI, 1.12–2.39] and 1.43 [95% CI, 1.01–2.01], respectively). In females, greater 1RM leg press and difference between legs in hip abduction strength increased the risk of acute non-contact ankle injury (HR for 1 SD increase, 1.44 [95% CI, 1.03–2.02] and 1.44 [95% CI, 1.03–2.00], respectively). However, ROC curve analyses showed AUC:s of 0.57–0.64 indicating “fail” to “poor” combined sensitivity and specifity of these tests. Conclusion Greater strength in both sexes along with asymmetry in hip abductor strength in females increased the risk of acute ankle injury.

The aim of this study was to examine the associations of spinal kinematics and physical activity (PA) with bodily pain, physical functioning, and work ability among health care workers with low back pain (LBP). Spinal kinematics and PA were measured with a wireless Inertial Measurement Unit system (ValedoMotion®) and a waist-worn tri-axial accelerometer (Hookie AM20), respectively. Their association was assessed in relation to Work Ability Index (WAI), bodily pain and physical functioning (RAND-36) in 210 health care workers with recurrent LBP. Greater lumbar movement variability/less deterministic lumbar movement (in angular velocity) during a "Pick Up a Box" functional task was correlated with higher amounts of step counts (r = -0.29, p = 0.01) and moderate PA (r = -0.24, p = 0.03). A higher amount of PA (p = 0.03) as well as less movement control impairment (p = 0.04) and movement variability (p = 0.03) were associated with greater work ability, whilst greater vigorous PA was the only parameter to explain higher physical functioning (p = 0.02). PA and movement variability were relative to each other to explain bodily pain (p = 0.01). These findings show the importance of considering the interaction between lumbar kinematics and physical activity while planning strategies to improve bodily pain, physical functioning and work ability among health care workers with LBP.

AimTo evaluate differences in menstrual and pubertal history and trends in eating behaviours among women with and without a competitive sports background. Additionally, we investigated if menstrual history and eating behaviours are associated with sports career-related factors.MethodsThis retrospective study was conducted on 100 women with a competitive endurance sports background and their age-matched, gender-matched and municipality-matched controls (n=98). Data were collected using a questionnaire using previously validated instruments. Generalised estimating equations were used to calculate associations of menstrual history and eating behaviours with outcome variables (career length, participation level, injury-related harms and career termination due to injury).ResultsAthletes reported higher rates of delayed puberty and menstrual dysfunction than controls. No differences between the groups were observed in the Eating Disorder Examination Questionnaire short form (EDE-QS) scores at any age. Previous disordered eating (DE) was associated with current DE in both groups. Among athletes, higher EDE-QS scores during the sports career were associated with a shorter career (B=−0.15, 95% CI −0.26 to –0.05). Secondary amenorrhoea was associated with lower participation level (OR 0.51, 95% CI 0.27 to 0.95), injury-related harms during the career (OR 4.00, 95% CI 1.88 to 8.48) and career termination due to injury (OR 1.89, 95% CI 1.02 to 3.51).ConclusionThe findings indicate that DE behaviours and menstrual dysfunction, specifically secondary amenorrhoea, have a disadvantageous relationship with a sports career in women competing in endurance sports. DE during the sports career is associated with DE after the career.

The aim of this study was to investigate physical fitness, football-specific skills and their association with injury risk in youth football. Altogether 447 male and female players aged 9 to 14 years (median 12 years) participated in performance tests and prospective follow-up. The physical fitness tests included five-jump test for distance, 30-m sprint, football-specific figure of eight agility, countermovement jump, and Yo-Yo intermittent endurance test level 1. The football-specific skill tests included dribbling and passing tests. Injuries and exposure were registered during the 20-week follow-up. Our candidate risk factors were low/high level of physical fitness measured with a composite score of physical fitness tests and low/high level of football-specific skills measured with a composite score of dribbling and passing tests. Secondarily, we investigated performance in individual tests and their association with injury risk. During the follow-up, players reported 565 injuries (264 acute and 301 overuse injuries). High level of physical fitness was associated with increased rate of all injuries (age-, sex- and mean team exposure - adjusted IRR 1.28, 95% CI 1.04–1.58). The level of football-specific skills had no influence on the overall injury rate. Burden of overuse injuries, but not acute injuries was significantly higher in most fit players compared with the players in the reference group (IRR 2.09, 95 % CI 1.04–4.24). In conclusion, most fit players were at greater risk of sustaining injuries in youth competitive football. peerReviewed

Introduction In cross-country skiing, the repetitive ventilation of large amounts of cold and dry air strains the airways. The aim of this systematic review was to establish an overview of the current literature on asthma in cross-country skiers, biathletes and ski-orienteers. Methods Six databases were searched on August 29, 2019. The search yielded 2161 articles. Thirty articles fulfilled the search criteria and were pooled together for a qualitative synthesis. Eight articles were included in the meta-analysis on the prevalence of asthma and the use of asthma medication. Results According to the meta-analysis, the prevalence of self-reported physician-diagnosed asthma in skiers was 21% (95% CI 14–28%). The onset age of asthma was higher in skiers than in non-skiers with asthma. The prevalence of asthma medication use was on average 23% (CI 95% 19–26%). Several studies reported that asthma was underdiagnosed in skiers, as previously healthy skiers without a prior asthma diagnosis or medication use were frequently found to fulfill diagnostic criteria for asthma according to lung function tests. Studies using bronchial biopsy demonstrated that eosinophilic asthma is not detected in skiers with asthma as often as it is in non-skiers with asthma and that there are signs of airway inflammation even in non-asthmatic skiers. Conclusion Our findings suggest that the accuracy and coverage of diagnosing asthma in skiers has improved over the recent decades. However, the optimal treatment and natural course of asthma in this population remain unclear. Future research should investigate how the intensity of training, airway infections and their treatment affect the development of asthma among skiers. PRD registration number CRD42017070940.

OBJECTIVE: This study investigates the association between depressive symptoms and multisite pain and health-related quality of life and work ability in currently employed health care workers with recurrent low back pain (LBP). METHODS: Multisite pain, depressive symptoms, quality of life, and work ability were assessed by validated questionnaires. A generalized linear model was used for statistical analysis. RESULTS: Notably, 28% of female health care workers with LBP had at least moderate levels of depressive symptoms. Depressive symptoms were significantly associated with decreased health-related quality of life and work ability. Multisite pain was not significantly associated with work ability. CONCLUSIONS: Depressive symptoms are relatively common in female health care workers with LBP, and treatment of these symptoms may be crucial to improve their work ability. publishedVersion

The objective of this study was to examine the effect of a neuromuscular training (NMT) warm-up on the prevalence of overuse lower extremity (LE) injuries in children's football. Twenty Finnish U11-U14 youth football clubs (n = 1409 players; females 280, males 1129; age range 9-14) were randomized into intervention and control groups containing 10 clubs each (intervention: 44 teams, n = 676 players; control: 48 teams, n = 733 players). The intervention group performed a structured NMT warm-up operated by team coaches for 20 weeks. The main outcome measure was the prevalence of football-related overuse LE injuries and injuries were tracked via weekly text messages. The average weekly prevalence of overuse LE injuries was 11.6% (95% CI: 11.0%-12.2%) in the intervention group and 11.3% (10.7%-11.9%) in the control group. The most common anatomical locations were the knee (weekly prevalence 6.0% in the intervention group and 5.7% in the control group) and heel (2.4% and 2.6%). There was no difference in the prevalence of overuse LE injuries between the groups: odds ratio (OR) 1.01 (95% CI: 0.99-1.03). In conclusion, NMT warm-up was equal to standard practice warm-up in preventing overuse LE injuries in children's football during a follow-up of 20 weeks.

Cross-country skiing causes strain in the airways because skiers train and compete in cold air. The aim of this survey was to investigate the prevalence and age at onset of asthma, asthma control, and use of asthma medication in Finnish competitive cross-country skiers. All cross-country skiers who were enrolled in the largest national competitions in winter 2019 (n = 1282) were invited to the study via the Finnish Ski Association. A control group (n = 1733) was matched for the responding skiers by age, gender, and region. The response rate was 27.4% (n = 351) for skiers and 19.5% (n = 338) for the controls. The prevalence of asthma was 25.9% in skiers and 9.2% in the controls (p

Background: Studies investigating biomechanical risk factors for knee injuries in sport-specific tasks are needed. Purpose: To investigate the association between change of direction (COD) biomechanics in a 180-degree pivot turn and knee injury risk among youth team sport players. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 258 female and male basketball and floorball players (age range, 12-21 years) participated in the baseline COD test and follow-up. Complete data were obtained from 489 player-legs. Injuries, practice, and game exposure were registered for 12 months. The COD test consisted of a quick ball pass before and after a high-speed 180-degree pivot turn on the force plates. The following variables were analyzed: peak vertical ground-reaction force (N/kg); peak trunk lateral flexion angle (degree); peak knee flexion angle (degree); peak knee valgus angle (degree); peak knee flexion moment (N·m/kg); peak knee abduction moment (N·m/kg); and peak knee internal and external rotation moments (N·m/kg). Legs were analyzed separately and the mean of 3 trials was used in the analysis. Main outcome measure was a new acute noncontact knee injury. Results: A total of 18 new noncontact knee injuries were registered (0.3 injuries/1000 hours of exposure). Female players sustained 14 knee injuries and male players 4. A higher rate of knee injuries was observed in female players compared with male players (incidence rate ratio, 6.2; 95% CI, 2.1-21.7). Of all knee injuries, 8 were anterior cruciate ligament (ACL) injuries, all in female players. Female players displayed significantly larger peak knee valgus angles compared with male players (mean for female and male players, respectively: 13.9°± 9.4° and 2.0°± 8.5°). No significant associations between biomechanical variables and knee injury risk were found. Conclusion: Female players were at increased risk of knee and ACL injury compared with male players. Female players performed the 180-degree pivot turn with significantly larger knee valgus compared with male players. However, none of the investigated variables was associated with knee injury risk in youth basketball and floorball players.

Ojective: To investigate the injury characteristics in Finnish male football players. Design: One-season prospective epidemiological study. Data were collected via injury reports from the medical staff and directly from the players using the Olso Sports Trauma Research Center Health Questionnaire. Participants: The first team squads of Finnish football league (n = 12 teams, 236 players). Main outcome measurement: Injury incidence. Results: A total of 541 injuries occurred during the exposure of 62 878 hours. Injury incidence per 1000 exposure hours was 8.6 (30.6 in matches and 3.4 in training). A player sustained on average 2.3 (median 2, range 0–13) injuries during the study. Thigh and ankle were the most commonly injured body parts for acute injuries and hip/groin were the most commonly injured body part for overuse injuries. The median absence time for all injuries was 12 (range 0–107) days, 12 (range 0–107) for acute, and 8 (range 0–61) for overuse injuries. Thigh injuries caused the greatest consequences in terms of absence from full participation (median 5 days, range 0–88). Conclusion: Lower limb muscle injuries were the most prevalent injuries in the study. Collecting data directly from the players enabled to report more injuries compared to what was reported only by the medical staff. publishedVersion

Both training volume and overall physical activity (PA) play a role in young athletes’ sports performance and athletic development. The purpose of this study was to describe the training volume and PA of young athletes in endurance, aesthetics, ball games, and power sports. Questionnaire data (n = 671) were obtained from 15-year-old Finnish athletes on sports participation, along with accelerometer data (n = 350) assessing the amount and intensity of their PA. The athletes’ mean weekly training volume was 11 h 41 min. Objectively assessed PA amounted to 4 h 31 min daily, out of which 1 h 31 min was at a level of moderate-to-vigorous intensity (MVPA). Among 24% of the athletes, the weekly training volume (in hours) exceeded the recommended level of age-in-years, which might increase their risk of sports injuries. At the same time, one in six athletes (16%) did not—on average—reach the internationally recommended threshold level of at least 60 minutes of MVPA per day. Compared to girls, boys averaged 2.5 more hours of training per week, and had 21 more minutes of MVPA per day. Moreover, boys had a higher goal orientation than girls, with 52% of the boys and only 29% of the girls focused on success at adult level. Although total training volume and PA did not differ among sports types, there were differences in training forms, and in the proportions of MVPA. The young athletes were found to vary greatly in training forms, training volumes, MVPA, and goal orientation; hence, training should be planned individually, both for team sports and individual sports. peerReviewed

Lateral ankle sprains are highly prevalent during sporting activities, as it accounts for approximately 60% of all athletic injuries. There is currently a paucity of research which provides kinetic and kinematic assessments of sprains and giving-way episodes of the ankle joint. The aim of this case study was to examine the kinetics and kinematics of the ankle and knee during a giving-way episode in a female ice hockey player during a 180-degree pivot turn, which was conducted in a 3D motion capture laboratory. Three trials were conducted on this participant (one accident trial, two control trials). Kinetic and kinematic analysis was conducted on the outside leg during a left 180-degree pivot turn (right leg). The plantarflexion angle of the giving-way trial was larger than the control trials from the point of initial contact until the end of the trial. Inversion was also 27-degrees greater 150 ms after initial contact in the giving-way trial and 26-degrees greater compared to control trials 1 and 2. Substantially greater plantarflexion, inversion and internal rotation angles of the ankle were observed during the giving-way trial compared to control trials. The maximum vertical and horizontal ground reaction forces, as well as ankle inversion and internal rotation moments, were lower for the giving-way trial in comparison to the control trials. Further research is needed to understand the influence of plantarflexion angle with a giving-way episode of the ankle. This study provides valuable kinetic and kinematic information regarding a giving-way episode of the ankle. (c) 2021 Elsevier Ltd. All rights reserved.

For adolescent athletes, data on nutrition behaviours are limited. The present study aimed to evaluate the dietary habits of adolescent sports club participants (SPs) compared with those of non‐participants (NPs). The cross‐sectional study of 1917 adolescents aged 14–16 was based on data from the Finnish Health Promoting Sports Club (FHPSC) study. The health behaviour surveys were conducted among SPs (n=1093) and NPs (n=824). Logistic regression was used to test statistical significance of the differences in dietary habits between SPs and NPs. SPs were more likely than NPs to eat breakfast on weekends [89% vs. 79%, odds ratio (OR) 1.46, 95% confidence interval (CI) 1.07–2.01] and to report daily consumption of vegetables (46% vs. 32%, OR 1.33, 95% CI 1.04–1.69) and fat‐free or semi‐skimmed milk (72% vs. 55%, OR 1.33, 95% CI 1.04–1.68). Dietary habits regarded as unhealthy, such as sugared soft drink consumption, were similar between the groups. The aforementioned healthy dietary habits are more frequent in SPs than NPs and unhealthy dietary habits are equally frequent in the groups. Both adolescent SPs’ and NPs’ dietary habits have deficiencies, like inadequate vegetable and fruit consumption. Sports clubs’ opportunities for adolescents’ healthy eating promotion should be examined. peerReviewed

Background: Prevention of sports injuries is essential in youth, as injuries are associated with less future physical activity and thus greater all-cause morbidity. Purpose: To investigate whether a neuromuscular training warm-up operated by team coaches is effective in preventing acute lower extremity (LE) injuries in competitive U11-U14 soccer players. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: Twenty top-level U11 to U14 soccer clubs in Finland were randomized into intervention and control groups and assessed for 20 weeks. Participants included 1403 players (280 female, 1123 male; age range, 9-14 years): 673 players (44 teams) in the intervention group and 730 players (48 teams) in the control group. The intervention group team coaches were introduced to a neuromuscular training warm-up to replace the standard warm-up 2 to 3 times per week. The control teams were asked to perform their standard warm-up. Injury data collection was done via weekly text messages. The primary outcome measure was a soccer-related acute LE injury, and the secondary outcome measure was an acute noncontact LE injury. Results: A total of 656 acute LE injuries occurred: 310 in the intervention group and 346 in the control group. The overall acute LE injury incidence was 4.4 per 1000 hours of exposure in the intervention group and 5.5 per 1000 hours of exposure in the control group, with no significant difference between groups (incidence rate ratio [IRR], 0.82 [95% CI, 0.64-1.04]). There were 302 acute noncontact LE injuries: 129 in the intervention group (incidence, 1.8 per 1000 hours) and 173 in the control group (2.7 per 1000 hours). A significant reduction in acute noncontact LE injuries of 32% (IRR, 0.68 [95% CI, 0.51-0.93]) was observed in the intervention group compared with the control group. Furthermore, significant reductions in injury incidence in favor of the intervention group were seen in the subanalyses of acute noncontact LE injuries, leading to ≤7 days of time loss and fewer ankle and joint/ligament injuries. Conclusion: A neuromuscular training warm-up operated by team coaches was found to be effective in preventing acute noncontact LE injuries in children’s soccer, but this was not seen in all acute LE injuries. Clinical Relevance: We encourage children’s soccer coaches and health care professionals to implement neuromuscular training warm-up in youth sports. Registration: ISRCTN14046021 (ISRCTN registry).

Objective: The purpose of this study is to investigate how multisite pain, depressive symptoms and disturbed sleep are associated with health-related quality of life (HRQoL) and work ability index (WAI) in health care workers with recurrent non-specific low back pain (LBP). Methods: 219 female health care workers suffering from recurrent non-specific LBP were recruited for the study. Multisite pain (three or more pain sites with pain intensity of 4 or more on the numeric rating scale), depressive symptoms [modified Finnish version of the nine-item Patient Health Questionnaire (PHQ─9-mFIN)], disturbed sleep, HRQoL (RAND-36) and WAI short form were assessed by validated questionnaires. Results: Depressive symptoms and disturbed sleep were significantly associated with mental HRQoL and WAI (pConclusion: In female health care workers with recurrent non-specific LBP and currently able to work, depressive symptoms and disturbed sleep were associated with decreased self-reported work ability.

Vigh-Larsen, JF, Haverinen, MT, Panduro, J, Ermidis, G, Andersen, TB, Overgaard, K, Krustrup, P, Parkkari, J, Avela, J, Kyröläinen, H, and Mohr, M. On-ice and off-ice fitness profiles of elite and U20 male ice hockey players of two different national standards. J Strength Cond Res 34(12): 3369-3376, 2020-Differences in body composition and performance were investigated between elite and U20 male ice hockey players of 2 different national standards. One hundred seventy-nine players were recruited from the highest Finnish (n = 82) and Danish (n = 61) national level, as well as from 1 U20 team from Finland (n = 19) and Denmark (n = 17). Body composition and countermovement jump performance (CMJ) were measured off-ice in addition to on-ice assessments of agility, 10- and 30-m sprint performance, and endurance capacity (the maximal Yo-Yo Intermittent Recovery Level 1 Ice Hockey Test, Yo-Yo IR1-IHmax). Large differences in on-ice performances were demonstrated between Finnish and Danish elite players for agility, 10- and 30-m sprint performance (2-3%, P ≤ 0.05), and Yo-Yo IR1-IHmax performance (15%, P ≤ 0.05). By contrast, no differences (P > 0.05) were present between elite players for CMJ ability or body composition. However, elite players possessed more body and muscle mass than U20 players. Finally, the Finnish U20 cohort had a similar performance level as the Danish elite players and superior 10-m sprint performance, whereas the Danish U20 level was inferior to the other groups in every performance assessment (P ≤ 0.05). In conclusion, on-ice speed and endurance differ markedly between elite players of 2 different national standards with no distinction in body composition or CMJ ability. Moreover, the most consistent difference between U20 and senior elite players was related to body and muscle mass. These results highlight the usefulness of on-ice assessments and suggest the importance of on-ice high-intensity training in elite players in addition to training targeted the development of lean body mass in youth prospects.

Context Much information is available on electrocardiogram (ECG) and blood pressure (BP) changes in senior athletes. However, corresponding data on adolescent athletes are scarce. Objective To study the differences in resting ECG and BP values among adolescent endurance athletes, nonendurance athletes, and nonathletes. Design Cross-sectional study. Setting A total of 154 youth sports clubs in Finland and 100 secondary schools for comparison data. Patients or Other Participants We recruited young athletes (n = 410) aged 14 to 16 years in 10 popular sport disciplines, including winter and summer as well as team and individual sports, and categorized them as endurance or nonendurance sports. Comparison data for age-matched, non–sports club participants (n = 164) were collected via secondary schools. Main Outcome Measure(s) Resting ECG, including heart rate, PR interval, QRS duration, QRS axis, QRS amplitude, T axis, and QT interval as well as systolic and diastolic BPs. Results No differences in any ECG variable of interest were found between the endurance and nonendurance athletes. The PR interval was longer in endurance athletes than in nonathletes (P = .05). The QRS amplitude (P = .03) was higher among nonendurance athletes than among nonathletes. Diastolic BP was lower among endurance (P = .002) and nonendurance (P = .02) athletes than among nonathletes. Endurance athletes (odds ratio [OR] = 2.85; 95% CI = 1.81, 4.50) and nonendurance athletes (OR = 2.19; 95% CI = 1.43, 3.35) were more likely to have sinus bradycardia than were nonathletes. Nonendurance athletes were more likely to have elevated systolic BP than were endurance athletes (OR = 1.70; 95% CI = 1.07, 2.72) and nonathletes (OR = 1.73; 95% CI = 1.04, 2.87). Conclusions Young athletes had similar ECG and BP findings independent of their sports. Physiological adaptations including sinus bradycardia, higher QRS amplitude, and lower diastolic BP, which are commonly seen in adult athletes, were also present in adolescent athletes.

The purpose of this article is to present how predictive machine learning methods can be utilized for detecting sport injury risk factors in a data-driven manner. The approach can be used for finding new hypotheses for risk factors and confirming the predictive power of previously recognized ones. We used three-dimensional motion analysis and physical data from 314 young basketball and floorball players (48.4% males, 15.72±1.79 yr, 173.34±9.14 cm, 64.65±10.4 kg). Both linear (L1-regularized logistic regression) and non-linear methods (random forest) were used to predict moderate and severe knee and ankle injuries (N=57) during three-year follow-up. Results were confirmed with permutation tests and predictive risk factors detected with Wilcoxon signed-rank-test (p

Cross-country skiing causes strain in the airways and athletes train and compete in cold and dry conditions during the winter. The aim of this postal questionnaire was to investigate the prevalence of asthma, use of asthma medication and asthma control in Finnish cross-country skiers competing at national level. A postal questionnaire was sent in May 2019 to all cross-country skiers who had enrolled in national championships at age categories 13–40 years (n=1282). The response rate was 27 % (n=351) and 58 % of the responders were women. The mean age was 18.8 (SD 6.1) years. The prevalence of asthma was 26 % in the whole responder population and 56 % in the most successful quartile of skiers. Any use of asthma medication was reported by 35 % of the skiers. Of skiers with asthma, 82 % used inhaled corticosteroids regularly while 60 % and 35 % of them used short-acting bronchodilators pre-emptively before exercise or only after having symptoms, respectively. Of skiers with no asthma diagnosis, 13 % used asthma medication, mostly short-acting bronchodilators before exercise or during infections. In skiers with asthma, mean Asthma Control Test score was 22.2, (SD 2.0) and 89 % had ACT ≥ 20. The peak incidence age of asthma onset was between 12 and 18 years of age. Asthma is more prevalent and diagnosed later in life in cross-country skiers compared to general population in Finland. Skiers with asthma use mostly inhaled corticosteroids, as recommended, and short-acting relievers are used more often before exercise than after having asthma-related symptoms. Asthma is mainly well controlled among skiers and the most prevalent among the most successful skiers, suggesting that well-controlled asthma does not prevent success.

Background Prospective studies investigating risk factors for low back pain (LBP) in youth athletes are limited. The aim of this prospective study was to investigate the association between hip-pelvic kinematics and vertical ground reaction force (vGRF) during landing tasks and LBP in youth floorball and basketball players. Methods Three-hundred-and-eighty-three Finnish youth female and male floorball and basketball players (mean age 15.7 ± 1.8) participated and were followed up on for 3 years. At the beginning of every study year the players were tested with a single-leg vertical drop jump (SLVDJ) and a vertical drop jump (VDJ). Hip-pelvic kinematics, measured as femur-pelvic angle (FPA) during SLVDJ landing, and peak vGRF and side-to-side asymmetry of vGRF during VDJ landing were the investigated risk factors. Individual exposure time and LBP resulting in time-loss were recorded during the follow-up. Cox’s proportional hazard models with mixed effects and time-varying risk factors were used for analysis. Results We found an increase in the risk for LBP in players with decreased FPA during SLVDJ landing. There was a small increase in risk for LBP with a one-degree decrease in right leg FPA during SLVDJ landing (HR 1.09, 95% CI 1.02 to 1.17, per one-degree decrease of FPA). Our results showed no significant relationship between risk for LBP and left leg FPA (HR 1.04, 95% CI 0.97 to 1.11, per one-degree decrease of FPA), vGRF (HR 1.83, 95% CI 0.95 to 3.51) or vGRF side-to-side difference (HR 1.22, 95% CI 0.65 to 2.27) during landing tasks. Conclusions Our results suggest that there is an association between hip-pelvic kinematics and future LBP. However, we did not find an association between LBP and vGRF. In the future, the association between hip-pelvic kinematics and LBP occurrence should be investigated further with cohort and intervention studies to verify the results from this investigation. Level of evidence Prognosis, level 1b.

To investigate the association between lower extremity alignment during unilateral and bilateral drop jump tests and the risk of acute noncontact knee or ankle injuries in young team sport athletes.Prospective cohort study.A 2-dimensional video analysis was used to measure the frontal plane knee projection angle in the single-leg vertical drop jump (VDJ) and the bilateral VDJ in young team sport athletes. Out of the 364 athletes (187 male, 177 female), 189 played basketball and 175 played floorball.Six male athletes sustained knee injuries and 23 sustained ankle injuries. Frontal plane knee projection angle in the single-leg VDJ or the bilateral VDJ was not associated with ankle injuries among male athletes. No statistical analysis was performed for the knee injuries. Among female athletes, 28 sustained knee and 41 sustained ankle injuries. Frontal plane knee projection angle during the single-leg VDJ or the bilateral VDJ was not a risk factor for knee or ankle injuries.Lower extremity alignment during unilateral and bilateral drop jump tests was not associated with future noncontact knee or ankle injuries among young team sport athletes. The findings should be interpreted cautiously due to the small number of injuries.

Background The injury mortality rates around the globe show considerable country-to-country differences and the rates have decreased at very different speeds. In Finland, the proportion of total mortality attributed to injuries has been one of the highest in the European Union. The purpose of the present study was to examine the 47-year nationwide trend and the male to female ratio in the number and incidence of fatal injuries among 0 to 14-year-old children in Finland. Methods The data were obtained from the Official Cause-of-Death Statistics of Finland during 1971–2017. The main categories for unintentional injury deaths were road traffic injuries, water traffic injuries, falls, drownings, and poisonings. For intentional injury deaths, the main categories were suicides and homicides. Results In 1971, there were 109 fatal injuries in girls and 207 in boys, while in 2017, these numbers had reduced to 9 and 12. The corresponding incidences (per 100,000 children per year) were 20.1 and 2.1 for girls, and 36.7 and 2.6 for boys, respectively. During the study period overall male to female injury incidence ratio decreased from 1.8 to 1.2. The greatest decline occurred in the number of fatal motor vehicle injuries. In 1971, the incidence of intentional deaths (suicides and homicides) was 2.6 in girls and 2.7 in boys, while in 2017 these numbers were 0.9 and 0.4, respectively. Conclusions This nationwide study confirms that the number and incidence rates of childhood injury deaths have reduced till current days and are already below the average in Europe.