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Objective: To evaluate best practices for neuromuscular training (NMT) injury prevention warm-up programme dissemination and implementation (D&I) in youth team sports, including characteristics, contextual predictors and D&I strategy effectiveness., Design: Systematic review., Data Sources: Seven databases were searched., Eligibility: The literature search followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines., Inclusion Criteria: participation in a team sport, ≥70% youth participants (<19 years), D&I outcomes with/without NMT-related D&I strategies. The risk of bias was assessed using the Downs & Black checklist., Results: Of 8334 identified papers, 68 were included. Sport participants included boys, girls and coaches. Top sports were soccer, basketball and rugby. Study designs included randomised controlled trials (RCTs) (29.4%), cross-sectional (23.5%) and quasi-experimental studies (13.2%). The median Downs & Black score was 14/33. Injury prevention effectiveness (vs efficacy) was rarely (8.3%) prioritised across the RCTs evaluating NMT programmes. Two RCTs (2.9%) used Type 2/3 hybrid approaches to investigate D&I strategies. 19 studies (31.6%) used D&I frameworks/models. Top barriers were time restrictions, lack of buy-in/support and limited benefit awareness. Top facilitators were comprehensive workshops and resource accessibility. Common D&I strategies included Workshops with supplementary Resources (WR; n=24) and Workshops with Resources plus in-season Personnel support (WRP; n=14). WR (70%) and WRP (64%) were similar in potential D&I effect. WR and WRP had similar injury reduction (36-72%) with higher adherence showing greater effectiveness., Conclusions: Workshops including supplementary resources supported the success of NMT programme implementation, however, few studies examined effectiveness. High-quality D&I studies are needed to optimise the translation of NMT programmes into routine practice in youth sport., Competing Interests: Competing interests: OBAO is a Deputy Editor for the British Journal of Sports Medicine. CE, KJS and KP are Associate Editors for the British Journal of Sports Medicine., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Occupational therapists (OT) are trained in interventions related to health and well-being, facilitating individuals in achieving occupational balance. This scoping review explored the current methods of disseminating Lifestyle Medicine (LM) knowledge in post-secondary health education and assessed the potential integration of LM principles into OT education. The review covered publications related to LM implementation in post-secondary health professions curricula. Six databases were searched. The authors conducted initial blind reviews of titles and abstracts, followed by a similar screening of full-text articles. Included full-text articles were obtained from university databases with the assistance of systematic review software. Among the 304 abstracts reviewed, 60 full-text articles were assessed, with 16 included in this scoping review. However, none of the programs in the literature were OT programs. The results show that the six pillars of lifestyle medicine were not equally emphasized in the reviewed programs, with social connection being the least addressed. However, OT education places importance on social connections, and the other pillars align well with the 2018 standards set by Accreditation Council of OT Education (ACOTE) and the parameters outlined in OT Practice Framework 4th Edition (OTFP-4). This alignment can be valuable for OT programs in meeting their accreditation requirements., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (Copyright © 2024 The Author(s).)

OBJECTIVE: To investigate open science practices in research published in the top 5 sports medicine journals from May 1, 2022, and October 1, 2022. DESIGN: A meta-research systematic review. LITERATURE SEARCH: Open science practices were searched in MEDLINE. STUDY SELECTION CRITERIA: We included original scientific research published in one of the identified top 5 sports medicine journals in 2022 as ranked by Clarivate: (1) British Journal of Sports Medicine , (2) Journal of Sport and Health Science , (3) American Journal of Sports Medicine , (4) Medicine and Science in Sports and Exercise , and (5) Sports Medicine-Open . Studies were excluded if they were systematic reviews, qualitative research, gray literature, or animal or cadaver models. DATA SYNTHESIS: Open science practices were extracted in accordance with the Transparency and Openness Promotion guidelines and patient and public involvement. RESULTS: Two hundred forty-three studies were included. The median number of open science practices in each study was 2, out of a maximum of 12 (range: 0-8; interquartile range: 2). Two hundred thirty-four studies (96%, 95% confidence interval [CI]: 94%-99%) provided an author conflict-of-interest statement and 163 (67%, 95% CI: 62%-73%) reported funding. Twenty-one studies (9%, 95% CI: 5%-12%) provided open-access data. Fifty-four studies (22%, 95% CI: 17%-27%) included a data availability statement and 3 (1%, 95% CI: 0%-3%) made code available. Seventy-six studies (32%, 95% CI: 25%-37%) had transparent materials and 30 (12%, 95% CI: 8%-16%) used a reporting guideline. Twenty-eight studies (12%, 95% CI: 8%-16%) were preregistered. Six studies (3%, 95% CI: 1%-4%) published a protocol. Four studies (2%, 95% CI: 0%-3%) reported an analysis plan a priori. Seven studies (3%, 95% CI: 1%-5%) reported patient and public involvement. CONCLUSION: Open science practices in the sports medicine field are extremely limited. The least followed practices were sharing code, data, and analysis plans. J Orthop Sports Phys Ther 2023;53(12):1-13. Epub 20 October 2023. doi:10.2519/jospt.2023.12016 .

Purpose: Force plates can be used to monitor landing asymmetries during rehabilitation, but they are not widely available. Accelerometer-based wearable technology may be a more feasible solution. The purpose of this article was to determine the agreement between impact accelerations measured with force plates and accelerometer-derived measures of (1) centre of mass (COM) acceleration and (2) tibial acceleration asymmetries during bilateral landings., Method: Participants completed three countermovement jumps (CMJ) and three squat jumps (SJ) on dual force plates with triaxial accelerometers attached to each tibia and lower back, near the COM. Bland and Altman 95% limits of agreement (95% LOA) were calculated., Results: 19 adults ( n = 11; 58% women, n = 8; 42% men) participated in the study. The mean differences between impact and COM accelerations were 0.24 g (95% LOA: -1.34 g to 1.82 g) and 0.38 g (95% LOA: -1.15 to 1.91 g) for the CMJ and SJ, respectively. The mean differences between the impact and tibial acceleration-based lower limb asymmetries in the CMJ and SJ were -6% (95% LOA: -32% to 19%) and 0% (95% LOA: -45% to 45%), respectively., Conclusions: Our findings show acceptable agreement between impact acceleration and accelerometer-based COM acceleration and lack of agreement between impact accelerations and accelerometer-based tibial acceleration asymmetries. COM acceleration could be used to quantify landing impacts during rehabilitation, but we do not consider the accelerometer-based asymmetry measures to be a suitable alternative for force plate-based measures. Future work should focus on determining normative values for lower extremity asymmetries during landing tasks., Competing Interests: Competing Interests: None declared. Funding: The University of Calgary Sport Injury Prevention Research Centre is one of the International Research Centres for Prevention of Injury and Protection of Athlete Health supported by the International Olympic Committee. This research was supported through a Canadian Institutes of Health Research Foundation Program (PI C Emery) and the Vi Riddell Pediatric Rehabilitation Research Program (Alberta Children’s Hospital Foundation). Lauren C. Benson is funded through a Canadian Institutes of Health Research Postdoctoral Fellowship (MFE – 164608). Jackie Whittaker holds a Michael Smith Foundation for Health Research Scholar award. Carolyn Emery holds a Canada Research Chair. The funding sources were not involved in study design, data collection, analysis and interpretation of data, writing of the report, or decision to submit the article., (© Canadian Physiotherapy Association, 2023.)

Objective: To determine what tests and measures accurately diagnose persisting post-concussive symptoms (PPCS) in children, adolescents and adults following sport-related concussion (SRC)., Design: A systematic literature review., Data Sources: MEDLINE, Embase, PsycINFO, Cochrane Central Register of Controlled Trials, CINAHL and SPORTDiscus through March 2022., Eligibility Criteria: Original, empirical, peer-reviewed findings (cohort studies, case-control studies, cross-sectional studies and case series) published in English and focused on SRC. Studies needed to compare individuals with PPCS to a comparison group or their own baseline prior to concussion, on tests or measures potentially affected by concussion or associated with PPCS., Results: Of 3298 records screened, 26 articles were included in the qualitative synthesis, including 1016 participants with concussion and 531 in comparison groups; 7 studies involved adults, 8 involved children and adolescents and 11 spanned both age groups. No studies focused on diagnostic accuracy. Studies were heterogeneous in participant characteristics, definitions of concussion and PPCS, timing of assessment and the tests and measures examined. Some studies found differences between individuals with PPCS and comparison groups or their own pre-injury assessments, but definitive conclusions were not possible because most studies had small convenience samples, cross-sectional designs and were rated high risk of bias., Conclusion: The diagnosis of PPCS continues to rely on symptom report, preferably using standardised symptom rating scales. The existing research does not indicate that any other specific tool or measure has satisfactory accuracy for clinical diagnosis. Future research drawing on prospective, longitudinal cohort studies could help inform clinical practice., Competing Interests: Competing interests: KOY is editor-in-chief of the journal Neuropsychology for which he receives an editorial stipend from the American Psychological Association. He is an unpaid consulting editor for Archives of Clinical Neuropsychology and Journal of Head Trauma Rehabilitation. He is an unpaid member of the Scientific Advisory Committee for Brain Injury Canada. He is the chair of the Canadian Concussion Network, which is funded by a grant from Canadian Institutes of Health Research (CIHR) to the University of Calgary; he is principal applicant on the grant but receives no income from it. He is a principal investigator (PI) on another grant from CIHR from which he derives no income. He is a co-investigator on research grants from CIHR, the US National Institutes of Health (NIH), Brain Canada Foundation and National Football League Scientific Advisory Board; he derives income only from the grant from NIH. He serves as a member of a CIHR grant review panel for which he receives an honorarium. He receives book royalties from Guilford Press and Cambridge University Press. He has received travel support and honorarium for presentations to multiple organisations. He has served or serves on the following committees/boards for which he receives honorarium: Independent Data Monitoring Committee (IDMC), Care for Post-Concussive Symptoms Effectiveness (CARE4PCS-2) Trial, National Institute for Child Health and Human Development; Observational Study Monitoring Board (OSMB), Approaches and Decisions in Acute Pediatric TBI (ADAPT) Trial, National Institute of Neurological Disorders and Stroke; National Research Advisory Council, National Pediatric Rehabilitation Resource Center, Center for Pediatric Rehabilitation: Growing Research, Education, and Sharing Science (C-PROGRESS), Virginia Tech University. AMR received a stipend for the clerical and administrative aspects of the systematic review. She has received research grants from the Tonal Strength Institute and Alberta Bone and Joint Strategic Clinical Network. ZP has no disclosures. CD was a pharmaceutical funded invited expert panelist (Teva) for CGRP monoclonal antibody treatment in chronic migraine and received a pharmaceutical funded grant for growth hormone deficiency following concussion. She has grants as PI or co-investigator from the Canadian Department of National Defense, CIHR, Tri-council funding New Frontiers, Alberta Provincial government and Foundations for Physical Medicine and Rehabilitation. She holds a patent for urine metabolites in the diagnosis of concussion. PF is a co-investigator on a research grant from the NFL’s 'Play Smart. Play Safe' Initiative and an Executive committee member of the Canadian Concussion Network (financed by CIHR). He received honorarium for an expert group discussion on blood biomarkers for concussion in December 2020. SH provides client consultation services for military/veteran health, neuroscience, health, sports medicine, neurodegenerative disease, neurotrauma, nuclear medicine, molecular imaging, nuclear and radiation accidents and incidents, and health equity. Consult services includes support to Prevent Biometrics; advisor to Synaptek; advisor/consultant for the Collaborative Neuropathology Network Characterizing Outcomes of TBI (CONNECT-TBI); advisor to NanoDX; and reviewer for Peer Reviewed Alzheimer’s Disease Research Program. SH is chief of Health Equity and Deputy Medical Director for the NFL Players Association, Medical Director for the MLS Players Association. He receives grant support (no income) from the following: Co-PI, Long-term Impact of Military-relevant Brain Injury Consortium – Chronic Effects of Neurotrauma Consortium (LIMBIC-CENC); Advisory Board member to Concussion Legacy Foundation Project Enlist; Advisory Board member to the University of Michigan Concussion Center; advisor to Gryphon Bio; ad hoc reviewer for VA Brain Health Research; invited reviewer to Congressionally Directed Medical Research Programs; National Academy of Science, Engineering, and Medicine 'Accelerating Progress in TBI Research and Care'; NASEM TBI Forum committee member (currently inactive); contributor to Post-traumatic Epilepsy Former Department of Defense work: NFL Scientific Advisory Board member; NCAA-DoD CARE Medical Advisory Board Member; DoD Brain Health Research Coordinating Officer and Medical Advisor to the Principal Assistant for Research and Technology (PAR&T), United States Army Medical Research and Development Command (USAMRDC); Ex Officio National Advisory Neurological Disorders and Stroke (NANDSC) Council Member. KJS has no disclosures. KB receives funding from the Motor Accident Insurance Commission, Queensland Australia. She is a committee member on the Medical Advisory Board, Concussion Australia. She is Chief Investigator, for the first Australia and New Zealand Guidelines for the assessment and management of mild traumatic brain injury and persisting post-concussion symptoms, supported by the Medical Research Future Fund Australia. She has received travel support and honorarium for presentations to organisations. GAD is a member of the Scientific Committee of the 6th International Conference on Concussion in Sport; an honorary member of the AFL Concussion Scientific Committee; Section Editor, Sport and Rehabilitation, NEUROSURGERY; and has attended meetings organised by sporting organisations including the NFL, NRL, IIHF, IOC and FIFA; however, he has not received any payment, research funding, or other monies from these groups other than for travel costs. RJE is a paid consultant for the NHL and co-chair of the NHL/NHLPA Concussion Subcommittee. He is also a paid consultant and chair of the Major League Soccer concussion committee, and a consultant to the US Soccer Federation. He previously served as a neuropsychology consultant to Princeton University Athletic Medicine and EyeGuide. He is currently a co-PI for a grant funded by the NFL (NFL-Long) through Boston Children’s Hospital. He occasionally provides expert testimony in matters related to MTBI and sports concussion, and occasionally receives honoraria and travel support/reimbursement for professional meetings. NF-D is a member of the International independent FIFA Concussion Advisory Group; GOTS Concussion Committee Innovation and Technology Panel, UK Department for Digital, Culture, Media and Sport; Concussion in Sport Group (CISG); NINDS CDE Sports Concussion CDE Subacute Subgroup (National Institutes of Health); IFAB Concussion Expert Group; Swiss Neurology Society; Swiss Society for Clinical Neurophysiology; European NeuroOphthalmology Society; and Concussion in Sport Group (CISG). She is an Editorial Board Member for the Journal of Concussion, Journal of Science and Medicine in Football. CF is a PhD candidate at the School of Medicine & Health at University College Cork, Ireland. He is currently head of physiotherapy at the sports medicine department of the Sports Surgery Clinic (SSC), Dublin Ireland. SSC have paid the fees of his PhD and contributed towards the cost of him attending the 6th International Conference on Concussion in Sport in Amsterdam, 2022. From October 2017 to July 2020, he worked as national team lead physiotherapist for the IRFU Senior Men’s rugby team. He is a member of the Irish Society of Chartered Physiotherapists. Since 2022, he is a founder and shareholder (10%) of Fizfit Ltd., a start-up which focused on recovery and activation products for musculoskeletal health. IG has paid employment relationships with McGill University and the McGill University Health Center. She has received grants in the last 3 years from: Canadian Institutes of Health Research; Fonds de recherche du Québec – Santé; Research Institute of the McGill University Health Center; McGill University; and Institut National du Sport du Québec. CCG discloses the following grants and research support: Hit-IQ (2022-2023); NIH NINDS (R01 NS110757 2019-2024); NINDS (U54 NS121688 2021-2026); UCLA Brain Injury Research Center, UCLA Steve Tisch BrainSPORT program, Easton Clinic for Brain Health/Je os a clinical consultant (provide clinical care to athletes) for the NBA, NFL-Neurological Care Program, NHL/NHLPA, and Los Angeles Lakers. He is a member of the Advisory Board (non-compensated) for Major League Soccer, National Basketball Association, and US Soccer Federation. He is a member of the Advisory Board (Compensated) for Highmark Interactive; he occasionally serves as an expert witness in medicolegal cases. He is a shareholder in Highmark Interactive stock options. He receives book royalties from Blackwell/Wiley Publishing. GLI serves as a scientific advisor for NanoDX®, Sway Operations, LLC, and Highmark, Inc. He has a clinical and consulting practice in forensic neuropsychology, including expert testimony, involving individuals who have sustained mild TBIs (including former athletes), and on the topic of suicide. He has received past research support or funding from several test publishing companies, including ImPACT Applications, Inc., CNS Vital Signs, and Psychological Assessment Resources (PAR, Inc.). He receives royalties from the sales of one neuropsychological test (WCST-64). He has received travel support and honorariums for presentations at conferences and meetings. He has received research funding as a principal investigator from the National Football League, and subcontract grant funding as a collaborator from the Harvard Integrated Program to Protect and Improve the Health of National Football League Players Association Members. He has received research funding from the Wounded Warrior Project™. He acknowledges unrestricted philanthropic support from ImPACT Applications, Inc., the Mooney-Reed Charitable Foundation, the National Rugby League, Boston Bolts, and the Schoen Adams Research Institute at Spaulding Rehabilitation. MM is a sport and exercise medicine physician working in private consulting practice and is the Chief Medical Officer for the Australian Football League. He is a shareholder of Olympic Park Sports Medicine Centre in Melbourne, Australia. He is ex-senior physician at the Hawthorn Football Club (AFL) and ex-Chief Executive Officer of the AFL Doctors Association. He has received research grants from the Australian Football League. He has received travel support from the Australian Football League, FIFA and the International Olympic Committee to attend and present at international conferences. He is a member of the Scientific Committee for the 6th International Conference on Concussion in Sport. He is an honorary member of the International Concussion in Sport Group,and the Australian Rugby Union Concussion Advisory Group. He is an independent concussion consultant for World Rugby. KS has received grant funding from CIHR, National Football League Scientific Advisory Board, International Olympic Committee Medical and Scientific Research Fund, World Rugby, Mitacs Accelerate, University of Calgary) with funds paid to her institution and not to her personally. She is an Associate Editor of BJSM (unpaid) and has received travel and accommodation support for meetings where she has presented. She coordinated the writing of the systematic reviews that informed the 6th International Conference on Concussion in Sport, for which she has received an educational grant to assist with the administrative costs associated with the writing of the reviews. She is a member of the AFL Concussion Scientific Committee (unpaid position) and Brain Canada advisory committee (unpaid positions). She works as a physiotherapy consultant and treats athletes of all levels of sport from grass roots to professional., (© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.)

The purpose of this paper is to summarise the consensus methodology that was used to inform the International Consensus Statement on Concussion in Sport (Amsterdam 2022). Building on a Delphi process to inform the questions and outcomes from the 5th International Conference on Concussion in Sport, the Scientific Committee identified key questions, the answers to which would help encapsulate the current science in sport-related concussion and help guide clinical practice. Over 3½ years, delayed by 2 years due to the pandemic, author groups conducted systematic reviews on each selected topic. The 6th International Conference on Concussion in Sport was held in Amsterdam (27-30 October 2022) and consisted of 2 days of systematic review presentations, panel discussions, question and answer engagement with the 600 attendees, and abstract presentations. This was followed by a closed third day of consensus deliberations by an expert panel of 29 with observers in attendance. The fourth day, also closed, was dedicated to a workshop to discuss and refine the sports concussion tools (Concussion Recognition Tool 6 (CRT6), Sport Concussion Assessment Tool 6 (SCAT6), Child SCAT6, Sport Concussion Office Assessment Tool 6 (SCOAT6) and Child SCOAT6). We include a summary of recommendations for methodological improvements for future research that grew out of the systematic reviews., Competing Interests: a Competing interests: OHA is a Senior Physiotherapist at University Hospitals Dorset NHS Foundation Trust (England) and is Para Football Physiotherapy Lead/Para Football Classification Lead at the Football Association (England). He also works on a consultancy basis with the Football Association as the squad physiotherapist to the England Cerebral Palsy Football squad, and teaches on the Football Association’s Advanced Trauma and Medical Management in Football course on a consultancy basis. He has a Visiting Senior Lecturer position at the University of Portsmouth, England (unpaid). He sits on several disability sport committees including Para Football Foundation as Medical Unit Co-Lead (unpaid), the International Federation of Cerebral Palsy Football as Medical and Sports Science Director (unpaid), and the International Blind Sports Association as Medical Committee member (unpaid). He has Associate Editor positions at the British Journal of Sports Medicine (unpaid) and British Medical Journal (BMJ) Open Sports & Exercise Medicine (unpaid). He is also an Institutional Ethics Committee external member for World Rugby (unpaid), and co-chair of the Concussion in Para Sport Group (unpaid). AB has received peer-reviewed research funding from the Social Sciences and Humanities Research Council. She is also a Sport Information Resource Centre board member and Canadian Athletic Therapists Association committee member. She has received an honorarium for the administrative aspects of the reviews. CB is an Associate Professor of Physical Medicine & Rehabilitation (PM&R) at Spaulding Rehabilitation Hospital/Harvard Medical School and Chief Medical Officer at Spaulding Rehabilitation Hospital. She receives grant funding from the United States (US) Center for Disease Control (CDC) and Prevention and the U.S. National Institute on Disability, Independent Living, and Rehabilitation Research. She serves on the Board of Directors of the United States Olympic & Paralympic Committee (unpaid) as well as the International Paralympic Committee Medical Committee (unpaid) and the International Olympic Committee Medical & Scientific Commission (unpaid). She serves as an Associate Editor of the British Journal of Sports Medicine (unpaid) as well as the PM&R Journal (unpaid). SB current or past research funding from the National Institutes of Health; Centers for Disease Control and Prevention (CDC); Department of Defense - USA Medical Research Acquisition Activity, National Collegiate Athletic Association (NCAA); National Athletic Trainers’ Association Foundation; National Football League (NFL)/Under Armour/General Electric (GE); Simbex; and ElmindA. He has consulted for US Soccer (paid), US Cycling (unpaid), University of Calgary SHRed Concussions external advisory board (unpaid), medicolegal litigation, and received speaker honorarium and travel reimbursements (including Concussion in Sport Group -CISG) for talks given. He is coauthor of “Biomechanics of Injury (3rd edition)” and has a patent pending on “Brain Metabolism Monitoring Through CCO Measurements Using All-Fiber-Integrated Super-Continuum Source” (US Application No. 17/164,490). He is/was on the editorial boards (all unpaid) for Journal of Athletic Training (2015 to present), Concussion (2014 to present), Athletic Training & Sports Health Care (2008 to present), British Journal of Sport Medicine (2008 to 2019). JSB is supported by the University of Calgary, the Natural Sciences and Engineering Research Council [CGSD3-559333- 2021], and an honorarium for the methods author work associated with Reviews two and four. RCC is a Senior Advisor NFL Head Neck & Spine Committee VP NOCSAE and Chair Scientific Advisory CommitteeCo-Founder Medical Director Concussion Legacy FoundationRoyalties Houghton Mifflin Harcourt Legal Expert Opinion. JDC National Collegiate Athletic Association payments for expert testimony. National Hockey League (NHL) payments for expert testimony. GAD is a member of the Scientific Committee of the 6th International Conference on Concussion in Sport; anhonorary member of the Australian Football League (AFL) Concussion Scientific Committee; Section Editor, Sport and Rehabilitation, NEUROSURGERY; and has attended meetings organised by sporting organisations including the NFL, National Rugby League (NRL), International Ice Hockey Federation (IIHF), International Olympic Committee (IOC) and Federation International de Football Association (FIFA); however, has not received any payment, research funding or other monies from these groups other than for travel costs. JD has nothing to disclose. RJE is a paid consultant for the NHL and co-chair of the NHL/NHL Players Association (NHLPA) Concussion Subcommittee. He is also a paid consultant and chair of the Major League Soccer concussion committee, and a consultant to the US Soccer Federation. He previously served as a neuropsychology consultant to Princeton University Athletic Medicine and EyeGuide. He is currently a co-Primary Investigator (PI) for a grant funded by the NFL (NFL-Long) through Boston Children’s Hospital. He occasionally provides expert testimony in matters related to mTBI and sports concussion, and occasionally receives honoraria and travel support/reimbursement for professional meetings. PE is a data consultant to the National Hockey League; received an honorarium for the administrative aspects of the reviews. CAE has received external peer-reviewed research funding from Canadian Institutes of Health Research (CIHR), Canada Foundation for Innovation, International Olympic Committee Medical and Scientific Committee, NFL Play Smart Play Safe Program, and World Rugby. She is an Associate Editor of British Journal of Sport Medicine (BJSM) (unpaid) and has received travel and accommodation support for meetings where she has presented. She is an external advisory board member (unpaid) for HitIQ. KAH has nothing to disclose. GI, PhD serves as a scientific advisor for NanoDX®, Sway Operations, LLC, and Highmark, Inc. He has a clinical and consulting practice in forensic neuropsychology, including expert testimony, involving individuals who have sustained mTBIs (including former athletes). He has received research funding from several test publishing companies, including ImPACT Applications, Inc., CNS Vital Signs, and Psychological Assessment Resources (PAR, Inc.). He has received research funding as a principal investigator from the NFL, and subcontract grant funding as a collaborator from the Harvard Integrated Program to Protect and Improve the Health of NFL Players Association Members. He has received research funding from the Wounded Warrior Project™. He acknowledges unrestricted philanthropic support from ImPACT Applications, Inc., the Mooney-Reed Charitable Foundation, Boston Bolts, the National Rugby League, and the Schoen Adams Research Institute at Spaulding Rehabilitation. JJL receives grant/research support from National Institutes of Health (NIH), Department of Defence (DoD) and American Medical Society for Sports Medicine (AMSSM); is a member of the Scientific Advisory Board for Neuronasal, Highmark Innovations, and Quadrant Biosciences; minority stock options in Highmark Innovations and 360 Concussion Care; expert consultant to NCAA. Consults with NFL and NHL teams on athlete care but does not receive any compensation from these organisations; Editorial Board of Journal of Head Trauma Rehabilitation. MM is sport and exercise medicine physician working in private consulting practice. He is the Chief Medical Officer for the Australian Football League (AFL) and an independent consultant to World Rugby. He is a Shareholder of Olympic Park Sports Medicine Centre in Melbourne. He has previously held positions as the senior physician at the Hawthorn Hawks Football Club (AFL) and Chief Executive Officer of the AFL Doctors Association. He has received research grants from the Australian Football League, outside the submitted work. He has received travel support received from the Australian Football League, FIFA and the International Olympic Committee to attend and present at international conferences. Member of the Scientific Committee for the 6th International Conference on Concussion in Sport. Honorary member of the International CISG and an honorary member of the Australian Rugby Union Concussion Advisory Group. MMcC reports research grants from the US NIH, US Department of Defense, US CDC, US Department of Veterans Affairs, Abbott Laboratories, NFL, and NCAA, and consultancy with the Green Bay Packers and Neurotrauma Sciences, Inc. MMcN 1. Chair, Ethics Expert Group, World Antidoping Agency (WADA) (2021–23) (paid) 2. Member, International Boxing Association, Ethics and Integrity Committee, (2021–22; resigned Oct 2022) (paid) 3. Chair, Therapeutic Use Exemption Fairness Committee (2020–) (paid) 4. Member, Steering Group, Sex Segregation in Sport, International Association of Athletics Federations (IAAF)/World Athletics, (2019–20) (unpaid) 5. Member, International Ice Hockey Federation, Ethics and Integrity Committee (2019–21) (paid) 6. Member, International Olympic Committee Consensus Statement Expert Group on Injuries in Children and Adolescents (2017) (unpaid) 7. Member, Ethics Expert Group, WADA (2016–21) (unpaid) 8. Member, International Olympic Committee Consensus Statement Expert Group on Pain Management (2016)) (unpaid). WM is employed as the Chief Medical Officer of the National Hockey League. JP: Editor BJSM (honorarium); Member of World Rugby Concussion Advisory Group (unpaid); Independent Concussion Consultant for World Rugby (fee per consultation); Medical consultant to South African Rugby (unpaid); Co-chair of the Scientific Committee, 6th International Conference on Concussion in Sport (unpaid); Board member of the CISG (unpaid); Scientific Board member, EyeGuideTM (unpaid). ZP has no conflicts of interests to declare. MP declares the following: Consultant, Chief Medical Officer (CMO), Major League Soccer; Senior Advisor, NFL Head, Neck NCAA-CARE-DoD 2.0, ended 2020; Have received honoraria and reimbursement for travel for speaking and conferences attended; Have written chapters for UpToDate, and received royalties for the Netter’s Sports Medicine textbook; Have provided work as an expert for cases involving concussion, team physician and other sports medicine topics. AMR: Stipend for the clerical and administrative aspects of the systematic review. Tonal Strength Institute: Research grant (not specifically related to the present work). Alberta Bone and Joint Strategic Clinical Network: Research grant (not specifically related to the present work). PER has no conflicts of interest to declare. GMS is an owner of a multidisciplinary practice (managing patients with MSK pain disorders). He is a board member of Hockey Calgary (Calgary, AB, Canada) and Chair of the Alberta Association of Physiotherapy. He received funding for the administrative aspects of the writing of two of the systematic reviews that informed the consensus process. KJS has received grant funding from the CIHR, NFL Scientific Advisory Board, International Olympic Committee Medical and Scientific Research Fund, World Rugby, Mitacs Accelerate, University of Calgary, with funds paid to her institution and not to her personally. She is an Associate Editor of BJSM (unpaid), Independent consultant to World Rugby and has received travel and accommodation support for meetings where she has presented. She coordinated the writing of the systematic reviews that informed Amsterdam International Consensus on Concussion in Sport, for which she has received an educational grant to assist with the administrative costs associated with the writing of the reviews (with funds paid to her institution). She is a member of the AFL Concussion Scientific Committee (unpaid position), Brain Canada (unpaid positions) and Board member of the Concussion in Sport Group (CISG)(unpaid). She works as a physiotherapy consultant and treats athletes of all levels of sport from grass roots to professional. JT: Doctoral funding through the CIHR; Jason also received an honorarium for the administrative parts of the review. KOY holds the Ronald and Irene Ward Chair in Pediatric Brain Injury funded by the Alberta Children’s Hospital Foundation. He is a principal investigator on grants from the CIHR, and co-investigator on research grants from CIHR, Brain Canada Foundation, Social Science and Humanities Research Council (Canada), and NFL Scientific Advisory Board. He is the Editor of Neuropsychology, for which he receives an editorial stipend from the American Psychological Association. He chairs the Canadian Concussion Network, which is funded by CIHR. He is a member of the Scientific Advisory Committee for Brain Injury Canada and the National Research Advisory Council for the National Pediatric Rehabilitation Resource Center., (© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.)

OBJECTIVES: To identify factors associated with nonresponse to neuromuscular training (NMT) warm-up programs among youth exposed to NMT warm-ups. METHODS: This is a secondary analysis of youth (aged 11-18 years) in the intervention groups of 4 randomized controlled trials in high school basketball, youth community soccer, and junior high school physical education. Youth who were exposed to NMT and who sustained an injury during the study were considered nonresponders . Odds ratios (ORs) were based on generalized estimating equations logistic regression controlling for clustering by team/class and adjusted for age, weight, height, balance performance, injury history, sex, and sport (soccer/basketball/physical education). RESULTS: A total of 1793 youth were included. Youth with a history of injury in the previous year had higher odds (OR = 1.64; 95% CI: 1.14, 2.37) of injury during the study, and females were more likely (OR = 1.67; 95% CI: 1.21, 2.31) to sustain an injury than males who were participating in NMT. Age was not associated with the odds of sustaining an injury (OR = 1.10; 95% CI: 0.93, 1.30). Soccer players benefited most from greater adherence, with 81% lower odds of injury (OR = 0.19; 95% CI: 0.06, 0.57) when completing 3 NMT sessions a week compared with 1 session per week. CONCLUSION: Factors associated with nonresponse to an NMT warm-up program were female sex, history of injury during the previous 12 months, and lower weekly NMT session adherence in some sports (soccer). J Orthop Sports Phys Ther 2023;53(2):94-102. Epub: 9 December 2022. doi:10.2519/jospt.2022.11526 .

The goal of the OPTIKNEE consensus is to improve knee and overall health, to prevent osteoarthritis (OA) after a traumatic knee injury. The consensus followed a seven-step hybrid process. Expert groups conducted 7 systematic reviews to synthesise the current evidence and inform recommendations on the burden of knee injuries; risk factors for post-traumatic knee OA; rehabilitation to prevent post-traumatic knee OA; and patient-reported outcomes, muscle function and functional performance tests to monitor people at risk of post-traumatic knee OA. Draft consensus definitions, and clinical and research recommendations were generated, iteratively refined, and discussed at 6, tri-weekly, 2-hour videoconferencing meetings. After each meeting, items were finalised before the expert group (n=36) rated the level of appropriateness for each using a 9-point Likert scale, and recorded dissenting viewpoints through an anonymous online survey. Seven definitions, and 8 clinical recommendations (who to target, what to target and when, rehabilitation approach and interventions, what outcomes to monitor and how) and 6 research recommendations (research priorities, study design considerations, what outcomes to monitor and how) were voted on. All definitions and recommendations were rated appropriate (median appropriateness scores of 7-9) except for two subcomponents of one clinical recommendation, which were rated uncertain (median appropriateness score of 4.5-5.5). Varying levels of evidence supported each recommendation. Clinicians, patients, researchers and other stakeholders may use the definitions and recommendations to advocate for, guide, develop, test and implement person-centred evidence-based rehabilitation programmes following traumatic knee injury, and facilitate data synthesis to reduce the burden of knee post-traumatic knee OA., Competing Interests: Competing interests: JLW, AGC, BP, EM and CE are associate editors of the British Journal of Sports Medicine (BJSM). CLA is the editor in chief and JLW an editor with the Journal of Orthopaedic and Sports Physical Therapy (JOSPT). AGC is an associate editor of Osteoarthritis and Cartilage. SF is an associate editor for Journal of Science in Medicine and Sport. JBT holds a research grant from Pfizer outside the submitted work. STS is co-founders of Good Life with Osteoarthritis from Denmark (GLA:D), associate editor of the JOSPT and has received grants from the Lundbeck Foundation and personal fees from Munksgaard and TrustMe-Ed, outside the submitted work. CMT is project leader of GLA:D, Ireland. MAR is a project leader of the Active Living with Osteoarthritis in Norway (AktivA), a not-for-profit initiative to implement clinical guidelines in primary health care in Norway. ER is a deputy editor of Osteoarthritis and Cartilage, developer of Knee injury and Osteoarthritis Outcome Score and several other freely available patient-reported outcomes, and founder of GLA:D. KMC is a senior advisor of BJSM, project leader of the GLA:D, Australia, and holds a research grant from Levin Health outside the submitted work., (© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.)

Objective: Determine the long-term health-related quality-of-life (HRQoL), work limitation, physical activity, health/economic cost and disease burden of traumatic ACL and/or meniscal injury. Findings will inform OPTIKNEE evidence-based consensus recommendations., Design: Random-effects meta-analysis evaluated HRQoL (SF-36/SF-12/VR-12 Physical Component Scores (PCS) and Mental Component Scores (MCS), EuroQol-5D (EQ-5D)) stratified by time postinjury, and pooled mean differences (95% CI) between ACL-injured and uninjured controls. Other outcomes were synthesised descriptively. Risk-of-bias (RoB) and certainty of evidence (Grading of Recommendations Assessment, Development and Evaluation) were assessed., Data Sources: MEDLINE, EMBASE, CENTRAL, SPORTDiscus, CINAHL searched inception: 22 November 2021., Eligibility: Studies reporting HRQoL, work limitations, physical activity levels, health/economic costs or disease burden, ≥2 years post-ACL and/or meniscal injury., Results: Fifty studies were included (10 high-RoB, 28 susceptible-to-some-bias and 12 low-RoB). Meta-analysis (27 studies, very low certainty of evidence) estimated a pooled mean (95% CI) PCS of 52.4 (51.4 to 53.4) and MCS of 54.0 (53.0 to 55.0) 2-14 years post-ACL injury. Pooled PCS scores were worse >10 years (50.8 (48.7 to 52.9)) compared with 2-5 years (53.9 (53.1 to 54.7)) postinjury. Excluding high-RoB studies, PCS scores were worse in ACL-injured compared with uninjured controls (-1.5 (-2.9 to -0.1)). Six studies (low certainty of evidence) informed a pooled EQ-5D score of 0.83 (0.81 to 0.84). Some individuals experienced prolonged work absenteeism and modified activities ≥2 years post-ACL injury. ACL injury was associated with significant direct and indirect costs, and early ACL reconstruction may be less cost-effective than rehabilitation. Only three studies evaluated meniscal injury outcomes (all evaluated HRQoL)., Conclusion: There is a very-low certainty of evidence that PCS scores ≥2 years post-ACL injury are worse than uninjured controls and decline over time, whereas MCS scores remain high. ACL injury can result in prolonged work absenteeism and high health/economic costs. Further studies are needed to determine the long-term burden of traumatic meniscal injury., Competing Interests: Competing interests: SRF is an Associate Editor with the Journal of Science and Medicine in Sport and a board member of Osteoarthritis Research Society International (OARSI), JLW and AGC are Associate Editors of the British Journal of Sports Medicine (BJSM). JLW is an Editor with the Journal of Orthopaedic & Sports Physical Therapy. KMC is a senior advisor of BJSM and holds a research grant from Levin Health outside the submitted work. EMR is Deputy Editor and CBJ an Associate Editor of Osteoarthritis and Cartilage. EMR and STS are cofounders of Good Life with Osteoarthritis in Denmark (GLA:D®), a not-for-profit initiative hosted at University of Southern Denmark aimed at implementing clinical guidelines for osteoarthritis in clinical practice. STS is also associate editor of the Journal of Orthopaedic & Sports Physical Therapy, has received grants from The Lundbeck Foundation and personal fees from Munksgaard, all of which are outside the submitted work. All other authors declare no competing interests., (© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Youth around the globe place their shoulders at risk for injury when participating in sports. Shoulder injuries may vary in severity, produce the potential for time-loss from sport, and result in functional disability. We sought to explore sport-related shoulder injuries in youth by identifying injury rates, risk factors, injury mechanisms, and injury prevention strategies., Methods: All relevant full-text articles were identified by searching MEDLINE, EMBASE, CINAHL, Sport Discus, and the Cochrane Controlled Trials Registry. No date restrictions were used. All full-text studies reporting original research describing sport-related shoulder injury among female and/or male youth from 5 to 18 years old were included., Results: Of 3,889 studies screened, 97 described shoulder injury in youth sports. Shoulder injuries were identified in 24 unique sports. The median seasonal prevalence of shoulder injury was 10.9% (range 1.2-28.2%). The most common injury mechanisms identified were contacted with another player, contact with the playing environment, and falling to the ground. Risk factors for shoulder injury identified were side-to-side strength imbalances, weak external rotator muscles, and scapular dyskinesia. One study evaluated a successful training strategy to prevent shoulder injuries, but two other interventions demonstrated no effect., Conclusions: Sport-related shoulder injuries are prevalent among youth athletes. Injury risk factors identified included modifiable intrinsic factors such as strength, range of motion, and training load. The most common injury mechanism was direct contact with either another person or an object in the playing environment. Innovative shoulder-specific strategies are needed to reduce shoulder injuries in this population. Trial Registration: PROSPERO ID: CRD42020189142., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2022 Eric S. Gibson et al.)

The aim of this study was to investigate sport-related injury rates, types, locations, and mechanisms in female youth team sports. This was a secondary analysis of a cross-sectional study. An anonymous online survey was administered to high school students (ages 14-19) in Alberta, Canada. The survey included questions regarding demographic information, sport participation and self-reported injuries sustained in the past year. Results were analyzed for girls who reported playing a top ten team sports for female participation. For girls participating in team sports, the overall injury rate was 55.5 injuries/100 participants/year. The rate of at least one concussion was 9.4 concussions/100 participants/year. Injury and concussion rates were highest in ringette (Injury rate=42.9 injuries/100 participants/year, Concussion rate=19.0 concussions/100 participants/year) and rugby (Injury rate=40.0, Concussion rate=15.3). The top three most serious injury locations were the knee (24.7%), ankle (21.6%) and head (16.1%). The most common injury types were joint/ligament sprain (26.71%), fracture (13.0%) and concussion (11.8%). Contact mechanisms accounted for 73.4% of all serious injuries reported in girls team sports. Team sport injury rates are high in female youth team sports. Specific consideration of sport-specific injury rates, types and mechanisms in girls' team sports will inform development and evaluation of targeted sport-specific prevention strategies., Competing Interests: The authors declare that they have no conflict of interest., (Thieme. All rights reserved.)

Inertial measurement units (IMUs) can be used to monitor running biomechanics in real-world settings, but IMUs are often used within a laboratory. The purpose of this scoping review was to describe how IMUs are used to record running biomechanics in both laboratory and real-world conditions. We included peer-reviewed journal articles that used IMUs to assess gait quality during running. We extracted data on running conditions (indoor/outdoor, surface, speed, and distance), device type and location, metrics, participants, and purpose and study design. A total of 231 studies were included. Most (72%) studies were conducted indoors; and in 67% of all studies, the analyzed distance was only one step or stride or <200 m. The most common device type and location combination was a triaxial accelerometer on the shank (18% of device and location combinations). The most common analyzed metric was vertical/axial magnitude, which was reported in 64% of all studies. Most studies (56%) included recreational runners. For the past 20 years, studies using IMUs to record running biomechanics have mainly been conducted indoors, on a treadmill, at prescribed speeds, and over small distances. We suggest that future studies should move out of the lab to less controlled and more real-world environments.

Background: This study examined the association between youth sport-related ankle sprain injury and health-related outcomes, 3-15 years postinjury., Methods: A historical cohort study in which uninjured controls were cluster-matched with injured cases. The primary outcome was self-reported Foot and Ankle Outcome Score (FAOS). Secondary outcomes included measures of adiposity, validated questionnaires for physical activity, athletic identity, fear of pain, and tests of strength, balance, and function., Results: We recruited 86 participants (median age of 23 years; 77% female); 50 with a time-loss ankle sprain, median of 8 years postinjury, and 36 uninjured controls cluster-matched by sex and sport. Based on mixed effects multivariable regression models, previously injured participants demonstrated poorer outcomes than controls on all 5 FAOS subscales regardless of sex and time since injury, with the largest differences observed in symptoms (-20.9, 99% CI: -29.5 to -12.3) and ankle-related quality of life (-25.3, 99% CI: -34.7 to -15.9) subscales. Injured participants also had poorer unipedal dynamic balance (-1.9, 99% CI: 3.5 to -0.2) and greater fear of pain (7.2, 99% CI: 0.9-13.4) compared with controls. No statistically significant differences were found for other secondary outcomes., Conclusion: At 3-15 years following time-loss ankle sprain injury in youth sport, previously injured participants had more pain and symptoms, poorer self-reported function, ankle-related quality of life, reduced sport participation, balance, and greater fear of pain than controls. This underlines the need to promote the primary prevention of ankle sprains and secondary prevention of potential health consequences, including posttraumatic osteoarthritis., Level of Evidence: Level III, historical cohort study.

Objective: To evaluate the effectiveness of a neuromuscular training warm-up prevention program, Surveillance in High school and community sport to Reduce (SHRed) Injuries Basketball, for reducing all-complaint ankle and knee injuries in youth basketball players., Design: Quasi-experimental study., Methods: High school/club basketball teams (male and female players aged 11-18 years) in Calgary, Canada participated in 2016-2017 (control; season 1) and 2017-2018 (intervention; season 2). The control season included a standard-of-practice warm-up. In season 2, a SHRed Injuries Basketball coach workshop was completed by participating team coaches. Teams were randomized by school/club to an unsupervised or a supervised (weekly supervision by study personnel) implementation of the coach-delivered SHRed Injuries Basketball program. The 10-minute SHRed Injuries Basketball program included 13 exercises (ie, aerobic, agility, strength, balance). All-complaint ankle and knee injuries were collected weekly using validated injury surveillance. Multilevel, multivariable Poisson regression analyses (considering important covariates, clustering by team and individual, and offset by exposure hours) estimated incidence rate ratios (IRRs) by intervention group (season 1 versus season 2) and secondarily considered the control versus completion of the SHRed Injuries Basketball program, unsupervised and supervised., Results: Sixty-three teams (n = 502 players) participated in season 1 and 31 teams (n = 307 players: 143 unsupervised, 164 supervised) participated in season 2. The SHRed Injuries Basketball program was protective against all-complaint knee and ankle injuries (IRR = 0.64; 95% confidence interval [CI]: 0.51, 0.79). Unsupervised (IRR = 0.62; 95% CI: 0.47, 0.83) and supervised (IRR = 0.64; 95% CI: 0.49, 0.85) implementations of the SHRed Injuries Basketball program had similar protective effects., Conclusion: The SHRed Injuries Basketball program was associated with a 36% lower rate of ankle and knee injuries. Neuromuscular training warm-ups are recommended as the minimal standard of practice for injury prevention in youth basketball. J Orthop Sports Phys Ther 2022;52(1):40-48. doi:10.2519/jospt.2022.10959 .

This study examined the impact of high adherence to a neuromuscular training (NMT) warm-up on the risk of lower extremity (LE) injuries in children's soccer. Twenty U11-U14 youth clubs ( n = 92 teams, 1409 players) were randomized into intervention ( n = 44 teams) and control ( n = 48 teams) groups. The intervention group was advised to perform an NMT warm-up 2 to 3 times a week for 20 weeks. Team adherence, injuries, and exposure were registered throughout the follow-up. Primary outcomes were the incidence of soccer-related acute LE injuries and the prevalence of overuse LE injuries. Intervention teams conducted mean 1.7 (SD 1.0) NMT warm-ups weekly through follow-up. The seasonal trend for adherence declined significantly by -1.9% (95% CI -0.8% to -3.1%) a week. There was no difference in the incidence of acute injuries nor the prevalence of overuse LE injuries in high team adherence group ( n = 17 teams) compared to controls. However, the risk for acute noncontact LE injuries was 31% lower in the high team adherence group compared to controls (IRR 0.69, 95% CI 0.49 to 0.97). In an efficacy analysis ( n = 7 teams), there was a significant reduction of 47% in the rate of noncontact LE injuries (IRR 0.53, 95% CI 0.29 to 0.97). In conclusion, teams conducted NMT warm-up sessions regularly, but with a declining trend. A greater protective effect was seen in teams with the highest adherence to the NMT warm-up.

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)., Competing Interests: One or more of the authors has declared the following potential conflict of interest or source of funding: This study was financially supported by the Finnish Ministry of Education and Culture, by the Competitive State Research Financing of the Expert Responsibility area of Tampere University Hospital, and by the Palloilu Säätiö, Tammela, Finland. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto., (© The Author(s) 2021.)

Overuse injuries are common in basketball. Wearable technology enables the workload to be monitored in sport settings. However, workload-injury models lack a biological basis both in the metrics recorded and how workload is accumulated. We introduce a new metric for monitoring workload: weighted jump height, where each jump height is weighted to represent the expected effect of the jump magnitude on damage to the tendon. The objectives of this study were to use principal components analysis to identify distinct modes of variation in all workload metrics accumulated over 1, 2, 3, and 4 weeks and to examine differences among the modes of variation in workload metrics between participants before the injury and uninjured participants. Forty-nine youth basketball players participated in their typical basketball practices and games, and lower extremity injuries were classified as patellar or Achilles tendinopathy, other overuse, or acute. An inertial measurement unit recorded the number and height of all jumps, and session rating of perceived exertion was recorded. The previous 1-, 2-, 3-, and 4-week workloads of jump count, jump height, weighted jump height, and session rating of perceived exertion were summed for each participant-week. Principal components analysis explained the variance in the accumulated workload variables. Using the retained principal components, the difference between the workload of injured participants in the week before the injury and the mean workload of uninjured participants was described for patellar or Achilles tendinopathy, overuse lower extremity injury, and any lower extremity injury. Participants with patellar or Achilles tendinopathy and overuse lower extremity injuries had a low workload magnitude for all variables in the 1, 2, 3, and 4 weeks before injury compared with the weeks before no injury. Participants with overuse lower extremity injuries and any lower extremity injury had a high previous 1-week workload for all variables along with a low previous 3- and 4-week jump count, jump height, and weighted jump height before injury compared with the weeks before no injury. Weighted jump height represents the cumulative damage experienced by tissues due to repetitive loads. Injured youth basketball athletes had a low previous 3- and 4-week workloads coupled with a high previous 1-week workload., 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 © 2021 Benson, Owoeye, Räisänen, Stilling, Edwards and Emery.)

Introduction: Regular use of neuromuscular training (NMT) warm-up programs improves performance and prevents injuries. However, low level of adoption of these programs remains a problem. Understanding the current warm-ups in youth basketball and coaches' perceptions on injury prevention can guide the design of superior implementation strategies. This study describes warm-ups in youth basketball and coaches' injury prevention-related knowledge, attitudes, beliefs, and information sources. Methods: Youth basketball coaches ( n = 50) completed a preseason questionnaire. The questionnaire covered warm-up length, use of aerobic/agility/balance/strength/other exercises in the warm-up, injury-related knowledge, attitudes, beliefs, and sources of information. Results: Typical warm-up duration was ≤ 10 min (48.0% of coaches, 95% CI: ±13.8%). All coaches included aerobic exercises in their warm-up. Agility, strength, and balance exercises were utilized by 80.0% (95% CI: ±11.7%), 70.7% (95% CI: ±13.6%), and 26.8% (95% CI: ±13.6%) of coaches, respectively. Most coaches agreed to some extent that basketball injuries are preventable (94%) and that participating in a NMT warm-up program would reduce player's risk of injury (92%). Other coaches were identified as the most common source of information on warm-ups and injury prevention. Discussion: Coaches use parts of effective NMT warm-up programs, but balance exercises are not well adopted. Considering the level of evidence supporting the importance of balance exercises in injury prevention, it is crucial to improve the implementation of NMT warm-up programs in youth basketball, for example, through educational courses. As fellow coaches were identified as the most important source of information, coaches' role in knowledge translation should be emphasized., 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 © 2021 Räisänen, Owoeye, Befus, van den Berg, Pasanen and Emery.)

Psychosocial factors have both direct and indirect influence on behavior change. Self-efficacy is a key psychosocial factor driving behavior change. It is an individual's perceived capability of performing a desired action. Structured injury prevention workshops targeting improvements in psychosocial factors in coaches may enhance the dissemination and implementation of the 11+ program in community settings. This study describes baseline psychosocial factors in youth soccer coaches and the effects of a structured 11+ injury prevention workshop on coaches' self-efficacy to implement the 11+. An adapted questionnaire based on the Health Action Process Approach Model was administered to a sample of coaches, before and after an 11+ workshop. Measures of self-efficacy included: their understanding of the 11+; their ability to use the 11+; using the 11+ with limited space, and using the 11+ when players lacked interest. Data from 73 of 81 coaches were retained for analyses. The majority (74%) of coaches knew about the 11+ program before the workshop, mostly through internet resources and colleagues. 40% to 55% of coaches had at least one unit increase (range, 1 to 6); 29% to 48% did not have a change in measures of self-efficacy. Ten percent to 24% had at least one unit decrease (range, -1 to -3). Wilcoxon matched-pairs signed-ranks test (with Bonferroni correction) indicated significant increases in coaches' post-workshop (compared to baseline) mean ranks for three of the four self-efficacy measures (p≤0.013). A structured workshop significantly improved self-efficacy towards the implementation of the 11+ program in youth soccer coaches.

Objectives: To (1) identify the wearable devices and associated metrics used to monitor workload and assess injury risk, (2) describe the situations in which workload was monitored using wearable technology (including sports, purpose of the analysis, location and duration of monitoring, and athlete characteristics), and (3) evaluate the quality of evidence that workload monitoring can inform injury prevention., Design: Scoping review., Literature Search: We searched the CINAHL, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Embase, HealthSTAR, MEDLINE, PsycINFO, SPORTDiscus, and Web of Science databases., Study Selection Criteria: We included all studies that used wearable devices (eg, heart rate monitor, inertial measurement units, global positioning system) to monitor athlete workload in a team sport setting., Data Synthesis: We provided visualizations that represented the workload metrics reported, sensors used, sports investigated, athlete characteristics, and the duration of monitoring., Results: The 407 included studies focused on team ball sports (67% soccer, rugby, or Australian football), male athletes (81% of studies), elite or professional level of competition (74% of studies), and young adults (69% of studies included athletes aged between 20 and 28 years). Thirty-six studies of 7 sports investigated the association between workload measured with wearable devices and injury., Conclusion: Distance-based metrics derived from global positioning system units were common for monitoring workload and are frequently used to assess injury risk. Workload monitoring studies have focused on specific populations (eg, elite male soccer players in Europe and elite male rugby and Australian football players in Oceania). Different injury definitions and reported workload metrics and poor study quality impeded conclusions regarding the relationship between workload and injury. J Orthop Sports Phys Ther 2020;50(10):549-563. doi:10.2519/jospt.2020.9753 .

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.

Objective: 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., Design: Prospective cohort study., Methods: 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., Results: 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., Conclusion: 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. J Orthop Sports Phys Ther 2020;50(5):267-274. doi:10.2519/jospt.2020.9247 .

This prospective study in youth football examined the relationship between frontal plane knee projection angle (FPKPA) during the single-leg squat and sustaining an acute lower extremity injury or acute non-contact lower extremity injury. Secondly, side-to-side asymmetry in FPKPA and sex as injury risk factors were explored. In addition, we investigated the influence of age, sex, and leg dominance on the FPKPA. A total of 558 youth football players (U11 to U14) participated in the single-leg squat test and prospective injury registration. FPKPA was not found as a risk factor for injuries at this age. There was no difference in the mean FPKPA between sexes. However, FPKPA was associated with age; oldest subjects displayed the smallest FPKPA. Among boys, the frontal plane knee control improved by age. Among girls, the relationship between age and FPKPA was not as clear, but the oldest girls displayed the smallest mean FPKPA in the study (12.2° ± 8.3°). The FPKPA was greater on the dominant kicking leg compared to the non-dominant support leg (P < .001 for boys, P = .001 for girls). However, side-to-side asymmetry in FPKPA was not associated with future injuries. In conclusion, frontal plane knee control in the single-leg squat was not associated with lower extremity injuries among young football players. As the single-leg squat to 90° knee flexion was too demanding for many subjects, easier single-leg squat test procedure or a different movement control test, such as a double-legged squat, could be more suitable for the young football players., (© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: The purpose of this study was to investigate the prevalence of adolescent physical activity-related injuries in sports club activities, leisure time physical activity and school-based physical activity. The secondary aim was to investigate the differences in the prevalence of physical activity -related injuries between years 2014 and 2016. In addition, we set out to study the associations between age, sex and the frequency of physical activity and injury prevalence., Methods: This cross-sectional study is based on the National Physical Activity Behaviour Study for Children and Adolescents (LIITU in Finnish) conducted in years 2014 and 2016. The subjects completed an online questionnaire in the classroom during school hours. A total of 8406 subjects participated in the current study. Out of these, 49% were boys and 51% were girls. The proportions of 11-, 13-, and 15-year-olds were 35%, 34% and 31%, respectively., Results: In the combined data for 2014 and 2016, injury prevalence was higher in sports club activities (46%, 95% CI 44.8-47.8) than in leisure time PA (30%, 95% CI, 28.5-30.5) or school-based PA (18%, 95% CI, 17.4-19.1). In leisure time PA, the injury prevalence was higher than in school-based PA. In all the three settings, injury prevalence was higher in 2016 than in 2014. Frequency of PA was associated with a higher risk for PA-related injuries in sports clubs and leisure time., Conclusions: With half of the subjects reporting at least one PA-related injury during the past year, results indicate that adolescent PA-related injuries are a large-scale problem. There is a worrisome rise in injury prevalence in recent years. From a public health standpoint, there is an urgent need to invest in injury prevention to reverse this trend.

Background/aim: Poor frontal plane knee control can manifest as increased dynamic knee valgus during athletic tasks. The purpose of this study was to investigate the association between frontal plane knee control and the risk of acute lower extremity injuries. In addition, we wanted to study if the single-leg squat (SLS) test can be used as a screening tool to identify athletes with an increased injury risk., Methods: A total of 306 basketball and floorball players participated in the baseline SLS test and a 12-month injury registration follow-up. Acute lower extremity time-loss injuries were registered. Frontal plane knee projection angles (FPKPA) during the SLS were calculated using a two-dimensional video analysis., Results: Athletes displaying a high FPKPA were 2.7 times more likely to sustain a lower extremity injury (adjusted OR 2.67, 95% CI 1.23 to 5.83) and 2.4 times more likely to sustain an ankle injury (OR 2.37, 95% CI 1.13 to 4.98). There was no statistically significant association between FPKPA and knee injury (OR 1.49, 95% CI 0.56 to 3.98). The receiver operating characteristic curve analyses indicated poor combined sensitivity and specificity when FPKPA was used as a screening test for lower extremity injuries (area under the curve of 0.59) and ankle injuries (area under the curve of 0.58)., Conclusions: Athletes displaying a large FPKPA in the SLS test had an elevated risk of acute lower extremity and ankle injuries. However, the SLS test is not sensitive and specific enough to be used as a screening tool for future injury risk., Competing Interests: Competing interests: None declared.