Dissertations / Theses on the topic 'Athlete Injury Prevention'

Background Estimates of 1.6 million to 3.8 million concussions or mild traumatic brain injuries (mTBI) occur annually in adolescent athletes participating in contact sports (Daneshvar et al., 2011). Current clinical guidelines call for interventions to include education, assessment, screening, and long term management of injury by the adolescent's primary care provider (PCP) (Giza et al., 2013). Without proper knowledge of the injury's physiological process and progression, providers are possibly increasing the risk of continued brain injury in this population (Reddy & Collins, 2009). Purpose This doctorate of nursing practice project aimed to determine if a gap existed between provider knowledge about the current guidelines for management of mTBI in adolescent athletes of Arizona. Knowledge obtained from this survey could be further used to drive practice change. Methods A quantitative needs assessments study was conducted via data collection obtained through PCP's participation in an anonymous electronic survey using the survey software Qualtrics. Survey links were sent to potential participant's email addresses throughout Yuma County, AZ. An additional survey link was posted to the Arizona Nurses Association e-newsletter. The survey consists of 28 questions divided into three categories of demographics, knowledge, and practice questions. Outcomes Survey results were limited due to only 21 providers responding to the request for participation. From this sampling, it was determined that participant's clinical knowledge and practice related to screening, assessment, long term management, and continuity of care between the ED provider and follow up care with the primary provider were not congruent with current practice guidelines.

Background Shoulder pain and injury is common in both the general population and among athletes. Overhead athletes, such as handball players, are at an even higher risk of shoulder injury. There is currently no consensus regarding how or if these injuries can be prevented.  Purpose The aim of this review was to examine whether preventive training programs reduce acute and/or overuse injuries in overhead athletes. Another aim was to examine if training programs increase the strength of the rotator cuff in overhead athletes.  Method Searches were made in PubMed, Cinahl, and Sport Discus in March and April 2021. Ten studies were included in the study. The PEDro-scale was used to assess methodological quality and GRADE was used to determine level of evidence.  Results The methodological quality was “moderate to high” for five of the studies. The remaining five studies were of lower quality. The level of evidence was “limited” for prevention and “inadequate” for rotator cuff strength.  Conclusion The evidence for prevention of shoulder injuries was “limited” and the evidence for rotator cuff strength was “inadequate”. A narrower focus on one sport might result in more robust evidence.  Keywords overhead athlete, prevention, shoulder, strength

The purpose of this study was to determine if athletic trainers have a positive impact on high school athletes’ knowledge of injury prevention strategies and/or their incorporation of that knowledge into practice. A survey was distributed to incoming college freshmen athletes during their pre-participation physical. The survey contained demographic data and question blocks that assessed a) the subject’s knowledge of an injury prevention strategy, b) source(s) of knowledge and c) whether he/she incorporates it into training. It was found that athletes with access to an athletic trainer reported 17% more knowledge (p = 0.015) and reported incorporating that knowledge into their training 33% more often(p = 0.003). Several other statistics were analyzed using the demographic information to create several sub-populations. The majority showed no significant difference, but some data was found that shows the need for future research.

The dissertation consists of five separate studies that all have focused on different aspects of the relationship between psychological factors and sport injuries. In the first study the aim was to investigate female elite soccer players’ experiences of the time prior to the occurrence of an ACL injury. In the result three themes of player experiences was identified: fatigue, life stress, and worry. The players interpreted these three themes as risk factors for ACL-injury.   The second study aimed to investigate whether personality, stress, and coping predicted injury occurrence in an elite soccer population. The result showed that an interaction between psychological variables (i.e. trait anxiety, negative life event stress and daily hassles, ineffective coping) could explain 24 % of the variance in injury occurrence. Moreover, the result showed that negative life event stress was found to have an indirect effect on injury occurrence through daily hassles. In the third study the aim was to investigate whether individual level and changes in hassle and uplift levels over a 10-week period could predict injury outcome in an elite junior soccer population. The results showed that both initial level as well as change in hassle influenced injury risk. More specific, both high initial level as well as slow decrease in hassle was associated with an increased risk of injury. The fourth study aimed to investigate the extent to which a mindfulness and acceptance based intervention program could reduce the number of sports injuries in a sample of soccer players. The result showed no statistically significant differences in injury rates between the two groups, but there was a medium effect size (adjusted Cohen´s d = - 0.59). In the fifth study the aim was to investigate an athletic injury as a career transition through the narrative expression of successful and less successful injury experiences of a former elite handball player. The participant’s narratives made possible to identify four phases (i.e., pre-injury, injury and first reactions, diagnosis and treatment, rehabilitation and consequences) in the injury transition with distinct psychological content (e.g., demands, resources, barriers, and coping strategies) relevant to each phase

Background: Lower extremity (LE) musculoskeletal injuries in soccer players are extremely common. These injuries can result in many days of lost time in competition, severely impacting players and their respective teams. Implementation of group injury prevention programs has gained popularity due to time and cost-effectiveness. Though participation in group injury prevention programs has been successful at reducing injuries, programs often target a single injury and all players do not benefit from participation. Players with a greater number of risk factors are most likely to sustain an injury, and unfortunately, less likely to benefit from a group injury prevention program. The purpose of the proposed research is to determine if targeting these high risk players with one-on-one treatment will result in a reduction in the number of risk factors they possess. Objectives: 1) Determine the effectiveness of one-on-one intervention for reducing the number of risk factors for LE musculoskeletal injury in soccer players with 3 or more risk factors; 2) Assess the effectiveness of matched interventions on reducing the magnitude of identified risk factors. Hypothesis: Fifty percent or more of subjects receiving one-on-one intervention will have a reduction of ≥ 1 risk factor(s). Design: Quasi-experimental pretest-posttest design. Subjects: NCAA Division I men’s and women’s soccer players. Methods: All subjects were screened for modifiable risk factors using a battery of tests which assessed mobility, asymmetry in fundamental movement pattern performance, neuromuscular control, and pain with movement. Players with ≥ 3 risk factors (“high risk”) were placed in the treatment group and received one-on-one treatment from a physical therapist. An algorithm was created with interventions matched to specific deficits to determine the treatment each subject received. Subjects in the intervention group were treated twice per week for four weeks. Players with < 3 risk factors (“low risk”) were placed in the control group and did not receive one-on-one intervention. Analysis: The primary outcome measure was proportion of treatment successes, defined as a reduction of ≥ 1 risk factor(s). Secondary outcomes included analysis of within group and between group differences. Results: Thirteen subjects were treated with one-on-one intervention, with twelve having a reduction of at least 1 risk factor at posttest. The proportion of treatment successes in the intervention group was 0.923 (95%CI 0.640-0.998). The proportion of high risk subjects that became low risk at posttest was 0.846, which was statistically significant (p = 0.003). Within group differences were noted in active straight leg raise (left; p = 0.017), hip external rotation (right, p=0.000; left, p = 0.001) thoracic spine rotation (left; p=0.026), and upper quarter neuromuscular control measures (left inferolateral reach, p = 0.003; left composite, p = 0.016). A statistically significant between group difference was noted in risk factor change from pretest to posttest (p = 0.002), with the median risk factor change in the intervention group and control group being -3 and -1, respectively. Conclusion: Utilizing one-on-one interventions designed to target evidence-based risk factors is an effective strategy to reduce LE musculoskeletal injury risk factors in high risk individuals.

This study was the result of a quantitative methods research design, which assessed: athletic training services, injury prevention at the time of the study, and intervention protocols for high schools within the Gateway Athletic Conference (GAC). This study explored the impact of injuries and concussions on student athletes. The study also examined the types of athletic training facilities, resources for rehabilitation, and procedures for athletic training programs available at the high school level in the GAC. The study uncovered some significant findings between the groups who were surveyed. The participants surveyed represented athletic trainers, athletic directors, and coaches. There were differences in how these groups viewed emergency care procedures, injury policies, and protocols. The differences ranged from views of job descriptions, written policies and procedures for emergency transportation, reporting and submitting accident reports, and regular review of the effectiveness of athletic training services. The groups did agree on most legal duties and responsibilities, general policies and procedures, injury management protocol and procedures, training room facilities, and operation questions. Blood-borne pathogens were an area in which notable improvement is needed, and there were some concerns with some of the data reporting injury statistics. Overall, the participants agreed with one another, but there were some differences throughout the study, as reported in this dissertation.

The aetiology behind overuse injuries such as stress fractures is complex and multi-factorial. In sporting events where the loading is likely to be uneven (e.g. hurdling and jumps), research has suggested that the frequency of stress fractures seems to favour the athlete’s dominant limb. The tendency for an individual to have a preferred limb for voluntary motor acts makes limb selection a possible factor behind the development of unilateral overuse injuries, particularly when repeatedly used during high loading activities. The event of sprint hurdling is well suited for the study of loading asymmetry as the hurdling technique is repetitive and the limb movement asymmetrical. Of relevance to this study is the high incidence of Navicular Stress Fractures (NSF) in hurdlers, with suggestions there is a tendency for the fracture to develop in the trail leg foot, although this is not fully accepted. The Ground Reaction Force (GRF) with each foot contact is influenced by the hurdle action, with research finding step-to-step loading variations. However, it is unknown if this loading asymmetry extends to individual forefoot joints, thereby influencing stress fracture development. The first part of the study involved a series of investigations using a commercially available matrix style in-shoe sensor system (FscanTM, Tekscan Inc.). The suitability of insole sensor systems and custom made discrete sensors for use in hurdling-related training activities was assessed. The methodology used to analyse foot loading with each technology was investigated. The insole and discrete sensors systems tested proved to be unsuitable for use during full pace hurdling. Instead, a running barrier task designed to replicate the four repetitive foot contacts present during hurdling was assessed. This involved the clearance of a series of 6 barriers (low training hurdles), place in a straight line, using 4 strides between each. The second part of the study involved the analysis of "inter-limb" and "within foot loading asymmetries" using stance duration as well as vertical GRF under the Hallux (T1), the first metatarsal head (M1) and the central forefoot peak pressure site (M2), during walking, running, and running with barrier clearances. The contribution to loading asymmetry that each of the four repetitive foot contacts made during a series of barrier clearances was also assessed. Inter-limb asymmetry, in forefoot loading, occurred at discrete forefoot sites in a non-uniform manner across the three gait conditions. When the individual barrier foot contacts were compared, the stance duration was asymmetrical and the proportion of total forefoot load at M2 was asymmetrical. There were no significant differences between the proportion of forefoot load at M1, compared to M2; for any of the steps involved in the barrier clearance. A case study testing experimental (discrete) sensors during full pace sprinting and hurdling found that during both gait conditions, the trail limb experienced the greater vertical GRF at M1 and M2. During full pace hurdling, increased stance duration and vertical loading was a characteristic of the trail limb hurdle foot contacts. Commercially available in-shoe systems are not suitable for on field assessment of full pace hurdling. For the use of discrete sensor technology to become commonplace in the field, more robust sensors need to be developed.

xiii, 89 p. : ill. A print copy of this thesis is available through the UO Libraries. Search the library catalog for the location and call number.
Participation in athletics includes an inherent risk of becoming injured that is related to the nature of the games and activities of the players. Current literature reports that approximately seven million high school students participate in sports yearly in the United States and, during the 2005-2006 sport seasons, 1.4 million injuries were reported. Considering this high number of injuries, there is little doubt that definitive research into the determination of factors that might help predict the degree of injury risk associated with sport participation is warranted. Despite common association of variables such as joint laxity, range of motion, strength and balance with injury, these traditional measures have not proven to be reliable predictors of vulnerability. Consequently, attempts have been made to identify practical methods that may better permit identification of individuals who show a high likelihood of injury during athletic competition. This study examined one such system, the Functional Movement Screen (FMS), which utilizes measures of mobility and stability to permit its developers to assert that it can be used to practically and accurately identify vulnerable athletes. Critical data on inter-rater and intra-rater performance were first obtained on a team of athletic trainers to ensure that they could reliably execute the testing methods. Following confirmation of this fact, 112 high school basketball athletes were screened with the FMS and their injuries (non-contact neuromusculoskeletal tissue damage in school-sanctioned basketball) were tracked throughout an entire season. Data analysis to determine if a commonly-used FMS cutoff score of less than 14 out of 21 could identify vulnerable athletes revealed that this value was not significantly related to the likelihood of sustaining an injury. Furthermore, logistic regression revealed that none of the individual predictors (gender, FMS movements, and movement asymmetries) were significant predictors of injury susceptibility. The results indicate that, despite the fact that multiple evaluators and trials can be practically used to evaluate FMS scores in a large group of high school basketball athletes, the test does not appear to be a valid tool in assessing injury risk in this population during an entire season.
Committee in charge: Gary Klug, Chairperson, Human Physiology; Paul van Donkelaar, Member, Human Physiology; Andrew Lovering, Member, Human Physiology; Roland Good, Outside Member, Special Education and Clinical Sciences

Study 1: Neuromuscular training improves movement competency and physical performance measures in 11-13 year old female netball athletes The purpose of this study was to examine the effects of a neuromuscular training program on movement competency and measures of physical performance in youth female netball players. It was hypothesized that significant improvements would be found in movement competency and physical performance measures following the intervention. Twenty-three junior female netball players (age, 12.17 ± 0.94 yrs; height, 1.63 ± 0.08 m; weight, 51.81 ± 8.45 kg) completed a test battery before and after a six-week training intervention. 13 of these athletes underwent six weeks of neuromuscular training, which incorporated plyometrics and resistance training. Trained athletes showed significant improvements in 20 m sprint time, 505 agility time, countermovement jump height and peak power (p ≤ 0.05, g > 0.8). Additionally, trained athletes significantly improved their score in the Netball Movement Screening Tool (NMST) (p < 0.05, g > -1.30); while the athletes also demonstrated increased reach in the anterior and posteromedial directions for the right and left leg, and in the posterolateral direction for the left leg only in the Star Excursion Balance Test (SEBT) (p < 0.05, g > -0.03). Control subjects did not exhibit any significant changes during the 6-week period. Significant negative correlations were found between improved score on the NMST and decreased 5 m, 10 m and 20 m sprint time, and 505 change of direction time (r > 0.4, p ≤ 0.05). Results of the study affirm the hypothesis that a six-week neuromuscular training intervention can improve performance and movement competency in youth netball players Study 2: Neuromuscular training improves lower extremity biomechanics associated with knee injury during landing in 11-13 year old female netball athletes. The purpose of this study was to examine the effects of a neuromuscular training program on lower extremity biomechanics in youth female netball athletes. The hypothesis was that significant improvements would be found in landing biomechanics of the lower extremities, commonly associated with anterior cruciate ligament (ACL) injury. Twenty-three athletes (age = 12.2 ± 0.9 yrs; height = 1.63 ± 0.08 m; weight = 51.8 ± 8.5 kg) completed two testing sessions separated by six weeks. Thirteen athletes underwent six weeks of neuromuscular training, while the remaining 13 served as controls. Three dimensional lower extremity kinematics and kinetics were measured during two landing tasks. Neuromuscular training significantly improved hip abduction angle and bilateral knee valgus motion in the bilateral landing task at maximum knee-flexion range of motion and knee internal rotation angle during the unilateral landing at maximum knee flexion-extension range of motion (p ≤ 0.05, g > 1.00). Additionally, the experimental group showed large, significant decreases in vertical ground reaction force in both landing tasks (p ≤ 0.05, g > -1.30). Control participants did not make any significant changes during the six-week study period. Results of the study affirm the hypothesis that a six week neuromuscular training program can enhance movement biomechanics associated with ACL injury.

The anterior cruciate ligament (ACL) originates from posterior part of the medial side of the lateral condyle of femur to anterior intercondylar notch between a transverse meniscal ligament and medial side of medial meniscus of tibia. Once ACL is disrupted, pain, effusion and atrophy are commonly observable and cause functional disability. Because of the functional limitations, athletic participation is severely restricted. ACL injury is more prevalent in physically active females compared to their male counterparts in the sports of basketball and soccer in high school and collegiate levels. Several attributes of females are considered risk factors for the higher ACL injury incidences and include: anatomy, physiology and neuromuscular/biomechanics. Among them, neuromuscular/biomechanics is the only modifiable risk factor. Performing neuromuscular training may change muscular strength profiles, which may lead to reduction in ACL injury incidence in female athletes. However, this principle was not fully examined. Also, neuromuscular compliance may play a role in muscular strength development and ACL injury incidences. Thus, the purpose of this dissertation was to investigate the effects of neuromuscular training compliance on muscular strength development and ACL injury incidence. The influence of hip abductor, hamstrings and quadriceps strength was examined in this project. The results of these studies indicate neuromuscular training is an effective intervention to reduce ACL injury incidence in female athletes, and there is an inverse dose-response relationship between compliance of the neuromuscular training and number of ACL incidences in female athletes. The effect of compliance on muscular strength development was inconsistent. The results of these studies support that compliance of neuromuscular training is a key to reduce ACL injury incidences; however, more studies are need to conclude neuromuscular training compliance effects on muscular strength development in female athletes.

Females suffer anterior cruciate ligament (ACL) injuries at a 2 to 10-fold greater rate compared to male athletes participating in similar sports. Altered movement patterns and inadequate knee stiffness are two interrelated factors that may increase ACL injury risk. Onset of these neuromuscular risk factors may coincide with the rapid adolescent growth that results in the divergence of a multitude of neuromuscular parameters between sexes. The overall purpose of this dissertation was to determine if neuromuscular ACL injury risk factors in female athletes increase following rapid growth and development compared to males. Male and female athletes were tested with three-dimensional motion analysis techniques during a drop vertical jump over two consecutive years to determine if ACL injury risk factors increased. Pubertal females showed a significant longitudinal increase in knee abduction angle compared to post-pubertal females and both male groups. The increase in knee abduction angle appeared to remain consistent, as the post pubertal female cohort had greater overall knee abduction compared to post-pubertal males. Similar results were found with a greater magnitude of knee abduction moment in post-pubertal females compared to males. Males and females increased ankle, knee and hip active stiffness from the first to second year of testing. Ankle and hip stiffness were increased significantly more in the pubertal group compared to post-pubertal. Sex and maturational group differences were found in hip and ankle joint stiffness. Post-pubertal males had significantly greater hip stiffness than the other groups (even when normalized to body mass). This indicates that post-pubertal males utilized a different neuromuscular strategy during landing. Males had a significantly greater increase from year to year in vertical jump height compared to females. Vertical jump height is often related to a measure of whole body power and indicates that males had a significant neuromuscular spurt compared to females. Early puberty appears to be a critical phase related to the divergence of increased ACL injury risk factors. Injury prevention programs that focus on neuromuscular training may be beneficial to help address the development of ACL injury risk factors that occur in female athletes during maturation.

Bakgrund: Det finns i tidigare studier beskrivna problem så som implementering och följsamhet när det gäller skadeförebyggande träningsprogram (SPP) för fotbollsspelare.   Syfte: Syftet med studien är att kartlägga och undersöka om kvinnliga och manliga fotbollslag i Stockholm utför ett SPP samt om det finns något samband med deras tillgång till medicinsk personal. Syftet är också att undersöka om det finns någon skillnad på tillgången till medicinsk personal och utförande av SPP mellan kvinnliga och manliga fotbollsspelare.   Metod: Enkäten skickades ut till 133 manliga och kvinnliga fotbollsspelare från samma fotbollsklubb. Enkäten innehöll 14 frågor om tillgång till medicinsk personal, information om skadeförebyggande träning samt utförande av SPP.   Resultat: Totalt 82 fotbollsspelare besvarade enkäten.  Majoriteten av deltagarna uppgav att de har tillgång till medicinsk personal. Fler manliga än kvinnliga fotbollsspelare har tillgång till medicinsk personal (P=0,018). Ingen korrelation visades mellan att ha tillgång till medicinsk personal och att ha fått information om skadeförebyggande träning (P=0,45). 66% av deltagarna angav att de utför ett SPP. Tillgång till medicinsk personal korrelerade med utförande av ett SPP (P=0,04).   Slutsats: Medicinsk personal verkar ha en betydelse när det gäller utförande av ett skadeförebyggande träningsprogram. Vidare forskning krävs inom området för att motivera fotbollslag att ta hjälp av medicinsk personal
Background: There are described problems with implementation and compliance in previous studies when it comes to Injury Prevention Programs (IPP) for soccer players.   Aim: The aim of this study was to examine if female and male soccer teams in Stockholm are performing an IPP in relation to their access to medical staff. The aim was also to examine if there are any difference between male and female soccer players in their access to medical staff and performing of an IPP.   Method: The survey was delivered to 133 male and female soccer players from the same soccer club. The survey involved 14 questions about medical staff, information about injury prevention training and performance of an IPP.   Results: Totally 82 soccer players answered the survey. The majority of the participants indicated that they have access to medical staff. More male than female soccer players indicated access to medical staff (P=0,018). No correlation was found between access to medical staff and have gotten information about injury prevention training (P=0,45). 66% of the participants indicated that they were performing an IPP. The access to medical staff correlated to the performing of an IPP (P=0,04).   Conclusion: Medical staff seems to have an impact when it comes to performing of an IPP. Further research is needed to motivate soccer teams to take advantage of medical staff with their injury prevention training.

Across the world, physical inactivity was found to be associated with cardiovascular and chronic diseases of lifestyle which often leads to an increased rate of various physical disabilities andpremature death. To combat these high incidences of chronic diseases of lifestyle, WHO strongly encourages people to become physically active on a daily basis to reduce the risk of 
premature death. Running has thus become the preferred choice of physical activity by thousands of people to help improve their overall health and wellbeing. Apart from the health benefits 
that running provides, it can also predispose the runner to potential injury especially when runners follow an inappropriate training programme and have inadequate knowledge about factors causing injury. Therefore, baseline data about the prevalence, incidence of injury and the identification of the aetiological factors associated with running injuries are needed to develop and 
implement preventative programmes to allow runners to optimally perform in training and races without injury. In South Africa, there is limited research available on the incidence of injury in runners yet there is an annual increase in participation in races such as Two Oceans and Comrades marathon which could lead to an increase in the number of running injuries.Thus, the purpose of this study was to determine the incidence of injuries and identify the various risk factors that are associated with injuries in road runners at a local athletic club. Methods: A prospective cohort study design over a 16 week period using quantitative research methods was used. A sample of 50 runners had consented to participate in the study. The participants had to complete a self-administered questionnaire and clinical measurements of BMI, Q-angle, leglength, muscle strength of lower leg and ROM of hip and knee were recorded. The participants had 
to complete an injury report form to record any new injuries sustained over the 16 week period of the study. Statistical Package for Social Sciences (SPSS) version 18 and software SAS v9 (SAS Institute Inc., Cary, NC, USA) was used for data capturing and analysis. Descriptive and inferential statistics were done to summarize the data and was expressed as frequencies, percentages, means and standard deviations. Injury prevalence and cumulative incidence was calculated as a proportion rate along with 95% confidence interval. The Poisson regression model was used to analyse the association between running injury and the independent variables of interest such as demographics, anthropometric measurements, training methods, running experience and 
previous injury. The alpha level was set as p<
0.05. Results: The study found that the majority (92%) of the participants (n=46) sustained running injuries in the past prior to the study. A total of 16 participants sustained a number of 50 new injuries over the 16 week study period. Thus the prevalence rate of injuries was 32%. The incidence rate of injuries for this study was 0.67 per 
1000km run at a 95% confidence interval of 0.41, 1.08. Furthermore, the most common location of new injuries reported were the calf (20%) and the second most common location was the 
knee (18%). PFPS was the most common type of knee injury diagnosed, followed by lumbar joint sprain. The results showed that none of the identified factors (running distance, stretching, age, Q-angle, BMI, running experience, leg-length discrepancy and previous running injuries) were directly associated with running injuries. However, a marginal significance was found for 
running distance (p = 0.08) and leg length discrepancy (p = 0.06). Conclusions: The study found a high prevalence and incidence rate of injury thus the need for preventative programmes have been highlighted. There was no statistical significance found between the identified factors and risk of injury however, there was clinical relevance found between factors identified. One major 
limitation was the small sample of participants and the short duration of study period. Thus, future research is needed to further determine possible factors associated with running injuries over a longer period and including a larger sample. The results of the study will be made available to all the stakeholders (runners, coaches and medical team) to implement in athletic club.

The study analyses available data (a total of 564 reports) on injuries to the musculoskeletal apparatus in a series of 240 professional soccer players, with the average age of 24.3 years as of the beginning of all football seasons (median 24.0 years, range 16 - 39 years), covering the period of 16 years (1997 - 2013). The analysed variables included age, height, body weight, BMI, different football positional roles (defence, offence, goalkeeper), number of injuries (injury to the ankle, the knee, lower limb muscles; lower limb fracture, injury to the upper limb, injury to the head, neck and back, injury to tendons and groins) and the surface on which the injury was sustained (dry - hard, wet - soft, artificial). Processing of statistical data and examination of a potential correlation between the respective injury and variables was based on the mixed model method. During the season the risk of a knee injury sustained in a match was statistically significantly higher as compared to training; at the same time the risk was decreasing with the growing BMI value. In addition to a statistically significant training/match variable (with matches posing a higher risk), the risk of injury to the knee depends on the type of surface, where dry surface is associated with a higher risk of such injury. Matches,...

BACKGROUND and OBJECTIVES: Low-back overexertion injuries represent a large proportion of fireground “strains, sprains and muscular pains” and are a leading cause of disability and early retirement in firefighters. Given the inherently hazardous and unpredictable nature of many fireground activities, it is often infeasible to implement “task-focused” ergonomic controls and there are limited options to accommodate injured firefighters. Accordingly, effective and practical “worker-focused” injury prevention approaches are needed. Toward this end, four studies were conducted to address the following global thesis objectives: 1) Examine the possible role that firefighters’ personal movement strategies could have on their occupational low-back loading demands and injury potential; and 2) Compare the effects of two different exercise approaches on firefighters’ occupational low-back loading demands and injury potential. STUDY 1: Low-Back Loading Demands during Simulated Firefighting Tasks – Inter-Subject Variation and the Impact of Fatigue and Gender. Background: Non-modifiable fireground duties are considered hazardous for low-back health, but personal movement strategies could modulate low-back loading demands and injury potential. Study objectives were to quantify low-back loading demands during simulated firefighting tasks and to examine the impact of fatigue and gender on the peak loading response. Methods: Ten men and 10 women performed a battery of laboratory-simulated firefighting tasks before and following repeated bouts of a fatiguing stair-climbing protocol. An EMG-assisted three-dimensional dynamic biomechanical model was used to compute peak L4/L5 joint forces during task performance. Results: Peak low-back loading demands varied considerably between subjects and tasks, but 70% of all loading variables examined were of greater magnitudes in male subjects and 40% of all loading variables were of lower magnitudes in both males and females after stair-climbing. Some inter-subject variation in low-back loading was attributed to body size differences, but between- and within-subject differences in movement strategies also contributed to low-back loading variability between subjects and over time. Conclusions: Results of this study suggest that characteristics of individuals, tasks performed, and physical fatigue may influence peak low-back loading demands and injury potential in firefighters. Despite considerable inter-subject variation in the internal low-back loading response to fixed external task and environmental constraints, opportunities to attenuate low-back loading demands through movement behaviour adaptations alone may be limited to only a subset of fireground activities. STUDY 2: Ankle Immobilization alters Lifting Kinematics and Kinetics – Occupational Low-Back Loading Demands and Potential for Injury. Background: Firefighters with lingering lower extremity functional impairments could be forced to move in ways that increase their potential for sustaining occupational low-back lifting injuries. The study objective was to examine the impact of unilateral ankle immobilization on lifting kinematics and kinetics. Methods: With and without their right ankle immobilized, 10 male volunteers performed laboratory-simulated occupational lifting tasks. Together with force platform data, three-dimensional kinematics of the lumbar spine, pelvis, and lower extremities were collected, and a three-dimensional dynamic biomechanical model was used to calculate peak low-back compression and shear loading demands. Results: In comparison to the unaffected conditions, ankle immobilization resulted in less knee (p-values between 0.0004 and 0.0697) and greater lumbar spine (p-values between 0.0006 and 0.3491) sagittal motion when lifting. Associated with this compensatory movement strategy were greater L4/L5 anterior/posterior reaction shear forces (p-values between 0.0009 and 0.2450). However, in a few cases where individual compensatory movement strategies differed from the “group” response (i.e., subjects increased their sagittal knee and hip motion on the affected side), peak L4/L5 joint compressive loads increased while the peak L4/L5 anterior-posterior shear did not change. Conclusions: Distal lower extremity joint dysfunction can alter the way in which individuals move and load their low-backs when lifting. The specific ways in which individuals compensate for personal movement constraints could alter the potential site and mechanism of occupational low-back injury. STUDY 3: FMS™ Scores and Occupational Low-Back Loading Demands – Whole-Body Movement Screening as an Ergonomic Tool? Background: Results of Study 1 suggested that a whole-body movement screen could be used to identify personal characteristics that constrain movement behaviour in ways that impact occupational low-back loading demands and injury potential. The purpose of this study was to examine if Functional Movement Screen™ (FMS) scores could be used to project the low-back loading response to lifting. Methods: Sagittally symmetric and asymmetric laboratory-based lifting tasks were performed by 15 firefighters who scored greater than 14 on the FMS (high-scorers) and 15 size-matched low-scorers (FMS < 14). A three-dimensional dynamic biomechanical model was used to calculate low-back loading demands, and lumbar spine posture was recorded when peak low-back compression was imposed. Results: Regardless of the task performed, there were no differences in peak L4/L5 joint compression (p ≥ 0.4157), anterior/posterior reaction shear (p ≥ 0.5645), or medial/lateral reaction shear (p ≥ 0.2581) loading demands between high- and low-scorers. At the instant when peak compression force was detected, lumbar spine deviation was not different between high- and low-scorers about the lateral bend (p ≥ 0.4215), axial twist (p ≥ 0.2734), or flexion/extension (p ≥ 0.1354) axes. Conclusions: Using the previously established musculoskeletal injury prediction threshold value of 14, the composite FMS score did not project the low-back loading response to lifting. Future attempts to modify or reinterpret FMS scoring are warranted given that several previous studies have revealed links between composite FMS scores and musculoskeletal complaints. STUDY 4: Movement- vs. Fitness-Centric Exercise – Firefighter Fitness, Whole-Body Movement Qualities, and Occupational Low-Back Loading Outcomes. Background: The impact of exercise on firefighter job performance and cardiorespiratory fitness has been studied extensively, but its effect on musculoskeletal loading remains less understood. The aim of this study was to compare various physical fitness, general movement quality, and low-back loading outcomes between groups of firefighters who completed fitness- or movement-centric exercise. Methods: Fifty-four firefighters participated and were assigned to a control (CON), fitness-centric exercise (FIT), or movement-centric exercise (MOV) group. Before and after 12 weeks of exercise, subjects performed a physical fitness test battery, the Functional Movement Screen™ (FMS), and laboratory-simulated firefighting tasks during which low-back loading demands were quantified. Results: FIT and MOV subjects exhibited statistically significant improvements in nearly all measures of physical fitness (i.e., body composition, cardiorespiratory capacity, muscular strength, power, endurance, and flexibility), but FMS scores and occupational low-back loading demands were not impacted in a consistent way across individuals. Conclusions: Improving physical fitness can enhance job performance and prevent cardiac events in firefighters, but it was not clear that 12 weeks of exercise would alter their occupational low-back loading demands. Given variability in individual responses, the short study duration, and limited number and nature of tasks examined, more research incorporating alternative biomechanical and statistical analyses is needed to better understand how individuals adapt to chronic exercise and what impact these adaptations have on occupational movement behaviours, low-back loading demands, and low-back loading capacity. SUMMARY and CONCLUSIONS: Results confirmed that fireground activities are potentially hazardous for low-back health, as simulated occupational low-back loading demands routinely exceeded recommended exposure limits in the studies performed. However, results also indicated that personal movement strategies – possibly influenced by body size, preference, gender, physical fatigue, or distal lower extremity joint dysfunction – could alter occupational low-back loading demands and injury potential. It could not be concluded that occupational low-back loading demands and injury potential would be consistently affected by short-term improvements in physical fitness, nor could the low-back loading response to lifting be projected by scoring above or below 14 on the Functional Movement Screen™. Future research is warranted to examine the low-back loading demands associated with performing non-fireground duties, as opportunities may exist to implement ergonomic strategies to control cumulative low-back loading exposures. Particular attention should be paid to the exercise and training practices of firefighters, as musculoskeletal injuries sustained during these activities are potentially avoidable and could reduce the capacity of the musculoskeletal system to withstand demands imposed during non-modifiable fireground operations.

Injury to the anterior cruciate ligament (ACL) may have consequences for an athlete in the form of pain, decreased activity levels and early-onset osteoarthritis. Female athletes are at increased risk of injury, perhaps because of differences in neuromuscular function. Methods of identifying risk factors and effective prevention strategies for ACL injury have traditionally involved athletes of high school age or older. However by that age, the opportune time to intervene may have passed. This thesis involves a sequence of studies which measures the neuromuscular function of younger athletes, aged 10-14 years. First, the reliability of measuring strength and power of the lower extremity on an isokinetic dynamometer was explored. Torque and power of the hip flexors and knee extensors were the only measures with acceptable reliability. Conversely, peak velocity of all the tested hip and knee movements demonstrated acceptable reliability. A high amount of variability was found with all test movements, and so alternate tests should be used if measuring an individual athlete’s ability. From the data collected within the reliability study, a sex comparison was undertaken to determine if neuromuscular power differed at this young age. It was determined that girls and boys between 10 and 14 years of age do not differ in terms of knee or hip movement velocity or power. There is evidence to suggest that sex differences exist by adulthood; further research is required to determine when the disparity becomes apparent. The final project was to determine whether strength training would improve the manner in which young female athletes land from a jump; a common ACL injury mechanism. This randomized controlled trial found no difference between the intervention group who trained their legs, and the control group who trained their arms. However those athletes with the poorest landings appeared to improve their movement pattern regardless of training regime. This thesis contributes to the literature by providing evidence for measurement protocols for young athletes, introducing neuromuscular power instead of strength into the investigation of contributing factors to injury, and by furthering the examination of strength training as an effective component of prevention programs.

Introduction : L’évaluation clinique du contrôle neuromusculaire des muscles du tronc est criante en réhabilitation et en entraînement. L’objectif principal de cette étude a été d’évaluer la reproductibilité intra et inter-évaluateur d’un test clinique le soulèvement actif de la jambe tendue (SAJT) chez une population active et saine. Méthode : Chaque sujet (18 joueurs de tennis) a été testé à deux reprises par 2 physiothérapeutes avec le SAJT. Résultats : La reproductibilité intra-évaluateur s’est avérée élevée à très élevée (ICC = 0.81 à 0.93) tandis la reproductibilité inter-évaluateur s’est avérée cliniquement non viable. Conclusion : À notre connaissance, le SAJT est le premier test clinique reproductible évaluant le contrôle neuromusculaire du tronc avec des compensations musculaires et cinétiques chez des sujets actifs et sains. Une formation plus importante des évaluateurs aurait certainement amélioré la reproductibilité inter-évaluateur.
Introduction: The clinical assessment of the trunk muscles neuromuscular control is lacking in rehabilitation and in conditioning. The main goal of this study was to assess the intra and inter-rater reliability of a clinical test, the active straight leg raise (ASLR), on an active and healthy population. Method: Each subject (18 tennis players) was tested twice by 2 physiotherapists with the ASLR. Results: The intra-rater reliability turned out to be high to very high (ICC = 0.81 à 0.93) while the inter-rater reliability came out clinically unsustainable. Conclusion: To our knowledge, the ASLR is the first reliable clinical test to assess the core neuromuscular control based on muscular and kinetic compensation observations with active and healthy subjects. A more exhaustive training of the assessors would definitely improve the inter-rater reliability.

碩士
國立台北護理學院
運動保健研究所
97
The study aims to understand the knowledge and attitudes toward the prevention of sports injuries from excellent athletes and general students of senior and vocational high schools of Hsinchu County. It also explores the influence of students’ backgrounds on the knowledge of prevention of sports injuries and on their attitudes, the relation between the knowledge of the prevention of sports injuries and students’ attitudes, and the differences in the knowledge and attitudes between the excellent athletes and general students. The study was conducted through the stratified cluster sampling method and the questionnaire distributed to seven schools in mid April 2009. A total of 1636 copies of the questionnaire were issued and 1518 valid copies were collected. The data were analyzed by t-test, one-way ANOVA, and Person product-moment correlation. The following are the major findings of this study: 1. 83.5% of male excellent athletes, 91.5% of female excellent athletes, 52.0% of male general students, and 34.0% of female general students had sport injuries. The course”Health & Nursing”in senior high school Provides students with more knowledge of prevention of sports injuries that the course”Health Education”in junior high school, the PE class in junior high school，and PE class in senior high school. 2. 83.0% of students reached up to standard. The cognition of the prevention of sports injuries was better. The knowledge of how to deal with sports injuries was insufficient. The accuracy in the applied knowledge of CPR and of hot or cold compress was the lowest. 3. All the students’ attitudes toward the prevention of sports injuries were positive. The attitude toward the prevention of sports injuries was better than that of how to deal with sports injuries. 4. In terms of the knowledge of the prevention of sports injuries, there was no difference between male and female general students as well as among grades. However, public schools showed better knowledge than private schools, senior high schools better than vocational high schools, students who had less one-hour daily exercise better than those with one-to-three-hour daily exercise. Female excellent athletes showed better knowledge than males, public schools better than private ones, senior high schools better than vocational schools, the second graders better than the third graders, the third graders better than the first graders, excellent athletes in ordinary classes better than those in the gym classes, the excellent athletes who exercised four days better than those with five-day exercise. 5. As to the general students’ attitudes toward the prevention of sports injuries, females were significantly superior to males. Students in public schools required more knowledge of how to deal with sports injuries and more related classes than those in private schools. The second graders took better attitudes toward the sports injuries than the first graders. The excellent athletes in public schools need more classes than those in private schools, junior-and-senior high schools more than vocational schools. 6. The more knowledge excellent athletes and general students got, the more positive attitudes toward the prevention of sport injuries they had. The more knowledge and positive attitudes they obtained, the more classes they required. 7. Statistically, there was no significant difference in knowledge and attitude between excellent athletes and general students. However, in terms of the score average, general students had more knowledge than excellent athletes while excellent students had more positive attitudes than general students.

Mok, Kam Ming.
Thesis (M.Phil.)--Chinese University of Hong Kong, 2010.
Includes bibliographical references (leaves 36-44).
Abstracts in English and Chinese.
Abstract --- p.ii
Chinese abstract --- p.iii
Acknowledgement --- p.iv
Table of contents --- p.V
List of figures --- p.vii
List of tables --- p.viii
Chapter Chapter 1: --- Introduction --- p.1
Chapter Chapter 2: --- Review of literature --- p.3
Chapter 2.1 --- Why prevent ankle ligamentous sprain? --- p.3
Chapter 2.2 --- A sequence of injury prevention --- p.4
Chapter 2.3 --- Biomechanical approaches in defining injury mechanism --- p.5
Chapter 2.4 --- Injury mechanism of ankle ligamentous sprain in sports --- p.6
Chapter 2.5 --- Model-Based Image-Matching motion analysis --- p.7
Chapter Chapter 3: --- Development of an ankle joint Model-Based Image-Matching motion analysis technique --- p.9
Chapter 3.1 --- Introduction --- p.9
Chapter 3.2 --- Materials and method --- p.10
Chapter 3.2.1 --- Cadaver test --- p.10
Chapter 3.2.2 --- Model-Based Image-Matching motion analysis --- p.12
Chapter 3.2.3 --- Statistical analysis --- p.14
Chapter 3.3 --- Results --- p.15
Chapter 3.3.1 --- Validity --- p.15
Chapter 3.3.2 --- Intra-rater reliability --- p.16
Chapter 3.3.3 --- Inter-rater reliability --- p.17
Chapter 3.4 --- Discussion --- p.17
Chapter 3.5 --- Conclusion --- p.21
Chapter Chapter 4: --- Biomechanical motion analysis on ankle ligamentous sprain injury cases --- p.22
Chapter 4.1 --- Introduction --- p.22
Chapter 4.2 --- Materials and method --- p.24
Chapter 4.2.1 --- Case screening --- p.24
Chapter 4.2.2 --- Model-Based Image-Matching motion analysis --- p.24
Chapter 4.3 --- Results --- p.28
Chapter 4.3.1 --- High Jump Injury --- p.28
Chapter 4.3.2 --- Field hockey Injury --- p.28
Chapter 4.3.3 --- Tennis Injury --- p.29
Chapter 4.4 --- Discussion --- p.30
Chapter 4.5 --- Conclusion --- p.34
Chapter Chapter 5: --- Summary and future development --- p.35
References --- p.36
List of publications --- p.42
List of presentations at international and local conference --- p.43
List of Awards --- p.44

After investigating the injury mechanism, this dissertation aims to design an intelligent sprain-free sports shoe for the prevention of sport-related ankle sprain injury. It consists of a three-step mechanism: (1) Sensing, (2) Identification, and (3) Correction. The progress of this dissertation covers two options of sensing and identification. The first option is to monitor the ankle spraining motion with the ankle inversion angle. A method to employ two tiny inertial and magnetic sensors at the shank and foot segment is adopted as the sensing system. A laboratory study is conducted to obtain ankle inversion magnitude and velocity during various sport motions. Together with the article kinematics reported in the accidental sprain case report, a standard for identifying ankle sprain is established. The second option is to monitor the ankle spraining motion with the ankle supination torque. A feasible method to estimate the complete ground reaction forces with the information from pressure insoles is presented. Then, a tiny in-shoe three-pressure-sensor system is devised to monitor the ankle supination torque during sport motions. With the information of failure torque at the ankle joint reported by previous cadaveric study, an identification system of the ankle supination torque is devised.
Ankle sprain injury is the most common single type of sport-related musculoskeletal trauma which causes rupture and tear to the anterior talofibular ligament and ankle instability. In this dissertation, a new paradigm, "Orthopaedic Sport Biomechanics", is proposed to present the role of biomechanics in the practice of orthopaedics sports medicine, including the analysis of injury mechanism, and the design of prophylactic equipment for injury prevention. To directly investigate the injury, a case report of an accidental injury event in laboratory is presented. It was found that an internally rotated ankle orientation at foot strike may predispose the ankle joint to a supination sprain injury, by triggering lateral drift of the rearfoot and the subsequent vigorous inversion. At injury, the ankle joint reached an inversion of 48 degrees and an internal rotation of 10 degrees.
Future studies on the sensing and identification process, the correction, and the final evaluation are suggested. We hope that we could really invent the sprain-free shoe to help reducing the incidence of ankle sprain injury in sports in future.
Fong, Tik Pui Daniel.
Adviser: Kai-Ming Chan.
Source: Dissertation Abstracts International, Volume: 70-06, Section: B, page: 3635.
Thesis (Ph.D.)--Chinese University of Hong Kong, 2008.
Includes bibliographical references (leaves 102-127).
Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Abstracts in English and Chinese.
School code: 1307.

no
Objective To evaluate landing strategies of female football and basketball athletes with relation to possible injury mechanisms and disparity in injury. Design Descriptive laboratory study. Participants 52 female football players and 41 female basketball players. Main outcome measures Frontal plane projection angle (FPPA) was measured during the single leg land (SLL) and drop jump (DJ) screening tasks. Results 2 × 2 × 2 mixed factorial ANOVA showed significant main effects were observed for sport, whilst significant interaction effects were seen between sport and task. Females in both sports exhibited significantly greater FPPA values during the SLL task than the DJ task (p < 0.001). Basketball players demonstrated significantly greater FPPA values during SLL than football players (p < 0.001), whilst no differences were found between sports in the DJ task (p = 0.328). Conclusion Female basketball players display greater FPPA values during unilateral landing tasks than female football players which may reflect the greater ACL injury occurrence in this population. Injury prevention programs in these athletes should incorporate unilateral deceleration and landing tasks and should consider the specific injury mechanisms in each sport.

Background: Overuse injuries (OI) account for a substantial part of sport injury incidence among athletes of various sports and levels. They lead to serious consequences for athletes’ physical and mental health, as well as athletic performance. Despite the gradual onset of symptoms, athletes often persevere in training and competing. The present study aimed to identify psychological risk profiles suggested to explain maladaptive behaviors prior or in response to first signs of overuse injuries. Design: Prospective cohort study. Methods: 149 athletes representing 10 individual and team sports responded to a range of questionnaires regarding personal (athletic identity, perfectionistic concerns, grit and negative life stress) and interpersonal (coach-athlete relationship) psychological traits. By using the mobile application Briteback®, participants subsequently answered the OSTRC Overuse Injury Questionnaire on a weekly basis during a 10 weeks period. A latent profile analysis was used in order to identify different psychological profiles. Results: Athletes were classified into 3 latent profiles regarding their psychological characteristics: profile 1 was labelled a “perfectionistic OI risk profile”, profile 2 a “negative stress OI risk profile” whereas profile 3 was called a “low risk profile for OI”. Indeed, athletes in profile 1 and 2 were found to be significantly more often affected by overuse problems than individuals in profile 3 (71% of the time, χ² (2) = 9.62, Hedges’ g = (0.71), p < .01 and 70% of the time χ² (2) = 9.13, Hedges’ g = (0.68), p < .01 vs 45% of the time), with athletes in profile 1 also experiencing more substantial overuse problems than for profile 3 (35% vs 21% of the time; χ² (2) = 4.12, Hedges’ g = (0.50), p < .05). Conclusions: Our findings support the existence of two “risk profiles” in which athletes are characterized either by elevated perfectionistic concerns or by high negative stress. These findings could be explained by the perseverative and rigid personality of perfectionistic concerns individuals and by the hypothesis of a synergy between psychological and physiological stress for negative stressed athletes. Coaches should pay particular attention to the psychological characteristics of their athletes in order to prevent overuse injury occurrence and worsening, especially those with high perfectionistic concerns and negative life stress. Cognitive behavioral interventions supporting at-risk athletes in reframing their rule-governed behaviors might decrease the risk of overuse problems.

No dia a dia de uma equipa, muitos são os fatores que influenciam o seu funcionamento e a sua construção. Uma constante adaptação ao contexto envolvente e à evolução em termos de conhecimento científico, são fatores determinantes no trabalho de um treinador. Desta forma, possuindo mais e melhores ferramentas de trabalho, permitir-lhe-á maximizar a aprendizagem e o rendimento dos seus jogadores. Neste relatório, pretende-se apresentar, analisar e refletir sobre a conceção e implementação das atividades práticas durante toda a época desportiva da equipa de Juniores do Grupo Desportivo Alcochetense, Para além da parte ligada às várias áreas do treino, este relatório irá abranger outras áreas de grande importância na vida de um treinador, sendo elas a área de Inovação e Investigação (Área 2) e a Relação com a Comunidade (Área 3). Com base na análise do contexto e nos objetivos definidos para a equipa, descrevemos e fundamentamos o modelo de jogo criado pela equipa técnica, assim como o planeamento definido para a época desportiva. Através de uma categorização dos exercícios de treino, foi possível fazer uma quantificação do volume de treino de cada categoria, o que permitiu perceber quais os conteúdos mais abordados durante toda a época desportiva. Na área 2 do estágio, procuramos aprofundar o conhecimento em torno da inclusão do trabalho físico complementar como meio de prevenção de lesões no processo de treino de uma equipa de futebol e a relação que este pode ter no desempenho desportivo. Embora não tenha sido possível proceder à sua aplicação prática, parece clara a importância deste tipo de abordagem no treino de uma equipa de futebol. Como tal, apresentamos uma proposta de protocolo de treino de prevenção de lesões. No âmbito da área 3, partindo da necessidade da comunidade de treinadores de futebol em manter uma formação teórica continua, foram organizadas duas ações de formação, em parceria com o Núcleo de Lisboa da Associação Nacional de Treinadores de Futebol, sobre a temática da Organização Estrutural do Exercício em Futebol e sobre as Bases para a construção de uma equipa de Futebol.
On the daily routine of a team, there are many factors that influence its operation and its construction. A constant adaptation to the surrounding context and the evolution in terms of scientific knowledge, are determinant factors in the work of a coach. Thus, having more and better work tools, will allow you to maximize the learning and performance of your players. This report is intended to present, analyze and reflect on the design and implementation of practical activities during the whole season of the Junior team of Grupo Desportivo Alcochetense. In addition to the part related to the various areas of training, this report will cover other areas of great importance in the life of a coach, these being the area of Innovation and Research (area 2) and the Relationship with the Community (area 3). Based on the analysis of the context and objectives defined for the team, we described and we based the game model created by the technical team, as well as the planning set for the sports season. Through a categorization of training exercises, it was possible to quantify the training volume for each category, which allowed understanding about which more content was covered during the whole season. In stage 2 area, we seek to deepen knowledge about the inclusion of additional physical exercise as a mean of injury prevention in the training process of a football team and the relationship that this can have on sports performance. Although it was not possible to effect practical application, it seems clear the importance of such approach in training a football team. As such, we propose a training protocol injury prevention. Within Area 3, starting from the need of football coaches community in maintaining a theoretical continuous formation, we organized two workshops in partnership with Núcleo de Lisboa of Associação Nacional de Treinadores de Futebol on the issue of Structural Organization Exercise in football and on the bases for the construction of a football team.

Thesis title: Effect of targeted training of the lower scapular fixators on the shoulder girdle function of rugby players The concept of the problem: Rugby is one of the toughest ball sports and there is no shortage of injuries. In addition, injuries in the shoulder area are among the most common and any possibility of reducing these injuries is beneficial. There is not much time left for compensation and targeted intervention; moreover, it is not usually led by physiotherapists but by fitness coaches and only in larger clubs. The consequence is a muscle imbalance in the shoulder girdle, which can result in the so-called scapular dyskinesis. This is turn affects the function and stability of the shoulder joint not only by the overhead athletes. It is possible to influence scapular dyskinesis in various ways. One of them is the inclusion of targeted training of lower scapular fixators into fitness training and thus their stability is improved. Objectives: The main aim of this thesis is to verify whether rugby players with painful shoulder have sufficiently scapular fixation based on kinesiological and biomechanical knowledge. Another aim of this thesis is to create such an exercise unit that would ensure the correct activity of the lower scapular fixators and verify this by measurement. The final...