Countermovement Jump and Isokinetic Dynamometry as Measures of Rehabilitation Status After Anterior Cruciate Ligament Reconstruction.

CONTEXT: Despite an increase in the literature, few definitive guidelines are available to determine when an athlete has been fully rehabilitated after anterior cruciate ligament reconstruction (ACLR). OBJECTIVE: To examine countermovement jump and isokinetic dynamometry measures to (1) identify which measures can best distinguish between ACLR and control participants and (2) provide normative values for identified measures in young adult male multidirectional field-sport athletes. DESIGN: Cross-sectional study. SETTING: Orthopaedic hospital. PATIENTS OR OTHER PARTICIPANTS: Young adult male multidirectional field-sport athletes (n = 118) who had undergone unilateral patellar-tendon graft ACLR at least 6 months earlier and healthy male participants (n = 44) with no previous knee injury. INTERVENTION(S): Single-legged countermovement jump (SL CMJ). MAIN OUTCOME MEASURE(S): Three-dimensional biomechanical analysis of the SL CMJ and mean peak concentric knee-extension and -flexion torque using isokinetic dynamometry (ISO) were compared in the 2 groups. A stepwise logistic regression was carried out to identify the best predictors of ACLR- or control-group membership (SL CMJ height, limb symmetry index, peak power, joint power contribution, ISO peak torque, limb symmetry index variables). RESULTS: The control group differed strongly from the ACLR group in isokinetic knee-extension peak torque (d = -1.33), SL CMJ performance (d > 0.4), and limb symmetry measures in both ISO and jump outcomes (d > 1.1). The combination of measures from both ISO and SL CMJ identified group membership with an accuracy of 89%. CONCLUSIONS: Rehabilitation of ACLR patients may be complete when they achieve isokinetic knee-extension peak torque of 260% (±40%) body mass, SL CMJ performance of >17 cm (±4 cm), and reach-limb symmetry measures of >90% in both strength and jump outcomes. The outcomes in the control group can inform return-to-play criteria for young adult male multidirectional field-sport athletes after ACLR.

Epidemiology of injuries in hurling: a prospective study 2007-2011.

OBJECTIVES: Hurling is a stick handling game which, although native to Ireland, has international reach and presence. The aim of this study was to report incidence and type of injuries incurred by elite male hurling players over five consecutive playing seasons. DESIGN: Prospective cohort study. SETTING: Male intercounty elite sports teams participating in the National GAA Injury Database, 2007-2011. PARTICIPANTS: A total of 856 players in 25 county teams were enrolled. PRIMARY AND SECONDARY OUTCOMES: Incidence, nature and mechanism of injury were recorded by team physicians or physiotherapists to a secure online data collection portal. Time-loss injury rates per 1000 training and match play hours were calculated and injury proportions were expressed. RESULTS: In total 1030 injuries were registered, giving a rate of 1.2 injuries per player. These were sustained by 71% (n=608) of players. Injury incidence rate was 2.99 (95% CI 2.68 to 3.30) per 1000 training hours and 61.75 (56.75 to 66.75) per 1000 match hours. Direct player-to-player contact was recorded in 38.6% injuries, with sprinting (24.5%) and landing (13.7%) the next most commonly reported injury mechanisms. Median duration of time absent from training or games, where the player was able to return in the same season, was 12 days (range 2-127 days). The majority (68.3%) of injuries occurred in the lower limbs, with 18.6% in the upper limbs. The trunk and head/neck regions accounted for 8.6% and 4.1% injuries, respectively. The distribution of injury type was significantly different (p<0.001) between upper and lower extremities: fractures (upper 36.1%, lower 1.5%), muscle strain (upper 5.2%, lower 45.8%). CONCLUSIONS: These data provide stable, multiannual data on injury patterns in hurling, identifying the most common injury problems. This is the first step in applying a systematic, theory-driven injury prevention model in the sport.

Normative data for the Functional Movement Screen in male Gaelic field sports.

OBJECTIVE: To determine normative values for the Functional Movement Screen (FMS) in Elite and Sub-Elite male Gaelic Football and Hurling players. DESIGN: A cross sectional study of functional movement in Gaelic games at Elite and Sub-Elite level. Players were video recorded completing the Functional Movement Screen Tool and scored post-test. Comparisons were analysed using Mann-Whitney U tests. SETTING: Field testing in team gym facility and university biomechanics laboratory. PARTICIPANTS: A total of 62 players were tested. This consisted of 41 Hurling, and 21 Gaelic Football players. 30 of these participants were deemed Elite and 32 were deemed Sub-Elite. The mean age of the sample was 22.15 ± 3.02 years. MAIN OUTCOME MEASURES: Functional Movement Screen (FMS). RESULTS: The FMS mean score for the sample was 15.56 ± 1.46. The Elite group (15.8 ± 1.58) scored higher than the Sub-Elite group (15.34 ± 1.31) but there was no significant difference between groups. CONCLUSIONS: This study provides normative reference values for Gaelic Players. Elite Gaelic Players perform no better than a young, active population in the FMS indicating a potential problem with the FMS as a measure.

Incidence of injury in Gaelic football: a 4-year prospective study.

BACKGROUND: Gaelic football is a national sport of Ireland. While predominantly played in Ireland, it is recognized in North America, the United Kingdom, Europe, and Australasia. Its high-velocity, multidirectional, and high physical contact elements expose players to a risk of injury. To date, prospective injury data for Gaelic football has been of short duration. PURPOSE: To describe the incidence and nature of sport-related injuries in elite male Gaelic football players over 4 consecutive seasons. STUDY DESIGN: Descriptive epidemiology study. METHODS: Over the period 2007 to 2010, a total of 851 Gaelic football players were tracked. Players were members of county-level teams who volunteered to be included in the study. Team injury, training, and match play data were submitted by the team physiotherapist on a weekly basis through a dedicated web portal to the National Gaelic Athletic Association (GAA) injury database. Injury was defined using a time loss criterion, in accordance with consensus statements in sports applicable to Gaelic games. RESULTS: A total of 1014 Gaelic football injuries were recorded. Incidence of injury was 4.05 per 1000 hours of football training. Match-play injury rates were 61.86 per 1000 hours. Muscle was the most frequently injured tissue (42.6%) and fractures accounted for 4.4% of Gaelic football injuries. Lower extremity injuries predominated (76.0%). Hamstring injuries were the single most common injury overall, representing almost one quarter (24%) of all injuries and over half of muscle injuries. Anterior cruciate ligament (ACL) injuries accounted for 13% of knee injuries. The majority of injuries were defined as new injuries (74.7%), with recurrent injuries constituting 23% of all injuries. The majority (59%) of match play injuries occurred in the second half of the match. Eighty six percent of injuries caused over one week's absence from play. CONCLUSION: These findings illustrate injury patterns in Gaelic football using a prospective methodology, over 4 consecutive seasons. Comparison with published literature suggests that Gaelic football match play injury risk is greater than soccer but less than rugby union.