Effectiveness of Protective Measures and Rules in Reducing the Incidence of Injuries in Combat Sports: A Scoping Review.

In recent years, much effort has been made to reduce the injury rate in combat sports. However, the question remains to what extent these measures are effective. Analysis of studies could provide evidence of the effectiveness of measures aimed at reducing the incidence of injuries. This scoping review aims (1) to map research articles dealing with the effectiveness of proper use of protective measures in reducing the incidence of injuries in combat sports; (2) to investigate to what extent the proper use of protective measures and compliance with sports rules help to reduce the incidence of injuries in combat sports; and (3) to identify gaps in the existing literature and suggest future research on this topic. The literature search was conducted on articles published between 2010 and 2023. The main inclusion criteria were studies investigating the effect of sports rules and protective equipment used during training or competition in combat sports on reducing the incidence of injuries. After meeting the criteria, only seven articles from boxing, karate, and taekwondo were included in this study. Results showed that mandatory head guards, along with modern thicker gloves, significantly reduced the rate of knockouts (KOs) and head injuries in boxing despite an increase in the number of head blows. However, the number of facial cuts increased significantly due to the removal of head guards as a piece of mandatory equipment. The use of mouth guards has significantly reduced the number of oral injuries. Changes in rules, such as shortening the duration of bouts, along with the introduction of greater competencies of referees in the supervision of bouts (the standing count, outclassed rule, and medical stops) have helped to reduce the rate of injuries in boxing. The application of a computerised scoring system also contributed to the rate of injuries reduction. The increase in the number of weight divisions had the same effect on U21 karate athletes. However, a higher incentive to attack the head area in taekwondo did not increase the incidence of injuries in youth athletes. It can be concluded that the proper use of protective measures (head and mouth guards) in combination with the rules established for health protection (higher competencies of referees and more weight divisions in competitions) effectively reduces the occurrence of injuries in combat sports. In all Olympic combat sports, the injury incidence should be regularly assessed using the Injury Incidence Rate (IIR) per 1000 min exposures (MEs). Nonetheless, further studies are needed to monitor how established rules (e.g., prohibited behaviour) affect the IIRs.

Karatekas educated on injury prevention and supported by fitness coaches are more likely to practise injury prevention.

To determine the current perceptions and practices of top-level karate athletes concerning risk factors and injury prevention programme (IPP) implementation in training and competition. Out of 90 eligible countries (933 athletes) participating in the karate World Senior Championships (WSC) in Madrid 2018, 50 countries (55.6%) represented by 137 athletes (14.7%; 52 females and 85 males) responded to a structured questionnaire. Of the athletes responding, 45% reported that their national team did not conduct any measures to reduce injury risk (43% among females and 47% among males; p = 0.68). Kumite athletes (51%) were more likely to practise injury prevention compared to kata athletes (25%; p = 0.016). Of the respondents, 69%, 60%, 60% and 34% reported having no team doctor, fitness coach, massage therapist and physiotherapist, respectively. A greater proportion of athletes who had access to a fitness coach (part-time or full-time) engaged in injury prevention strategies (67% and 51%, respectively) than those who did not (35%; p = 0.031). Athletes who had received previous advice about injury prevention were more likely to practise injury prevention (58%) compared to the rest (21%; p < 0.001). The current study revealed that: i) almost half of the karatekas already benefited from an injury prevention programme, ii) injury prevention programmes were practised more frequently when there was a fitness coach among their coaching staff, iii) karatekas who had received education about injury prevention were more likely to practise injury prevention programmes.

Severe knee injuries among karate athletes ranking towards the Tokyo Olympic Games: a retrospective study.

BACKGROUND: Injury prevention strategies should be built upon data about the more frequent injuries in each specific sport. Therefore, this study aimed to describe the lifetime prevalence and characteristics of severe knee injuries among world-class karatekas. METHODS: A retrospective study based on a face-to-face survey was conducted. Participants were athletes who competed in World Karate Senior Championships in Madrid 2018, which was a tournament with the highest value to rank athletes to the Tokyo Olympic Games. A questionnaire was used to collect retrospective information on the prevalence and characteristics of severe knee injuries that occurred along elite karatekas sport careers. Odds Ratio (OR) were calculated to identify the association of sex and karate modality (kata / kumite) with severe knee injury risk. RESULTS: Out of the 293 athletes surveyed (23.4±4.0 years; 137 female), 71 (24.2%) had suffered a serious knee injury at some point of their careers, without a statistically significant difference between male and female athletes. There was no difference between the percentage of injuries that took place during training (54.9%) or during competition (45.1%) both in male and female athletes. Kumite athletes suffered more knee injuries during competition than training. The most common injury mechanism for both genders was a pivoting or dodging movement (36.4% in males and 39.5% in females). CONCLUSIONS: The information presented in this study about the prevalence and characteristics (mechanism, anatomical location, moment, time off) of the severe knee injuries in elite karatekas could be useful to design prevention programs to be implemented among karate athletes.

Gut Microbiota Diversity in Lean Athletes Is Associated with Positive Energy Balance.

INTRODUCTION: In contrast to obesity, little is known about the human lean phenotype associated with gut microbiota composition. OBJECTIVE: We aimed to investigate whether the bacterial composition of lean athletes with a positive energy balance differs from the equal-calorie food group. METHODS: Twenty-four male participants were included in this cross-sectional study: lean athletes with a positive energy balance (LA, n 12) and control group athletes (CTRLs, n 12). Nutritional data, resting and total energy expenditure, and body composition were determined. DNA was extracted from stool samples and subjected to 16S rRNA gene analysis. RESULTS: We found 7 differentially abundant bacterial taxa between the LA and CTRL groups. Of those, 5 were significantly less abundant and 2 were enriched in the LA group. The following categories significantly associated with the community structure were identified: body fat parameters, BMI, energy intake and expenditure, oxygen consumption, and respiratory exchange ratio. CONCLUSIONS: Although we are far from a detailed interpretation of lean human body maintenance, the primary findings of our study suggest that gut microbial composition may be a factor influencing the regulation of weight gain in lean athletes with a positive energy balance.

Epidemiology of injuries in Olympic-style karate competitions: systematic review and meta-analysis.

OBJECTIVE: To report the epidemiology of injuries in Olympic-style karate competitions. DESIGN: Systematic review and meta-analysis. Pooled estimates of injury incidence rates per 1000 athlete-exposures (IIRAE) and per 1000 min of exposure (IIRME) were obtained by fitting random-effects models. DATA SOURCES: MEDLINE, Embase, AMED, SPORTDiscus and AusportMed databases were searched from inception to 21 August 2019. ELIGIBILITY CRITERIA: Prospective cohort studies published in peer-reviewed journals and reporting injury data (ie, incidence, severity, location, type, mechanism or risk factors) among athletes participating in Olympic-style karate competition. RESULTS: Twenty-eight studies were included. The estimated IIRAE and IIRME were 88.3 (95%CI 66.6 to 117.2) and 39.2 (95%CI 30.6 to 50.2), respectively. The most commonly injured body region was the head and neck (median: 57.9%; range: 33.3% to 96.8%), while contusion (median: 68.3%; range: 54.9% to 95.1%) and laceration (median: 18.6%; range: 0.0% to 29.3%) were the most frequently reported types of injury. Despite inconsistency in classifying injury severity, included studies reported that most injuries were in the least severe category. There was no significant difference in IIRME between male and female karate athletes (rate ratio 1.09; 95%CI 0.88 to 1.36). CONCLUSION: Karate athletes sustain, on average, 1 injury every 11 exposures (bouts) or approximately 25 min of competition. The large majority of these injuries were minor or mild in severity.

Time-Loss Injuries in Karate: A Prospective Cohort Study of 4 Consecutive World Karate Championships.

BACKGROUND: Prospective studies on injuries in martial arts competitions are scarce, especially those involving time-loss injuries. The upsurge of karate athletes competing in top-level karate competitions warrants elucidation of the time-loss injury risk. PURPOSE: To determine the time-loss injury proportion and incidence rate, describe the injury pattern among elite senior karate athletes, and compare the risk of time-loss injuries in male versus female athletes and in individual (ie, weight categories) versus team competitions (free-weight category). STUDY DESIGN: Descriptive epidemiology study. METHODS: Data were collected at 4 consecutive World Karate Championships (2010, 2012, 2014, and 2016). Injury incidence rates were calculated per 1000 athlete-exposures (IIRAE) and per 1000 minutes of exposure (IIRME), with 95% CIs. Subgroups were compared by calculating their rate ratios with 95% CIs. RESULTS: A total of 506 injuries were recorded, of which 51 were time-loss injuries (10%). The overall time-loss injury rate was significantly lower for female versus male athletes and slightly lower for team versus individual competitions. Overall, 1.4% of all athletes sustained a time-loss injury, and the IIRAE and IIRME were 5.13 (95% CI, 3.82-6.74) and 1.98 (95% CI, 1.47-2.60), respectively. The most common type of time-loss injury was fracture (41%), followed by dislocation (20%) and concussion (12%). CONCLUSION: The time-loss injury incidence rate for top-level karate competitions found in this prospective study was relatively low. Comprehensive knowledge about the incidence of time-loss injuries during karate competitions represents an essential basis to develop effective strategies for injury prevention. Thus, the introduction of a uniform injury surveillance system in martial arts is of utmost importance.