BIORUN – Biomechanics of running-related injuries

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Funding

The study was funded by the Department of Rehabilitation Medicine of the Amsterdam UMC

Background

Running is one of the most popular sports globally. Many runners get injured; among these, Achilles tendinopathy (AT) is one of the most common running-related injuries. The mechanisms underlying the development and recovery of AT in runners are poorly understood. Understanding these mechanisms can help improve the early identification of runners at risk of AT and result in more effective treatment programs in order to prevent and manage the injury.

Few studies have focused on the biomechanical factors involved in AT. Those studies had small sample sizes and mainly focused on running kinematics. Kinematics and inverse dynamics are often used to measure the load on the Achilles tendon. With emerging techniques like dynamic ultrasound, we can now quantify the mechanical behaviour (i.e. load, stress and strain) of the Achilles tendon during running. This allows for assessing the effect of neuromuscular control, running kinematics, variability and more on the intertendinous load on the Achilles tendon.

Objectives

This project aims to gain insight into the biomechanical factors that play a role in the development and recovery of Achilles tendinopathy in runners. Specifically, we compare the Achilles tendon mechanical behaviour (i.e. strain, stress, stiffness, Young’s modulus) between runners with Achilles tendinopathy and injury-free runners. For that, we combine 3D running analyses, including kinematics and kinetics, with dynamic ultrasound of the muscle-tendon junction of the gastrocnemius medialis during running. Moreover, since we follow the injured runners in their recovery from AT, we can gain insight into changes in running biomechanics and tendon mechanical behaviour during or after recovery.

Prevalence and incidence of health problems in Brazilian para athletes and muscle function and joint mobility characterisation

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Team

  • Juliana Melo Ocarino

  • Andressa Silva

  • Renan Alves Resende

Project partners

  • Universidade Federal de Minas Gerais, Brazil.

  • Centro de Referência Paralímpico Brasileiro, CTE-UFMG, Brazil.

  • Comitê Paralímpico Brasileiro, Brazil.

Funding

The study was funded by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)—09/2022-, Fundação de Amparo à Pesquisa do Estado de Minas Gerais (FAPEMIG)—CDS - APQ-01017-17, Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brasil (CAPES)—Finance Code 001.

Background

Most of the studies related to the health problems epidemiology in para-athletes investigated the prevalence of injuries and illnesses during competitions, which might not detect most gradual onset injuries or less severe illnesses. The profile and occurrence rates of health problems vary between Paralympic sports modalities. For example, para powerlifting and athletics were among the ten modalities with the highest injury incidence rates, while para swimming had the lowest rates during the Rio 2016 Summer Paralympic Games. On the other hand, para-swimming had the greatest illness incidence rate. The incidence and severity of injuries and illnesses in para-athletes are higher than in athletes without impairment, which also results in a long time-loss since para-athletes have unique medical conditions related to the disability itself. Thus, the surveillance of health problems in a longitudinal follow-up study and also the characterisation of body functions and structural aspects, such as muscle function and joint mobility, may contribute to the proposal of treatment and prevention strategies in future studies.

Objectives

The project aims to investigate the prevalence, incidence and their characterisation of health problems in para-athletes. The project is organized in three phases. In a first step, a systematic review of the literature on prevalence, incidence and the profile of musculoskeletal injuries in para-athletes was conducted. The second step aimed to describe the prevalence, incidence, and severity of health problems and their characterisation in para-athletes from the modalities of para-athletics, para powerlifting and para-swimming of the Brazilian Paralympic Reference Center during a sports season. We also aim to compare the prevalence of health problems between the three modalities. In a third step, we will describe the muscle function and joint mobility of these para-athletes and also investigate how the assessment is performed by clinicians and their practical experiences in the dichotomy of an individualized and group approach with Paralympic athletes, considering the diversity of health conditions, the classification category, and the sports modality's characteristics and demands.

Understanding the Managers’ perceptions of the Sports Organizations in monitoring the health and performance departments

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Background

Sports organizations have transformed into highly structured organizations to serve elite athletes. Health & performance teams in elite sports have become essential to increase the quantity and quality offered in sports science and health care.  These teams have an important role in the athletes’ performances but don’t have a way to measure such teams' impact on sports performance and health. The problem is the lack of management tools to measure the results and align these results with the strategic planning of the sports organization. That is why it is necessary to understand more about the context of the health and performance department in sports organizations. This is important to develop strategies that fit the context of managing the health and performance teams. 

Objectives

This project explores the contemporary context of health and performance management in sports organizations. Based on the narratives of the management leaders, this project aims to explore the role of the medical department in the bigger organization. The main objective will be to understand the Sports organizations’ managers (high-level managers and H&P department managers) about the management of the Health and Performance departments and the importance of incorporating management tools into strategic performance. 

Diagnosis of longstanding groin pain in athletes

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Funding

The project is funded by Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.

Team

  • Hans Tol,

  • Adam Weir,

  • Andreas Serner,

  • Zarko Vuckovic

Project Partners

Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar

Background

Diagnosing longstanding groin pain in athletes is challenging. Within the groin region, numerous anatomical structures are located in close proximity, and no gold standard exists for diagnosis. Complexity is added by numerous diagnostic terms being used to describe similar conditions. The 2015 Doha agreement meeting addressed this terminology problem by proposing a clinical classification system based on history and clinical examination findings. It is unknown if clinicians have adopted the classification system in clinical practice, and scientific support for specific clinical examination tests is limited.

Objectives

We aim to evaluate if the Doha agreement meeting classification system has been adopted by clinicians who regularly assess and treat athletes with groin pain. Secondly, we want to evaluate the inter-examiner reliability of the classification system and specific clinical examination tests that are used to classify athletes with groin pain.

Durability By Design

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Funding

Royal Netherlands Marechaussee.

Team

  • Evert Verhagen

  • Paul Kuijer

  • Paul Schermers

  • Herman IJzerman

  • Pablo Stegerhoek

Project Partners

Royal Netherlands Marechaussee

Background

The Royal Netherlands Marechaussee monitors the security of the Netherlands and the Caribbean part of the Kingdom of the Netherlands. The Marechaussee is deployed worldwide in places of strategic importance. From royal palaces to the outer borders of Europe. From airports in the Netherlands and the Caribbean to war and crisis areas worldwide. Therefore, the work of Royal Netherlands Marechaussee personnel is very diverse in nature. From very monotonous, long-lasting to sudden, very demanding situations. This type of work requires a lot from the personnel, both physical and mental. Wearing and carrying heavy equipment for entire shifts and dealing with highly unpredictable and stressful situations are just some of the challenges. This research project aims to develop, implement, and evaluate effective interventions to improve the sustainable work ability of the personnel. 

Objectives

The project aims to develop practical and implementable interventions that help Royal Netherlands Marechaussee deal with their demanding workloads and thereby increase their durability.

1stMYMAn - Cardiac effects of first-time marathon training, running, and recovery in middle-aged men

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Funding

This study is funded by the Indonesia Endowment Fund for Education (grant number 201803220412678).

Team

Background

Regular participation in physical activity is associated with numerous health benefits. However, it is unclear what the upper limits of healthy physical exercise are and whether exceeding a certain amount of exercise may have detrimental effects on the cardiovascular system or general health.

Marathon running is a classic example of a popular sports activity. In the last three decades, the number of recreational marathon runners has markedly increased, with middle-aged men constituting the largest group. Importantly, this is also the age group where the atherosclerotic cardiovascular disease becomes clinically apparent.

Several phenomena that point to potentially detrimental cardiac effects of running have been reported, such as elevated biomarkers for myocardial injury (troponin T and I, NT-proBNP), and reductions in left- and right ventricular systolic and diastolic function directly after marathon completion. Most studies on cardiac effects of marathon running are cross-sectional or retrospective, do not include state-of-the-art imaging investigations such as cardiovascular magnetic resonance imaging (MRI) coupled with functional assessments and do not include recovery follow-up. Furthermore, COVID-19 in athletes is associated with myocardial abnormalities, such as inflammation and fibrosis, but no studies have reported the effects of marathon running after recovery from COVID-19.

Objectives

Our exploratory prospective cohort study in middle-aged men who train for and participate in their first marathon, including a subset of participants who recovered from COVID-19, aims to comprehensively investigate potentially detrimental cardiac changes during marathon training and participation.

The primary outcomes are cardiac morphological changes from before initiating marathon training up to 1 month after completion of the marathon: 1) 4 months before the marathon, 2) pre-marathon (2 weeks before the marathon), 3) post-marathon (<24 hours post-marathon), and 4) recovery (4 weeks after the marathon). 

Secondary outcomes include changes in other cardiac and non-cardiac parameters: 1) quantitative parameter mapping of the myocardium with MRI, 2) cardiac morphology and function with echocardiography, 3) VO2max, 4) electrocardiogram (ECG) characteristics, and 5) circulating cardiac biomarkers: high sensitivity troponin-T (hs-TnT), high sensitivity troponin-I (hs-TnI), and N-terminal pro-B-type natriuretic peptide (NT-proBNP).

DEFENCE: Determination and Evaluation of the Frequency and Effects of myocardial damage iN patients with a SARS-CoV-2 infEction [DEFENCE]

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Featured
Harald Jorstad
Harald Jorstad

Funding

The Netherlands Organization for Health Research and Development (ZonMw), grant number 10430102110006 DEFENCE

Team

  • F.W. Asselbergs         https://orcid.org/0000-0002-1692-8669

  • H.T. Jorstad                https://orcid.org/0000-0003-3617-3256

  • J.J.N. Daems              https://orcid.org/0000-0002-5589-2806

Project Partners

This project is a research consortium consisting of multiple multi-centre studies

COMMIT is an ongoing, actively recruiting subcohort of the ELITE lifetime cohort, which is composed of >300 competitive elite athletes with a CMR scan prior to the COVID-19 pandemic. In individuals with a SARS-CoV-2 infection, a repeated scan is made. To date >100 CMR’s in athletes post-COVID have been performed. With this cohort, the cardiac impact of SARS-CoV-2 in healthy individuals who engage in extreme levels of physical activity, a documented second hit in general cases of myocarditis, is prospectively assessed.

COVID@Heart is an initiative established to determine the course of COVID-19 in patients that are treated by their general physician and recover from the SARS-CoV-2 infection at home. The study contains 100 subjects derived from the Nijmegen Exercise Study (NES) and Rotterdam Study (ERGO), which both are population-based cohorts that have collected extensive data before and during the first and subsequent waves of SARS-CoV-2 infections in the Netherlands.

CAPACITY-COVID consortium has established two studies: CAPACITY 1 (www.capacity-covid.eu) and CAPACITY 2. CAPACITY 1 is a retrospective cohort study/patient registry in which clinical data generated during routine clinical care has been collected from >5000 patients hospitalized in the Netherlands during the first wave of the pandemic. This number comprises ~40% of all hospitalized patients during the first wave. The ISARIC core case report form was used as a basis within CAPACITY 1 and extended with additional data collection items to capture in-depth information on the cardiovascular history and medication use, cardiac additional diagnostic tests (ECG, echocardiography, MRI) and cardiovascular complications. The manuscript of the main findings is currently under review but has been published on a preprint server.14 CAPACITY 2 is a prospective cohort study within the hospital setting that aims to harmonize clinical care pathways across sites with standard diagnostic testing for the early detection of myocardial damage to investigate cardiac complications in both the short and long-term.

COPP is a nationwide multicentre hospital-based prospective cohort study on paediatric COVID-19, including COVID-19-associated multi-system inflammatory syndrome (MIS-C) associated with severe cardiac dysfunction, myocarditis and coronary artery dilatation. In total, 125 MIS-C children are included in this registry. Near real-time automated results and analysis of MIS-C, including medical history, laboratory data, length of ICU/hospital stay, and therapy, can be found online (www.covidkids.nl). Serial echocardiographic data, ECGs, troponin and NT-proBNP levels are available in the acute phase in all MIS-C patients.

POPCORN consortium (EurQol Foundation based) collected data in the population of 8 countries (n=24.000), including the Netherlands (first wave). Subsequent waves (from April 2021) will be an individual repeat and include a major part of the CAPACITY patient outcome survey, where data will be available for reference and maximise the diagnostic value of patient outcome data.

Lifelines – The lifelines study started in 2006. Lifelines is a national long-running cohort study which collects health-related data from 167.000 participants from the North of the Netherlands in 2006. They have collected data regarding cardiovascular risk factors and utilize biobanking. They follow a large sample of long-COVID-19 patients and aim to make 100 CMR scans to investigate the possible correlation between cardiovascular abnormalities and symptoms post-COVID-19.

Background

Cardiovascular abnormalities in the context of COVID-19 are currently being investigated worldwide. Such abnormalities range from cardiac biomarker increases to increased rates of cardiovascular events and death from various causes. Myocardial involvement and myocarditis are of particular import for individuals who engage in sports and exercise, as physical activity can trigger life-threatening arrhythmias and induce chronic myocardial inflammatory states.

The DEFENCE consortium aims to collect extensive data across a range of individuals who have been diagnosed with COVID-19: from the very young to the elderly, from sedentary to elite athletes, and from asymptomatic to severely ill.

Objectives

  • What is the frequency of myocardial damage in patients that have been infected with SARS-CoV-2?

  • How does the frequency, extent and pattern of myocardial damage relate to COVID-19 disease severity, symptomatology and patient characteristics?

  • What are the consequences of myocardial damage in the short- (<6 months) and long-term (up to 2 years)?

ALPINE skiing project: Application of Learnings to Prevent Injuries in National teams from Elite alpine skiing contexts

Project Partners

Balgrist University Hospital, Zurich, Switzerland.

International Ski Federation (FIS)

Funding

The study is funded PhD Grant from the Andorran Government

Background

The International Ski Federation (FIS) Alpine Ski World Cup is the primary international circuit for alpine skiing competitions. Alpine skiers compete in a performance-driven environment where the aim is to increase sports performance. Such a context is well known for its high risk of injury, directly impacting the athlete’s ability to perform. In 2006, the FIS established an injury surveillance system to provide data on injury trends in international elite skiing and snowboarding to reduce injury risk. Injury rates are still high regardless of all the efforts and changes made throughout the last decade to improve alpine skiers’ safety.

While current literature has only focused on single factors, other components as contextual factors in preventive strategies in elite alpine skiing have not been addressed yet. Thus, the literature regarding injury epidemiology in elite alpine skiing faces many challenges. On the one hand, it has overlooked the wide range of factors influencing injury and involving injury prevention in such context. On the other hand, it is still hampered by small sample sizes, methodological issues and the constant evolution of injury factors with equipment and competitive rules regulations. Consequently, there is a lack of acknowledgement and understanding of the elite alpine skiing context and how it can influence and lead to preventive behaviours.

By using different methodological approaches such as qualitative methods to investigate elite athletes’ and stakeholders’ perspectives, this project can provide greater knowledge and better insight into injury prevention in elite alpine skiing by helping to identify potentially modifiable factors which could improve injury prevention in practice and increasing the level of success on injury prevention programs.

Objectives
The proposed project aims to develop an effective injury prevention program for elite alpine skiers founded on the narrative of elite alpine skiers, coaches, managers, health care providers, official and race organisers and topic-specific experts concerning their perceptions and perspectives of injury and illness prevention.

Based on this narrative, this project aims to explore and understand the practicalities of sports-related injury and illness prevention based on beliefs, attitudes and knowledge from key stakeholders in national teams from different countries.

Thereby, understanding the context and the injury risk factors within elite alpine skiing will set the foundations for further designing and implementing specific injury prevention strategies targeting elite alpine skiing, assessing their effectiveness in their respective settings.

This project will apply a mixed-methods approach. To explore the research questions, both qualitative and quantitative methods will be employed.

The development of a university-based injury-monitoring system for prioritized university sports codes in South Africa

Supervisor

Prof L.L Leach

Co-supervisors

Dr. B.S Andrews, Prof. Dr. R Meeusen, Prof E. Verhagen 

Project Partners

This project is a study coordinated and supervised in The Department of Sport, Recreation &Exercise Science at The University of the Western Cape (UWC), South Africa)  

VU University Medical Center Amsterdam, The Netherlands.

Vrije Universiteit, Brussels

Funding

The study is partially funded by an HDI grant through High-Performance Sport at The University of the Western Cape (UWC), South Africa).

Background

Varsity sports is undoubtedly the most commercialized and popular university sports tournament in South Africa, aligning and contributing to the national sports agenda. In recent years, there has been a continuous increase in athlete participation, investments in student-athletes and team support, and improvement in sport science support services in Varsity Sports. These complement the International Olympic Committee and international sports organizations’ continuous recognition and support on injury surveillance and epidemiological research on sports injury in sport in the effort to protect athlete's health.  Despite this, information on sports injuries during the Varsity Sports tournaments is limited to only one retrospective study. Similarly, Varsity Sports has no mandatory injury monitoring system.  This study aims to develop a university-based injury-monitoring system for prioritized sporting codes competing in Varsity Sports in South Africa. The Translating Research into Injury Prevention Practice (TRIPP) framework by (Finch, 2006a). will be utilized as the theoretical framework in this study. 

The study will use a mixed-methods sequential explanatory study design implemented in four phases. The four sequential phases will include (i) a systematic review of the best available evidence on the methods for recording and reporting of sports injuries in student-athletes; (ii) a quantitative phase to assess the current state of injury-monitoring within universities in Varsity Sports through a cross-sectional online survey design; (iii) a qualitative phase to explore the end users' perceptions and experiences on injury-monitoring systems through semi-structured interviews and focus groups discussions; and (iv) a Delphi study to develop the university-based injury monitoring system. 

Study aim

The purpose of this study will be to develop a comprehensive university-based injury monitoring system for prioritized university sports codes in South Africa. The objectives of the study will be the following:

•       To identify the best available evidence on the methods for recording and reporting sports injuries in student-athletes at universities by conducting a systematic review. 

•       To determine how information on injury data is collected, recorded, and reported for prioritized sport codes at universities in South Africa.

•       To identify the perceived barriers and facilitators in reporting injuries in prioritized sport codes at universities in South Africa. 

•       To assess the current injury-monitoring systems for prioritized sport codes at universities in South Africa.

•       To explore how information on injury data is collected, recorded, and reported for prioritized sport codes at universities in South Africa.

•       To explore the barriers and facilitators influencing the development of a university-based injury-monitoring system for prioritized sports codes competing within varsity sports. 

•       To develop a university-based injury-monitoring system for prioritized sport codes at universities in South Africa using the Delphi study.

A Biokinetics model for the prevention of sports injuries: Lessons learned from rugby and long-distance running

Project Partners

This project is for a PhD in Health Science (Biokinetics) at the University of Johannesburg (SA). Supervised by Prof. Evert Verhagen at the VU University of Amsterdam, The Netherlands and Prof. Leon Lategan at the UJ.

Funding

None

Background

There are numerous studies that have been done on the prevention of sports injuries, but they always focus on one sporting code or type of sport, with little integration between different sports. The purpose of this study is to determine if there is an overlap in the risk factors between rugby (team, contact sport) and long-distance running (individual, non-contact sport). By identifying the potential overlap, one would develop a model which can be applied in all the different types of sport and settings. Although it is labelled as a Biokinetics model, it will be a model that can be used in various professions related to sport, wellness and orthopaedic. Biokinetics is a South African term, but appeals to physical therapy and exercise science in most other countries. 

Injury prevention is a very popular topic, but numerous approaches have failed, due to the poor compliance rate. This is something that has been noted so far in this project and with the development of this model, hoping to overcome this barrier, by ensuring that the model is specific in its goals and success. Another possible outcome for this study is to develop a model that would be sustainable for the profession and industry and to simplify matters when it comes to injury prevention. 

Study aim

The aim of the study is to establish a Biokinetic model for the prevention of sports injuries in rugby players and long-distance runners. These two sports fit into the different ends of the sporting continuum, with individual sports (long-distance running) on one end and team sports (rugby) on the other end. The model will be suited for the team, contact sports as well as individual, endurance sports. In order to reach this aim, the project is divided into different phases. A scoping review was done during the first phase to determine the prevalence of injuries in both sports, the risk factors for both sports and the current injury prevention strategies being utilized. Secondly, the Delphi process will be conducted with a panel of experts in the field of rugby, running and specialist Biokineticists, who focus on sports injuries, as well as athletic trainers or sport and conditioning specialists. Concurrently, retrospective injury surveillance will be conducted through an online injury recall questionnaire from the previous 12 months. After all the rounds of the Delphi has been completed, a draft of the model will be designed and then the last rounds of the Delphi process will be used to evaluate and critique the model. After the final model has been developed, it will be implemented at various running and rugby clubs for a 12-month period. Thereafter, another retrospective injury recall questionnaire will be distributed to the same clubs and comparative analysis will be done to determine if the implementation of the model was successful. The final step will be focus groups, to assess the effect and success of the model, to critique it if needed and to make the final changes to provide the best possible model for sports injury prevention. 

Golf Related injury Prevention Program (GRIPP)

Project Partners

  • Department of Orthopaedics and Sports Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands

  • Department of Orthopaedic Surgery, Amphia Hospital, Breda, The Netherlands.

Funding

  • ZonMW ‘Sportinnovator Voucher’

Background

Injury prevention programs have been shown to be effective to prevent injuries in different sports. However, there is no injury prevention program available for golfers. Therefore, the Golf Related Injury Prevention Program (GRIPP) intervention is developed following the Knowledge Transfer Schema (KTS). Following the KTS we organized 3 multidisciplinary Knowledge Transfer Groups to translate evidence into practice. The efficacy of the conducted program to prevent golf-related injuries will be studied in a randomized controlled trial. 

Alongside the evaluation of its efficacy with the RCT, there is also a need to describe how the program is delivered on the golf course. Otherwise, the effect of the intervention and implementation can be over or underestimated. We developed our program for the RCT with a protocol:performance-as-imagine. But the question is: How is the program performed on the golf course:performance-as-done. Is the program performed as imagined or is something else actually happening? What is the behaviour of the golfer on the golf course with the program, what is the culture, what are contextual factors and how are the perceptions and beliefs of the golfer? Therefore, qualitative exploratory research can help to visualize the implementation and compare the performance-as-imagined and the performance-as-done on the golf course.

Study aim

The aim of this qualitative exploratory study is to explore the perceptions and experiences of golfers during their performance of the Golf Related Injury Prevention Program (GRIPP) on the golf course.

Effective Injury Prevention - A Living Systematic Review

BACKGROUND

Leading a physically active lifestyle and participating in sport are associated with many health benefits spanning physical, cognitive, and psychological/emotional domains. However, many features of well-established sports (e.g., high-speed running, landing from a jump, quickly changing direction, tackling) expose athletes to a risk of sustaining sudden-onset injuries. Because acute sports injuries can cause short-to-long-term physical impairment and functional disability, and lead to substantial healthcare and economic costs, identifying and implementing effective intervention strategies that protect athlete health and ensure safe participation in sports is imperative.

An increasingly large body of evidence on sports injury prevention strategies has emerged over the past two decades.[69,70]Such proliferation of injury prevention research has resulted in a swell of evidence syntheses to systematically appraise, synthesise, and interpret both pre-existing and newly emerging literature. By systematically mapping the quality of evidence, quantifying the preventive effect of intervention strategies, and identifying gaps for future research, rigorously performed evidence syntheses possess substantial value to inform clinical and preventive sports injury practice.

STUDY AIM

The purpose of this systematic review and meta-analysis is to

1.     perform a baseline systematic review that:

  • categorises sudden-onset sports injury prevention strategies by the (i) timing of its effect relative to when the injury event/mechanism occurs (i.e., pre-event, event, post-event) and (ii) target of its effect (i.e., athlete, kinetic energy, environment);

  • evaluates the pooled efficacy (i.e., interventions tested under highly controlled conditions) and effectiveness (i.e., intervention tested under pragmatic, ‘real-world’ conditions) of sports injury prevention strategies, and;

  • identifies priority areas for future design and implementation of sudden-onset sports injury prevention strategies.

2.     transition to a living systematic review that:

  • continually monitors emerging evidence on sports injury prevention strategies, and; 

  • incorporates relevant evidence on sports injury prevention strategies into review conclusions at regular fixed time intervals.

The health of female and male professional footballers

PROJECT PARTNER

Christa Janse van Rensburg, Section Sports Medicine, University of Pretoria

 

FUNDING

Department of Orthopedic Surgery, Amsterdam UMC

Drake Foundation

Mehiläinen NEO Hospital Turku 

Sports Hospital Mehiläinen Helsinki 

Nea International bv. 

 

BACKGROUND

During their careers, professional footballers are likely to experience problems with their mental, neurocognitive and musculoskeletal health. Severe injuries and related surgeries are associated with cartilage degeneration in the hip and knee joints, and may cause early onset of osteoarthritis (OA) in the long term. Severe injuries and related surgery are also recognized as one of numerous stressors that may trigger mental health symptoms in professional footballers. When it comes to neurocognition, insight into relevant neurocognitive functions (e.g., attention, memory) among professional footballers remains limited. Amongst female professional footballers, data about gynaecological health is lacking. In order to address this knowledge gap, FIFPRO (Football Players Worldwide) and the Amsterdam UMC (University Medical Centers) have implemented a health surveillance programme in professional football aimed at gathering epidemiological evidence about the onset and course of mental, musculoskeletal, neurocognitive, cardiovascular and gynaecological (if applicable) health conditions in professional footballers during their pre- and post-retirement years.

OBJECTIVES

The overall aim of these two PhD research projects is twofold, namely (i) to present epidemiological evidence about the health (i.e., gynaecological, mental, musculoskeletal, neurocognitive) of male and female professional footballers and (ii) to explore the recovery strategies of male and female professional footballers and capture their potential needs towards additional measures.

No time to waste: moving towards a necessary health support system for retired national level rugby players

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PROJECT PARTNERS

Section Sports Medicine, University of Pretoria (Prof. Christa Janse van Rensburg)

South African Rugby Legends Association (SARLA)

South African Rugby Union (SARU)

 

FUNDING

Department of Orthopedic Surgery, Amsterdam UMC

World Rugby

 

BACKGROUND

Transitioning out of professional sport is not easy and during that process, athletes might face several challenges such as adjusting to a new life and lifestyle, being suddenly ‘like everyone else’ or missing the sport atmosphere and competition. Retired professional athletes might also face health conditions affecting various domains (e.g., musculoskeletal, psychological, cardiovascular, neurocognitive). 

As high-speed collision sport, rugby union (hereinafter ‘rugby’) has been associated with post-career health risks, especially osteoarthritis, mental health symptoms and neurocognitive deficits. Despite these health conditions likely to occur after retiring from professional rugby, support measures remain lacking. Accordingly, an After Rugby Career Consultation was developed as a transitioning health examination to empower the sustainable health and quality of life of retired professional rugby players. Being implemented globally in professional football, such an approach is likely to be of added value in professional rugby.  

 

OBJECTIVES

The overall aim of this PhD research project is to evaluate the feasibility of the After Rugby Career Consultation in South African professional rugby. Specifically, (i) epidemiological evidence regarding the occurrence of health conditions (e.g., musculoskeletal, cardiovascular, neurocognitive, psychological) among retired professional rugby players is gathered, (ii) the feasibility of the After Rugby Career Consultation among male South African retired professional rugby players is evaluated, and (iii) the view and experience of South African retired male professional rugby players and physicians about the After Rugby Career Consultation is captured and potential additional supportive strategies explored.

Towards the medical care and support of retired male and female professional footballers

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 PROJECT PARTNERS

FIFPRO (Football Players Worldwide)

FIFA (Fédération Internationale de Football Association)

FUNDING

FIFPRO (Football Players Worldwide)

FIFA (Fédération Internationale de Football Association)

 

BACKGROUND

Transitioning out of professional football is not easy and during that process, players might face several challenges such as adjusting to a new life and lifestyle, being suddenly ‘like everyone else’ or missing the sport atmosphere and competition. Retired professional footballers might also face health conditions affecting various domains (e.g., musculoskeletal, psychological, cardiovascular, neurocognitive). Despite the health conditions likely to occur after retiring from professional football, support measures remain lacking. Accordingly, FIFPRO (Football Players Worldwide) and the Amsterdam University Medical Centers developed an After Career Consultation as an exit health examination to empower the sustainable health and quality of life of retired male professional footballers. A pilot-study conducted in the Netherlands revealed that retired male professional footballers were positive about the relevancy, suitability, satisfaction and added value of the After Career Consultation.

 

OBJECTIVES

The overall aim of this PhD research project is to work towards the medical care and support of retired male and female professional footballers. Specifically, (i) the health (e.g., mental, musculoskeletal) of retired male and female professional footballers is assessed, (ii) the After Career Consultation is implemented among male retired professional footballers, (iii) the view, experience and needs of retired male and female professional footballers and their physicians is explored, and (iv) a female-specific After Career Consultation is developed. 

What is the secret behind the successful Nordic hamstring prevention programme?

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PROJECT PARTNERS

  • VU Amsterdam: The Faculty of Behavioural and Human Movement Sciences

  • Koninklijke Nederlandse Voetbalbond (KNVB)

FUNDING

  • ZonMW ‘Sportinnovator Voucher’

BACKGROUND

Executing Nordic curls for a period of three months, reduces the amount of hamstring injuries by 50%. Although convincing evidence by a number of RCT’s, the actual mechanism behind the intervention is still unrevealed.

Is it possible that an innovative method for measuring electromyographic data, can map individual characteristics in neurophysiological recruitment of the hamstring muscles and define the secret behind the Nordic hamstring curl?’

OBJECTIVES

The objective is to describe neurophysiological characteristics while executing a Nordic hamstring curl, and the effect of a three-month Nordic hamstring injury prevention programme.

Fixable Primary and Large Secondary Osteochondral Defects of the Talus: Evidence-Based Therapy

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PROJECT PARTNERS

  • None

FUNDING

  • Department of Orthopedic Surgery, Amsterdam UMC

  • Foundation Friends of ACES

BACKGROUND

An osteochondral lesion in the ankle can occur after a trauma such as an ankle sprain or an ankle fracture. It seems that there are different types of defects from a morphological perspective when considering the defect on the CT scan or intra-operatively. Large fixable lesions can be treated with a fixation techniques, while non-fixable large lesions probably need to undergo some form of osteo(chondral) transplantation. From the present existing research it is evident that there is a scarcity of evidence on the personalized efficacy of these treatment options in an evidence-based manner.

OBJECTIVES

The objective of this thesis is therefore to work towards an evidence-based therapy for patients with osteochondral lesions of the ankle through determining the efficacy of fixation and osteochondral transplantation in an evidence-based manner so it will become evident which therapy works for which individual patient.

Treatment of Osteochondral Defects in the Ankle: Working Towards an Evidence-Based Personalized Approach

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PROJECT PARTNERS

  • None

FUNDING

  • Department of Orthopedic Surgery, Amsterdam UMC

  • Foundation Friends of ACES

BACKGROUND

Ankle sprains and fractures are highly prevalent and result in damage to the cartilage and bone in over 70% of patients. Aforementioned damage is also referred to as an osteochondral lesion (OCL). Patients suffering from an OCL of the ankle will develop osteo-arthritis over time. and during the different stages of the disease are known to suffer from impairment of the mental and physical quality of life, thereby involving a significant societal health- and economic burden. Presently there is a clear scarcity on the evidence of the treatment of these painful OCLs in the different stages of the disease, consequently as no superior treatment exists.

OBJECTIVES

The core aim of the PhD-Thesis from Dr. Jari Dahmen, within the Amsterdam Ankle Cartilage Team, is therefore to identify an evidence-based personalized treatment of OCLs in the ankle by means of cadaveric biomechanical and radiological research, a prognostic systematic review, two RCTs and an international prospective registry with a consequent development of a comprehensive web-based clinical decision support for the national and international community. 

 Another focus of the research team is to investigate the rare but impactful OCLs of the distal tibia, led by MD/PhD student Quinten Rikken. These lesions prove difficult to treat and lack evidence, thus warranting further research. The aim is to strengthen the evidence-based personalized-treatment of these lesions by providing insights in clinical, radiological, and sport outcomes of these patients as well as to explore novel treatment techniques and applications. 

 The goal of the research carried out by the Amsterdam Ankle Cartilage team is to provide answers to important clinical questions so that in the near future the treating physician and the patient with the OCL together can collectively decide what the best treatment option would be in order to facilitate an active and pain-free life.

Proximal Hamstring Avulsions: Towards an Individualized Treatment Algorithm

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PROJECT PARTNERS

  • Amager-Hvidovre Hospital, IOC Research Center, Copenhagen, Denmark

  • University college hospital, IOC Research Center, London, United Kingdom

  • Aspetar Orthopedic and Sports Medicine Hospital, IOC Research Center, Doha, Qatar

FUNDING

  • None

BACKGROUND

Full-thickness hamstring tendon injuries have a large impact on sports participation and activities of daily living. These injuries have the ability to end a professional sports career. Full-thickness hamstring tendon injuries are relatively rare. There is a lack of evidence to advise if and when operative or non-operative treatment is indicated. These and other pressing clinical questions remain unanswered to today’s date.

OBJECTIVES

With our prospective study we gather clinical and imaging data on full-thickness hamstring tendon injuries on international base. Due to the international research collaboration we create a large database, which will provide us the ability to study different aspects of these injuries. By mapping these different aspects, we expect to be able to create an evidence-based individualized treatment algorithm for full-thickness hamstring tendon injuries in the future.

Novel Perspectives on Aetiology and Treatment of Osteochondral Lesions of the Talus

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PROJECT PARTNERS

  • None

FUNDING

  • Department of Orthopedic Surgery, Amsterdam UMC

  • Foundation Friends of ACES

BACKGROUND

Osteochondral defects (OCD) can occur after ankle sprains and ankle fractures. Due to the high impact of the tibial plafond on the talus, a cartilage crack could cause this defects. Last years, a lot of surgical treatment strategies are developed. After the surgical procedure, a certain period of rehabilitation is needed. This rehabilitation period could play a prominent role in the end result of the treatment. To this date, evidence based guidelines are not available for this specific injury.

Despite the developing treatment strategies, it’s seen that patients will suffer from end-stage osteo-arthritis in the long term, which brought up the hypothesis that osteochondral lesions may be a sign of early osteo-arthritis in the ankle joint.

OBJECTIVES

This PhD will focus on these two gaps in the literature. The first part will focus on the current used rehabilitation guidelines. An international survey and a review of the literature will be conducted, and an evidence based protocol will be developed.

The second part of this PhD will focus on the etiology of OCDs. More specific, signs of early osteoarthritis of the ankle will be studied in patients who have an OCD of their talus.