Projects

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)?

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.

Recurrence risk in shoulder instability

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PROJECT PARTNERS

  • OLVG, Amsterdam, the Netherlands

  • Amsterdam Shoulder and Elbow Center of Expertise (ASECE), Amsterdam, the Netherlands

  • Faculty of Behavioural and Movement Sciences, VU, Amsterdam, the Netherlands

FUNDING

  • AMC MD/PhD Scholarship: The AMC Medical School and Graduate School for Medical Sciences offer a grand to outstanding and scientifically promising students to participate in the MD-PhD program. The program combines the medical Master’s degree program with PhD research.

BACKGROUND

With 4000 new anterior shoulder dislocations annually in the Netherlands, it is the most dislocated joint. The trauma occurs mainly in young individuals and up to 60% of patients later experience a dislocation again (re-dislocation), which has a negative impact on quality of life. Determining risk of a re-dislocation is a difficult task, as there are a lot of factors that contribute to the stability of the shoulder. For example, glenoid bone loss, a Hill-Sachs lesion, neuromusculair control and muscle strength are factors that play an important role in stabilizing the shoulder. Currently, glenoid bone loss is used as a parameter to predict recurrence risk. However, this is not the only factor that determines this risk and how do you measure something that is not there? Advances in technology create the opportunity to analyze (dynamic) 3D-models of humerus and scapula. By analyzing the interaction between these bony structures, this project looks for parameters that can predict recurrence risk more accurately by taking more of the factors that determine stability into account.

OBJECTIVES

The main objective of this project is to improve our ability to estimate risk of a re-dislocation. This goal is achieved through multiple objectives:

1.     Identify and critically evaluate currently available methods and risk factors that are used to determine re-dislocation risk

2.     Determine if new factors can be identified through 3D analysis of the bony structures' interactions.

3.     Determine which patient-reported and clinical outcomes should be used in shoulder instability research. These outcomes will facilitate standardized research and setting up a prospective cohort.

Further Information

More can be found at http://www.shoulderelbowcenter.com/

Outcome of acute ankle ligament injuries with stable syndesmosis involvement in athletes

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PROJECT PARTNERS

  • Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar

FUNDING

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

BACKGROUND

Acute ankle sprains are one of the most common injuries in sports. Historically, ankle sprains were considered to primarily affect the lateral ankle ligaments. With increased understanding of the injury mechanism, we now know that other structures might be affected concomitantly (e.g. syndesmosis; cartilage). While many studies have investigated the diagnosis and outcome of acute lateral ligament injuries, few studies have evaluated the outcome of these concomitant injuries.

OBJECTIVES

The aim of the study is to evaluate the outcome of acute ligamentous ankle injuries in athletes. First, the diagnostic value of various diagnostic strategies for ligamentous ankle injuries will be evaluated. Using MR imaging as the reference standard, physical examination, clinical tests and (dynamic-) ultrasound in the diagnosis of ligamentous ankle injuries will be investigated. 

To determine the outcome of acute ligamentous ankle injuries, time to return to play and functional outcome questionnaires will be administered 6 weeks, 6 months and 12 months after the injury.

Impact of Continuing Medical Education on Clinical Practice in a Multidisciplinary Sports Medicine Hospital

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PROJECT PARTNERS

  • Aspetar orthopaedic and sports medicine hospital

FUNDING

  • None

 BACKGROUND

In recent years, continuing medical education has gained significant attention in Qatar due to the implementation of the mandatory CME/CPD participation policy by the Qatar Council for Healthcare Practitioners (QCHP). Since the implementation, Aspetar has delivered various types of CME/CPD activities including conferences, symposia, workshops, journal clubs and lecture series. There is increasing focus to measure the impact of CME programs to determine their effectiveness on clinical performance and healthcare outcomes as some evidence has shown that CME activities lack such an effect. 

OBJECTIVES

The aim of the study is to determine the impact of a locally - accredited interprofessional lecture series on clinical practice among healthcare practitioners in a specialized orthopaedic and sports medicine hospital. Impact on clinical practice will be initially assessed through the Implementation and evaluation of the Aspetar Tuesday Lecture Series.

METHODS

Data is initially collected using an anonymous online questionnaire in which healthcare practitioners will provide information on demographics and assess their feedback relevant to the overall learning objectives of the lecture series including impact on clinical care, contribution to evidence-based medicine, and interprofessional education. Furthermore, healthcare practitioners will report on perceived barriers and facilitators in changing clinical practice and suggest topics to address perceived practice gaps. 

Self-report questionnaires remains a valuable tool to assess outcomes of CPD activities, but are known to be subject to limitations. Consequently, in addition we ask if healthcare practitioners are willing to participate in focus groups interviews; in which we will examine group perceptions towards the Tuesday Lecture Series and discuss strategies for improvement. 

SUB-PROJECTS

1.     Implementation and evaluation of an accredited lecture series in a sports medicine hospital: a retrospective cohort study;

2.     What makes an impactful presentation? An analysis of the lectures presented during the 2018/2019 Aspetar Tuesday Lecture Series; and

3.     Value of Tuesday Lectures, Journal Clubs to improve clinical outcomes.

Bringing Research To Real Life: Development, Implementation, and Evaluation of a Context-Specific Longitudinal Injury Monitoring System for the Maltese National Football Team - A Mixed-Method Study

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FUNDING

  • Malta Sports Scholarship Scheme

PROJECT PARTNERS

  • Malta Football Association

  • Cardiff University

BACKGROUND

National team sporting events are popular and exciting for spectators, however, they entail a risk of injury for the National team players. In order to mitigate the risk and prevent injuries, sporting organisational bodies have carried out injury surveillance under the guidance of the respective consensus statements to understand injury patterns during such tournaments. Yet, it has been reported that injury data obtained from these short events only provide a ‘snapshot’ of information with regards to the injury burden, thus emphasising the need for a long-term, continuous injury monitoring system for national team players. Therefore, this study will aim to bridge the gap in knowledge through the design of a prospective longitudinal injury monitoring system framework that aims to monitor injuries of national team players both while with their clubs and with the National team. However, designing and implementing an injury monitoring system as guided by sport-respective consensus statements will not translate effectively in non-elite settings –such as in Maltese football setting- due to different and various contextual determinants revolving around injury perceptions and injury reporting methods. Hence, there is a need to understand the role of contextual determinants in order to develop and implement a longitudinal injury monitoring system that best fit the context of the Maltese National team football players

Objectives of the project:

1.     Develop a longitudinal injury monitoring system tailored for Maltese National team football players

2.     Understand Injury Problem

3.     Evaluate the Injury monitoring system as a practical tool

This development of the injury monitoring system will be based on findings from the initial qualitative study, which will shed light on the perceptions of injuries and the current practices and barriers in injury reporting. The injury monitoring system will be implemented with the U-21 National Maltese Football Team and the Senior Female Maltese Football Team for 2 consecutive seasons. The monitoring system will be used both as a practical tool to monitor injuries throughout the study period and as a research tool to understand the injury problem. Thereafter, the injury monitoring system will be evaluated using the RE-AIM framework, triangulated with qualitative findings on the acceptability and utility of the system.

Long-term and Sports Outcomes of Osteochondral defects of the Ankle

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PROJECT PARTNERS

  • None

FUNDING

BACKGROUND

An osteochondral defect (OCD) of the ankle can significantly impact the life of the athletic patient. Surgical intervention is a common tool to relieve pain, improve function and have patients return to sports. To date, consensus for surgical interventions for a range of morphological OCDs is slim and new techniques are being pioneered at a constant rate. However, for existing proven treatments long-term outcomes, as well as outcomes from its application in the distal tibia are lacking. These findings could question our understanding of the sustainability and long-term implications of the treatments for the often younger and active patients who sustain an OCD.

OBJECTIVES

To determine long-term treatment outcomes for established treatments and identify possible characteristics leading to osteo-arthritis after an ankle OCD. Another objective is to asses sport outcomes following ankle OCD treatment.

QRSMed: Qualitative Research in Sports Medicine

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PROJECT PARTNERS

  • University of Tubingen

  • University of Bath

  • University of Zurich

  • Aspetar

  • Linkoping University

FUNDING

  • None

BACKGROUND

Over the past decades research within the field of sports medicine has yielded a large amount of evidence of the prevention and treatment of athletic injuries. Despite the availability of high quality evidence, compliance to interventions that protect athletes’ health is low. Consequently, evidence-based programs are not achieving their optimal effect in real-life athletic situations. Implementation and knowledge translation are the contemporary incantations to resolve this apparent gap between science and practice. This has provided us novel research questions and challenges that follow on efficacious outcomes. Most of these questions are not answered through quantifiable outcomes measures as they revolve around user behaviors. If we want to know why athletes and coaches behave as they do, and what barriers there may be to changing their behavior, qualitative research can be used to give athletes and coaches a voice.

OBJECTIVES

Within the QRSMed initiative we aim to bring together sports medicine researchers with an expertise in qualitative research. The goal is to develop and implement qualitative research methods within sports medicine research.