Imaging of physeal stress in the upper extremity: (ab)normal redefined

PROJECT PARTNERS

None

FUNDING

None

BACKGROUND

An increasing number of young athletes are encouraged to specialize in a single sport at a young age. Especially elite-athletes are involved in intensive training schedules, exposing the musculoskeletal system to excessive repetitive stress. The most vulnerable structure in the musculoskeletal system of young athletes is the cartilaginous growth plate. As a result, injuries of this growth plate are prevalent.

Although the exact effect of growth plate injuries is uncertain, some studies have linked physeal injuries to long term effects as growth disturbances. Accurate assessment of the growth plate is therefore important to prevent long-term side effects or injuries, and ensure long-term healthy sport participation. However, extensive loading of the musculoskeletal system can result in a changing appearance of the musculoskeletal system on diagnostic images, even in healthy athletes. As these appearance changes can reflect adaptations of the athlete’s body, these changes should not be interpreted as pathology in order to prevent unnecessary sport cessation.

Many studies have focused on the appearance of the injured upper extremity; however, the appearance of the healthy athlete’s wrist, elbow and shoulder is less well established.

OBJECTIVES

The aim of the study is to develop an imaging based strategy for the early detection and accurate evaluation of the presence and severity of injuries of the growth plates in the upper extremity. In order to achieve this, new methods that can be valuable in the diagnostic workup of physeal injuries are tested in elite gymnasts that are involved in extensive wrist-loading. This analysis is done by evaluating MR images of the wrist both morphologically and quantitatively.

Reducing the re-injury rate and enhancing return to play after acute hamstring injurie

PROJECT PARTNERS

· Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar

FUNDING

· This PhD project is internally funded by Aspetar.

BACKGROUND

Injuries in professional football (UEFA Champions League, UCL) are estimated to cost up to €20 million per season or up to €20.000 a day. Hamstring injuries are the most common muscle injury in professional football and despite preventative efforts, the injury rate is increasing with 2.3% per year. In the Australian Football League (AFL), 27% of all hamstring injuries are re-injuries. Re-injuries are thought to have longer recovery period and thus pose an even greater (financial) burden on teams. A previous hamstring injury is also the primary risk factor for a future hamstring injury.

Increasingly, research is focused on either preventing hamstring (re-)injuries or returning the athlete with a hamstring injury to sport as fast and safe as possible. Currently there is only an expert-opinion based consensus on the return to sport criteria and decision-making process, but it lacks validation.

OBJECTIVES

Due to the limited evidence in the return to sports period and due to the need to promote a faster and safer return to sport after an acute hamstring (re-)injury, this research project aims to:

1. To enhance return to sport and reduce re-injury rate after an acute hamstring injury.

2. To provide validation for the expert-based consensus in the return to sports decision making process.

Visual stimuli and motor performance in athletes with anterior cruciate ligament reconstruction

PROJECT PARTNERS

· University of Paderborn

FUNDING

· None

BACKGROUND

Rehabilitation progression and return to play decisions after anterior cruciate ligament reconstruction are based on measures within the psychomotor domain.

Strength, flexibility and speed are the ground motor skills, which are commonly assessed by clinicians. New sensor technology allows quantifying movement quality and balance in a more easy way.

Investigators studying neuroplasticity after ACL reconstruction (ACLR) have suggested a possible visual-motor control alteration after injury that remains unresolved after conventional therapy. Recently, patients who were 3 years after ACLR demonstrated altered knee range of motion wearing stroboscopic glasses during a drop landing task. It is unknown whether these alterations are also present in the first year after ACLR. Whether or not motor output is affected by the amount of visual input is also questioned.

In the light of the return to sports (RTS) continuum decision making process, it would be of interest if the outcomes of commonly used hop tests will reveal differences in conditions with and without wearing stroboscopic glasses. It is known that patients after ACLR have altered kinematics, however based on recent findings it is hypothesized that a more pronounced effect will occur if patients perform a balance task and hop test with stroboscopic vision (SV).

OBJECTIVES

The purpose of this observatory study is to determine the effect of SV on a set of performance test outcomes in patients with a history of ACLR. The patients will be performing a hop test in normal visual conditions as well as during SV in a counterbalanced order.

Patients will be recruited from an outpatient sports physical therapy clinic in Utrecht, the Netherlands. Patients are routinely tested at 6, 9 and 12 months after ACLR and will perform several tests in 2 conditions 1) normal full visual condition 2) stroboscopic vision (SV). In order to assure that patients have no visual impairments prior to measurements, a validated visual test using the Bioptor will be carried out. Measurements include:

1. Single leg hop test for distance. First maximal hop distance for the injured leg will be determined. In order to standardize conditions for this study, 50% of the maximal hop distance will be used for both legs. 3 hop tests will be performed per side.

2. Maximal single leg hop for distance (best of 3). Absolute (per side) and relative limb symmetry index (LSI) outcomes will be studied.

3. Maximal triple hop for distance (best of 3). Absolute and relative LSI will be studied.

4. Side hop. Patients will perform a maximum number of hops over 2 lines, 40 cm apart.

5. Balance task. This will be assessed in two conditions during a 30 sec static balance task on a pressure plate (RSScan).

Outcome measures on the hop tests:

1. Distance jumped

2. Absolute and relative LSI

3. Number of hops for side hop

4. Hip and knee kinematics using IMU’s

Outcome measure on the balance task:

1. Center of Pressure

2. Balance error scoring system (BESS)

The Basketball and Muscle Injury (BAMI) study: Game changing innovative sports research

PROJECT PARTNERS

None

FUNDING

· The study was funded by ‘NBA & GE Orthopedics and Sports Medicine Collaboration’

BACKGROUND

The current literature on muscle injuries in basketball is limited and there are no clinical studies in elite female basketball. To help advance the field, innovative new techniques can be utilized. Current standard MRI techniques do not allow visualization of individual muscle fiber architecture. Consequently, the quantification of both muscle pathology and muscle architecture is only indirectly estimated by measuring the extent of edema (suggesting minor injury) and hematoma (suggesting fiber disruption) with suboptimal reproducibility and unknown validity.

OBJECTIVES

The main objectives are:

1. Evaluate and monitor the injury and recovery mechanisms of the hamstrings muscles

2. Evaluate efficacy of injury prevention programs for the hamstrings and calf muscles

3. Evaluate the risk of re-injury

Using an innovative Diffuse Tensor (DT) MRI imaging technique, which allows accurate evaluation of the muscle fibers.

FURTHER INFORMATION

For further information and current updates on the project, please refer to our website (only in Dutch): www.hamstringonderzoek.nl

PRIMA Study: Platelet-Rich plasma Injection Management for Ankle osteoarthritis

PROJECT PARTNERS

· Flevoziekenhuis – Orthopaedic surgery, Almere, The Netherlands

· OLVG – Sports Medicine, Amsterdam, The Netherlands

· Spaarne gasthuis – Orthopaedic surgery, Hoofddorp, The Netherlands

· Erasmus Medical Center – Sports Medicine, Rotterdam, The Netherlands

· The Bergman Clinics – Sports Medicine, Naarden, The Netherlands

FUNDING

· The study was funded by the Dutch Arthritis Foundation

BACKGROUND

Platelet-rich plasma (PRP) is a potentially efficacious treatment for ankle osteoarthritis (OA), but its use has not been examined in high-quality studies. Systematic reviews show that PRP injections significantly decrease pain and improve function in patients with knee OA. Ankle OA is more common than hip or knee OA in the young active population; with a prevalence of 3.4%. PRP injections in ankle OA are shown to be safe and improve quality of life over time, but no randomized controlled trial has been conducted.

OBJECTIVES

Our randomized controlled trial will evaluate the efficacy of PRP injections for symptom reduction and functional improvement, compared with placebo, in the treatment of ankle (talocrural) OA, using standardized questionnaires and physical examination.

FURTHER INFORMATION

For further information and current updates on the project we refer you to the published protocol of the study or the website of the Dutch Arthritis Foundation.

ACTION Trial: The goal attainment scaling for knee arthroplasty in younger patients

PROJECT PARTNERS

· This project is a single center study performed at the Amphia hospital, Breda, The Netherlands

FUNDING

· The study was funded by Foundation NuthsOhra (grant number 1403-026).  

BACKGROUND

Knee arthroplasty (KA) has proven to be a reliable treatment to relieve pain, improve function and enhance health-related quality of life in patients suffering from knee osteoarthritis (OA). Following the increasing prevalence of knee OA, the demand for KA is expected to rise worldwide, especially in patients 55 – 65 years of age. These patients often wish to return to work and to participate in knee-demanding leisure time activities. Despite the aforementioned benefits of KA, up to 20% of patients remain dissatisfied after surgery.

Unmet expectations are the primary cause for dissatisfaction after KA, and rehabilitation likely plays a crucial role in establishing and obtaining reasonable goals. Since younger KA patients have a wide variety of activity goals and expectations, a ‘one-size-fits-all’ rehabilitation approach likely does not suffice. A possible instrument to tailor the rehabilitation to patients’ personal goals is Goal Attainment Scaling (GAS). Theoretically, GAS could prove to be a useful instrument to establish realistic goals, increase goal attainment and thus improve satisfaction in younger KA patients.

OBJECTIVES

We will investigate the effect of GAS-based rehabilitation on satisfaction in younger, active KA patients. We hypothesize that a GAS-based, personalized, goal-directed rehabilitation leads to higher satisfaction scores for postoperative performance of activities, compared to usual-care rehabilitation after KA.

FURTHER INFORMATION

Witjes S, Hoorntje A, Kuijer PP, Koenraadt KL, Blankevoort L, Kerkhoffs GM, van Geenen RC. Does Goal Attainment Scaling improve satisfaction regarding performance of activities of younger knee arthroplasty patients? Study protocol of the randomized controlled ACTION trial. BMC Musculoskelet Disord. 2016 Mar 2;17:113. doi: 10.1186/s12891-016-0965-3. PMID: 26936270

Hoorntje A, Witjes S, Kuijer PPFM, Bussmann JBJ, Horemans HLD, Kerkhoffs GMMJ, van Geenen RCI, Koenraadt KLM. Does Activity-Based Rehabilitation With Goal Attainment Scaling Increase Physical Activity Among Younger Knee Arthroplasty Patients? Results From the Randomized Controlled ACTION Trial. J Arthroplasty. 2019 Oct 23. pii: S0883-5403(19)31005-8. doi: 10.1016/j.arth.2019.10.028. [Epub ahead of print]. PMID:31740103

Witjes S, Hoorntje A, Kuijer PP, Koenraadt KL, Blankevoort L, Kerkhoffs GM, van Geenen RC. Goal Setting and Achievement in Individualized Rehabilitation of Younger Total and Unicondylar Knee Arthroplasty Patients: A Cohort Study. Arch Phys Med Rehabil. 2019 Aug;100(8):1434-1441. doi: 10.1016/j.apmr.2018.11.019. Epub 2018 Dec 22. PMID: 30582918

PHAROS: Prospective Hamstring Avulsion Registry for Outcome following Surgical and nonoperative treatment

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

No external funding

BACKGROUND

Full-thickness hamstring tendon injuries are severe injuries that substantially impact sports participation and activities of daily living. There is a lack of evidence to advise if and when operative or non-operative treatment is indicated. Evidence-based treatment indications and an optimal timeframe for operative intervention are unknown. These and other pressing clinical questions remain unanswered, partly due to the relative rarity of these injuries and isolated research efforts.

OBJECTIVES

PHAROS is developed to systematically gather prospective clinical data on full-thickness hamstring injury due to tendon avulsion or rupture on a large scale. By means of this international research collaboration, we expect to be able to answer the pressing clinical questions that have remained unanswered to date.

Redefining the Normal Triangular Fibrocartilage Complex in Children

PROJECT PARTNERS

· Amsterdam Movement Sciences (AMS) research institute

FUNDING

None

BACKGROUND

The triangular fibrocartilage complex (TFCC) is a soft tissue structure located between the distal ulna and carpal bones that provides distal radioulnar joint (DRUJ) stability, ulnocarpal stability, axial load distribution and enables complex movements of the wrist. Injury to this structure, chronic or acute, is considered a common cause of ulnar sided wrist pain.

Magnetic resonance imaging (MRI) is increasingly being used to diagnose TFCC injury based on signal intensity changes. However, the meaning of these signal changes is being questioned since high prevalence rates (38% up to 70%) of abnormal signal intensities are reported in asymptomatic subjects. In elite tennis players, no statistical difference in TFCC abnormalities on MRI was even found between symptomatic, asymptomatic and healthy control subjects. This implies that a substantial amount of signal abnormalities on MRI might not be associated with clinical symptoms.

Meanwhile, surgical intervention in children with suspected TFCC injury has become more prevailing. Multiple studies on surgical techniques and outcomes of wrist arthroscopy in children with TFCC injury have been published recently. Also, shorter immobilization and earlier intervention in young elite athletes with TFCC injury is encouraged in order to facilitate a more rapid return to sport, while the meaning of TFCC signal changes on MRI for this young patient group remains unclear.

OBJECTIVES

The aim of the study is to redefine the normal TFCC by studying the fetal morphologic TFCC development and systematically assessing the normal TFCC appearance on MRI in asymptomatic children and young gymnasts. By acquiring more knowledge on the normal TFCC, a better distinction can be made between pathologic and non-pathologic TFCC variations seen on diagnostic MRI and benefit the decision-making process for treatment. In order to do so, fetal TFCC development will be analyzed in a 3-dimensional manner and correlated with imaging. Also, a systematic score form will be developed and used to study normal TFCC appearance on MRI in healthy children and possible pre-pathological TFCC changes in young gymnasts. Additionally, a new MRI technique will be used to assess TFCC’s in healthy young adults, in order to study its feasibility to improve diagnostic accuracy of detecting TFCC pathology in the future.

Drake Football Study - Monitoring the health of transitioning professional footballers

PROJECT PARTNERS

· FIFPRO (Football Players Worldwide), Hoofddorp, the Netherlands

· Mehiläinen NEO Hospital, Turku, Finland

· Drake Foundation, London, UK

· Push Sports, Maastricht, the Netherlands

FUNDING

The Drake Football Study received seed funding from the Drake Foundation located in London (United Kingdom) and financial support from FIFPRO located in Hoofddorp (the Netherlands), Mehiläinen NEO Hospital located in Turku (Finland), from Sports Hospital Mehiläinen located in Helsinki (Finland) and from Push Sports located in Maastricht (the Netherlands).

BACKGROUND

Transitioning out of professional football is a challenging time in most players’ lives. During these pre- and post-retirement years, professional footballers may struggle with their mental, musculoskeletal, neurocognitive and cardiovascular health. Currently, longitudinal data about these health conditions is lacking.

OBJECTIVES

The aims of the study are (i) to gather epidemiological evidence about the onset and course of mental, musculoskeletal, neurocognitive and cardiovascular health conditions in professional footballers during their pre- and post-retirement years, comparing them to matched controls from the non-elite sport population (if applicable), and (ii) to evaluate the associations between risk indicators  and the onset and course of mental, musculoskeletal, neurocognitive and cardiovascular health conditions in professional footballers during their pre- and post-retirement years.

An observational prospective cohort study with repeated measurements over a follow-up period of 10 years is conducted among professional footballers (male). Mental health will be explored by assessing symptoms of distress, anxiety, depression, sleep disturbance, alcohol misuse, drug misuse and disordered eating. Musculoskeletal health will be explored by assessing severe joint injury and related surgery, clinical and radiological osteoarthritis, and joint function (hips, knees, ankles). Neurocognitive health will be explored by assessing concussion, brain structure and functioning, and neurocognitive functioning. Cardiovascular health will be explored by assessing blood pressure, lipid profile and electrocardiogram abnormalities.

OUTBACK Trial: Treating Osteochondral Lesions of the Talus

PROJECT PARTNERS

· Academic Center for Evidence based Sports medicine (ACES)

· Oklahoma Medical Center, Department of Orthopedic Surgery

· Flevoziekenhuis, Department of Orthopedic Surgery

· Amphia Hospital, Department of Orthopedic Surgery

· Sanquin, Diagnostic Services, Research Department

· Amsterdam UMC, Location VUmc, VU Department of Public and Occupational Health

FUNDING

· Department of Orthopedic Surgery, Amsterdam UMC

· Foundation Friends of Aces

BACKGROUND

Small osteochondral lesions of the talus that undergo bone marrow stimulation show 75% success rate on the mid- to long-term. In order to increase this success rate, bone marrow aspirate concentrate in addition to the bone marrow stimulation may be beneficial. However, no randomized, blinded study has ever proven this.

OBJECTIVES

There are multiple objectives. The main objective of the present study is to compare the clinical outcome of bone marrow stimulation alone versus bone marrow stimulation and bone marrow aspirate concentrate (BMAC) for small osteochondral lesions of the talus at 2 years follow-up. Other objectives are to study the cost-effectiveness of the study, the sport and work-outcomes of the trial, and to study the radiological outcomes as well as cell characteristics.

Why don't we treat eSports Participants as Athletes?

PROJECT PARTNERS

· Portugal Football School, Portuguese Football Federation, Oeiras, Portugal

· Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, University Institute of Maia, Maia, Portugal

· VU University Medical Center Amsterdam, The Netherlands.

FUNDING

The study has the Portugal Football School support.

BACKGROUND

eSports (or electronic sports or virtual sports) are a worldwide phenomenon. Generally, eSports comprise a number of different videogame modalities, played competitively (at professional or recreational level) on controlled environments, with structure and regulations similar to the traditional sports (e.g. leagues, ladders and tournaments), being Virtual football an example. Over the past decade, eSports have grown exponentially and now also reaches competitively into the realm of traditional sports. The time schedules, professionalization and training needed to achieve elite positions, along with the possibility of participating in major eSports events require domain-specific skills, precision, coordination and rapid response, perceptual-cognitive abilities and ethical aptness. As the popularity and stakes raise, concerns about the health and emerging risks of eSports participation might arise, since little is known about the demands of eSports competitions and continuous training. Therefore, different areas of expertise are trying to fundament and elaborate on the topic, and the field of exercise and sports medicine is not an exception.

OBJECTIVES

In this project, we aim to develop a baseline study on the quality of sports medical care in people formally engaged with eSports. For that purpose, we will study virtual football players participating in official tournaments included in the Portuguese Football Federation (FPF) agenda, during one competitive season. We expect to provide novel scientifically-based arguments on demographic characteristics, diseases and injuries, mental health, lifestyle behaviour (i.e. substances consume, physical activity, sleep, screen time) of eSports participants. Given the exponential growth of eSports, awareness on this topic is of upmost importance, and the current project can therefore open a new field for research and professional activity in sports sciences and medicine.

Breaking the High Load: Overhead Sports Injuries Management

PROJECT PARTNERS

This project is a cooperative effort between:

· Royal Netherlands Baseball and Softball Federation.

· Royal Netherlands Lawn Tennis Association.

· Vrije Universiteit Amsterdam.

· Delft University of Technology.

· Manual Fysion.

· PLUX.

FUNDING

The project is funded by the NWO Domain Applied and Engineering Sciences (AES) under project number [R/003635].

BACKGROUND

In both baseball and tennis, throwing and hitting a ball is a fast pre-planned action based on engrained motor patterns that involve the whole body. In these motions ​correct relative timing of body part motions is essential. Despite the current body of knowledge regarding hitting biomechanics on the one hand and injury-prone structures on the other, no useful guidelines regarding the prevention of overload injuries or the ‘correct’ throwing or hitting technique have been developed.

The key reasons for this are:

1. The lack of measurement systems that allow for fast and unhindered recording of motion ​timing​;

2. The missing link between motion timing and mechanical loading of anatomical structures;

3. The missing link between mechanical loading, intersegmental coordination and injury risk.

Since in tennis and baseball performance is highly dependent on (highly repetitive!) fast pre-planned full-body actions that can only marginally be modified during the action itself, pain, injury or weakness somewhere in the kinetic chain can lead to faulty coordination and related injury elsewhere in the chain, usually more distally at the level of the arm or elbow. Proper retraining of ‘correct coordination’ is essential to be able to return to the sport (RTS). While to date the focus in retraining is on identification of strength imbalance and limitations in range of motion, these are likely only secondary factors in the correct coordination. ​Correct relative timing, is believed to be the key factor​. This applies especially to the motion of the scapula, as the bridge between trunk motion (the motor) and arm motion (the ‘whip’). Up till now relative timing has had low attention in rehabilitation practice. In this project we will develop (1) a feedback system on motion timing, link this system to a platform for the monitoring of athlete health status and develop an algorithm for the (interactive) quantification of injury risk (accumulated value) and stroke or throw performance (incidental value); (2) an integrated method, requiring online monitoring of progress, for the detailed quantification of relative timing in and after upper extremity injury to improve rehabilitation, modify injury risk, and facilitate the RTS process.

OBJECTIVES

The project goal is to break the high load due to bad coordination in overhead sports injuries, by developing a system for risk identification and modification through new feedback applications based on motion timing.

FURTHER INFORMATION

For further information and current updates on the project please refer to our website: https://www.tudelft.nl/en/3me/research/check-out-our-science/playing-scientifically-sound-baseball-and-tennis/

Trailblazer: Identification of risk factors related to trail running

PROJECT PARTNERS

· VU University Medical Center Amsterdam, The Netherlands.

· Department of Physiotherapy, University of Pretoria, South Africa.

· Section Sports Medicine, University of Pretoria, South Africa.

FUNDING

· University of Pretoria, South Africa and VU University Medical Center Amsterdam, The Netherlands

BACKGROUND

Trail running involves running outdoors on varying off-road terrains. It is a highly popular and fast-growing sport. Even though running as a form of physical activity has positive health benefits, it also presents with a high risk for injury. The nature of trail running requires a specific endurance effort affected by altitude, large elevation gains/losses, distance covered and varying uneven surfaces. Therefore, the injury profile will differ between road and trail runners. A lack of literature on injuries among trail runners exists, limiting our understanding of injuries in this specific field. Trail runs are mostly hosted in remote geographical regions where medical care is challenging. A trail running injury screening tool (TRISI), based on risk factors related to trail running can help identify runners at higher risk and guide future risk management strategies.

OBJECTIVES

The aim of this project will be to develop a TRISI. The project consists of two phases. Phase 1 will aim to increase our understanding of trail running injuries through 1) prospectively recording injuries among trail runners, 2) analysing a large data set of injury data collected over three years among trail running race entrants, and 3) investigating trail runners’ opinions relating to trail running injury risk factors. The data obtained will be used to develop a TRISI. In phase two, an injury screening instrument will be developed based on the risk factors identified in phase 1. The developed screening instrument will be peer-reviewed through Human Judgement Modelling and adjusted accordingly. Phase 2 will consist of two expert panels that will firstly establish a final list of relevant risk factors, and then give weighting to each risk factor in the TRISI.

PIE=M: Physicians Implement Exercise = Medicine

FUNDING

• The Netherlands Organisation for Health Research and Development (ZonMw)

PROJECT PARTNERS

• University Medical Center Groningen (UMCG)

• Huis voor de Sport Groningen

• Gemeente Groningen

• Lifelines

• Hanze Hogeschool Groningen

• Genomics Coordination Center UMCG

• EPIC UMCG

• Kenniscentrum Sport 

BACKGROUND

Although prescription of physical activity in clinical care has been advocated worldwide through the ‘exercise is medicine’ (E=M) paradigm. E=M currently has no position in general routine hospital care, which is hypothesized to be due to attitudinal and practical barriers to implementation. This study aims to create E=M implementation strategies to reduce practical barriers to enforcing E=M in hospital care.

OBJECTIVES

Firstly, this project will perform a mixed methods study (questionnaire and interviews) to investigate the current implementation status of E=M in clinical care as well as its facilitators and barriers to implementation among clinicians and hospital managers. In the second phase of the project, strategies will be developed in order to facilitate the implementation of E=M in clinical care. One of the strategies is the development of an E=M tool that will facilitate prescription of individually tailored E=M advice based on the combination of individual patient characteristics and data from earlier research. In the final stage of the project, the feasibility of the developed E=M implementation strategies will be investigated with a process evaluation. A pilot-study will, therefore, integrate the E=M implementation strategies in routine care in at least four clinical departments in two Dutch university hospitals. 

---

Injury prevention in volleyball and field hockey - Implementation of two efficacious warm-up programmes

FUNDING

• The Netherlands Organisation for Health Research and Development (ZonMw)

PROJECT PARTNERS

• Nevobo

• KNHB

• UMC Groningen

• University of Bath (Department for Health)

• Livewall

• Dotcomsport Nederland

BACKGROUND

In the Netherlands, volleyball is in the top 5 sports with the highest number of injuries and field hockey in the top 5 sports with the most severe (medically treated) injuries. Therefore, the Dutch Volleyball Federation (Nevobo) and the Royal Dutch Hockey Association (KNHB) have allied few years ago in order to work towards injury prevention in recreational volleyball and field hockey. As a consequence, ‘VolleyVeilig’ and ‘Warming-up Hockey’ were developed as exercise-based warm-up programmes to reduce or prevent injuries. Two recent studies showed that both ‘VolleyVeilig’ and ‘Warming-up Hockey’ were efficacious for reducing or preventing injuries in recreational volleyball and field hockey. The logical next step is to work towards the implementation of both programmes in the Netherlands.

Objectives

1. Develop a structured and evidence-based implementation (delivery) plan tailored to volleyball and field hockey contexts to promote the structured implementation of ‘VolleyVeilig’ / ‘Warming-up Hockey’.

2. Initiate and evaluate the implementation of ‘VolleyVeilig’ / ‘Warming-up Hockey’ in volleyball and field hockey.

The implementation of ‘VolleyVeilig’ / ‘Warming-up Hockey’ is initiated in volleyball and field hockey for the 2019-2020 season. A quasi-experimental study based on a one-group design with repeated measurements is conducted to evaluate the implementation of the programmes in volleyball and field hockey, using the RE-AIM Sport Setting Matrix framework. For the evaluation, two convenient samples of clubs (one sample in volleyball and one sample in field hockey) are included: 10 volleyball clubs (in total 100 trainers/coaches and 20 technical policy/decision makers) and 10 field hockey clubs (in total 100 trainers/coaches and 20 technical policy/decision makers).

---

IPPON: Injury prevention and performance optimisation in judo athletes

FUNDING

• The Netherlands Organisation for Health Research and Development (ZonMw)

PROJECT PARTNERS

• Judobond Nederland

• Sportmedisch adviescentrum Jessica Gal Sportartsen

• VeiligheidNL

BACKGROUND

With a top-3 position on the priority list of sports with the highest incidence rate of injuries (4.3 per 1,000 hours) and top-5 position on both absolute number of injuries (180,000) and injuries presenting at the emergency department (4,400) in the Netherlands, combat sports should be a priority for injury prevention interventions.

For judo, the most practiced combat sports, a specific prevention program based on existing proven effective exercises has been developed by experts who are both strongly embedded in judo practice, and world leading experts in judo research: the Judo 9+. Although sport-specific neuromuscular training programs have been shown to effectively reduce injury rates in various sports, the effectiveness and implementation of the judo 9+ program has not been studied yet.

OBJECTIVES

1. Translation of the Judo 9+ exercise programme to the Dutch recreational judo practice: the NL-Judo9+

2. Evaluation of the effectiveness of the NL-Judo9+ exercise programme on injury risk profiles and injury rates

3. Preparation for national implementation of the NL-Judo9+ in recreational judo (if proven effective).

---

Effectiveness of VolleyVeilig: the prevention of injury among youth volleyball players

FUNDING

• The Netherlands Organisation for Health Research and Development (ZonMw)

PROJECT PARTNERS

• Nevobo

• VeiligheidNL

• UMC Groningen

• Dotcomsport

BACKGROUND

Volleyball is played by around 500,000 Dutch youth and adult residents. In the Netherlands, volleyball is in the top 5 sports with the highest number of injuries. Therefore, the Dutch Volleyball Federation (Nevobo) initiated the development of a warm-up programme called ‘VolleyVeilig’ for youth and adult volleyball players to prevent injuries.

The effectiveness of ‘VolleyVeilig’ has been recently assessed through a randomized prospective controlled trial among recreational adult volleyball players. The logical next step is to evaluate the effectiveness of the intervention for youth volleyball players.

Objective of the project is to evaluate the effectiveness of ‘VolleyVeilig’ over one-season (2019-2020) on injury rate, severity, and burden among recreational youth volleyball players using a prospective controlled design. Secondary aim is to evaluate the delivery and use of the programme within the context of the effectiveness study, in order to explain programme outcomes and gain insight in facilitators and barriers that influence the uptake of the programme by youth volleyball trainers/coaches (process evaluation). Results will be used to optimize the programme for post-trial implementation and nationwide release by Nevobo.

---

Skating on thick ice: Systematic development and implementation of injury prevention measures in long track speed skating in the Netherlands

PROJECT PARTNERS

• KNSB (Koninklijke Nederlandsche Schaatsenrijders Bond)

BACKGROUND

Long track speed skating is the most famous and successful competitive winter sport for the Netherlands. Dutch speed skaters won 16 out of 42 speed skating medals at the 2018 Olympics in PyeongChang. About 22.000 athletes are regularly competing in speed skating in the Netherlands.   

Speed skating is a physically highly demanding sport with a unique movement patternplacing a high mechanical load on the muscular- skeletal system. A skater adopts an aero dynamical, crouched body posture, characterized by a small knee angles and a nearly horizontal trunk position. In this position, the skater generates a powerful sideward directed impulse of the lower extremity to create a high forward speed.  

While clinically experience indicates that acute and overuse injuries are common in this physically highly demanding sport, there is little sport specific scientific data on injury epidemiology and injury prevention. Consequently, measures to prevent injuries are mainly based on clinical experience and knowledge of experts in this sport.  

The aim of this research project is therefore (i) to develop an evidence based, sport specific injury prevention program for young talented speed skaters in the Netherlands. Here, a broad research focus will be applied by including external evidence as well as (clinical) experience of experts in the field of speed skating injuries.  (ii) to implement this program in real-life sporting context and (iii) to evaluate its effectiveness. To initiate this, first the existing gaps in sport specific injury prevention knowledge needs to be closed by conducting a comprehensive analysis of relevant acute and overuse injuries in speed skating. 

Insights from this project will contribute to protect the health of talented Dutch speed skaters and, therefore, promote long term and healthy participation in speed skating. 

---

The effects of sports injuries on the brain

When an athlete suffered an injury in the past, the main focus of both researchers and clinicians was mainly directed to the affected peripheral structures. However, the current view of the World Health Organization (WHO) shifted this focus towards a more holistic rehabilitation approach with the introduction of the biopsychosocial model. This paradigm shift in patient care became also very present in sports rehabilitation and led to the development of a general Return-To-Sport-Algorithm. Nevertheless, current scientific research within this complex vision has made significant steps forward and contributed to new insights within this domain, but is still in its initial phase. This line of research will explore and document the function of the brain after (sports) injuries and its interactions with fatigue.

---

Fatigue & the athlete's injury risk profile

Sports injury prevention is becoming increasingly important in organised sports. This domain has evolved rapidly in the last decades, leading to a better understanding of peripheral risk factors and injury mechanisms. This line of research focuses on the role of the brain in the context of primary sports injury prevention and the influence of fatigue on the injury risk profile of athletes.

---