Lennert Goossens

The role of hip abductor and external rotator muscle strength in the development of exertional medial tibial pain: a prospective study

Objective To prospectively identify proximal risk factors contributing to the development of exertional medial tibial pain (EMTP). Methods Data were prospectively collected on healthy female students in physical education, who were freshmen in 2010–2011 and 2011–2012. 95 female students, aged 18.15±0.84, were tested at the beginning of their first academic year. Testing included isokinetic hip strength measurements of the abductors, adductors, internal rotators and external rotators. The follow-up of the individulas was assessed using a weekly online questionnaire and a 3-monthly retrospective control questionnaire. EMTP was diagnosed by an experienced MD (Doctor of Medicine). Cox regression analysis was used to identify the potential risk factors for the development of EMTP. Results 21 individuals were diagnosed with EMTP during follow-up. The results of this study identified that decreased hip abductor concentric strength is a predictive parameter for the development of EMTP in females. More specifically, total work (p=0.010) and average power (p=0.045) for concentric abduction strength were found to be significant predictors for this lower leg overuse injury. Conclusions Hip abductor weakness is a significant predictor for EMTP in women. Preventive screening methods for EMTP should therefore include this proximal contributing factor.

Lower eccentric hamstring strength and single leg hop for distance predict hamstring injury in PETE students

Abstract Hamstring injuries have not been under research in physical education teacher education (PETE) students so far. Within the frame of the development of an injury prevention program, for this study we conducted an analysis of modifiable risk factors for hamstring injuries in PETE students. Hamstring injuries of 102 freshmen bachelor PETE students were registered prospectively during one academic year. Eighty-one students completed maximum muscle strength tests of hip extensors, hamstrings, quadriceps (isometric) and hamstrings (eccentric) at the start of the academic year. Sixty-nine of the latter completed a single leg hop for distance (SLHD). Risk factors for hamstring injuries were statistically detected using logistic regression. Sixteen hamstring injuries (0.16 injuries/student/academic year; 0.46 injuries/1000 h) occurred to 10 participants. Eight cases were included in the risk factor analysis. Lower eccentric hamstring strength (odds ratio (ODD) = 0.977; p = 0.043), higher isometric/eccentric hamstring strength ratio (ODD = 970.500; p = 0.019) and lower score on the SLHD (ODD = 0.884; p = 0.005) were significant risk factors for hamstring injury. A combination of eccentric hamstring strength test and SLHD could give a good risk analysis of hamstring injuries in PETE students. This might offer great perspectives for easily applicable screening in a clinical setting.

A multifactorial injury prevention intervention reduces injury incidence in Physical Education Teacher Education students

Abstract Physical Education Teacher Education (PETE) students are at considerable risk for non-contact sports injuries of the lower extremities. Multifactorial injury prevention interventions including exercises have been successful in sports populations, but no such study has ever been performed in PETE students. This study investigated the efficacy of a multifactorial injury prevention intervention on injury incidence reduction in PETE students. PETE students in the intervention group (n = 154) and in the control group (n = 189) registered sports injuries prospectively. The intervention lasted one academic year and consisted of an injury awareness programme and preventive strategies, implemented by the PETE sports lecturers. Differences in injury incidence between the intervention and control group were tested by Poisson regression Wald tests. There was a trend towards significantly lower incidence rate (2.18 vs. 2.73; p = 0.061) in the intervention group compared with the control group. Students in the intervention group had significantly less acute, first-time and extracurricular injuries. The largest reduction was observed for injuries during unsupervised practice sessions. A multifactorial injury prevention intervention embedded into a regular PETE programme is a promising and feasible strategy to prevent injuries in PETE students. Further research is needed to investigate whether the results may be generalised to other PETE programmes.

Musculoskeletal injuries in physical education versus non-physical education teachers: a prospective study

ABSTRACT Physical education (PE) teachers have a physically demanding job, putting them at a considerable risk for musculoskeletal injuries. To structurally develop tailored injury prevention programmes for PE teachers, a clear understanding of the extent, characteristics and underlying factors of their musculoskeletal injuries compared to referents is necessary. Therefore, the current study prospectively followed 103 PE teachers and 58 non-PE teachers, who registered musculoskeletal injuries and time of exposure to sports participation during one school year. Pearson χ2-tests and independent samples t-tests determined significant differences between PE and non-PE teachers regarding demographics and variables possibly related to injury occurrence. PE teachers had 1.23 and non-PE teachers 0.78 injuries/teacher/school year. This difference was significantly different after adjustment for hours spent weekly on intracurricular teaching during the career and for injury history during the preceding six months (P = 0.009; OR = 0.511; 95% CI = 0.308–0.846). PE teachers’ most affected body parts were the knee and the back. PE teachers had a more extensive injury history (P < 0.001), a higher work- (P < 0.001) and sport index (P < 0.001), practiced more sports (P < 0.002) and taught more extracurricular sports (P = 0.001). Future injury prevention programmes should take account for the great injury history and heavy physical load in PE teachers.

Incidence and risk factors of injuries and their impact on academic success : a prospective study in PETE students

Injuries can have a major impact on the physical performance and academic career of physical education teacher education (PETE) students. To investigate the injury problem, risk factors, and the impact of injuries on academic success, 252 PETE students were followed during their first semester. Risk factor analysis was conducted by means of logistic regression analysis with a differentiation for upper body, lower body, acute, overuse, and severe injuries. An incidence of 1.26 injuries/student/semester was found. Most injuries involved the lower body (61%), were new injuries (76%), occurred acutely (66%), and were sustained during curricular gymnastics (25%) or extracurricular soccer (28%). Significant risk factors for lower body acute injuries were age (OR=2.14; P=.01), previous injury (OR=2.23; P=.01), and an injury at the start of the year (OR=2.56; P=.02). For lower body overuse injuries, gender (OR=2.85; P=.02) and the interval shuttle run test score (OR=2.44; P=.04) were significant risk factors. Previous injury (OR=2.59; P=.04) and injury at the start of the year (upper body: OR=4.57; P=.02; lower body: OR=3.75; P<.01) were risk factors for severe injuries. Injury‐related time loss was positively related to total academic success (r=.20; P=.02) and success in theoretical courses (r=.24; P=<.01). No association was found between time loss and academic success for sport courses.

Development and optimization of an injury prevention intervention for physical education teachers

ABSTRACT Background: Injury prevention is highly needed in physically active populations, such as pre-service and in-service physical education teachers (PETs). As a lack of adherence to preventive strategies is problematic in injury, it seems crucial to develop and optimize interventions that correspond to the specific needs and wishes of PETs. Aim: The purpose of the present study was fourfold. Specifically, we aimed at (1) systematically optimizing an injury prevention intervention for PETs, based on teachers’ qualitative evaluation of the intervention, (2) quantitatively investigating whether the appreciation of the injury prevention intervention was higher after optimization, (3) examining whether participation in the intervention resulted in positive changes in teachers’ perceived utility of, and confidence to apply the proposed preventive strategies, as well as their knowledge about these strategies, and (4) describing teachers’ adherence to the proposed preventive strategies while they were engaging in the intervention. Participants: Twenty PETs (13 men, Mage = 42.1 ± 12.17 years) from nine different secondary schools in Flanders (Belgium) voluntarily participated in this study. The intervention, based on findings from the continuing professional development (CPD) literature, and the principles of the self-determination theory, took place on two different training days (Training A and Training B) and consisted of seven intrinsic injury prevention strategies. Data collection and analysis: Qualitative data on teachers’ appreciation of the intervention were collected by means of focus group interviews, which were used to optimize the intervention (Aim 1). Quantitative data on teachers’ appreciation were collected directly after they had engaged in the intervention and were used to compare the appreciation from the initial to more optimized versions of the trainings (Aim 2). Further, by means of repeated measures ANOVAs positive evolutions in teachers’ belief in the utility of, confidence to apply and knowledge about the provided strategies across time were examined (Aim 3). Finally, teachers’ adherence was evaluated by relying on weekly online registrations of minutes and types of preventive strategies teachers had practised during the past week (Aim 4). Findings: Despite the relatively high initial appreciation scores (4.2 out of 5), the optimized versions of the trainings scored better on interaction, intelligibility, innovation, practical usefulness, and recommendation (Aims 1 and 2). Significant differences were found over time in terms of within-teacher changes in perceived utility of (4.05–4.73–4.48; p < .001), confidence to apply (3.75–3.96–4.26; p < .001) and knowledge about preventive strategies (2.49–3.53–3.39; p < .001; Aim 3). Finally, prospective registrations of teachers’ adherence to the proposed strategies showed a mean time of 62.1 ± 48.6 min/week with a balanced distribution of the different strategies (Aim 4). Conclusions: The present study developed an intervention that optimally fulfils the wishes and needs of the target population, namely PETs, and can readily be implemented in PET education programmes or CPD programmes for in-service PETs. Results of this pilot study are promising because teachers displayed increases in several relevant outcomes. Various suggestions are formulated on how to increase PETs’ appreciation of CPD programmes.

Age and maturity related differences in motor coordination among male elite youth soccer players

ABSTRACT This study investigated differences in generic and soccer specific motor coordination, as well as speed and agility depending on age and maturity in elite youth soccer players (U10-U15, N = 619). Measurements included body height, body weight and sitting height to estimate age at peak height velocity (APHV); three Körperkoordinationstest für Kinder subtests (i.e. jumping sideways (JS), moving sideways (MS), balancing backwards (BB)) to assess generic motor coordination; the UGent dribbling test for soccer specific motor coordination; a 5m/30m sprint and T-test for speed and agility, respectively. Age specific z-scores of the predicted APHV identified players as earlier, on time or later maturing. (M)ANOVA analyses showed significant age by maturity interaction effects for the speed and agility test cluster, revealing maturity related differences in U14 and U15 players. Next to an overall higher performance with age for all test clusters (η2 0.080–0.468), earlier maturing players outperformed their later maturing peers in 5m/30m sprinting. The opposite was seen for JS and BB. So, players’ maturity status should be taken into account to adequately value performance in talent identification. Also, the focus on characteristics that appear to be minimally biased by an earlier maturational timing (i.e. motor coordination) should be increased.

Injury prevention in physical education teacher education students: lessons from sports. A systematic review

Sports injuries are a considerable problem in physical education teacher education (PETE) students. They have important consequences and might affect the attitude that PETE students have towards sports and physical activity. Up to now, several efficacious injury prevention programmes have been developed for various sports disciplines. There is a high probability that several components of those prevention programmes are transferable to the PETE environment. A systematic review was conducted to identify intrinsic components that are potentially applicable in PETE programmes. The databases PubMed and Web of Science were searched for articles published between 1974 and 1 February 2015. The systematic study selection resulted in the inclusion of 59 studies. Seventeen studies were rated as having a low risk of bias. Efficacy of the applied programme was proven in 11 of these. Analysis led to guidelines for an injury prevention programme for PETE students. A multiple preventive intervention should include an awareness programme, functional strength training, stretching, warm-up, core stability and dynamic stability exercises of the lower limbs. This multiple preventive intervention preferably has a gradual build-up, makes use of no or only simple materials and is executed around three times per week.

EFFICACY OF A PHYSICAL EDUCATION TEACHER EDUCATION-INHERENT INJURY PREVENTION PROGRAM

Background Since physical education teacher education (PETE) students have to deal with a considerable amount of non-contact injuries to the lower limbs (Goossens et al., 2013), strategies relying on preventive exercises might reduce injury incidence in this population. Objective Is a prevention program for injuries to the lower limbs efficacious in reducing the injury incidence and does it enhance functional performance, self-reported behaviour and consciousness, motivation and knowledge towards injury prevention?. Design The study followed a historically controlled design with prospective injury registration and a pre-post design without control group concerning the other outcomes. Setting Freshmen academic bachelor PETE students (±7 hours of intracurricular sports activities weekly) of three consecutive years took part in the study. Participants The control group (CG) consisted of 128 freshmen students in academic year (AY) 2010–11 and 102 freshmen students in AY 2011–12. The intervention group (IG) consisted of 88 freshmen students in AY 2012–13. Intervention The prevention program ran during 1 AY and had 2 main components: an injury awareness program (information brochure, theoretical course, posters, website, technical training) and the application of active strategies (warm-up, cool-down, stretching, dynamic stabilization, functional strength and core stability). Main outcome measurements Injury risk and incidence rate were the primary outcomes. Functional performance of Lateral Step Down (LSD) and Single Leg Hop and Hold for Distance (SLHHD), self-reported behaviour, consciousness, motivation and knowledge towards injury prevention were secondary outcomes. Results The IG had a lower injury risk (0.77 Vs. 0.89) and incidence rate (2.34 Vs. 2.72) than the CG. Self-reported behaviour (P<.01), consciousness (P<.01) and knowledge (P=.01) towards injury prevention and functional performance of LSD (P<.01) and SLHHD (P<.01) were significantly better after the intervention. Conclusions An intervention for the prevention of injuries to the lower limbs in PETE students is efficacious, but more feasibility studies are needed.