Oluwatoyosi Owoeye

Diagnostic Accuracy of a Self-report Measure of Patellar Tendinopathy in Youth Basketball

BACKGROUND: To engage clinicians in diagnosing patellar tendinopathy in large surveillance studies is often impracticable. The Oslo Sports Trauma Research Centre‐patellar tendinopathy (OSTRC‐P) questionnaire, a self‐report measure adapted from the OSTRC questionnaire, may provide a viable alternative. OBJECTIVES: To evaluate the diagnostic accuracy of the OSTRC‐P questionnaire in detecting patellar tendinopathy in youth basketball players when compared to clinical evaluation. METHODS: Following the STAndards for Reporting of Diagnostic accuracy studies guidelines, the researchers recruited 208 youth basketball players (13–18 years of age) for this prospective diagnostic accuracy validation study. Participants completed the OSTRC‐P questionnaire (index test) prior to a clinical evaluation (reference standard) by a physical therapist blinded to OSTRC‐P questionnaire results. Sensitivity, specificity, predictive value, likelihood ratio, and posttest probability were calculated. Linear regression was used to examine the association between the OSTRC‐P questionnaire severity score and the patellar tendinopathy severity rating during a single‐leg decline squat. RESULTS: The final analysis included 169 players. The OSTRC‐P questionnaire had a sensitivity of 79% (95% confidence interval [CI]: 65%, 90%), specificity of 98% (95% CI: 94%, 100%), positive predictive value of 95% (95% CI: 83%, 99%), negative predictive value of 92% (95% CI: 86%, 96%), positive likelihood ratio of 48 (95% CI: 12, 191), and negative likelihood ratio of 0.21 (95% CI: 0.12, 0.37). The posttest probabilities were 95% and 8%, given positive and negative results, respectively. A positive association was found between OSTRC‐P questionnaire severity score and single‐leg decline squat rating (&bgr; = 0.08; 95% CI: 0.03, 0.12; P = .001). CONCLUSION: The OSTRC‐P questionnaire is an acceptable alternative to clinical evaluation for self‐reporting patellar tendinopathy and grading its severity in settings involving youth basketball players. LEVEL OF EVIDENCE: Diagnosis, level 1b.

THE EFFICACY OF A NEUROMUSCULAR TRAINING INJURY PREVENTION WARM-UP PROGRAM IN JUNIOR HIGH SCHOOL STUDENTS

Background Previous studies have established the efficacy of neuromuscular training (NMT) warm-up programs at reducing the risk of injury in youth in sport-specific contexts and, more recently, in a pilot study that included two Calgary junior high schools. Objective To determine the efficacy of iSPRINT (Implementing a School Prevention program to Reduce Injuries through Neuromuscular Training), a NMT warm-up program in reducing sport and recreational (S&R) injuries. Design Cluster randomized controlled trial. Setting Junior high school physical education (PE) classes in Calgary, Alberta, Canada. Participants Students in grades 7–9, ages 11–16 years (n=429), from four of twelve junior high schools in the first of three study years. Interventions The iSPRINT NMT program was taught to and delivered by teachers as a S&R injury prevention warm-up program in PE classes. Schools were randomized into the NMT intervention group or a control group (two schools per group). Main Outcome Measurements Incidence rate ratios (IRRs) were estimated using Poisson regression analyses to compare injuries between groups. Injuries were assessed by a physiotherapist or athletic therapist and included any S&R injury that resulted in inability to return to the same activity, time loss from physical activity, or required medical attention. Results Injury rates (adjusted for hours of sport participation, previous injury, and clustering by class) were significantly lower in the intervention group (n=241) compared to the control group (n=188) for all sport injury (IRR=0.48, 95% CI; 0.26–0.91) and lower extremity injury (IRR=0.38, 95% CI; 0.20–0.74). Crude time loss injury rates (IRR=0.09, 95% CI; 0.02–0.45) and knee injury rates (IRR=0.18, 95% CI; 0.05–0.66) were also significantly lower in the intervention group. Conclusions These preliminary results suggest the efficacy of the iSPRINT program in reducing the risk of S&R injury in a junior high PE context. This research will inform the public health impact of school-based injury prevention programs.

158 Prevention of ankle sprain injuries in youth soccer and basketball

Background Sport participation is the leading cause of injury in youth and ankle sprain is the most common sport injury. This study evaluates the effectiveness of neuromuscular training (NMT) in reducing the risk of ankle sprains in youth soccer and basketball players. The secondary objective includes evaluation of sex, age, sport and previous lower extremity (LE) injury as independent risk factors for ankle sprain. Methods A secondary data analysis of three cohort studies and two randomised controlled trials conducted in one season of play in youth soccer and basketball players (ages 11–18) in Alberta, Canada (2005–2011) was completed. The definition of ankle sprain and injury surveillance methodology was consistent in all studies. Multivariable Poisson regression analysis (controlling for clustering by team) was used to estimate incidence rate ratios (IRR) with 95% confidence intervals (CI), considering confounding and effect modification (e.g., sex, age, sport, previous injury). Results There were 188 ankle sprains in 171 players in 2,265 study participants. Multivariable analysis suggests that NMT was protective for ankle sprain injury [IRR = 0.69 (95% CI: 0.45–1.05)] based on the point estimate. Sex, age, sport and previous injury did not modify this effect. Independent risk factors for ankle sprain injury included previous LE injury history [(IRR = 1.77 (95% CI: 1.34–2.35)] and participation in basketball vs. soccer [(IRR = 1.98 (95% CI: 1.30–3.01)]. The risk of ankle sprain injury did not differ by sex [IRR = 1.01 (95% CI: 0.53–1.92)]. Conclusions Exposure to a NMT program is protective for ankle sprain injury in youth soccer and basketball players. Independent risk factors for ankle sprain in youth sport include basketball participation (vs. soccer) and previous LE injury. Future research should focus on optimising NMT programs for the prevention of ankle sprain injuries and maximising player-adherence to NMT programs in youth soccer and basketball.

915 Evaluating the implementation of a sport injury prevention program in a school setting

Background Sport injuries are a significant burden, and while there are studies demonstrating the effectiveness of injury prevention programs, there is less guidance on how they are adopted and implemented successfully. The aim of this project was to conduct a process and formative evaluation of an injury prevention program implemented in a school setting. Methods This study proposes two frameworks [RE-AIM and the Consolidated Framework for Implementation Research (CFIR)] to evaluate the implementation of a neuromuscular training program (iSPRINT) to reduce sport injury and improve health-related measures in a junior high school population. The five dimensions of the RE-AIM and CIFR frameworks will be used. Results A total of 245/320 students were willing to participate in the program (68% reach). There was a lower risk of injury in intervention schools (n = 2) compared to controls (n = 2) [RR = 0.52 (95% CI: 0.33–0.81)]. 76% of students and 83% of teachers reported positive attitudes towards the program, 60% of students reported they believed the program could reduce the risk of injury, and 74% reported the program could improve fitness. 14% of the schools approached agreed to participate in the program (adoption). For students, the most frequently reported reason for participating was the belief that the program would reduce injury and increase fitness. Factors related to successful implementation of the program in schools included clear explanation and demonstration of the program, and barriers included difficulty in executing certain program components. Finally, 88% of teachers reported interest in maintaining the program. Ongoing formative evaluation will be collected via focus groups using CFIR constructs (2015–2016). Conclusions Teachers were able and keen to continue to use the iSPRINT program. We will provide further discussion on the dimensions of REAIM, and report the specific constructs that facilitated and impeded implementation of the iSPRINT program.