Table 1.
Study Features (author, year, design, country) |
Participants (sport, level, sex, age, sample size) |
Outcome (definition and ascertainment) |
Injury estimate | Exposure (Risk factor(s) |
Reported as significant risk factor(s) |
Reported statistics |
Reported non- significant risk factor(s) |
DB score (/23)^ |
Level of Evidence |
---|---|---|---|---|---|---|---|---|---|
Azzam et al., 201518 Historical Cohort United States |
Professional Basketball Players Male = 34 Age = not reported n = 34 (17 injuries) |
Injury = traumatic or overuse MSK event resulting from basketball that led to time loss of ≥7 days from practice and/or games. Ascertained by ATC |
50% of players experienced an injury over the 2008–2011 seasons |
Movement Quality
|
|
|
|
9 | 4 |
Bardenett et al., 201519 Cohort United States |
High School Athletes (multiple sports) Male = 77 Female = 97 Mean age (range): 15.2 (11–18) n=176 (39 injuries) |
Injury = a MSK injury resulting from organized high school sport practice or competition that required medical attention (sought care from ATC, PT, physician or other health care provider) and was restricted from full participation ≥1 practice or game. Ascertained by ATC |
69.5% of players experienced an injury over the 2012 fall season |
Movement Quality
|
|
|
12 | 4 | |
Bushman et al., 201520 Cohort United States |
Military Soldiers Male = 2,476 Age range: 18–57 n = 2,476 (916 injuries) |
Injury = all inpatient and outpatient medical encounters for any overuse and traumatic injury found in a soldiers’ electronic medical records with ECD-9_CM diagnostic code determined to be an injury. Overuse injuries ICD-9-CM codes 710–739 Traumatic injuries ICD-9-CM codes 800–999 Ascertained by Defense Medial Surveillance System |
Any injury: 37% Overuse: 28% Traumatic 16% In the 6 months following screening |
Movement Quality
|
Any injury
|
|
12 | 4 | |
Butler et al., 201321 Cohort United States |
Firefighter trainees Sex = not reported Age: not reported n=108 (number of injuries not reported) |
Injury = any episode that resulted in 3 consecutive missed days of training due to MSK pain Ascertained: Strength and conditioning staff |
No injury estimate was reported for the 16 week training academy |
|
|
SEN: 0.83 SPE: 0.62 PLR: 2.2 NLR: 0.26 |
|
8 | 4 |
Chorba et al., 201022 Cohort United States |
NCAA Division II collegiate athletes Female = 38 Mean age (SD): 19.2±1.2 n=38 (18 injuries) |
Injury = a MSK injury resulting from organized intercollegiate sport practice or competition that required medical attention or advice from an ATC, AT student or physician. Ascertained: ATC |
47% of players experienced an injury over the 2007–2008 season |
|
|
SPE = 0.74 |
n/a | 9 | 4 |
Dossa et al., 201431 Cohort Canada |
Junior hockey players Male = 20 Mean age (range): 18.2 (16–20) n=20 (17 injuries) |
Injury = a physical condition which occurred during a game or practice which resulted in the player missing ≥1 game. Contact = involved collision with another body, ice, boards, puck or stick. Non-contact = not a contact injury Ascertained: ATC |
85% of players experienced an injury over the 2013–2014 season (76 games) |
|
n/a | n/a |
SPE: 0.7 (0.3,0.9) PLR: 1.7 (0.6,5.2) NLR: 0.7 (0.2,0.9) |
12 | 4 |
Garrison et al., 201523 Cohort United States |
NCAA Division I collegiate athletes Sex = not reported Age range: 17–22 n=160 (52 injuries) |
Injury = any MSK pain complaint associated with athletic participation, that required consultation with an ATC, PT or MD and resulted in modified training for ≥24 hours or required protective splinting or taping for continued participation Ascertained: ATC |
32.5% of players experienced an injury over the season |
Movement Quality
|
|
n/a | 8 | 4 | |
Hotta et al., 201533 Cohort Japan |
Collegiate track and field athletes Male: 84 Mean age (range): 20.0 (18–24) n= 84 (15 injuries) |
Running injury = a MSK injury that occurred during participation in track and field practice or competition that prevented participation for 4 weeks. Ascertained: not reported |
17.9% of runners experienced an injury over a 6 month season |
Movement Quality
|
|
|
14 | 4 | |
Kiesel et al., 200724 Cohort United States |
Professional American football players Sex = not reported Age = not reported n=46 (13 injuries) |
Injury = on the injury reserve list and a time loss of ≥3 weeks. Ascertained: not reported |
28.3% of players experienced an injury over the season |
|
|
SEN: 0,54 (0.3,0.7) SPE: 0.91 (0.8,0.96) PLR: 5.92 (2.0,18.4) NLR: 0.51 (0.3,0.8) |
n/a | 7 | 4 |
Kiesel et al., 201425 Cohort United States |
Professional American football players Sex = not reported Age = not reported n=238 (60 injuries) |
Injury = MSK injury resulting in time loss from preseason practice or games. Ascertained: Sports medicine staff |
25% of players experienced an injury over the preseason |
|
|
SEN: 0.58 (0.5,0.7) SPE: 0.62 (0.6,0.7)
SPE: 0.87 (0.8,0.9) |
|
8 | 4 |
Knapik et al., 201526 Historical Cohort United States |
Coast Guard cadets Male = 770 Female = 275 Mean age (SD) Male: 18.1 (0.7) Female: 17.9 (0.7) n=1,045 (number of injuries not reported) |
Injury = any physical bodily damage resulting in a clinic visit which was suspected to be caused by cadet training. Ascertained: PT and other health care providers |
Male = CII 18.6% Female = CII 24.7% For candidates attending classes between 2004–2007 |
|
Males
|
Males
SEN: 0.22 SPE: 0.87Females
SPE: 0.61
|
Males
|
9 | 4 |
Lisman et al., 201327 Cohort United States |
Marine Corps Officer Trainees Male = 874 Mean age (SD): 22.4±2.7 n=874 (number of injuries not reported) |
Any Injury = sought medical care ≥1 times during training due to physical bodily damage resulting from training Overuse = sought medical care for presumed long-term repetitive energy exchanges that led to cumulative micro-trauma Traumatic = sought medical care for acute or sudden energy exchanges leading to abrupt overload and tissue damage Ascertained: Health care providers |
Not reported (6 or 10 week training) |
Movement Quality
|
Any Injury
|
Any Injury
|
|
15 | 2b |
Padua et al., 201528 Cohort United States |
Elite youth soccer players Male = 348 Female = 481 Mean age (SD, Range): 13.9 (1.8, 11–18) n=829 (7 injuries) |
Injury = ACL tear verified at surgical reconstruction Non-contact = no direct contact to the LE by an external force Indirect-Contact = contact with a body part other than the knee Ascertained: self-report verified by surgeon |
0.8 % of players experienced an ACL tear over 2006–2009 seasons IRR = 0.006 (0002,0.012) |
|
|
SPE: 0.65 (0.62,0.67) PPV: 0.01 (0.006,0.03) NPV: 0.998 (0.991,0.999) |
n/a | 11 | 2b |
Shojaedin et al., 201432 Cohort Iran |
Competitive or recreational university athletes Male = 50 Female = 50 Mean age (SD; range): 22.6 (3.0; 18–25) n=100 (35 injuries) |
Any injury = not reported Knee injury = not reported Ankle injury = not reported |
35% sustained injury during the season |
|
Any injury
|
Any Injury
SPE: 0.78 PLR: 2.46 NLR: 0.62 |
|
3 | 4 |
Smith et al., 201234 Case-control (embedded in a cohort) United States |
High school and college athletes Male = 29 Female = 73 Mean age (SD): 18.3 (2) n= 92 (28 injured) |
Noncontact ACL tear = ACL tear resulting from a non-knee contact event with another athlete, ground, or extraneous structure Ascertained: orthopedic surgeon, MRI and surgery |
30.4% of athletes sustained an injury over 1 season |
|
|
|
|
14 | 3b |
Warren et al., 201529 Cohort United States |
NCAA Division 1 collegiate athletes Male = 89 Female = 78 Age range: 18–24 n= 167 (74 injuries) |
Injury = First non-contact MSK problem that resulted in medical intervention. Non-contact injury: non-contact mechanism Contact injury = contact mechanism Ascertained: ATC |
44% of athletes experienced an injury over the competitive season |
Movement Quality
|
|
|
11 | 4 | |
Wiese et al., 201430 Cohort United States |
NCAA Division 1 collegiate American football players Sex: not reported Mean age (SD): 18.9 ± 1.3 n = 144 (93 injuries) |
Injury = initial MSK problem arising from organized training or game requiring medical attention and restricted participation for ≤ 1 days LE injury = groin – toes Overuse injury = tendinopathy, muscle spasm, tightness or soreness Non-contact injury = non-contact mechanism Injury >10 days Ascertained: ATC |
65% of players experienced an injury over 1 season 52% LE 39% overuse 42% noncontact 20% >10 days |
|
|
|
|
10 | 4 |
Statistically significant p<0.05,
Multivariable analyses,
Estimated from reported injury incidence,
analyses did not account for matched design,
Maximum Downs and Black Score for prospective cohort study = 23, while the maximum score for a randomized control trail is 33, AC = abdominal crunch, ASLR = active straight leg raise, ATC = certified athletic trainers, BMI = body mass index (kg/m2), CI = confidence interval, DB = Downs and Black Score, DF = dorsiflexion, DS = deep squat, FMS = Functional Movement Screen, GES = general sport and exercise, HR = Hazard ratio, hrs=hours, HS = hurdle step, ICD-9-CM = International Classification of Disease, Ninth Revision, Clinical Modification, ILL = in-line lunge, IR = incidence rate, IRR = incidence rate ratio, LE = lower extremity, LESS = Landing Error Scoring System, LOE = level of evidence, n/a = not applicable, MD = medical doctor, MSK = musculoskeletal, n/a = not applicable, NLR = negative likelihood ratio, OR = odds ratio, PLR = positive likelihood ratio, PT = physical therapists, PU = pull ups, ROM=range of motion, RR = risk ratio, RS = rotary stability, RT = 3-mile run time, SD = standard deviation, SLHB = single leg hamstring bridge, SLR = straight leg raise, SM = shoulder mobility, TOP = tenderness on palpation, TSPU = trunk stability push-up, TXHD = triple cross-over hop for distance, UE = upper extremity, VDJ = vertical drop jump, wks = weeks, YBT = Y-balance test, yrs = years.