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Can prognostic factors for indirect muscle injuries in elite football (soccer) players be identified using data from preseason screening? An exploratory analysis using routinely collected periodic health examination records

Hughes, Tom; Riley, Richard; Callaghan, Michael J; Sergeant, Jamie C

Can prognostic factors for indirect muscle injuries in elite football (soccer) players be identified using data from preseason screening? An exploratory analysis using routinely collected periodic health examination records Thumbnail


Authors

Tom Hughes

Richard Riley

Michael J Callaghan

Jamie C Sergeant



Abstract

Background: In elite football, periodic health examination (PHE) may be useful for injury risk prediction.

Objective: To explore whether PHE-derived variables are prognostic factors for indirect muscle injuries (IMIs) in elite players.

Design: Retrospective cohort study.

Setting: An English Premier League football club.

Participants: 134 outfield elite male players, over 5 seasons (1 July 2013–19 May 2018).

Outcome and analysis: The outcome was any time-loss, lower extremity index IMI (I-IMI). Prognostic associations were estimated using odds ratios (ORs) and corresponding statistical significance for 36 variables, derived from univariable and multivariable logistic regression models. Missing data were handled using multiple imputation. Non-linear associations were explored using fractional polynomials.

Results: During 317 participant-seasons, 138 I-IMIs were recorded. Univariable associations were determined for previous calf IMI frequency (OR 1.80, 95% CI 1.09 to 2.97), hamstring IMI frequency (OR 1.56, 95% CI 1.17 to 2.09), if the most recent hamstring IMI occurred >12 months but <3 years prior to PHE (OR 2.95, 95% CI 1.51 to 5.73) and age (OR 1.12 per 1-year increase, 95% CI 1.06 to 1.18). Multivariable analyses showed that if a player’s most recent previous hamstring IMI was >12 months but <3 years prior to PHE (OR 2.24, 95% CI 1.11 to 4.53), this was the only variable with added prognostic value over and above age, which was a confirmed prognostic factor (OR 1.12 per 1-year increase, 95% CI 1.05 to 1.18). Allowing non-linear associations conferred no advantage over linear associations.

Conclusion: PHE has limited use for injury risk prediction. Most variables did not add prognostic value over and above age, other than if a player experienced a hamstring IMI >12 months but <3 years prior to PHE. However, the precision of this prognostic association should be confirmed in future.

Citation

Hughes, T., Riley, R., Callaghan, M. J., & Sergeant, J. C. (2023). Can prognostic factors for indirect muscle injuries in elite football (soccer) players be identified using data from preseason screening? An exploratory analysis using routinely collected periodic health examination records. BMJ Open, 13(1), Article e052772. https://doi.org/10.1136/bmjopen-2021-052772

Journal Article Type Article
Acceptance Date Apr 17, 2022
Online Publication Date Jan 24, 2023
Publication Date Jan 24, 2023
Publicly Available Date May 30, 2023
Journal BMJ Open
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 13
Issue 1
Article Number e052772
DOI https://doi.org/10.1136/bmjopen-2021-052772
Keywords Sports Medicine; Rehabilitation Medicine; Musculoskeletal disorders
Publisher URL https://www.medrxiv.org/content/10.1101/2021.01.15.21249653v1.article-info

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