5/8/2014 Disclosures Effectiveness of Exercise Programs in Preventing Ankle Injuries in the Young Athlete: There are no relevant disclosures. � a Review of Literature Keiko Amano, M.D. Eliana Delgado, M.D., M.P.H. Inman Abbot Symposium May 8-9, 2014 Prevention of Ankle Injury Injuries in the young athlete 30 million US children in organized sports � Ankle stability to prevent injuries � � 1/3 will sustain injury needing medical attention Modalities: � � Estimated cost=$1.8 million 1 � Ankle taping and bracing � Stability exercises and warm up programs Most common = ankle injures 1
5/8/2014 Question: Literature Pubmed Search: Ankle Injury Prevention Trials 196 Studies Can strengthening exercises prevent ankle injuries in young athletes? Criteria Young age + Controlled trial + Outcome = ankle injury Discussion Results Little data. � Difficult to directly link exercises to injury outcome. Wedderkopp et � Verhagen et al Olsen et al Longo et al al Most studies look into multiple injuries. � Sport Volleyball Handball Basketball Handball Players/ 1127 Players 1837 Players 11 Teams 11 Teams Teams Possible trend: prevention of overall injuries. � Structured Activity Balance Board FIFA 11+ Ankle Disc Warm-up Reduction in ankle Reduction in Reduction in Reduction in Outcome sprains overall injuries overall injuries ankle injuries Analysis RR=0.5, CI 0.3-0.9 Non-significant Non-significant < 0.05 2
5/8/2014 Acknowledgements Next Approaches: More randomized controlled studies Biomedical Health Sciences Internship, UCSF � � Other types of studies: Mario Goins II (BHSI student intern) � � � There are team/organizations that already utilize exercises. Can we compare outcomes? � Data from retrospective studies Reference 1. Adirim TA, Cheng TL. Overview of injuries in the young athlete. Sports Med . 2003;33(1):75-81. � 2. Nelson AJ, Collins CL, Yard EE, Fields SK, Comstock RD. Ankle injuries among united states high � school sports athletes, 2005-2006. J Athl Train . 2007;42(3):381-387. 3. Hootman JM, Dick R, Agel J. Epidemiology of collegiate injuries for 15 sports: Summary and � recommendations for injury prevention initiatives. J Athl Train . 2007;42(2):311-319. 4. Caine DJ, Golightly YM. Osteoarthritis as an outcome of paediatric sport: An epidemiological � perspective. Br J Sports Med . 2011;45(4):298-303. Thank you 5. Maffulli N, Longo UG, Spiezia F, Denaro V. Aetiology and prevention of injuries in elite young � athletes. Med Sport Sci . 2011;56:187-200. 6. Bahr R, Krosshaug T. Understanding injury mechanisms: A key component of preventing injuries � in sport. Br J Sports Med . 2005;39(6):324-329. 7. Verhagen E, van der Beek A, Twisk J, Bouter L, Bahr R, van Mechelen W. The effect of a � proprioceptive balance board training program for the prevention of ankle sprains: A prospective controlled trial. Am J Sports Med . 2004;32(6):1385-1393. 8. Olsen OE, Myklebust G, Engebretsen L, Holme I, Bahr R. Exercises to prevent lower limb injuries � in youth sports: Cluster randomised controlled trial. BMJ . 2005;330(7489):449. 9. Longo UG, Loppini M, Berton A, Marinozzi A, Maffulli N, Denaro V. The FIFA 11+ program is � effective in preventing injuries in elite male basketball players: A cluster randomized controlled trial. Am J Sports Med . 2012;40(5):996-1005. 10. Wedderkopp N, Kaltoft M, Lundgaard B, Rosendahl M, Froberg K. Prevention of injuries in � young female players in european team handball. A prospective intervention study. Scand J Med Sci Sports . 1999;9(1):41-47. 11. Maffulli N, Longo UG, Gougoulias N, Caine D, Denaro V. Sport injuries: A review of outcomes. � Br Med Bull . 2011;97:47-80. 12. van Mechelen W, Hlobil H, Kemper HC. Incidence, severity, aetiology and prevention of sports � injuries. A review of concepts. Sports Med . 1992;14(2):82-99. � 3
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