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      Improving the accuracy of sports medicine surveillance: when is a subsequent event a new injury?

      , , , ,
      British Journal of Sports Medicine
      BMJ

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          Categorising sports injuries in epidemiological studies: the subsequent injury categorisation (SIC) model to address multiple, recurrent and exacerbation of injuries

          Objective Sports injuries are often recurrent and there is wide recognition that a subsequent injury (of either the same or a different type) can be strongly influenced by a previous injury. Correctly categorising subsequent injuries (multiple, recurrent, exacerbation or new) requires substantial clinical expertise, but there is also considerable value in combining this expertise with more objective statistical criteria. This paper presents a new model, the subsequent injury categorisation (SIC) model, for categorising subsequent sports injuries that takes into account the need to include both acute and overuse injuries and ten different dependency structures between injury types. Methods The suitability of the SIC model was demonstrated with date ordered sports injury data from a large injury database from community Australian football players over one playing season. A subsequent injury was defined to have occurred in the subset of players with two or more reported injuries. Results 282 players sustained 469 subsequent injuries of which 15.6% were coded to categories representing injuries that were directly related to previous index injuries. This demonstrates that players can sustain a number of injuries over one playing season. Many of these will be unrelated to previous injuries but subsequent injuries that are related to previous injury occurrences are not uncommon. Conclusion The handling of subsequent sports injuries is a substantial challenge for the sports medicine field—both in terms of injury treatment and in epidemiological research to quantify them. Application of the SIC model allows for multiple different injury types and relationships within players, as well as different index injuries.
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            A framework for recording recurrences, reinjuries, and exacerbations in injury surveillance.

            A previous injury can increase the risk of sustaining a similar injury by up to an order of magnitude. To understand the role of previous injury as a risk factor, it is necessary to consider, among other issues, the clinical status of the first (index) injury at the time of the subsequent (recurrent) injury: currently, the inconsistent use of descriptive terms for recurrent injuries makes this extremely difficult. Although recent consensus statements on injury definitions based on return-to-play criteria have provided a consistent methodology for recording and reporting index and recurrent injuries, these statements do not differentiate between the types of recurrent injuries that can occur. This paper presents a recording and reporting framework that subcategorizes recurrent injuries into reinjuries and exacerbations on the basis of whether a player was fully recovered from the preceding index injury, with the state of fully recovered determined by medical opinion. A reinjury is a repeat episode of a fully recovered index injury and an exacerbation is a worsening in the state of a nonrecovered index injury. With this more detailed framework, researchers will be able to investigate risk factors for reinjuries and exacerbations separately, and they will be able to investigate how well players have been rehabilitated before returning to full training and match play.
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              Clinical and morphological changes following 2 rehabilitation programs for acute hamstring strain injuries: a randomized clinical trial.

              Randomized, double-blind, parallel-group clinical trial.
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                Author and article information

                Journal
                British Journal of Sports Medicine
                Br J Sports Med
                BMJ
                0306-3674
                1473-0480
                December 14 2016
                January 2017
                January 2017
                June 28 2016
                : 51
                : 1
                : 26-28
                Article
                10.1136/bjsports-2016-096160
                3a05b2ca-1e4f-41eb-b0a9-8beeea318d6f
                © 2016
                History

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