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Battaglia, G.1,2, Alesi, M.1, Inguglia, M.3, Roccella, M.1, Caramazza, G.2, Bellafiore, M.1,2, Palma, A.1,2 1: University of Palermo, Italy; 2: Regional Sports School of CONI Sicilia, Italy. 3: Local Health of Palermo, Italy.

Introduction If physical activity is a pivotal component of good health for everyone, there is an increasing emphasis on its importance for psychiatric patients affected from schizophrenia, Alzheimer’s dementia, major depressive disorder (Knochel et al. 2012). The aim of this study was to investigate the effects of soccer practice on the self reported health quality of life (SRHQL) and sports performance (SP) in psychotic subjects. Methods Eighteen schizophrenic male patients were randomized into either a trained (TG) and control group (CG). TG was trained for 12 weeks by two soccer training sessions/week. CG did not perform any regular sports activity during experimental period. Anthropometric measurements, SRHQL, personal time records in 30-meter sprint test (30-mST) and slalom test running with ball (STB) were evaluated before and after the experimental period. SRHQL was assessed using SF-12 questionnaire measuring physical (PCSand mental (MCS-12) component summary scores. Results After the training period, TG showed a relevant reduction by 4.6% in bodyweight (BW) and body mass index (BMI) compared to baseline. On the contrary, CG showed an increased BW and BMI by 1.8% from baseline to post test. Moreover, at 12 weeks we found that control patients increased significantly their BW than trained ones (∆= 5.4%;

p0.05). After the training period, comparing baseline TG’s SF-12-scores to post-test results, we found an improvement by 10.5% and 10.8% in PCS and MCS respectively. In addition, 30-mST and STB performances of TG improved significantly (p0.05) from baseline to post-test compared to CG. Discussion Soccer practice appears to be able to improve psychophysical health in schizophrenic subjects (Pringle, 2009). Indeed, our study showed that programmed soccer physical activity could reduce antipsychotic medication-related weight gain and improve SRHQL and SP in psychotic subjects. To sum up, the results of this study suggest some interesting implications on the educational and clinical field on the psychiatric rehabilitation. We suggest that it might be worth looking further into the need to plan multifaceted interventions aimed at combining traditional pharmacologic treatments and alternative behavioural methods such as physical activity. References Knochel, C, Oertel-Knochel V, O’Dwyer L, Prvulovic D, Alves G, Kollmann B, Hampel H. (2012). Prog Neurobiol.

England, 2011 Elsevier Ltd. 96: 46-68. Pringle, A. (2009). J Psychiatr Ment Health Nurs. England. 16: 553-557.

10:20 - 11:50 Oral presentations OP-PM41 Sports Medicine [SM] 2



Janssen, K.W., van Mechelen, W., Verhagen, E.A.L.M.

EMGO+ VUmc Amsterdam Introduction Ankle sprains are the most common sports and physical activity (PA) related injury. There is extensive evidence that there is a twofold increased risk for injury recurrence for at least one year post injury. Recurrences result in about 50% of all cases in chronic complaints requiring prolonged medical care. Therefore, ankle sprain recurrence prevention is essential. Evidence shows that despite different working pathways, braces and neuromuscular training (NMT) are both effective in reducing ankle sprain recurrence risk. We aimed to evaluate the preventive effectiveness of the combined use of braces and neuromuscular training (NMT) against the individual use of either braces or NMT alone. Methods This study was designed as a three-way randomized controlled trial with one year follow-up. Adult active sports participants who had sustained a lateral ankle sprain within the preceding two months were eligible for inclusion. After participants finished ankle sprain treatment by means of usual care they were randomized to one of three study groups. Participants in group 1 received an eight week NMT program (Hupperets et al, 2009); participants in group 2 received a sports brace (Aircast A60) to be worn during all sports activities for the duration of one year; and participants in group 3 received a combination of the NMT program and a sports brace to be worn during all sports activities for the duration of eight weeks. The primary outcome measure was injury rate of ankle sprain recurrences, which was registered prospectively through monthly follow-ups. Results 384 athletes with an ankle sprain were included and randomly assigned to the three intervention groups. Injury rate of ankle sprain recurrences was 29% for the NMT group, 18% for the brace group and 20% for the combination group. The OR for having a recurrent injury was 1,96 (95% BI 0,85-3,22) for the NMT group compared to the brace group and 1,64 (95% BI 0,67-2,32) for the NMT group compared to the combination group. Discussion Current findings indicate braces to be at least equally effective, and potentially superior to NMT. The accumulating evidence on the effectiveness of bracing supports the use of bracing as a (cost) effective secondary preventive measure for ankle sprains (McGuine 2011). In our practical RCT adherence to the different interventions was mediocre (Full adherence: NMT 45%, sports brace 23% and combination 28%).

There seems to be more public support for the use of NMT in sports but the support for brace use is often lacking. Therefore we advise future research to focus on the implementation of the effective preventive measures for ankle sprains. References McGuine et al. Am J Sp Med 2011;39(9):1840-8. Hupperets et al. BMJ 2009;339:b2684.


Fujitaka, K.1, Otuki, S.2, Takemura, M.3, Okubo, M.4, Tanaka, Y.5 1: Osaka Sangyo university of Graduate School, 2: Osaka Sangyo University, 3: Hyogo College of Medicine, 4: Biwako Seikei Sport College, 5: Nara Medical University, Orthopedic surgery Introduction The purpose of this study was to investigate morphological characteristics of the foot with Jones fracture in university soccer players. Methods Male university soccer players were investigated. Radiographs of 12 feet (injury group) of 11 players with Jones fracture and those of 10 normal feet (control group) of 10 players were compared. Anterior-posterior non-weightbearing foot radiographs were taken for all subjects. Radiographs of injured feet in the injury group and those of a non-dominant leg (The player itself used the dominant leg as the leg of the side which is found in soccer and kicks a ball) in the control group were analyzed. The lengths of the first metatarsal and fifth metatarsal were measured. In addition, the angle between the axes of the first and fifth made metatarsals (M1M5 angle)

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was measured. The axis of each metatarsal was a line that connected the mid-point of the proximal and distal ends of its metaphysis (Y.

Tanaka et al.,1995). The rate of the first metatarsal length to the fifth metatarsal length (length ratio of the fifth metatarsal) was calculated.

Mann-Whitney test was performed to compare differences between the two groups. Results In comparing the length ratio of the fifth metatarsal, the injury group (1.35±0.10) was significantly greater than the control group(1.25±0.05)(p0.05). The values of the M1M5 angle were 24.1 ± 2.7 ° in the injury group and 24.4 ± 4.8 ° in the control group. There was no statistical significance. Discussion The fifth metatarsal is longer than the first metatarsal in the foot with Jones fracture. There is a possibility that rotational stress and stress from the lateral side may increase in the foot with the long fifth metatarsal. In addition, stress may concentrate on the plantar side of the fifth metatarsal base during contraction of the toe flexors. References Tanaka, Y., Takakura, Y., Kumai, T., Samoto, N., Tamai, S. (1995). J.

Bone and Surg, 77(2), 205-213.



Mukherjee, S.

National Institute of Education Introduction The university physical education (PE) programme is rigorous and exposes the students to increased risks of sports injuries.

The higher risk of injuries in the university PE students is a concern as it can adversely affect their teacher training and also interfere with their professional career in the long term. Therefore, keeping the PE programme safe by minimising the injury risks should be of prime concern to the programme organisers and the institute. This study was a prospective epidemiological investigation of sports injuries in university PE students. Methods 327 students from different PE programmes participated in the study. Sports-related injuries during a 12 week semester were reported once every three weeks on an injury registration form. The form was adapted from the NCAA injury surveillance system (Dick et al., 2007). Injuries sustained during intramural (curriculum sports lessons and voluntary practice) and extramural sports participation were documented. Severity of injuries was classified based on absenteeism and medical attention. Results A total of 82 injuries were documented during the 12 week semester. The students in the first semester of the PE programmes sustained the majority (70%) of injuries. 55% of the 82 injuries were sustained during the intramural activities and 45% during extramural participation.

Male and female students sustained 70% and 30% of the injuries respectively. 79% were new injuries, 16% were recurrent and 5% were aggravations of pre-existing injuries. Lower limb was the most commonly injured part (49%) followed by the upper limb (28%) and the head and face (12%). Ankle was the commonest body part to be injured (18%) followed by the knee (16%) and fingers (13%). Sprain was the commonest type of injury (29%) followed by contusion (15%) and muscle-tendon strain (11%). Of the injuries sustained during curriculum sports lessons, majority of injuries were sustained on artificial turf (44%) and cement (31%) surfaces. Contact with another player was the cause of 29% of the injuries while contact with equipment caused 23% of the injuries. With regard to medical attention, 68% injuries were classified as mild, 27% as moderate and 5% as severe injuries. In terms of absenteeism, 76% injuries were mild, 23% moderate and 1% was severe injury. Discussion Injury prevention programmes are critical for safety in training and safeguarding professional careers of university PE students. This study provides useful information on epidemiology of sports injuries in university PE students. Evidence from the present study can be used to identify the modifiable risk factors to develop and implement injury prevention strategies to minimize the risk of injuries in university PE students. Future studies on elucidation of intrinsic and extrinsic risk factors and implications of intervention programmes in this population are desired. Reference Dick R, Agel J, Marshall SW (2007). Am J Sports Med, 42, 173-182.


Lystad, R.P., Gregory, K., Wilson, J.

Macquarie University Introduction Mixed martial arts (MMA) is an increasingly popular sport that involves unarmed, full contact contest with minimal rules.

Graphic images of caged combatants often evoke visceral responses, and medical associations have repeatedly called for an outright ban on MMA tournaments (White, 2007; Ball & Dixon, 2011). Despite safety concerns, no epidemiologic evidence-synthesis is currently available. Thus, the aim of this systematic review was to provide pooled estimates of incidence, severity, injury patterns and risk factors for injury in MMA. Methods Studies were identified by electronic searching of PubMed, Scopus, CINAHL, EMBASE, AMED and SPORTDiscus databases. Eligibility and quality were assessed independently by two reviewers, and relevant epidemiologic data were subsequently extracted and compiled. Random-effects models were used to obtain weighted incidence rate (IR), injury proportion (IP), incidence rate ratio (IRR) and odds ratio (OR) estimates with 95% confidence intervals (CI). Heterogeneity was evaluated with Cochran’s Q and I^2 statistics. Results The searches returned 2,248 citations (1,416 unique), of which only six studies were eligible for inclusion. Pooled estimates suggested the overall IR and concussion IR to be 226.6 (CI 184.5, 278.2) and 21.5 (CI 9.2, 50.1) per 1000 exposures, respectively. No studies reported on injury severity. The most commonly injured anatomical region was the head/neck (61.2%) followed by the upper limb (21.9%). Common types of injury included laceration (29.4%), fracture (12.2%) and concussion (10.2%). Losing fighters had significantly greater risk of injury compared to their winning counterparts (IRR 2.20 [CI 1.56, 3.11]; OR 2.59 [CI 1.96, 3.43]). Discussion The IR in MMA is higher than in other popular combat sports, perhaps with the exception of professional boxing (Zazryn et al, 2003). While the IP of head injuries in MMA is smaller than in professional boxing, it is far greater than in other popular combat sports. The dearth of injury severity data in MMA precludes any comparison with other sports. The conclusions about pooled estimates in this review are limited by heterogeneity, which is most likely owing to the low number of included studies and differences in methodology (e.g. operational injury definitions and data collection methods). The scarcity of quality data underscores the urgent need for more epidemiologic research upon which evidence-informed decisions concerning the regulation of MMA can be made. References Ball CG, Dixon E. The consensus statement on mixed martial arts: emotion, not evidence-based. Can J Surg 2011;54:e1-e2. White C. Mixed martial arts and boxing should be banned, says BMA. BMJ 2007;335:469. Zazryn TR, Finch CF, McCrory P. A 16 year study of injuries to professional boxers in the state of Victoria, Australia. Br J Sports Med 2003;37:321-324.

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