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Functional Contributions to Lower Extremity Musculoskeletal Injury in High School Soccer and Basketball Athletes

Clifton, Daniel R
http://orcid.org/0000-0003-3857-124X
http://rave.ohiolink.edu/etdc/view?acc_num=osu1516979638283332

Abstract Details

2018, Doctor of Philosophy, Ohio State University, Health and Rehabilitation Sciences.
Approximately 7.8 million high school students participate in athletics annually and although athletic participation comes with many benefits, it also comes with an inherent risk of lower extremity (LE) musculoskeletal (MSK) injury. Effectively identifying individuals at greatest risk of injury first requires an accurate understanding of injury risk. Despite the breadth of research, current injury risk assessment models are inadequate and no gold standard exists for effectively identifying risk of injury in physically active populations. Most research fails to target multiple risk factors and, instead, often focuses on how one specific risk factor alters injury risk. Additionally, research has not examined how injury risk is altered by relationships among risk factors. These gaps in knowledge have formed an understanding of injury risk that does not reflect a multi-factorial model where factors influence risk through a combination of direct, indirect and moderated effects. Therefore, the purpose of this research was to assess the complex multifactorial nature of LE MSK injury risk in adolescent athletes. Aim 1 established similarities and differences in epidemiology of injury in boys’ and girls’ high school soccer and basketball using a national injury surveillance system. The results of this aim indicated that injury rates are greater in soccer than basketball, and greater in competitions than practices, regardless of sex. The most common injuries were similar between sports, suggesting both sports should emphasize preventing sprains and strains affecting the ankle and knee, specifically those resulting from player contact and noncontact mechanisms. Additional efforts are also needed to prevent hip and thigh/upper leg injuries in soccer. Aim 2 evaluated direct and indirect effects of functional performance asymmetries, as well as drop landing mechanics, on injury in 2,645 high school soccer and basketball players. Results from this aim indicate that ankle dorsiflexion (DF) range of motion (ROM) limb symmetry index (LSI), single leg anterior reach (SLAR) LSI, anterior single leg hop for distance (SLHOP) LSI, and Impression Landing Error Scoring System performance are neither directly nor indirectly related to odds of LE MSK injury in high school soccer and basketball players. Injury history was directly related to an increased likelihood of future injury. Aim 3 evaluated whether potential relationships between functional asymmetries and LE injury were moderated by functional performance in 2,645 high school soccer and basketball players. Results from this aim indicate that effects of ankle DF ROM LSI, SLAR LSI, and SLHOP LSI on injury may not be moderated by ankle DF ROM performance, SLAR performance, and SLHOP performance, respectively. Additionally, functional performances may not be directly related to injury independent of functional asymmetries, age, sex, sport, and injury history. Findings from this study suggest that additional functional performance tests, as well as more sensitive measures of functional performance, should be evaluated in an attempt to better identify individuals at increased risk of injury. The statistically significant relationship between previous injury and future injury highlights the need to obtain accurate injury history during PPEs to identify individuals requiring further medical evaluation to mitigate time loss LE MSK injury.
James Onate, PhD, ATC (Advisor)
Andrew Persch, PhD, OTR/L (Committee Member)
Jingzhen Yang, PhD, MPH (Committee Member)
Ajit Chaudhari, PhD (Committee Member)
Thomas Best, MD, PhD (Committee Member)
156 p.
Health Sciences; Sports Medicine
functional performance; screening; adolescent athletes; lower extremity injury

Recommended Citations

Citations

  • Clifton, D. R. (2018). Functional Contributions to Lower Extremity Musculoskeletal Injury in High School Soccer and Basketball Athletes [Doctoral dissertation, Ohio State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=osu1516979638283332

    APA Style (7th edition)

  • Clifton, Daniel. Functional Contributions to Lower Extremity Musculoskeletal Injury in High School Soccer and Basketball Athletes. 2018. Ohio State University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=osu1516979638283332.

    MLA Style (8th edition)

  • Clifton, Daniel. "Functional Contributions to Lower Extremity Musculoskeletal Injury in High School Soccer and Basketball Athletes." Doctoral dissertation, Ohio State University, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=osu1516979638283332

    Chicago Manual of Style (17th edition)

osu1516979638283332
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This open access ETD is published by The Ohio State University and OhioLINK.