The reported incidence, severity and nature of injuries sustained in tennis vary considerably between studies. While some of these variations can be explained by differences in sample populations and conditions, the main reasons are related to differences in definitions and methodologies employed in the studies.
This statement aims to review existing consensus statements for injury surveillance in other sports in order to establish definitions, methods and reporting procedures that are applicable to the specific requirements of tennis.
The International Tennis Federation facilitated a meeting of 11 experts from seven countries representing a range of tennis stakeholders. Using a mixed methods consensus approach, key issues related to definitions, methodology and implementation were discussed and voted on by the group during a structured 1-day meeting. Following this meeting, two members of the group collaborated to produce a draft statement, based on the group discussions and voting outcomes. Three revisions were prepared and circulated for comment before the final consensus statement was produced.
A definition of medical conditions (injuries and illnesses) that should be recorded in tennis epidemiological studies and criteria for recording the severity and nature of these conditions are proposed. Suggestions are made for recording players’ baseline information together with recommendations on how medical conditions sustained during match play and training should be reported.
The definitions and methodology proposed for recording injuries and illnesses sustained during tennis activities will lead to more consistent and comparable data being collected. The surveillance procedures presented here may also be applicable to other racket sports.
To assess the effects of differing impact exercise protocols on postmenopausal bone loss at the hip and spine.
Systematic review and meta-analysis.
Electronic bibliographic databases, key journals and reference lists of reviews and articles.
Two independent reviewers assessed controlled trials evaluating effects of impact exercise on lumbar spine, femoral neck and total hip bone mineral density (BMD) in postmenopausal women for inclusion. Heterogeneity amongst trials and publication bias were assessed. Trial quality assessment was also performed.
Impact protocols that included jogging mixed with walking and stair climbing, and protocols that incorporated impact exercise with high-magnitude loading (resistance exercises), were effective at lumbar spine (weighted mean difference (random effects) 0.025 g/cm2 95% CI (0.004 to 0.046) and 0.016 g/cm2 95% CI (0.005 to 0.027); p = 0.02 and p = 0.005 respectively), although heterogeneity was evident (I2 = 88% and I2 = 73%, where I2 measures the extent of inconsistency among the trials). Effects on femoral neck BMD following these types of protocols were significant (weighted mean difference (fixed effect) 0.022 g/cm2 95% CI (0.014 to 0.030); p<0.001 and 0.005 g/cm2 95% CI (0.001 to 0.010); p = 0.03 respectively). High-impact only and odd-impact only protocols were ineffective in increasing BMD at any site.
Mixed loading exercise programmes combining jogging with other low-impact loading activity and programmes mixing impact activity with high-magnitude exercise as resistance training appear effective in reducing postmenopausal bone loss at the hip and spine. Other forms of impact exercise appear less effective at preserving BMD in this population. However, diverse methodological and reporting discrepancies are evident in current published trials.
Exercise is widely promoted as a method of weight management, while the other health benefits are often ignored. The purpose of this study was to examine whether exercise-induced improvements in health are influenced by changes in body weight.
Fifty-eight sedentary overweight/obese men and women (BMI 31.8 (SD 4.5) kg/m2) participated in a 12-week supervised aerobic exercise intervention (70% heart rate max, five times a week, 500 kcal per session). Body composition, anthropometric parameters, aerobic capacity, blood pressure and acute psychological response to exercise were measured at weeks 0 and 12.
The mean reduction in body weight was –3.3 (3.63) kg (p<0.01). However, 26 of the 58 participants failed to attain the predicted weight loss estimated from individuals’ exercise-induced energy expenditure. Their mean weight loss was only –0.9 (1.8) kg (p<0.01). Despite attaining a lower-than-predicted weight reduction, these individuals experienced significant increases in aerobic capacity (6.3 (6.0) ml/kg/min; p<0.01), and a decreased systolic (–6.00 (11.5) mm Hg; p<0.05) and diastolic blood pressure (–3.9 (5.8) mm Hg; p<0.01), waist circumference (–3.7 (2.7) cm; p<0.01) and resting heart rate (–4.8 (8.9) bpm, p<0.001). In addition, these individuals experienced an acute exercise-induced increase in positive mood.
These data demonstrate that significant and meaningful health benefits can be achieved even in the presence of lower-than-expected exercise-induced weight loss. A less successful reduction in body weight does not undermine the beneficial effects of aerobic exercise. From a public health perspective, exercise should be encouraged and the emphasis on weight loss reduced.
This study aims to investigate the association between mode of transportation to work and dyslipidaemia.
During the period between January and February 2006, telephone interviews were conducted with 2506 randomly selected urban residents aged 18 years or older in the 8 districts of Beijing, using a multiple stratified random sampling technique. Of the selected individuals, 1024 (40.86%) members of the workforce were subsequently tested for biomarkers (ie, total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C)). Multiple logistic regression modelling was used, adjusted for potential confounders.
The probability of dyslipidaemia in workers who travel to work by bus, car or taxi is higher than that of workers who walk to work, with prevalence odds ratios (PORs) of 1.99 (95% CI 1.33 to 2.97) and 2.21 (95% CI 1.28 to 3.84), respectively. There is no significant difference in the risk of experiencing dyslipidaemia when workers who ride bicycles are compared with those who walk to work (POR = 1.22, 95% CI 0.83 to 1.78).
These findings indicate that modes of transportation to work are significantly associated with the prevalence of dyslipidaemia. Prevention education should be emphasised among higher-risk people who usually go to work by car, bus or taxi.
To investigate whether childhood sports participation, particularly weight-bearing sports, has any effect on bone mineral content (BMC), areal bone mineral density (aBMD) and bone geometric characteristics in middle-aged postmenopausal women.
In this cross-sectional comparison of two groups, 46 middle-aged women (mean age, 60.2 (SD 5.6) years; range, 52–73 years) were grouped according to sport participation during growth: weight-bearing sports, including high-impact weight-bearing activities; and low-impact non-weight-bearing sports or no participation.
Dual energy X-ray absorptiometry (DXA)-measured BMC, aBMD in the lumbar spine and femur. Magnetic resonance imaging (MRI) determined bone geometric characteristics in the femur, such as femoral mid-diaphyseal cross-sectional area, periosteal and endosteal perimeters and maximum and minimum second moment of area.
Postmenopausal middle-aged women with participation in weight-bearing sports during junior high to high school (12–18 years old) displayed significantly greater BMC in both lumbar spine and femoral neck regions, and also significantly greater femoral mid-diaphyseal bone cross-sectional area, periosteal perimeter and maximum and minimum second moment of area than the non-weight-bearing sports group.
Adolescent weight-bearing exercise exerts preservational effects on femoral mid-diaphyseal size and shape, while DXA-measured BMC effectively identified the same tendency. Weight-bearing exercise in youth affects bone, and these effects may be preserved as BMC, geometric and structural advantages even after 40 years.
Few studies have examined the physiology, training and more recently injury profile of the soccer referee, and these have involved almost exclusively male referees.
To analyse the frequency and characteristics of injuries and musculoskeletal problems in female referees selected for the FIFA Women’s World Cup 2007.
Retrospective and prospective descriptive epidemiological study.
During the preparation camps a few months before the FIFA Women’s World Cup 2007, all 81 preselected female referees completed a questionnaire on injuries and musculoskeletal problems. During the final 32 matches of the tournament in China, all injuries, musculoskeletal problems and related treatment of the 36 officiating referees were documented.
Almost 50% of the referees reported having incurred at least one injury during their career that had led to time loss from the game. In the previous 12 months, 13 (16%) referees reported having sustained an injury and 64 (79%) reported musculoskeletal problems related to refereeing. During the World Cup and 14 (39%) referees incurred an injury and 17 (33%) were treated for musculoskeletal problems. The commonest location of injuries and problems were hamstrings, quadriceps, calf and ankle. The prospectively collected data found an incidence of 34.7 match injuries per 1000 match hours (95% CI 4.2 to 65.1).
Top-level female referees are exposed to an even greater risk of injury and/or musculoskeletal problems related to officiating than are male referees. Considering the growth of women’s soccer, injury prevention programmes should be specifically developed for female referees.
Delay onset of the vastus medialis obliquus (VMO) has often been reported to happen in people with patellofemoral pain (PFP). Previous studies revealed that a motion control shoe could check rearfoot pronation in overpronators. Literature suggested that movements of the lower leg could affect patellar tracking; thus motion control shoe may help prevent PFP by controlling excessive foot movements. This study aimed to compare the vasti muscle activities in people with excessive foot pronation when running with different footwear.
Twenty female subjects with rearfoot pronation >6° were tested by running for 10 km on a treadmill on two separate days. During each test, subjects either wore a motion-control running shoe or a neutral running shoe. EMG activities of their right VMO and vastus lateralis (VL) were recorded. Their EMG onset timing and median frequency (MF) were compared between the two shoe conditions.
A more significant delay in VMO onset of the running duty cycle was observed in the neutral shoe condition than in the motion control shoe (p<0.001). In the neutral shoe condition, the delay in VMO increased with running mileage (Pearson correlation = 0.948), whereas no such pattern was observed in the motion control shoe. A significant drop in MF of the quadriceps after the 10 km run in both shoe conditions was observed (p ranged from <0.001 to 0.008), and there was a larger drop in VMO MF when running with the neutral shoe.
The findings suggest that the motion control shoe may facilitate a stable temporal activation of VMO during running.
To characterise Achilles tendon structure and thickness a minimum of 8 years after intratendinous surgery.
Fourteen patients (16 tendons; nine men and five women, mean age 43 years, range 27–55) surgically treated (intratendinous surgery) for chronic painful midportion Achilles tendinosis, were followed with clinical examination and grey-scale ultrasonography for a minimum of 8 years (range 8–16, mean 13).
All patients were satisfied with the result of surgery and were active in Achilles tendon loading activities without restrictions. In all operated tendons, structural abnormalities remained and tendons remained thicker than normal tendons.
Resection of tendinosis is associated with persistent structural abnormalities and thickening of the tendon 13 years after surgery, despite successful clinical outcomes.