Exercise prescription to prevent injuries during recreational alpine skiing and snowboarding

Abstract

Background: Skiing and snowboarding are popular recreational sports worldwide, promoting health through physical activity. Regrettably, participation in snow sports also involves injury risk. Each year, skiing and snowboarding activities contribute to the total number of sports-related injuries, and associated high socio-economic and personal costs. In several sports, targeted exercise programs are reported to be effective in reducing injury rates, and therefore have the potential to prevent skiing and snowboarding injuries. Purpose: The purpose of this work was to systematically review the literature to identify exercises and/or training strategies that are suggested to prevent alpine skiing and snowboarding injuries in recreational participants. Methods: Fourteen electronic databases were systematically searched using relevant MeSH terms and keywords. Articles were included when they addressed injury prevention, recreational alpine skiing or snowboarding, and musculoskeletal injuries. Two independent reviewers quality assessed all articles meeting inclusion using a validated checklist with higher percentage scores indicating higher quality. Data were subsequently extracted from articles using a standard form and categorized to facilitate data synthesis and interpretation. Results: Thirty articles met the defined inclusion criteria and scored 72±17% (range: 23–100%) during quality assessment. From these articles, 80 recommendations forthe prevention of musculoskeletal injuries in recreational alpine skiers and snowboarders were sourced, but none pertained to exercise prescription per se. The recommendations were instead grouped into 5 main categories: equipment (n=24), education and knowledge (n=11), awareness and behaviour (n=15), experience (n=10) and third-party involvement (n=20). Most articles (73%) contained recommendations relevant to than one of these areas. Conclusion(s): The importance of targeting physical fitness in injury prevention is accepted in sports medicine and rehabilitation; yet, exercise programs for the prevention of injuries in snow sports are not readily available. As these sports involve high velocities and impact forces, it is not surprising that equipment related injury prevention recommendations were often reported. However, the nature of these sports also indicates a need for appropriate levels of strength, endurance, and conditioning to ensure an adequate control of alpine manoeuvres and avoidance of injuries. Despite the lack of documented exercise programs, the value of using a multi-facetted approach to preventing injuries was evident. The lack of published data in this area is perhaps due to the challenges of performing an exercise-based injury prevention study in recreational skiers and snowboarders, which would need relatively large sample sizes, long-term follow-up, and extensive documentation and attention to confounding variables for valid, reliable and conclusive results. Implications: Until large-scale experimental research is performed, the prescription of exercises for the prevention of injuries in recreational alpine skiers and snowboarders has limited specificity and depends on empirical evidence from other sports.

Full text

eS552 WCPT Congress 2015 / Physiotherapy 2015; Volume 101, Supplement 1 eS427–eS632
Research Report Poster Presentation
Number: RR-PO-22-02-Mon
Monday 4 May 2015 13:00
Exhibit halls 401–403
EXERCISE PRESCRIPTION TO PREVENT
INJURIES DURING RECREATIONAL
ALPINE SKIING AND SNOWBOARDING
K. Hebert-Losier1,2, H.-C. Holmberg 1
1Mid Sweden University, Health Sciences, Östersund,
Sweden;2National Sports Institute of Malaysia, Kuala
Lumpur, Malaysia
Background: Skiing and snowboarding are popular
recreational sports worldwide, promoting health through
physical activity. Regrettably, participation in snow sports
also involves injury risk. Each year, skiing and snowboard-
ing activities contribute to the total number of sports-related
injuries, and associated high socio-economic and personal
costs. In several sports, targeted exercise programs are
reported to be effective in reducing injury rates, and there-
fore have the potential to prevent skiing and snowboarding
injuries.
Purpose: The purpose of this work was to systemati-
cally review the literature to identify exercises and/or training
strategies that are suggested to prevent alpine skiing and
snowboarding injuries in recreational participants.
Methods: Fourteen electronic databases were systemat-
ically searched using relevant MeSH terms and keywords.
Articles were included when they addressed injury pre-
vention, recreational alpine skiing or snowboarding, and
musculoskeletal injuries. Two independent reviewers qual-
ity assessed all articles meeting inclusion using a validated
checklist with higher percentage scores indicating higher
quality. Data were subsequently extracted from articles using
a standard form and categorized to facilitate data synthesis
and interpretation.
Results: Thirty articles met the defined inclusion crite-
ria and scored 72 ±17% (range: 23–100%) during quality
assessment. From these articles, 80 recommendations for the
prevention of musculoskeletal injuries in recreational alpine
skiers and snowboarders were sourced, but none pertained
to exercise prescription per se. The recommendations were
instead grouped into 5 main categories: equipment (n= 24),
education and knowledge (n= 11), awareness and behaviour
(n= 15), experience (n= 10) and third-party involvement
(n= 20). Most articles (73%) contained recommendations
relevant to than one of these areas.
Conclusion(s): The importance of targeting physical fit-
ness in injury prevention is accepted in sports medicine
and rehabilitation; yet, exercise programs for the preven-
tion of injuries in snow sports are not readily available.
As these sports involve high velocities and impact forces,
it is not surprising that equipment related injury prevention
recommendations were often reported. However, the nature
of these sports also indicates a need for appropriate levels
of strength, endurance, and conditioning to ensure an ade-
quate control of alpine manoeuvres and avoidance of injuries.
Despite the lack of documented exercise programs, the value
of using a multi-facetted approach to preventing injuries was
evident. The lack of published data in this area is perhaps
due to the challenges of performing an exercise-based injury
prevention study in recreational skiers and snowboarders,
which would need relatively large sample sizes, long-term
follow-up, and extensive documentation and attention to con-
founding variables for valid, reliable and conclusive results.
Implications: Until large-scale experimental research is
performed, the prescription of exercises for the prevention of
injuries in recreational alpine skiers and snowboarders has
limited specificity and depends on empirical evidence from
other sports.
Keywords: Injury prevention; Snow sports; Systematic
review
Funding acknowledgements: The authors acknowledge
the contribution of Maria Hansson, PT, and Mette Bäckström,
PT, for their assistance in this work.
Ethics approval: Ethical approval was not required to
perform this work.
http://dx.doi.org/10.1016/j.physio.2015.03.3366
Research Report Poster Presentation
Number: RR-PO-10-11-Sat
Saturday 2 May 2015 12:15
Exhibit halls 401–403
A RANDOMISED PLACEBO-CONTROLLED
STUDY INVESTIGATING THE EFFECTS OF
MOBILISATION TREATMENT DURATION
ON PAIN IN PARTICIPANTS WITH CHRONIC
LOW BACK PAIN
C. Hebron1, A. Moore 1, K. Saber Sheikh1,
A. Jackson2
1University of Brighton, School of Health Sciences,
Eastbourne, United Kingdom;2University of Brighton,
Brighton, United Kingdom
Background: A common treatment used by physiothera-
pists for patients with low back pain is mobilisation. The aim
of applying mobilisation treatment is to increase range of
movement and reduce pain and stiffness. Therapists choose a
specific dose of mobilisation for each patient, which includes
a decision on the duration of applied force, commonly up to
3 minutes. Little research has been done to determine the
effects of different durations of treatment. There is tentative
evidence that increased duration beyond 3minutes leads to a
decrease in pain.