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Abstract

Shoulder injuries are a common problem in handball. One likely cause of such injuries is excessive throwing. However, it is difficult to measure the number of player throws in large cohort studies using existing methods accurately. Therefore, the purpose of this study is to develop and validate a method for identifying overhead throws using a low-cost inertial measurement unit (IMU) worn on the wrist. In a two-stage approach, we developed a threshold-based automatic identification method for overhead throws in a laboratory study using the IMU. Subsequently, we validated the suggested thresholds in a field setting by comparing throws identified by the threshold-method to throws identified by video recordings of handball practices. The best set of threshold values resulted in a per-player median sensitivity of 100% (range: 84–100%) and a median positive predictive value (PPV) of 96% (range: 86–100%) in the development study. In the validation study, the per-player median sensitivity dropped to 78% sensitivity (range: 52–91%), while the per-player median PPV dropped to 79% (range: 47–90%). The proposed method is a promising method for automatically identifying handball throws in a cheap and feasible way.

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Injuries in handball are common due to the repetitive demands of overhead throws at high velocities. Monitoring workload is crucial for understanding these demands and improving injury-prevention strategies. However, in handball, it is challenging to monitor throwing workload due to the difficulty of counting the number, intensity, and type of throws during training and competition. The aim of this study was to investigate if an inertial measurement unit (IMU) and machine learning (ML) techniques could be used to detect different types of team handball throws and predict ball velocity. Seventeen players performed several throws with different wind-up (circular and whip-like) and approach types (standing, running, and jumping) while wearing an IMU on their wrist. Ball velocity was measured using a radar gun. ML models predicted peak ball velocity with an error of 1.10 m/s and classified approach type and throw type with 80–87% accuracy. Using IMUs and ML models may offer a practical and automated method for quantifying throw counts and classifying the throw and approach types adopted by handball players.
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Background It is widely accepted that athletes sustain sports injury if they train ‘too much, too soon’. However, not all athletes are built the same; some can tolerate more training than others. It is for this reason that prescribing the same training programme to all athletes to reduce injury risk is not optimal from a coaching perspective. Rather, athletes require individualised training plans. In acknowledgement of athlete diversity, it is therefore essential to ask the right causal research question in studies examining sports injury aetiology. Purpose In this first part of a British Journal of Sports Medicine educational series, we present four different causal research questions related to the ‘too much, too soon’ theory and critically discuss their relevance to sports injury prevention. Content If it is true that there is no ‘one size fits all’ training programme, then we need to consider by how much training can vary depending on individual athlete characteristics. To provide an evidence-base for subgroup-specific recommendations, a stronger emphasis on the following questions is needed: (1) How much training is ‘too much’ before athletes with different characteristics sustain sports-related injury? and (2) Does the risk of sports injury differ among athletes with a certain characteristic (eg, high experience) compared with athletes with other characteristics (eg, low experience) depending on how much training they perform? Conclusion We recommend that sports injury researchers aiming to examine the ‘too much, too soon’ theory should carefully consider how they, assisted by coaches, athletes and clinicians, pose their causal research question. In the light of the limitations of population-based prevention that intends to provide all athletes with the same advice, we argue that a stronger emphasis on research questions targeting subgroups of athletes is needed. In doing so, researchers may assist athletes, clinicians and coaches to understand what training advice/programme works best, for whom and under what circumstances.
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Study design: Prospective cohort study. Background: Shoulder injuries are common in handball. Shoulder weakness, scapular dyskinesia and range of motion (ROM) deficits are associated with shoulder injury in adults, but studies of adolescent players are scarce. Objective: To investigate if elite adolescent female and male handball players with shoulder muscle weakness, deficits in shoulder rotation ROM or joint position sense (JPS), or scapular dyskinesia in preseason have an increased shoulder injury rate compared to players not having these characteristics. Methods: 341 uninjured players (452 player-seasons, 50% females) had isometric external rotational (IER), internal rotational (IIR), abduction (IABD) and eccentric external rotational (EER) shoulder strength, shoulder ROM, JPS, and scapular dyskinesia measured during pre-season. Players were monitored weekly regarding match- and training hours and shoulder injuries during one or two seasons. We used multivariable Cox proportional hazard models to calculate hazard rate ratios (HRR) related to the first injury with 95% confidence intervals (95% CI). Results: 48 new shoulder injuries were reported during the two seasons. In females, the HRR for IER was 2.37 (95% CI 1.03-5.44), for IIR 2.44 (95% CI 1.06-5.61), and for scapular dyskinesia 1.53 (95% CI 0.36-6.52). In males, the HRR for IER was 1.02 (95% CI 0.44-2.36), for IIR 0.74 (95% CI 0.31-1.75), and for scapular dyskinesia 3.43 (95% CI 1.49-7.92). There were no associations between new shoulder injuries and deficits in ROM or JPS. Conclusion: In adolescent elite handball, male players with pre-season scapula dyskinesia, and female players with pre-season internal or external rotation shoulder weakness, had an increased shoulder injury rate. J Orthop Sports Phys Ther, Epub 27 Nov 2019. doi:10.2519/jospt.2020.9044.
Article
Context: Few researchers have identified intrinsic risk factors for shoulder injury in team handball players by analyzing measurements of maximal isokinetic rotator muscle strength. Objective: To identify possible intrinsic risk factors for shoulder injury by analyzing measurements of maximal isokinetic rotator muscle strength. Design: Cross-sectional study. Setting: Male team handball senior divisions (the highest level) in France and Belgium. Patients or other participants: A total of 108 male high-level handball players (age = 24 ± 4 years, height = 189 ± 6 cm, mass = 87 ± 11 kg) were enrolled. Main outcome measure(s): All players completed a preseason questionnaire and performed a bilateral isokinetic assessment of the shoulder rotator muscles. On a monthly questionnaire, players reported any shoulder injury that they sustained during the season. Results: On the preseason questionnaire, 51 of 108 (47%) participants reported a history of dominant-shoulder injury. A total of 106 participants completed the in-season questionnaire, with 22% (n = 23) reporting a shoulder injury on their dominant side during the subsequent season. Fourteen percent (n = 15) sustained microtraumatic injuries, and 8% (n = 8) described a traumatic injury. Backcourt players had a 3.5-times increased risk of injury during the new season compared with players in other positions. Among the isokinetic results, no risk factor for further injury was identified in handball players with microtraumatic injuries. For traumatic injuries, the concentric maximal strength developed by the internal rotators at high speed (240°/s) in the dominant shoulder was a protective factor against the risk of further injury. Conclusions: These results can potentially identify intrinsic risk factors for shoulder injury and may be used to determine potential interventions for reducing this risk in handball players.
Article
Background Shoulder injuries are common among handball players and predominantly characterised by overuse characteristics. Reduced total glenohumeral rotation, external rotation weakness and scapular dyskinesis have been identified as risk factors among elite male handball players. Aim To assess whether previously identified risk factors are associated with overuse shoulder injuries in a large cohort of elite male and female handball players. Methods 329 players (168 male, 161 female) from the two upper divisions in Norway were included and tested prior to the 2014–2015 season. Measures included glenohumeral internal and external rotation range of motion, isometric internal and external rotation strength, and assessment of scapular dyskinesis. Players were followed prospectively for one competitive season, with prevalence and severity of shoulder problems registered monthly using the Oslo Sports Trauma Research Center Overuse Injury Questionnaire. A severity score based on players’ questionnaire responses was used as the outcome measure in multivariable logistic regression to investigate associations between candidate risk factors and overuse shoulder injury. Results No significant associations were found between total rotation (OR 1.05 per 5° change, 95% CI 0.98 to 1.13), external rotation strength (OR 1.05 per 10 N change, 95% CI 0.92 to 1.20) or obvious scapular dyskinesis (OR 1.23, 95% CI 0.25 to 5.99) and overuse shoulder injury. A significant positive association was found between greater internal rotation (OR 1.16 per 5° change, 95% CI 1.00 to 1.34) and overuse shoulder injury. Conclusion None of the previously identified risk factors were associated with overuse shoulder injuries in a mixed-sex cohort of elite handball players.
Article
This paper proposes a new sports injury research framework, the Translating Research into Injury Prevention Practice framework, or TRIPP. This model builds on the fact that only research that can, and will, be adopted by sports participants, their coaches and sporting bodies will prevent injuries. Future advances in sports injury prevention will only be achieved if research efforts are directed towards understanding the implementation context for injury prevention, as well as continuing to build the evidence base for their efficacy and effectiveness of interventions. There is no doubt that intervention research in the sporting field can be difficult and many challenges need to be overcome; however, that should not be put up as a barrier towards undertaking it. Over the next few years, sports injury researchers will need to think carefully about the "best" study designs and analysis tools to achieve this. All reported sports injury studies, of whatever design, should include information on key implementation factors such as player/club recruitment rates and other biases as well as the rate of uptake of the interventions being tested, including reasons for use/non-use. However, it will only be broad research endeavours that adopt the TRIPP six-staged approach that will lead to real-world injury prevention gains.
Norges idrettshøgskole
  • S R Prestkvern
  • B Clarsen
  • G Myklebust
Er det en sammenheng mellom pasnings-og skuddeksponering og skulderproblemer i norsk herrehåndball
  • S R Prestkvern
  • B Clarsen
  • G Myklebust
Prestkvern, S. R., Clarsen, B., & Myklebust, G. (2013). Er det en sammenheng mellom pasnings-og skuddeksponering og skulderproblemer i norsk herrehåndball?. Norges idrettshøgskole. Retrieved December 18, 2020, from https://nih.brage.unit.no/nih-xmlui/handle/11250/171860