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Sports Medicine: What Artificial Intelligence Can Do for Preventing Athlete Injuries
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Physical activity analysis assessment has been a concern throughout human history. The intersection of technological growth with sports has given rise to a burgeoning field known as sports engineering. In the 19th century, the advent of chrono-photography and pioneering marked the inception of sports performance analysis. In recent years, the noticeable developments achieved in wearable low-power electronics with wireless high interconnection capability, as a part of modern technologies, have aided us in studying sports parameters such as motor behavior, biomechanics, equipment design, and materials science, playing an essential role in the understanding of sports dynamics. This study aims to review over 250 published articles since 2018, focusing on utilizing and validating these emergent technologies in sports and clinical aspects. It is predicted that one of the next steps in sports technology and engineering development will be using algorithms based on artificial intelligence to analyze the measurements obtained by multi-sensor systems (sensor fusion) to monitor biometric and physiological parameters in performance analysis and health assessments.
We are currently witnessing an unprecedented era of digital transformation in sports, driven by the revolutions in Artificial Intelligence (AI), Virtual Reality (VR), Augmented Reality (AR), and Data Visualization (DV). These technologies hold the promise of redefining sports performance analysis, automating data collection, creating immersive training environments, and enhancing decision-making processes. Traditionally, performance analysis in sports relied on manual data collection, subjective observations, and standard statistical models. These methods, while effective, had limitations in terms of time and subjectivity. However, recent advances in technology have ushered in a new era of objective and real-time performance analysis. AI has revolutionized sports analysis by streamlining data collection, processing vast datasets, and automating information synthesis. VR introduces highly realistic training environments, allowing athletes to train and refine their skills in controlled settings. AR overlays digital information onto the real sports environment, providing real-time feedback and facilitating tactical planning. DV techniques convert complex data into visual representations, improving the understanding of performance metrics. In this paper, we explore the potential of these emerging technologies to transform sports performance analysis, offering valuable resources to coaches and athletes. We aim to enhance athletes’ performance, optimize training strategies, and inform decision-making processes. Additionally, we identify challenges and propose solutions for integrating these technologies into current sports analysis practices. This narrative review provides a comprehensive analysis of the historical context and evolution of performance analysis in sports science, highlighting current methods’ merits and limitations. It delves into the transformative potential of AI, VR, AR, and DV, offering insights into how these tools can be integrated into a theoretical model.
Use injuries, i.e., injuries caused by repetitive strain on the body, represent a serious problem in athletics that has traditionally relied on historic datasets and human experience for prevention. Existing methodologies have been frustratingly slow at developing higher precision prevention practices. Technological advancements have permitted the emergence of artificial intelligence and machine learning (ML) as promising toolsets to enhance both injury mitigation and rehabilitation protocols. This article provides a comprehensive overview of recent advances in ML techniques as they have been applied to sports injury prediction and prevention. A comprehensive literature review was conducted searching PubMed/Medline, Institute of Electrical and Electronics Engineers (IEEE)/Institute of Engineering and Technology (IET), and ScienceDirect. Ovid Discovery and Google Scholar were used to provide additional aggregate results and a grey literature search. A focus was placed on papers published from 2017 to 2022. Algorithms of interest were limited to K-Nearest Neighbor (KNN), K-means, decision tree, random forest, gradient boosting and AdaBoost, and neural networks. A total of 42 original research papers were included, and their results were summarized. We conclude that given the current lack of open source, uniform data sets, as well as a reliance on dated regression models, no strong conclusions about the real-world efficacy of ML as it applies to sports injury prediction can be made. However, it is suggested that addressing these two issues will allow powerful, novel ML architectures to be deployed, thus rapidly advancing the state of this field, and providing validated clinical tools.
Training load (TL) is frequently documented among team sports and the development of emerging technology (ET) is displaying promising results towards player performance and injury risk identification. The aim of this systematic review was to identify ETs used in field-based sport to monitor TL for injury/performance prediction and provide sport specific recommendations by identifying new data generation in which coaches may consider when tracking players for an increased accuracy in training prescription and evaluation among field-based sports. Data was extracted from 60 articles following a systematic search of CINAHL, SPORTDiscus, Web of Science and IEEE XPLORE databases. Global positioning system (GPS) and accelerometers were common external TL tools and Rated Perceived Exertion (RPE) for internal TL. A collection of analytics tools were identified when investigating injury/performance prediction. Machine Learning showed promising results in many studies, identifying the strongest predictive variables and injury risk identification. Overall, a variety of TL monitoring tools and predictive analytics were utilized by researchers and were successful in predicting injury/performance, but no common method taken by researchers could be identified. This review highlights the positive effect of ETs, but further investigation is desired towards a ‘gold standard” predictive analytics tool for injury/performance prediction in field-based team sports.
Artificial intelligence (AI) has the potential to develop the field of sports medicine. It can be used to improve injury prevention by analyzing player performance data, biomechanical factors and physiological indicators to identify injury risk and develop personalized prevention programs. Likewise, AI can improve training strategies by analyzing data and performance metrics to create individualized and precise training programs, optimizing intensity and duration while avoiding overtraining. Additionally, AI can redefine rehabilitation by dynamically influencing rehabilitation programs, providing real-time feedback, and customizing therapies based on individual recovery. In this editorial we present in detail the benefits of AI in these three areas and we discuss ethical considerations for using AI as a powerful tool in an appropriate way.
Artificial intelligence (AI) is looked upon nowadays as the potential major catalyst for the fourth industrial revolution. In the last decade, AI use in Orthopaedics increased approximately tenfold. Artificial intelligence helps with tracking activities, evaluating diagnostic images, predicting injury risk, and several other uses. Chat Generated Pre-trained Transformer (ChatGPT), which is an AI-chatbot, represents an extremely controversial topic in the academic community. The aim of this review article is to simplify the concept of AI and study the extent of AI use in Orthopaedics and sports medicine literature. Additionally, the article will also evaluate the role of ChatGPT in scientific research and publications.
Level of evidence : Level V, letter to review.
Introduction
Dribbling is an important soccer skill that, when effective, allows players to overcome opponents. It can provide a strong tactical advantage; for this reason, all of its components (sprint, speed, and ball control) are fundamental to the development of young players. Dribbling can also be considered a decision-making process, and due to its characteristics, it is not always easy to study ecologically. Using a video analysis study, this research aimed to determine whether dribbling skills, specifically dribbling choice (i.e., decision-making), were related to U10 soccer players’ quality.
Methods
Several outcomes measures, divided into three categories, were taken during video analyses: (i) measures related to the efficacy of dribbling skill; (ii) measures related to the ability of players without the ball to support the player in possession; and (iii) measures related to ball circulation. These data were retrospectively assessed to whether the coaches had formed the teams in training through an implicit knowledge of the players’ dribbling skills.
Results
The percentage of accurate dribbling (that is, the ability to perform correct passes after a successful dribble) was found to be the variable that coaches may have implicitly used in creating the three groups differentiated by technical skills (p < 0.05). In fact, this percentage was 12.9%, 24.0%, and 48.1% for the groups with lower, average, and higher technical skills, respectively.
Conclusion
Overall, the results demonstrate that dribbling accuracy has an important weight in the coach’s evaluation of the technical skills level of young soccer players.
Introduction
Two-thirds of athletes (65%) have at least one injury complaint leading to participation restriction (ICPR) in athletics (track and field) during one season. The emerging practice of medicine and public health supported by electronic processes and communication in sports medicine represents an opportunity for developing new injury risk reduction strategies. Modelling and predicting the risk of injury in real-time through artificial intelligence using machine learning techniques might represent an innovative injury risk reduction strategy. Thus, the primary aim of this study will be to analyse the relationship between the level of I njury R isk E stimation F eedback (I-REF) use (average score of athletes’ self-declared level of I-REF consideration for their athletics activity) and the ICPR burden during an athletics season.
Method and analysis
We will conduct a prospective cohort study, called I njury Predict ion with A rtificial I ntelligence (IPredict-AI), over one 38-week athletics season (from September 2022 to July 2023) involving competitive athletics athletes licensed with the F rench F ederation of A thletics. All athletes will be asked to complete daily questionnaires on their athletics activity, their psychological state, their sleep, the level of I-REF use and any ICPR. I-REF will present a daily estimation of the ICPR risk ranging from 0% (no risk for injury) to 100% (maximal risk for injury) for the following day. All athletes will be free to see I-REF and to adapt their athletics activity according to I-REF. The primary outcome will be the ICPR burden over the follow-up (over an athletics season), defined as the number of days lost from training and/or competition due to ICPR per 1000 hours of athletics activity. The relationship between ICPR burden and the level of I-REF use will be explored by using linear regression models.
Ethics and dissemination
This prospective cohort study was reviewed and approved by the Saint-Etienne University Hospital Ethical Committee (Institutional Review Board: IORG0007394, IRBN1062022/CHUSTE). Results of the study will be disseminated in peer-reviewed journals and in international scientific congresses, as well as to the included participants.
Sports diagnostics is a comprehensive scientific concept and comprises an aspect of training monitoring and/or sports medicine [...]
Background
In the emergency room, clinicians spend a lot of time and are exposed to mental stress. In addition, fracture classification is important for determining the surgical method and restoring the patient's mobility. Recently, with the help of computers using artificial intelligence (AI) or machine learning (ML), diagnosis and classification of hip fractures can be performed easily and quickly. The purpose of this systematic review is to search for studies that diagnose and classify for hip fracture using AI or ML, organize the results of each study, analyze the usefulness of this technology and its future use value.
Methods
PubMed Central, OVID Medline, Cochrane Collaboration Library, Web of Science, EMBASE, and AHRQ databases were searched to identify relevant studies published up to June 2022 with English language restriction. The following search terms were used [All Fields] AND (", "[MeSH Terms] OR (""[All Fields] AND "bone"[All Fields]) OR "bone fractures"[All Fields] OR "fracture"[All Fields]). The following information was extracted from the included articles: authors, publication year, study period, type of image, type of fracture, number of patient or used images, fracture classification, reference diagnosis of fracture diagnosis and classification, and augments of each studies. In addition, AI name, CNN architecture type, ROI or important region labeling, data input proportion in training/validation/test, and diagnosis accuracy/AUC, classification accuracy/AUC of each studies were also extracted.
Results
In 14 finally included studies, the accuracy of diagnosis for hip fracture by AI was 79.3–98%, and the accuracy of fracture diagnosis in AI aided humans was 90.5–97.1. The accuracy of human fracture diagnosis was 77.5–93.5. AUC of fracture diagnosis by AI was 0.905–0.99. The accuracy of fracture classification by AI was 86–98.5 and AUC was 0.873–1.0. The forest plot represented that the mean AI diagnosis accuracy was 0.92, the mean AI diagnosis AUC was 0.969, the mean AI classification accuracy was 0.914, and the mean AI classification AUC was 0.933. Among the included studies, the architecture based on the GoogLeNet architectural model or the DenseNet architectural model was the most common with three each. Among the data input proportions, the study with the lowest training rate was 57%, and the study with the highest training rate was 95%. In 14 studies, 5 studies used Grad-CAM for highlight important regions.
Conclusion
We expected that our study may be helpful in making judgments about the use of AI in the diagnosis and classification of hip fractures. It is clear that AI is a tool that can help medical staff reduce the time and effort required for hip fracture diagnosis with high accuracy. Further studies are needed to determine what effect this causes in actual clinical situations.
Wearable technologies are small electronic and mobile devices with wireless communication capabilities that can be worn on the body as a part of devices, accessories or clothes. Sensors incorporated within wearable devices enable the collection of a broad spectrum of data that can be processed and analysed by artificial intelligence (AI) systems. In this narrative review, we performed a literature search of the MEDLINE, Embase and Scopus databases. We included any original studies that used sensors to collect data for a sporting event and subsequently used an AI-based system to process the data with diagnostic, treatment or monitoring intents. The included studies show the use of AI in various sports including basketball, baseball and motor racing to improve athletic performance. We classified the studies according to the stage of an event, including pre-event training to guide performance and predict the possibility of injuries; during events to optimise performance and inform strategies; and in diagnosing injuries after an event. Based on the included studies, AI techniques to process data from sensors can detect patterns in physiological variables as well as positional and kinematic data to inform how athletes can improve their performance. Although AI has promising applications in sports medicine, there are several challenges that can hinder their adoption. We have also identified avenues for future work that can provide solutions to overcome these challenges.
Background
In professional sports, injuries resulting in loss of playing time have serious implications for both the athlete and the organization. Efforts to quantify injury probability utilizing machine learning have been met with renewed interest, and the development of effective models has the potential to supplement the decision-making process of team physicians.
Purpose/Hypothesis
The purpose of this study was to (1) characterize the epidemiology of time-loss lower extremity muscle strains (LEMSs) in the National Basketball Association (NBA) from 1999 to 2019 and (2) determine the validity of a machine-learning model in predicting injury risk. It was hypothesized that time-loss LEMSs would be infrequent in this cohort and that a machine-learning model would outperform conventional methods in the prediction of injury risk.
Study Design
Case-control study; Level of evidence, 3.
Methods
Performance data and rates of the 4 major muscle strain injury types (hamstring, quadriceps, calf, and groin) were compiled from the 1999 to 2019 NBA seasons. Injuries included all publicly reported injuries that resulted in lost playing time. Models to predict the occurrence of a LEMS were generated using random forest, extreme gradient boosting (XGBoost), neural network, support vector machines, elastic net penalized logistic regression, and generalized logistic regression. Performance was compared utilizing discrimination, calibration, decision curve analysis, and the Brier score.
Results
A total of 736 LEMSs resulting in lost playing time occurred among 2103 athletes. Important variables for predicting LEMS included previous number of lower extremity injuries; age; recent history of injuries to the ankle, hamstring, or groin; and recent history of concussion as well as 3-point attempt rate and free throw attempt rate. The XGBoost machine achieved the best performance based on discrimination assessed via internal validation (area under the receiver operating characteristic curve, 0.840), calibration, and decision curve analysis.
Conclusion
Machine learning algorithms such as XGBoost outperformed logistic regression in the prediction of a LEMS that will result in lost time. Several variables increased the risk of LEMS, including a history of various lower extremity injuries, recent concussion, and total number of previous injuries.
This study examined associations between cumulative training load, travel demands and recovery days with athlete-reported outcome measures (AROMs) and countermovement jump (CMJ) performance in professional basketball. Retrospective analysis was performed on data collected from 23 players (mean±SD: age = 24.7±2.5 years, height = 198.3±7.6 cm, body mass = 98.1±9.0 kg, wingspan = 206.8±8.4 cm) from 2018–2020 in the National Basketball Association G-League. Linear mixed models were used to describe variation in AROMs and CMJ data in relation to cumulative training load (previous 3- and 10-days), hours travelled (previous 3- and 10-day), days away from the team’s home city, recovery days (i.e., no travel/minimal on-court activity) and individual factors (e.g., age, fatigue, soreness). Cumulative 3-day training load had negative associations with fatigue, soreness, and sleep, while increased recovery days were associated with improved soreness scores. Increases in hours travelled and days spent away from home over 10 days were associated with increased sleep quality and duration. Cumulative training load over 3 and 10 days, hours travelled and days away from home city were all associated with changes in CMJ performance during the eccentric phase. The interaction of on-court and travel related stressors combined with individual factors is complex, meaning that multiple athletes response measures are needed to understand fatigue and recovery cycles. Our findings support the utility of the response measures presented (i.e., CMJ and AROMs), but this is not an exhaustive battery and practitioners should consider what measures may best inform training periodization within the context of their environment/sport.
A growing number of artificial intelligence (AI)-based clinical decision support systems are showing promising performance in preclinical, in silico evaluation, but few have yet demonstrated real benefit to patient care. Early-stage clinical evaluation is important to assess an AI system's actual clinical performance at small scale, ensure its safety, evaluate the human factors surrounding its use and pave the way to further large-scale trials. However, the reporting of these early studies remains inadequate. The present statement provides a multi-stakeholder, consensus-based reporting guideline for the Developmental and Exploratory Clinical Investigations of DEcision support systems driven by Artificial Intelligence (DECIDE-AI). We conducted a two-round, modified Delphi process to collect and analyze expert opinion on the reporting of early clinical evaluation of AI systems. Experts were recruited from 20 pre-defined stakeholder categories. The final composition and wording of the guideline was determined at a virtual consensus meeting. The checklist and the Explanation & Elaboration (E&E) sections were refined based on feedback from a qualitative evaluation process. In total, 123 experts participated in the first round of Delphi, 138 in the second round, 16 in the consensus meeting and 16 in the qualitative evaluation. The DECIDE-AI reporting guideline comprises 17 AI-specific reporting items (made of 28 subitems) and ten generic reporting items, with an E&E paragraph provided for each. Through consultation and consensus with a range of stakeholders, we developed a guideline comprising key items that should be reported in early-stage clinical studies of AI-based decision support systems in healthcare. By providing an actionable checklist of minimal reporting items, the DECIDE-AI guideline will facilitate the appraisal of these studies and replicability of their findings.
In the last decade, the number of studies about machine learning algorithms applied to sports, e.g., injury forecasting and athlete performance prediction, have rapidly increased. Due to the number of works and experiments already present in the state-of-the-art regarding machine-learning techniques in sport science, the aim of this narrative review is to provide a guideline describing a correct approach for training, validating, and testing machine learning models to predict events in sports science. The main contribution of this narrative review is to highlight any possible strengths and limitations during all the stages of model development, i.e., training, validation, testing, and interpretation, in order to limit possible errors that could induce misleading results. In particular, this paper shows an example about injury forecaster that provides a description of all the features that could be used to predict injuries, all the possible pre-processing approaches for time series analysis, how to correctly split the dataset to train and test the predictive models, and the importance to explain the decision-making approach of the white and black box models.
Background and objectives
: Wearable technologies have added completely new and fast emerging tools to the popular field of personal gadgets. Aside from being fashionable and equipped with advanced hardware technologies such as communication modules and networking, wearable devices have the potential to fuel artificial intelligence (AI) methods with a wide range of valuable data.
Methods
: Various AI techniques such as supervised, unsupervised, semi-supervised and reinforcement learning (RL) have already been used to carry out various tasks. This paper reviews the recent applications of wearables that have leveraged AI to achieve their objectives.
Results
: Particular example applications of supervised and unsupervised learning for medical diagnosis are reviewed. Moreover, examples combining the internet of things, wearables, and RL are reviewed. Application examples of wearables will be also presented for specific domains such as medical, industrial, and sport. Medical applications include fitness, movement disorder, mental health, etc. Industrial applications include employee performance improvement with the aid of wearables. Sport applications are all about providing better user experience during workout sessions or professional gameplays.
Conclusion
: The most important challenges regarding design and development of wearable devices and the computation burden of using AI methods are presented. Finally, future challenges and opportunities for wearable devices are presented.
Background
Technological innovation is a key component of orthopaedic surgery. With the integration of powerful technologies in surgery and clinical practice, artificial intelligence (AI) may become an important tool for orthopaedic surgeons in the future. Through adaptive learning and problem solving that serve to constantly increase accuracy, machine learning algorithms show great promise in orthopaedics.
Purpose
To investigate the current and potential uses of AI in the management of anterior cruciate ligament (ACL) injury.
Study Design
Systematic review; Level of evidence, 3.
Methods
A systematic review of the PubMed, MEDLINE, Embase, Web of Science, and SPORTDiscus databases between their start and August 12, 2020, was performed by 2 independent reviewers. Inclusion criteria included application of AI anywhere along the spectrum of predicting, diagnosing, and managing ACL injuries. Exclusion criteria included non-English publications, conference abstracts, review articles, and meta-analyses. Statistical analysis could not be performed because of data heterogeneity; therefore, a descriptive analysis was undertaken.
Results
A total of 19 publications were included after screening. Applications were divided based on the different stages of the clinical course in ACL injury: prediction (n = 2), diagnosis (n = 12), intraoperative application (n = 1), and postoperative care and rehabilitation (n = 4). AI-based technologies were used in a wide variety of applications, including image interpretation, automated chart review, assistance in the physical examination via optical tracking using infrared cameras or electromagnetic sensors, generation of predictive models, and optimization of postoperative care and rehabilitation.
Conclusion
There is an increasing interest in AI among orthopaedic surgeons, as reflected by the applications for ACL injury presented in this review. Although some studies showed similar or better outcomes using AI compared with traditional techniques, many challenges need to be addressed before this technology is ready for widespread use.
Sports injuries of high-level athletes restrict the improvement of sports performance. Under this premise, an efficient and accurate sports injury assessment method is needed to detect potential sports injuries and conduct injury prevention training. Therefore, this paper proposes a novel sports injury prediction algorithm based on visual analysis technology. The proposed algorithm first takes the time-frequency of sensed data as the convolutional neural network (CNN) input. The one-dimensional time series collected by the sensor is converted into two-dimensional images using the Gram angle domain algorithm. The one-dimensional sensed data provides a new perspective and provides a basis for better use of convolutional neural networks and computer vision technology. Second, combining the residual network’s structure and advantages and hole convolution and multihole convolution kernel residual module is proposed. It improves the model’s ability to extract features at different scales while effectively controlling the parameter scale. Based on these modules, a single-sensor-based athlete action recognition algorithm is proposed. Several comparative experiments have been conducted on a public data set containing only acceleration sensors to verify the proposed algorithm’s effectiveness.
Purpose
Injuries are common in sports and can have significant physical, psychological and financial consequences. Machine learning (ML) methods could be used to improve injury prediction and allow proper approaches to injury prevention. The aim of our study was therefore to perform a systematic review of ML methods in sport injury prediction and prevention.
Methods
A search of the PubMed database was performed on March 24th 2020. Eligible articles included original studies investigating the role of ML for sport injury prediction and prevention. Two independent reviewers screened articles, assessed eligibility, risk of bias and extracted data. Methodological quality and risk of bias were determined by the Newcastle–Ottawa Scale. Study quality was evaluated using the GRADE working group methodology.
Results
Eleven out of 249 studies met inclusion/exclusion criteria. Different ML methods were used (tree-based ensemble methods ( n = 9), Support Vector Machines ( n = 4), Artificial Neural Networks ( n = 2)). The classification methods were facilitated by preprocessing steps ( n = 5) and optimized using over- and undersampling methods ( n = 6), hyperparameter tuning ( n = 4), feature selection ( n = 3) and dimensionality reduction ( n = 1). Injury predictive performance ranged from poor (Accuracy = 52%, AUC = 0.52) to strong (AUC = 0.87, f1-score = 85%).
Conclusions
Current ML methods can be used to identify athletes at high injury risk and be helpful to detect the most important injury risk factors. Methodological quality of the analyses was sufficient in general, but could be further improved. More effort should be put in the interpretation of the ML models.
Background
Artificial intelligence (AI) is one of the most promising areas in medicine with many possibilities for improving health and wellness. Already today, diagnostic decision support systems may help patients to estimate the severity of their complaints. This fictional case study aimed to test the diagnostic potential of an AI algorithm for common sports injuries and pathologies.
Methods
Based on a literature review and clinical expert experience, five fictional “common” cases of acute, and subacute injuries or chronic sport-related pathologies were created: Concussion, ankle sprain, muscle pain, chronic knee instability (after ACL rupture) and tennis elbow. The symptoms of these cases were entered into a freely available chatbot-guided AI app and its diagnoses were compared to the pre-defined injuries and pathologies.
Results
A mean of 25–36 questions were asked by the app per patient, with optional explanations of certain questions or illustrative photos on demand. It was stressed, that the symptom analysis would not replace a doctor’s consultation. A 23-yr-old male patient case with a mild concussion was correctly diagnosed. An ankle sprain of a 27-yr-old female without ligament or bony lesions was also detected and an ER visit was suggested. Muscle pain in the thigh of a 19-yr-old male was correctly diagnosed. In the case of a 26-yr-old male with chronic ACL instability, the algorithm did not sufficiently cover the chronic aspect of the pathology, but the given recommendation of seeing a doctor would have helped the patient. Finally, the condition of the chronic epicondylitis in a 41-yr-old male was correctly detected.
Conclusions
All chosen injuries and pathologies were either correctly diagnosed or at least tagged with the right advice of when it is urgent for seeking a medical specialist. However, the quality of AI-based results could presumably depend on the data-driven experience of these programs as well as on the understanding of their users. Further studies should compare existing AI programs and their diagnostic accuracy for medical injuries and pathologies.
Recent advances in sensor technologies and data acquisition systems opened up the era of big data in the field of structural health monitoring (SHM). Data-driven methods based on statistical pattern recognition provide outstanding opportunities to implement a long-term SHM strategy, by exploiting measured vibration data. However, their main limitation, due to big data or high-dimensional features, is linked to the complex and time-consuming procedures for feature extraction and/or statistical decision-making. To cope with this issue, in this article we propose a strategy based on autoregressive moving average (ARMA) modeling for feature extraction, and on an innovative hybrid divergence-based method for feature classification. Data relevant to a cable-stayed bridge are accounted for to assess the effectiveness and efficiency of the proposed method. The results show that the offered hybrid divergence-based method, in conjunction with ARMA modeling, succeeds in detecting damage in cases strongly characterized by big data.
Purpose:
To assess injury risk in elite-level youth football players based on anthropometric, motor coordination and physical performance measures with a machine learning approach.
Methods:
A total of 734 players in the U10 to U15 age categories (mean age: 11.7 +/- 1.7 years) from seven Belgian youth academies were prospectively followed during one season. Football exposure and occurring injuries were monitored continuously by the academies' coaching and medical staff, respectively. Preseason anthropometric measurements (height, weight, and sitting height) were taken and test batteries to assess motor coordination and physical fitness (strength, flexibility, speed, agility, and endurance) were performed. An extreme gradient boosting algorithms (XGBoost) was used to predict injury based on the preseason test results. Subsequently, the same approach was used to classify injuries as either overuse or acute.
Results:
During the season, half of the players (n = 368) sustained at least one injury. Of the first occurring injuries, 173 were identified as overuse and 195 as acute injuries. The machine learning algorithm was able to identify the injured players in the hold-out test sample with 85% precision, 85% recall (sensitivity) and 85% accuracy (f1-score). Furthermore, injuries could be classified as overuse or acute with 78% precision, 78% recall and 78% accuracy.
Conclusion:
Our machine learning algorithm was able to predict injury and to distinguish overuse from acute injuries with reasonably high accuracy based on preseason measures. Hence, it is a promising approach to assess injury risk among elite-level youth football players. This new knowledge could be applied in the development and improvement of injury risk management strategies, to identify youth players with the highest injury risk.
There has been an exponential growth in the application of AI in health and in pathology. This is resulting in the innovation of deep learning technologies that are specifically aimed at cellular imaging and practical applications that could transform diagnostic pathology. This paper reviews the different approaches to deep learning in pathology, the public grand challenges that have driven this innovation and a range of emerging applications in pathology. The translation of AI into clinical practice will require applications to be embedded seamlessly within digital pathology workflows, driving an integrated approach to diagnostics and providing pathologists with new tools that accelerate workflow and improve diagnostic consistency and reduce errors. The clearance of digital pathology for primary diagnosis in the US by some manufacturers provides the platform on which to deliver practical AI. AI and computational pathology will continue to mature as researchers, clinicians, industry, regulatory organizations and patient advocacy groups work together to innovate and deliver new technologies to health care providers: technologies which are better, faster, cheaper, more precise, and safe.
Background:
The application of artificial intelligence (AI) opens an interesting perspective for predicting injury risk and performance in team sports. A better understanding of the techniques of AI employed and of the sports that are using AI is clearly warranted. The purpose of this study is to identify which AI approaches have been applied to investigate sport performance and injury risk and to find out which AI techniques each sport has been using.
Methods:
Systematic searches through the PubMed, Scopus, and Web of Science online databases were conducted for articles reporting AI techniques or methods applied to team sports athletes.
Results:
Fifty-eight studies were included in the review with 11 AI techniques or methods being applied in 12 team sports. Pooled sample consisted of 6456 participants (97% male, 25 ± 8 years old; 3% female, 21 ± 10 years old) with 76% of them being professional athletes. The AI techniques or methods most frequently used were artificial neural networks, decision tree classifier, support vector machine, and Markov process with good performance metrics for all of them. Soccer, basketball, handball, and volleyball were the team sports with more applications of AI.
Conclusions:
The results of this review suggest a prevalent application of AI methods in team sports based on the number of published studies. The current state of development in the area proposes a promising future with regard to AI use in team sports. Further evaluation research based on prospective methods is warranted to establish the predictive performance of specific AI techniques and methods.
Background:
Wearable sensors permit efficient data collection and unobtrusive systems can be used for instrumenting knee patients for objective assessment. Machine learning can be leveraged to parse the abundant information these systems provide and segment patients into relevant groups without specifying group membership criteria. The objective of this study is to examine functional parameters influencing favorable recovery outcomes by separating patients into functional groups and tracking them through clinical follow-ups.
Methods:
Patients undergoing primary unilateral total knee arthroplasty (n = 68) completed instrumented timed-up-and-go tests preoperatively and at their 2-, 6-, and 12-week follow-up appointments. A custom wearable system extracted 55 metrics for analysis and a K-means algorithm separated patients into functionally distinguished groups based on the derived features. These groups were analyzed to determine which metrics differentiated most and how each cluster improved during early recovery.
Results:
Patients separated into 2 clusters (n = 46 and n = 22) with significantly different test completion times (12.6 s vs 21.6 s, P < .001). Tracking the recovery of both groups to their 12-week follow-ups revealed 64% of one group improved their function while 63% of the other maintained preoperative function. The higher improvement group shortened their test times by 4.94 s, (P = .005) showing faster recovery while the other group did not improve above a minimally important clinical difference (0.87 s, P = .07). Features with the largest effect size between groups were distinguished as important functional parameters.
Conclusion:
This work supports using wearable sensors to instrument functional tests during clinical visits and using machine learning to parse complex patterns to reveal clinically relevant parameters.
Here we present deep-learning techniques for healthcare, centering our discussion on deep learning in computer vision, natural language processing, reinforcement learning, and generalized methods. We describe how these computational techniques can impact a few key areas of medicine and explore how to build end-to-end systems. Our discussion of computer vision focuses largely on medical imaging, and we describe the application of natural language processing to domains such as electronic health record data. Similarly, reinforcement learning is discussed in the context of robotic-assisted surgery, and generalized deep-learning methods for genomics are reviewed.
Injuries have a great impact on professional soccer, due to their large influence on team performance and the considerable costs of rehabilitation for players. Existing studies in the literature provide just a preliminary understanding of which factors mostly affect injury risk, while an evaluation of the potential of statistical models in forecasting injuries is still missing. In this paper, we propose a multi-dimensional approach to injury forecasting in professional soccer that is based on GPS measurements and machine learning. By using GPS tracking technology, we collect data describing the training workload of players in a professional soccer club during a season. We then construct an injury forecaster and show that it is both accurate and interpretable by providing a set of case studies of interest to soccer practitioners. Our approach opens a novel perspective on injury prevention, providing a set of simple and practical rules for evaluating and interpreting the complex relations between injury risk and training performance in professional soccer.
Heat stroke can be potentially damaging for people while exercising in hot environments. To prevent this dangerous situation, we designed a wearable heat-stroke-detection device (WHDD) with early notification ability. First, we used several physical sensors, such as galvanic skin response (GSR), heart beat, and body temperature, to acquire medical data from exercising people. In addition, we designed risk evaluation functional components that were based on fuzzy theory to detect the features of heat stroke for users. If a dangerous situation is detected, then the device will activate the alert function to remind the user to respond adequately to avoid heat stroke.
Electrocardiography (ECG) has proven to be one of the most efficient ways of tracking heart defects in athletes. However, the interpretation of electrocardiograms often require the expertise of a cardiologist. Meanwhile, an automated heart monitoring system could be used to ensure early heart defect detection in athletes, even in the absence of a cardiologist. In this paper, an automated heart defect detection model is proposed for athletes using ECG and Artificial Neural Network (ANN). We developed an ECG biomedical equipment to acquire 400 ECG data vectors from 40 participants, who comprises of athletes and non-athletes. Four classes of possible heart conditions among athletes, namely: normal, tachyarrhythmia, bradyarrhythmia and hypertrophic cardiomyopathy were considered. The ECG data collected were pre-processed and features were extracted based on first order moment. Different ANNs were trained to correctly classify the ECG data. By and large, the performances of ANNs that were trained based on Levenberg-Marquardt learning algorithm outperformed those trained based on Scale Conjugate Gradient learning algorithm. The network architecture with tansig activation function at both hidden and output layers and ten neurons in the hidden layer (TTLM) produced the best performance that cut across all the key performance indicators. The generalization testing of the developed TTLM model with new input data (that were excluded from the training dataset) produced acceptable results with classification accuracy, sensitivity and specificity of 90.00, 91.96 and 97.06% respectively. In essence, the implementation of the developed model in this study could potentially assist in reducing sudden cardiac death among athletes.
Artificial Intelligence (AI) is a general term that implies the use of a computer to model intelligent behaviour with minimal human intervention. AI is generally accepted as having started with the invention of robots. The term derives from the Czech word robota, meaning biosynthetic machines used as forced labour. In this field, Leonardo Da Vinci's lasting heritage is today's burgeoning use of robotic-assisted surgery, named after him, for complex urologic and gynecologic procedures. Da Vinci's sketchbooks of robots helped set the stage for this innovation. AI, described as the science and engineering of making intelligent machines, was officially born in 1956. The term is applicable to a broad range of items in medicine such as robotics, medical diagnosis, medical statistics, and human biology—up to and including today's “omics”. AI in medicine, which is the focus of this review, has two main branches: virtual and physical. The virtual branch includes informatics approaches from deep learning information management to control of health management systems, including electronic health records, and active guidance of physicians in their treatment decisions. The physical branch is best represented by robots used to assist the elderly patient or the attending surgeon. Also embodied in this branch are targeted nanorobots, a unique new drug delivery system. The societal and ethical complexities of these applications require further reflection, proof of their medical utility, economic value, and development of interdisciplinary strategies for their wider application.
Aims
(1) To investigate whether a daily acute:chronic workload ratio informs injury risk in Australian football players; (2) to identify which combination of workload variable, acute and chronic time window best explains injury likelihood.
Methods
Workload and injury data were collected from 53 athletes over 2 seasons in a professional Australian football club. Acute:chronic workload ratios were calculated daily for each athlete, and modelled against non-contact injury likelihood using a quadratic relationship. 6 workload variables, 8 acute time windows (2–9 days) and 7 chronic time windows (14–35 days) were considered (336 combinations). Each parameter combination was compared for injury likelihood fit (using R²).
Results
The ratio of moderate speed running workload (18–24 km/h) in the previous 3 days (acute time window) compared with the previous 21 days (chronic time window) best explained the injury likelihood in matches (R²=0.79) and in the immediate 2 or 5 days following matches (R²=0.76–0.82). The 3:21 acute:chronic workload ratio discriminated between high-risk and low-risk athletes (relative risk=1.98–2.43). Using the previous 6 days to calculate the acute workload time window yielded similar results. The choice of acute time window significantly influenced model performance and appeared to reflect the competition and training schedule.
Conclusions
Daily workload ratios can inform injury risk in Australian football. Clinicians and conditioning coaches should consider the sport-specific schedule of competition and training when choosing acute and chronic time windows. For Australian football, the ratio of moderate speed running in a 3-day or 6-day acute time window and a 21-day chronic time window best explained injury risk.
Background
Coaches, sport scientists, clinicians and medical personnel face a constant challenge to prescribe sufficient training load to produce training adaption while minimising fatigue, performance inhibition and risk of injury/illness. Objective
The aim of this review was to investigate the relationship between injury and illness and longitudinal training load and fatigue markers in sporting populations. Methods
Systematic searches of the Web of Science and PubMed online databases to August 2015 were conducted for articles reporting relationships between training load/fatigue measures and injury/illness in athlete populations. ResultsFrom the initial 5943 articles identified, 2863 duplicates were removed, followed by a further 2833 articles from title and abstract selection. Manual searching of the reference lists of the remaining 247 articles, together with use of the Google Scholar ?cited by? tool, yielded 205 extra articles deemed worthy of assessment. Sixty-eight studies were subsequently selected for inclusion in this study, of which 45 investigated injury only, 17 investigated illness only, and 6 investigated both injury and illness. This systematic review highlighted a number of key findings, including disparity within the literature regarding the use of various terminologies such as training load, fatigue, injury and illness. Athletes are at an increased risk of injury/illness at key stages in their training and competition, including periods of training load intensification and periods of accumulated training loads. Conclusions
Further investigation of individual athlete characteristics is required due to their impact on internal training load and, therefore, susceptibility to injury/illness.
This paper presents a novel adaptive synthetic (ADASYN) sampling approach for learning from imbalanced data sets. The essential idea of ADASYN is to use a weighted distribution for different minority class examples according to their level of difficulty in learning, where more synthetic data is generated for minority class examples that are harder to learn compared to those minority examples that are easier to learn. As a result, the ADASYN approach improves learning with respect to the data distributions in two ways: (1) reducing the bias introduced by the class imbalance, and (2) adaptively shifting the classification decision boundary toward the difficult examples. Simulation analyses on several machine learning data sets show the effectiveness of this method across five evaluation metrics.
Sports medicine, an essential branch of orthopedics, focuses on preserving, restoring, improving, and rebuilding the function of the human motor system. As a thriving interdisciplinary field, sports medicine attracts not only the interest of the orthopedic community, but also artificial intelligence (AI). In this study, our team summarized the potential applications of GPT-4 in sports medicine including diagnostic imaging, exercise prescription, medical supervision, surgery treatment, sports nutrition, and science research. In our opinion, it is impossible that GPT-4 could make sports physicians obsolete. Instead, it could become an indispensable scientific assistant for sport doctors in future.
The increasing availability of biomedical data from large biobanks, electronic health records, medical imaging, wearable and ambient biosensors, and the lower cost of genome and microbiome sequencing have set the stage for the development of multimodal artificial intelligence solutions that capture the complexity of human health and disease. In this Review, we outline the key applications enabled, along with the technical and analytical challenges. We explore opportunities in personalized medicine, digital clinical trials, remote monitoring and care, pandemic surveillance, digital twin technology and virtual health assistants. Further, we survey the data, modeling and privacy challenges that must be overcome to realize the full potential of multimodal artificial intelligence in health. Multimodal artificial intelligence models could unlock many exciting applications in health and medicine; this Review outlines the most promising uses and the technical pitfalls to avoid.
Purpose:
Achilles tendon ruptures (ATR) are career-threatening injuries in elite soccer players due to the decreased sports performance they commonly inflict. This study presents an exploratory data analysis of match participation before and after ATRs and an evaluation of the performance of a machine learning (ML) model based on pre-injury features to predict whether a player will return to a previous level of match participation.
Methods:
The website transfermarkt.com was mined, between January and March of 2021, for relevant entries regarding soccer players who suffered an ATR while playing in first or second leagues. The difference between average minutes played per match (MPM) 1 year before injury and between 1 and 2 years after the injury was used to identify patterns in match participation after injury. Clustering analysis was performed using k-means clustering. Predictions of post-injury match participation were made using the XGBoost classification algorithm. The performance of this model was evaluated using the area under the receiver operating characteristic curve (AUROC) and Brier score loss (BSL).
Results:
Two hundred and nine players were included in the study. Data from 32,853 matches was analysed. Exploratory data analysis revealed that forwards, midfielders and defenders increased match participation during the first year after injury, with goalkeepers still improving at 2 years. Players were grouped into four clusters regarding the difference between MPMs 1 year before injury and between 1 and 2 years after the injury. These groups ranged between a severe decrease (n = 34; - 59 ± 13 MPM), moderate decrease (n = 75; - 25 ± 8 MPM), maintenance (n = 70; 0 ± 8 MPM), or increase (n = 30; 32 ± 13 MPM). Regarding the predictive model, the average AUROC after cross-validation was 0.81 ± 0.10, and the BSL was 0.12, with the most important features relating to pre-injury match participation.
Conclusion:
Most players take 1 year to reach peak match participation after an ATR. Good performance was attained using a ML classifier to predict the level of match participation following an ATR, with features related to pre-injury match participation displaying the highest importance.
Level of evidence:
I.
Basketball is among the most popular sports in the world, and its related industries have also produced huge economic benefits. In recent years, the application of artificial intelligence (AI) technology in basketball has attracted a large amount of attention. We conducted a comprehensive review of the application research of AI in basketball through literature retrieval. Current research focuses on the AI analysis of basketball team and player performance, prediction of competition results, analysis and prediction of shooting, AI coaching system, intelligent training machine and arena, and sports injury prevention. Most studies have shown that AI technology can improve the training level of basketball players, help coaches formulate suitable game strategies, prevent sports injuries, and improve the enjoyment of games. At the same time, it is also found that the number and level of published papers are relatively limited. We believe that the application of AI in basketball is still in its infancy. We call on relevant industries to increase their research investment in this area, and promote the improvement of the level of basketball, making the game increasingly exciting as its worldwide popularity continues to increase.
Artificial intelligence (AI) represents the fourth industrial revolution and the next frontier in medicine poised to transform the field of orthopaedics and sports medicine, though widespread understanding of the fundamental principles and adoption of applications remain nascent. Recent research efforts into implementation of AI in the field of orthopaedic surgery and sports medicine have demonstrated great promise in predicting athlete injury risk, interpreting advanced imaging, evaluating patient-reported outcomes, reporting value-based metrics, and augmenting the patient experience. Not unlike the recent emphasis thrust upon physicians to understand the business of medicine, the future practice of sports medicine specialists will require a fundamental working knowledge of the strengths, limitations, and applications of AI-based tools. With appreciation, caution, and experience applying AI to sports medicine, the potential to automate tasks and improve data-driven insights may be realized to fundamentally improve patient care. In this Current Concepts review, we discuss the definitions, strengths, limitations, and applications of AI from the current literature as it relates to orthopaedic sports medicine.
The ubiquity and commoditisation of wearable biosensors (fitness bands) has led to a deluge of personal healthcare data, but with limited analytics typically fed back to the user. The feasibility of feeding back more complex, seemingly unrelated measures to users was investigated, by assessing whether increased levels of stress, anxiety and depression (factors known to affect cardiac function) and general health measures could be accurately predicted using heart rate variability (HRV) data from wrist wearables alone. Levels of stress, anxiety, depression and general health were evaluated from subjective questionnaires completed on a weekly or twice-weekly basis by 652 participants. These scores were then converted into binary levels (either above or below a set threshold) for each health measure and used as tags to train Deep Neural Networks (LSTMs) to classify each health measure using HRV data alone. Three data input types were investigated: time domain, frequency domain and typical HRV measures. For mental health measures, classification accuracies of up to 83% and 73% were achieved, with five and two minute HRV data streams respectively, showing improved predictive capability and potential future wearable use for tracking stress and well-being.
Injuries exert an enormous impact on athletes and teams. This is seen especially in professional soccer, with a marked negative impact on team performance and considerable costs of rehabilitation for players. Existing studies provide some preliminary understanding of which factors are mostly associated with injury risk, but scientific systematic evaluation of the potential of statistical models in forecasting injuries is still missing. Some factors raise the risk of a sport injury, but there are also elements that predispose athletes to sports injuries. The biological mechanisms involved in non-contact musculoskeletal soft tissue injuries are poorly understood. Genetic risk factors may be associated with susceptibility to injuries, and may exert marked influence on recovery times. Athletes are complex systems, and depend on internal and external factors to attain and maintain stability of their health and their performance. Organisms, participants or traits within a dynamic system adapt and change when factors within that system change. Scientists routinely predict risk in a variety of dynamic systems, including weather, political forecasting and projecting traffic fatalities and the last years have started the use of predictive models in the human health industry. We propose that the use of artificial intelligence may well help in assessing risk and help to predict the occurrence of sport injuries.
One of the fascinating aspects of the field of artificial intelligence (AI) is that the precise nature of its subject matter turns out to be surprisingly difficult to define. The problem, of course, has two parts, since securing an adequate grasp of the nature of the artificial would do only as long as we were already in possession of a suitable understanding of the idea of intelligence. What is supposed to be “artificial” about artificial intelligence, no doubt, has to do with its origins and mode of creation in arising as a product of human contrivance and ingenuity rather than as a result of natural (especially biological or evolutionary) influence. Things that are artificially intelligent, in other words, differ from those that are naturally intelligent as artifacts that possess special properties ordinarily possessed by non-artifacts. So these are things that have a certain property (intelligence) as a result of a certain process (because they were created, designed, or manufactured in this way).
Injury prediction in sports using artificial intelligence applications: a brief review
- G S Kumar
- M D Kumar
- S V R Reddy
- B V S Kumari
- C R Reddy
Training load prior to injury in professional rugby league players: analysing injury risk with machine learning
- M Welch
- C Cummins
- H Thornton
- D King
- A Murphy
Secure prediction and assessment of sports injuries using deep learning based convolutional neural network
- H Song
- H Xiu-Ying
- C E Montenegro-Marin
- S Krishnamoorthy