Background Youth athletes in single hand overhead sport are at risk of upper extremity overuse injuries due to musculoskeletal immaturity, repetitive actions and stress overload. While several upper extremity injury prevention programs have been developed, the effectiveness of upper extremity injury prevention programs on performance outcome measures in overhead youth athletes has not been investigated. This study critically evaluated the effectiveness of existing upper extremity injury prevention programs on performance outcome measures in overhead youth athletes and identified and categorized the training components of these programs.Methods A systematic search was conducted in PubMed, Physiotherapy Evidence Database (PEDro), SPORTDiscus (via EBSCOhost), ScienceDirect, and Web of Science. The inclusion criteria were youth athletes with full participation in throwing or striking sports; the intervention utilized training programs or exercises; control group performed usual training or sham exercises; reported at least one performance outcome measure; and utilized either randomized controlled trials, cluster-randomized controlled trials, or non-randomized controlled trials. Studies had to be published in the English language and within the last two decades. Methodological quality was assessed based on the PEDro Scale. Results Five studies, with a total of 456 youth athletes (age range 10.2-17.1 years) were included. The average PEDro score was 6.6. The effectiveness of the injury prevention programs on the identified performance outcome measures of strength, mobility, and sport-specific measures (ball speed and serve accuracy) were 30.4%, 28.6%, and 22.2%, respectively. The training components targeted were categorized as strength, mobility, and plyometrics. Strength was the most common training component and the most widely investigated performance outcome measure among existing upper extremity injury prevention programs. ConclusionCurrent injury prevention programs have a modest effect on sport performance outcome measures. Future upper extremity injury prevention programs should include training components of strength, mobility and plyometrics in their design given their moderate effects on strength, mobility, and sport-specific outcome measures. Standardized protocols are required for injury prevention program characteristics, and measurement and reporting of performance outcomes measures.
Background: There is a dearth of information related to shoulder and elbow overuse injuries in Asian overhead youth athletes. Purpose: To determine the prevalence and severity of shoulder and elbow overuse injuries, as well as their associated factors, among competitive overhead youth athletes in Singapore. Study Design: Descriptive epidemiology study. Methods: Participants completed a survey consisting of 4 multiple-choice questions and 1 open-ended question. Data on sex, age, playing experience, and weekly training hours were also collected. Separate injury severity scores (range, 0-100, with higher scores indicating greater severity) for the shoulder and elbow were tabulated from the responses to the multiple-choice questions. The association between participant characteristics and presence of shoulder and elbow overuse injuries was determined using the chi-square test. Crude odds ratios (ORs) and 95% CIs were also calculated. Results: 532 overhead youth athletes (age, 12-18 years) responded, of which 434 responses were included for analysis. Badminton, cricket, softball, swimming, and volleyball were some of the sports studied. The prevalence of shoulder and elbow overuse injuries was 31.3% and 9.2%, respectively. The respective severity scores were 30.4 ± 14.4 and 38.4 ± 22.4. Age was associated with the presence of both shoulder ( P = .016) and elbow ( P = .037) overuse injuries. Years of experience was associated with the presence of substantial elbow injuries ( P = .049). Weekly training hours was associated with the presence of shoulder ( P = .016) and substantial shoulder ( P = .020) injuries. Being older (15-18 years) increased the odds of shoulder (OR, 1.65; 95% CI, 1.10-2.49) and elbow (OR, 2.04; 95% CI, 1.03-4.01) overuse injuries. Having >8 years of experience increased the odds of substantial shoulder (OR, 2.71; 95% CI, 1.01-7.29) and substantial elbow (OR, 3.92; 95% CI, 1.01-15.24) overuse injuries. Training >11 hours per week increased the odds of shoulder overuse injuries (OR, 2.64; 95% CI, 1.31-5.30). Conclusion: Shoulder overuse injuries were more prevalent, but elbow injuries tended to be of greater severity among competitive overhead youth athletes in Singapore. Coaches working with older and experienced youth athletes, especially those training >11 hours per week, should be cognizant of the risk of shoulder and elbow overuse injuries.
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