Tendinopathy Clinical Trial
Official title:
Prevention of Patellar and Achilles Tendinopathies in Youth Basketball
This study seeks to determine the prevalence of knee and ankle tendinopathies in youth basketball players, as well as determine the efficacy of a Basketball specific Neuromuscular training warm-up in reducing injuries.
1. BACKGROUND & RATIONALE Basketball is one of the most popular youth sports in the United
States and Canada. Knee and ankle injuries are the most common injuries in youth
basketball (40%). Patellar and Achilles tendinopathies (PATs) are of particular concern
in elite level basketball with a prevalence of 32% for patellar tendinopathy in elite
male athletes (60% career prevalence). The risk for injury may be initiated in youth
basketball where overuse injury incidence increases with age. Previously reported PAT
injury rates likely underestimate the burden of overuse injury in youth basketball as
current surveillance guidelines are optimized for acute injury and there are no
guidelines on appropriate tendinopathy diagnosis in youth athletes. Current knowledge on
basketball-related injuries (acute and overuse) in adolescent athletic community is
sparse. Jump loads, landing mechanics, joint morphology and tendon structure changes may
be predictive of tendinopathy. However, their consequences on PAT risk in basketball
remain to be investigated using prospective cohort study methodologies. Encouragingly,
the potential for mediating injury risk in youth sport through neuromuscular training
programs has been demonstrated. A basketball specific neuromuscular training program
(BSpecNMT) in turn may be efficacious for primary PAT prevention. Clearly, there is an
urgent need to advance the current state of injury surveillance, prevention programs,
sport-specific risk factors for PATs and structural consequences of PATs in youth
basketball.
2. RESEARCH OBJECTIVES Primary Objectives 1) To quantify the prevalence and severity of
patellar and Achilles tendinopathies and assess associated risk factors in youth
basketball (Year 1); and 2) To evaluate the efficacy of a BSpecNMT program in reducing
patellar and Achilles tendinopathies and all injuries in youth basketball players (Year
2 and 3).
3. METHODS A Hybrid (effectiveness-implementation) Type 2 RCT design will be conducted.
Teams will be randomized into either a comprehensive or standard intervention delivery
group. All coaches will attend one pre-season coach workshop for the basketball specific
neuromuscular (BSpecNMT) warm-up program. The workshop was led by a physiotherapist,
athletic trainer, or strength and conditioning coach before the start of the season.
During the pre-season coach workshop, coaches will take part in a theoretical and
practical session about basketball injury prevention and warm-up exercises. Coaches in
the both study groups will be instructed to carry out the 10-minute warm-up program at
the beginning of all training sessions.
In addition, the comprehensive intervention group will receive weekly visits at team
practices from a research physiotherapist, athletic trainer, or strength and conditioning
coach. These visits will provide the team guidance with the BSpecNMT warm-up to facilitate
proper technique and appropriate progression of the BSpecNMT warm-up exercises.
All teams will have their adherence to the BSpecNMT recorded on a weekly basis by a Team
Designate. In addition, injuries will be prospectively monitored through a weekly self-report
questionnaire, a post-season questionnaire (completed by players) and injury report form
(completed by team designates). Also, Coaches' knowledge and attitudes to injury prevention
will be registered by surveys during the pre-season, post-workshop, post-season, 6-month
post-season, and 12-month post-season timepoints.
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