17 th Annual PARM Residents’ Research Forum February 28,2007 Cagayan de Oro City

1. 17th Annual PARM Residents’ Research Forum February 28,2007 Cagayan de Oro City

2. Incidence of Musculoskeletal Injuries and Associated Risk Factors Among Adult Males Participating in a Non-Professional Basketball League

3. Introduction • The nature of the game of basketball has changed dramatically over the years • Injuries in sports can be costly to both the player and the team • Incidence of injuries in basketball has increased over the past decades McClay, et al. (1994). A Kinematic Profile of Skills in Professional Basketball Players. Journal of Applied Biomechanics, 10, 205-221.

4. Introduction • Local study • Subjects were UP varsity athletes • Goal: establish a database for the identification, planning and evaluation of sports injury prevention strategies Magpily, Alberto T. A Continuing Study of Sports Injuries among Varsity Athletes of the University of the Philippines.

5. Introduction • Highest incidence of injuries in 2000- thoraco-lumbar, ankle/foot & shoulder/arm • 3 most common injuries in 2000- ankle joint sprain, PFPS & musculoskeletal pain syndrome or spasm of upper trapezius muscles Magpily, Alberto T. A Continuing Study of Sports Injuries among Varsity Athletes of the University of the Philippines.

6. Introduction • No local study available • Several risk factors were identified that contributed to the development of musculoskeletal injuries associated to basketball

7. Intrinsic factors Prior physical activity Physical/ aerobic fitness Muscular endurance Flexibility Past injuries Cigarette smoking Life and job satisfaction Gender/ age Anatomic factors Introduction

8. Introduction Extrinsic factors • Running distance • Running shoes • Weather

9. Objectives • To determine the incidence of musculoskeletal injuries among adult males participating in a non-professional basketball league • To identify the associated factors contributing to such injuries

10. Objectives • To identify the most frequently occurring injuries related to basketball

11. Methodology Study design • Prospective cohort study Participants • Adult male non-professional basketball players from 17-55 years old

12. Methodology Inclusion Criterion • All players who participated in the Ateneo Basketball League from January-March 2006 Exclusion Criteria • Injuries sustained prior to the basketball season • Injuries sustained during instances other than the basketball league

13. Methodology Study Procedure • Consent forms, personal data sheet and questionnaires were filled up by the players • Primary investigator evaluated all the injured players

14. Gym activity Cigarette smoker Warm-up Proper basketball shoes Proper socks Protective equipments Proper basketball techniques Inspection of courts Cleanliness of courts Physical hazards Use of accessories Rest breaks Methodology

15. Data Analysis • Univariate analysis of socio-demographic factors and risk factors • Incidence= # of players with injuries # of players at risk • Multivariate analysis using a stepwise logistic regression

16. Results • Characteristics of Study Population (n= 1875)

17. Results • Characteristics of Study Population (n= 1875)

18. Results

19. Ankle sprain: 27 ACL tear: 9 Superficial wounds/abrasions: 7 Wrist sprain: 5 Thumb injuries (sprain): 5 Pulled hamstring: 4 PCL tear: 4 Total number of injured players: 86

20. Results • Distribution of Risk Factors

21. Results • Distribution of Risk Factors

22. Results • Distribution of Risk Factors

23. Results • Distribution of Risk Factors

24. Results • Distribution of Risk Factors

25. Results • Distribution of Risk Factors

26. Results • Multivariate Analysis

27. Discussion • Total of 1,875 participants enrolled in the study • Mean age of 31±6 • Participants were categorized as non-injured or injured

28. Discussion • Sociodemographic data did not yield a significant relationship in the development of musculoskeletal injuries

29. Discussion

30. Discussion • Injuries and illnesses in the NBA • A 10-year perspective from the 1988–1989 through the 1997–1998 seasons • Ankle sprains were the most frequently occurring injury (9.4%), followed by patellofemoral inflammation (8.1%), lumbar strains (5.0%), and knee sprains (2.3%)

31. Discussion • Stepwise logistic regression showed that the question on having rest breaks was the only significant risk factor for having injuries with a p-value <0.05

32. Discussion • Sports injury incidence should be expressed as: # of sports injuries/exposure time Van Mechelen, et al. Incidence, severity, aetiology and prevention of sports injuries. A review of concepts. Sports Med. 1992 Aug; 14(2):82-89.

33. Discussion Other risk factors • Gym activity • Cigarette smoking • Warm-up • Use of protective equipment • Inspection of courts

34. Discussion • Level of aerobic fitness as a risk factor of injury • Once fatigued, most athletes alter their muscle recruitment patterns • Relation between aerobic fitness and injury is unclear Murphy D, Connolly D and Beynnon B. Risk Factors for Lower Extremity Injury. The British Medical Journal of Sports Medicine 200337:13-39.

35. Discussion Protective factors • Proper basketball shoes • Cotton socks • Proper basketball techniques • Checking of cleanliness of courts • Checking of physical hazards • Use of accessories

36. Discussion • Ankle sprain- most common injury • Ankle sprains made up the majority of injuries both locally and in the US

37. Discussion • Sprains of the lateral ankle complex make up 38-45% of all injuries in sports • 50% of patients with ankle sprains had recurrence Singer KM, Jones DC: Ligament injuries of the ankle and foot. The Lower Extremity and Spine in Sports Medicine. Vol 2. 1995:475-497.

38. Discussion • Use of ankle braces to reduce the incidence of ankle sprains • Prospective, randomized study of ankle brace use in 1601 subjects • Unbraced control group sustained more than a 3-fold incidence of ankle ligamentous injuries compared with the braced group Sitler M, Ryan J, Wheeler B, et al. The efficacy of a semi-rigid ankle stabilizer to reduce acute ankle injuries in basketball. A randomized clinical study at West Point. The American Journal of Sports Medicine 1985. ;13:259-62.

39. Discussion • Cochrane Database Systematic Review • 14 randomized trials with 8,279 participants • Prophylactic intervention: application of external ankle support

40. Discussion • Result: significant reduction in the number of ankle sprains in subjects allocated external ankle support • Review provides good evidence for the beneficial effect of ankle supports during high-risk sports

41. Conclusion • 86 (4.58%) out of 1,875participants were injured

42. Conclusion Most common injuries • Ankle sprain • ACL tear • Superficial wounds/ abrasions • Wrist sprain • Thumb injuries (sprain) • Pulled hamstring • PCL tear

43. Conclusion • Lack of rest breaks-only significant factor in the development of musculoskeletal injuries

44. Conclusion Possible risk factors • Gym activity • Cigarette smoking • Warm-up • Use of protective equipments • Inspection of courts

45. Conclusion • Identified risk factors may greatly reduce the medical cost from basketball-related injuries

46. Recommendations • Rest breaks should be considered • Further investigation of the duration and frequency of rest breaks • Good conditioning and strengthening program • Systematic way of monitoring injuries

47. Recommendations • Professional vs. non-professional players • Basketball vs. other high-risk sports • Education of players, coaches, trainers and other officials • Evaluation of psychological and psychosocial aspects

48. Thank you!