Latest research in football - week 17 - 2013

#1 Cardiac events in football and strategies for first-responder treatment on the field
Authors: Schmied C, Drezner J, Kramer E, Dvorak J.
Reference: Br J Sports Med. 2013 Apr 23. [Epub ahead of print]
Summary: The incidence and outcomes of sudden cardiac arrest (SCA) and global strategies for prevention of sudden cardiac death (SCD) in football are not known. The purpose of this study was to estimate the occurrence of cardiac events in football and to investigate the preventive measures taken among the FIFA member associations internationally. A questionnaire was sent to the member associations of FIFA. The first section addressed the previous events of SCA, SCD or unexplained sports-related sudden death within the last 10 years. Further questions focused on football player medical screening strategies and SCA resuscitation response protocols on the field. 126 of 170 questionnaires were returned, and 103 questionnaires were completed sufficiently to include in further analysis. Overall, 107 cases of SCA/SCD and 5 unexplained football-associated sudden deaths were reported. These events occurred in 52 of 103 responding associations (50.5%). 23 of 112 (20.5%) footballers survived. 12 of 22 (54.5%) players treated with an available automated external defibrillators (AED) on the pitch survived. A national registry to monitor cardiac events was established in only 18.4% of the associations. Most associations (85.4%) provide regular cardiac screening for their national teams while 75% screen teams of the national leagues. An AED is available at all official matches in 68% of associations.  
National registries to accurately measure SCA/SCD in football are rare and greatly needed. Deficiencies in emergency preparations, undersupply of AEDs on the field during matches, and variability in resuscitation response protocols and training of team-staff members should be addressed to effectively prevent SCD in football.


#2 Nutritional status and physical condition of adolescent football players after consuming fishmeal as a nutritional complement
Authors: Accinelli-Tanaka R, López-Oropeza L.
Reference: Rev Peru Med Exp Salud Publica. 2013 Mar;30(1):49-53. [Article in Spanish]
Summary: The purpose of the study is to identify the changes in the nutritional parameters and the physical condition of teenage players after eating fishmeal as a nutritional complement. For this purpose, a quasi-experimental study, blinded for investigators, was conducted, involving 100 teenage football players, divided in two groups, homogeneous in terms of all study parameters, one of which received fishmeal for four months. After evaluating the nutritional status and physical condition, before and after the intervention, no change was found in the nutritional and anthropometric status or laboratory results, or in the physical condition. However, those who received fishmeal did report a change in their hemoglobin and hematocrit levelsin comparison to the control group. In conclusion, the consumption of fishmeal did not lead to changes in the nutritional status or the physical condition of teenage football players.


#3 Investigation of characteristics and risk factors of sports injuries in young soccer players: a retrospective study
Authors: Bastos FN, Vanderlei FM, Vanderlei LC, Júnior JN, Pastre CM.
Reference: Int Arch Med. 2013 Apr 20;6(1):14. [Epub ahead of print]
Summary: The participation of children and adolescents in sports has become increasingly frequent, including soccer. This growing involvement gives rise to concerns regarding the risk of sports injuries. Therefore, the aim of the present study was to describe the musculoskeletal injuries in young soccer players. 301 male soccer players with an average age of 15 years were randomly recruited. The Referred Condition Inquiry was used to collect information on the mechanism of injury and anatomic site affected as well as personal data on the participants. The variables were analyzed based on the degree of association using Goodman's test for contrasts between multinomial populations. Among the 301 athletes, 24.25% reported at least one injury. With regard to height, taller individuals reported more injuries than shorter individuals (62.5% and 37.5%, respectively). Injuries were more frequent among players with a training duration greater than five years (69.7%) in comparison to those who trained for a shorter duration (30.4%). The lower limbs, especially the ankle/foot and knee, were the most affected anatomic sites. Impact was the most common mechanism of injury. The young practitioners of soccer analyzed had low rates of injury. The main causal mechanism was the impact. A taller height and longer exposure to training were the main risk factors for injury among young soccer players.


#4 Lower Injury Rates for Newcomers to Professional Soccer: A Prospective Cohort Study Over 9 Consecutive Seasons
Authors: Kristenson K, Waldén M, Ekstrand J, Hägglund M.
Reference: Am J Sports Med. 2013 Apr 23. [Epub ahead of print]
Summary: No study has investigated whether newcomers to professional soccer have a different injury rate than established players. The purpose of the study was to investigate whether being a newcomer to professional soccer influences injury rates. Furthermore, secondary purpose was to evaluate whether playing position and player age influence injury rates. Twenty-six soccer clubs, with 1401 players, were followed prospectively over 9 consecutive seasons between 2001 and 2010. Club medical staff recorded time-loss injuries and soccer exposure on an individual level. Cox regression analyses were used to evaluate associations between time-loss injuries and time in professional soccer, playing position, and age. A total of 6140 injuries and 797,389 hours of exposure were registered. A decreased general injury rate was observed for newcomers  compared with established players. In contrast, newcomers had a higher rate of fractures, especially stress-related bone injuries. Using goalkeepers as a reference, all outfield playing positions had significantly higher adjusted injury rates: defenders with a ratio of 1.91, midfielders with a ratio of 1.78, and forwards with a ratio of 1.82. Using players aged ≤21 years as a reference, the overall adjusted injury rate increased with age, with a peak injury rate among players aged 29 to 30 years Newcomers to professional soccer had a lower general injury rate than established players but a higher rate of stress-related bone injuries. Being a goalkeeper was associated with lower injury rates than all outfield playing positions. Injury rates increased with age, a pattern that persisted after adjusting for playing position and match exposure.