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Injuries in Field Hockey Players: a Systematic Review

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Injuries in Field Hockey Players: a Systematic Review Sports Med (2018) 48:849–866 https://doi.org/10.1007/s40279-017-0839-3 SYSTEMATIC REVIEW Injuries in Field Hockey Players: A Systematic Review 1 2 1 1,3,4,5 Saulo Delfino Barboza • Corey Joseph • Joske Nauta • Willem van Mechelen • Evert Verhagen1,2,4 Published online: 3 January 2018 Ó The Author(s) 2018. This article is an open access publication Abstract peer-reviewed journal and observed all possible injuries Background To commence injury prevention efforts, it is sustained by field hockey players during the period of the necessary to understand the magnitude of the injury prob- study. lem. No systematic reviews have yet investigated the Results The risk of bias score of the 22 studies included extent of injuries in field hockey, despite the popularity of ranged from three to nine of a possible ten. In total, 12 the sport worldwide. studies (55%) reported injuries normalized by field hockey Objective Our objective was to describe the rate and exposure. Injury rates ranged from 0.1 injuries (in school- severity of injuries in field hockey and investigate their aged players) to 90.9 injuries (in Africa Cup of Nations) characteristics. per 1000 player-hours and from one injury (in high-school Methods We conducted electronic searches in PubMed, women) to 70 injuries (in under-21 age women) per 1000 Embase, SPORTDiscus, and CINAHL. Prospective cohort player-sessions. Studies used different classifications for studies were included if they were published in English in a injury severity, but—within studies—injuries were inclu- ded mostly in the less severe category. The lower limbs Electronic supplementary material The online version of this were most affected, and contusions/hematomas and abra- article (https://doi.org/10.1007/s40279-017-0839-3) contains supple- sions were common types of injury. Contact injuries are mentary material, which is available to authorized users. common, but non-contact injuries are also a cause for & Evert Verhagen concern. [email protected] Conclusions Considerable heterogeneity meant it was not possible to draw conclusive findings on the extent of the 1 Amsterdam Collaboration on Health and Safety in Sports, rate and severity of injuries. Establishing the extent of Department of Public and Occupational Health, Amsterdam sports injury is considered the first step towards prevention, Public Health Research Institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The so there is a need for a consensus on injury surveillance in Netherlands field hockey. 2 Australian Collaboration for Research into Injury in Sport and its Prevention, Federation University Australia, Lydird Street South, Ballarat, VIC 3350, Australia Key Points 3 School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, QLD 4072, Australia Substantial heterogeneity between studies prevents 4 Division of Exercise Science and Sports Medicine, conclusive findings on the extent of the rate and Department of Human Biology, Faculty of Health Sciences, severity of injuries in field hockey. University of Cape Town, Anzio Road, Observatory 7925, Cape Town, South Africa Injury prevention efforts in field hockey may benefit from a consensus on the methodology of injury 5 School of Public Health, Physiotherapy and Population Sciences, University College Dublin, Belfield, Dublin 4, surveillance. Ireland 123 850 S. D. Barboza et al. 1 Introduction 2.2 Eligibility Criteria Field hockey is an Olympic sport played by men and Studies were eligible for inclusion if they were published in women at both recreational and professional levels. The the English language in a peer-reviewed academic journal, five continental and 132 national associations that are were prospective cohort studies, and observed all possible members of the International Hockey Federation [1] injuries sustained by field hockey players during the period demonstrate the high level of popularity of field hockey of the study (i.e., studies that looked only at specific worldwide. Field hockey participation may contribute to injuries were not included). To minimize the possibility of players’ health through the well-known benefits of regular recall bias, only prospective cohort studies were included exercise. However, participation in field hockey also [8, 9]. Studies were not included if they described field entails a risk of injury [2]. hockey injuries together with those from other sports, and In general, sports injuries result in individual and soci- specific data on field hockey could not be distinguished. etal costs [3], hamper performance, and compromise a Conference abstracts were not included. teams’ success over the sporting season [4, 5]. Therefore, injury prevention strategies are of great importance for 2.3 Study Selection and Data Collection Process teams at both recreational and professional levels. Estab- lishing the extent of the injury problem is considered the Two reviewers (SDB and CJ) independently screened all first step towards effective prevention [6]. In field hockey, records identified in the search strategy in two steps: title as well as in other sports, this information can aid and abstract screening, and full-text screening. References researchers and health professionals in developing appro- of full texts were also screened for possible additional priate strategies to reduce and control injuries [6]. studies not identified in the four databases. Conflicts To the best of our knowledge, no systematic reviews between reviewers’ decisions were resolved through dis- have provided a synthesis of information on injuries sus- cussion. A third reviewer (EV) was consulted for consensus tained by field hockey players. Systematic reviews involve rating when needed. gathering evidence from different sources to enable a One reviewer (SDB) extracted the following informa- synthesis of what is currently known about a specific topic tion from the included studies: first author, publication (e.g., injuries) and may facilitate the link between research year, country in which the study was conducted, primary evidence and optimal strategies for healthcare [7]. There- objective, setting, follow-up period, number and descrip- fore, the aim of this study was to systematically review the tion of field hockey players, injury definition, injury data literature on injuries sustained by field hockey players, in collection procedure, number of injured players, number of order to describe the extent of such injuries in terms of rate injuries sustained by players during the study, and severity and severity as well as to identify injury characteristics of injuries (Table 1). The number of injuries normalized by according to body location, type, and mechanism of injury. exposure to field hockey (i.e., injury rate) was also extracted. In addition, information on injury according to body location, type of injury, mechanism, and player 2 Methods position was gathered whenever possible. When different studies used the same dataset (Table 1), the results of such 2.1 Information Sources and Search Strategy studies were combined in one row in all other tables for simplicity. Electronic searches were conducted in PubMed, Exerpta Medical Database (Embase), SPORTDiscus, and Cumula- 2.4 Risk of Bias Assessment tive Index to Nursing and Allied Health Literature (CINAHL) databases with no limits on the publication Two independent reviewers (SDB and CJ) assessed the risk date. The search strategy combined keywords for injury, of bias in the included studies using ten criteria previously field hockey, and study design: ((((((((((((injur*) OR used in systematic reviews on sports injury [9, 10]. All traum*) OR risk*) OR overuse) OR overload) OR acute) criteria were rated as 1 (i.e., low risk of bias) or 0 (i.e., high OR odds) OR incidence) OR prevalence) OR hazard)) risk of bias). When insufficient information was presented AND (((field AND hockey)) OR (hockey NOT ice))) AND in a study to rate a specific criterion as 1 or 0, the rating (((prosp*) OR retrosp*) OR case*). The detailed search was categorized as ‘unable to determine’ (UD) and counted strategy for each database can be found Appendix S1 in the as 0. The assessment of each reviewer was compared, and Electronic Supplementary Material (ESM). The last search conflicts were resolved through discussion. The ten criteria was conducted on 31 May 2017. are described in Table 2. 123 Injuries in Field Hockey Table 1 Characteristics of prospective studies on field hockey injuries arranged by year of publication (least recent to most recent) Study (country) Primary objective Setting and Description of Injury definition (summary) Injury data Injured Number Severity of injury follow-up field hockey collection players of period players injuries Weightman and Survey injuries in 11 selected Season (8 Men (25 NR Sport clubs’ NR 117 Average TL. Women: Browne 1975 sports months) clubs) and secretaries form 1.5 days; Men: 6.5 (UK) [11] women (36 days clubs). Number, age, and level NR Clarke and Preliminary overview of injury Season (3 High-school An injury causing the athlete to Athletic trainer NR NR TL and consequences: Buckley 1980 experiences among collegiate years) women from miss at least 1 week of injury report [3 weeks: 23%; (USA) [13] women athletes reported to annual participation (C 1 week TL) form Surgery: 5% the National Athletic Injury/ average of 16 Illness Reporting System teams. during its first 3 operational Number and years age NR Zaricznyj et al. Analyze causes and severity of School season
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