Incidence of Football and Futsal Injuries Among Youth in Malaysian Games 2018
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5-OA5-212_OA1 3/20/20 6:34 PM Page 28 Malaysian Orthopaedic Journal 2020 Vol 14 No 1 Ahmad-Shushami AH, et al doi: https://doi.org/10.5704/MOJ.2003.005 Incidence of Football and Futsal Injuries Among Youth in Malaysian Games 2018 Ahmad-Shushami AH, MBBS, Abdul-Karim S, MSpMed Sports Medicine Unit, University of Malaya, Kuala Lumpur, Malaysia This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited Date of submission: 21st August 2019 Date of acceptance: 12th November 2019 ABSTRACT influenced by the characteristics of the players, such as age and gender. It was during the 1998 FIFA World Cup that the Introduction: Football and futsal were the main sports in the Fédération Internationale de Football Association (FIFA) Malaysian Games. However, they were associated with a 2 started the initiative to document match injury risk of injury. The purpose of the study was to analyse the systematically. incidence, circumstances, and characteristics of football and futsal injuries during the Malaysian Games of 2018. Based on the football injury surveillance involving twelve Materials and method: During the tournament, 14 teams FIFA tournaments at the Olympics from 1998 to 2001, the participated in men's football, 12 teams in men's futsal and total incidence recorded was 88.7 injuries per 1000 match 11 teams in women's futsal. The biannual event involved hours or 2.7 injuries per match. The most frequently injured athletes aged under 21 years. A medical report form used by 2 body parts were the ankle (17%) and thigh (16%) . The FIFA Medical Assessment and Research Centre (F-Marc), overall incidence of injuries had reduced by 37% during the was provided to the physiotherapists and team doctors of all subsequent four editions of FIFA World Cup, from 2002 to the teams to report all injuries after each match. 2014. During the FIFA World Cup 2014 in Brazil, a total of Results: The response rate was 84.62% in football and 104 injuries was recorded, which equalled to 58 injuries per 59.76% in futsal. A total of 48 injuries were reported from 26 1000 match hours or 1.68 injuries per match. The reduction football matches, equivalent to 64.64 injuries per 1000 match occurred possibly due to stricter refereeing and a better hours (95%CI 46.35 to 82.93). In futsal, a total of 48 injuries 3 approach by players towards fair play . from 41 matches were reported, equivalent to 292.42 injuries per 1000 match hours (95% CI 209.7 to 375.14). The rate of Futsal is one of the most popular indoor sports worldwide. It injury in women futsal players was higher compared to men: is a five-sided variant of football played on a different pitch 358.21 versus 247.04 injuries per 1000 match hours surface and in a smaller sized field. A FIFA survey in 2006 (p=0.224). Futsal recorded higher injuries per 1000 match showed that there were around one million registered futsal hours than football (p<0.001). 4 players worldwide . Based on game analysis, futsal is a team Conclusion: The rate of severe injury in futsal and football sport characterised by multiple sprints and has more high- recorded in the study as compared to previous studies gave 5,6 intensity phases than football . rise to serious concerns. Hence, there was an urgent need to pay more attention to injury prevention strategies. Despite the popularity of football and futsal in Malaysia, systematic documentation regarding injury surveillance in Key Words: both games, particularly among the youth, was limited. football, futsal, injury, Malaysian games, youth Although a study was conducted in 2010, describing the incidence of injury in futsal during the National Futsal League, it did not focus on young athletes. The study showed INTRODUCTION that the incidence of futsal injuries was 61 per 1000 player Football is undoubtedly the most popular sports today and hours 7. Incidences of injuries recorded during three editions played widely around the globe, numbering approximately of Futsal World Cups were higher, ranging from 168.5 to 400 million players in 208 countries 1. The injury rate varied 236.0 injuries per 1000 player hours 8. To date, there were no depending on the level of the tournament. It was also published data on football injury surveillance in Malaysia. Corresponding Author: Ahmad Hazwan Ahmad Shushami, Sports Medicine Unit, Faculty of Medicine, University of Malaya, Jalan Universiti, 50603, Kuala Lumpur, Malaysia Email: [email protected] 28 5-OA5-212_OA1 3/20/20 6:34 PM Page 29 Injuries in Football and Futsal Given the paucity of injury-related research on young Response rate, exposure time and incidences were computed athletes, the study aimed to analyse the incidence and as proposed by the F-MARC consensus and previous characteristics of football and futsal injuries among young studies 2,3,7,10 . The injury rates were stated as the number of athletes during the Malaysian Games of 2018. Injury injuries per match, and the number of injuries per 1000 surveillance study was an important first step in the match hours. The exposure factor was the duration of time implementation of injury prevention programs 9. Such studies during which the participant was exposed to the injury risk. were crucial to ensure that the types and mechanism of In the study, the exposure time was only recorded from injuries could be analysed, and prevention programs started match exposure. For football, the total match exposure was at an early age. Hence, the study was essential in formulating calculated as 11 players multiplied by 1.5 hours multiplied injury prevention programmes in conjunction with by the number of returned injury report forms 10 . In the case protecting the health of athletes in Malaysia. of futsal, the total match exposure was calculated as five players multiplied by 40 or 60 minutes multiplied by the number of returned injury report forms 10 . Extra time MATERIALS AND METHODS allocated for a match and the reduction in the number of players on the field were not considered. Therefore, injuries The study was conducted during the 2018 Malaysian Games, per 1000 match hours were computed as the number of the SUKMA Games, which was held from 12th to 22nd injuries multiplied by 1000 divided by total match hours. For September 2018 in the state of Perak. There were 14 teams incidence rates, 95% CI was calculated as the incidence participating in men's football, 12 teams in men's futsal and ±1.96 times the incidence divided by the square root of the 11 teams in women's futsal. This biannual event involved 10 number of injuries . The severity of injuries was classified as athletes under 21 years of age While the football matches slight (1-3 days’ absence), minor (4-7 days), moderate (8-28 were held in four different stadiums, both the men's and 10 days), and major (more than 28 days) . women's futsal matches were conducted in one venue, the Manjung Indoor Sports Arena. Microsoft Excel and SPSS were used to process the data. Data were analysed descriptively with normality test The data collection was conducted based on the method conducted using the Shapiro-Wilk test. The statistical proposed by the Injury Consensus Group, which was analysis applied were frequencies, and Mann-Whitney U test established under the Federation Internationale de Football as the injury incidences between the teams were not Association Medical Assessment and Research Centre (F- 10 normally distributed. The significance value was accepted at MARC) . Before data collection, a briefing on how to fill up the 5% level. The study objective and procedures were the injury report form was completed by the investigator to explained clearly to all the participants with the patient's those involved in the study: the team doctor, the team information sheet. They were required to sign the informed physiotherapist and the tournament doctor. After each match, consent form before participating in the study. For the team doctor or the physiotherapist of the participating participants who were less than 18-years old, written consent teams was requested to document all injuries. was obtained from parents or guardians. The ethical approval to proceed with the study was granted by the Medical The injury report form as proposed by the F-MARC Research and Ethics Committee (MREC) of the University consensus, comprised of a single page on which all injuries of Malaya Medical Centre. sustained during a match were recorded. If there was no injury, the non-occurrence was also reported. According to the consensus statement 10 , an injury was defined as “any physical complaint sustained by a player that resulted from a RESULTS football match or football training, irrespective of the need A total of 252 players from 14 teams participated in football for medical attention or time loss from football activities”. during the Malaysian Games 2018. The median age group An injury that resulted in a player receiving medical for injured players was 20±2. In total, 44 out of 52 daily attention was referred to as a “medical attention” injury and medical report forms were returned with a response rate of an injury that resulted in a player being unable to take a full 84.62%. Therefore, the total match exposure calculated was part in future football training or match play as a “time loss” 726 hours (Table I). The training exposure was not included injury. Details of the injury documented were the time of in the study.