Prediction of core and lower extremity strains and sprains in collegiate football players: a preliminary study.
BACKGROUND
Poor core stability is believed to increase vulnerability to uncontrolled joint displacements throughout the kinetic chain between the foot and the lumbar spine.


OBJECTIVE
To assess the value of preparticipation measurements as predictors of  core or lower extremity strains or sprains in collegiate football players.


METHODS
Cohort study.


METHODS
National Collegiate Athletic Association Division I Football Championship Subdivision football program.


METHODS
All team members who were present for a mandatory physical examination on the day before preseason practice sessions began (n = 83).


METHODS
Preparticipation administration of surveys to assess low back, knee, and ankle function; documentation of knee and  ankle injury history; determination of body mass index; 4 different assessments of core muscle endurance; and measurement of step-test recovery heart rate. All injuries were documented throughout the preseason practice period and 11-game season. Receiver operating characteristic analysis and  logistic regression analysis were used to identify dichotomized predictive factors that best discriminated injured from uninjured status. The 75th and 50th percentiles were evaluated as alternative cutpoints for dichotomization of injury predictors.


RESULTS
Players with ≥2  of 3 potentially modifiable risk factors related to core function had 2 times greater risk for injury than those with <2 factors (95% confidence interval = 1.27, 4.22), and adding a high level of exposure to game conditions increased the injury risk to 3 times greater (95% confidence interval  = 1.95, 4.98). Prediction models that used the 75th and 50th percentile cutpoints yielded results that were very similar to those for the model that used receiver operating characteristic-derived cutpoints.


CONCLUSIONS
Low back dysfunction and suboptimal endurance of the  core musculature appear to be important modifiable football injury risk factors that can be identified on preparticipation screening. These predictors need to be assessed in a prospective manner with a larger sample of collegiate football players.
Graduate Athletic Training Education Program, University of Tennessee at Chattanooga, 615 McCallie Avenue, Chattanooga, TN 37403-2598, USA. garywilkerson@utc.edu
Gary B
GB
Wilkerson
Jessica L
JL
Giles
Dustin K
DK
Seibel
D000842:Ankle / Q000502:physiology; D016512:Ankle Injuries / Q000517:prevention & control; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D005538:Football / Q000293:injuries*; D006801:Humans; D007717:Knee / Q000502:physiology; D007718:Knee Injuries / Q000517:prevention & control; D017116:Low Back Pain / Q000517:prevention & control; D035002:Lower Extremity / Q000293:injuries*; D008297:Male; D053580:Muscle Strength; D018482:Muscle, Skeletal / Q000502:physiology*; D012307:Risk Factors; D013180:Sprains and Strains / Q000517:prevention & control*; D013334:Students; D014495:Universities