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  • 1.
    Asker, Martin
    et al.
    Karolinska Institutet.
    Brooke, Hannah L
    Karolinska Institutet.
    Waldén, Markus
    Linköping University.
    Tranaeus, Ulrika
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Johansson, Fredrik
    Karolinska Institutet.
    Skillgate, Eva
    Karolinska Institutet.
    Holm, Lena W
    Karolinska Institutet.
    Risk factors for, and prevention of, shoulder injuries in overhead sports: a systematic review with best-evidence synthesis.2018In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 52, no 20, p. 312-1319, article id bjsports-2017-098254Article, review/survey (Refereed)
    Abstract [en]

    OBJECTIVE: To assess the evidence for risk factors and prevention measures for shoulder injuries in overhead sports.

    DESIGN: Systematic review with best-evidence synthesis.

    DATA SOURCES: Medline (Ovid), PubMed (complementary search), Embase (Elsevier), Cochrane (Wiley), SPORTDiscus (Ebsco) and Web of Science Core Collection (Thomson Reuters), from 1 January 1990 to 15 May 2017.

    ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Randomised controlled trials, cohort studies and case-control studies on risk factors or prevention measures for shoulder injuries in overhead sports. The eligible studies were quality assessed using the Scottish Intercollegiate Guidelines Network criteria.

    RESULTS: Of 4778 studies identified, 38 were eligible for quality review and 17 met the quality criteria to be included in the evidence synthesis. One additional quality study presented a shoulder injury prevention programme. Most studies focused on baseball, lacrosse or volleyball (n=13). The risk factors examined included participation level (competition vs training) (n=10), sex (n=4), biomechanics (n=2) and external workload (n=2). The evidence for all risk factors was limited or conflicting. The effect of the prevention programme within the subgroup of uninjured players at baseline was modest and possibly lacked statistical power.

    CONCLUSIONS: All investigated potential risk factors for shoulder injury in overhead sports had limited evidence, and most were non-modifiable (eg, sex). There is also limited evidence for the effect of shoulder injury prevention measures in overhead sports.

    PROSPERO TRIAL REGISTRATION NUMBER: CRD42015026850.

  • 2.
    Clement, Damien
    et al.
    College of Physical Activity and Sport Sciences, West Virginia University.
    Ivarsson, Andreas
    Center of Research on Welfare, Health and Sport (CVHI), Halmstad University..
    Tranaeus, Ulrika
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences. Musculoskeletal and Sports Injury Epidemiology Center, Institute of Environmental Medicine Karolinska Institutet.
    Johnson, Urban
    Center of Research on Welfare, Health and Sport (CVHI), Halmstad University..
    Stenling, Andreas
    Department of Psychology, Umeå University.
    Investigating the influence of intra-individual changes in perceived stress symptoms on injury risk in soccer.2018In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 28, no 4, p. 1461-1466Article in journal (Refereed)
    Abstract [en]

    Research has shown that high levels of stress and stress responsivity can increase the risk of injuries. However, most of the research that has supported this notion has focused on between-person relationships, ignoring the relationships at the within-person level. As a result, the objective of this study was to investigate if within-person changes in perceived stress symptoms over a one-month time period could predict injury rates during the subsequent three months. A prospective design with two measurement points (Time 1 - at the beginning of the season and Time 2 - one month into the season) was utilized. A total of 121 competitive soccer players (85 males and 36 females; Mage = 18.39, SD = 3.08) from Sweden and the United States completed the Kessler Psychological Distress Scale (KPDS) and a demographic sheet at Time 1. The KPDS was also completed at Time 2 and all acute injuries that occurred during the subsequent three-month period were recorded. A Bayesian latent change scores model was used to determine if within-person changes in stress symptoms could predict the risk of injury. Results revealed that there was a credible positive effect of changes in stress symptoms on injury rates, indicating that an increase in reported stress symptoms was related to an increased risk for injury. This finding highlights the importance of creating caring and supportive sporting environments and relationships and teaching stress management techniques, especially during the earlier portion of competitive seasons, to possibly reduce the occurrence of injuries. This article is protected by copyright. All rights reserved.

  • 3.
    Hallquist, Charlotte
    et al.
    Linnaeus University, Kalmar, Sweden.
    Tranaeus Fitzgerald, Ulrika
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences. Karolinska Institutet, Stockholm, Sweden.
    Alricsson, Marie
    Linnaeus University, Kalmar, Sweden; Mid Sweden University, Östersund, Sweden.
    Responsibility for child and adolescent's psychosocial support associated with severe sports injuries2016In: Journal of Exercise Rehabilitation, ISSN 2288-176X, Vol. 12, no 6, p. 589-597Article in journal (Refereed)
    Abstract [en]

    The manner in which health professionals and coaches act and decide on treatment and prognosis can influence athletes in a way that not only strengthens them, but it can also reduce their confidence in their own ability. The purpose was to determine who has the responsibility for child and adolescent psychosocial support needed in connection with a severe sports injury as well as investigate whether coaches, physiotherapists and parents are aware of the support that is needed. Qualitative interviews with coaches, parents and physiotherapists with experience of serious sports injuries in young people aged 12 to 16 years old from different sports were analysed using content analysis. The study showed that all actors independently imparted communica-tion as being the major problem and indicated that the role of a coordi-nator was missing. They imparted cognitive, emotional and behavioural reactions in children, which were considered to be more common in younger children as indicated in previous studies. Coaches felt they had lack of education and time; parents described their disappointment in caregivers and personality changes in their children in connection with the injury. Physiotherapists felt that rehabilitation was often served as a substitute for the sport and that they therefore had greater responsibili-ty for the child than they had been educated for. Results should be com-municated to participants who are involved in children’s and adoles-cent’s sports to increase their knowledge and thus allow them to be able to give our children the best possibility, regardless of whether they return to the sport or not.

  • 4.
    Hildingsson, Malin
    et al.
    Linnéuniversitetet.
    Tranaeus Fitzgerald, Ulrika
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Alricsson, Marie
    Linnéuniversitetet.
    Perceived motivational factors for female football players during rehabilitation after sports injury - a qualitative interview study.2018In: Journal of exercise rehabilitation, ISSN 2288-176X, Vol. 14, no 2, p. 199-206Article in journal (Refereed)
    Abstract [en]

    Compliance with a rehabilitation program is significant among athletes following a sports injury. It is also one of the main factors that influence the rehabilitation process; moreover, the outcome is also influenced by the athlete's motivation. It is primarily an autonomous motivation, resulting in rehabilitation adherence. The aim of this study was to investigate the perceived motivation of female football players during rehabilitation after a sports injury and the extent to which these motivating factors were autonomous. Qualitative interviews, based on a semistructured interview guide with injured female football players undergoing rehabilitation, were analyzed using content analysis. The motivational factors that were described were their set goals, social support as well as external and internal pressures during rehabilitation. The perceived autonomy varied somewhat but overall, they experienced external motivation; therefore, the behavior was not entirely self-determined. Results are expected to provide a better understanding of women football players' motivation in relation to their rehabilitation; hence, physiotherapists and coaches who are part of the rehabilitation process can contribute by increasing the autonomous motivation, thus, improving the compliance and outcome of the rehabilitation.

  • 5.
    Ivarsson, Andreas
    et al.
    Halmstad University.
    Tranaeus, Ulrika
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Johnson, Urban
    Halmstad University.
    Stenling, Andreas
    Umeå University.
    Negative psychological responses of injury and rehabilitation adherence effects on return to play in competitive athletes: a systematic review and meta-analysis.2017In: Open Access Journal of Sports Medicine, ISSN 1179-1543, E-ISSN 1179-1543, Vol. 8, p. 27-32Article, review/survey (Refereed)
    Abstract [en]

    Previous research offers evidence that psychological factors influence an injured athlete during the rehabilitation process. Our first objective was to conduct a systematic review and meta-analysis of the results from all published studies that examined the relationships among negative affective responses after sport injuries, rehabilitation adherence, and return to play (RTP). The second objective was to use a meta-analytic path analysis to investigate whether an indirect effect existed between negative affective responses and RTP through rehabilitation adherence. This literature review resulted in seven studies providing 14 effect sizes. The results from the meta-analysis showed that negative affective responses had a negative effect on successful RTP, whereas rehabilitation adherence had a positive effect on RTP. The results from the meta-analytic path analysis showed a weak and nonsignificant indirect effect of negative affective responses on RTP via rehabilitation adherence. These results underline the importance of providing supportive environments for injured athletes to increase the chances of successful RTP via a decrease in negative affective responses and increase in rehabilitation adherence.

  • 6.
    Samuelsson, Martin
    et al.
    Karolinska Institutet.
    Weiss, Nathan
    Karolinska Institutet.
    Johnson, Urban
    Högskolan i Halmstad.
    Skillgate, Eva
    Karolinska Institutet.
    Tranaeus, Ulrika
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Maladaptive coping strategies as risk factors for the development of overuse injuries among adolescent female soccer players: Karolinska football Injury Cohort, KIC2018Conference paper (Refereed)
  • 7.
    Tranaeus, Ulrika
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Karolinska Football Injury Cohort, KIC-studien2019In: Rapport från aktuella studier, 2019Conference paper (Other academic)
  • 8.
    Tranaeus, Ulrika
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Sport Psychology research group.
    Post-injury psychology and return to sport: Frontline of sports psychology2019Conference paper (Other academic)
  • 9.
    Tranaeus, Ulrika
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Psychological factors in the prevention of sport injury2019In: Sportskongres 2019: Invited symposium: Psychology of sport injury - prevention, return to sport and behaviour change, 2019Conference paper (Refereed)
  • 10.
    Tranaeus, Ulrika
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences. The Swedish School of Sport and Health Sciences, GIH.
    Psychology of sports injuries: from pre-injury to return to sport. Current research and practical implications: Psychosocial risk factors for traumatic and overuse injuries in sport2019Conference paper (Refereed)
    Abstract [en]

    Symposium

    Topics: Prevention and rehabilitation

    Keywords: Injury, prevention, rehabilitation, sport

    Psychology of sports injuries: from pre-in jury to return to sport. Current research and practical implications

    Chair(s): Ulrika Tranaeus (The Swedish School of Sport and Health Sciences, GIH, Sweden)

    In addition to the physical consequences of sport injuries, athletes must contend with a range of psychosocial challenges – both in the immediate injury aftermath (pain, loss of function) and throughout the recovery process (motivational decrements, lack of confidence in return toplay). It is therefore important to identify factors influencing injury risk, recovery, and return to play. Evaluation of injury prevention strategies are also of evident importance.The purpose of this symposium is to examine psychosocial factors and interventions influencing injury risk, rehabilitation and return to play. By doing so, each presenter highlights empirical and applied implications. This symposium includes five presentations.The initial presentation overviews psychosocial risk factors for traumatic and overuse injuries and discussion regarding prevention strategies. A presentation of methodological implications for research on psychosocial risk factors will follow. This presentation includes how interactions of risk factors influence injury risk and recommendations for statistical analyses.The third presentation gives an example of a cognitive-behavioural therapy smartphone-based intervention programme. The intervention consists of daily use of a stress management programme delivered in a smartphone app aiming to reduce stress and prevent injuries.The fourth presentation articulates reviews some examples of future research strategies in rehabilitation. Longitudinal study designs that examines intra-individual changes will be discussed.Finally, the fifth presentation examines the role of psychosocial factors influencing return versus non-return to sport following injury, as well as the quality of post-injury performance. This will be discussed in the framework of the self-determination theory.

    Presentations of the Symposium

    Psychosocial risk factors for traumatic and overuse injuries in sport

    Ulrika Tranaeus The Swedish Sch ool of Sport and Health Sciences, GIH

    Despite the health benefits of sport participation, involvement in competitive sport is associated with injury risk. Injuries are classified into two kinds with different causation − traumatic injuries and overuse injuries. Traumatic injuries have a sudden onset with or without contact, while overuse injuries occur after repetitive load without feasible recovery (Fuller et al., 2006). The psychosocial risk factors for these kinds of injuries differ. Risk factors for traumatic injuries are described in various models, the most prominent and well-tested being the Williams and Andersen’s (1998) Stress-Injury Model. An evaluation of the model showed that the stress response had the strongest relationship to injury rates (Ivarssonet al., 2017). The magnitude of the stress response and the athlete’s appraisal of a stressful situation are suggested to be influenced by the interplay between various psychosocial factors: personality factors, history of stressors, and coping resources. With this knowledge, prevention programmes designed to address injury risk factors (e.g., stress perceptions) and subsequent injury occurrence have been evaluated. Risk factor studies for overuse injuries and overtraining have showed similarities such as intrapersonal factors (e.g., motivation, dealing with pain), interpersonal factors (e.g., communication, social support), and situational factors (e.g., stress in sport and/or from life events) (Richardson,Andersen, & Morris, 2008; Tranaeus, Johnson, Engström, Skillgate, & Werner, 2014). These factors are suggested to influence athletes’ excessive behaviours and limited recovery which may lead to overuse injuries. This presentation is germane for researchers and practitioners hoping to mitigate acute and overuse injury occurrence.

  • 11.
    Tranaeus, Ulrika
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Sport Psychology research group.
    Recovery from sport injuries, a psychological insight2019Conference paper (Other academic)
  • 12.
    Tranaeus, Ulrika
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    The mental aspect matters: How to assess and how to help2018Conference paper (Other academic)
  • 13.
    Tranaeus, Ulrika
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    The role of psychology in injury prevention2018In: Part of the seminar: Motor Control and Learning in Injury Prevention, 2018Conference paper (Other academic)
  • 14.
    Tranaeus, Ulrika
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Hallgren, Linn
    Jörlund, Hanna
    Psykologiska faktorer för en skadefri idrottskarriär - en kvalitativ studie2019Conference paper (Refereed)
  • 15.
    Tranaeus, Ulrika
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences. Karolinska Institutet, IMM, MUSIC.
    Ivarsson, Andreas
    Högskolan i Halmstad.
    Johnson, Urban
    Högskolan i Halmstad.
    Stress and injuries in elite sport2018In: Handbuch Stressregulation und Sport / [ed] Fuchs, Reinhard & Gerber, Markus, Springer, 2018, 1, p. 451-466Chapter in book (Refereed)
  • 16.
    Tranaeus, Ulrika
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Johansson, Johanna
    MUSIC, Karolinska Institutet.
    Tiftikci, Sirin
    MUSIC, Karolinska Institutet.
    Johnson, Urban
    Högskolan i Halmstad.
    Skillgate, Eva
    MUSIC Karolinska Institutet, SHH.
    Samband mellan upplevd stress och överbelastningsskador hos unga fotbollsspelande flickor – en prospektiv kohortstudie2019In: Svensk Idrottsmedicin, 2019:2, sid 55 / [ed] Anna Nylén, Svensk förening för fysisk aktivitet och idrottsmedicin , 2019Conference paper (Refereed)
    Abstract [sv]

    BAKGRUND: Fotboll är en av de populäraste lagidrotterna även bland flickor/damer i Sverige. Skador, varav överbelastningsskador är en av skadekategorierna, är vanligt förekommande. Skadefrekvensen är högre bland män än kvinnor inom fotboll och allvarliga knäskador är vanligare hos fotbollsspelande kvinnor än män. Stress är en riskfaktor för traumatiska skador. Upplevd stress som riskfaktor för överbelastningsskador är ännu inte undersökt.

    SYFTE: Syftet denna delstudie var att undersöka eventuella samband mellan upplevd stress och överbelastningsskador hos unga fotbollsspelande flickor.

    METOD: Detta är en pågående prospektiv kohortstudie, The Karolinska Injury Cohort (KIC) study, med det övergripande syftet att identifiera riskfaktorer för skador hos fotbollsspelande flickor, 13-16 år på elitnivå. Från studiestart september 2016 till september 2018 var 280 spelare inkluderade. Målet är att inkludera 600 spelare. I samband med inkludering besvarades bland annat frågor om upplevd stress. Spelarna följdes veckovis under 53 veckor och besvarade frågor om skador samt begränsningar i träning och match på grund av smärta och/eller fysiska besvär. Varje skada följdes upp med mer detaljer kring skadan via telefon. I denna delstudie inkluderas spelarna vid första registrerade överbelastningsskada. Alla potentiella störfaktorer såsom coping, passion till sport, sömn, idrottspsykologisk träning samt fotbollsrelaterade frågor registrerades i baslinjen. En logistisk regressionsanalys utfördes i StataSE version 14.2 med kontroll för störfaktorer för sambandet mellan graden av upplevd stress och överbelastningsskador.

    RESULTAT: Av de 280 inkluderade spelarna i KIC var det 145 spelare som angav att de var skadefria vid studiestart och som inkluderades i denna analys. Av dessa hade 31 spelare en överbelastningsskada och 17 (55 %) spelare rapporterade att de upplevde stress, medan resterande 14 (45 %) spelare inte upplevde stress. Spelare som rapporterade upplevd stress vid baslinjen hade inte en högre risk att få en överbelastningsskada under uppföljningsperioden (OR:1.1; 95 % CI: 0.6-2.1; p= 0.8), jämfört med spelare utan upplevd stress.

    SLUTSATS: Denna delstudie visade inget samband mellan upplevd stress vid studiestart och överbelastningsskador under uppföljningstiden. Denna analys är baserad på få spelare och kommer att upprepas då 600 spelare är inkluderade i studien och information om upplevd stress från veckorapporten kommer att användas.

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