Clinical Evaluation Techniques for Injury Risk Assessment in Elite Swimmers: A Systematic Review

Abstract

<jats:sec><jats:title>Context:</jats:title><jats:p> Evidence concerning a systematic, comprehensive injury risk assessment in the elite swimming population is scarce. </jats:p></jats:sec><jats:sec><jats:title>Objective:</jats:title><jats:p> To evaluate the quality of current literature regarding clinical assessment techniques used to evaluate the presence and/or development of pain/injury in elite swimmers and to categorize objective clinical assessment tools into relevant predictors (constructs) that should consistently be evaluated in injury risk screens of elite swimmers. </jats:p></jats:sec><jats:sec><jats:title>Data Sources:</jats:title><jats:p> PubMed, Embase, Scopus, CINAHL, SPORTDiscus, PEDro, and the Cochrane Library Reviews were searched through September 2018. </jats:p></jats:sec><jats:sec><jats:title>Study Selection:</jats:title><jats:p> Studies were included for review if they assessed a correlation between clinic-based objective measures and the presence and/or development of acute or chronic pain/injury in elite swimmers. All body regions were included. Elite swimmers were defined as National Collegiate Athletic Association, collegiate, and junior-, senior-, or national-level swimmers. Only cohort and cross-sectional studies were included (both prospective and retrospective); randomized controlled trials, expert opinion, and case reports were excluded, along with studies that focused on interventions, performance, or specific swim-stroke equipment or technology. </jats:p></jats:sec><jats:sec><jats:title>Study Design:</jats:title><jats:p> Systematic review and qualitative analysis. </jats:p></jats:sec><jats:sec><jats:title>Level of Evidence:</jats:title><jats:p> Level 3. </jats:p></jats:sec><jats:sec><jats:title>Data Extraction:</jats:title><jats:p> PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were utilized at each phase of review by 2 reviewers; a third reviewer was utilized for tie breaking purposes. Qualitative analysis was performed using the Methodological Items for Non-Randomized Studies (MINORS) assessment tool. </jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p> A total of 21 studies assessed the presence and/or development of injury/pain in 3 different body regions: upper extremity, lower extremity, and spine. Calculated average MINORS scores for comparative (n = 17) and noncomparative (n = 4) studies were 18.1 of 24 and 10.5 of 16, respectively. Modifiable, objectively measurable injury risk factors in elite swimmers were categorized into 4 constructs: (1) strength/endurance, (2) mobility, (3) static/dynamic posture, and (4) patient-report regardless of body region. </jats:p></jats:sec><jats:sec><jats:title>Conclusion:</jats:title><jats:p> Limited evidence exists to draw specific correlations between identified clinical objective measures and the development of pain and/or injury in elite swimmers. </jats:p></jats:sec>

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Analysis of Research Trends on Elbow Pain in Overhead Sports: A Bibliometric Study Based on Web of Science Database and VOSviewer

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