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Biomechanical Risk Factors of Injury-Related Single-Leg Movements in Male Elite Youth Soccer Players
(2022)
Altered movement patterns during single-leg movements in soccer increase the risk of lower-extremity non-contact injuries. The identification of biomechanical parameters associated with lower-extremity injuries can enrich knowledge of injury risks and facilitate injury prevention. Fifty-six elite youth soccer players performed a single-leg drop landing task and an unanticipated side-step cutting task. Three-dimensional ankle, knee and hip kinematic and kinetic data were obtained, and non-contact lower-extremity injuries were documented throughout the season. Risk profiling was assessed using a multivariate approach utilising a decision tree model (classification and regression tree method). The decision tree model indicated peak knee frontal plane angle, peak vertical ground reaction force, ankle frontal plane moment and knee transverse plane angle at initial contact (in this hierarchical order) for the single-leg landing task as important biomechanical parameters to discriminate between injured and non-injured players. Hip sagittal plane angle at initial contact, peak ankle transverse plane angle and hip sagittal plane moment (in this hierarchical order) were indicated as risk factors for the unanticipated cutting task. Ankle, knee and hip kinematics, as well as ankle and hip kinetics, during single-leg high-risk movements can provide a good indication of injury risk in elite youth soccer players.
Purpose
To (1) identify neuromuscular and biomechanical injury risk factors in elite youth soccer players and (2) assess the predictive ability of a machine learning approach.
Material and Methods
Fifty-six elite male youth soccer players (age: 17.2 ± 1.1 years; height: 179 ± 8 cm; mass: 70.4 ± 9.2 kg) performed a 3D motion analysis, postural control testing, and strength testing. Non-contact lower extremities injuries were documented throughout 10 months. A least absolute shrinkage and selection operator (LASSO) regression model was used to identify the most important injury predictors. Predictive performance of the LASSO model was determined in a leave-one-out (LOO) prediction competition.
Results
Twenty-three non-contact injuries were registered. The LASSO model identified concentric knee extensor peak torque, hip transversal plane moment in the single-leg drop landing task and center of pressure sway in the single-leg stance test as the three most important predictors for injury in that order. The LASSO model was able to predict injury outcomes with a likelihood of 58% and an area under the ROC curve of 0.63 (sensitivity = 35%; specificity = 79%).
Conclusion
The three most important variables for predicting the injury outcome suggest the importance of neuromuscular and biomechanical performance measures in elite youth soccer. These preliminary results may have practical implications for future directions in injury risk screening and planning, as well as for the development of customized training programs to counteract intrinsic injury risk factors. However, the poor predictive performance of the final model confirms the challenge of predicting sports injuries, and the model must therefore be evaluated in larger samples.