Epidemiological Analysis of Shoulder Injuries Among Greek CrossFit Participants and Predictive Modeling for Shoulder Injury Incidence.

NCT05909592 | Completed

• 1 other identifier: 14279
• Study Type: observational
• Target: 111
• Locations: 1 country
• Sites: 1

Brief Summary

CrossFit is a modern sport, introduced to the public in 2000 and popular quickly with more than 15,000 affiliates worldwide. Due to the highly demanding nature of the workouts, it is claimed to be a sport with a high prevalence of injuries. Most preliminary retrospective studies had shown that shoulder area is injured most frequently, at about a quarter of all injuries. Therefore, the initial goal of this observational (prospective cohort) study is to learn about the incidence rates of shoulder injuries and potential risk factors in a Greek population of CrossFit participants. Based on these results, this study's ultimate purpose is to create a short warm-up program capable of reducing shoulder injuries and evaluate its effectiveness. The main questions it aims to answer are:

• Are shoulder injuries as frequent as previous studies have shown to be?
• Can we blame for these injuries a previous history of musculoskeletal injury or deficits of range of motion, strength, and muscular endurance?
• Can a short warm up which targets revealed deficiencies be effective in reducing shoulder injuries incidence rates? Participants will be asked to:
• take part in baseline measurements (personal data, previous musculoskeletal history, shoulder and core range of motion, shoulder and hip muscle strength, shoulder stabilizers endurance, functional assessment sport-specific tests)
• be monitored for new shoulder injuries or aggravation of old shoulder injuries that will occur during 12 months following baseline measurements. In this case, they must refer it to their coaches to be contacted and assessed by the researcher.
• be in touch with the researcher throughout the observational study and provide any required data regarding their participation

Conditions

Sports Injury; Shoulder Injuries; Risk Factors; Injury Prediction; Machine Learning; CrossFit

Keywords

Sports Injury; Shoulder Injuries; Risk Factors; Injury Prevention; Injury Prediction; Machine Learning; CrossFit

Outcome Measures

Primary Outcomes (16)

• BMI

  Weight (kg) and Height (cm) data will be collected to report BMI in kg/m\^2

  Baseline assessment

• Demographic, general history and shoulder injuries history, activity and experience level

  Participant profile will be formed using an especially designed questionnaire, data will be collected regarding the age, upper limb dominance, months of experience, training volume in hours per week, level of competition, warm up and recovery routines adequacy, details of previous injuries and current situation of shoulder functionality.

  Baseline assessment

• Core rotation active range of motion

  Right and left core rotation will be measured in degrees utilizing a digital goniometer (HALO digital goniometer, HALO Medical Devices) which has affixed on an aluminum stick. Participant will be holding the stick by hands at the level of scapulas spines and starting rotate his or her core to right and then left direction.

  Baseline assessment

• Shoulder active range of motion symmetries

  Comparative measurements among shoulders. In an upright position, knees forward and flexed as far as it will be needed in order back and lower back to be attached on the wall, participant will move his/her shoulders toward flexion while maintaining the initial position on the wall. When movement will reach the end point of the available range of motion, the researcher will measure the distances between each wrist and the wall using a measuring tape. The distance may be symmetrical otherwise the shoulder of the upper limb with the bigger distance will be documented as deficient. Same procedure in the same body position will be followed for external and internal rotation of the shoulders but movements will be performed with 90 degrees of shoulder abduction and 90 degrees of elbow flexion.

  Baseline assessment

• Shoulder stabilizers muscle strength

  Maximal strength of each shoulder external and internal rotators will be measured in kilograms of resistance utilizing a handheld digital dynamometer, K-Force Muscle Controller, via K-Force Pro application reporting (Kinvent, Montpellier, France)

  Baseline assessment

• Lateral differences in muscle strength between shoulders

  The percentage of lateral differences in maximal strength of internal and external rotation between shoulders will be measured utilizing a handheld digital dynamometer, K-Force Muscle Controller, via K-Force Pro application reporting (Kinvent, Montpellier, France)

  Baseline assessment

• Hip abductors muscle strength

  Maximal strength of each hip abductors muscles will be measured in kilograms of resistance with the use of a handheld digital dynamometer, K-Force Muscle Controller, via K-Force application reporting (Kinvent, Montpellier, France)

  Baseline assessment

• Lateral differences in hip abductors strength

  The percentage of lateral differences in maximal strength of abduction between hips will be measured utilizing a handheld digital dynamometer, K-Force Muscle Controller, via K-Force Pro application reporting (Kinvent, Montpellier, France)

  Baseline assessment

• Muscular endurance of shoulder external rotators

  Using the aforementioned dynamometer application, participants will be asked to do 3 sets of 30 seconds isometric hold at the 60% of the maximal previously produced strength by external rotators muscles (outcome 5). 5 seconds rest between sets will be used. The percentage of the time, on which participants can produce the requested amount of power, will be recorded. This measurement will reflect the endurance capability of this muscle group for each shoulder. Measurement data will be collected using a handheld digital dynamometer, K-Force Muscle Controller, via K-Force Pro application reporting (Kinvent, Montpellier, France).

  Baseline assessment

• Lateral differences in shoulder external rotators endurance

  The percentage of lateral differences in external rotation isometric hold between right and left side will be exported from K-Force Pro application reporting.

  Baseline assessment

• Shoulder stability

  Closed Kinetic Chain Upper Extremity Stability test (CKCUES) will be performed to evaluate shoulder stability.

  Baseline assessment

• CrossFit-specific functional parameters (flexibility, stability, power) using an innovative evaluation tool: CrossFit Functional Assessment Battery for Shoulder (CrossFit FABS)

  Flexibility, stability and power will be evaluated using an innovative assessment tool which was developed especially for the purpose of the present research. CrossFit FABS (Functional Assessment Battery for Shoulder) is a CrossFit-specific, functional evaluation battery in regard to shoulder injury risks. It is composed of 6 tests which resulted from a wider tool through applied pilot research: deep air squat, shoulder mobility, upper frontal kinetic chain flexibility, overhead squat facing wall, windmill with kettlebell and sots press. Each test is scored from 0 to 3, using a 3-point scoring scale with a maximum total score of 18 points.

  Baseline assessment

• Shoulder injury incidents

  Any new or aggravated pre-existing shoulder injury that will be responsible for at least 1-day training or game loss or training modification to avoid specific high-impact exercises will be recorded. Also, the whole progression of the recovery until return-to-sport will be monitored.

  Up to 12 months

• Shoulder injury characteristics

  Injury profile will be formed using an especially designed objective and subjective assessment questionnaire, including present injury history, correlation with performed exercise, symptoms, observation abnormalities and special diagnostic tests for shoulder pain (clinical assessment). Exact kind of injury will be determined by the researcher.

  Up to 12 months

• Disability of injured participants

  A self-reported questionnaire for shoulder, the SDQ (Shoulder Disability Questionnaire), will be filled by injured participants via interview method by the researcher.

  Up to 12 months

• Pain intensity of injured participants

  VAS pain scale will be used to determine shoulder pain intensity in injured participants.

  Up to 12 months

Secondary Outcomes (2)

• Shoulder injury risk factors

  After study completion, 2nd year

• Predictive modeling for shoulder injury incidence in CrossFit

  After study completion, 2nd year

Study Arms (1)

Healthy CrossFit participants and athletes

No intervention. The group will be monitored for incidence data of shoulder injuries (new or aggravated pre-existing)

Eligibility Criteria

• Age: 18 Years - 62 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)
• Sampling Method: Non-Probability Sample

Study Population

150 (anticipated) healthy individuals who participate in CrossFit. They are training in Crossfit affiliated boxes located at 4 different towns in Greece.

You may qualify if:

• Healthy adults CrossFit participants of any level of experience
• Novices who have already completed the trial workouts

You may not qualify if:

• Injured CrossFit participants who have not yet returned to ordinary training

Sponsors & Collaborators

• University of Patras: lead

Study Sites (1)

University of Patras

Patras, Peloponnese, 26504, Greece

Location

Related Publications (7)

• Bullock GS, Mylott J, Hughes T, Nicholson KF, Riley RD, Collins GS. Just How Confident Can We Be in Predicting Sports Injuries? A Systematic Review of the Methodological Conduct and Performance of Existing Musculoskeletal Injury Prediction Models in Sport. Sports Med. 2022 Oct;52(10):2469-2482. doi: 10.1007/s40279-022-01698-9. Epub 2022 Jun 11.

  PMID: 35689749 BACKGROUND

• Schwank A, Blazey P, Asker M, Moller M, Hagglund M, Gard S, Skazalski C, Haugsbo Andersson S, Horsley I, Whiteley R, Cools AM, Bizzini M, Ardern CL. 2022 Bern Consensus Statement on Shoulder Injury Prevention, Rehabilitation, and Return to Sport for Athletes at All Participation Levels. J Orthop Sports Phys Ther. 2022 Jan;52(1):11-28. doi: 10.2519/jospt.2022.10952.

  PMID: 34972489 BACKGROUND

• Asker M, Brooke HL, Walden M, Tranaeus U, Johansson F, Skillgate E, Holm LW. Risk factors for, and prevention of, shoulder injuries in overhead sports: a systematic review with best-evidence synthesis. Br J Sports Med. 2018 Oct;52(20):1312-1319. doi: 10.1136/bjsports-2017-098254. Epub 2018 Mar 26.

  PMID: 29581141 BACKGROUND

• Angel Rodriguez M, Garcia-Calleja P, Terrados N, Crespo I, Del Valle M, Olmedillas H. Injury in CrossFit(R): A Systematic Review of Epidemiology and Risk Factors. Phys Sportsmed. 2022 Feb;50(1):3-10. doi: 10.1080/00913847.2020.1864675. Epub 2021 Jan 7.

  PMID: 33322981 BACKGROUND

• Silva ER, Maffulli N, Migliorini F, Santos GM, de Menezes FS, Okubo R. Function, strength, and muscle activation of the shoulder complex in Crossfit practitioners with and without pain: a cross-sectional observational study. J Orthop Surg Res. 2022 Jan 15;17(1):24. doi: 10.1186/s13018-022-02915-x.

  PMID: 35033136 BACKGROUND

• Torres-Banduc MA, Jerez-Mayorga D, Moran J, Keogh JWL, Ramirez-Campillo R. Isokinetic force-power profile of the shoulder joint in males participating in CrossFit training and competing at different levels. PeerJ. 2021 Sep 17;9:e11643. doi: 10.7717/peerj.11643. eCollection 2021.

  PMID: 34616590 BACKGROUND

• Montalvo AM, Shaefer H, Rodriguez B, Li T, Epnere K, Myer GD. Retrospective Injury Epidemiology and Risk Factors for Injury in CrossFit. J Sports Sci Med. 2017 Mar 1;16(1):53-59. eCollection 2017 Mar.

  PMID: 28344451 BACKGROUND

MeSH Terms

Conditions

Athletic Injuries; Shoulder Injuries

Condition Hierarchy (Ancestors)

Wounds and Injuries

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Target Duration: 1 Year
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: May 1, 2023
• First Posted: June 18, 2023
• Study Start: September 24, 2022
• Primary Completion: February 12, 2023
• Study Completion: February 12, 2024
• Last Updated: February 5, 2025

Record last verified: 2025-01

Locations

GR (1)