Dissertation
A multifactorial model of risk factors for non-contact musculoskeletal injury in collegiate swimmers: a prospective study
Doctor of Philosophy (Ph.D.), Drexel University
Jun 2020
DOI:
https://doi.org/10.17918/00001031
Abstract
Swimmers are known for high training loads and overuse injuries. Due to a limited number of prospective studies, especially on college swimmers, the risk factors for injury remain uncertain. The overall objective of this dissertation was to determine the risk factors that were most strongly associated with non-contact musculoskeletal injury in college swimmers. I hypothesized that previous injury, swimming technique, perceived susceptibility to injury, movement competency, and training load would all be associated with injury. I also hypothesized that multiple risk factors would be more strongly associated with injury than any one alone. Thirty-seven Division III college swimmers participated in a prospective cohort study. In the preseason, they completed questionnaires on previous injuries and perceived susceptibility. At the beginning of the season, they completed the Movement System Screening Tool and Freestyle Swimming Technique Assessment. During the season, the student-athletes and swim coach reported their workloads (kilometers swum) and injuries. Univariate and multiple logistic regressions were used to assess the associations between risk factors and injury. Eleven participants sustained an injury. Previous injury (OR = 8.89, 95% CI: 1.78, 44.48) and a cross-over hand position during the entry phase of the freestyle stroke (OR = 8.50, 95% CI: 1.50, 48.05) increased odds of injury. Together, previous injury and hand position at entry estimated model fit at 42.8%, which exceeded the model fit for either risk factor alone by over 14%. After adjusting for previous injury, higher perceived percentage chance of injury decreased injury odds (adjusted OR = 0.11, 95% CI: 0.02, 0.82). Poor scores on the Movement System Screening Tool were not associated with injury (OR = 1.06, 95% CI: 0.96, 1.16). Nor were the number of kilometers swum over the entire season (OR = 1.00, 95% CI: 0.99, 1.01). However, the odds of injury were higher during weeks in which workloads exceeded 37.2 km/week (27.1, 95% CI: 8.2, 89.8) compared to all other weeks. Similarly, compared to all other weeks, injury odds were higher for weeks in which the ratio of the most recent week of training to the most recent four weeks of training (i.e. the acute:chronic workload ratio) exceeded 1.56 (OR = 25.1, 95% CI: 7.7, 81.4). In summary, previous injury, a cross-over hand entry position in freestyle, and low perceived percentage chance of injury all predisposed college swimmers to injury. While college swimmers tolerated high workloads spread throughout the season, injuries were more likely to occur during high-workload weeks than all other weeks.
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Details
- Title
- A multifactorial model of risk factors for non-contact musculoskeletal injury in collegiate swimmers
- Creators
- Travis R. Pollen
- Contributors
- Sheri P. Silfies (Advisor)
- Awarding Institution
- Drexel University
- Degree Awarded
- Doctor of Philosophy (Ph.D.)
- Publisher
- Drexel University; Philadelphia, Pennsylvania
- Number of pages
- x, 189 pages
- Resource Type
- Dissertation
- Language
- English
- Academic Unit
- College of Nursing and Health Professions; Drexel University; Physical Therapy (and Rehabilitation Sciences)
- Other Identifier
- 991014695141404721