Development of a system dynamics model for the prediction of acute noncontact lower extremity injuries in team sports
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Date
2025-01-07
Authors
Λιβέρης, Νικόλαος
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Abstract
Introduction : Recent theoretical studies have suggested adopting systems thinking methodologies to examine risk of injury. However, their application remains limited in the domain of sports injuries.
Objectives : The purpose of this study is to apply system thinking methodologies to examine the complex interactions of risk factors leading to acute noncontact Lower Extremity (LE) and Hamstring (HS) injuries using qualitative and quantitative procedures.
Methodology : In the qualitative stage, a series of in depth discussions of the core modeling team and stakeholders based on structured group modeling building workshops, in combination with an extensive literature review, were conducted. The output of this stage was a detailed causal loop model illustrating the complexity of the risk factors leading to hamstring injury (HI-CLD). In the quantitative stage, data on internal risk factors from 99 professional and semiprofessional football athletes were collected using a holistic field based screening protocol. The data on injuries were collected during the competitive season. The risk factor interrelationships and their direct, indirect, and mediating effects on injury were evaluated using the Partial Least Square Structural Equation Modeling (PLS-SEM) method. Two PLS-SEMs were formulated separately for Hamstring Injuries (HIs) and the frequency of acute noncontact LE injuries.
Results : The HI-CLD specifies the injury risk factor interrelationships, showing the possible nonlinear effects of various factors. PLS-SEM results indicate that years of age > 24 and increased HS strength asymmetries have a statistically significant association with HIs. Further, previous injuries and LE strength asymmetries have been shown to have a direct statistically significant association with acute noncontact LE injuries. Furthermore, HS and core endurance measures have shown significant indirect effects in both models. Moreover, previous injuries and age have shown a significant moderating effect on both the PLS-SEM models.
Conclusions : The results provide information on the complex interactions of risk factors affecting the likelihood of injury occurrence. Therefore, the models developed in this thesis can be used to formulate effective injury prevention strategies.
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Keywords
Sports injuries, Injury prevention, Systems thinking, System dynamics, Structural equation modeling