Citation

Nielsen RO, Malisoux L, Møller M, Theisen D, Parner ET. J. Orthop. Sports Phys. Ther. 2016; 46(4): 300-311.

Affiliation

Section of Biostatistics, Department of Public Health, Aarhus University, Aarhus, Denmark.

Copyright

(Copyright © 2016, Orthopaedic Section and Sports Physical Therapy Section of the American Physical Therapy Association)

DOI

10.2519/jospt.2016.6510

PMID

26954269

Abstract

The etiological mechanism underpinning any sports-related injury is complex and multifactorial. Frequently, the athlete perceives 'excessive training' as the principle factor for their injury; an observation that is biologically plausible yet somewhat ambiguous. If the applied training load is suddenly increased, this may increase the risk for sports injury development, irrespective of the absolute amount of training. Indeed, little to no rigorous scientific evidence exists to support the hypothesis that it is the fluctuations in training load, compared to absolute training load that is more important in explaining sports injury development. One reason for this could be that prospective data from scientific studies should be analyzed in a different manner. Time-to-event analysis is a useful statistical tool in which to analyze the influence of changing exposures on injury risk. However, the potential of time-to-event analysis remains insufficiently exploited in sports injury research. Therefore, the purpose of the present article was to present and discuss measures of association used in time-to-event analyses and to present the advanced concept of time-varying exposures and outcomes. In the paper, different measures of association, such as cumulative relative risk, cumulative risk difference, and the classical hazard rate ratio, are presented in a non-technical manner, and suggestions for interpretation of study results are provided. Summarized, time-to-event analysis complements the statistical arsenal of sports injury prevention researchers, since it enables for analyzing the complex and highly dynamic reality of injury etiology, injury recurrence and time-to-recovery, across a range of sporting contexts. J Orthop Sports Phys Ther, Epub 8 Mar 2016. doi:10.2519/jospt.2016.6510.

Language: en