***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Cognitive behavioral stress management ( CBSM ) has previously been found to reduce fatigue , depression , and cortisol response to heavy exercise training among competitive collegiate athletes and to speed physical and psychological recovery from surgery ( 1,2 ) . Our study assessed the efficacy of a CBSM program to reduce the frequency of injury and illness among collegiate athletes in a r and omized , single-blind , controlled clinical trial . Following assessment of baseline medical history , mood state , stress , cortisol , sleep , alcohol use , and exercise training , collegiate rowers were stratified by gender and competitive level and r and omly assigned to either a control group or a CBSM group . Exercise training information and psychosocial assessment s were repeated immediately following the intervention period , and health care providers who were blinded to participant assignment recorded the frequency of medical visits and the number of days injured or ill until the end of the season . Athletes r and omly assigned to a CBSM group experienced significant reductions in the number of illness and injury days as compared to control group athletes . CBSM participants also had half the number of health service visits as did controls . The data suggest that a time-limited CBSM intervention design ed specifically for an athlete population may be an effective prophylactic treatment to reduce the incidence of injury and illness among competitive collegiate athletes Abstract We investigated the relationship between skill qualities and contact injury risk in professional rugby league players . Sixty-six professional rugby league players aged 23 ± 4 years ( mean ± s ) participated in this three-year prospect i ve study . Players underwent assessment s of  tackling proficiency , dual-task draw- and -pass proficiency  ,  reactive agility , pattern recall  , and  pattern prediction . The frailty model was applied to calculate the adjusted risk ratios of injury . When the players ' age and playing position were adjusted in the frailty model , the risk ratios showed that reactive agility was a predictor for the risk of injury . Players with reactive agility decision times of > 80 ms had a lower incidence ( relative risk = 0.68 , 95 % CI 0.47–0.98 , P = 0.04 ) of injuries than players with reactive agility decision times of ≤80 ms . Although there was no relationship between injury and the majority of skill qualities ( P = 0.47–0.93 ) , players with poor reactive agility performances ( specifically longer decision times ) had a lower risk of injury , suggesting that poor perceptual skill is protective against contact injuries in professional rugby league players . These players might inadvertently avoid the heavy collisions that result in injury , or at best result in partial contact that does not result in exposure to the full force of a tackle Background The influence of injuries on team performance in football has only been scarcely investigated . Aim To study the association between injury rates and team performance in the domestic league play , and in European cups , in male professional football . Methods 24 football teams from nine European countries were followed prospect ively for 11 seasons ( 2001–2012 ) , including 155 team-seasons . Individual training and match exposure and time-loss injuries were registered . To analyse the effect of injury rates on performance , a Generalised Estimating Equation was used to fit a linear regression on team-level data . Each team 's season injury rate and performance were evaluated using its own preceding season data for comparison in the analyses . Results 7792 injuries were reported during 1 026 104 exposure hours . The total injury incidence was 7.7 injuries/1000 h , injury burden 130 injury days lost/1000 h and player match availability 86 % . Lower injury burden ( p=0.011 ) and higher match availability ( p=0.031 ) were associated with higher final league ranking . Similarly , lower injury incidence ( p=0.035 ) , lower injury burden ( p<0.001 ) and higher match availability ( p<0.001 ) were associated with increased points per league match . Finally , lower injury burden ( p=0.043 ) and higher match availability ( p=0.048 ) were associated with an increase in the Union of European Football Association ( UEFA ) Season Club Coefficient , reflecting success in the UEFA Champions League or Europa League . Conclusions Injuries had a significant influence on performance in the league play and in European cups in male professional football . The findings stress the importance of injury prevention to increase a team 's chances of success Purpose The objective was to evaluate the effect of a psychological group-based injury prevention , which was implemented throughout the first season , after the second season , in Swedish elite floorball teams ( males and females ) . The secondary objective was to evaluate the effect of the intervention over the two consecutive floorball seasons as a whole . Methods Twenty-three teams in the premier leagues for males and females volunteered and were allocated to an  intervention group , n = 175 players , and a control group n = 171 players . The intervention group participated in psychological skills training during the first season . The control group did not receive any alternative treatment . Neither of the groups received any intervention during the second season . All injuries were registered and documented according to time-loss definition and classified into either traumatic or overuse injuries . Results Ninety-three players ( 27 % ) sustained 119 injuries during the second season . The intervention group 0.31 ( 95 % CI 0.22–0.39 ) and the control group 0.41 ( 95 % CI 0.29–0.53 ) injuries/player . The injury incidence decreased in the intervention group and was lower than the control group . The analysis showed no statistical differences when comparing the intervention group and the control group neither after the second season nor after the two seasons together , Cohen ’s d 0.2 . Conclusion This group-based training showed a small effect size after the second year result ing in fewer injuries , especially severe injuries , in the intervention group compared to the control group . It is , therefore , important not to overlook the potential of a group-based psychological injury prevention programme . Level of incidenceII Identifying and underst and ing injury risk factors are necessary to target the injury-prone athlete and develop injury prevention measurements . The influence of psychological factors on injuries in football is poorly documented . The purpose of this 8-month prospect i ve cohort study therefore was to examine whether psychological player characteristics assessed by a self-administered question naire represent risk factors for injury . At baseline , female football players ( 14 - 16 years ) were asked to complete a detailed question naire covering player history , previous injuries , perception of success and motivational climate , life stress , anxiety and coping strategies . During the 2005 season , a total of 1430 players were followed up to record injuries . A history of a previous injury [ odds ratio (OR)=1.9 ( 1.4 ; 2.5 ) , P<0.001 ] increased the risk of a new injury to the same region . There were significant differences in disfavor for previously injured compared with non-injured players for ego orientation ( P=0.007 ) , perception of a performance climate ( P=0.003 ) and experienced stressful life events ( P<0.001 ) . However , only high life stress ( P=0.001 ) and perception of a mastery climate ( P=0.03 ) were significant risk factors for new injuries . In conclusion , a perceived mastery climate and a high level of life stress were significant predictors for new injuries in a cohort of young female football players Background The injury rate in soccer is high , and effective injury prevention methods are needed . Purpose To test the effect of a video-based awareness program on the incidence of acute injuries in soccer . Study Design R and omized control trial ; Level of evidence , 1 . Methods Participants were elite male soccer players from the top 2 divisions in Icel and . Fifteen of 20 teams completed the study : 7 intervention teams  ( 127 players ) and 8 control teams  ( 144 players ) chosen by r and om . Just before the start of the 2000soccer season , the intervention teams were visited with an intervention program . The program included a 15-minutepresentation with information on the injury risk of playing elite soccer , typical injuries , and their mechanisms . Then the players workedtogether in pairs and analyzed video sequences to develop preventive strategies . The 12 video sequences were selected fromthe previous Icel and ic soccer season , representing 3 typical injury mechanisms that accounted for more than half of all incidentsrecorded . During the season , team physical therapists prospect ively recorded all acute injuries , and coaches recorded trainingexposure on a special form . Injury incidence was compared between groups and between the 1999 and 2000 seasons for teamsthat participated in both seasons . Results No difference was observed in injury incidence between the intervention ( 6.6 ± 0.7 injuries per 1000 player hours ) and control groups ( 6.6 ± 0.7 injuries per 1000 player hours ) . Furthermore , there was no difference in injury location or type . Conclusion The video-based injury awareness program showed no effect on injury rate Background Ankle injury is common in football , but the circumstances surrounding them are not well characterised . Aim To investigate the rates , especially time-trends , and circumstances of ankle injuries in male professional football . Methods 27 European clubs with 1743 players were followed prospect ively between 2001/2002 and 2011/2012 . Time loss injuries and individual-player exposure during training sessions and matches were recorded . Injury rate was defined as the number of injuries/1000 h. Results A total of 1080 ankle injuries were recorded ( 13 % of all injuries ) with lateral ligament ankle sprain being the most common injury subtype ( 51 % of all ankle injuries ) . The rates of ankle injury and ankle sprain were 1/1000 h and 0.7/1000 h , respectively . The ankle sprain rate declined slightly over time during the 11-year study period ( on average 3.1%/season ) with a statistically significant seasonal trend ( p=0.041 ) . Foul play according to the referee was involved in 40 % of the match-related ankle sprains . Syndesmotic sprains and ankle impingement were uncommon causes of time loss ( 3 % each of all ankle injuries ) . Conclusions Lateral ligament ankle sprain constituted half of all ankle injuries in male professional football , whereas ankle impingement syndromes were uncommon . The ankle sprain rate decreased slightly over time , but many ankle sprains were associated with foul play . Our data extend the body of literature that provides football policy makers with a foundation to review existing rules and their enforcement CONTEXT Athletes participating in sport are exposed to a high injury risk . Previous research has found a great number of risk factors ( both physiological and psychological ) that could increase injury risk . One limitation in previous studies is that few have considered the complex interaction between psychological factors in their research design . OBJECTIVE To study whether personality , stress , and coping predicted injury occurrence in an elite soccer population based on a hypothesized model . DESIGN Prospect i ve . PARTICIPANTS 56 ( n = 38 male , n = 18 female ) Swedish Premiere League soccer players were selected based on convenience sampling . INTERVENTION Participants completed 4 question naires including the Swedish Universities Scales of Personality , Life Events Survey for Collegiate Athletes , and Brief COPE during the initial question naire administration . Subsequent to the first meeting , participants also completed the  Hassle and Uplift Scale5  once per wk for a 13-wk period throughout the competitive season . MAIN OUTCOME MEASURES A path analysis was conducted examining the influence of personality traits ( ie , trait anxiety ) , state-level stressors ( ie , negative-life-event stress and daily hassles ) , and coping on injury frequency . RESULTS Results of the path analysis indicated that trait anxiety , negative-life-event stress , and daily hassle were significant predictors of injury among professional soccer players , accounting for 24 % of the variance . CONCLUSION The findings highlight the need for athletes , coaches , and medical practitioners to attempt to reduce state-level stressors , especially daily hassles , in minimizing injury risk . Educating and training athletes and coaches in proactive stress-management techniques appears warranted Motor imagery ( MI ) is the mental representation of an action without any concomitant movement . MI has been used frequently after peripheral injuries to decrease pain and facilitate rehabilitation . However , little is known about the effects of MI on muscle activation underlying the motor recovery . This study aim ed to assess the therapeutic effects of MI on the activation of lower limb muscles , as well as on the time course of functional recovery and pain after surgery of the anterior cruciate ligament ( ACL ) . Twelve patients with a torn ACL were r and omly assigned to a  MI or control group  , who both received a series of physiotherapy .  Electromyographic activity of the quadriceps , pain , anthropometrical data , and lower limb motor ability were measured throughout a 12-session therapy . The data provided evidence that MI elicited greater muscle activation , even though imagery practice did not result in pain decrease . Muscle activation increase might originate from a redistribution of the central neuronal activity , as there was no anthropometric change in lower limb muscles after imagery practice . This study confirmed the effectiveness of integrating MI in a rehabilitation process by facilitating muscular properties recovery following motor impairment . MI may thus be considered a reliable adjunct therapy to help injured patients to recover motor functions after reconstructive surgery of ACL OBJECTIVES To investigate by use of a latent growth curve analysis framework whether athletes ' individual levels and changes in hassle and uplift levels over a 10-week period could predict injury outcome in an elite junior soccer population . DESIGN A prospect i ve design with repeated measurement points . METHODS Participants were 101 Swedish elite junior soccer players ( 67 males and 34 females ) .  Ten sets of measures were taken on a weekly basis during which participants completed the Hassles and Uplifts Scale ( HUS ) . Latent 
    Output:
    
There is a dominance of stress  management-based interventions in literature due to the prominence of the model of stress and athletic injury within the area .