***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: OBJECTIVE To prospect ively document the incidence of game injury rates in youth ice hockey tournaments to compare with season-long game injury rates and to analyze the injuries occurring at tournaments by mechanism , type , body location , severity , player position , and period of play . DESIGN A prospect i ve injury report form completed for injured players by the tournament athletic trainer . SETTING  Four boys ' tournaments  and one girls ' tournament  during the 1993 - 94 season . PARTICIPANTS 807 boys and girls , ages 9 - 19 . MEASUREMENTS /MAIN RESULTS 60 injuries occurred in boys and 4 occurred in girls . There were 26 boys with significant injuries and no girls with significant injuries . The significant game injury rates per 1000 player hours were 50.9 for boys combined , 57.9 for boys ' Peewee A , 42.7 for boys ' Bantam A , 64.8 for boys ' varsity high school , 44.8 for boys ' Junior Gold , and 0 for girls ' Peewee A and B. Cerebral concussion comprised 15 % of boys ' injuries . CONCLUSIONS The significant injury rate for boys ' tournament game play was 4 - 6 times higher than the season game injury rates in two previous season-long studies . In boys ' games , 65 % of " all " injuries and 77 % of " significant " injuries were related to collisions . The girls ' rules of play do not allow body checking , and there were no significant injuries in girls ' games . The boys had high rates of cerebral concussion injury at all age levels . Minimizing the frequency and intensity of collisions in the boys ' game may decrease the injury rates , especially in the tournament setting Eighty-six male high school ice hockey players partic ipated in this prospect i ve study to determine both the incidence of injury in high school ice hockey and the influence of physical , situational , and psychosocial fac tors . Physical factors included height , weight , vision , previous injuries , musculoskeletal abnormalities , and injuries present at the time of screening evaluations . Situational factors examined were level of participa tion , playing time , player position , and games versus practice s. Psychosocial factors such as confidence , stress , social support , positive states of mind , and mood states were also examined to determine their influences on injury . Twenty-seven injuries occurred during the 1994 to 1995 season . As hypothesized , the overall incidence of injury in high school hockey games ( 34.4 per 1000 player-game hours ) was less than the incidence of injury in Junior A hockey ( 96.1 per 1000 player-game hours ) and was more than previously re ported for Bantam youth hockey ( 10.9 per 1000 player- game hours ) . Injuries occurred more often in games than in practice s , usually as a result of collisions . Phys ical factors such as player position and previous inju ries did not significantly predict injuries , but players in the high playing time group were more likely to be injured . Psychosocial factors of low vigor and high fatigue as measured by the Incredibly Short Profile of Mood States ( ISPOMS ) significantly predicted high school ice hockey injuries Young female players in European h and ball have a very high injury incidence , up to 50 injuries per 1000 hours of game . More than half of these injuries happen without any external cause . The aim of the study was to investigate the effect of an intervention programme design ed to reduce the number of injuries in young female players in European h and ball , with special emphasis on injuries in the lower extremities . The programme was created using elite athlete training programmes and those design ed for rehabilitation of injured athletes with functional instability of their ankles and rupture of the anterior cruciate ligament . It included the use of an ankle disk for 10 - 15 min at all practice sessions , for one 10-month season ( August 1995-May 1996 ) . Twenty-two teams participated in the study , and were r and omly assigned to the intervention or control group . Eleven teams with 111 players were r and omised to the intervention group and 11 teams with 126 players to the control group . Data were analysed using a t-test for continuous variables , chi2- analysis and Fisher 's exact test for dichotomous variables and multivariate methods to determine odds-ratios . The results indicated that using the intervention programme decreased the numbers of both traumatic and overuse injuries significantly . The differences in injuries between the groups were 80 % during games and 71 % during practice . In addition , the players in the control group had a 5.9 times higher risk of acquiring an injury than the players in the intervention group OBJECTIVE To establish the previous rugby experience , the knowledge and the use of injury prevention techniques by South African schoolboy rugby players . DESIGN Before the first full-contact match of the 1991 rugby season , 2,330 players completed a detailed question naire . SETTING High schools in the Cape Province . Three thous and three hundred and thirty players from 25 schools selected because of a record of excellence in and commitment to schoolboy rugby . MAIN OUTCOME MEASURES Personal data including age , height , mass and rugby experience ; history and nature of previous rugby injuries ; knowledge of techniques known to prevent rugby injuries ; parental and personal reasons for playing rugby . RESULTS The incidence and distribution of the different types of injuries previously sustained by the players were the same as those identified prospect ively in the same population . A-team players were significantly heavier and taller than players in lower teams in most playing positions in most age groups . Although A-team players were more likely to participate in pre-season endurance or strength training , fewer than 40 % of players overall trained adequately in the pre-season . Less than 30 minutes was allocated to the practice of  tackling and falling techniques  prior to the first full-contact match . Knowledge of different high-risk situations during play was generally sketchy , and only 24 % of players wore gumguards all the time . More fathers ( 84 % ) than mothers ( 63 % ) encouraged their sons to play rugby . CONCLUSIONS The results indicate that the incidence and nature of the injuries reported retrospectively were similar to those reported in prospect i ve studies at the same schools . The players ' knowledge of techniques known to prevent rugby injuries was inadequate and too little attention was paid at the start of the rugby season to training and coaching techniques to reduce injury risk . Coaching errors may therefore have predisposed players to injury A prospect i ve study of injuries encountered during participation in a summer soccer camp for youths aged 6 through 17 years revealed an injury incidence of 10.6 per 1000 hours for girls ( 107 injuries in 458 girls ) and 7.3 per 1000 hours for boys ( 109 injuries in 681 boys ) . For both sexes , the incidence of injury increased at age 14 years . One certified athletic trainer ( W.D.C. ) assessed and documented all injuries during the course of the study . Seventy percent of injuries involved the lower extremities . Contusions represented 35.2 % , strains 27.8 % , sprains 19.4 % , and fractures and dislocations 2 % of all reported injuries . The ankle was the most frequent site of injury in both sexes . Quadriceps strain was a common injury in boys . The boys with the highest incidence of injury were tall ( greater than 165 cm ) and had a weak grip ( less than 25 kg ) , suggesting that skeletally mature but muscularly weak boys may be more susceptible to injury while playing soccer with peers of the same chronological age OBJECTIVE To determine the rate , type , and severity of injuries to child hockey players as well as assessing coaches ' , parents ' , and players ' attitudes and knowledge of hockey . DESIGN A prospect i ve observation of a population 's injuries using injury-reporting forms and surveys . SETTING A community-organized hockey program in Minnesota . PARTICIPANTS One hundred fifty boys , aged 9 through 15 years , who played ice hockey during the 1990 - 1991 winter season . MEASUREMENTS AND MAIN RESULTS Injuries were reported by multiple observers , including coaches , managers , and trained independent observers at the time an injury occurred ; coaches , parents , and players were surveyed regarding hockey injuries , knowledge , and attitudes . One in three players experienced an injury during the season . The most common injuries were contusions . Six of 100 players experienced injuries severe enough to require cessation of physical activities for 8 to 25 days or longer . Weight differences of 53 kg and height differences of 55 cm were reported between Bantam-aged players ( 13 through 15 years ) , and body contact , including legal checks , accounted for 86 % of injuries during games . Illegal checks and violations were associated with 66 % of injuries during games , yet only four penalties ( 14 % ) were assessed . In addition , one in three games in which an injury result ed was described as hostile and 15 % of the injuries were considered intentional . CONCLUSIONS Eliminating violence and body checking for prepubertal boys while emphasizing rule enforcement and good sportsmanship are recommended Physical training-related injuries are common among army recruits and other vigorously active population s , but little is known about their causation . To identify intrinsic risk factors , we prospect ively measured 391 army trainees . For 8 weeks of basic training , 124 men and 186 women ( 79.3 % ) were studied . They answered question naires on past activities and sports participa tion , and were measured for height , weight , and body fat percentage ; 71 % of the subjects took an initial army physical training test . Women had a significantly higher incidence of time-loss injuries than men , 44.6 % com pared with 29.0 % . During training , more time-loss in juries occurred among the 50 % of the men who were slower on the mile run , 29.0 % versus 0.0 % . Slower women were likewise at greater risk than faster ones , 38.2 % versus 18.5 % . Men with histories of inactivity and with higher body mass index were at greater injury risk than other men , as were the shortest women . We conclude that female gender and low aerobic fitness measured by run times are risk factors for training injuries in army trainees , and that other factors such as prior activity levels and stature may affect men and women differently We performed a prospect i ve study to evaluate injury patterns in a large population of high school wrestlers during one season .  Preseason screening was performed on 458 male wrestlers from 14 different high schools . Certified athletic trainers su bmi tted detailed weekly team and individual injury reports . There were 219 injuries in 418 wrestlers followed throughout the season for an overall injury incidence of 52 injuries per 100 wrestlers per season and an injury rate of 6.0 injuries per 1000 exposures . The most commonly injured areas were the shoulder ( 24 % ) and knee ( 17 % ) . Injured wrestlers were an average of 5 months older and had a 32 % higher experience level than noninjured wrestlers . Wrestlers with ligamentous laxity suffered fewer shoulder injuries than the other wrestlers . The majority of injuries occurred in practice ( 63 % ) , although the injury rate was higher in match competitions . Sixty-eight percent of practice injuries occurred during hard wrestling , 23 % during drills , and 9 % during conditioning . The most common wrestling situation result ing in injury was the takedown position ( 68 % ) . Our results show that the older and more experienced wrestler may be at greater risk of injury . Hard wrestling during practice and the takedown position result ed in the highest occurrence of injury Proprioceptive training has been shown to reduce the incidence of ankle sprains in different sports . It can also improve rehabilitation after anterior cruciate ligament ( ACL ) injuries whether treated operatively or nonoperatively . Since ACL injuries lead to long absence from sports and are one of the main causes of permanent sports disability , it is essential to try to prevent them . In a prospect i ve controlled study of 600 soccer players in 40 semiprofessional or amateur teams , we studied the possible preventive effect of a gradually increasing proprioceptive training on four different types of wobble-boards during three soccer seasons . Three hundred players were instructed to train 20 min per day with 5 different phases of increasing difficulty . The first phase consisted of balance training without any balance board ; phase 2 of training on a rectangular balance board ; phase 3 of training on a round board ; phase 4 of training on a combined round and rectangular board ; phase 5 of training on a so-called BABS board .  A control group of 300 players from other , comparable teams trained “ normally ” and received  no special balance training . Both groups were observed for three whole soccer seasons , and possible ACL lesions were diagnosed by clinical examination , KT-1000 measurements , magnetic resonance imaging or computed tomography , and arthroscopy . We found an incidence of 1.15 ACL injuries per team per year in the control group and 0.15 injuries per team per year in the proprioceptively trained group ( P<0.001 ) . Proprioceptive training can thus significantly reduce the incidence of ACL injuries in soccer players Background : Risk factors for soccer injuries and possibilities for prevention have been discussed by several authors , but only a few have investigated the effectiveness of preventive interventions . Purpose : The aim of the present study was to evaluate the effects of a prevention program on the incidence of soccer injuries in male youth amateur players . Study Design : Prospect i ve controlled intervention study . Methods : Seven soccer teams took part in a  prevention program that focused on education and supervision of coaches and players , while seven other teams were instructed to train and play soccer as usual . Over 1 year all injuries were documented weekly by physicians . Complete weekly injury reports were available for 194 players . Results : The incidence of injury per 1000 hours of training and playing soccer was 6.7 in the intervention group and 8.5 in the control group , which equates to 21 % fewer injuries in the intervention group . The greatest effects were observed for mild injuries , 
    Output:
    
DATA SYNTHESIS There is some evidence that potentially modifiable risk factors including poor endurance , lack of preseason training , and some psychosocial factors are important risk factors for injury in child and adolescent sport .
Sport participation and injury rates in child and adolescent sport are high .