***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: Background Little is known about the rate and pattern of injuries in international volleyball competition . Objective To describe the risk and pattern of injuries among world-class players based on data from the The International Volleyball Federation ( FIVB ) Injury Surveillance System ( ISS ) ( junior and senior , male and female ) . Methods The FIVB ISS is based on prospect i ve registration of injuries by team medical staff during all major FIVB tournaments ( World Championships , World Cup , World Gr and Prix , World League , Olympic Games ) . This paper is based on 4-year data ( September 2010 to November 2014 ) obtained through the FIVB ISS during 32 major FIVB events ( 23 senior and 9 junior ) . Results The incidence of time-loss injuries during match play was 3.8/1000 player hours ( 95 % CI 3.0 to 4.5 ) ; this was greater for senior players than for junior players ( relative risk : 2.04 , 1.29 to 3.21 ) , while there was no difference between males and females ( 1.04 , 0.70 to 1.55 ) . Across all age and sex groups , the ankle was the most commonly injured body part ( 25.9 % ) , followed by the knee ( 15.2 % ) , fingers/thumb ( 10.7 % ) and lower back ( 8.9 % ) . Injury incidence was greater for centre players and lower for liberos than for other player functions ; injury patterns also differed between player functions . Conclusions Volleyball is a very safe sport , even at the highest levels of play . Preventive measures should focus on acute ankle and finger sprains , and overuse injuries in the knee , lower back and shoulder Aim To determine whether players who completed a greater number of planned preseason training sessions  were more or less likely to be injured during the competitive season . Methods A cohort of 30 elite rugby league players was prospect ively studied during their 17-week preseason and 26-round competitive season . Injuries were recorded using a match time loss definition . Preseason participation was quantified as the number of ‘ full ’ training sessions that players completed , excluding modified , rehabilitation or missed sessions . In-season training load variables , collected using global positioning system ( GPS ) data , included distance covered ( m ) , high-speed distance covered ( m ) and the percentage of distance covered at high speeds ( % ) . Multilevel logistic regression models were used to determine injury likelihood in the current and subsequent week , with r and om intercepts for each player . Odds ratios ( OR ) were used as effect size measures to determine the changes in injury likelihood with ( 1 ) a 10-session increase in preseason training participation or ( 2 ) st and ardised changes in training load variables . Results Controlling for training load in a given week , completing 10 additional preseason sessions was associated with a 17 % reduction in the odds of injury in the subsequent week ( OR=0.83 , 95 % CI=0.70 to 0.99 ) . Increased preseason participation was associated with a lower percentage of games missed due to injury ( r=−0.40 , p<0.05 ) , with 10 preseason sessions predicting a 5 % reduction in the percentage of games missed . Conclusions Maximising participation in preseason training may protect elite rugby league players against in-season injury Background Despite research on the increased risk of anterior cruciate ligament tears in female athletes , few studies have addressed sex differences in the incidence of associated intraarticular injuries . Hypothesis When patients are stratified by sport and competition level , no sex differences exist in either the mechanism of injury or pattern of intraarticular injuries observed at  anterior cruciate ligament reconstruction .  Study Design Prospect i ve cohort study . Methods Two hundred twenty-one athletes undergoing anterior cruciate ligament reconstruction met our inclusion criteria of anterior cruciate ligament tear as a singular event without reinjury or history of prior injury or surgery in either knee . Data were collected on competition level ( high school , amateur ) , sport ( basketball , soccer , skiing ) , mechanism of injury , articular cartilage injuries , and meniscal tears . Data were statistically analyzed by sex with the chi-square test and Student 's t-test . Results High school athletes had no significant sex differences in mechanism of injury .  Female soccer athletes had fewer medial meniscal tears than did male athletes , and female basketball players had fewer medial femoral condyle injuries . At the amateur level , female basketball players had more contact injuries , an earlier onset of swelling , and fewer lateral meniscal tears than did male players . Conclusion At the high school level , male and female athletes shared a common mechanism of injury , and yet the female athletes had fewer intraarticular injuries in basketball and soccer . If such intraarticular injuries prove to be a significant risk factor for poor long-term outcome , women may enjoy a better prognosis after reconstruction BACKGROUND Functional instability of the ankle joint may interfere with proper execution of quick cutting movements in sports . Previous studies have provided information regarding the ground reaction force characteristics in such movements in healthy players but no research was found in players with ankle instability . The purpose of this study was to evaluate and compare ground reaction forces in functionally unstable ankles with healthy ones during two cutting movements , the v-cut and the defensive shuffle . METHODS Fifteen male basketball players with self reported unilateral functional instability and 17 matched controls , performed three v-cuts and three defensive shuffles on two synchronised force platforms . Both joints were tested and ground reaction forces analysed by an one-way ANOVA for independent groups to test differences between groups , and paired t-test to examine differences within affected players . FINDINGS Unstable ankles , demonstrated significantly greater first vertical force peak , than contralateral unaffected joints ( P < or = 0.05 ) and lower relative time to peak than controls ( P < or = 0.05 ) , during v-cut movement . No significant differences were seen in variables between groups during lateral shuffling . INTERPRETATION Unstable ankles demonstrated altered patterns of ground reaction forces , with a rapid onset of high vertical force during the first millisecond post-impact , while the medial component was unchanged . Although the increased vertical forces are considered predisposing factors to repeated injury , this finding is likely a neuromuscular response making the ankle joint more stable avoiding excessive inversion forces BACKGROUND It has been suggested that gender differences in the performance of athletic maneuvers is a contributory factor with respect to the disproportionate incidence of non-contact anterior cruciate ligament injury in female athletes . The purpose of this study was to evaluate gender differences in knee joint kinematics , kinetics and muscle activation during a side-step cutting . METHODS Three-dimensional kinematics , ground reaction forces ( 2400 Hz ) and electromyographic activity ( surface electrodes ) were recorded during the early deceleration phase of side-step cutting in 30 healthy collegiate soccer players ( 15 male , 15 female ) .  Gender differences in knee joint kinematics , peak moments , net joint moment impulse and average muscle EMG intensity were evaluated with one-tailed t-tests . FINDINGS No differences in kinematics were found . However , when compared to males , females demonstrated a smaller peak knee flexor moment ( 1.4 ( 0.8 ) vs. 2.1 ( 0.8 ) Nm/kg , P = 0.05 ) and a greater knee adductor moment ( 0.43 ( 0.5 ) vs. 0.01 ( 0.3 ) Nm/kg , P < 0.01 ) during early deceleration . In addition , females displayed greater average quadriceps EMG intensity than males ( 191 % vs. 151 % maximum voluntary isometric contraction , P = 0.02 ) . INTERPRETATION In general , females experienced increased frontal plane moments and decreased sagittal plane moments during early deceleration . These differences are suggestive of an " at risk " pattern in that frontal plane support of the knee is afforded primarily by passive structures ( including the anterior cruciate ligament ) . Furthermore , increased quadriceps activity and smaller net flexor moments may suggest less sagittal plane protection ( i.e. , increased tendency towards anterior tibial translation ) Background Female athletes participating in high-risk sports suffer anterior cruciate ligament injury at a 4- to 6-fold greater rate than do male athletes . Hypothesis Prescreened female athletes with subsequent anterior cruciate ligament injury will demonstrate decreased neuromuscular control and increased valgus joint loading , predicting anterior cruciate ligament injury risk . Study Design Cohort study ; Level of evidence , 2 . Methods There were 205 female athletes in the high-risk sports of soccer , basketball , and volleyball prospect ively measured for neuromuscular control using 3-dimensional kinematics ( joint angles ) and joint loads using kinetics ( joint moments ) during a jump-l and ing task . Analysis of variance as well as linear and logistic regression were used to isolate predictors of risk in athletes who subsequently ruptured the anterior cruciate ligament . Results Nine athletes had a confirmed anterior cruciate ligament rupture ; these 9 had significantly different knee posture and loading compared to the 196 who did not have anterior cruciate ligament rupture . Knee abduction angle ( P < . 05 ) at l and ing was 8 ° greater in anterior cruciate ligament-injured than in uninjured athletes . Anterior cruciate ligament-injured athletes had a 2.5 times greater knee abduction moment ( P < . 001 ) and 20 % higher ground reaction force ( P < . 05 ) , whereas stance time was 16 % shorter ; hence , increased motion , force , and moments occurred more quickly . Knee abduction moment predicted anterior cruciate ligament injury status with 73 % specificity and 78 % sensitivity ; dynamic valgus measures showed a predictive r2 of 0.88 . Conclusion Knee motion and knee loading during a l and ing task are predictors of anterior cruciate ligament injury risk in female athletes . Clinical Relevance Female athletes with increased dynamic valgus and high abduction loads are at increased risk of anterior cruciate ligament injury . The methods developed may be used to monitor neuromuscular control of the knee joint and may help develop simpler measures of neuromuscular control that can be used to direct female athletes to more effective , targeted interventions Background While injuries in football ( soccer ) have been the subject of numerous publications , little information is available about the injury risk in futsal . Objective Analysis of the incidence and characteristics of injury in  futsal players during top-level international tournaments . Design Prospect i ve survey . Methods Player injuries during three consecutive Futsal World Cups  were analysed using an established injury report system . The physicians of all participating teams reported all injuries after each match on a st and ardised injury report form . The average response rate was 93 % . Results A total of 165 injuries were reported from 127 matches , which is equivalent to an incidence of 195.6 injuries per 1000 player hours ( 95 % CI 165.8 to 225.6 ) or 130.4 injuries per 1000 player matches ( 95 % CI 110.5 to 150.3 ) . The majority of injuries were caused by contact with another player , and 36 % of the injuries occurred during non-contact activities . Most injuries affected the lower extremity ( 70 % ) , followed by head and neck ( 13 % ) , upper extremity ( 10 % ) and trunk ( 7 % ) . The most frequent diagnoses were contusion of the lower leg ( 11 % ) , ankle sprain ( 10 % ) and groin strain ( 8 % ) . On average , one time-loss injury in every two matches was reported . Conclusion While the location and diagnosis of injuries were similar in the two types of football , fewer injuries in futsal than in football were caused by contact with another player and by foul play . More information on injury mechanisms in futsal is needed to develop specific injury preventive interventions CONTEXT The Lower-Extremity Functional Test ( LEFT ) has been used to assess readiness to return to sport after a lower-extremity injury . Current recommendations suggest that women should complete the LEFT in 135 s ( average ; range 120 - 150 s ) and men should complete the test in 100 s ( average ; range 90 - 125 s ) . However , these estimates are based on limited data and may not be reflective of college athletes . Thus , additional assessment , including normative data , of the LEFT in sport population s is warranted . OBJECTIVE To examine LEFT times based on descriptive information and off-season training habits in NCAA Division III ( DIII ) athletes . In addition , this study prospect ively examined the LEFT 's ability to discriminate sport-related injury occurrence . DESIGN Descriptive epidemiology . SETTING DIII university . SUBJECTS 189 DIII college athletes ( 106 women , 83 men ) from 15 teams . MAIN OUTCOME MEASURES LEFT times , preseason question naire , and time-loss injuries during the sport season . RESULTS Men completed the LEFT ( 105 ± 9 s ) significantly faster than their female counterparts ( 117 ± 10 s ) ( P < .0001 ) . Female athletes who reported > 3 - 5 h/wk of plyometric training during the off-season had significantly slower LEFT scores than those who performed ≤3 h/wk of plyometric training ( P = .03 ) . The overall incidence of a lower-quadrant ( LQ ) time-loss injury for female athletes was 4.5/1000 athletic exposures ( AEs ) and 3.7/1000 AEs for male athletes . Female athletes with slower LEFT scores ( ≥118 s ) experienced a higher rate of LQ time-loss injuries than those with faster LEFT scores ( ≤117 s ) ( P = .03 ) . CONCLUSION Only off-season plyometric training practice s seem to affect LEFT score times among female athletes . Women with slower LEFT scores are more likely to be injured than those with faster LEFT 
    Output:
    
Specifically , soccer and field hockey dem and ed the most volume of running , while basketball required the highest ratio of high-intensity running to sprinting .
Basketball ( 42–56 per game ) , h and ball ( up to 90 per game ) , and volleyball ( up to 35 per game ) were found to require the most jumping .