Effectiveness of a Judo-specific Injury Prevention Programme on Performance in Judo Athletes

Official title

Effectiveness of a Judo-specific Injury Prevention Programme on Performance: a Randomized Controlled Trial in Judo Athletes

Overview

Judo is a popular international combat sport with an estimated 20 million active participants world-wide and participation in judo entails a substantial risk of injury in both elite and recreational judo. It is known that judo involves a significantly higher risk of sports per activity compared with another combat sports such as wrestling, karate, taekwondo an deven popular team sports such as football, basketball and volleyball. Therefore, preventing injuries in judo is so important and various interventions can use in this regard. These include; taping, warm-up and cool-down programs, proper technique trainings and exercise programs. Injury prevention programmes in other sports have been proven effective in reducing injury rates for elite and recreational athletes. In judo, research on exercise-based prevention is limited to the description of injury prevention programs, but the effectiveness of these programs has never been evaluated. The aim of this study is to investigate the effects of the judo-specific ''IPPON'' warm-up programs for injury prevention of judokas on performance parameters and incidence of injuries among professional judo athletes. In this study, the investigators research the Judo-Specific Special Conditioning Test and the Isometric/Dynamic Judogi Grip Strength Test will be evaluated for performance parameters. In addition, the Upper and Lower Extremity Y Balance Test will be evaluated for balance and the Upper Extremity Internal/External Rotation Strength Test and the Lower Extremity Hamstring/Quadriceps Strength Test will be evaluated for muscle strength assessment. The Turkish translation of the Oslo Trauma Research Center Overuse Questionnaire (OSTRC-O) will be used to monitor the incidence of injuries among professional judo athletes.

Detailed description

Judo is a popular international combat sport with an estimated 20 million active participants worldwide. Judo is characterised by the combination of balance, coordination, flexibility, agility, speed and strength with the aim to incapacitate their opponent. It is demanding of the neuromuscular and physical capacity of athletes. Participation in judo entails a substantial risk of injury in both elite and recreational judo. Injury prevention programmes in other sports have been proven effective in reducing injury rates for elite and recreational athletes. In judo, research on exercise-based prevention is limited to the description of injury prevention programmes, but the effectiveness of these programmes has never been evaluated. The main objective of our study was to evaluate the effectiveness of the bottom-up developed trainer-based IPPON intervention on the performance parameters compared with the usual warm-up in judo athletes. The secondary objectives were to evaluate injury severity, injury incidence, location-specific prevalences, time loss and sudden and gradual onset injury recurrence rates. We hypothesised that the IPPON intervention would increase performance parameters and reduce the overall injury prevalences. The IPPON intervention is an injury prevention programme designed specifically to reduce injuries in judo athletes. IPPON intervention mainly focuses on preventing musculoskeletal injuries of the shoulder, knee and ankle. The IPPON intervention consists of 36 exercises divided into (1) flexibility and agility, (2) balance and coordination and (3) strength and stability. Each category consisted of 12 exercises with 3 levels of difficulty. Athletes performed 4 exercises per category and thus 12 exercises at the start of the training at least two times per week. Prior to the intervention exercises, athletes completed running exercises and falling techniques. Athletes in the control group were instructed to continue their usual warm-up and regular judo practice as warm-up prior to training or competition is standard routine in judo. The duration of the IPPON intervention was aligned with the average duration of the usual warm-up in the control groups. Although, not measured in the study procedure, the approximate duration of warm-up was 15 min in both groups. The primary outcome was the performance parameters (Judo-Specific Special Conditioning Test, Isometric/Dynamic Judogi Grip Strength Test, Upper and Lower Extremity Y Balance Test, Upper Extremity Internal/External Rotation Strength Test, Lower Extremity Hamstring/Quadriceps Strength Test) over 8 weeks of follow-up, and secondary outcome was the overall injury prevalences (injury severity, injury incidence, location-specific prevalences, time loss and sudden and gradual onset injury recurrence rates) measured with the Turkish translation of the Oslo Trauma Research Center Overuse Questionnaire (OSTRC-O) at 2 weekly intervals over 16 weeks of follow-up.

Interventions

• Other IPPON warm-up programme
  The IPPON intervention is an injury prevention programme designed specifically to reduce injuries in judo athletes. The trainer-supervised IPPON intervention mainly focuses on preventing musculoskeletal injuries of the shoulder, knee and ankle. The IPPON intervention consists of 36 exercises divided into (1) flexibility and agility, (2) balance and coordination and (3) strength and stability. Each category consisted of 12 exercises with 3 levels of difficulty. Athletes performed 4 exercises per

Primary outcome measures

• Specific Judo Fitness Test (SJFT) [Time frame: 8 weeks]
• Isometric Judogi Grip Strength Test [Time frame: 8 weeks]
• Dynamic Judogi Grip Strength Test [Time frame: 8 weeks]
• Upper Extremity Y Balance Test (UQ-YBT) [Time frame: 8 weeks]
• Lower Extremity Y Balance Test (LQ-YBT) [Time frame: 8 weeks]
• Upper Extremity External/Internal Rotation (ER/IR) Muscle Strength Ratio [Time frame: 8 weeks]
• Lower Extremity Hamstring/Quadriceps (H/Q) Muscle Strength Ratio [Time frame: 8 weeks]

Secondary outcome measures (1)

• Oslo Trauma Research Center Overuse Questionnaire (OSTRC-O) [Time frame: 16 weeks]

Eligibility criteria

Inclusion criteria

• age should be more than 13 years
• the asymptomatic judokas with no history of major injury or surgery in last 6 months,
• having experience in at least 3 years competitive judo,
• actively participating in competitive judo at least 1 year,
• competing at least in national level.

Exclusion criteria

• competing in paralympic sports,
• if they had any major injuries or surgeries in last 6 months,
• if they had any systemic, neurological or rheumatological diseases,
• being pre-pubertal stage (Tanner I) according to Tanner Scale,
• indicated their unwillingness to participate to this study.

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: Yes

Study design

Allocation

Randomized

Model

Crossover

Masking

Open label

Primary purpose

Prevention

Study locations

Turkey (Türkiye) · 2 centers

• Hacettepe University, Faculty of Physical Therapy and Rehabilitation — Ankara
• Hacettepe University — Ankara

Publications

• Malliaropoulos NG, Callan M, Johnson J. Comprehensive training programme for judo players nine plus 9+: possible lower limb primary injury prevention. Muscles Ligaments Tendons J. 2014 Jul 14;4(2):262-8. eCollection 2014 Apr. No abstract available. PMID 25332945
• Kamitani T, Malliaropoulos NG, Omiya M, Otaka Y, Inoue K, Onidani N. On the way to the Tokyo Summer Olympic Games (2020). Prevention of severe head and neck injuries in judo: it's time for action. Br J Sports Med. 2017 Nov;51(22):1581-1582. doi: 10.1136/bjsports-2017-097681. Epub 2017 Aug 17. No abstract available. PMID 28818954
• von Gerhardt AL, Vriend I, Verhagen E, Tol JL, Kerkhoffs GMMJ, Reurink G. Systematic development of an injury prevention programme for judo athletes: the IPPON intervention. BMJ Open Sport Exerc Med. 2020 Sep 29;6(1):e000791. doi: 10.1136/bmjsem-2020-000791. eCollection 2020. PMID 33033621
• Pocecco E, Ruedl G, Stankovic N, Sterkowicz S, Del Vecchio FB, Gutierrez-Garcia C, Rousseau R, Wolf M, Kopp M, Miarka B, Menz V, Krusmann P, Calmet M, Malliaropoulos N, Burtscher M. Injuries in judo: a systematic literature review including suggestions for prevention. Br J Sports Med. 2013 Dec;47(18):1139-43. doi: 10.1136/bjsports-2013-092886. PMID 24255909
• von Gerhardt AL, Reurink G, Kerkhoffs GMMJ, Verhagen E, Krabben K, Mooren J, Gal JSI, Brons A, Joorse R, van den Broek B, Kemler E, Tol JL. Effectiveness of a judo-specific injury prevention programme: a randomised controlled trial in recreational judo athletes. Br J Sports Med. 2023 Apr;57(8):450-456. doi: 10.1136/bjsports-2022-105869. Epub 2023 Jan 30. PMID 36717214

Identifiers

NCT: NCT06929377 · 03.2025fbu

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗