TRAINING RELATED AND SUPPORTIVE FACTORS FOR THE OCCURRENCE OF ACUTE INJURIES FOR JUNIOR ATHLETES AT ETHIOPIAN ATHLETICS TRAINING CENTERS

Amensisa Kebede Legesse 1 And Habtamu Dadi Dika 2 . 1. (Ph.D),Ethiopian Youth Sports Academy. 2. (MSc.),Ethiopian Youth Sports Academy. ...................................................................................................................... Manuscript Info Abstract ......................... ........................................................................ Manuscript History Received: 22 February 2019 Final Accepted: 24 March 2019 Published: April 2019 Copy Right, IJAR, 2019,. All rights reserved.


Method of Data Analysis
The following statistical procedures were employed for numerical interpretation. 1. Descriptive statistics like mean, grand mean, standard deviation and percentage were used to analyze basic information and distribution of scores. Charts, Graphs and histograms were used to clarify and elaborate differences. 2. Analysis of variance (ANOVA) was also applied to calculate statistical differences in rate of injuries distributions and locations between different athletics sports. Athletes without and with tendon, joint, muscle or all the other overuse injury rates were also included. 3. Logistic regression models were used to analyze the association between covariates and acute and overuse injuries. Gender and sports were used as covariates in all the logistic regression models. The associations were expressed using odds ratios (OR) and confidence intervals (CI). From a coach's point of view, It is categorised the significant training-related risk and supportive factors for an injury as well as coach's role in prevention of injuries. 4. Poisson regression was used to calculate the sports-adjusted training related acute and overuse injury incidences risk factors. The associations were also expressed using relative risks (RR) and their confidence intervals (CI).

Occurrences of Acute Injuries
A total number of 101(49.5%) athletes get at least one acute injury. 40(48.2%) of total female athletes face at least one acute injury whereas 61 (50.4%) of male athletes have at least one acute injury. A chi square test for independent (with rates continuity correction) indicated no significant association between gender and the occurrence of Acute injury

Kind of Acute Injury
All kinds of acute injury had occurred for male and female athletes. The highest number of kind of acute injury sustained by male athletes was ligament Rupture whereas for females was muscle strain.A total number of 10(12%) female athletes got muscle cramp acute injury whereas 12(9.9%) of total male athletes got muscle cramp acute injury. A chi square test for independent (with rates continuity correction) indicated no significant association between gender and the occurrence of muscle cramp acute injury  0  1  2  1  5  0  Ankle  4  3  5  5  9  3  Calf  1  6  2  0  2  0  Lower leg  1  6  2  0  1  1  Knee  0  0  8  6  3  5  Hamstring  3  10  5  6  4  0  Thigh  9  4  3  4  0  0  Others  5  7  1  1  5  0  Lower back  3  0  0  1  3  0 A total number of 11(13.3%) female athletes and 11(9.1%) of total male athletes got knee acute injury. A chi square test for independent (with rates continuity correction) indicated no significant association between gender and the occurrence of knee acute injury 2  (1, n=204) =.507, .p=.48, phi=-.07 Generally, in earlier study Male athletes have been reported to have a higher risk for severe sport-related injuries than female athletes (Conn et al., 2003). Ankle injuries were common in this study; more athletes got acute injury around ankle. More male athletes got acute injury also at ankle location. This finding strengthens the earlier findings as in Rolf (1995) and Restelonine (2012). In this study there is no significance association between the gender and occurrence of ankle injury. Only a few gender differences in the anatomical locations of injuries were found. In relation to this, in a review, van Gent et al. (2007) reported that the overall injury rate in the lower extremities was similar in female and male runners. More female athletes injured at hamstring acute injury. In relation to this unlike earlier findings, a slightly more association was recorded between the occurrence of hamstring injury and gender.

Total Incidence of Acute Injury
There were a total of 163 acute injury incidences. Out of those total incidences around forty seven percent 76 (47%) were from females and 87 (53%) by male athletes. In addition the incidence of acute injury by male long distance 33 (20%) was not significantly higher than female long distance athletes Female short distance athletes 38 (23.3%) was also not significantly higher than males 26 (16%). To date, only a few sport injury studies have compared acute injury rates (Kujala et al., 1995)

Acute Injuries Training and Supportive Factors Differences between Injured & Uninjured Athletes
Results of the two-independent samples t-test showed that mean age differs between injured (M = 18, SD =

Differences in Number and Rates of Acute Injury
A one way between groups analysis of variance was conducted to explore the impact of events on number of injuries .There was no statistical significant difference in number of injuries : F(2,201)=1.56, P=.213 .
A two way between groups analysis of variance was also conducted to explore the impact of sex and events on the rates of acute injuries exist. Subjects were divided in to three groups according to their events. The interaction effect between sex and events group were not statistically significant: F ( A one way between groups analysis of variance was also conducted to explore the impact of weekly frequency of stretching effect towards rates of acute injuries .The group was four according to their frequency of stretching in a week( never=for who never stretch,>3 times to do stretching for more than 3 times, 2-3 times and ,< 2 times accordingly. There was a statistical significant difference rates of acute injuries: F (3,200) =5.97, P=.001. Despite reaching a statistical difference, the actual difference in mean scores between the groups was quite small. The effect size, calculated using eta squared, was .08.Post hoc comparisons using the sheffe test indicated that the mean score for > 3 times (M=.7, SD=1.2) was significantly different from the mean score of 1-3 times (M=1.3, SD=1.2) < 1 times (M=1.5, SD=1.2) and Never (M=2.14, SD=1.14) A one way between groups analysis of variance was conducted to explore the impact of frequency of massage on rates of acute injuries. The group was four according to their frequency of massage in a week (never=for who never take massage, one times to do massage in a month, for less than 1 times in a week, every second week and once a week. There was a statistical significant difference in the rate of injuries: F (4,199) =3.64, P=.007.Despite reaching a statistical difference, the actual difference in mean scores between the groups was quite small. The effect size, calculated using eta squared, was .07.Post hoc comparisons using the sheffe test indicated that the mean score for once a week (M=1.8, SD=.28) was significantly different from the mean score of every second week (M=1.3, SD=1.2) but not < 1 times in a month (M=.88, SD=1.3) and Never (M=1.079, SD=1.59)Direct logistic regression was performed to assess the impact of a number of factors on the likelihood that respondents would report that acute injury occurred. The model contained nine independent variables (sex, event, training age, number of competition, rest days per week, worming up length, frequency of stretching, yearly exposure hours and mileage in the year). Long distance running is used as a reference for events and less than one times or never for frequency of stretching.

Risk Factors for acute Injury Occurrences
The full model containing all predictors was statistically significant 2  (11, N =204) = 111.58, P < .001), indicating that the model was able to distinguish between injured athletes and who didn't injured. The model as a whole explained between 42.3% (coxand snell R square) and 56% ( Nagelkerke R square ) of the Acute injury occurrence status and correctly classified 83.7% of cases. As shown in table, only three of the independent variables made a unique statistically significant contribution to the model (worming up length, Frequency of stretching, and exposure hours).The strongest predictor of reporting an occurrence of Acute injury was the frequency of stretching o.262 (95%, CI 0.99 to 0.698, P=0.007) is frequently stretching athletes were.262 times less likely to report having the occurrence of Acute Injury compared to those who never or less than one time do stretching per a week, controlling for other factors in the model.Controversial and inconsistent results had been found in this regard. Safran (1989) in his study found that stretching can reduce the risk for athletic performance. The exposure hour is also the last predictor of the occurrence of acute injury, recording an odds ratio of 1.003 (CI 1.00 TO 1.006, P = .027). This indicated that athletes who had more exposure hour in the year more likely to report the acute injury. That is for every extra hour of training or exercise; athletes were 1.003 times more likely to face acute injury, controlling other factors in the model. However, Mileage were not associated to acute injury occurrences.
Poisson regression was performed to assess the impact of selected variables on the likelihood of the incidence rate of acute injuries occurred. The model contained two categorical and two continuous variables (Sex, Events, Exposure hours and Mileage).The full model containing all predictors was statistically significant x 2  ( 5,204)=22.87 , P<.00. As shown in the above table only exposure hour is a significant predictor .For every additional one hour of exposure in the training or exercise , the incidence rate of an overuse injury is 0.2% .Which refers to there is a 1.oo2 times likely incidence rate of overuse injury for every extra hour of training and competition. There is also a marginal significance in incidence rate of acute range between genders. We can imagine that there is a slightly 33% more injury rate of males compared to females In general the current finding of the research indicated that annual exposure hour is a predictive variable for the occurrence of both overuse and acute injury occurrences. A similar predictive result was found for the incidence of both number of acute injury and overuse injury. Accordingly previous researches indicated that training variables that have been identified as contributing factors to running injuries are excessive running distance or intensity of the training program, rapid increases in weekly running distance or intensity, and the surface and

Conclusions:-
1. There was no significant association between gender and the occurrence of different locations and kinds of acute injury. The interaction effect between sex and events group for the incidence of acute injury was not significantly differ each other. The highest number of kind of acute injury sustained by male athletes was ligament rupture and for females was muscle strain. 2. The highest number of acute injury was sustained at ankle injury for males and total athletes. However female athletes got acute injured more at the hamstring. 3. There was a difference in training related and supportive factors between acute injured and uninjured athletes (Age, training age, BMI, annual Training exposure hours, weekly training hours and frequency, annual mileage, Rest and recovery days per week and Worming up length and frequency). Athletes that stretch for more than three times a week had less acute injury than from those who did 1-3 times and < 1 times or Never per week. However acute injury had shown no differences in usage of massage. 4. Worming up length prevents the occurrence of Acute Injury. Frequently stretching preventsoccurrence of acute injury compared to those who stretch once or never in a week. Females are with a slightly higher risk of acute injury.

Recommendations
Based on the findings of this study, the following recommendations were made: 1. Intervention directed to training science of running to athletes and coaches in form health promotion programmes and current training findings through education to increase their knowledge and support in implementation of all prevention strategies either in training or in competition should be provided. 2. Athletics training centres should develop, implement and monitor a comprehensive sport safety plan paying particular attention to the development and implementation of policies covering issues that this study has identified as being poorly addressed. 3. Clubs should ensure that all safety measures are observed and implemented at both training session and during competition. 4. Governing bodies in Ethiopia, especially Ethiopian Sport Commission should develop and disseminate written sports safety policies and guidelines and supervise athletics training centres in their development, implementation and monitoring. 5. Training related risk factors should further be identified and roles of coaches and health officers training science intervention programs should be updated continuously through further researches in the canters by coaches and physicians.
Generally, there is a need to provide education to increase the general knowledge about the prevention of injuries in the running community and also overcome all the identified barriers that render the implementation difficult or impossible. There is also a need to support training centers to develop meaningful and relevant policies. The result of this study indicated that most training centers in Ethiopia had no safety policies with limited resources. More research into the role of menstrual disturbances and the risk of overuse injuries needs to be undertaken. The impact of dietary behaviors and habits on the incidence of injuries, particularly in women, needs to be determined. Guidelines for minimum safety requirements for Little Athletics meetings and other running events should be developed and widely disseminated. · Improved data collection about the occurrence of running injuries and their associated factors needs to be developed and maintained. Information about preventing running injuries should be disseminated widely through shoe points of sale, running magazines and more general magazines.