TY - JOUR
T1 - The Association Between the Acute:Chronic Workload Ratio and Running-Related Injuries in Dutch Runners
T2 - A Prospective Cohort Study
AU - Nakaoka, Gustavo
AU - Barboza, Saulo Delfino
AU - Verhagen, Evert
AU - van Mechelen, Willem
AU - Hespanhol, Luiz
N1 - Funding Information: Gustavo Nakaoka was granted with a Master’s scholarship from the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brasil (CAPES)—Finance Code 001. Luiz Hespanhol was granted with a Young Investigator Grant from the Sao Paulo Research Foundation (FAPESP), Grant 2016/09220-1. Funding Information: This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brasil (CAPES)—Finance Code 001. This study was financed in part by the Sao Paulo Research Foundation (FAPESP), process code 2016/09220-1. Publisher Copyright: © 2021, The Author(s), under exclusive licence to Springer Nature Switzerland AG.
PY - 2021/11
Y1 - 2021/11
N2 - OBJECTIVE: To investigate the association between the acute:chronic workload ratio (ACWR) and running-related injuries (RRI).METHODS: This is a secondary analysis using a database composed of data from three studies conducted with the same RRI surveillance system. Longitudinal data comprising running exposure (workload) and RRI were collected biweekly during the respective cohorts' follow-up (18-65 weeks). ACWR was calculated as the most recent (i.e., acute) external workload (last 2 weeks) divided by the average external (i.e., chronic) workload of the last 4, 6, 8, 10 and 12 weeks. Three methods were used to calculate the ACWR: uncoupled, coupled and exponentially weighted moving averages (EWMA). Bayesian logistic mixed models were used to analyse the data.RESULTS: The sample was composed of 435 runners. Runners whose ACWR was under 0.70 had about 10% predicted probability of sustaining RRI (9.6%; 95% credible interval [CrI] 7.5-12.4), while those whose ACWR was higher than 1.38 had about 1% predicted probability of sustaining RRI (1.3%; 95% CrI 0.7-1.7). The association between the ACWR and RRI was significant, varying from a small to a moderate association (1-10%). The higher the ACWR, the lower the RRI risk.CONCLUSIONS: The ACWR showed an inversely proportional association with RRI risk that can be represented by a smooth L-shaped, second-order, polynomial decay curve. The ACWR using hours or kilometres yielded similar results. The coupled and uncoupled methods revealed similar associations with RRIs. The uncoupled method presented the best discrimination for ACWR strata. The EWMA method yielded sparse and non-significant results.
AB - OBJECTIVE: To investigate the association between the acute:chronic workload ratio (ACWR) and running-related injuries (RRI).METHODS: This is a secondary analysis using a database composed of data from three studies conducted with the same RRI surveillance system. Longitudinal data comprising running exposure (workload) and RRI were collected biweekly during the respective cohorts' follow-up (18-65 weeks). ACWR was calculated as the most recent (i.e., acute) external workload (last 2 weeks) divided by the average external (i.e., chronic) workload of the last 4, 6, 8, 10 and 12 weeks. Three methods were used to calculate the ACWR: uncoupled, coupled and exponentially weighted moving averages (EWMA). Bayesian logistic mixed models were used to analyse the data.RESULTS: The sample was composed of 435 runners. Runners whose ACWR was under 0.70 had about 10% predicted probability of sustaining RRI (9.6%; 95% credible interval [CrI] 7.5-12.4), while those whose ACWR was higher than 1.38 had about 1% predicted probability of sustaining RRI (1.3%; 95% CrI 0.7-1.7). The association between the ACWR and RRI was significant, varying from a small to a moderate association (1-10%). The higher the ACWR, the lower the RRI risk.CONCLUSIONS: The ACWR showed an inversely proportional association with RRI risk that can be represented by a smooth L-shaped, second-order, polynomial decay curve. The ACWR using hours or kilometres yielded similar results. The coupled and uncoupled methods revealed similar associations with RRIs. The uncoupled method presented the best discrimination for ACWR strata. The EWMA method yielded sparse and non-significant results.
KW - Athletic Injuries/epidemiology
KW - Bayes Theorem
KW - Humans
KW - Prospective Studies
KW - Running
KW - Workload
UR - http://www.scopus.com/inward/record.url?scp=85106987923&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s40279-021-01483-0
DO - https://doi.org/10.1007/s40279-021-01483-0
M3 - Article
C2 - 34052983
SN - 0112-1642
VL - 51
SP - 2437
EP - 2447
JO - Sports Medicine
JF - Sports Medicine
IS - 11
ER -