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Tunis Med
Tunis Med
Tunis Med
La Tunisie Médicale
0041-4131
2724-7031
Tunisian Society of Medical Sciences

Article
Conception d'une étude sur les blessures des footballeurs lors de la Coupe d'Afrique des Nations 2024 (Côte d’Ivoire)
Designing a study on footballers’ injuries in the 2024 African cup of nations competition (Ivory Coast)Chaabeni Amr 11
Kalai Amine 112
Dhouibi Jaouher 11
Ben Saad Helmi 33
Jellad Anis 114
1. Department of physical medicine and rehabilitation, Faculty of medicine, University of Monastir, Tunisia
2. Research laboratory of technology and medical imaging - LR12ES06, Center for musculoskeletal biomechanics research, Faculty of medicine, University of Monastir, Tunisia.
3. University of Sousse, Farhat Hached Hospital, Research laboratory LR12SP09 “Heart Failure”, Sousse, Tunisia
4. Research laboratory of technology and medical imaging - LR12ES06, Center for musculoskeletal biomechanics research, Faculty of medicine, University of Monastir, Tunisia
2 2023
05 2 2023
102 2 7073
2022
https://creativecommons.org/licenses/by-nc-nd/4.0/ This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 Unported License. To view a copy of this license, visit https://creativecommons.org/licenses/by-nc-nd/4.0/
RESUME

Introduction: L’amélioration des performances des joueurs et la mise en place des protocoles de prévention et de surveillance des blessures en football nécessitent la réalisation d'études épidémiologiques. Étant donné la disparité dans les taux de blessures notés dans diverses compétitions de football, il est important de caractériser les blessures dans le contexte de la Coupe d'Afrique des Nations (CAN) 2024. Objectif: Déterminer l'incidence et les facteurs associés aux blessures chez les footballeurs africains lors de la compétition de la CAN 2024 (Côte d'Ivoire; 13 janvier-11 février 2024). Méthodes: Deux médecins experts en médecine du sport réaliseront une étude analytique (une analyse basée sur la vidéo) des 52 matchs qui seront joués. Les paramètres suivants seront notés: i) Incidence des blessures, ii) Caractéristiques des joueurs blessés (âge, position sur le terrain, et continent de la ligue du joueur), iii) Caractéristiques des blessures (mécanisme, localisation du corps, moment de la blessure en termes de minute de jeu et de tour du match, lieu de la blessure en termes de zone du stade, remplacement du joueur consécutif à la blessure, absence au prochain match, récidive, récurrence de la blessure au même endroit pendant la compétition, décision de l'arbitre et temps d'arrêt pour blessure sur le terrain), et iv) Caractéristiques des matchs (horaire du match, température ambiante, humidité et vitesse du vent). Conclusion: Cette étude permettra d'enrichir la littérature existante avec des données supplémentaires concernant les blessures et les caractéristiques des joueurs dans le contexte africain.

ABSTRACT

Introduction: To enhance players' performance and implement effective injury prevention protocols and surveillance programs in football, it is essential to conduct epidemiological studies. Since significant disparities in injury rates across various football competitions were reported, it is important to characterize injuries in the context of the African cup of nation (AFCON) competition. Aim: To determine the incidence and factors associated with injuries among African footballers during the 2024 AFCON competition, which will be held in Ivory Coast from January 13 to February 11, 2024. Methods: Two expert physician in sports medicine will perform an analytical study (i.e.; a video-based analysis) of the 52 matches that will be played during the 2024 AFCON. The following parameters will be noted: i) Injury incidence, ii) Characteristics of injured players such as age, on-field position, and player league continent, iii) Characteristics ofinjuries such as mechanism, body location, moment of injury in terms of the minute of play and the round of the match, place of the injury in term of stadium zone, replacement consequent to the injury, absence next match, re-injury, recurrence of the injury with the same location during the competition, referee decision, and stoppage time for on-field injury, and iv) Characteristics of matches such as the match’ schedule, ambient temperature, humidity, and wind speed. Conclusion: This study will allow enriching the existing literature with additional data regarding the injuries and the players’ characteristics in the African context.

Mots clés

Blessures de Football
CAN
Étude Epidémiologique
Football
Footballeurs Africains
Prévention des Blessures CorrespondanceAnis JelladDepartment of Physical Medicine and Rehabilitation
Faculty of Medicine
University of Monastir
TunisiaEmail
anisjellad
gmail
Keywords

African Footballers
Epidemiological Study
AFCON
Football Injuries
Injury Prevention
SoccerrésuméIntroduction
L
amélioration des performances des joueurs et la mise en place des protocoles de prévention et de surveillance des blessures en football nécessitent la réalisation d
études épidémiologiques
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pmcINTRODUCTION

Football stands as the most widely embraced sport globally, boasting over 265 million licensed players worldwide, including a staggering 46 million in Africa (1). The inherent nature of football, characterized by repetitive and high-impact movements, exposes players to an elevated risk of injuries (2). Crucially, the implementation of protocols and programs geared towards injury prevention is paramount, underscoring the necessity of surveillance initiatives aimed at identifying and quantifying the epidemiological characteristics of injuries with heightened risk for players (3). These protocols and programs assume a vital role in dissecting the causes and nature of injuries, subsequently enabling the formulation of action protocols designed to curtail the risk and incidence of injuries(3). This aligns seamlessly with the van Mechelen model (4), wherein the initial steps involve assessing the incidence, followed by comprehending the causes and mechanisms of injuries. Furthermore, within the domain of sports medicine, epidemiological studies prove indispensable, acting as a cornerstone for enhancing athletic performance and crafting effective injury prevention programs (4–6). It is noteworthy that injury characteristics may be influenced by geographical factors such as climate and competition type (7, 8), thereby emphasizing the need for region-specific data to tailor preventive measures accordingly.Injury rates manifest significant disparities across various football competitions (9). Particularly noteworthy is the rate of 32.3 injuries per 1000 hours of exposure in national leagues, escalating to 41.1 in international tournaments (9). Even within Africa, substantial variability exists (10, 11). For example, while the South African league reported 24.8 injuries per 1000 match hours (10), the EPFKIN (for Entente Provinciale de Football de Kinshasa) league in Congo RDC documented a stark contrast with 182 injuries per 1000 match hours ( 11).Understanding the epidemiology of injuries assumes pivotal importance for tailoring preventive measures to local contexts (3). Prior studies have employed different methods for data collection, often relying on an injury report form developed by Fuller et al. (12), encompassing multiple outcomes, with team physicians actively participating in data collection. While epidemiological studies have been conducted previously for various competitions, such as FIFA (Fédération Internationale de Football Association) tournaments and the Olympic Games (13), there is a gap in data specifically related to African Cup of Nations (AFCON). As of end December 2023, and to the best of the authors' knowledge, no study has explored injury characteristics during any of AFCON competitions. The latter is distinguished by the diversity of players who participate in different leagues and are exposed to climates that markedly differ, particularly from those prevalent in Europe, where a majority of players is based. This discrepancy is accentuated in the 2024 edition of the AFCON, which is slated to take place in Ivory Coast, a sub-Saharan country characterized by an equatorial and tropical climate. This climate is typified by elevated temperature and humidity levels (14, 15).Taking into account the aforementioned points, the primary aim of this study will be to determine the incidence of injuries among African footballers during the 2024 AFCON competition, slated to be held in Ivory Coast from January 13 to February 11, 2024. The secondary aim will be to identify factors associated with injuries, with particular attention to the characteristics of injured players, types of injuries, and match attributes.

METHODS

Study design and context This will be an analytical study. Two expert physician in sports medicine will perform an analytical study (i.e.; a video-based analysis) of the 2024 AFCON matches. The 2024 AFCON competition is scheduled to be held in Ivory Coast, commencing on January 13 and concluding on February 11, 2024. The competition will feature the participation of twenty-four national teams, listed here in alphabetical order: Algeria, Angola, Burkina Faso, Cameroon, Cape Verde, DR Congo, Ivory Coast, Egypt, Equatorial Guinea, Gambia, Ghana, Guinea, Guinea-Bissau, Mali, Mauritania, Morocco, Mozambique, Namibia, Nigeria, South Africa, Senegal, Tanzania, Tunisia, and Zambia. The finalized 23-player squad list for each national team will be made available ten days prior to the start of the competition (i.e.; January 3, 2024). The event will encompass fifty-two matches, spanning from the group stage to the final (Box 1).There is no need for an ethical committee approval, as the data will be taken from publicly available video footages. Study protocol and injury definition Each independent expert physician in sports medicine (AC and AJ in the authors’ list) will actively engage in live streaming the 52 matches (Box 1). During this process, they will systematically collect various data pertinent to each match. Additionally, if deemed necessary, these physicians are authorized to review replay footage of injury moments for a more comprehensive assessment. Subsequently, each physician will complete an injury report form (Box 2).To ensure the accuracy and reliability of the collected data, the two physicians will convene either online or in person on the day following each match. This meeting is crucial to verify the concordance of their recorded observations noted in the injury report forms. In the event of any disparities or divergences in their notes, the physicians have the prerogative to jointly review the replay footage of injury moments. This collaborative review aims to facilitate a consensual decision, resolving any discrepancies and ensuring the integrity of the data collected during the study.The adopted definition for football injury in this study will be as follows: "Any physical complaint sustained by a player that results from a football match or football training, irrespective of the need for medical attention or time loss from football activities" (12).

Data collected and incidence of injury

Outcomes will be meticulously recorded on a pre-established injury report form (Box 2), encompassing various aspects related to the characteristics of the injured player, the injuries themselves, and the matches. Regarding the characteristics of the injured player, the following data will be gathered: Age (in years), on-field position (e.g.; goalkeeper, defender, midfielder, or forward), and the player's league continent (i.e.; Africa, Europe, North America, South America, Asia, or Australia).Concerning the characteristics of injuries, a comprehensive set of data will be collected. Firstly, the injury mechanism will be classified as direct contact (i.e.; occurring at the point of contact), indirect contact (i.e. force not directly applied to the injured area), or non-contact (i.e.; occurring without direct or indirect contact) (16). Secondly, the moment of injury will be identified in terms of the minute of play and the round of the match (i.e.; group stage, round of 16, quarterfinals, semi-finals, third place, or final). Thirdly, the stadium zone where the injury occurred (i.e.; defense, midfield, or attack zone) will be documented. Fourthly, the specific body location, utilizing the Orchard sports injury classification system (17 , 18) (Box 3), will be reported. Additionally, supplementary information will be recorded, including the replacement consequent to the injury, absence from the next match, re-injury (recurrence of the injury with the same location during the competition), referee decision (foul for, foul against, or no foul), and stoppage time for on-field injury .Concerning the characteristics of the matches, the following data will be documented: match schedule, temperature, humidity, and wind speed as presented at the commencement of each match just before kick-off.Furthermore, the two physicians will actively seek injury details from pre- and post-match press conferences and official websites of the corresponding country confederations and the Confederation of African Football. This comprehensive approach aims to ensure a thorough and accurate compilation of injury-related information throughout the competition.

The calculation of injury incidence will be expressed in terms of both match and training exposure. For match exposure, the calculation will involve multiplying 11 players by 1.5 hours for a standard 90-minute match and

2 hours for matches with additional extra time.As for training exposure, the total minutes played during training sessions will be obtained from the respective teams' medical staff. The injury incidence will then be calculated per 1000 hours of both match and training time, in accordance with established methodology (9).

Statistical analysis

The collected data will undergo analysis using IBM SPSS version 23.0. The distribution of quantitative data will be assessed using the Kolmogorov–Smirnov test, and the results will be presented as means ± standard deviation (95% confidence interval) or as median (interquartile). Categorical data will be represented by numbers and percentages. For the analytical study, comparisons between means and medians of two groups, such as African vs. Non-African league players or injured vs. non-injured players, will be conducted using the Student t-test or Mann-Whitney U test, respectively. The 2-sided Chi-squared test will be employed to compare categorical data and rates between groups. The significance level for all analyses will be set at p < 0.05.

CONCLUSION

To the best of the author’s knowledge, this study will be the first to determine the incidence of injuries during the 2024-AFCON and analyze their characteristics. The results of our investigation will offer valuable insights into injury patterns and will help to elaborate specific prevention strategies relevant to the AFCON context.
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