| Abstract | Osnovni cilj ovog istraživanja bio je utvrditi točan broj, težinu i tip ozljeda u 1. Hrvatskoj nogometnoj ligi na treningu i utakmicama. Sekundarni cilj je bio utvrditi implementacijski kontekst, odnosno stajališta igrača prema prevencijskim programima i učestalost provedbe istih, utvrditi faktore koji doprinose i koji sprečavaju provedbu prevencijskih programa. Uzorak ispitanika sastojao se od 340 nogometaša iz klubova u 1. HNL prosječne kronološke dobi 24,22 ± 3,95 godina. Prikupljanje podataka je provedeno prospektivnim putem gdje je zadužena osoba za pojedini klub upisivala podatke svaka dva tjedna u bazu podataka. Upisivali su se podaci o izloženosti kao i incidenciji ozljeda igrača na treninzima i utakmicama. Osim izloženosti, prikupljeni su podaci o antropometrijskim mjerama ispitanika kao i o stajalištima prema prevencijskim programima te pozitivnim i negativnom faktorima na provedbu istih. Obrada podataka je provedena statističkim paketom SPSS 20. Za sve antropometrijske mjerne parametre izračunati su deskriptivni statistički postupci (mod, median, standardna devijacija, izgled distribucije). Također je izračunana izloženost igrača na utakmicama/treningu kao i incidencija ozljede igrača na 1000 sati izloženosti na utakmicama/treningu. Učestalost i postoci odgovora na pitanja o stavovima prema prevencijskih programima su dobiveni iz kategorijskih podataka (Crosstabulationtables). Povezanost nezavisnih i zavisnih varijabli je utvrđena primjenom logističkih regresijskih analiza. Zavisna varijabla se transformirala u binomnu (ozlijeđen/neozlijeđen) odnosno multinomijalnu (neozlijeđen/lakša ozljeda/teža ozljeda). Također je izračunat omjer izgleda (oddsratio), i pripadajući 95% interval (95% CI). Rezultati istraživanja pokazali su da je ukupna izloženost igrača bila 47835 sati. Od toga je izloženost na utakmicama iznosila 2640 sati (5.51%), odnosno 264 sata po ekipi. Ukupna izloženost ekipa na treningu je iznosila 45195 sati (94.48%), odnosno 4519.5 sati po ekipi. Incidencija ozljeda na utakmicama je iznosila 60.22/1000h ozljeda dok je incidencija na treningu iznosila 15.4 ozljeda na 1000h izloženosti. Od svih ozljeda, na ozljede donjih ekstremiteta se odnosilo 76.9% svih zabilježenih ozljeda. Prema ozlijeđenom dijelu tijela je utvrđen visok postotak ozljeda glave/lica dok su prema tipu ozljede najzastupljenija bila nagnječenja/hematomi, nakon kojih slijede rupture mišića/prenaprezanja i uganuća/ozljede ligamenata. Istraživanjem se utvrdilo da je broj ponovljenih ozljeda u klubovima 1. HNL mnogo viši od europskog prosjeka. Također je utvrđeno da je veći broj ozljeda zadobiven traumom dok je manji broj ozljeda nastao preopterećenjem. Nije potvrđena hipoteza da slabije rangirani klubovi imaju statistički značajno više ozljeda, ali razlika svejedno postoji između klubova koji su završili prvenstvo na vrhu tablice u odnosnu na najlošije rangirane klubove. Dokazana je statistički značajna povezanost između ozljeda glave/lica s dužim vremenskim periodom izbivanja s terena kao i povezanost dužeg vremenskog perioda izbivanja i ozljede koljena. Ozljede tog tipa su definirane kao teške. Ozljeda trbuha je također povezana u usporedbi s dužim vremenskim periodom izbivanja sa terena. Dokazana je statistički značajna povezanost između klubova koji redovito provode prevencijske programe s manjom incidencijom ozljeda u odnosu na klubove koji ne provode prevencijske programe. Najveći broj ispitanika smatra da su igrači sami odgovorni za prevenciju ozljeda, nakon čega slijedi glavni trener dok su prema ispitanicima najmanje odgovorni liječnici, fizioterapeuti i kondicijski treneri. Kada se pogleda vrijednost značajnosti regresijskog koeficijenta za model 'ukupan broj dana izbivanja (jedan do osam ; devet i više) i promatrane klubove, utvrđeno je kako nema statistički značajne povezanosti u navedenom modelu (p=>0.05). Vrijednost regresijskog koeficijenta za ponovljene ozljede također nije statistički značajan (p=>0.05), te se na temelju toga zaključuje kako nema statističke značajnosti između ponovljenih ozljeda i ukupnog broja dana izbivanja. Prema stajalištima najveći stupanj slaganja ispitanika o prevencijskim programima je zabilježen kod pitanja; ozljede donjih ekstremiteta mogu skratiti profesionalnu karijeru nogometaša, zatim nogometni igrači su pod velikim pritiskom zadobivanja ozljeda donjih ekstremiteta. Najniži stupanj slaganja je zabilježen kod pitanja; vježbe ravnoteže mogu prevenirati ozljede donjih ekstremiteta, zatim trčanje/trčkaranje u fazi hlađenja mogu prevenirati ozljede donjih ekstremiteta. Većina odgovora se razlikuje u odnosu na druga istraživanja koja su citirana u ovom radu. Kao pozitivne faktore provedbe prevencijskih programa ispitanici su naveli kako prevencijski programi moraju biti zabavni i nogometno specifični, da se provode duži vremenski period te da se odvijaju na više lokacija. Kao negativni faktori utvrđeni su nedostatak opreme, nedostatak vremena i neadekvatan nadzor za provedbu programa. Dokazano je da je broj ozljeda u 1 HNL na utakmicama i treninzima značajno veći u odnosu na klubove koji pripadaju elitnim Europskim klubovima. Osim specifičnog vremenskog perioda u kojem se istraživanje provodilo, za vrijeme pandemije COVID 19, nema drugih vanjskih čimbenika koji su mogli utjecati na dobivene rezultate. Bitno je naglasiti da treba veći vremenski period utrošiti na edukaciju samih igrača i njihovih stručnih timova, kao i na bolje tehničko materijalne uvjete na terenu jer ispunjenjem tih pretpostavki provedba prevencijskih programa će biti kvalitetnija. Ovim istraživanjem se utvrdilo koji su to pozitivni faktori koji utječu na provođenje prevencijskih programa te ih treba implementirati u svakodnevni trenažni proces u svakom klubu. Smanjenjem broja ozljeda 1. HNL će postati konkurentnija i jača liga nego što je to u ovom trenutku. |
| Abstract (english) | The main goal of this research was to determine the exact number, severity, and type of injuries in the 1st Croatian Football League in training and matches. The secondary goal was to determine the attitudes of players towards prevention programs and the frequency of their implementation, to determine the factors that contribute to and prevent the implementation of prevention programs. The sample of respondents consisted of 340 football players from clubs in the 1st HNL with an average chronological age of 24.22 ± 3.95 years. Data collection was carried out in a prospective way, where the person in charge of a particular club entered data into the database every two weeks. Data on exposure as well as the incidence of player injuries in training and matches were entered. In addition to exposure, data were collected on anthropometric measures of respondents as well as on attitudes towards prevention programs and positive and negative factors on their implementation. Data processing was performed with the SPSS 20 statistical package. Descriptive statistical procedures (mode, median, standard deviation, distribution appearance) were calculated for all anthropometric measurement parameters. The exposure of players in matches / training as well as the incidence of player injury per 1000 hours of exposure in matches / training was also calculated. The frequency and percentages of responses to questions about attitudes toward prevention programs were derived from Crosstabulation tables. The relationship between independent and dependent variables was determined by applying logistic regression analyzes. The dependent variable was transformed into binomial (injured / uninjured) or multinomial (uninjured / minor injury / severe injury). The odds ratio was also calculated, and the corresponding 95% interval (95% CI). The results of the research showed that the total exposure of the players was 47,835 hours. Of that, the exposure in matches was 2640 hours (5.51%), or 264 hours per team. The total exposure of teams in training was 45195 hours (94.48%), or 4519.5 hours per team. The incidence of injuries in matches was 60.22 / per 1000h of injuries while the incidence of training was 15.4 injuries per 1000h of exposure. Of all injuries, lower extremity injuries accounted for 76.9% of all recorded injuries. According to the injured part of the body, a high percentage of head/face injuries was found, while according to the type of injury, bruises/hematomas were the most common, followed by muscle ruptures/strains and ligament sprains/injuries. The research established that the number of repeated injuries in clubs in the 1st HNL is much higher than the European average. It was also found that a greater number of injuries were sustained by trauma while a smaller number of injuries were caused by overload. The hypothesis that lower-ranked clubs have statistically significantly more injuries has not been confirmed, but the difference still exists between clubs that finished the championship at the top of the table compared to the worst-ranked clubs. There was a statistically significant association between head/face injuries with a longer period of absence from the field as well as an association between a longer period of absence and a knee injury. Injuries of this type are defined as severe. Abdominal injury is also associated with a longer period of absence from the field. There was a statistically significant association between clubs that regularly implement prevention programs with a lower incidence of injuries compared to clubs that do not implement prevention programs. Most of the respondents believe that the players are responsible for injury prevention, followed by the head coach, while according to the respondents, doctors, physiotherapists, and fitness trainers are the least responsible. When looking at the value of the significance of the regression coefficient for the model's total number of absence days (1-8; 9 and more) and the observed clubs, it was found that there is no statistically significant correlation in this model (p => 0.05). The value of the regression coefficient for repeated injuries is also not statistically significant (p => 0.05), and on this basis, it is concluded that there is no statistical significance between repeated injuries and the total number of absence days. According to the views, the highest degree of agreement of the respondents on prevention programs was recorded in the question; lower extremity injuries can shorten a professional footballer’s career, then football players are under a lot of pressure to get lower extremity injuries. The lowest degree of agreement was recorded in the question; balance exercises can prevent lower extremity injuries, then running/jogging in the cooling phase can prevent lower extremity injuries. Most of the answers differ from other studies cited in this paper. As positive factors in the implementation of prevention programs, the respondents stated that prevention programs must be fun and football-specific, that they are implemented for a longer period, and that they take place in several locations. Lack of equipment, lack of time, and inadequate supervision for the implementation of the program were identified as negative factors. It has been proven that the number of injuries is in 1 HNL in matches and training significantly higher compared to clubs belonging to elite European clubs. Apart from the specific time period in which the research was conducted, during the COVID-19 pandemic, there are no other external factors that could affect the results obtained. It is important to emphasize that more time should be spent on educating players and their professional teams, as well as on better technical and material conditions on the field, because fulfilling these assumptions of proven prevention programs will be better. This research has identified positive factors that affect the implementation of prevention programs and should be implemented in the daily training process in each club. By reducing the number of injuries, 1. HNL will become a more competitive and stronger league than it currently is. |
