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Fältström, A., Kvist, J., Gauffin, H. & Hägglund, M. (2019). Female Soccer Players With Anterior Cruciate Ligament Reconstruction Have a Higher Risk of New Knee Injuries and Quit Soccer to a Higher Degree Than Knee-Healthy Controls. American Journal of Sports Medicine, 47(1), 31-40
Open this publication in new window or tab >>Female Soccer Players With Anterior Cruciate Ligament Reconstruction Have a Higher Risk of New Knee Injuries and Quit Soccer to a Higher Degree Than Knee-Healthy Controls
2019 (English)In: American Journal of Sports Medicine, ISSN 0363-5465, E-ISSN 1552-3365, Vol. 47, no 1, p. 31-40Article in journal (Refereed) Published
Abstract [en]

Background:

Many patients with anterior cruciate ligament (ACL) reconstruction who return to sport suffer new ACL injuries or quit sports soon after returning.

Purpose:

To prospectively follow a cohort of female soccer players with primary unilateral ACL reconstruction and matched knee-healthy controls from the same soccer teams to compare (1) the rate of new traumatic and nontraumatic knee injuries and other injuries, (2) the proportion of players who quit soccer, and (3) player-reported activity level and satisfaction with activity level and knee function.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

A total of 117 active female soccer players (mean ± SD age, 19.9 ± 2.5 years) 18.9 ± 8.7 months after ACL reconstruction and 119 knee-healthy female soccer players (19.5 ± 2.5 years) matched from the same teams were prospectively followed for 2 years for new knee injuries, other injuries, soccer playing level, activity level according to the Tegner Activity Scale, and satisfaction with activity level and knee function.

Results:

Players with ACL reconstruction had a higher rate of new ACL injuries (n = 29 vs 8; 19 vs 4 per 100 player years; rate ratio [RR], 4.82; 95% CI, 2.20-10.54; P < .001), other traumatic knee injuries (29 vs 16 per 100 player years; RR, 1.84; 95% CI, 1.16-2.93; P < .01), and nontraumatic knee injuries (33 vs 9 per 100 player years; RR, 3.62; 95% CI, 2.11-6.21; P < .001) as compared with controls. There was no difference in the rate of other (not knee) injuries (43 vs 48 per 100 player years; RR, 0.90; 95% CI, 0.65-1.23; P = .494). During the 2-year follow-up, 72 (62%) players with ACL reconstruction quit soccer, as opposed to 43 (36%) controls (P = .001). The median Tegner Activity Scale score decreased in both groups (P < .001) but more for the ACL-reconstructed group (P < .015).

Conclusion:

Female soccer players with ACL reconstruction had nearly a 5-fold-higher rate of new ACL injuries and a 2- to 4-fold-higher rate of other new knee injuries, quit soccer to a higher degree, and reduced their activity level to a greater extent as compared with knee-healthy controls.

Place, publisher, year, edition, pages
Sage Publications, 2019
Keywords
Female, football, soccer, anterior cruciate ligament, return to sports, reinjury, satisfaction
National Category
Physiotherapy Orthopaedics Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:liu:diva-153246 (URN)10.1177/0363546518808006 (DOI)000454146900010 ()30481050 (PubMedID)
Available from: 2018-12-05 Created: 2018-12-05 Last updated: 2019-01-11Bibliographically approved
Arundale, A., Kvist, J., Hägglund, M. & Fältström, A. (2019). Jumping performance based on duration of rehabilitation in female football players after anterior cruciate ligament reconstruction. Knee Surgery, Sports Traumatology, Arthroscopy, 27(2), 556-563
Open this publication in new window or tab >>Jumping performance based on duration of rehabilitation in female football players after anterior cruciate ligament reconstruction
2019 (English)In: Knee Surgery, Sports Traumatology, Arthroscopy, ISSN 0942-2056, E-ISSN 1433-7347, Vol. 27, no 2, p. 556-563Article in journal (Refereed) Published
Abstract [en]

Purpose

To determine if female football players who had longer durations of rehabilitation, measured in months, after anterior cruciate ligament reconstruction would have lower tuck jump scores (fewer technique flaws) and smaller asymmetries during drop vertical jump landing.

Methods

One-hundred-and-seventeen female football players, aged 16ᅵ25 years, after primary unilateral ACL reconstruction (median 16 months, range 6ᅵ39) were included. Athletes reported the duration of rehabilitation they performed after anterior cruciate ligament reconstruction. Athletes also performed the tuck jump and drop vertical jump tests. Outcome variables were: tuck jump score, frontal plane knee motion and probability of peak knee abduction moment during drop vertical jump landing.

Results

There was no difference in tuck jump score based on duration of rehabilitation (n.s.). No interaction (n.s.), difference between limbs (n.s.), or duration of rehabilitation (n.s.) was found for peak knee abduction moment during drop vertical jump landing. No interaction (n.s.) or difference between limbs (n.s.) was found for frontal plane knee motion, but there was a difference based on duration of rehabilitation (P?=?0.01). Athletes with >?9 months of rehabilitation had more frontal plane knee motion (medial knee displacement) than athletes with <?6 months (P?=?0.01) or 6ᅵ9 months (P?=?0.03).

Conclusion

As there was no difference in tuck jump score or peak knee abduction moment based on duration of rehabilitation, the results of this study press upon clinicians the importance of using objective measures to progress rehabilitation and clear athletes for return to sport, rather than time alone.

Place, publisher, year, edition, pages
Springer Berlin/Heidelberg, 2019
National Category
Public Health, Global Health, Social Medicine and Epidemiology Physiotherapy Sport and Fitness Sciences
Identifiers
urn:nbn:se:liu:diva-151695 (URN)10.1007/s00167-018-5154-5 (DOI)000460315200027 ()30267186 (PubMedID)
Note

Funding agencies: Swedish Research Council for Sport Science [CIF P2015-0150, FO2016-0021]; Futurum-the Academy for Healthcare, Region Jonkoping County; Medical Research Council of Southeast Sweden; Faculty of Health Sciences at Linkoping University; Swedish Football Assoc

Available from: 2018-10-01 Created: 2018-10-01 Last updated: 2019-03-20Bibliographically approved
Lindblom, H., Waldén, M., Carlfjord, S. & Hägglund, M. (2019). Limited positive effects on jump-landing technique in girls but not in boys after 8 weeks of injury prevention exercise training in youth football. Knee Surgery, Sports Traumatology, Arthroscopy
Open this publication in new window or tab >>Limited positive effects on jump-landing technique in girls but not in boys after 8 weeks of injury prevention exercise training in youth football
2019 (English)In: Knee Surgery, Sports Traumatology, Arthroscopy, ISSN 0942-2056, E-ISSN 1433-7347Article in journal (Refereed) Epub ahead of print
Abstract [en]

PURPOSE: To evaluate changes in jump-landing technique in football-playing boys and girls after 8 weeks of injury prevention training.

METHODS: Four boys' and four girls' teams (mean age 14.1 ± 0.8 years) were instructed to use either the original Knee Control injury prevention exercise programme (IPEP) or a further developed IPEP, Knee Control + , at every training session for 8 weeks. Baseline and follow-up testing of jump-landing technique included drop vertical jumps (DVJ), assessed subjectively and with two-dimensional movement analysis, and tuck jump assessment (TJA).

RESULTS: Only minor differences in intervention effects were seen between the two IPEPs, and results are therefore presented for both intervention groups combined. At baseline 30% of the boys showed good knee control during the DVJ, normalised knee separation distances of 77-96% (versus hip) and a median of 3 flaws during the TJA. Among girls, 22% showed good knee control, normalised knee separation distances of 67-86% and a median of 4 flaws during the TJA. At follow-up, boys and girls performed significantly more jumps during TJA. No changes in jump-landing technique were seen in boys, whereas girls improved their knee flexion angle at initial contact in the DVJ (mean change + 4.7°, p < 0.001, 95% CI 2.36-6.99, d = 0.7) and their TJA total score (- 1 point, p = 0.045, r = - 0.4).

CONCLUSION: The study showed small positive effects on jump-landing technique in girls, but not in boys, after 8 weeks of injury prevention training.

LEVEL OF EVIDENCE: Level II.

TRIAL REGISTRATION: Clinical Trials gov identifier: NCT03251404.

Keywords
Effect mechanisms, Movement quality, Neuromuscular training
National Category
Sport and Fitness Sciences
Identifiers
urn:nbn:se:liu:diva-160777 (URN)10.1007/s00167-019-05721-x (DOI)31541293 (PubMedID)
Available from: 2019-10-07 Created: 2019-10-07 Last updated: 2019-12-03
Lindblom, H., Carlfjord, S. & Hägglund, M. (2018). Adoption and use of an injury prevention exercise program in female football: A qualitative study among coaches. Scandinavian Journal of Medicine and Science in Sports, 28(3), 1295-1303
Open this publication in new window or tab >>Adoption and use of an injury prevention exercise program in female football: A qualitative study among coaches
2018 (English)In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 28, no 3, p. 1295-1303Article in journal (Refereed) Published
Abstract [en]

This study focuses on an injury prevention exercise program (IPEP), Knee Control, which has been shown to reduce the incidence of acute knee injury in female adolescent football players. The aim was to explore the factors influencing coaches adoption and use of Knee Control within female football in Sweden. This was a qualitative study involving interviews with 20 strategically selected coaches for female football teams, predominantly adolescent teams. The semi-structured interview guide was influenced by the Health Belief Model, and an ecological perspective was adopted during the interviews. Interviews were analyzed with qualitative content analysis. The results illustrate the different influences that interact on adoption and use of Knee Control by coaches. The coaches described themselves as crucial for Knee Control adoption and use, but external facilitators and barriers such as resources for training, social support from other coaches, clubs and football associations and player buy-in were also described as important. Knee Control characteristics, such as how well the program fit the team, also influenced use of Knee Control. Many coaches modified the program to improve player buy-in and Knee Control fit. Such modifications may risk compromising the preventive effect but may increase feasibility, that is the ease of using Knee Control, and thereby long-term use. These findings may guide the design and delivery of future IPEPs, and improve use of Knee Control, for example, by expanding the program to fit different target groups and supporting coaches and players in the use of Knee Control.

Place, publisher, year, edition, pages
Wiley-VCH Verlagsgesellschaft, 2018
Keywords
dissemination; implementation; neuromuscular training; team sports; youth
National Category
Sport and Fitness Sciences
Identifiers
urn:nbn:se:liu:diva-147150 (URN)10.1111/sms.13012 (DOI)000426529300058 ()29130536 (PubMedID)
Note

Funding Agencies|Swedish Research Council for Sport Science; Region Ostergotland

Available from: 2018-04-20 Created: 2018-04-20 Last updated: 2019-10-08
Kvist, J., Gauffin, H., Tigerstrand Grevnerts, H., Ardern, C., Hägglund, M., Stalman, A. & Frobell, R. (2018). Natural corollaries and recovery after acute ACL injury: the NACOX cohort study protocol. BMJ Open, 8(6), Article ID e020543.
Open this publication in new window or tab >>Natural corollaries and recovery after acute ACL injury: the NACOX cohort study protocol
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2018 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 8, no 6, article id e020543Article in journal (Refereed) Published
Abstract [en]

Introduction Anterior cruciate ligament (ACL) injury can result in joint instability, decreased functional performance, reduced physical activity and quality of life and an increased risk for post-traumatic osteoarthritis. Despite the development of new treatment techniques and extensive research, the complex and multifaceted nature of ACL injury and its consequences are yet to be fully understood. The overall aim of the NACOX study is to evaluate the natural corollaries and recovery after an ACL injury. Methods and analysis The NACOX study is a multicentre prospective prognostic cohort study of patients with acute ACL injury. At seven sites in Sweden, we will include patients aged 15-40 years, within 6 weeks after primary ACL injury. Patients will complete questionnaires at multiple occasions over the 3 years following injury or the 3 years following ACL reconstruction (for participants who have surgical treatment). In addition, a subgroup of 130 patients will be followed with clinical examinations, several imaging modalities and biological samples. Data analyses will he specific to each aim. Ethics and dissemination This study has been approved by the regional Ethical committee in Linkoping, Sweden (Dnr 2016/44-31 and 2017/221-32). We plan to present the results at national and international conferences and in peer-reviewed scientific journals. Participants will receive a short summary of the results following completion of the study.

Place, publisher, year, edition, pages
BMJ PUBLISHING GROUP, 2018
National Category
Surgery
Identifiers
urn:nbn:se:liu:diva-151521 (URN)10.1136/bmjopen-2017-020543 (DOI)000442924700037 ()29950463 (PubMedID)
Note

Funding Agencies|Swedish Medical Research Council [VR 2015-03687]; Swedish Research Council for Sport Science [CIF P2016-0063, P2017-0151]; Medical Research Council of Southeast Sweden FORSS [FORSS -662081]; Medical Faculty at Linkoping University, Sweden

Available from: 2018-09-21 Created: 2018-09-21 Last updated: 2018-10-08
Waldén, M., Hägglund, M., Bengtsson, H. & Ekstrand, J. (2018). Perspectives in football medicine. Der Unfallchirurg (Berlin. Print), 121(6), 470-474
Open this publication in new window or tab >>Perspectives in football medicine
2018 (English)In: Der Unfallchirurg (Berlin. Print), ISSN 0177-5537, E-ISSN 1433-044X, Vol. 121, no 6, p. 470-474Article in journal (Refereed) Published
Abstract [en]

The high injury rate among mens professional football players is well-known. Therefore, the Union of European Football Associations (UEFA) launched an injury study already in 2001. This study, the UEFA Elite Club Injury Study (ECIS), currently includes data from a total of 51 clubs from 18 European countries with more than 14,000 registered injuries. With the 21(st) World Cup (WC) in Russia just around the corner, we have from our study identified a higher match injury rate and a higher proportion of severe injuries in the European Championships compared to the preceding club competitive seasons. Moreover, we have also recently showed that the muscle injury rate is higher when players are given a recovery window of five days or less between two matches. Considering the congested match schedule of the upcoming WC, it is therefore likely that injuries and fatigue once again will be a topic of discussion this summer.

Place, publisher, year, edition, pages
Springer, 2018
Keywords
Research; UEFA; Injury; Epidemiology; Prevention
National Category
Sport and Fitness Sciences
Identifiers
urn:nbn:se:liu:diva-149373 (URN)10.1007/s00113-018-0496-5 (DOI)000434044100011 ()29651514 (PubMedID)
Available from: 2018-07-02 Created: 2018-07-02 Last updated: 2018-08-10
Waldén, M., Hägglund, M., Magnusson, H. & Ekstrand, J. (2016). ACL injuries in mens professional football: a 15-year prospective study on time trends and return-to-play rates reveals only 65% of players still play at the top level 3 years after ACL rupture. British Journal of Sports Medicine, 50(12), 744-750
Open this publication in new window or tab >>ACL injuries in mens professional football: a 15-year prospective study on time trends and return-to-play rates reveals only 65% of players still play at the top level 3 years after ACL rupture
2016 (English)In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 50, no 12, p. 744-750Article in journal (Refereed) Published
Abstract [en]

Background Studies investigating the development of ACL injuries over time in football are scarce and more data on what happens before and after return to play (RTP) are needed. Aim To investigate (1) time trends in ACL injury rates, (2) complication rates before return to match play following ACL reconstruction, and (3) the influence of ACL injury on the subsequent playing career in male professional football players. Methods 78 clubs were followed between 2001 and 2015. Time trend in ACL injury rate was analysed using linear regression. ACL-injured players were monitored until RTP and tracked for 3 years after RTP. Results We recorded 157 ACL injuries, 140 total and 17 partial ruptures, with a non-significant average annual increase in the ACL injury rate by 6% (R-2=0.13, b=0.059, 95% CI -0.04 to 0.15, p=0.20). The match ACL injury rate was 20-fold higher than the training injury rate (0.340 vs 0.017 per 1000 h). 138 players (98.6%) with a total rupture underwent ACL reconstruction; all 134 players with RTP data (4 players still under rehabilitation) were able to return to training, but 9 of them (6.7%) suffered complications before their first match appearance (5 reruptures and 4 other knee surgeries). The median layoff after ACL reconstruction was 6.6 months to training and 7.4 months to match play. We report 3-year follow-up data for 106 players in total; 91 players (85.8%) were still playing football and 60 of 93 players (65%) with ACL reconstruction for a total rupture played at the same level. Conclusions The ACL injury rate has not declined during the 2000s and the rerupture rate before return to match play was 4%. The RTP rate within a year after ACL reconstruction was very high, but only two-thirds competed at the highest level 3 years later.

Place, publisher, year, edition, pages
BMJ PUBLISHING GROUP, 2016
National Category
Sport and Fitness Sciences
Identifiers
urn:nbn:se:liu:diva-129482 (URN)10.1136/bjsports-2015-095952 (DOI)000376762000010 ()27034129 (PubMedID)
Note

Funding Agencies|UEFA; Swedish Football Association; Football Association Premier League Limited; Swedish National Centre for Research in Sports

Available from: 2016-06-21 Created: 2016-06-20 Last updated: 2017-11-28
Fältström, A., Hägglund, M. & Kvist, J. (2016). Factors associated with playing football after anterior cruciate ligament reconstruction in female football players.. Scandinavian Journal of Medicine and Science in Sports, 26(11), 1343-1352
Open this publication in new window or tab >>Factors associated with playing football after anterior cruciate ligament reconstruction in female football players.
2016 (English)In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 26, no 11, p. 1343-1352Article in journal (Refereed) Published
Abstract [en]

This study investigated whether player-related factors (demographic, personality, or psychological factors) or the characteristics of the anterior cruciate ligament (ACL) injury were associated with the return to playing football in females after ACL reconstruction (ACLR). We also compared current knee function, knee related quality of life and readiness to return to sport between females who returned to football and those who had not returned. Females who sustained a primary ACL rupture while playing football and underwent ACLR 6-36 months ago were eligible. Of the 460 contacted, 274 (60%) completed a battery of questionnaires, and 182 were included a median of 18 months (IQR 13) after ACLR. Of these, 94 (52%) returned to football and were currently playing, and 88 (48%) had not returned. Multiple logistic regression analysis identified two factors associated with returning to football: short time between injury and ACLR (0-3 months, OR 5.6; 3-12 months OR 4.7 vs reference group > 12 months) and high motivation. Current players showed higher ratings for current knee function, knee-related quality of life, and psychological readiness to return to sport (P < 0.001). Undergoing ACLR sooner after injury and high motivation to return to sports may impact a player's return to football after ACLR.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2016
Keywords
ACL; knee; return to sport; soccer
National Category
Physiotherapy
Identifiers
urn:nbn:se:liu:diva-123889 (URN)10.1111/sms.12588 (DOI)000386938300009 ()26589671 (PubMedID)
Note

Funding agencies:The authors acknowledge statistician Henrik Magnusson. The study was supported financially by Futurum-The Academy for Healthcare, Jonkoping County Council, the Medical Research Council of Southeast Sweden, the Faculty of Health Sciences at Linkoping University, and the Swedish National Centre for Research in Sports (CIF).

Available from: 2016-01-13 Created: 2016-01-13 Last updated: 2017-11-30Bibliographically approved
Ekstrand, J., Waldén, M. & Hägglund, M. (2016). Hamstring injuries have increased by 4% annually in mens professional football, since 2001: a 13-year longitudinal analysis of the UEFA Elite Club injury study. British Journal of Sports Medicine, 50(12), 731-737
Open this publication in new window or tab >>Hamstring injuries have increased by 4% annually in mens professional football, since 2001: a 13-year longitudinal analysis of the UEFA Elite Club injury study
2016 (English)In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 50, no 12, p. 731-737Article in journal (Refereed) Published
Abstract [en]

Background There are limited data on hamstring injury rates over time in football. Aim To analyse time trends in hamstring injury rates in male professional footballers over 13 consecutive seasons and to distinguish the relative contribution of training and match injuries. Methods 36 clubs from 12 European countries were followed between 2001 and 2014. Team medical staff recorded individual player exposure and time-loss injuries. Injuries per 1000 h were compared as a rate ratio (RR) with 95% CI. Injury burden was the number of lay off days per 1000 h. Seasonal trend for injury was analysed using linear regression. Results A total of 1614 hamstring injuries were recorded; 22% of players sustained at least one hamstring injury during a season. The overall hamstring injury rate over the 13-year period was 1.20 injuries per 1000 h; the match injury rate (4.77) being 9 times higher than the training injury rate (0.51; RR 9.4; 95% CI 8.5 to 10.4). The time-trend analysis showed an annual average 2.3% year on year increase in the total hamstring injury rate over the 13-year period (R-2=0.431, b=0.023, 95% CI 0.006 to 0.041, p=0.015). This increase over time was most pronounced for training injuries-these increased by 4.0% per year (R-2=0.450, b=0.040, 95% CI 0.011 to 0.070, p=0.012). The average hamstring injury burden was 19.7 days per 1000 h (annual average increase 4.1%) (R-2=0.437, b=0.041, 95% CI 0.010 to 0.072, p=0.014). Conclusions Training-related hamstring injury rates have increased substantially since 2001 but match-related injury rates have remained stable. The challenge is for clubs to reduce training-related hamstring injury rates without impairing match performance.

Place, publisher, year, edition, pages
BMJ PUBLISHING GROUP, 2016
National Category
Sport and Fitness Sciences
Identifiers
urn:nbn:se:liu:diva-129480 (URN)10.1136/bjsports-2015-095359 (DOI)000376762000008 ()26746908 (PubMedID)
Note

Funding Agencies|UEFA; Swedish Football Association; Football Association Premier League Limited; Swedish National Centre for Research in Sports

Available from: 2016-06-21 Created: 2016-06-20 Last updated: 2017-11-28
Kristenson, K., Bjørneboe, J., Waldén, M., Andersen, T. E., Ekstrand, J. & Hägglund, M. (2016). Injuries in male professional football: a prospective comparison between individual and team-based exposure registration. Scandinavian Journal of Medicine and Science in Sports, 26(10), 1225-1232
Open this publication in new window or tab >>Injuries in male professional football: a prospective comparison between individual and team-based exposure registration
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2016 (English)In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 26, no 10, p. 1225-1232Article in journal (Refereed) Published
Abstract [en]

Methodological considerations of football injury epidemiology have only scarcely been described. The aim of this study was to evaluate the inter-rater agreement in injury capture rate and injury categorisation for data registered in two different prospective injury surveillance audits studying the same two Norwegian male professional football clubs for two consecutive seasons, 2008-2009. One audit used team-based exposure (TBE) recording and the other individual-based exposure (IBE). The number of injuries recorded and corresponding injury rates (injuries/1000 h exposure) were compared between audits. Cohen’s Kappa and Prevalence Adjusted Bias Adjusted Kappa (PABAK) coefficients were calculated for injury variables. Of 323 injuries included, the IBE audit captured 318 (overall capture rate 98.5%, training 98.9%, match 97.8%) and the TBE audit 303 injuries (overall capture rate 93.8%, training 91.4%, match 97.1%). Agreement analysis showed Kappa and PABAK coefficients regarded as almost perfect (> 0.81) for 8 of 9 injury variables, and substantial (ƙ 0.75) for the variable injury severity. In conclusion, the capture rate for training injuries was slightly higher with individual-based exposure recording, and inter-agreement in injury categorisation was very high.

Place, publisher, year, edition, pages
John Wiley & Sons, 2016
Keywords
Elite, epidemiology, methodology, reliability, soccer, validity
National Category
Public Health, Global Health, Social Medicine and Epidemiology Health Sciences
Identifiers
urn:nbn:se:liu:diva-117169 (URN)10.1111/sms.12551 (DOI)000386937200011 ()26376838 (PubMedID)
Note

At the time for thesis presentation publication was in status: Manuscript

Funding agencies: Union of European Football Associations; Swedish Football Association; Football Association Premier League Limited; Swedish National Centre for Research in Sports; County Council of Ostergotland; Royal Norwegian Ministry of Culture and Church Affairs; Sou

Available from: 2015-04-21 Created: 2015-04-21 Last updated: 2017-12-04Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-6883-1471

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