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Protocol and registration
The protocol for this scoping review was meticulously crafted to ensure thoroughness and consistency in the research methodology. The development process entailed comprehensive consultation of current literature, and relevant best practice guidelines, including the PRISMA extension for scoping reviews (Table S1 – Supplemental File), in order to formulate an effective strategy for carrying out the scoping review [13].
The protocol has been registered with the Open Science Framework (OSF) to ensure transparency and accessibility [14]. This step was taken as an assurance of the quality and reliability of the review process. The protocol was registered on the 14th of June 2023, and can be accessed freely online via the following link: https://osf.io/kyjv8.
Eligibility criteria
The eligibility criteria for this scoping review were developed to guide the selection of relevant studies and ensure alignment with the research objectives. The focus of the review was conceptualized using the Population, Concept, Context (PCC) framework, recommended by the Joanna Briggs Institute for scoping reviews [15]. The Population refers to athletes involved in various sports. The Concept includes injury prevention, with an emphasis on the role of technologies in load measurement. The Context encompasses the conditions under which these measurements and strategies are applied, which can include various sports settings, training programs, rehabilitation scenarios, and risk management situations.
Population (P): This review encompasses studies involving athletes of all ages, including both male and female participants, across various levels of experience from amateur to professional. The rationale for including athletes from different levels is to capture a comprehensive understanding of how load measurement devices inform training and injury prevention strategies across different populations.
Concept (C): The review focuses on the utilization of load measurement devices in sport. This includes devices such as force plates, GPS systems, accelerometers, and wearable technology. The objective is to explore the existing literature on the use of these devices and how they contribute to injury prevention strategies in the field of sports.
Context (C): The review includes studies conducted in various sporting disciplines, including but not limited to team sports, individual sports, and endurance sports. The intention is to encompass a diverse range of sports contexts to allow for a comprehensive analysis of load measurement device usage across different athletic activities.
This review, while broadly encompassing a variety of study designs to capture diverse perspectives and methodologies, established specific exclusions to refine the focus. Therefore, review articles, meta-analyses, opinion pieces, and case reports were not included. This exclusion criteria were carefully chosen to ensure the inclusion of original research studies that provide direct evidence on the use of load measurement devices in sports for injury prevention. The review only included English language publications to ensure feasibility in the analysis and synthesis of the available literature. There were no restrictions on the publication date to capture a wide range of relevant studies.
Information sources
In the pursuit of comprehensiveness and inclusivity, the present review’s search strategy involved an extensive examination of published literature. Four major databases were utilized to ensure broad coverage: PubMed/Medline, Scopus (Elsevier), Web of Science (Clarivate), and SPORTDiscus (EBSCOhost). These databases were selected to offer a balance between biomedical, psychological, and sports science perspectives. The literature search in these databases was last executed on June 15, 2023.
To supplement the database search, the present review also adopted additional search methods. These included scanning the reference lists of pertinent reviews and articles for additional sources that might not have been identified in the initial database search. This process, commonly known as “snowballing”, can help capture relevant studies that might otherwise be overlooked. Key journals in the field were also hand-searched to uncover articles of relevance that may not have been indexed in the databases used. This comprehensive and systematic search strategy was designed to ensure that all relevant studies were identified, regardless of their publication status or source.
Search
The search strategy developed for the present review was meticulously designed and carried out to promote easy replication by other researchers. Additionally, the search strategy followed the Peer Review of Electronic Search Strategies (PRESS) checklist to ensure the robustness and comprehensiveness of the search [16].
The search was conducted using a combination of Medical Subject Headings (MeSH) terms and keywords in titles and abstracts. The strategy was designed to capture articles pertaining to load measurement, force plate, accelerometer, GPS tracking, wearable technology, athletes, sports, training load, exercise, training adaptation, overtraining, injury prevention, risk management, and rehabilitation. The entire search strategy for each database is available in the supplemental material file.
The review employed specific search limitations to refine the scope of retrieved results. Filters such as “Journal Article” for publication type and “English” for language were applied to facilitate manageability and relevance of the search results. These limitations were deemed necessary for the practical execution of the review and to ensure the quality and relevance of the articles included.
Selection of sources of evidence
The process of selecting sources of evidence for this review involved a comprehensive, multi-step screening procedure to ensure the relevance and quality of the studies included. The process began with title screening (A.R. and D.V.M.), which involved a systematic review of the titles of retrieved articles to exclude any that were patently irrelevant to the review’s focus. Subsequently, an abstract and keyword screening was conducted on the remaining articles (A.R., D.V.M., and D.S.T.), assessing their relevance based on the inclusion and exclusion criteria.
To standardize the selection process, a review form was developed, containing pertinent questions about the study design, methodology, and findings. The form was developed and tested iteratively within the review team, with adjustments made based on feedback from initial testing. A software platform, CADIMA, was employed to facilitate the title screening and deduplication procedures, thus ensuring a systematic and consistent process [17].
Prior to the official screening, a calibration exercise was undertaken to validate the screening form and process. A subset of citations and full-text articles was independently screened by the review team members. Discrepancies were identified and discussed, leading to further refinement of the form and clarification of the screening criteria.
In the full screening process, each citation and full-text article was independently assessed by two reviewers. Any discrepancies between the reviewers were resolved through discussion and, if necessary, referral to a third reviewer for a final decision. A verification process was implemented to ensure that all relevant studies were included, and duplicates were identified and removed using CADIMA to maintain the integrity of the review. This rigorous selection process was employed to ensure the comprehensiveness and relevance of the studies included in the review.
Data charting
The data charting process for the present review was underpinned by a carefully designed form, utilized to extract the most salient information from the selected sources of evidence. The items charted encompassed variables of interest, estimations of associations or effect sizes, qualitative data fragments, descriptions of methods, and metadata. The selection of these items was guided by their relevance to the research questions.
To ensure the consistency and reliability of the data charting, a calibration exercise was conducted. The review team members independently charted a subset of sources using the initial version of the charting form. The team then compared their charting results and resolved discrepancies through discussion. These discussions facilitated the identification of necessary changes or refinements to the charting form and procedure.
The full charting process was implemented by multiple reviewers, with each source being independently charted by at least two reviewers. Any inconsistencies between reviewers in their charting were resolved through discussion or, where necessary, the input of a third reviewer. This approach ensured the thoroughness and accuracy of the charting process. Changes made to the charting form during the iterative process were carefully documented, along with the rationales for those changes. This documentation ensures transparency and allows for replication and further refinement in future reviews.
For data that were unclear or missing from the source documents, attempts were made to contact the original investigators for clarification or additional information. The obtained data were then cross-verified with the published sources to confirm their accuracy and validity. This rigorous process was critical to ensuring the integrity of the data used in the review.
Data items
For the current review, data items were carefully selected to address the study’s focus on the use of load measurement devices, training parameters, injury prevention strategies, and rehabilitation protocols for athletes.
Certain items involved interpretation, such as the training adaptation, overtraining, and rehabilitation strategies. For these items, charting required a detailed reading and understanding of the source document to accurately represent the study’s methodologies and outcomes. Details about the methods of included studies, such as study design, sample size, sample characteristics, and timing of data collection, were also charted. These pieces of information were crucial for contextualizing the findings and assessing their applicability to the research questions. Lastly, metadata including author names, institutions, year of publication, and journal or source of publication were charted for each source.
Critical appraisal of individual sources of evidence
Given the nature of the present scoping review, a critical appraisal of individual sources of evidence was not a primary focus. The main aim was to map the existing literature and identify key concepts, sources of evidence, and research gaps related to load measurements, training adaptation, and injury prevention in athletes. Therefore, the review did not attempt to synthesize and weigh the evidence to draw conclusions or make recommendations, which is more typical of systematic reviews.
However, to ensure the general credibility of the sources included, a basic quality check was conducted. This consisted of evaluating the relevance of each study to the research questions and assessing whether the methodologies used in the studies were sufficiently rigorous and clearly described. This process was performed by the review team during the data charting phase.
It is important to clarify that the findings from this step did not influence the inclusion of sources in the review or the extraction of data. All sources that met the inclusion criteria and provided relevant data were included, regardless of their individual quality ratings. The intent was to capture a broad scope of the literature in the field, including potentially differing perspectives and methodologies.
Synthesis of results
The synthesis of results in the present review was structured to systematically capture and present the breadth of evidence related to load measurements, training adaptation, and injury prevention in athletes. The primary aim was not to draw definitive conclusions, but to map the range of evidence and identify key concepts, common themes, and gaps in the research field.
The synthesis process involved grouping the extracted data into thematic clusters based on their relevance to the research objectives. Each theme was then explored and summarized narratively, with the purpose of providing an overview of the existing literature in that area and pointing out any significant findings, trends, consistencies, or divergences.
In addition to the narrative synthesis, the results were also presented visually. This involved creating tables that provide an at-a-glance understanding of the key findings and themes. For instance, a summary table was used to display key information about each included study, such as the variables measured and the main findings.
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