Towards the reduction of injury and illness in athletes : Defining our research priorities
- Authors: Finch, Caroline , Bahr, Roald , Drezner, Jonathan , Dvorak, Jiri , Engebretsen, Lars , Hewett, Timothy , Junge, Astrid , Khan, Karim , Macauley, Domhnall , Matheson, Gordon , McCrory, Paul , Verhagen, Evert
- Date: 2017
- Type: Text , Journal article , Review
- Relation: British Journal of Sports Medicine Vol. 51, no. 16 (2017), p. 1178-1182
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
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What is the definition of sports-related concussion : A systematic review
- Authors: McCrory, Paul , Feddermann-Demont, Nina , Dvorak, Jiri , Cassidy, David , McIntosh, Andrew , Vos, Pieter , Echemendia, Ruben , Meeuwisse, Willem , Tarnutzer, Alexander
- Date: 2017
- Type: Text , Journal article , Review
- Relation: British Journal of Sports Medicine Vol. 51, no. 11 (2017), p. 877-887
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- Description: Objectives: Various definitions for concussion have been proposed, each having its strengths and weaknesses. We reviewed and compared current definitions and identified criteria necessary for an operational definition of sports-related concussion (SRC) in preparation of the 5th Concussion Consensus Conference (Berlin, Germany). We also assessed the role of biomechanical studies in informing an operational definition of SRC. Design: This is a systematic literature review. Data sources: Data sources include MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, Cochrane Central Register of Clinical Trials and SPORT Discus (accessed 14 September 2016). Eligibility criteria for selecting studies: Eligibility criteria were studies reporting (clinical) criteria for diagnosing SRC and studies containing SRC impact data. Results: Out of 1601 articles screened, 36 studies were included (2.2%), 14 reported on criteria for SRC definitions and 22 on biomechanical aspects of concussions. Six different operational definitions focusing on clinical findings and their dynamics were identified. Biomechanical studies were obtained almost exclusively on American football players. Angular and linear head accelerations linked to clinically confirmed concussions demonstrated considerable individual variation. Summary/conclusions: SRC is a traumatic brain injury that is defined as a complex pathophysiological process affecting the brain, induced by biomechanical forces with several common features that help define its nature. Limitations identified include that the current criteria for diagnosing SRC are clinically oriented and that there is no gold/standard to assess their diagnostic properties. A future, more valid definition of SRC would better identify concussed players by demonstrating high predictive positive/negative values. Currently, the use of helmet-based systems to study the biomechanics of SRC is limited to few collision sports. New approaches need to be developed to provide objective markers for SRC. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved.
Whose research agenda is it? Reconciling the views of researchers and sports stakeholders
- Authors: Finch, Caroline
- Date: 2017
- Type: Text , Journal article , Editorial
- Relation: British Journal of Sports Medicine Vol. 51, no. 1 (2017), p. 3-4
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
- Full Text: false
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- Description: It is now widely recognised that it is important to involve a full range of stakeholders and other research end-users, from the outset when designing and implementing prevention programmes. As long ago as 2003, my team recognised that the views of those actively involved in sport should also be considered when setting research priorities. Findings from our survey of coaches and sports administrators have since informed the direction of much of our sports injury research over the following decade in community Australian Football. There will be similar examples from other sports, even if they have not been formally documented in the sports medicine literature.
But can someone like me do it? The importance of appropriate role modelling for safety behaviours in sports injury prevention
- Authors: White, Peta , Donaldson, Alex , Finch, Caroline
- Date: 2016
- Type: Text , Journal article , Editorial
- Relation: British Journal of Sports Medicine Vol. 50, no. 10 (2016), p. 569-570
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text: false
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- Description: Preventing sports injuries requires behaviour change. Observational learning, or role modelling, is one way to develop self-efficacy, a key behavioural determinant. This premise underpins the social cognitive theory (SCT), and is the reason why role models have such a strong influence on behaviour. Most human behaviour is learned by observing others. Therefore, understanding role modelling and how to use it effectively could be important for sports injury prevention.
Effects of exercise and manual therapy on pain associated with hip osteoarthritis : A systematic review and meta-analysis
- Authors: Beumer, Lucy , Wong, Jennie , Warden, Stuart , Kemp, Joanne , Foster, Paul , Crossley, Kay
- Date: 2016
- Type: Text , Journal article , Review
- Relation: British Journal of Sports Medicine Vol. 50, no. 8 (2016), p. 458-463
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- Description: Aim: To explore the effects of exercise (water-based or land-based) and/or manual therapies on pain in adults with clinically and/or radiographically diagnosed hip osteoarthritis (OA). Methods: A systematic review and meta-analysis was performed, with patient reported pain assessed using a visual analogue scale (VAS) or the Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain subscale. Data were grouped by follow-up time (0-3 months=short term; 4-12 months=medium term and; >12 months=long term), and standardised mean differences (SMD) with 95% CIs were used to establish intervention effect sizes. Study quality was assessed using modified PEDro scores. Results: 19 trials were included. Four studies showed short-term benefits favouring water-based exercise over minimal control using the WOMAC pain subscale (SMD -0.53, 95% CI -0.96 to -0.10). Six studies supported a short-term benefit of land-based exercise compared to minimal control on VAS assessed pain (SMD -0.49, 95% CI -0.70 to -0.29). There were no medium (SMD -0.23, 95% CI -0.48 to 0.03) or long (SMD -0.22, 95% CI -0.51 to 0.06) term benefits of exercise therapy, or benefit of combining exercise therapy with manual therapy (SMD -0.38, 95% CI -0.88 to 0.13) when compared to minimal control. Conclusions: Best available evidence indicates that exercise therapy (whether land-based or water-based) is more effective than minimal control in managing pain associated with hip OA in the short term. Larger highquality RCTs are needed to establish the effectiveness of exercise and manual therapies in the medium and long term.
Increasing compliance with neuromuscular training to prevent ankle sprain in sport : Does the 'Strengthen your ankle' mobile App make a difference? A randomised controlled trial
- Authors: van Reijen, Miriam , Vriend, Ingrid , Zuidema, Victor , van Mechelen, Willem , Verhagen, Evert
- Date: 2016
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 50, no. 19 (2016), p. 1200-1205
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- Description: Background: E-health has the potential to facilitate implementation of effective measures to prevent sports injuries. Aim: We evaluated whether an interactive mobile application containing a proven effective exercise programme to prevent recurrent ankle sprains resulted in higher compliance as compared with regular written exercise materials. Methods: 220 athletes participated in this randomised controlled trial with a follow-up of 8 weeks; 110 athletes received a booklet explaining an 8-week neuromuscular training programme; 110 athletes participated in the same programme in an interactive mobile App (Strengthen your ankle). The primary outcome was compliance with the exercise programme. Secondary outcome measure was the incidence density of self-reported recurrent ankle sprains. Results: The mean compliance to the exercise scheme was 73.3% (95% CI 67.7% to 78.1%) in the App group, compared with 76.7% (95% CI 71.9% to 82.3%) in the Booklet group. No significant difference in compliance was found between groups. The incidence densities of self-reported time-loss recurrences were not significantly different between both groups (HR 3.07; 95% CI 0.62 to 15.20). Summary: This study shows that the method of implementing the exercises by using an App or a Booklet does not lead to different compliance rates. New findings: The use of a mobile App or a Booklet lead to similar compliance and injury rates in the short term. Trial registration number: The Netherlands National Trial Register NTR 4027. The NTR is part of the WHO Primary Registries. © 2016, BMJ Publishing Group. All rights reserved.
International consensus statement on injury surveillance in cricket : A 2016 update
- Authors: Orchard, John , Ranson, Craig , Olivier, Benita , Dhillon, Mandeep , Gray, Janine , Langley, Ben , Mansingh, Akshai , Moore, Isabel , Murphy, Ian , Patricios, Jon , Alwar, Thiagarajan , Clark, Christopher , Harrop, Brett , Khan, Hussain , Kountouris, Alex , Macphail, Mairi , Mount, Stephen , Mupotaringa, Anesu , Newman, David , O'Reilly, Kieran , Peirce, Nicholas , Saleem, Sohail , Shackel, Dayle , Stretch, Richard , Finch, Caroline
- Date: 2016
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 50, no. 20 (2016), p. 1245-1251
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- Description: Cricket was the first sport to publish recommended methods for injury surveillance in 2005. Since then, there have been changes to the nature of both cricket and injury surveillance. Researchers representing the major cricket playing nations met to propose changes to the previous recommendations, with an agreed voting block of 14. It was decided that 10 of 14 votes (70%) were required to add a new definition element and 11 of 14 (80%) were required to amend a previous definition. In addition to the previously agreed 'Match time-loss' injury, definitions of 'General time-loss', 'Medical presentation', 'Player-reported' and 'Imaging-abnormality' injuries are now provided. Further, new injury incidence units of match injuries per 1000 player days, and annual injuries per 100 players per year are recommended. There was a shift towards recommending a greater number of possible definitions, due to differing contexts and foci of cricket research (eg, professional vs amateur; injury surveillance systems vs specific injury category studies). It is recommended that researchers use and report as many of the definitions as possible to assist both comparisons between studies within cricket and with those from other sports.
It will take more than an existing exercise programme to prevent injury
- Authors: O'Brien, James , Donaldson, Alex , Finch, Caroline
- Date: 2016
- Type: Text , Journal article , Editorial
- Relation: British Journal of Sports Medicine Vol. 50, no. 5 (Mar 2016), p. 264-265
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
- Full Text: false
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- Description: In 1983, Ekstrand et al published the first randomised controlled trial (RCT) of an injury prevention programme for team ball sport. Three decades on from this landmark study, it is worth reflecting on the progress made and the current ‘state-of-play’ in the field of team ball sport injury prevention research. The volume of published research has grown considerably with a recent systematic review of team ball sport injury prevention exercise programmes (IPEPs) identifying over 50 published trials. The scale, quality and outcomes of recent RCTs are also encouraging with a Swedish trial including over 4500 female soccer players and demonstrating a 64% reduction in the rate of anterior cruciate ligament (ACL) injuries.
Sports-related workload and injury risk : Simply knowing the risks will not prevent injuries : Narrative review
- Authors: Drew, Michael , Cook, Jill , Finch, Caroline
- Date: 2016
- Type: Text , Journal article , Review
- Relation: British Journal of Sports Medicine Vol. 50, no. 21 (2016), p. 1306-1309
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
- Full Text: false
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- Description: Training loads contribute to sports injury risk but their mitigation has rarely been considered in a sports injury prevention framework. A key concept behind monitoring training loads for injury prevention is to screen for those at increased risk of injury so that workloads can be adjusted to minimise these risks. This review describes how advances in management of workload can be applied as a preventive measure. Primary prevention involves screening for preparticipation load risk factors, such as low training loads, prior to a training period or competition. Secondary prevention involves screening for workloads that are known to precede an injury developing so that modification can be undertaken to mitigate this risk. Tertiary prevention involves rehabilitation practices that include a graded return to training programme to reduce the risk of sustaining a subsequent injury. The association of training loads with injury incidence is now established. Prevention measures such as rule changes that affect the workload of an athlete are universal whereas those that address risk factors of an asymptomatic subgroup are more selective. Prevention measures, when implemented for asymptomatic individuals exhibiting possible injury risk factors, are indicated for an athlete at risk of developing a sports injury. Seven key indicated risks and associated prevention measures are proposed.
Tendon neuroplastic training : Changing the way we think about tendon rehabilitation : A narrative review
- Authors: Rio, Ebonie , Kidgell, Dawson , Lorimer Moseley, Graham , Gaida, Jamie , Docking, Sean , Purdam, Craig , Cook, Jill
- Date: 2016
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 50, no. 4 (2016), p. 209-215
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- Description: Tendinopathy can be resistant to treatment and often recurs, implying that current treatment approaches are suboptimal. Rehabilitation programmes that have been successful in terms of pain reduction and return to sport outcomes usually include strength training. Muscle activation can induce analgesia, improving self-efficacy associated with reducing one's own pain. Furthermore, strength training is beneficial for tendon matrix structure, muscle properties and limb biomechanics. However, current tendon rehabilitation may not adequately address the corticospinal control of the muscle, which may result in altered control of muscle recruitment and the consequent tendon load, and this may contribute to recalcitrance or symptom recurrence. Outcomes of interest include the effect of strength training on tendon pain, corticospinal excitability and short interval cortical inhibition. The aims of this concept paper are to: (1) review what is known about changes to the primary motor cortex and motor control in tendinopathy, (2) identify the parameters shown to induce neuroplasticity in strength training and (3) align these principles with tendon rehabilitation loading protocols to introduce a combination approach termed as tendon neuroplastic training. Strength training is a powerful modulator of the central nervous system. In particular, corticospinal inputs are essential for motor unit recruitment and activation; however, specific strength training parameters are important for neuroplasticity. Strength training that is externally paced and akin to a skilled movement task has been shown to not only reduce tendon pain, but modulate excitatory and inhibitory control of the muscle and therefore, potentially tendon load. An improved understanding of the methods that maximise the opportunity for neuroplasticity may be an important progression in how we prescribe exercise-based rehabilitation in tendinopathy for pain modulation and potentially restoration of the corticospinal control of the muscle-tendon complex.
Boxing headguard performance in punch machine tests
- Authors: McIntosh, Andrew , Patton, Declan
- Date: 2015
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 49, no. 17 (2015), p. 1108-1112
- Full Text: false
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- Description: Background: The paper presents a novel laboratory method for assessing boxing headguard impact performance. The method is applied to examine the effects of headguards on head impact dynamics and injury risk. Methods: A linear impactor was developed, and a range of impacts was delivered to an instrumented Hybrid III head and neck system both with and without an AIBA (Association Internationale de Boxe Amateur)- approved headguard. Impacts at selected speeds between 4.1 and 8.3 m/s were undertaken. The impactor mass was approximately 4 kg and an interface comprising a semirigid 'fist' with a glove was used. Results: The peak contact forces were in the range 1.9-5.9 kN. Differences in head impact responses between the Top Ten AIBA-approved headguard and bare headform in the lateral and forehead tests were large and/or significant. In the 8.3 m/s fist-glove impacts, the mean peak resultant headform accelerations for bare headform tests was approximately 130 g compared with approximately 85 g in the forehead impacts. In the 6.85 m/s bare headform impacts, mean peak resultant angular head accelerations were in the range of 5200-5600 rad/s
Caution this drug may cause serious harm! why we must report adverse effects of physical activity promotion
- Authors: Verhagen, Evert , Bolling, Caroline , Finch, Caroline
- Date: 2015
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 49, no. 1 (January 2015), p. 1-2
- Full Text: false
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Competing with injuries : Injuries prior to and during the 15th FINA World Championships 2013 (aquatics)
- Authors: Mountjoy, Margo , Junge, Astrid , Benjamen, Sarah , Boyd, Kevin , Diop, Mohamed , Gerrard, David , van den Hoogenband, Cees-Rein , Marks, Saul , Martinez-Ruiz, Enrique , Miller, Jim , Nanousis, Kyriakos , Shahpar, Farhad , Veloso, Jose , van Mechelen, Willem , Verhagen, Evert
- Date: 2015
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 49, no. 1 (2015), p. 37-43
- Full Text: false
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- Description: Background: Injury and illness surveillance is the foundation for the development of prevention strategies. Objective: To examine injuries among the aquatic disciplines in the 4 weeks prior to and during the 2013 FINA World Championships. Methods: The study was comprised of two components: (1) a retrospective athlete survey recording injuries in the 4 weeks prior to the Championships and (2) a prospective recording of injuries and illnesses by the medical teams of the participating countries and the local host medical team. Results: One-third of the 1116 responding athletes reported an injury/physical complaint in the 4 weeks prior to the Championships. Significantly more women (36.7%) than men (28.6%) reported injuries. Divers reported the highest rate of injury/physical complaints (55.7%). At the start of the Championships, 70% of injured respondents (n=258) were still symptomatic; however, full participation was expected by 76%. During the Championships, 186 new injuries were reported (8.3/100 registered athletes) with the highest injury incidence rate in water polo (15.3/100 registered athletes). The most common injured body part was the shoulder (21%). A total of 199 illnesses were reported during the Championships (9.0/100 registered athletes) with the most common diagnosis of illness being gastrointestinal infection. Environmental exposure (allergy, otitis and jellyfish stings) was responsible for 27% of all illnesses in open water swimming. Conclusions: Injuries pose a significant health risk for elite aquatic athletes. A prospective study would improve understanding of out-of-competition injuries. Future injury and illness surveillance at FINA World Championships is required to direct and measure the impact of prevention strategies.
Patient-Reported Outcome (PRO) questionnaires for young to middle-aged adults with hip and groin disability : A systematic review of the clinimetric evidence
- Authors: Thorborg, Kristian , Tijssen, M. , Habets, B. , Bartels, Else , Roos, Ewa , Kemp, Joanne , Crossley, Kay , Hölmich, Per
- Date: 2015
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 49, no. 12 (2015), p. 812
- Full Text: false
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- Description: Background/aim: To recommend Patient-Reported Outcome (PRO) questionnaires to measure hip and groin disability in young-aged to middle-aged adults. Methods: A systematic review was performed in June 2014. The methodological quality of the studies included was determined using the COnsensus-based Standards for the selection of health Measurement INstruments list (COSMIN) together with standardised evaluations of measurement properties of each PRO. Results: Twenty studies were included. Nine different questionnaires for patients with hip disability, and one for hip and groin disability, were identified. Hip And Groin Outcome Score (HAGOS), Hip Outcome Score (HOS), International Hip Outcome Tool-12 (IHOT-12) and IHOT-33 were the most thoroughly investigated PROs and studies including these PROs reported key aspects of the COSMIN checklist. HAGOS and IHOT-12 were based on studies with the least ratings of poor study methodology (23% and 31%, respectively), whereas IHOT-33 and HOS had a somewhat larger distribution (46%). These PROs all contain adequate measurement qualities for content validity (except HOS), test-retest reliability, construct validity, responsiveness and interpretability. No information or poor quality rating on methodological aspects made it impossible to fully evaluate the remaining PROs at present. Conclusions: HAGOS, HOS, IHOT-12 and IHOT-33 can be recommended for assessment of young-aged to middle-aged adults with pain related to the hip joint, undergoing non-surgical treatment or hip arthroscopy. At present, HAGOS is the only PRO also aimed for young-aged to middle-aged adults presenting with groin pain and is recommended for use in this population. Trial registration number: CRD42014009995. © 2015, BMJ Publishing Group. All rights reserved.
Protecting the health of the @hlete : how online technology may aid our common goal to prevent injury and illness in sport
- Authors: Verhagen, Evert , Bolling, Caroline
- Date: 2015
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 49, no. 18 (2015), p. 1174-1178
- Full Text: false
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- Description: Online technology dominates our era and eHealth has become a reality for sports clinicians and researchers. Contemporary online platforms enable self-monitoring and provide tailored feedback to the different stakeholders who play a role in the health and care of athletes. Innovations such as digital monitoring, mobile applications and connected hardware provide the critical tools to solve current enigmas in sports medicine research, and to streamline and facilitate injury prevention, management and rehabilitation. eHealth is not an emerging future of sports medicine-the technology to move our field forward in terms of research and practice is already available. This Analysis is based on Evert Verhagen's keynote presentation at the IOC World Conference on Injury and Illness Prevention in Sport (Monaco, 12 April 2014). It outlines the use of eHealth in research, implementation and practice, and provides an overview of possibilities and opportunities that existing and emerging eHealth solutions provide for sports and exercise medicine and physiotherapy.
Rehabilitation will increase the 'capacity' of your.... -insert musculoskeletal tissue here..... Defining 'tissue capacity': A core concept for clinicians
- Authors: Cook, Jill , Docking, Sean
- Date: 2015
- Type: Text , Journal article , Editorial
- Relation: British Journal of Sports Medicine Vol. 49, no. 23 (2015), p. 1484-1485
- Full Text: false
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- Description: Capacity is a helpful term in clinical practice to indicate to clients that they (and more importantly their musculoskeletal tissues) are either able or unable to complete a task or participate in physical activity. In the context of injury—having exceeded the capacity of the tissue—the term has immediacy for muscle and ligament: a musculotendinous or ligament strain is an acute injury due to a loading event beyond the tissue's capacity. The tissue response in tendon is usually more gradual—acute traumatic injury of normal tendon is rare, whereas the pathological tendon can fail catastrophically (rupture).
The impact performance of headguards for combat sports
- Authors: McIntosh, Andrew , Patton, Declan
- Date: 2015
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 49, no. 17 (2015), p. 1113-1117
- Full Text: false
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- Description: Background/aim: To assess the impact energy attenuation performance of a range of headguards for combat sports. Methods: Seven headguards worn during combat sport training or competition, including two Association Internationale de Boxe Amateur (AIBA)-approved boxing models, were tested using drop tests. An International Organization for Standardization (ISO) rigid headform was used with a 5.6 kg drop assembly mass. Tests were conducted against a flat rigid anvil both with and without a boxing glove section. The centre forehead and lateral headguard areas were tested. Peak headform acceleration was measured. Tests from a selection of drop heights and repeated tests on the same headguard were conducted. Results: Headguard performance varied by test condition. For the 0.4 m rigid anvil tests, the best model headguard was the thickest producing an average peak headform acceleration over 5 tests of 48 g compared with 456 g for the worst model. The mean peak acceleration for the 0.4, 0.5 and 0.6 frontal and lateral rigid anvil impact tests was between 32% and 40% lower for the Top Ten boxing model compared with the Adidas boxing model. The headguard performance deterioration observed with repeat impact against the flat anvil was reduced for impacts against the glove section. The overall reduction in acceleration for the combination of glove and headguard in comparison to the headguard condition was in the range of 72-93% for 0.6 and 0.8 m drop tests. Conclusions: The impact tests show the benefits of performance testing in identifying differences between headguard models.
Ensuring implementation success: how should coach injury prevention education be improved if we want coaches to deliver safety programmes during training sessions?
- Authors: White, Peta , Otago, Leonie , Saunders, Natalie , Romiti, Maria , Donaldson, Alex , Ullah, Shahid , Finch, Caroline
- Date: 2014
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 48, no. 5 (2014), p. 402-403
- Relation: http://purl.org/au-research/grants/nhmrc/565900
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- Description: Coaches play a major role in encouraging and ensuring that participants of their teams adopt appropriate safety practices. However, the extent to which the coaches undertake this role will depend upon their attitudes about injury prevention, their perceptions of what the other coaches usually do and their own beliefs about how much control they have in delivering such programmes. Fifty-one junior netball coaches were surveyed about incorporating the teaching of correct (safe) landing technique during their delivery of training sessions to junior players. Overall, >94% of coaches had strongly positive attitudes towards teaching correct landing technique and >80% had strongly positive perceptions of their own control over delivering such programmes. Coaches’ ratings of social norms relating to what others think about teaching safe landing were more positive (>94%) than those relating to what others actually do (63–74%). In conclusion, the junior coaches were generally receptive towards delivering safe landing training programmes in the training sessions they led. Future coach education could include role modelling by prominent coaches so that more community-level coaches are aware that this is a behaviour that many coaches can, and do, engage in.
Independent appraiser assessment of the quality, methodological rigour and transparency of the development of the 2008 international consensus statement on concussion in sport
- Authors: White, Peta , Wong Shee, Anna , Finch, Caroline
- Date: 2014
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 48, no. 2 (2014), p. 130-134
- Relation: http://purl.org/au-research/grants/nhmrc/565900
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- Description: Aim: In recent years, considerable effort has been devoted to the development and revisions to an international consensus statement on concussion in sport (ICSCS). The aim of this study was to obtain expert views on the methodological rigour and transparency with which the 2008 ICSCS was developed, as a precursor to the development of the 2012 update. Methods: Delegates registered for the 2012 fourth International Conference on Concussion in Sport, selected local concussion researchers not involved in any prior international consensus meetings, and all authors of the 2008 ICSCS published paper were invited to assess the methodological rigour and transparency with which the 2008 ICSCS was developed. The online Appraisal of Guidelines for Research and Evaluation (AGREE) II assessment tool, with six quality domains, was used and domain scores were expressed as a percentage of the maximum possible score for that domain. Results: 18 appraisers completed the online AGREE II assessment. Ten appraisers said they would recommend the 2008 ICSCS for use (without modification) and seven said they would recommend its use with some modification. The 'scope and purpose' and 'clarity of presentation' were rated highest, both scoring 78%. The lowest scoring domain was 'applicability' with a score of 55%. Conclusions: The quality of the ICSCS is important because it is used to guide return-to-play decisions and the management of sport-related concussions. This appraisal of the 2008 ICSCS suggests that a greater focus is needed on the actual implementation of future ICSCS and the relationship between implementation and desired health outcomes.
Knowledge about sports-related concussion: is the message getting through to coaches and trainers?
- Authors: White, Peta , Newton, Joshua , Makdissi, Michael , Sullivan, John , Davis, Gavin , McCrory, Paul , Donaldson, Alex , Ewing, Michael , Finch, Caroline
- Date: 2014
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 48, no. 2 (2014), p. 119-124
- Relation: http://purl.org/au-research/grants/nhmrc/565900
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- Description: Aim: The need for accurate diagnosis and appropriate return-to-play decisions following a concussion in sports has prompted the dissemination of guidelines to assist managing this condition. This study aimed to assess whether key messages within these guidelines are reflected in the knowledge of coaches and sports trainers involved in community sport. Methods: An online knowledge survey was widely promoted across Australia in May–August 2012 targeting community Australian Football (AF) and Rugby League (RL) coaches and sports trainers. 260 AF coaches, 161 AF sports trainers, 267 RL coaches and 228 RL sports trainers completed the survey. Knowledge scores were constructed from Likert scales and compared across football codes and respondent groups. Results: General concussion knowledge did not differ across codes but sports trainers had higher levels than did coaches. There were no significant differences in either concussion symptoms or concussion management knowledge across codes or team roles. Over 90% of respondents correctly identified five of the eight key signs or symptoms of concussion. Fewer than 50% recognised the increased risk of another concussion following an initial concussion. Most incorrectly believed or were uncertain that scans typically show damage to the brain after a concussion occurs. Fewer than 25% recognised, and >40% were uncertain that younger players typically take longer to recover from concussion than adults. Conclusions: The key messages from published concussion management guidelines have not reached community sports coaches and sports trainers. This needs to be redressed to maximise the safety of all of those involved in community sport.