Description:
Background: Knee injuries are a major injury concern for Australian Football players and participants of many other sports worldwide. There is increasing evidence from laboratory and biomechanically focused studies about the likely benefit of targeted exercise programmes to prevent knee injuries. However, there have been few international studies that have evaluated the effectiveness of such programmes in the real-world context of community sport that have combined epidemiological, behavioural and biomechanical approaches. Objective: To implement a fully piloted and tested exercise training intervention to reduce the number of football-related knee injuries. In so doing, to evaluate the intervention's effectiveness in the real-world context of community football and to determine if the underlying neural and biomechanical training adaptations are associated with decreased risk of injury. Setting: Adult players from community-level Australian Football clubs in two Australian states over the 2007-08 playing seasons. Methods: A group-clustered randomised controlled trial with teams of players randomly allocated to either a coach-delivered targeted exercise programme or usual behaviour (control). Epidemiological component: field- based injury surveillance and monitoring of training/game exposures. Behavioural component: evaluation of player and coach attitudes, knowledge, behaviours and com- pliance, both before and after the intervention is implemented. Biomechanical component: biomechanical, game mobility and neuromuscular parameters assessed to determine the fundamental effect of training on these factors and injury risk. Outcome measures: The rate and severity of injury in the intervention group compared with the control group. Changes, if any, in behavioural components. Process evaluation: coach delivery factors and likely sustainability.
Description:
Introduction: Child sport participation, both in Australia and internationally, has increased during the past decade and the health benefits associated with child sport participation are now well established. Some evidence suggests that sport participation contributes importantly to children's overall levels of physical activity, thus helping to reduce the risk of childhood obesity and associated childhood diseases. Although the benefits of sport participation are known, sport injury among children has become an international public health concern and it remains unclear how sport injury impacts children's long-term sport involvement. This research aimed to undertake a qualitative investigation of the impact of sport injury experiences and injury risk perceptions on children's on-going sport participation. Methods: Focus group discussions, each with 6–10 children who were involved in an organised (after school) sport, were conducted until saturation of themes was obtained. Children were recruited from sports including badminton, soccer, golf, swimming, dance, netball and cricket and participated at a community or sub-elite level. Each focus group session was approximately 30 min in duration. Questions focussed on children's sport participation, reasons for their continuation or discontinuation of sport involvement, the encouragement or discouragement they received from parents, any injuries they had sustained while participating and whether sport injury discouraged children or their parents from child sport participation in the future. The qualitative research software NVivo was used to analyse the discussions. Results/conclusion: Few children were concerned about the risk of sport injury while participating in sport. However, many children discussed not wanting to play sports such as football, rugby or boxing, perceiving these sports as too rough, and with increased chance of injury. The main reasons children reported for discontinuation of sport involvement were lack of enjoyment and restrictions of their time. Children reported parents to be supportive of their sport behaviours regardless of safety concerns. No instances of parents preventing child sport involvement were reported by children. This study forms part of a larger study, to determine the influence of child and parent injury perceptions on sport choice and participation. Findings will inform sporting bodies of sport injury and safety concerns held by children and their parents, highlighting areas that can be targeted in order to retain child participants.
Description:
The multi-purpose recreation facilities (MPRF) users' perceptions of the safety-related policies and practices within those facilities are discussed. Some of the measures that can be applied by MPRF managers and others to promote safety in these facilities are highlighted.
Description:
Objective: To determine the rate of injury in junior Australian football, and to describe the patterns and severity of these injuries across nine levels of play (U9 to U18). Design: Prospective cohort study. Setting: Junior Australian football games and training sessions were observed for 54 teams from New South Wales and Victoria over the 2004 playing season. Participants: Six teams from each level of play were invited to participate in the study. Overall, data were collected for 51 teams over 40 208 hours of player exposure. Independent variables: Participation and injury data were collected prospectively. Main outcome measures: Injury was defined as "any trauma that causes some disability or pain''. Injury severity was identified by the action of players immediately after the injury event. Results: The overall injury rate was 18.0 (95% CI 16.6 to 19.3) injuries per 1000 player hours. The main cause of injury was body contact (67.3%). There was an increased frequency of sprains and strains, and injury severity with increasing level of play. The rates of injury for players who stayed off the field (6.4 injuries per 1000 hours, 95% CI 5.6 to 7.2) or were advised to seek off-field medical advice (5.0 injuries per 1000 hours, 95% CI 4.3 to 5.7) were low. Conclusion: Compared with the adult game, junior Australian football is relatively safe. However, injury rates increase as children progress across age-determined levels of play towards the more adult form of the game.
Description:
Objective: To determine the factors that influence appropriate restraint usage by child occupants across the age range for which any type of child restraint may be appropriate (0-10 years). Design: Randomized household telephone survey. Setting: Statewide survey, New South Wales, Australia. Subjects: Parents or carers of children aged 0-10 years. Main outcome measures: Parental reporting of appropriateness of child restraint. Methods: Demographic information and data on age, size, restraint practices, parental knowledge of child occupant safety, and attitude to restraint use was collected using a structured interview. Data were analysed using logistic regression after cluster adjustment. Results: Inappropriate restraint use by children was widespread, particularly in children aged 2+ years. Overall, parental knowledge of appropriate ages for restraint transitions was associated with increased likelihood of appropriate restraint use. Lower levels of formal parental education, larger families, parental restraint non-use, and parent/child negotiability of restraint use were predictors of inappropriate restraint use. For particular child age subgroups, the parental knowledge that predicted appropriate restraint use was specific to that age group. Most parents felt that they knew enough to safely restrain their child, despite widespread inappropriate restraint use. Conclusions: Parents are more likely to make appropriate restraint choices for their children if they possess restraint knowledge specific to their children's age and size. Educational campaigns may be most effective when they provide information for specific ages and transition points. Strategies to overcome parents' misplaced confidence that they know enough to restrain their children safely are also indicated.
Description:
Objective: To determine the factors that influence appropriate restraint usage by child occupants across the age range for which any type of child restraint may be appropriate (0-10 years). Design: Randomized household telephone survey. Setting: Statewide survey, New South Wales, Australia. Subjects: Parents or carers of children aged 0-10 years. Main outcome measures: Parental reporting of appropriateness of child restraint. Methods: Demographic information and data on age, size, restraint practices, parental knowledge of child occupant safety, and attitude to restraint use was collected using a structured interview. Data were analysed using logistic regression after cluster adjustment. Results: Inappropriate restraint use by children was widespread, particularly in children aged 2+ years. Overall, parental knowledge of appropriate ages for restraint transitions was associated with increased likelihood of appropriate restraint use. Lower levels of formal parental education, larger families, parental restraint non-use, and parent/child negotiability of restraint use were predictors of inappropriate restraint use. For particular child age subgroups, the parental knowledge that predicted appropriate restraint use was specific to that age group. Most parents felt that they knew enough to safely restrain their child, despite widespread inappropriate restraint use. Conclusions: Parents are more likely to make appropriate restraint choices for their children if they possess restraint knowledge specific to their children's age and size. Educational campaigns may be most effective when they provide information for specific ages and transition points. Strategies to overcome parents' misplaced confidence that they know enough to restrain their children safely are also indicated.
Description:
Objective: To investigate the association between restraint use and death in rear-seated child passengers and to examine whether the estimated association varies by restraint type and age. Design: Matched cohort study. Setting: All reported crashed passenger vehicles with at least 2 rear-seated child passengers of whom at least 1 died from the US Fatality Analysis Reporting System for 1998 to 2006. Participants: Rear-seated child passengers aged 2 to 6 years. Interventions: Three models of restraint use: (1) no restraint use, any restraint use; (2) no restraint use, recorded improper restraint use (including improper use of seat belts or child restraints, use of shoulder-only seat belts, and use of an unknown type of restraint), any other restraint use; and (3) no restraint use, improper restraint use, seat belts, and child restraints. Main Outcome Measure: Death within 30 days of a crash. Results: Compared with no restraint use, being restrained reduced the risk of death in rear-seated child passengers (relative risk [RR], 0.33; 95% confidence interval [CI], 0.22-0.49). Compared with improper restraint use, any other restraint use reduced the risk of death (RR, 0.46; 95% CI, 0.20-0.63). The RR of death for using child restraints compared with seat belts was 0.91 (95% CI, 0.57-1.14). Child restraints performed slightly better in fatality risk reduction in children aged 2 to 3 years (RR, 0.24; 95% CI, 0.09-0.33) than in children aged 4 to 6 years (RR, 0.32; 95% CI, 0.11-0.44) compared with traveling unrestrained. Conclusions: This study demonstrates the protective effects of restraints for child passengers and highlights the importance of using restraints correctly.
Description:
Introduction: Published netball data have indicated that the ankle and knee are common sites for injury, often as a result of incorrect landing technique. Promising results have been demonstrated across various sports using training intervention studies designed to reduce lower limb injury rates. This qualitative study examines the barriers and facilitators towards the implementation of a 6-week landing intervention program (“Down to Earth”) by coaches of junior netball teams. Methodology: Coaches of junior teams (n = 30) were recruited prior to the competition season (October 2007 to March 2008) and attended a workshop where the coaching requirements of the program were demonstrated. Coaches were instructed to implement the program at training, noting any issues regarding program compliance. Pre- and post-season surveys modelled on the Theory of Planned Behaviour were used to indicate coaches’ attitudes, perceived social norms and behavioural control towards safe landing programs in netball. Retention of correct landing principles was assessed and barriers and facilitators for broader implementation among junior netball coaches were determined. Results and discussion: Results will be presented to indicate how coaches’ attitudes and knowledge towards landing intervention programs can assist in the development of an effective implementation strategy of a training injury prevention intervention, to a broader netball community. An example of feedback provided was”…we have noticed quite an improvement in the kids, and their landing and balancing, so it is all been worth while. We were also discussing…about including the program into our junior training next year and how best to do this”.
Comparison of methods to correct the miscounting of multiple episodes of care when estimating the incidence of hospitalised injury in child motor vehicle passengers