Statistical modelling for falls count data
- Authors: Ullah, Shahid , Finch, Caroline , Day, Lesley
- Date: 2010
- Type: Text , Journal article
- Relation: Accident Analysis and Prevention Vol. 42, no. 2 (2010), p. 384-392
- Relation: http://purl.org/au-research/grants/nhmrc/565900
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- Description: Falls and their injury outcomes have count distributions that are highly skewed toward the right with clumping at zero, posing analytical challenges. Different modelling approaches have been used in the published literature to describe falls count distributions, often without consideration of the underlying statistical and modelling assumptions. This paper compares the use of modified Poisson and negative binomial (NB) models as alternatives to Poisson (P) regression, for the analysis of fall outcome counts. Four different count-based regression models (P, NB, zero-inflated Poisson (ZIP), zero-inflated negative binomial (ZINB)) were each individually fitted to four separate fall count datasets from Australia, New Zealand and United States. The finite mixtures of P and NB regression models were also compared to the standard NB model. Both analytical (F, Vuong and bootstrap tests) and graphical approaches were used to select and compare models. Simulation studies assessed the size and power of each model fit. This study confirms that falls count distributions are over-dispersed, but not dispersed due to excess zero counts or heterogeneous population. Accordingly, the P model generally provided the poorest fit to all datasets. The fit improved significantly with NB and both zero-inflated models. The fit was also improved with the NB model, compared to finite mixtures of both P and NB regression models. Although there was little difference in fit between NB and ZINB models, in the interests of parsimony it is recommended that future studies involving modelling of falls count data routinely use the NB models in preference to the P or ZINB or finite mixture distribution. The fact that these conclusions apply across four separate datasets from four different samples of older people participating in studies of different methodology, adds strength to this general guiding principle. © 2009 Elsevier Ltd. All rights reserved.
Statistical modelling for recurrent events : An application to sports injuries
- Authors: Ullah, Shahid , Gabbett, Tim , Finch, Caroline
- Date: 2014
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 48, no. 17 (2014), p. 1287-1293
- Relation: http://purl.org/au-research/grants/nhmrc/565900
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- Description: Background: Injuries are often recurrent, with subsequent injuries influenced by previous occurrences and hence correlation between events needs to be taken into account when analysing such data. Objective: This paper compares five different survival models (Cox proportional hazards (CoxPH) model and the following generalisations to recurrent event data: Andersen-Gill (A-G), frailty, Wei-Lin-Weissfeld total time (WLW-TT) marginal, Prentice-Williams-Peterson gap time (PWP-GT) conditional models) for the analysis of recurrent injury data. Methods: Empirical evaluation and comparison of different models were performed using model selection criteria and goodness-of-fit statistics. Simulation studies assessed the size and power of each model fit. Results: The modelling approach is demonstrated through direct application to Australian National Rugby League recurrent injury data collected over the 2008 playing season. Of the 35 players analysed, 14 (40%) players had more than 1 injury and 47 contact injuries were sustained over 29 matches. The CoxPH model provided the poorest fit to the recurrent sports injury data. The fit was improved with the A-G and frailty models, compared to WLW-TT and PWP-GT models. Conclusions: Despite little difference in model fit between the A-G and frailty models, in the interest of fewer statistical assumptions it is recommended that, where relevant, future studies involving modelling of recurrent sports injury data use the frailty model inpreference to the CoxPH model or its other generalisations. The paper provides a rationale for future statistical modelling approaches for recurrent sports injury.
The causes of injuries sustained at fitness facilities presenting to Victorian emergency departments - identifying the main culprits
- Authors: Gray, Shannon , Finch, Caroline
- Date: 2015
- Type: Text , Journal article
- Relation: Injury Epidemiology Vol. 2, no. 1 (2015), p. 1-8
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- Description: BACKGROUND: Fitness facilities provide an avenue to engage in physical activity, which is widely encouraged to improve health. However, there is risk of injury. This study aimed to identify the specific causes of injuries sustained at fitness facilities and the activity being participated in, to aid in the development of injury prevention strategies. METHODS: Analysis of routinely collected emergency department case-series data were obtained from July 1999 to June 2013. Fitness activity-related injury cases were identified from narratives of injury events, with narrative information recoded into cause of injury and activity at time of injury categories. Recoded data were then analysed. RESULTS: Overall, 2,873 cases were identified that specified the exact cause of injury associated with injuries that occurred at fitness facilities. Injuries due to overexertion were most common overall (36.2% of all cases), as well as the main cause of injuries related to general free weight activities (52.6% of this activity) and group exercise classes (35.9%). Crush injuries due to falling weights were common for all free weight activities. Falls and awkward landings were common causes of injuries during group exercise classes (28.5% and 25.8%, respectively). Trips and falls were common throughout facilities, as well as from cardiovascular equipment more specifically. CONCLUSIONS: Detailed information on the causes of injuries allows the development of injury prevention strategies for fitness facilities and fitness activities. Facilities should implement risk management strategies to reduce the risk of injuries in their clientele, based on the identified major causes of injury in this study.
The characteristics of incorrect restraint use among children traveling in cars in New South Wales, Australia
- Authors: Brown, Julie , Hatfield, Julie , Du, Wei , Finch, Caroline , Bilston, Lynne
- Date: 2010
- Type: Text , Journal article
- Relation: Traffic Injury Prevention Vol. 11, no. 4 (2010), p. 391-398
- Relation: http://purl.org/au-research/grants/nhmrc/565900
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- Description: Objective: This study aims to provide population estimates of incorrect restraint use among children aged 0-12 traveling in cars in New South Wales (NSW) and describe the errors occurring in different restraint types. Methods: Observations of randomly selected children and restraints were conducted in situ by trained researchers at sites statewide. Observation sites were randomly selected using a multistage stratified sample plan. Restraint use errors were recorded and analyzed by severity of error and restraint type using complex survey analysis techniques. Results: One in two children was incorrectly restrained, and 38 percent in a serious manner. Multiple errors were common (31% of children). Both installation and "securing" errors were common, with installation errors more common in convertible restraints (rearward-facing/forward-facing restraints and forward-facing restraints/booster seats) than singlemode restraints (odds ratio [OR] 4.3; 95% confidence interval [CI] 1.7-10.8). Multiple errors were more common in convertible restraints (OR 3.6; 95% CI 1.9-7.0). The most frequently observed errors were excessive seat belt slack (>25 mm), incorrect belt routing, nonengagement of the seat belt buckle, very loose harness (>25 mm slack), harness off the shoulder, nonuse of belt guides, sash belt worn under the arm, and very twisted harnesses and belts (>2 twists). For rearwardand forward-facing restraints the highest priorities in terms of frequency and degradation in crash protection are errors related to harness use. For booster seat users the most important are those related to correct seat belt and belt guide use. For seat belt users, errors related to correct positioning of the sash belt are key. Conclusions: The results indicate that many errors are currently occurring in the way children are using restraints, as well as problems associated with the way child restraint systems are installed in vehicles. Incorrect use is particularly problematic in convertible restraints (rearward-facing/forward-facing restraints and forward-facing restraints/booster seats). Different priorities, in terms of the frequency and potential degradation in crash protection due to incorrect use for different restraint types, exist and these are important for those designing countermeasures to this problem. © 2010 Taylor & Francis Group, LLC.
The Development of the Lunchtime Enjoyment of Activity and Play Questionnaire
- Authors: Hyndman, Brendon , Telford, Amanda , Finch, Caroline , Ullah, Shahid , Benson, Amanda
- Date: 2013
- Type: Text , Journal article
- Relation: Journal of School Health Vol. 83, no. 4 (2013), p. 256-264
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- Description: Background: Enjoyment of physical activity is as an important determinant of children's participation in physical activity. Despite this, there is an absence of reliable measures for assessing children's enjoyment of play activities during school lunchtime. The purpose of this study was to develop and assess the reliability of the Lunchtime Enjoyment of Activity and Play (LEAP) Questionnaire. Methods: Questionnaire items were categorized employing a social-ecological framework including intrapersonal (20 items), interpersonal (2 items), and physical environment/policy (17 items) components to identify the broader influences on children's enjoyment. An identical questionnaire was administered on 2 occasions, 10days apart, to 176 children aged 8-12years, attending a government elementary school in regional Victoria, Australia. RESULTS: Test-retest reliability confirmed that 35 of 39 LEAP Questionnaire items had at least moderate kappa agreement ranging from .44 to .78. Although 4 individual kappa values were low, median kappa scores for each aggregated social-ecological component reached at least moderate agreement (.44-.60). Conclusions: This study confirms the LEAP Questionnaire to be a reliable, context-specific instrument with sound content, and face validity that employs a social-ecological framework to assess children's enjoyment of school play and lunchtime activities. © 2013, American School Health Association.
- Description: 2003010857
The effectiveness of a squash eyewear promotion strategy
- Authors: Eime, Rochelle , Finch, Caroline , Wolfe, R. , Owen, Neville , McCarty, Catherine
- Date: 2005
- Type: Text , Journal article
- Relation: Britsh Journal of Sports Medicine Vol. 39, no. (2005), p. 681-684
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- Description: Objective: To evaluate the protective eyewear promotion (PEP) project, which was a comprehensive educational strategy to increase the use of appropriate protective eyewear by squash players. Methods: An ecological study design was used. Four squash venues in one playing association were randomly chosen to receive PEP and four in another association maintained usual practice and hence formed a control group. The primary evaluation measurements were surveys of cross sectional samples of players carried out before and after the intervention. The surveys investigated players’ knowledge, behaviours, and attitudes associated with the use of protective eyewear. The survey carried out after the intervention also determined players’ exposure to PEP. Univariate and multivariate analyses were undertaken to describe differences at PEP venues from pre- to post-intervention and to compare these with the control venues. Results: The PEP players had 2.4 times the odds (95% confidence interval, 1.3 to 4.2) of wearing appropriate eyewear compared with control group players post-intervention, relative to the groups’ preintervention baselines. Components of PEP, such as stickers and posters and the availability and prominent positioning of the project eyewear, were found to contribute to players adopting favourable eyewear behaviours. Conclusions: Components of the PEP intervention were shown to be effective. The true success will be the sustainability and dissemination of the project, favourable eyewear behaviours, and evidence of the prevention of eye injuries long into the future.
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- Description: 2003005015
The epistemic basis of distance running injury research : A historical perspective
- Authors: Hulme, Adam , Finch, Caroline
- Date: 2016
- Type: Text , Journal article , Editorial
- Relation: Journal of Sport and Health Science Vol. 5, no. 2 (2016), p. 172-175
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
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The evolution of multiagency partnerships for safety over the course of research engagement : Experiences from the NoGAPS project
- Authors: Finch, Caroline , Donaldson, Alex , Gabbe, Belinda , Muhammad, Akram , Shee, Anna Wong , Lloyd, David , Cook, Jill
- Date: 2016
- Type: Text , Journal article
- Relation: Injury Prevention Vol. 22, no. 6 (2016), p. 386-391
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
- Relation: http://purl.org/au-research/grants/nhmrc/565907
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- Description: Objective Implementation of effective population-level injury prevention interventions requires broad multiagency partnerships. Different stakeholders address this from varying perspectives, and potential conflicts in priorities need to be addressed for such partnerships to be effective. The researcher-led National Guidance for Australian football Partnerships and Safety (NoGAPS) project involved the engagement and participation of seven non-academic partners, including government health promotion and safety agencies; peak sports professional and advocacy bodies and health insurance organisations. Design The partnership's ongoing development was assessed by each partner completing the Victorian Health Promotion Foundation Partnership Analysis Tool (VPAT) annually over 2011-2015. Changes in VPAT scores were compared through repeated measures analysis of variance. Results Overall, mean total VPAT scores increased significantly over the 5-year period (125.1-141.2; F-5,F-30=4.61, p=0.003), showing a significant improvement in how the partnership was functioning over time. This was largely driven by significant increases in several VPAT domains: determining the need for a partnership' (F-5,F-30=4.15, p=0.006), making sure the partnership works' (F-5,F-30=2.59, p=0.046), planning collaborative action' (F-5,F-30=5.13, p=0.002) and minimising the barriers to the partnership' (F-5,F-30=6.66, p<0.001). Conclusion This is the first study to assess the functioning of a multiagency partnership to address sport injury prevention implementation. For NoGAPS, the engagement of stakeholders from the outset facilitated the development of new and/or stronger links between non-academic partners. Partners shared the common goal of ensuring the real-world uptake of interventions and research evidence-informed recommendations. Effective multiagency partnerships have the potential to influence the implementation of policies and practices beyond the life of a research project.
The impact of environmental, vehicle and driver characteristics on injury severity in older drivers hospitalized as a result of a traffic crash
- Authors: Boufous, Soufiane , Finch, Caroline , Hayen, Andrew , Williamson, Ann
- Date: 2008
- Type: Text , Journal article
- Relation: Journal of Safety Research Vol. 39, no. 1 (2008), p. 65-72
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- Description: Introduction: Compared to younger age groups, older people are more likely to be seriously injured or to die as a result of a traffic crash. Method: The aim of the study is to examine the impact of environmental, vehicle, crash, and driver characteristics on injury severity in older drivers involved in traffic crashes by using recently linked police crash records and hospitalization data from New South Wales, Australia. The severity of injury resulting from traffic crashes was measured using the International Classification of Diseases, 10th revision (ICD-10) Injury Severity Score (ICISS). Results: Multivariate analysis identified rurality, presence of complex intersections, road speed limit, driver error, speeding, and seat belt use as independent predictors of injury severity in older people. The type of intersection configuration explained over half of the observed variations in injury severity. Impact on Industry: Environmental modification such as intersection treatments might contribute to a decrease in the severity of injury in older people involved in road crashes.
- Description: 2003006544
The incidence and burden of hospital-treated sports-related injury in people aged 15+ years in Victoria, Australia, 2004-2010 : A future epidemic of osteoarthritis?
- Authors: Finch, Caroline , Kemp, Joanne , Clapperton, Angela
- Date: 2015
- Type: Text , Journal article
- Relation: Osteorthritis and Cartilage Vol. 23, no. 7 (2015), p. 1138-1143
- Relation: http://purl.org/au-research/grants/nhmrc/565900
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- Description: Objectives: Previous sports injury is a known risk factor for subsequent osteoarthritis (OA), but population-based rates of sports injury are unknown. The aims of this study were to: (1) describe the trends in the population incidence and burden of all hospital-treated sports injury in Victoria, Australia in adults aged 15+ years; (2) determine the incidence of lower limb and knee injuries; and (3) quantify their population health burden as average direct hospital costs per injury and lengths of stay. Methods: Health sector data relating to adults aged 15+ years, for 2004-2010 inclusive, was extracted from the Victorian Admitted Episodes Dataset (VAED) and Victorian Emergency Minimum Dataset (VEMD). Data relating to sports injuries were identified using activity codes in each dataset Trends in injury frequency and rates were determined, and economic burden was calculated. Results: The overall annual rate of hospital treated sports injuries increased by 24% (P = 0.001), and lower limb injuries by 26% (P = 0.001) over the 7 years. The associated accumulated economic burden was $265 million for all sports injuries and $110 million for lower limb injuries over the 7-years. Conclusions: The findings of this study show a significant increase in sports injuries in the state of Victoria, Australia over a 7-year period. As previous sports injury is a risk factor for the development of OA, the future incidence of OA will escalate, placing an even greater burden on health care systems. Population-wide preventative strategies that reduce the risk of sports injury are urgently required in order to reduce the future burden of OA. © 2015 Osteoarthritis Research Society International.
The policies and practices of sports governing bodies in relation to assessing the safety of sports grounds
- Authors: Swan, Peter , Otago, Leonie , Finch, Caroline , Payne, Warren
- Date: 2009
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 12, no. 1 (2009), p. 171-176
- Relation: http://purl.org/au-research/grants/nhmrc/565900
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- Description: Sport is an important context for physical activity and it is critical that safe environments are provided for such activity. Sports safety is influenced by the presence of sports ground environmental hazards such as ground hardness, poorly maintained playing fields, surface irregularities and the presence of debris/rubbish. To reduce injury risk, sports governing bodies need to ensure regular assessment of grounds safety and the removal of identified hazards. This study describes sports ground safety guidelines and recommendations of a sample of sports governing bodies and provides recommendations for how they could be improved. Semi-structured key informant interviews were conducted with nominees of state governing bodies for Australian football, cricket, soccer and hockey. The use of matchday checklists to identify ground hazards, as mandated by insurance companies was widely promoted across all levels of play. Sports governing bodies had more direct involvement in assessing grounds used for higher level of play, than grounds used for community or junior sport. There was a general presumption that identified hazards on community grounds would be corrected by local councils or clubs before anyone played on them, but this was rarely monitored. Sports governing bodies run the risk of being negligent in their duty of care to sports participants if they do not formally monitor the implementation of their ground safety polices and guidelines. There is also further scope for sports bodies to work closely with insurers to develop ground safety assessment guidelines specific to their sport. © 2008 Sports Medicine Australia.
- Description: 2003008186
The reach and adoption of a coach-led exercise training programme in community football
- Authors: Finch, Caroline , Diamantopoulou, Kathy , Twomey, Dara , Doyle, Tim , Lloyd, David , Young, Warren , Elliot, Bruce
- Date: 2013
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine. Vol. 48(8), p.718-723.
- Relation: http://purl.org/au-research/grants/nhmrc/565900
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- Description: Objective: To determine the reach and adoption of a coach-led exercise training programme for lower limb injury prevention. Design: Secondary analysis of data from a group-clustered randomised controlled trial. Setting: A periodised exercise training warm-up programme was delivered to players during training sessions over an 8-week preseason (weeks 1–8) and 18-week playing season. Participants: 1564 community Australian football players. Main outcome measurements: Reach, measured weekly, was the number of players who attended training sessions. Adoption was the number of attending players who completed the programme in full, partially or not at all. Reasons for partial or non-participation were recorded. Results: In week 1, 599 players entered the programme; 55% attended 1 training session and 45% attended > 1 session. By week 12, 1540 players were recruited but training attendance (reach) decreased to <50%. When players attended training, the majority adopted the full programme—ranging from 96% (week 1) to above 80% until week 20. The most common reasons for low adoption were players being injured, too sore, being late for training or choosing their own warm-up. Conclusions: The training programme's reach was highest preseason and halved at the playing season's end. However, when players attended training sessions, their adoption was high and remained close to 70% by season end. For sports injury prevention programmes to be fully effective across a season, attention also needs to be given to (1) encouraging players to attend formal training sessions and (2) considering the possibility of some form of programme delivery outside of formal training.
The reliability of musculoskeletal screening tests used in cricket
- Authors: Dennis, Rebecca , Finch, Caroline , Elliott, Bruce , Farhart, Patrick
- Date: 2008
- Type: Text , Journal article
- Relation: Physical Therapy in Sport Vol. 9, no. 1 (2008), p. 25-33
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- Description: Objectives: To determine the inter- and intra-observer reliability of a field-based musculoskeletal screening protocol used to measure potential injury risk factors in cricket fast bowlers. Design: Test-retest reliability study. Setting: High performance Australian cricket. Participants: Ten volunteers. Two sports physiotherapists conducted the testing. Main outcome measures: Participants completed the following tests: knee extension; modified Thomas test (hip extension and abduction); hip internal and external rotation; combined elevation; ankle dorsiflexion lunge; bridging hold; prone four point hold; and calf heel raises. Methods: For each of the tests, the participants were tested by each physiotherapist twice, and the inter- and intra-observer reliability were concurrently assessed. Results: The inter-observer reliability of the tests was generally poor, with only four of the ten tests having an intraclass correlation coefficient (ICC) greater than 0.80 (range of ICCs 0.27-0.99). The intra-observer reliability of the tests was considerably higher, with nine tests having an ICC greater than 0.80 (range of ICCs 0.56-0.99). Conclusions: With the exception of the bridging hold, all tests would be considered acceptable where only one observer was conducting the testing. However, only the ankle dorsiflexion lunge, combined elevation test, calf heel raise test and prone four point hold have acceptable reliability when there are multiple physiotherapists recording measurements. © 2007 Elsevier Ltd. All rights reserved.
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The translation of sports injury prevention and safety promotion knowledge : Insights from key intermediary organisations
- Authors: Bekker, Sheree , Paliadelis, Penny , Finch, Caroline
- Date: 2017
- Type: Text , Journal article
- Relation: Health Research Policy and Systems Vol. 15, no. 1 (2017), p. 1-9
- Relation: http://purl.org/au-research/grants/nhmrc/565907
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
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- Description: Background: A recognised research-to-practice gap exists in the health research field of sports injury prevention and safety promotion. There is a need for improved insight into increasing the relevancy, accessibility and legitimacy of injury prevention and safety promotion research knowledge for sport settings. The role of key organisations as intermediaries in the process of health knowledge translation for sports settings remains under-explored, and this paper aims to determine, and describe, the processes of knowledge translation undertaken by a set of key organisations in developing and distributing injury prevention and safety promotion resources. Methods: The National Guidance for Australian Football Partnerships and Safety (NoGAPS) project provided the context for this study. Representatives from five key NoGAPS organisations participated in individual face-to-face interviews about organisational processes of knowledge translation. A qualitative descriptive methodology was used to analyse participants' descriptions of knowledge translation activities undertaken at their respective organisations. Results: Several themes emerged around health knowledge translation processes and considerations, including (1) identifying a need for knowledge translation, (2) developing and disseminating resources, and (3) barriers and enablers to knowledge translation. Conclusions: This study provides insight into the processes that key organisations employ when developing and disseminating injury prevention and safety promotion resources within sport settings. The relevancy, accessibility and legitimacy of health research knowledge is foregrounded, with a view to increasing the influence of research on the development of health-related resources suitable for community sport settings. © 2017 The Author(s).
The use and modification of injury prevention exercises by professional youth soccer teams
- Authors: O'Brien, James , Young, Warren , Finch, Caroline
- Date: 2017
- Type: Text , Journal article
- Relation: Scandinavian Journal of Medicine and Science in Sports Vol. 27, no. 11 (2017), p. 1337-1346
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
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- Description: The efficacy of injury prevention exercise programs (IPEPs) for amateur youth soccer has been established, but little is known about their adaptability to other soccer populations. This study aimed to assess the use of individual injury prevention exercises by professional youth soccer teams, against the industry-standard, FIFA 11+ program. Four teams' chosen IPEPs were observed across one season and documented on a standardized form. The use of each FIFA 11+ exercise was coded as “performed”, “performed modified” or “not performed”. The proportion of the 160 observed sessions containing each individual exercise was calculated. Staff provided reasons for their use and modification of FIFA 11+ exercises. On average, individual FIFA 11+ exercises were conducted in original form in 12% of the sessions (range 0–33%), and in modified form in 28% of sessions (range 2–62%). The five most frequently observed exercises, in either original or modified form, were “bench” (72%), “squats” (69%), “running straight” (68%), “single-leg stance” (66%), and “sideways bench” (64%). Staff modified exercises to add variation, progression, and individualization, and to align with specific training formats and goals. Professional youth soccer teams often use injury prevention exercises similar to those in the FIFA 11+, but tailor them considerably to fit their implementation context.
Time to add a new priority target for child injury prevention? The case for an excess burden associated with sport and exercise injury : Population-based study
- Authors: Finch, Caroline , Shee, Anna Wong , Clapperton, Angela
- Date: 2014
- Type: Text , Journal article
- Relation: BMJ Open Vol. 4, no. 7. e005043
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
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- Description: Objective: To determine the population-level burden of sports injuries compared with that for road traffic injury for children aged <15 years in Victoria, Australia. Design: Retrospective observational study. Setting: Analysis of routinely collected data relating to non-fatal hospital-treated sports injury and road traffic injury cases for children aged <15 years in Victoria, Australia, over 2004-2010, inclusive. Participants: 75 413 non-fatal hospital-treated sports injury and road traffic injury cases in children aged <15 years. Data included: all Victorian public and private hospital hospitalisations, using the International Statistical Classification of Diseases and Health Related Problems, 10th Revision, Australian Modification (ICD-10-AM) activity codes to identify sports-related cases and ICD-10-AM cause and location codes to identify road traffic injuries; and injury presentations to 38 Victorian public hospital emergency departments, using a combination of activity, cause and location codes. Main outcome measures: Trends in injury frequency and rate were analysed by log-linear Poisson regression and the population-level injury burden was assessed in terms of years lived with disability (YLD), hospital bed-days and direct hospital costs. Results: Over the 7-year period, the annual frequency of non-fatal hospital-treated sports injury increased significantly by 29% (from N=7405 to N=9923; p<0.001) but the frequency of non-fatal hospital-treated road traffic injury decreased by 26% (from N=1841 to N=1334; p<0.001). Sports injury accounted for a larger population health burden than did road traffic injury on all measures: 3-fold the number of YLDs (7324.8 vs 2453.9); 1.9-fold the number of bed-days (26 233 vs 13 886) and 2.6-fold the direct hospital costs ($A5.9 millions vs $A2.2 millions). Conclusions: The significant 7-year increase in the frequency of hospital-treated sports injury and the substantially higher injury population-health burden (direct hospital costs, bed-day usage and YLD impacts) for sports injury compared with road traffic injury for children aged <15 years indicates an urgent need to prioritise sports injury prevention in this age group.
Time-to-event analysis for sports injury research part 1 : Time-varying exposures
- Authors: Nielsen, Rasmus , Bertelsen, Michael , Ramskov, Daniel , Møller, Merete , Hulme, Adam , Theisen, Daniel , Finch, Caroline , Fortington, Lauren , Mansournia, Mohammad , Parner, Erik
- Date: 2019
- Type: Text , Journal article , Review
- Relation: British Journal of Sports Medicine Vol. 53, no. 1 (2019), p. 61-68
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- Description: Background: 'How much change in training load is too much before injury is sustained, among different athletes?' is a key question in sports medicine and sports science. To address this question the investigator/practitioner must analyse exposure variables that change over time, such as change in training load. Very few studies have included time-varying exposures (eg, training load) and time-varying effect-measure modifiers (eg, previous injury, biomechanics, sleep/stress) when studying sports injury aetiology. Aim: To discuss advanced statistical methods suitable for the complex analysis of time-varying exposures such as changes in training load and injury-related outcomes. Content: Time-varying exposures and time-varying effect-measure modifiers can be used in time-to-event models to investigate sport injury aetiology. We address four key-questions (i) Does time-to-event modelling allow change in training load to be included as a time-varying exposure for sport injury development? (ii) Why is time-to-event analysis superior to other analytical concepts when analysing training-load related data that changes status over time? (iii) How can researchers include change in training load in a time-to-event analysis? and, (iv) Are researchers able to include other time-varying variables into time-to-event analyses? We emphasise that cleaning datasets, setting up the data, performing analyses with time-varying variables and interpreting the results is time-consuming, and requires dedication. It may need you to ask for assistance from methodological peers as the analytical approaches presented this paper require specialist knowledge and well-honed statistical skills. Conclusion: To increase knowledge about the association between changes in training load and injury, we encourage sports injury researchers to collaborate with statisticians and/or methodological epidemiologists to carefully consider applying time-to-event models to prospective sports injury data. This will ensure appropriate interpretation of time-to-event data. © 2019 Author(s).
Time-to-event analysis for sports injury research part 2 : Time-varying outcomes
- Authors: Nielsen, Rasmus , Bertelsen, Michael , Ramskov, Daniel , Møller, Merete , Hulme, Adam , Theisen, Daniel , Finch, Caroline , Fortington, Lauren , Mansournia, Mohammad , Parner, Erik
- Date: 2019
- Type: Text , Journal article , Review
- Relation: British Journal of Sports Medicine Vol. 53, no. 1 (2019), p. 70-78
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- Description: Background: Time-to-event modelling is underutilised in sports injury research. Still, sports injury researchers have been encouraged to consider time-to-event analyses as a powerful alternative to other statistical methods. Therefore, it is important to shed light on statistical approaches suitable for analysing training load related key-questions within the sports injury domain. Content: In the present article, we illuminate: (i) the possibilities of including time-varying outcomes in time-to-event analyses, (ii) how to deal with a situation where different types of sports injuries are included in the analyses (ie, competing risks), and (iii) how to deal with the situation where multiple subsequent injuries occur in the same athlete. Conclusion: Time-to-event analyses can handle time-varying outcomes, competing risk and multiple subsequent injuries. Although powerful, time-to-event has important requirements: researchers are encouraged to carefully consider prior to any data collection that five injuries per exposure state or transition is needed to avoid conducting statistical analyses on time-to-event data leading to biased results. This requirement becomes particularly difficult to accommodate when a stratified analysis is required as the number of variables increases exponentially for each additional strata included. In future sports injury research, we need stratified analyses if the target of our research is to respond to the question: 'how much change in training load is too much before injury is sustained, among athletes with different characteristics?' Responding to this question using multiple time-varying exposures (and outcomes) requires millions of injuries. This should not be a barrier for future research, but collaborations across borders to collecting the amount of data needed seems to be an important step forward.
Too much information? A document analysis of sport safety resources from key organisations
- Authors: Bekker, Sheree , Finch, Caroline
- Date: 2016
- Type: Text , Journal article
- Relation: BMJ Open Vol. 6, no. 5 (2016), p. 1-8
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
- Relation: http://purl.org/au-research/grants/nhmrc/565907
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- Description: Objectives: The field of sport injury prevention has seen a marked increase in published research in recent years, with concomitant proliferation of lay sport safety resources, such as policies, fact sheets and posters. The aim of this study was to catalogue and categorise the number, type and topic focus of sport safety resources from a representative set of key organisations. Design: Cataloguing and qualitative document analysis of resources available from the websites of six stakeholder organisations in Australia. Setting: This study was part of a larger investigation, the National Guidance for Australian Football Partnerships and Safety (NoGAPS) project. Participants: The NoGAPS study provided the context for a purposive sampling of six organisations involved in the promotion of safety in Australian football. These partners are recognised as being highly representative of organisations at national and state level that reflect similarly in their goals around sport safety promotion in Australia. Results: The catalogue comprised 284 resources. More of the practical and less prescriptive types of resources, such as fact sheets, than formal policies were found. Resources for the prevention of physical injuries were the predominant sport safety issue addressed, with risk management, environmental issues and social behaviours comprising other categories. Duplication of resources for specific safety issues, within and across organisations, was found. Conclusions: People working within sport settings have access to a proliferation of resources, which creates a potential rivalry for sourcing of injury prevention information. Important issues that are likely to influence the uptake of safety advice by the general sporting public include the sheer number of resources available, and the overlap and duplication of resources addressing the same issues. The existence of a large number of resources from reputable organisations does not mean that they are necessarily evidence based, fully up to date or even effective in supporting sport safety behaviour change. © 2016, BMJ Publishing Group. All rights reserved.
Towards a national sports safety strategy: Addressing facilitators and barriers towards safety guideline uptake
- Authors: Finch, Caroline , Gabbe, Belinda , Lloyd, David , Cook, Jill , Young, Warren , Nicholson, Matthew , Seward, Hugh , Donaldson, Alex , Doyle, Tim
- Date: 2011
- Type: Text , Journal article
- Relation: Injury Prevention Vol. 17, no. 3 (2011), p. 1-10
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Relation: http://purl.org/au-research/grants/nhmrc/565907
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- Description: Background: Limited information exists about how best to conduct intervention implementation studies in community sport settings. Research should be directed towards understanding the context within which evidence-based injury prevention interventions are to be implemented, while continuing to build the evidencebase for the effectiveness of sports injury interventions. Objectives: To identify factors that influence the translation of evidence-based injury prevention interventions into practice in community sport, and to provide specific evidence for the effectiveness of an evidence-based exercise training programme for lower limb injury prevention in community Australian football. Setting: Community-level Australian football clubs, teams and players. Methods: An exercise-based lower limb injury prevention programme will be developed and evaluated in terms of the implementation context, infrastructure and resources needed for its effective translation into community sport. Analysis of the community sports safety policy context will be undertaken to understand the barriers and facilitators to policy development and uptake. A randomised group-clustered ecological study will be conducted to compare the reach, effectiveness, adoption, implementation and maintenance (RE-AIM) of the intervention over 2 years. Outcome Measures: The primary outcome will be evidence-based prevention guidelines that are fully supported by a comprehensively evaluated dissemination plan. The plan will detail the support structures and add-ons necessary to ensure sustainability and subsequent national implementation. Research outcomes will include new knowledge about how sports safety policy is set, how consensus is reached among sports safety experts in the community setting and how evidence-based safety guidelines are best developed, packaged and disseminated to community sport.