Using principles of motor learning to enhance ACL injury prevention programs
- Authors: Gokeler, Alli , Benjaminse, Anne , Seil, Romain , Kerkhoffs, Gino , Verhagen, Evert
- Date: 2018
- Type: Text , Journal article , Review
- Relation: Sports Orthopaedics and Traumatology Vol. 34, no. 1 (2018), p. 23-30
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- Description: Findings from efficacy studies have shown decreased in ACL injury rates in (predominantly female) athletes participating in prevention programs. Given the inherent higher ACL injury risk for females, the majority of intervention studies, have focused on female athletes. Subsequently, the content of exercises in ACL prevention programs is directed to target the modifiable ACL injury risk factors for female athletes. The literature is generally scarce regarding the efficacy of prevention programs to reduce ACL injuries in male athletes. In general, reduction of ACL injury rates seem to be limited to (young) female athletes and male athletes playing at low level of sports. Typically, ACL injury prevention programs entail a combination of plyometrics, strength training, agility and balance exercises. A problem is that improvements of movement patterns are not sustained over time. The reason may be related to the type of instructions given during training. Encouraging athletes to consciously control knee movements during exercises may not be optimal for the acquisition of complex motor skills. In the motor learning domain, these type of instructions are defined as an internal attentional focus. An internal focus, on one's own movements results in a more conscious type of control that may hamper motor learning. It has been established in numerous studies that an external focus of attention facilitates motor learning more effectively due to the utilization of automatic motor control. Subsequently, the athlete has more recourses available to anticipate on situations on the field and take appropriate feed forward directed actions. The purpose of this manuscript was to present methods to optimize motor skill acquisition of athletes and elaborate on athletes’ behavior.
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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OARSI Clinical Trials Recommendations : Design and conduct of clinical trials for primary prevention of osteoarthritis by joint injury prevention in sport and recreation
- Authors: Emery, Carolyn , Roos, Ewa , Verhagen, Evert , Finch, Caroline , Bennell, Kim , Spindler, Kurt , Kemp, Joanne , Lohmander, Stefan
- Date: 2015
- Type: Text , Journal article
- Relation: Osteorthritis and Cartilage Vol. 23, no. 5 (2015), p. 815-825
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- Description: The risk of post-traumatic osteoarthritis (PTOA) substantially increases following joint injury. Research efforts should focus on investigating the efficacy of preventative strategies in high quality randomized controlled trials (RCT). The objective of these OARSI RCT recommendations is to inform the design, conduct and analytical approaches to RCTs evaluating the preventative effect of joint injury prevention strategies. Recommendations regarding the design, conduct, and reporting of RCTs evaluating injury prevention interventions were established based on the consensus of nine researchers internationally with expertise in epidemiology, injury prevention and/or osteoarthritis (OA). Input and resultant consensus was established through teleconference, face to face and email correspondence over a 1 year period. Recommendations for injury prevention RCTs include context specific considerations regarding the research question, research design, study participants, randomization, baseline characteristics, intervention, outcome measurement, analysis, implementation, cost evaluation, reporting and future considerations including the impact on development of PTOA. Methodological recommendations for injury prevention RCTs are critical to informing evidence-based practice and policy decisions in health care, public health and the community. Recommendations regarding the interpretation and conduct of injury prevention RCTs will inform the highest level of evidence in the field. These recommendations will facilitate between study comparisons to inform best practice in injury prevention that will have the greatest public health impact.
Children's route choice during active transportation to school : Difference between shortest and actual route
- Authors: Dessing, Dirk , de Vries, Sanne , Hegeman, Geerje , Verhagen, Evert , van Mechelen, Willem , Pierik, Frank
- Date: 2016
- Type: Text , Journal article
- Relation: International Journal of Behavioral Nutrition and Physical Activity Vol. 13, no. 1 (2016), p. 1-11
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- Description: Background: The purpose of this study is to increase our understanding of environmental correlates that are associated with route choice during active transportation to school (ATS) by comparing characteristics of actual walking and cycling routes between home and school with the shortest possible route to school. Methods: Children (n = 184; 86 boys, 98 girls; age range: 8-12 years) from seven schools in suburban municipalities in the Netherlands participated in the study. Actual walking and cycling routes to school were measured with a GPS-device that children wore during an entire school week. Measurements were conducted in the period April-June 2014. Route characteristics for both actual and shortest routes between home and school were determined for a buffer of 25 m from the routes and divided into four categories: Land use (residential, commercial, recreational, traffic areas), Aesthetics (presence of greenery/natural water ways along route), Traffic (safety measures such as traffic lights, zebra crossings, speed bumps) and Type of street (pedestrian, cycling, residential streets, arterial roads). Comparison of characteristics of shortest and actual routes was performed with conditional logistic regression models. Results: Median distance of the actual walking routes was 390.1 m, whereas median distance of actual cycling routes was 673.9 m. Actual walking and cycling routes were not significantly longer than the shortest possible routes. Children mainly traveled through residential areas on their way to school ( > 80 % of the route). Traffic lights were found to be positively associated with route choice during ATS. Zebra crossings were less often present along the actual routes (walking: OR = 0.17, 95 % CI = 0.05-0.58; cycling: OR = 0.31, 95 % CI = 0.14-0.67), and streets with a high occurrence of accidents were less often used during cycling to school (OR = 0.57, 95 % CI = 0.43-0.76). Moreover, percentage of visible surface water along the actual route was higher compared to the shortest routes (walking: OR = 1.04, 95 % CI = 1.01-1.07; cycling: OR = 1.03, 95 % CI = 1.01-1.05). Discussion: This study showed a novel approach to examine built environmental exposure during active transport to school. Most of the results of the study suggest that children avoid to walk or cycle along busy roads on their way to school. © 2016 Dessing et al.
Coaches' and referees' perceptions of the BokSmart injury prevention programme
- Authors: Brown, James , Verhagen, Evert , van Mechelen, Willem , Lambert, Mike , Draper, Catherine
- Date: 2016
- Type: Text , Journal article
- Relation: International Journal of Sports Science & Coaching Vol. 11, no. 5 (2016), p. 637-647
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- Description: The South African Rugby Union launched the BokSmart nationwide injury prevention programme to reduce rugby-related catastrophic injuries. The aim of this qualitative study was to evaluate the coaches and referees' perceptions of the implementation of BokSmart. Seven focus groups were conducted with coaches (n=43) and referees (n=7) from a variety of socioeconomic status and age groups. The RE-AIM framework was used to categorize the findings. There was consensus that BokSmart was capable of reducing catastrophic injuries in players. However, coaches' perceptions varied by socioeconomic status : mid/low socioeconomic status coaches described infrastructure-related barriers. Referees felt incapable of policing all BokSmart regulations. In general, most coaches, referees and trainers felt that the training course could be shorter and more practical. The barriers identified in this study could be hindering optimal BokSmart implementation. These barriers differed by role (coach/referee) and socioeconomic status of the coaches (high, mid or low).
Injuries in field hockey players : A systematic review
- Authors: Barboza, Saulo , Joseph, Corey , Nauta, Joske , van Mechelen, Willem , Verhagen, Evert
- Date: 2018
- Type: Text , Journal article , Review
- Relation: Sports Medicine Vol. 48, no. 4 (2018), p. 849-866
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- Description: Background: To commence injury prevention efforts, it is necessary to understand the magnitude of the injury problem. No systematic reviews have yet investigated the extent of injuries in field hockey, despite the popularity of the sport worldwide. Objective: Our objective was to describe the rate and severity of injuries in field hockey and investigate their characteristics. Methods: We conducted electronic searches in PubMed, Embase, SPORTDiscus, and CINAHL. Prospective cohort studies were included if they were published in English in a peer-reviewed journal and observed all possible injuries sustained by field hockey players during the period of the study. Results: The risk of bias score of the 22 studies included ranged from three to nine of a possible ten. In total, 12 studies (55%) reported injuries normalized by field hockey exposure. Injury rates ranged from 0.1 injuries (in school-aged players) to 90.9 injuries (in Africa Cup of Nations) per 1000 player-hours and from one injury (in high-school women) to 70 injuries (in under-21 age women) per 1000 player-sessions. Studies used different classifications for injury severity, but—within studies—injuries were included mostly in the less severe category. The lower limbs were most affected, and contusions/hematomas and abrasions were common types of injury. Contact injuries are common, but non-contact injuries are also a cause for concern. Conclusions: Considerable heterogeneity meant it was not possible to draw conclusive findings on the extent of the rate and severity of injuries. Establishing the extent of sports injury is considered the first step towards prevention, so there is a need for a consensus on injury surveillance in field hockey. © 2018, The Author(s).
Acceptability and perceptions of end-users towards an online sports-health surveillance system
- Authors: Barboza, Saulo , Bolling, Caroline , Nauta, Joske , van Mechelen, Willem , Verhagen, Evert
- Date: 2017
- Type: Text , Journal article
- Relation: BMJ Open Sport and Exercise Medicine Vol. 3, no. 1 (2017), p. 1-8
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- Description: Aim To describe the acceptability and the perceptions of athletes and staff members (ie, end-users) towards an online sports-health surveillance system. Methods A pilot study with a mixed-methods approach was pursued. Descriptive analysis was conducted to present the adherence of judo (n=34), swimming (n=21) and volleyball (n=14) athletes to an online registration of their sport exposure and any health complaints between April 2014 and January 2015. End-users' perceptions towards the system were investigated qualitatively with semistructured interviews (n=21). Qualitative analysis was based on the constant comparative method using principles of the grounded theory. Results The response rates of judo, swimming and volleyball athletes were 50% (SD 23), 61% (SD 27) and 56% (SD 25), respectively. Most athletes found it simple to register their sport exposure and health complaints online; however, personal communication was still preferred for this purpose. The system facilitated the communication between medical and trainer staff, who were able to identify in the system reports health complaints from athletes that were not necessarily communicated face-to-face. Therefore, staff members reported that they were able to intervene earlier to prevent minor health complaints from becoming severe health problems. However, staff members expected higher adherence of athletes to the online follow-ups, and athletes expected to receive feedback on their inputs to the system. Conclusion An online system can be used in sporting settings complementary to regular strategies for monitoring athletes' health. However, providing feedback on athletes' inputs is important to maintain their adherence to such an online system.
'In a blink of an eye your life can change ' : Experiences of players sustaining a rugby-related acute spinal cord injury
- Authors: Badenhorst, Marelise , Verhagen, Evert , Lambert, Michael , van Mechelen, Willem , Brown, James
- Date: 2019
- Type: Text , Journal article
- Relation: Injury Prevention Vol. 25, no. 4 (2019), p. 313-320
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- Description: Background Though rare, rugby union carries a risk for serious injuries such as acute spinal cord injuries (ASCI), which may result in permanent disability. Various studies have investigated injury mechanisms, prevention programmes and immediate medical management of these injuries. However, relatively scant attention has been placed on the player's experience of such an injury and the importance of context. Aim The aim of this study was to explore the injury experience and its related context, as perceived by the catastrophically injured player. Methods A qualitative approach was followed to explore the immediate, postevent injury experience. Semi-structured interviews were conducted with 48 (n=48) players who had sustained a rugby-related ASCI. Results Four themes were derived from the data. Participants described the context around the injury incident, which may be valuable to help understand the mechanism of injury and potentially minimise risk. Participants also described certain contributing factors to their injury, which included descriptions of foul play and aggression, unaccustomed playing positions, pressure to perform and unpreparedness. The physical experience included signs and symptoms of ASCI that is important to recognise by first aiders, fellow teammates, coaches and referees. Lastly, participants described the emotional experience which has implications for all ASCI first responders. Significance All rugby stakeholders, including players, first responders, coaches and referees, may gain valuable information from the experiences of players who have sustained these injuries. This information is also relevant for rugby safety initiatives in shaping education and awareness interventions.
Quality of life among individuals with rugby-related spinal cord injuries in South Africa : A descriptive cross-sectional study
- Authors: Badenhorst, Marelise , Brown, James , Lambert, Mike , van Mechelen, Willem , Verhagen, Evert
- Date: 2018
- Type: Text , Journal article
- Relation: BMJ Open Vol. 8, no. 6 (2018), p. 1-12
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- Description: Objectives Rugby-related spinal cord injuries (SCIs) are rare but life altering and traumatic events. Little is known about the long-term consequences and outcomes of players who have sustained these injuries. This study investigated current quality of life (QoL) and factors associated with QoL, among individuals with rugby-related SCI in South Africa, by using the International Classification of Functioning, Disability and Health (ICF) framework. Design Descriptive cross-sectional study. Setting Rugby-related SCI population of South Africa, as captured in the BokSmart/Chris Burger Petro Jackson Players' Fund database. Participants Ninety (n=90) of the 102 eligible players on the database agreed to participate in the study. Main outcome measure The relationship between QoL, as measured with the WHO Quality of Life questionnaire (WHOQOL-BREF) and specific independent variables (demographic information, level of independence and participation in various activities and life roles) was investigated. Variables that were significantly associated with QoL in bivariate analyses were included in multiple linear regression analyses. Results The mean score and SD of the WHOQOL-BREF was 15.1±2.3 arbitrary units. Participation (an ICF framework construct) and income were significantly associated with overall QoL (p<0.001). Participation was the only variable significantly associated with all QoL subdomains (p<0.001). Additionally, number of health concerns, type of healthcare (public vs private) and level of education were significantly associated with various QoL domains (p<0.001). Conclusions On average, these individuals with rugby-related SCI presented with higher QoL scores than other comparable SCI studies. However, lower levels of participation and income, certain levels of education, increased health concerns and use of public healthcare were associated with lower levels of QoL. Sporting bodies have a responsibility to optimise player welfare, by acting on the modifiable factors associated with QoL.
When this happens, you want the best care : Players' experiences of barriers and facilitators of the immediate management of rugby-related acute spinal cord injury
- Authors: Badenhorst, Marelise , Verhagen, Evert , Lambert, Mike , van Mechelen, Willem , Brown, James
- Date: 2019
- Type: Text , Journal article
- Relation: Qualitative Health Research Vol. 29, no. 13 (2019), p. 1862-1876
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- Description: Most contact sports, including rugby union, carry a risk of injury. Although acute spinal cord injuries (ASCIs) in rugby are rare, the consequences of such injuries are far-reaching. Optimal management of these injuries is challenging, and a detailed understanding of the different barriers and facilitators to optimal care is needed. In this study, we aimed to describe the perception of players, regarding factors related to the optimal immediate management of a catastrophic injury in a developing country with socioeconomic and health care inequities. The most frequently reported barriers were transportation delays after injury and admission to appropriate medical facilities. Other barriers included inadequate equipment, the quality of first aid care, and barriers within the acute hospital setting. Barriers were more prevalent in rural and lower socioeconomic areas. These findings are relevant for all rugby stakeholders and may help shape education, awareness, and future policy around the immediate management of ASCIs.
Effectiveness of an online tailored intervention on determinants and behaviour to prevent running related sports injuries: A randomised controlled trial
- Authors: Adriaensens, Lize , Hesselink, Arlette , Fabrie, M , Brugmans, Marco , Verhagen, Evert
- Date: 2014
- Type: Text , Journal article
- Relation: Schweizerische Zeitschrift fur Sportmedizin und Sporttraumatologie Vol. 62, no. 3 (September 2014), p. 6-13
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- Description: Methods. Runners between 18 and 35 years were randomly assigned to the intervention (n=109) or control group (n=105). Participants in the intervention group were invited to visit the website for 30 minutes. Those in the control group were invited to read magazines that did not contain information about running, injuries or other sport related issues for 30 minutes. Online questionnaires were completed just before (TO) and immediately after the intervention (Ti), and after 3 months (T2). Outcome measures were knowledge, risk perception, attitude, intention and injury prevention behaviour. Objective. Sports injuries are one of the most common injuries in the modern Western society. In line with the increased interest in eHealth, a tailor-based online injury prevention intervention was developed to influence determinants and actual sports injury preventive behaviour. An effect study was carried out among runners. Results. Immediately after the intervention (Tl) an effect was found on all outcome measures. After three months (T2) the effect remained only for behaviours relating to warm-up and frequency of shoe replacement. Conclusion. Short-term (3 months) effects were demonstrated on determinants and actual performance of sports injury prevention behaviour. These results confirm the value of online tailored interventions for the dissemination of injury prevention knowledge.
- Description: C1