Modelling the population-level impact of tai-chi on falls and fall-related injury among community-dwelling older people
- Authors: Day, Lesley , Finch, Caroline , Harrison, James , Hoareau, Effie , Segal, Leonie , Ullah, Shahid
- Date: 2010
- Type: Text , Journal article
- Relation: Injury Prevention Vol. 16, no. 5 (2010), p. 321-326
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text: false
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- Description: Objective: To model the population level impact of tai-chi on future rates of falls and fall-related injury in older people as a tool for policy development. Design: An epidemiological and economic model for estimating population-level effectiveness of tai-chi. Setting: Australia, 2009. Patients or subjects: Australian community-dwelling population aged 70+ years, ambulatory and without debilitating conditions or profound visual defects. Intervention: Group-based tai-chi, for 1 h twice weekly for 26 weeks, assuming no sustained effect beyond the intervention period. Main outcome measure: Total falls and fall-related hospitalisation prevented in 2009. Results: Population-wide tai-chi delivery would prevent an estimated 5440 falls and 109 fall-related hospitalisations, resulting in a 0.18% reduction in the fall related hospital admission rate for community-dwelling older people. The gross costs per fall and per fall-related hospital admission prevented were $ A4414 ((sic)3013) and $A220 712 ((sic)150 684), respectively. A total investment of $A24.01 million ((sic)16.39 million), equivalent to 4.2% of the cost of fall-related episodes of hospital care in 2003/4, would be required to provide tai-chi for 31 998 people and achieve this effect. Conclusions: Substantial investment in, and high population uptake of, tai-chi would be required to have a large effect on falls and fall-related hospitalisation rates. Although not accounted for in this study, investment in tai-chi is likely to be associated with additional significant health benefits beyond falls prevention. This approach could be applied to other interventions to assist selection of the most cost effective falls-prevention portfolio for Australia and other countries.
Identifying risk factors for contact injury in professional rugby league players - Application of a frailty model for recurrent injury
- Authors: Gabbett, Tim , Ullah, Shahid , Finch, Caroline
- Date: 2012
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 15, no. 6 (November 2012), p. 496-504
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text: false
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- Description: Objectives: Well-developed physical qualities may protect against contact injuries. However, the potential contribution of physical qualities as risk or protective factors to contact injury risk is yet to be determined for rugby league. This study applied a frailty survival model that accounts for recurrent injury to identify risk factors for all physiotherapist-reported contact injury in professional rugby league players. Design: Prospective cohort study. Methods: Sixty-six professional rugby league players participated in this three successive year prospective study. At the start of each season, all players underwent measurements of standard anthropometry (height, body mass, and sum of seven skinfolds), speed (10 m and 40 m sprint), muscular strength (1 repetition maximum [RM] bench press, 1RM squat, 1RM weighted chin-ups), power (vertical jump, bench throw, 1RM power clean, jump squat), and endurance (maximum repetition bench press with 60 kg resistance), repeated-sprint ability (12 × 20 m sprints performed on a 20 s cycle), prolonged high-intensity intermittent running ability (8 × 12 s maximal effort shuttles performed on a 48 s cycle), and maximal aerobic power (multi-stage fitness test). Data was used to demonstrate the application of the frailty model extension of the Cox proportional regression model for recurrent events to identify factors associated with a high hazard ratio (HR) of injury. Results: Heavier (body mass, HR = 2.6, 95% CI = 1.2-5.7), and faster (40 m sprint, HR = 2.1, 95% CI = 1.0-4.2) players, and those with poorly developed prolonged high-intensity intermittent running ability (HR = 2.9, 95% CI = 1.7-5.0) and upper-body strength (chin-up, HR = 2.2, 95% CI = 1.3-3.7) had a higher incidence of contact injuries. Conclusions: This study demonstrates application of a novel statistical approach for the analysis of injury data that is recurrent in nature. This approach identified that the greater impact forces generated from heavier players with faster speed may result in an increase in recurrent contact injury rates. However, the development of prolonged high-intensity intermittent running ability and upper-body strength and power may assist to reduce the risk of contact injury in professional rugby league players.
Encouraging junior community netball players to learn correct safe landing technique
- Authors: White, Peta , Ullah, Shahid , Donaldson, Alex , Otago, Leonie , Saunders, Natalie , Romiti, Maria , Finch, Caroline
- Date: 2011
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol.15 , no.1 (2011), p.19-24
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text: false
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- Description: Behavioural factors and beliefs are important determinants of the adoption of sports injury interventions. This study aimed to understand behavioural factors associated with junior community netball players' intentions to learn correct landing technique during coach-led training sessions, proposed as a means of reducing their risk of lower limb injury. 287 female players from 58 junior netball teams in the 2007/2008-summer competition completed a 13-item questionnaire developed from the Theory of Planned Behaviour (TPB). This assessed players' attitudes (four items), subjective norms (four), perceived behavioural control (four) and intentions (one) around the safety behaviour of learning correct landing technique at netball training. All items were rated on a seven-point bipolar scale. Cluster-adjusted logistic regression was used to assess which TPB constructs were most associated with strong intentions. Players had positive intentions and attitudes towards learning safe landing technique and perceived positive social pressure from significant others. They also perceived themselves to have considerable control over engaging (or not) in this behaviour. Players' attitudes (p < 0.001) and subjective norms (p < 0.001), but not perceived behavioural control (p = 0.49), were associated with strong intentions to learn correct landing technique at training. Injury prevention implementation strategies aimed at maximising junior players' participation in correct landing training programs should emphasise the benefits of learning correct landing technique (i.e. change attitudes) and involve significant others and role models whom junior players admire (i.e. capitalise on social norms) in the promotion of such programs. © 2011 Sports Medicine Australia.