- Hyndman, Brendon, Telford, Amanda, Ullah, Shahid, Benson, Amanda, Finch, Caroline
- Authors: Hyndman, Brendon , Telford, Amanda , Ullah, Shahid , Benson, Amanda , Finch, Caroline
- Date: 2014
- Type: Text , Journal article
- Relation: Journal of Physical Activity & Health Vol. 11, no. 1 (January 2014 2014), p. 109-117
- Full Text: false
- Reviewed:
- Description: Background: Enjoyment and play during school lunchtime are correlated with children's physical activity. Despite this, there is an absence of studies reporting children's enjoyment of play during school lunchtime breaks. The purpose of this study was to examine the intraday and interday reliability of children's enjoyment of school lunchtime play. Methods: Surveys used to assess children's enjoyment of lunchtime play were distributed to and completed by 197 children (112 males, 85 females), aged 8-12 years attending an elementary school in Victoria, Australia. Children completed the surveys during class before lunch (expected enjoyment) and after lunch (actual enjoyment) for 5 days. The intra- and interday enjoyment of school lunchtime play reliability were determined using a weighted kappa. Results: Intraday kappa values ranged from fair (0.31) to substantial (0.75) within each of the 5 days (median kappa = 0.41). In comparison, "expected" (0.09-0.40; median 0.30) and "actual" (0.05-0.46; median 0.28) interday enjoyment of lunchtime play displayed low reliability. Conclusions: Children's enjoyment of lunchtime play appears to be more consistent within days than across days. The findings suggest that assessment of children's enjoyment of lunchtime play once on a single day would be representative of a particular day but not necessarily that particular school week.
Ensuring implementation success: how should coach injury prevention education be improved if we want coaches to deliver safety programmes during training sessions?
- White, Peta, Otago, Leonie, Saunders, Natalie, Romiti, Maria, Donaldson, Alex, Ullah, Shahid, Finch, Caroline
- 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
- Full Text:
- Reviewed:
- 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.
- 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
- Full Text:
- Reviewed:
- 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.
- Fortington, Lauren, Berry, Jason, Buttifant, David, Ullah, Shahid, Diamantopoulou, Kathy, Finch, Caroline
- Authors: Fortington, Lauren , Berry, Jason , Buttifant, David , Ullah, Shahid , Diamantopoulou, Kathy , Finch, Caroline
- Date: 2014
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 19, no. 1 (2014), p.18-23
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
- Full Text: false
- Reviewed:
- Description: AbstractObjectives Australian Football League (AFL) players have a high risk of injury. Anecdotally, this injury risk is greater in emerging players (i.e. those in their first year), compared with established players (with 3+ years of experience). This study aimed to conduct the first comparison of injury risk and playing experience in these two player groups across a large number of AFL clubs. Design Prospective, cohort. Methods Injuries, game participation and training participation were collected weekly by 8 AFL clubs for 61 emerging and 64 established players. Injury incidence rates (IIR) and Cox proportional hazard models for time to first injury, separately for games and training, were computed. Results The game IIR was significantly higher for emerging than established players: 45.6 (95% CI: 35.7, 57.6) versus 18.3 (95% CI: 13.1, 24.9) per 1000 game-hours. Emerging players also had a higher training IIR than did the established players: 9.6 (95% CI: 7.6, 11.9) versus 8.9 (95% CI: 7.0, 11.1) per 1000 training-hours. Emerging players were significantly less likely to remain injury free in games than established players (HR = 3.46, 95% CI: 1.27, 9.45). A similar outcome was seen in training sessions, although to a lesser degree (HR = 1.41, 95% CI: 1.19, 1.69). Conclusions Despite efforts to modify the playing/training program of emerging players, this group remain at greater risk of injury in games and training sessions, compared with established players. Continued efforts should be made toward understanding reasons for this increased risk to better prevent injury during the early years of a professional football career.
Statistical modelling for recurrent events : An application to sports injuries
- Ullah, Shahid, Gabbett, Tim, Finch, Caroline
- 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
- Full Text:
- Reviewed:
- 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.
- 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
- Full Text:
- Reviewed:
- 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.
Applications of functional data analysis : A systematic review
- Ullah, Shahid, Finch, Caroline
- Authors: Ullah, Shahid , Finch, Caroline
- Date: 2013
- Type: Text , Journal article
- Relation: BMC Medical Research Methodology Vol. 13, no. 43 (2013), p.1-12
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: Background Functional data analysis (FDA) is increasingly being used to better analyze, model and predict time series data. Key aspects of FDA include the choice of smoothing technique, data reduction, adjustment for clustering, functional linear modeling and forecasting methods. Methods A systematic review using 11 electronic databases was conducted to identify FDA application studies published in the peer-review literature during 1995–2010. Papers reporting methodological considerations only were excluded, as were non-English articles. Results In total, 84 FDA application articles were identified; 75.0% of the reviewed articles have been published since 2005. Application of FDA has appeared in a large number of publications across various fields of sciences; the majority is related to biomedicine applications (21.4%). Overall, 72 studies (85.7%) provided information about the type of smoothing techniques used, with B-spline smoothing (29.8%) being the most popular. Functional principal component analysis (FPCA) for extracting information from functional data was reported in 51 (60.7%) studies. One-quarter (25.0%) of the published studies used functional linear models to describe relationships between explanatory and outcome variables and only 8.3% used FDA for forecasting time series data. Conclusions Despite its clear benefits for analyzing time series data, full appreciation of the key features and value of FDA have been limited to date, though the applications show its relevance to many public health and biomedical problems. Wider application of FDA to all studies involving correlated measurements should allow better modeling of, and predictions from, such data in the future especially as FDA makes no a priori age and time effects assumptions.
- Authors: Ullah, Shahid , Finch, Caroline
- Date: 2013
- Type: Text , Journal article
- Relation: BMC Medical Research Methodology Vol. 13, no. 43 (2013), p.1-12
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: Background Functional data analysis (FDA) is increasingly being used to better analyze, model and predict time series data. Key aspects of FDA include the choice of smoothing technique, data reduction, adjustment for clustering, functional linear modeling and forecasting methods. Methods A systematic review using 11 electronic databases was conducted to identify FDA application studies published in the peer-review literature during 1995–2010. Papers reporting methodological considerations only were excluded, as were non-English articles. Results In total, 84 FDA application articles were identified; 75.0% of the reviewed articles have been published since 2005. Application of FDA has appeared in a large number of publications across various fields of sciences; the majority is related to biomedicine applications (21.4%). Overall, 72 studies (85.7%) provided information about the type of smoothing techniques used, with B-spline smoothing (29.8%) being the most popular. Functional principal component analysis (FPCA) for extracting information from functional data was reported in 51 (60.7%) studies. One-quarter (25.0%) of the published studies used functional linear models to describe relationships between explanatory and outcome variables and only 8.3% used FDA for forecasting time series data. Conclusions Despite its clear benefits for analyzing time series data, full appreciation of the key features and value of FDA have been limited to date, though the applications show its relevance to many public health and biomedical problems. Wider application of FDA to all studies involving correlated measurements should allow better modeling of, and predictions from, such data in the future especially as FDA makes no a priori age and time effects assumptions.
The Development of the Lunchtime Enjoyment of Activity and Play Questionnaire
- Hyndman, Brendon, Telford, Amanda, Finch, Caroline, Ullah, Shahid, Benson, Amanda
- 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
- Full Text:
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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
- 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
- Full Text:
- Reviewed:
- 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
- Gabbett, Tim, Ullah, Shahid, Finch, Caroline
- 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
- Reviewed:
- 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.
Combining epidemiology and biomechanics in sports injury prevention research : A new approach for selecting suitable controls
- Finch, Caroline, Ullah, Shahid, McIntosh, Andrew
- Authors: Finch, Caroline , Ullah, Shahid , McIntosh, Andrew
- Date: 2011
- Type: Text , Journal article
- Relation: Sports Medicine Vol. 41, no. 1 (2011), p. 59-72
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: Several important methodological issues need to be considered when designing sports injury case-control studies. Major design goals for case-control studies include the accounting for prior injury risk exposure, and optimal definitions of both cases and suitable controls are needed to ensure this. This article reviews methodological aspects of published sports injury case-control studies, particularly with regard to the selection of controls. It argues for a new approach towards selecting controls for case-control studies that draws on an interface between epidemiological and biomechanical concepts. A review was conducted to identify sport injury case-control studies published in the peer-review literature during 1985-2008. Overall, 32 articles were identified, of which the majority related to upper or lower extremity injuries. Matching considerations were used for control selection in 16 studies. Specific mention of application of biomechanical principles in the selection of appropriate controls was absent from all studies, including those purporting to evaluate the benefits of personal protective equipment to protect against impact injury. This is a problem because it could lead to biased conclusions, as cases and controls are not fully comparable in terms of similar biomechanical impact profiles relating to the injury incident, such as site of the impact on the body. The strength of the conclusions drawn from case-control studies, and the extent to which results can be generalized, is directly influenced by the definition and recruitment of cases and appropriate controls. Future studies should consider the interface between epidemiological and biomechanical concepts when choosing appropriate controls to ensure that proper adjustment of prior exposure to injury risk is made. To provide necessary guidance for the optimal selection of controls in case-control studies of interventions to prevent sports-related impact injury, this review outlines a new case-control selection strategy that reflects the importance of biomechanical considerations, which ensures that controls are selected based on the presence of the same global injury mechanism as the cases. To summarize, the general biomechanical principles that should apply to the selection of controls in future case-control studies are as follows: (i) each control must have been exposed to the same global injury mechanism as the case, (e.g. head impact, fall onto outstretched arm); and (ii) intrinsic (individual) factors (e.g. age, sex, skill level) that might modify the person's response to the relevant biomechanical loads are adjusted when either selecting the controls or are in the analysis phase. The same considerations for control selection apply to other study designs such as matched cohort studies or case-crossover studies. © 2011 Adis Data Information BV. All rights reserved.
- Authors: Finch, Caroline , Ullah, Shahid , McIntosh, Andrew
- Date: 2011
- Type: Text , Journal article
- Relation: Sports Medicine Vol. 41, no. 1 (2011), p. 59-72
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: Several important methodological issues need to be considered when designing sports injury case-control studies. Major design goals for case-control studies include the accounting for prior injury risk exposure, and optimal definitions of both cases and suitable controls are needed to ensure this. This article reviews methodological aspects of published sports injury case-control studies, particularly with regard to the selection of controls. It argues for a new approach towards selecting controls for case-control studies that draws on an interface between epidemiological and biomechanical concepts. A review was conducted to identify sport injury case-control studies published in the peer-review literature during 1985-2008. Overall, 32 articles were identified, of which the majority related to upper or lower extremity injuries. Matching considerations were used for control selection in 16 studies. Specific mention of application of biomechanical principles in the selection of appropriate controls was absent from all studies, including those purporting to evaluate the benefits of personal protective equipment to protect against impact injury. This is a problem because it could lead to biased conclusions, as cases and controls are not fully comparable in terms of similar biomechanical impact profiles relating to the injury incident, such as site of the impact on the body. The strength of the conclusions drawn from case-control studies, and the extent to which results can be generalized, is directly influenced by the definition and recruitment of cases and appropriate controls. Future studies should consider the interface between epidemiological and biomechanical concepts when choosing appropriate controls to ensure that proper adjustment of prior exposure to injury risk is made. To provide necessary guidance for the optimal selection of controls in case-control studies of interventions to prevent sports-related impact injury, this review outlines a new case-control selection strategy that reflects the importance of biomechanical considerations, which ensures that controls are selected based on the presence of the same global injury mechanism as the cases. To summarize, the general biomechanical principles that should apply to the selection of controls in future case-control studies are as follows: (i) each control must have been exposed to the same global injury mechanism as the case, (e.g. head impact, fall onto outstretched arm); and (ii) intrinsic (individual) factors (e.g. age, sex, skill level) that might modify the person's response to the relevant biomechanical loads are adjusted when either selecting the controls or are in the analysis phase. The same considerations for control selection apply to other study designs such as matched cohort studies or case-crossover studies. © 2011 Adis Data Information BV. All rights reserved.
Encouraging junior community netball players to learn correct safe landing technique
- White, Peta, Ullah, Shahid, Donaldson, Alex, Otago, Leonie, Saunders, Natalie, Romiti, Maria, Finch, Caroline
- 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
- Reviewed:
- 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.
Implementing an exercise-training programme to prevent lower-limb injuries : Considerations for the development of a randomised controlled trial intervention delivery plan
- Finch, Caroline, White, Peta, Twomey, Dara, Ullah, Shahid
- Authors: Finch, Caroline , White, Peta , Twomey, Dara , Ullah, Shahid
- Date: 2011
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 45, no. 10 (2011), p. 791-796
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: Objective To identify important considerations for the delivery of an exercise training intervention in a randomised controlled trial to maximise subsequent participation in that randomised controlled trial and intervention uptake. Design A cross-sectional survey, with a theoretical basis derived from the Health Belief Model (HBM) and the Reach, Efficacy/Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework. Participants 374 male senior Australian Football players, aged 17-38 years. Main outcome measurements Beliefs about lowerlimb injury causation/prevention, and the relative value of exercise training for performance and injury prevention. The data are interpreted within HBM constructs and implications for subsequent intervention implementation considered within the RE-AIM framework. Ordinal logistic regression compared belief scores across player characteristics. Results 74.4% of players agreed that doing specific exercises during training would reduce their risk of lower-limb injury and would be willing to undertake them. However, 64.1% agreed that training should focus more on improving game performance than injury prevention. Younger players (both in terms of age and playing experience) generally had more positive views. Players were most supportive of kicking (98.9%) and ball-handling (97.0%) skills for performance and warm-up runs and cool-downs (both 91.5%) for injury prevention. Fewer than three-quarters of all players believed that balance (69.2%), landing (71.3%) or cutting/stepping (72.8) training had injury-prevention benefits. Conclusions Delivery of future exercise training programmes for injury prevention aimed at these players should be implemented as part of routine football activities and integrated with those as standard practice, as a means of associating them with training benefits for this sport.
- Authors: Finch, Caroline , White, Peta , Twomey, Dara , Ullah, Shahid
- Date: 2011
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 45, no. 10 (2011), p. 791-796
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: Objective To identify important considerations for the delivery of an exercise training intervention in a randomised controlled trial to maximise subsequent participation in that randomised controlled trial and intervention uptake. Design A cross-sectional survey, with a theoretical basis derived from the Health Belief Model (HBM) and the Reach, Efficacy/Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework. Participants 374 male senior Australian Football players, aged 17-38 years. Main outcome measurements Beliefs about lowerlimb injury causation/prevention, and the relative value of exercise training for performance and injury prevention. The data are interpreted within HBM constructs and implications for subsequent intervention implementation considered within the RE-AIM framework. Ordinal logistic regression compared belief scores across player characteristics. Results 74.4% of players agreed that doing specific exercises during training would reduce their risk of lower-limb injury and would be willing to undertake them. However, 64.1% agreed that training should focus more on improving game performance than injury prevention. Younger players (both in terms of age and playing experience) generally had more positive views. Players were most supportive of kicking (98.9%) and ball-handling (97.0%) skills for performance and warm-up runs and cool-downs (both 91.5%) for injury prevention. Fewer than three-quarters of all players believed that balance (69.2%), landing (71.3%) or cutting/stepping (72.8) training had injury-prevention benefits. Conclusions Delivery of future exercise training programmes for injury prevention aimed at these players should be implemented as part of routine football activities and integrated with those as standard practice, as a means of associating them with training benefits for this sport.
Reliability of equipment for measuring the ground hardness and traction
- Twomey, Dara, Otago, Leonie, Ullah, Shahid, Finch, Caroline
- Authors: Twomey, Dara , Otago, Leonie , Ullah, Shahid , Finch, Caroline
- Date: 2011
- Type: Text , Journal article
- Relation: Proceedings of the Institution of Mechanical Engineers, Part P: Journal of Sports Engineering and Technology Vol. 225, no. 3 (2011), p. 131-137
- Full Text: false
- Reviewed:
- Description: The aim of this paper is to report the inter-rater reliabilities and intra-rater reliabilities of the Clegg hammer, penetrometer, and studded-boot apparatus used for measuring the mechanical properties of natural turf, and to determine whether the level of experience influences the reliability. Three experienced and three novice testers measured the surface hardness and rotational traction at nine locations on a community-level Australian football oval. A repeated-measures analysis of variance tested for significant differences between the six testers for all equipment, and intra-class correlation coefficients (ICCs) were calculated to determine the inter-rater reliabilities and intra-rater reliabilities. The ICCs for the reliability between the six testers ranged between 0.77 and 0.87 for the Clegg hammer, ranged between 0.55 and 0.73 for the penetrometer, and equalled 0.51 for the studded-boot apparatus. The inter-rater reliabilities and intra-rater reliabilities were greater for the experienced testers than for the novice testers for the Clegg hammer and penetrometer but the novice testers produced greater inter-rater reliabilities for the studded-boot apparatus. This study highlights the potential variability that can exist between testers using the ground hardness and traction equipment, which has implications for future research involving multiple testers both in agronomic-based studies and in linking the surface properties to the injury risk across multiple venues. © Authors 2011.
Functional data modelling approach for analysing and predicting trends in incidence rates-an application to falls injury
- Ullah, Shahid, Finch, Caroline
- Authors: Ullah, Shahid , Finch, Caroline
- Date: 2010
- Type: Text , Journal article
- Relation: Osteoporosis International Vol. 21, no. 12 (2010), p. 2125-2134
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
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- Description: Summary: Policy decisions about the allocation of current and future resources should be based on the most accurate predictions possible. A functional data analysis (FDA) approach improves the understanding of current trends and future incidence of injuries. FDA provides more valid and reliable long-term predictions than commonly used methods. Introduction: Accurate information about predicted future injury rates is needed to inform public health investment decisions. It is critical that such predictions derived from the best available statistical models to minimise possible error in future injury incidence rates. Methods: FDA approach was developed to improve long-term predictions but is yet to be widely applied to injury epidemiology or other epidemiological research. Using the specific example of modelling age-specific annual incidence of fall-related severe head injuries of older people during 1970-2004 and predicting rates up to 2024 in Finland, this paper explains the principles behind FDA and demonstrates their superiority in terms of prediction accuracy over the more commonly reported ordinary least squares (OLS) approach. Results: Application of the FDA approach shows that the incidence of fall-related severe head injuries would increase by 2.3-2.6-fold by 2024 compared to 2004. The FDA predictions had 55% less prediction error than traditional OLS predictions when compared to actual data. Conclusions: In summary, FDA provides more accurate predictions of long-term incidence trends than commonly used methods. The production of FDA prediction intervals for future injury incidence rates gives likely guidance as to the likely accuracy of these predictions. © 2010 International Osteoporosis Foundation and National Osteoporosis Foundation.
- Authors: Ullah, Shahid , Finch, Caroline
- Date: 2010
- Type: Text , Journal article
- Relation: Osteoporosis International Vol. 21, no. 12 (2010), p. 2125-2134
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: Summary: Policy decisions about the allocation of current and future resources should be based on the most accurate predictions possible. A functional data analysis (FDA) approach improves the understanding of current trends and future incidence of injuries. FDA provides more valid and reliable long-term predictions than commonly used methods. Introduction: Accurate information about predicted future injury rates is needed to inform public health investment decisions. It is critical that such predictions derived from the best available statistical models to minimise possible error in future injury incidence rates. Methods: FDA approach was developed to improve long-term predictions but is yet to be widely applied to injury epidemiology or other epidemiological research. Using the specific example of modelling age-specific annual incidence of fall-related severe head injuries of older people during 1970-2004 and predicting rates up to 2024 in Finland, this paper explains the principles behind FDA and demonstrates their superiority in terms of prediction accuracy over the more commonly reported ordinary least squares (OLS) approach. Results: Application of the FDA approach shows that the incidence of fall-related severe head injuries would increase by 2.3-2.6-fold by 2024 compared to 2004. The FDA predictions had 55% less prediction error than traditional OLS predictions when compared to actual data. Conclusions: In summary, FDA provides more accurate predictions of long-term incidence trends than commonly used methods. The production of FDA prediction intervals for future injury incidence rates gives likely guidance as to the likely accuracy of these predictions. © 2010 International Osteoporosis Foundation and National Osteoporosis Foundation.
- Day, Lesley, Finch, Caroline, Harrison, James, Hoareau, Effie, Segal, Leonie, Ullah, Shahid
- 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
- Reviewed:
- 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.
Statistical modelling for falls count data
- Ullah, Shahid, Finch, Caroline, Day, Lesley
- 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
- Full Text:
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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.
- 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
- Full Text:
- Reviewed:
- 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.
- Ullah, Shahid, Finch, Caroline
- Authors: Ullah, Shahid , Finch, Caroline
- Date: 2010
- Type: Text , Technical report
- Full Text: false
- Day, Lesley, Hoareau, Effie, Finch, Caroline, Harrison, James, Segal, Leonie, Bolton, Tom, Bradley, Clare, Boufous, Soufiane, Ullah, Shahid, National Injury Prevention Injury Working Group
- Authors: Day, Lesley , Hoareau, Effie , Finch, Caroline , Harrison, James , Segal, Leonie , Bolton, Tom , Bradley, Clare , Boufous, Soufiane , Ullah, Shahid , National Injury Prevention Injury Working Group
- Date: 2009
- Type: Text , Technical report
- Full Text: false
- Description: The ageing of the population is one of the major transformations being experienced in Australia, with falls a significant threat to safety, health and independence. There is now substantial evidence regarding effective interventions for preventing falls among older people living independently in the community. The aim of this project was to develop and apply a framework for epidemiological modelling of the population level impact of proven interventions on future fall rates, providing a powerful policy-setting tool for prevention. We used the Cochrane review to source current best efficacy evidence from randomised controlled trials which have provided evidence of minimising the incidence of falls among older people living in the community. Six interventions defined in that review as most promising for community dwelling older people were modelled. Additionally, one other intervention not in the Cochrane review, expedited cataract removal, was also modelled. Occupational therapy delivered home hazard assessment and modification for those with recent fall history, as modelled here, represents the best falls prevention investment. Cardiac pacing is a good falls prevention investment over the medium term, although is unlikely to have a major impact on population level hospital admission rates. The relative cost-effectiveness of psychotropic medication withdrawal appears high, although some implementation issues would need to be addressed and further costs included. Multi-disciplinary multi-factorial risk management represents good clinical practice for high risk individuals, but is not relatively cost-effective for widespread implementation. Tai chi programs may represent good value for falls prevention resources, if local circumstances allow the cost per participant to be substantially lower than modelled here. Predicted reductions in national fall-related hospital admission rates for people aged 65 years and over ranged from 0.4% to 4.6% for five of the six falls prevention strategies implemented over a one year period. These reductions, however, suggest that substantial investment in falls prevention will be required to have large effects on the fall-related hospitalisation rates. In addition, the costeffectiveness of a number of the modelled interventions could be improved by variations to the implementation processes such as measures to increase uptake, or decrease the cost per participant. The framework developed provides the potential for the research evidence base to better guide policy and practice with respect to reducing falls and future fall-related hospitalisation rates.
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