A one-season prospective study of injuries and illness in elite junior tennis
- Pluim, Babette, Loeffen, F., Clarsen, Ben, Bahr, Roald, Verhagen, Evert
- Authors: Pluim, Babette , Loeffen, F. , Clarsen, Ben , Bahr, Roald , Verhagen, Evert
- Date: 2016
- Type: Text , Journal article
- Relation: Scandinavian Journal of Medicine and Science in Sports Vol. 26, no. 5 (2016), p. 564-571
- Full Text: false
- Reviewed:
- Description: The objective of this study was to estimate the incidence and prevalence of injury and illness among elite junior tennis players. A cohort of 73 players (11-14 years) in the 2012-2013 Dutch national high-performance program was followed for 32 weeks; all participants completed the study. The OSTRC Questionnaire on Health Problems was used to record self-reported injuries and illnesses and to record training and match exposure. Main outcome measures were average prevalence of overuse injury and illness and incidence density of acute injury. On average, players practiced 9.1h/week (SD 0.6; range 2.3-12.0) and had 2.2h of match play (SD 0.6; range 2.3-12.0). During the course of the study, 67 players reported a total of 187 health problems. The average weekly prevalence of all health problems was 21.3% (95% CI: 19.2-22.9), of which 12.1% (95% CI: 10.9-13.3) constituted overuse injuries and 5.8% (95% CI: 4.6-6.9) illnesses. The incidence of acute injuries was 1.2/1000h of tennis play (95% CI: 0.7-1.7). The high occurrence of overuse injuries among elite junior tennis players suggests that an early focus on preventative measures is warranted, with a particular focus on the monitoring and management of workload. © 2016 John Wiley & Sons A/S.
The impact of injury definition on injury surveillance in novice runners
- Kluitenberg, Bas, van Middelkoop, Marienke, Verhagen, Evert, Hartgens, Fred, Huisstede, Bionka, Diercks, Ron, van der Worp, Henk
- Authors: Kluitenberg, Bas , van Middelkoop, Marienke , Verhagen, Evert , Hartgens, Fred , Huisstede, Bionka , Diercks, Ron , van der Worp, Henk
- Date: 2016
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 19, no. 6 (Jun 2016), p. 470-475
- Full Text: false
- Reviewed:
- Description: Objectives: Despite several consensus statements, different injury definitions are used in the literature. This study aimed to identify the impact of different injury definitions on the nature and incidence of complaints captured during a short-term running program for novice runners. Methods: 1696 participants completed weekly diaries on running exposure and musculoskeletal complaints during a 6-week running program. These data were used to compare six different injury definitions (presence of running-related pain, training-reduction, time-loss of.one day or one week). Injuries were registered under these different definitions. Consequently incidence and the nature of complaints were compared between definitions. Results: The different injury definitions resulted in incidences that varied between 7.5% and 58.0%, or 18.7 and 239.6 injuries per 1000 h of running. The median duration of injury complaints was 4-7 days for injuries registered under a 'day definition', while complaints registered under a 'week definition' lasted 20-22 days. For running-related pain injuries the median of the maximum amount of pain was 3.0. In training-reduction and time-loss injuries these median values were scored between 5.0 and 7.0. No significant differences in anatomical locations between injuries that were registered under a 'day definition' or a 'week definition' were found. Injuries registered under a time-loss definition were located relatively more often at the knee, while complaints at the pelvis/sacrum/buttock were captured more often under a running-related pain definition. Conclusions: Injury definitions largely impact injury incidence. Location of injury is also affected by choice of injury definition. This stressed the need for standardized injury registration methods. (C) 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved. Groningen, Netherlands.
Intervention strategies used in sport injury prevention studies : A systematic review identifying studies applying the Haddon matrix
- Vriend, Ingrid, Gouttebarge, Vincent, Finch, Caroline, van Mechelen, Willem, Verhagen, Evert
- Authors: Vriend, Ingrid , Gouttebarge, Vincent , Finch, Caroline , van Mechelen, Willem , Verhagen, Evert
- Date: 2017
- Type: Text , Journal article , Review
- Relation: Sports Medicine Vol. 47, no. 10 (2017), p. 2027-2043
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- Description: Background: Prevention of sport injuries is crucial to maximise the health and societal benefits of a physically active lifestyle. To strengthen the translation and implementation of the available evidence base on effective preventive measures, a range of potentially relevant strategies should be considered. Objective: Our aim was to identify and categorise intervention strategies for the prevention of acute sport injuries evaluated in the scientific literature, applying the Haddon matrix, and identify potential knowledge gaps. Methods: Five electronic databases were searched (PubMed, EMBASE, SPORTDiscus, CINAHL, Cochrane) for studies that evaluated the effect of interventions on the occurrence of acute sport injuries. Studies were required to include a control group/condition, prospective data collection, and a quantitative injury outcome measure. Results: A total of 155 studies were included, mostly randomised controlled trials (43%). The majority of studies (55%) focussed on strategies requiring a behavioural change on the part of athletes. Studies predominantly evaluated the preventive effect of various training programmes targeted at the ‘pre-event’ phase (n = 73) and the use of equipment to avoid injury in the ‘event phase’ (n = 29). A limited number of studies evaluated the preventive effect of strategies geared at rules and regulations (n = 14), and contextual modifications (n = 18). Studies specifically aimed at preventing re-injuries were a minority (n = 8), and were mostly related to ankle sprains (n = 5). Conclusions: Valuable insight into the extent of the evidence base of sport injury prevention studies was obtained for 20 potential intervention strategies. This approach can be used to monitor potential gaps in the knowledge base on sport injury prevention. © 2017, The Author(s).
- Authors: Vriend, Ingrid , Gouttebarge, Vincent , Finch, Caroline , van Mechelen, Willem , Verhagen, Evert
- Date: 2017
- Type: Text , Journal article , Review
- Relation: Sports Medicine Vol. 47, no. 10 (2017), p. 2027-2043
- Full Text:
- Reviewed:
- Description: Background: Prevention of sport injuries is crucial to maximise the health and societal benefits of a physically active lifestyle. To strengthen the translation and implementation of the available evidence base on effective preventive measures, a range of potentially relevant strategies should be considered. Objective: Our aim was to identify and categorise intervention strategies for the prevention of acute sport injuries evaluated in the scientific literature, applying the Haddon matrix, and identify potential knowledge gaps. Methods: Five electronic databases were searched (PubMed, EMBASE, SPORTDiscus, CINAHL, Cochrane) for studies that evaluated the effect of interventions on the occurrence of acute sport injuries. Studies were required to include a control group/condition, prospective data collection, and a quantitative injury outcome measure. Results: A total of 155 studies were included, mostly randomised controlled trials (43%). The majority of studies (55%) focussed on strategies requiring a behavioural change on the part of athletes. Studies predominantly evaluated the preventive effect of various training programmes targeted at the ‘pre-event’ phase (n = 73) and the use of equipment to avoid injury in the ‘event phase’ (n = 29). A limited number of studies evaluated the preventive effect of strategies geared at rules and regulations (n = 14), and contextual modifications (n = 18). Studies specifically aimed at preventing re-injuries were a minority (n = 8), and were mostly related to ankle sprains (n = 5). Conclusions: Valuable insight into the extent of the evidence base of sport injury prevention studies was obtained for 20 potential intervention strategies. This approach can be used to monitor potential gaps in the knowledge base on sport injury prevention. © 2017, The Author(s).
We dare to ask new questions. Are we also brave enough to change our approaches?
- Verhagen, Evert, Bolling, Caroline
- Authors: Verhagen, Evert , Bolling, Caroline
- Date: 2018
- Type: Text , Journal article
- Relation: Translational sports medicine Vol. 1, no. 1 (2018), p. 54-55
- Full Text: false
- Reviewed:
- Description: Over the past decades research within the field of sports medicine has yielded a large amount of evidence of the prevention and treatment of athletic injuries. Despite the availability of high quality evidence, compliance to interventions that protect athletes’ health is low. Consequently, evidence‐based programs are not achieving their optimal effect in real‐life athletic situations. Implementation and knowledge translation are the contemporary incantations to resolve this apparent gap between science and practice. This has provided us novel research questions and challenges that follow on efficacious outcomes. Most of these questions are not answered through quantifiable outcomes measures as they revolve around user behaviors. This editorial argues that if we want to know why athletes and coaches behave as they do, and what barriers there may be to changing their behavior, qualitative research can be used to give athletes and coaches a voice.
Injuries in field hockey players : A systematic review
- Barboza, Saulo, Joseph, Corey, Nauta, Joske, van Mechelen, Willem, Verhagen, Evert
- 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).
- 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
- Full Text:
- Reviewed:
- 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).
- van Reijen, Miriam, Vriend, Ingrid, van Mechelen, Willem, Verhagen, Evert
- Authors: van Reijen, Miriam , Vriend, Ingrid , van Mechelen, Willem , Verhagen, Evert
- Date: 2018
- Type: Text , Journal article
- Relation: Scandinavian Journal of Medicine & Science in Sports Vol. 28, no. 2 (2018), p. 641-648
- Full Text: false
- Reviewed:
- Description: Recurrent ankle sprains can be reduced by following a neuromuscular training (NMT) program via a printed Booklet or a mobile application. Regarding the high incidence of ankle sprains, cost-effectiveness regarding implementation can have a large effect on total societal costs. In this economic analysis, we evaluated whether the method of implementing a proven effective NMT program using an App or a Booklet resulted in differences in injury incidence rates leading to costs and hence to differences in cost-effectiveness. In total, 220 athletes with a previous ankle sprain were recruited for this randomized controlled trial with a follow-up of 12 months. Half of the athletes used the freely available “Strengthen your ankle” App and the other half received a printed Booklet. After the 8-week program, athletes were questioned monthly on their recurrent injuries. Primary outcome measures were incidence density of ankle injury and incremental cost-effectiveness ratio (ICER). During follow-up, 31 athletes suffered from a recurrent ankle sprain that led to costs resulting in a hazard ratio of 1.13 (95% CI: 0.56-2.27). The incremental cost-effectiveness ratio of the App group in comparison with the Booklet group was €361.52. The CE plane shows that there was neither a difference in effects nor in costs between both intervention methods. This study showed that the method of implementing the NMT program using an App or a Booklet led to similar cost-effectiveness ratios and the same occurrence of recurrent injuries leading to costs. Both the App and the Booklet can be used to prevent recurrent ankle injuries, showing no differences in (cost-) effectiveness at 12-month follow-up.
- Van der Sluis, Alien, Brink, Michel, Pluim, Babette, Verhagen, Evert, Elferink-Gemser, Marije, Visscher, Chris
- Authors: Van der Sluis, Alien , Brink, Michel , Pluim, Babette , Verhagen, Evert , Elferink-Gemser, Marije , Visscher, Chris
- Date: 2019
- Type: Text , Journal article
- Relation: Scandinavian Journal of Medicine and Science in Sports Vol. 29, no. 7 (2019), p. 1050-1058
- Full Text: false
- Reviewed:
- Description: Talented athletes use metacognitive skills to improve their performance. Also, it is known that these skills are important for managing one's health. The goal of this study was to identify the relationship between metacognitive skills and overuse injuries in talented tennis players. Metacognitive skills were measured in 73 talented tennis players (45 boys and 28 girls, age 11-14) at the start of the season, using the Self-Regulation of Learning Self-Report Scale. Overuse injuries were monitored for one season using the Oslo Sports Trauma Research Centre Questionnaire on Health Problems. Ordinal regression indicated that moderate or low selfmonitoring skills (compared to high selfmonitoring) (OR 4.555, CI 1.096-18.927, P = 0.037) and exposure time (OR 1.380, CI 1.106-1.721, P = 0.004) were associated with more time loss overuse injuries. A second analysis showed that this was the case in girls (OR 10.757, CI 1.845-62.714, P = 0.008), but not in boys. Linear regression revealed that higher reflection scores and exposure time predicted overuse severity (F(5,58) = 2.921, P = 0.020, R2 = 0.201). Possibly, selfmonitoring can help players to prevent themselves from time loss overuse injuries. Coaches should be aware that players can differ in selfmonitoring ability and thus in the ability to prevent overuse injuries. The role of reflection needs more research.
- Kluitenberg, Bas, van der Worp, Henk, Huisstede, Bionka, Hartgens, Fred, Diercks, Ron, Verhagen, Evert, van Middelkoop, Marienke
- Authors: Kluitenberg, Bas , van der Worp, Henk , Huisstede, Bionka , Hartgens, Fred , Diercks, Ron , Verhagen, Evert , van Middelkoop, Marienke
- Date: 2016
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 19, no. 8 (2016), p. 642-646
- Full Text: false
- Reviewed:
- Description: Objectives: The incidence of running-related injuries is high. Some risk factors for injury were identified in novice runners, however, not much is known about the effect of training factors on injury risk. Therefore, the purpose of this study was to examine the associations between training factors and running-related injuries in novice runners, taking the time varying nature of these training-related factors into account. Design: Prospective cohort study. Methods: 1696 participants completed weekly diaries on running exposure and injuries during a 6-week running program for novice runners. Total running volume (min), frequency and mean intensity (Rate of Perceived Exertion) were calculated for the seven days prior to each training session. The association of these time-varying variables with injury was determined in an extended Cox regression analysis. Results: The results of the multivariable analysis showed that running with a higher intensity in the previous week was associated with a higher injury risk. Running frequency was not significantly associated with injury, however a trend towards running three times per week being more hazardous than two times could be observed. Finally, lower running volume was associated with a higher risk of sustaining an injury. Conclusions: These results suggest that running more than 60 min at a lower intensity is least injurious. This finding is contrary to our expectations and is presumably the result of other factors. Therefore, the findings should not be used plainly as a guideline for novices. More research is needed to establish the person-specific training patterns that are associated with injury. © 2015 Sports Medicine Australia.
Theoretical perspectives on using epidemiology and systems thinking to better understand the aetiology and prevention of distance running-related injury
- Authors: Hulme, Adam
- Date: 2017
- Type: Text , Thesis , PhD
- Full Text:
- Description: On a global scale, the sporting activity of distance running has increased in popularity. This is likely attributable to a growing societal concern for the documented rise in several lifestyle-related chronic diseases. As a form of exercise, running provides significant beneficial effects on a range of biomedical health indices, and is the preferred physical activity of choice for many people given its high accessibility and relatively low financial cost. Notwithstanding the many health-related benefits associated with running, the risk of sustaining a distance running-related injury (RRI) can be high. Therefore, from an injury prevention perspective, understanding why runners sustain RRI is of primary scientific importance. Over the last fifty years, the science behind RRI causation and prevention has attracted considerable interest amongst sports injury prevention researchers. During that time, there has been a concerted scholarly effort to understand the aetiology of RRI from an epidemiological and clinical research-based standpoint. Traditional scientific approaches have attempted to identify the effect of discrete trainingrelated, behavioural, and/or biomechanical exposures on the risk of developing either general or specific RRI. Despite what is now a considerable body of work, several descriptive and systematic reviews have found a history of previous injury to be the only definitive risk factor for subsequent RRI development. Alongside the continuing application of traditional scientific approaches, this PhD thesis promotes the use of a complementary ‘systems thinking’ theoretical perspective for better understanding the development and prevention of RRI. There are several contained chapters, the first of which is a systematic review of the RRI aetiological literature. After examining in closer detail the causal mechanism underpinning RRI development, a series of papers urge injury prevention scientists to consider drawing on alternative philosophical perspectives when planning and designing research. In building on the preceding arguments, the final chapters involve the construction of a systems ergonomics control structure model of the Australian distance running system, including the way RRI is managed and controlled.
- Description: Doctor of Philosophy
- Authors: Hulme, Adam
- Date: 2017
- Type: Text , Thesis , PhD
- Full Text:
- Description: On a global scale, the sporting activity of distance running has increased in popularity. This is likely attributable to a growing societal concern for the documented rise in several lifestyle-related chronic diseases. As a form of exercise, running provides significant beneficial effects on a range of biomedical health indices, and is the preferred physical activity of choice for many people given its high accessibility and relatively low financial cost. Notwithstanding the many health-related benefits associated with running, the risk of sustaining a distance running-related injury (RRI) can be high. Therefore, from an injury prevention perspective, understanding why runners sustain RRI is of primary scientific importance. Over the last fifty years, the science behind RRI causation and prevention has attracted considerable interest amongst sports injury prevention researchers. During that time, there has been a concerted scholarly effort to understand the aetiology of RRI from an epidemiological and clinical research-based standpoint. Traditional scientific approaches have attempted to identify the effect of discrete trainingrelated, behavioural, and/or biomechanical exposures on the risk of developing either general or specific RRI. Despite what is now a considerable body of work, several descriptive and systematic reviews have found a history of previous injury to be the only definitive risk factor for subsequent RRI development. Alongside the continuing application of traditional scientific approaches, this PhD thesis promotes the use of a complementary ‘systems thinking’ theoretical perspective for better understanding the development and prevention of RRI. There are several contained chapters, the first of which is a systematic review of the RRI aetiological literature. After examining in closer detail the causal mechanism underpinning RRI development, a series of papers urge injury prevention scientists to consider drawing on alternative philosophical perspectives when planning and designing research. In building on the preceding arguments, the final chapters involve the construction of a systems ergonomics control structure model of the Australian distance running system, including the way RRI is managed and controlled.
- Description: Doctor of Philosophy
- van Dyk, Nicol, Bahr, Roald, Burnett, Angus, Verhagen, Evert, Von Tiggelen, D., Witvrouw, Erik
- Authors: van Dyk, Nicol , Bahr, Roald , Burnett, Angus , Verhagen, Evert , Von Tiggelen, D. , Witvrouw, Erik
- Date: 2018
- Type: Text , Journal article
- Relation: Scandinavian Journal of Medicine and Science in Sports Vol. 28, no. 10 (2018), p. 2153-2163
- Full Text: false
- Reviewed:
- Description: Hamstring injuries remain a significant burden in sports that involve high-speed running. In elite male football, hamstring injury has repeatedly been identified as the most common non-contact injury, representing 12% of all injuries. As the incidence remains high, investigations are aimed at better understanding how to improve prevention efforts. Intrinsic risk factors such as strength have been investigated extensively in a cohort of professional football players; however, other intrinsic measures of neuromuscular function have not been studied in this cohort. This study aims to investigate the association between timing of hamstring muscle activity onset and the rate of torque development during the early phase of isokinetic strength testing with risk of hamstring injury in professional football players in a prospective cohort study. All teams (n = 18) eligible to compete in the premier football league in Qatar underwent a comprehensive strength assessment during their annual periodic health evaluation at Aspetar Orthopaedic and Sports Medicine Hospital in Doha, Qatar. Variables included rate of torque development and timing of muscle activity onset. A total of 367 unique players (60.6% of all QSL players) competed for 514 player seasons (103 players competed both seasons) and sustained 65 hamstring injuries. There was no difference in the onset of muscle activity between the biceps femoris and medial hamstrings comparing the injured to uninjured players. For both onset of muscle activity and rate of torque development, there were no significant differences between any of the variables (P >.05), with small effect sizes detected across all the different variables (d < 0.3). Rate of torque development and onset of muscle activity were not associated with a risk of future hamstring injury. The use of these measures as part of a periodic health evaluation to identify risk of hamstring injury is unsupported.
- Emery, Carolyn, Roos, Ewa, Verhagen, Evert, Finch, Caroline, Bennell, Kim, Spindler, Kurt, Kemp, Joanne, Lohmander, Stefan
- 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
- Full Text: false
- Reviewed:
- 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.
- Verhagen, Evert, Huuperans, Maarten, Finch, Caroline, van Mechelen, Willem
- Authors: Verhagen, Evert , Huuperans, Maarten , Finch, Caroline , van Mechelen, Willem
- Date: 2011
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 14, no. 4 (July 2011 2011), p. 287-292
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text: false
- Reviewed:
- Description: Objective: To investigate estimated outcome effects of a sports injury prevention intervention when analysed by means of a per protocol (PP) analysis approach. Design: Randomised controlled trial (RCT) involving 522 athletes who sustained a lateral ankle sprain allocated to either an intervention (received a preventive programme in addition to usual care) or control group who were followed prospectively for one year. Methods: Secondary analysis of data relating to registered ankle sprain recurrences, exposure and adherence to the allocated intervention using a PP analysis approach. Results: Twenty-three percent of the RCT intervention group indicated to have fully adhered with the neuromuscular training programme. A per protocol analysis only considering fully adherent athletes and control athletes, showed a Hazard Ratio of 0.18 (95% CI: 0.07-0.43). Significantly fewer recurrent ankle sprains were found in the fully adherent group compared to the group that was not adherent (relative risk = 0.63; 95% CI: 0.43-0.99). Conclusions: A PP analysis on fully adherent athletes versus control group athletes showed that the established intervention effect was over threefold higher compared to an earlier intention-to-treat based analysis approach. This shows that outcomes of intervention studies are heavily biased by adherence to the allocated intervention.
Controlled ecological evaluation of an implemented exercise-training programme to prevent lower limb injuries in sport : Population-level trends in hospital-treated injuries
- Finch, Caroline, Gray, Shannon, Akram, Muhammad, Donaldson, Alex, Lloyd, David, Cook, Jill
- Authors: Finch, Caroline , Gray, Shannon , Akram, Muhammad , Donaldson, Alex , Lloyd, David , Cook, Jill
- Date: 2019
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 53, no. 8 (2019), p. 487-492
- Full Text:
- Reviewed:
- Description: Objective Exercise-training programmes have reduced lower limb injuries in trials, but their population-level effectiveness has not been reported in implementation trials. This study aimed to demonstrate that routinely collected hospital data can be used to evaluate population-level programme effectiveness. Method A controlled ecological design was used to evaluate the effect of FootyFirst, an exercise-training programme, on the number of hospital-treated lower limb injuries sustained by males aged 16-50 years while participating in community-level Australian Football. FootyFirst was implemented with a € support' (FootyFirst+S) or a € without support' (FootyFirst+NS) in different geographic regions of Victoria, Australia: 22 clubs in region 1: FootyFirst+S in 2012/2013; 25 clubs in region 2: FootyFirst+NS in 2012/2013; 31 clubs region 3: control in 2012, FootyFirst+S in 2013. Interrupted time-series analysis compared injury counts across regions and against trends in the rest of Victoria. Results After 1 year of FootyFirst+S, there was a non-statistically significant decline in the number of lower limb injuries in region 1 (2012) and region 3 (2013); this was not maintained after 2 years in region 1. Compared with before FootyFirst in 2006-2011, injury count changes at the end of 2013 were: region 1: 20.0% reduction (after 2 years support); region 2: 21.5% increase (after 2 years without support); region 3: 21.8% increase (after first year no programme, second year programme with support); rest of Victoria: 12.6% increase. Conclusion Ecological analyses using routinely collected hospital data show promise as the basis of population-level programme evaluation. The implementation and sustainability of sports injury prevention programmes at the population-level remains challenging.
- Authors: Finch, Caroline , Gray, Shannon , Akram, Muhammad , Donaldson, Alex , Lloyd, David , Cook, Jill
- Date: 2019
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 53, no. 8 (2019), p. 487-492
- Full Text:
- Reviewed:
- Description: Objective Exercise-training programmes have reduced lower limb injuries in trials, but their population-level effectiveness has not been reported in implementation trials. This study aimed to demonstrate that routinely collected hospital data can be used to evaluate population-level programme effectiveness. Method A controlled ecological design was used to evaluate the effect of FootyFirst, an exercise-training programme, on the number of hospital-treated lower limb injuries sustained by males aged 16-50 years while participating in community-level Australian Football. FootyFirst was implemented with a € support' (FootyFirst+S) or a € without support' (FootyFirst+NS) in different geographic regions of Victoria, Australia: 22 clubs in region 1: FootyFirst+S in 2012/2013; 25 clubs in region 2: FootyFirst+NS in 2012/2013; 31 clubs region 3: control in 2012, FootyFirst+S in 2013. Interrupted time-series analysis compared injury counts across regions and against trends in the rest of Victoria. Results After 1 year of FootyFirst+S, there was a non-statistically significant decline in the number of lower limb injuries in region 1 (2012) and region 3 (2013); this was not maintained after 2 years in region 1. Compared with before FootyFirst in 2006-2011, injury count changes at the end of 2013 were: region 1: 20.0% reduction (after 2 years support); region 2: 21.5% increase (after 2 years without support); region 3: 21.8% increase (after first year no programme, second year programme with support); rest of Victoria: 12.6% increase. Conclusion Ecological analyses using routinely collected hospital data show promise as the basis of population-level programme evaluation. The implementation and sustainability of sports injury prevention programmes at the population-level remains challenging.
Could targeted exercise programmes prevent lower limb injury in community Australian football?
- Andrew, Nadine, Gabbe, Belinda, Cook, Jill, Lloyd, David, Donnelly, Cyril, Nash, Clare, Finch, Caroline
- Authors: Andrew, Nadine , Gabbe, Belinda , Cook, Jill , Lloyd, David , Donnelly, Cyril , Nash, Clare , Finch, Caroline
- Date: 2013
- Type: Text , Journal article
- Relation: Sports Medicine Vol. 43, no. 8 (2013), p. 751-763
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Relation: http://purl.org/au-research/grants/nhmrc/565907
- Full Text:
- Reviewed:
- Description: Background: Australian football is a popular sport in Australia, at both the community and elite levels. It is a high-speed contact sport with a higher incidence of medically treated injuries when compared with most other organized sports. Hamstring injuries, ligament injuries to the knee or ankle, hip/groin injuries and tendinopathies are particularly common and often result in considerable time lost from sport. Consequently, the prevention of lower limb injuries is a priority for both community and elite Australian football organizations. There is considerable literature available on exercise programmes aimed at reducing lower limb injuries in Australian football and other running-related sports. The quality and outcomes of these studies have varied considerably, but indicate that exercise protocols may be an effective means of preventing lower limb injuries. Despite this, there has been limited high-quality and systematic evaluation of these data. Objective: The aim of this literature review is to systematically evaluate the evidence about the benefits of lower limb injury prevention exercise protocols aimed at reducing the most common severe lower limb injuries in Australian football. Methods: The Cochrane Central Register of Controlled Trials, the Cochrane Bone Joint and Muscle Trauma Group Specialized Register, MEDLINE and other electronic databases were searched, from January 1990 to December 2010. Papers reporting the results of randomized controlled trials (RCTs), quasi-RCTs, cohort and case-control studies were extracted. Primary outcomes were injury reduction or risk factor identification and/or modification. Secondary outcomes were adherence to any trialled interventions, injury severity and adverse effects such as secondary injuries and muscle soreness. The methodological quality of extracted manuscripts was assessed and results were collated. Results: Forty-seven papers were identified and reviewed of which 18 related to hamstring injury, eight related to knee or ankle ligament injury, five related to tendon injury and four were hip or groin injury related. Another 12 papers targeted general lower limb injuries. Most (n = 27 [57 %]) were observational studies, investigating injury risk factors. Twenty reported the results of intervention trials. Of these, 15 were efficacy trials reporting the effects of an intervention in reducing injury rates, four were biomechanical interventions in which the impact of the intervention on a known injury risk factor was assessed and one reported changes in injury risk factors as well as injury rates. The strength of the evidence base for exercise programmes for lower limb injury prevention was found to be limited, primarily due to the research methods employed, low adherence to interventions by the study participants and a lack of statistical power. Limited evidence obtained from a small number of RCTs suggests that balance and control exercises might be efficacious in preventing ankle ligament injuries and a programme involving a combination of balance and control exercises, eccentric hamstring, plyometrics and strength exercises could be efficacious in preventing all lower limb injuries. Conclusions: Overall, the evidence for exercise programmes as an efficacious lower limb injury prevention strategy is predominantly restricted to studies addressing injury aetiology and mechanisms. The findings of this review highlight the need to develop and test interventions in well designed population-based trials with an emphasis on promoting intervention uptake and adherence and, hence, intervention effectiveness. The results of this review can inform the development of the components of a future lower limb injury prevention exercise protocol for community-level Australian football. © 2013 Springer International Publishing Switzerland. Funded by the NHMRC.
- Description: 2003011215
- Authors: Andrew, Nadine , Gabbe, Belinda , Cook, Jill , Lloyd, David , Donnelly, Cyril , Nash, Clare , Finch, Caroline
- Date: 2013
- Type: Text , Journal article
- Relation: Sports Medicine Vol. 43, no. 8 (2013), p. 751-763
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Relation: http://purl.org/au-research/grants/nhmrc/565907
- Full Text:
- Reviewed:
- Description: Background: Australian football is a popular sport in Australia, at both the community and elite levels. It is a high-speed contact sport with a higher incidence of medically treated injuries when compared with most other organized sports. Hamstring injuries, ligament injuries to the knee or ankle, hip/groin injuries and tendinopathies are particularly common and often result in considerable time lost from sport. Consequently, the prevention of lower limb injuries is a priority for both community and elite Australian football organizations. There is considerable literature available on exercise programmes aimed at reducing lower limb injuries in Australian football and other running-related sports. The quality and outcomes of these studies have varied considerably, but indicate that exercise protocols may be an effective means of preventing lower limb injuries. Despite this, there has been limited high-quality and systematic evaluation of these data. Objective: The aim of this literature review is to systematically evaluate the evidence about the benefits of lower limb injury prevention exercise protocols aimed at reducing the most common severe lower limb injuries in Australian football. Methods: The Cochrane Central Register of Controlled Trials, the Cochrane Bone Joint and Muscle Trauma Group Specialized Register, MEDLINE and other electronic databases were searched, from January 1990 to December 2010. Papers reporting the results of randomized controlled trials (RCTs), quasi-RCTs, cohort and case-control studies were extracted. Primary outcomes were injury reduction or risk factor identification and/or modification. Secondary outcomes were adherence to any trialled interventions, injury severity and adverse effects such as secondary injuries and muscle soreness. The methodological quality of extracted manuscripts was assessed and results were collated. Results: Forty-seven papers were identified and reviewed of which 18 related to hamstring injury, eight related to knee or ankle ligament injury, five related to tendon injury and four were hip or groin injury related. Another 12 papers targeted general lower limb injuries. Most (n = 27 [57 %]) were observational studies, investigating injury risk factors. Twenty reported the results of intervention trials. Of these, 15 were efficacy trials reporting the effects of an intervention in reducing injury rates, four were biomechanical interventions in which the impact of the intervention on a known injury risk factor was assessed and one reported changes in injury risk factors as well as injury rates. The strength of the evidence base for exercise programmes for lower limb injury prevention was found to be limited, primarily due to the research methods employed, low adherence to interventions by the study participants and a lack of statistical power. Limited evidence obtained from a small number of RCTs suggests that balance and control exercises might be efficacious in preventing ankle ligament injuries and a programme involving a combination of balance and control exercises, eccentric hamstring, plyometrics and strength exercises could be efficacious in preventing all lower limb injuries. Conclusions: Overall, the evidence for exercise programmes as an efficacious lower limb injury prevention strategy is predominantly restricted to studies addressing injury aetiology and mechanisms. The findings of this review highlight the need to develop and test interventions in well designed population-based trials with an emphasis on promoting intervention uptake and adherence and, hence, intervention effectiveness. The results of this review can inform the development of the components of a future lower limb injury prevention exercise protocol for community-level Australian football. © 2013 Springer International Publishing Switzerland. Funded by the NHMRC.
- Description: 2003011215
Enhancing the implementation of injury prevention exercise programs in professional soccer
- Authors: O’Brien, James
- Date: 2016
- Type: Text , Thesis , PhD
- Full Text:
- Description: Recently, injury prevention exercise programs (IPEPs) for soccer have received considerable attention and their efficacy has been demonstrated in large-scale trials. However, the ultimate impact of IPEPs will depend not only on their efficacy under controlled conditions, but also on the extent to which they are successfully implemented under real-world conditions. Despite increasing recognition of the challenges involved in successfully implementing IPEPs, there is a paucity of research addressing these challenges. The first aim of this thesis was to systematically review published IPEP trial reports, from an implementation perspective, in both soccer and other team ball sports. To achieve this, an established health-promotion framework, called the Reach Effectiveness Adoption Implementation Maintenance (RE-AIM) framework, was employed. The subsequent phases of the thesis aimed to identify IPEP implementation barriers and facilitators in the specific context of professional soccer. Two cross-sectional surveys explored the perceptions of IPEP users in professional teams and a prospective observational study assessed IPEP use, over one playing season, in a professional youth soccer academy. Evaluation of the published literature against the RE-AIM framework revealed major gaps in the reporting of specific IPEP implementation aspects, particularly relating to program adoption and maintenance. In professional soccer teams, multiple IPEP implementation barriers and facilitators were identified. These factors related either to the content and nature of the IPEPs themselves (e.g. variation, progression and soccer-specificity), or the delivery and support of programs (e.g. communication and team work) at different levels of the professional soccer ecology. In summary, there are major gaps in the reporting of implementation aspects in team ball sport trials. To enhance the implementation of IPEPs in professional soccer settings, the content and delivery of programs require significant tailoring to the specific implementation context.
- Description: Doctor of Philosophy
- Authors: O’Brien, James
- Date: 2016
- Type: Text , Thesis , PhD
- Full Text:
- Description: Recently, injury prevention exercise programs (IPEPs) for soccer have received considerable attention and their efficacy has been demonstrated in large-scale trials. However, the ultimate impact of IPEPs will depend not only on their efficacy under controlled conditions, but also on the extent to which they are successfully implemented under real-world conditions. Despite increasing recognition of the challenges involved in successfully implementing IPEPs, there is a paucity of research addressing these challenges. The first aim of this thesis was to systematically review published IPEP trial reports, from an implementation perspective, in both soccer and other team ball sports. To achieve this, an established health-promotion framework, called the Reach Effectiveness Adoption Implementation Maintenance (RE-AIM) framework, was employed. The subsequent phases of the thesis aimed to identify IPEP implementation barriers and facilitators in the specific context of professional soccer. Two cross-sectional surveys explored the perceptions of IPEP users in professional teams and a prospective observational study assessed IPEP use, over one playing season, in a professional youth soccer academy. Evaluation of the published literature against the RE-AIM framework revealed major gaps in the reporting of specific IPEP implementation aspects, particularly relating to program adoption and maintenance. In professional soccer teams, multiple IPEP implementation barriers and facilitators were identified. These factors related either to the content and nature of the IPEPs themselves (e.g. variation, progression and soccer-specificity), or the delivery and support of programs (e.g. communication and team work) at different levels of the professional soccer ecology. In summary, there are major gaps in the reporting of implementation aspects in team ball sport trials. To enhance the implementation of IPEPs in professional soccer settings, the content and delivery of programs require significant tailoring to the specific implementation context.
- Description: Doctor of Philosophy
Changes in muscle activation following balance and technique training and a season of Australian football
- Donnelly, Cyril, Elliott, Bruce, Doyle, Tim, Finch, Caroline, Dempsey, Alasdair, Lloyd, David
- Authors: Donnelly, Cyril , Elliott, Bruce , Doyle, Tim , Finch, Caroline , Dempsey, Alasdair , Lloyd, David
- Date: 2014
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 18, no. 3 (2014), p.348-352
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: Objectives: Determine if balance and technique training implemented adjunct to 1001 male Australian football players' training influenced the activation/strength of the muscles crossing the knee during pre-planned and unplanned sidestepping. Design: Randomized Control Trial. Methods: Each Australian football player participated in either 28 weeks of balance and technique training or 'sham' training. Twenty-eight Australian football players (balance and technique training, n = 12; 'sham' training, n = 16) completed biomechanical testing pre-to-post training. Peak knee moments and directed co-contraction ratios in three degrees of freedom, as well as total muscle activation were calculated during pre-planned and unplanned sidestepping. Results: No significant differences in muscle activation/strength were observed between the 'sham' training and balance and technique training groups. Following a season of Australian football, knee extensor (p = 0.023) and semimembranosus (p = 0.006) muscle activation increased during both pre-planned sidestepping and unplanned sidestepping. Following a season of Australian football, total muscle activation was 30% lower and peak valgus knee moments 80% greater (p = 0.022) during unplanned sidestepping when compared with pre-planned sidestepping. Conclusions: When implemented in a community level training environment, balance and technique training was not effective in changing the activation of the muscles crossing the knee during sidestepping. Following a season of Australian football, players are better able to support both frontal and sagittal plane knee moments. When compared to pre-planned sidestepping, Australian football players may be at increased risk of anterior cruciate ligament injury during unplanned sidestepping in the latter half of an Australian football season.
- Authors: Donnelly, Cyril , Elliott, Bruce , Doyle, Tim , Finch, Caroline , Dempsey, Alasdair , Lloyd, David
- Date: 2014
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 18, no. 3 (2014), p.348-352
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: Objectives: Determine if balance and technique training implemented adjunct to 1001 male Australian football players' training influenced the activation/strength of the muscles crossing the knee during pre-planned and unplanned sidestepping. Design: Randomized Control Trial. Methods: Each Australian football player participated in either 28 weeks of balance and technique training or 'sham' training. Twenty-eight Australian football players (balance and technique training, n = 12; 'sham' training, n = 16) completed biomechanical testing pre-to-post training. Peak knee moments and directed co-contraction ratios in three degrees of freedom, as well as total muscle activation were calculated during pre-planned and unplanned sidestepping. Results: No significant differences in muscle activation/strength were observed between the 'sham' training and balance and technique training groups. Following a season of Australian football, knee extensor (p = 0.023) and semimembranosus (p = 0.006) muscle activation increased during both pre-planned sidestepping and unplanned sidestepping. Following a season of Australian football, total muscle activation was 30% lower and peak valgus knee moments 80% greater (p = 0.022) during unplanned sidestepping when compared with pre-planned sidestepping. Conclusions: When implemented in a community level training environment, balance and technique training was not effective in changing the activation of the muscles crossing the knee during sidestepping. Following a season of Australian football, players are better able to support both frontal and sagittal plane knee moments. When compared to pre-planned sidestepping, Australian football players may be at increased risk of anterior cruciate ligament injury during unplanned sidestepping in the latter half of an Australian football season.
Preventing lower limb injuries : Is the latest evidence being translated into the football field?
- Twomey, Dara, Finch, Caroline, Roediger, E., Lloyd, David
- Authors: Twomey, Dara , Finch, Caroline , Roediger, E. , Lloyd, David
- Date: 2009
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 12, no. 4 (2009), p. 452-456
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: There is accumulating international evidence that lower limb injuries in sport can be prevented through targeted training but the extent to which this knowledge has been translated to real-world sporting practice is not known. A semi-structured questionnaire of all coaches from the nine Sydney Australian Football League Premier Division teams was conducted. Information was sought about their knowledge and behaviours in relation to delivering training programs, including their uptake of the latest scientific evidence for injury prevention. Direct observation of a sample of the coach-delivered training sessions was also undertaken to validate the questionnaire. Coaches ranked training session elements directly related to the game as being of most importance. They strongly favoured warming-up and cooling-down as injury prevention measures but changing direction and side-stepping training was considered to be of little/no importance for safety. Only one-third believed that balance training had some importance for injury prevention, despite accumulating scientific evidence to the contrary. Drills, set play, ball handling and kicking skills were all considered to be of least importance to injury prevention. These views were consistent with the content of the observed coach-led training sessions. In conclusion, current football training sessions do not give adequate attention to the development of skills most likely to reduce the risk of lower limb injury in players. There is a need to improve the translation of the latest scientific evidence about effective injury prevention into coaching practices. © 2008 Sports Medicine Australia.
- Description: 2003006500
Enhancing integration of specialised exercise training into coach practice to prevent lower-limb injury : Using theory and exploring coaches' salient beliefs
- Authors: McGlashan, Angela
- Date: 2015
- Type: Text , Thesis , PhD
- Full Text:
- Description: Lower limb injuries (LLIs) are common in community-Australian football (CAF) and specialised exercise training (SET) programs can reduce their incidence. Despite the protection SET programs afford, the use of SET by coaches in CAF contexts, who play a key role in the preparation of players, is largely unknown. The overall purpose of this thesis research was to explore and describe: (1) the contextual and specific nature of CAF coaching practices, and, (2) the factors central to understanding whether or not coaches will make changes in their training practices in the future. Thereby, assisting to devise effective behaviour change and implementation strategies that maximise future integration (adoption and maintainence) of SET programs in CAF contexts to reduce the risk of LLIs for players. This mixed methods research was underpinned by a combination of behavioural and social science theories and models (BSSTM). Coaches’ were sampled from CAF clubs in Victoria and Western Australia. Eligible coaches completed cross-sectional questionnaires pre (n=31) and post (n=28) season in 2007/08. Three coaches engaged in semi-structured, in-depth interviews, 12-18 months later. At preseason, 58% of coaches used injury prevention strategies with their team. Only 69% of them had a formal training plan for the entire season, and most did not explicitly incorporate SET programs, despite their views being favourable towards the latter. Coaches believed their players had a high chance of sustaining a LLI and that LLI could have serious consequences. They believed it was important to have current knowledge of SET programs, but many lacked the behavioural capability and self-efficacy to implement SET programs. They also reported that player attendance at training could also impact on SET program outcomes. Postseason findings were similar with generally positive SET outcome expectancies; many coaches reported they intended to modify SET program implementation in future seasons. Suggested improvements related to collaboration, feedback/reinforcement approaches, education and other sociocultural themes. Coaches reported divergent views about their self-efficacy in relation to SET program implementation but were motivated by what their players thought. Qualitative analysis of the in-depth interviews identified four main themes (and associated coach salient beliefs) that supported and extended quantitative findings. These included: (1) the development of coach behavioural capability/self-efficacy (including informal and formal learning sources), (2) biopsychosocial risk perceptions regarding players’ injury susceptibility, (3) facilitators and hindrances to adopting/maintaining SET, and (4) cues to action/planning. The promotion of SET programs to reduce the susceptibility of LLIs and ensure safe and sustainable participation in AF is important. This thesis has captured a complexity of factors that can be used to enhance and facilitate CAF coaches’ adoption and maintenance of SET, alongside wider-prevention efforts. Future research should continue to use a range of BSSTM and methodological approaches, and devise and evaluate the efficacy of a comprehensive taxonomy of cognitive-behavioural strategies, to provide more insight into effective translation of SET programs into practice. Coaches and their players will be safer if such work continues.
- Description: Doctor of Philosophy
- Authors: McGlashan, Angela
- Date: 2015
- Type: Text , Thesis , PhD
- Full Text:
- Description: Lower limb injuries (LLIs) are common in community-Australian football (CAF) and specialised exercise training (SET) programs can reduce their incidence. Despite the protection SET programs afford, the use of SET by coaches in CAF contexts, who play a key role in the preparation of players, is largely unknown. The overall purpose of this thesis research was to explore and describe: (1) the contextual and specific nature of CAF coaching practices, and, (2) the factors central to understanding whether or not coaches will make changes in their training practices in the future. Thereby, assisting to devise effective behaviour change and implementation strategies that maximise future integration (adoption and maintainence) of SET programs in CAF contexts to reduce the risk of LLIs for players. This mixed methods research was underpinned by a combination of behavioural and social science theories and models (BSSTM). Coaches’ were sampled from CAF clubs in Victoria and Western Australia. Eligible coaches completed cross-sectional questionnaires pre (n=31) and post (n=28) season in 2007/08. Three coaches engaged in semi-structured, in-depth interviews, 12-18 months later. At preseason, 58% of coaches used injury prevention strategies with their team. Only 69% of them had a formal training plan for the entire season, and most did not explicitly incorporate SET programs, despite their views being favourable towards the latter. Coaches believed their players had a high chance of sustaining a LLI and that LLI could have serious consequences. They believed it was important to have current knowledge of SET programs, but many lacked the behavioural capability and self-efficacy to implement SET programs. They also reported that player attendance at training could also impact on SET program outcomes. Postseason findings were similar with generally positive SET outcome expectancies; many coaches reported they intended to modify SET program implementation in future seasons. Suggested improvements related to collaboration, feedback/reinforcement approaches, education and other sociocultural themes. Coaches reported divergent views about their self-efficacy in relation to SET program implementation but were motivated by what their players thought. Qualitative analysis of the in-depth interviews identified four main themes (and associated coach salient beliefs) that supported and extended quantitative findings. These included: (1) the development of coach behavioural capability/self-efficacy (including informal and formal learning sources), (2) biopsychosocial risk perceptions regarding players’ injury susceptibility, (3) facilitators and hindrances to adopting/maintaining SET, and (4) cues to action/planning. The promotion of SET programs to reduce the susceptibility of LLIs and ensure safe and sustainable participation in AF is important. This thesis has captured a complexity of factors that can be used to enhance and facilitate CAF coaches’ adoption and maintenance of SET, alongside wider-prevention efforts. Future research should continue to use a range of BSSTM and methodological approaches, and devise and evaluate the efficacy of a comprehensive taxonomy of cognitive-behavioural strategies, to provide more insight into effective translation of SET programs into practice. Coaches and their players will be safer if such work continues.
- Description: Doctor of Philosophy
Epidemiology, injury and illness prevention in Olympic combat sports
- Authors: Bromley, Sally
- Date: 2018
- Type: Text , Thesis , PhD
- Full Text:
- Description: Background: Olympic combat sports are commonly considered dangerous, however injury rates for these sports are not well understood. Isolated studies in combat sports have investigated injury, however these are mainly during competition, and therefore are unlikely to include significant or persistent injury which prevents athletes competing and participating in data collection. This thesis was undertaken as a series of linked studies, to provide further detail into the types, mechanisms and aetiology of injuries in combat sports. Methods: Study 1 was a systematic review that utilised the PRISMA guidelines to investigate the current evidence. Study 2 was a repeated measures study to examine the reliability of training load measures. Study 3 employed a longitudinal study design to assess the feasibility of injury, illness and training load monitoring. Finally, Study 4 was a cross-sectional cohort study that gathered perspectives of combat sport coaches and managers before and after an injury and illness prevention workshop. Results: Study 1 found one high-quality epidemiological study with low risk of bias in Judo. Variation in injury and illness definitions prevented cross-sport comparisons, however the injury incidence was comparable to other sports. In Study 2, rating of perceived exertion (RPE) was shown to have good stability across sessions (ICC=0.84), and no significant differences were found between coach (observed) and athlete (experienced) RPE (ordered logistic regression coefficient = 0.47 [1.51–0.57 95%CI]). Study 3 found that athlete engagement with the monitoring system was low, with only 13% of athletes entering data across a 12-week period. Irrespective of low engagement, 62 injuries and illnesses were recorded. In Study 4, combat sport coaches and managers were found to be generally well informed of the risk and seriousness of injury and illness, however, illness risk perceptions changed after the workshop (p=0.048). Discussion and Conclusion: Currently, cross-sport comparisons are not possible due to varying data methodology and study quality. Based upon the results presented in this thesis, RPE can be used as a tool to quantify training load in the sport of judo. Longitudinal surveillance of training load, injury and illness in combat sport is not currently feasible within the Australian system, due to low uptake and engagement. However, the collection of data on a large number of injuries and illnesses indicates that athletes are experiencing multiple, repeated health problems. Coaches and managers are well informed about injury and illness risk and seriousness, indicating that injury and illness prevention education alone may not translate to a decrease in injury and illness incidence in combat sport.
- Description: Doctor of Philosophy
- Authors: Bromley, Sally
- Date: 2018
- Type: Text , Thesis , PhD
- Full Text:
- Description: Background: Olympic combat sports are commonly considered dangerous, however injury rates for these sports are not well understood. Isolated studies in combat sports have investigated injury, however these are mainly during competition, and therefore are unlikely to include significant or persistent injury which prevents athletes competing and participating in data collection. This thesis was undertaken as a series of linked studies, to provide further detail into the types, mechanisms and aetiology of injuries in combat sports. Methods: Study 1 was a systematic review that utilised the PRISMA guidelines to investigate the current evidence. Study 2 was a repeated measures study to examine the reliability of training load measures. Study 3 employed a longitudinal study design to assess the feasibility of injury, illness and training load monitoring. Finally, Study 4 was a cross-sectional cohort study that gathered perspectives of combat sport coaches and managers before and after an injury and illness prevention workshop. Results: Study 1 found one high-quality epidemiological study with low risk of bias in Judo. Variation in injury and illness definitions prevented cross-sport comparisons, however the injury incidence was comparable to other sports. In Study 2, rating of perceived exertion (RPE) was shown to have good stability across sessions (ICC=0.84), and no significant differences were found between coach (observed) and athlete (experienced) RPE (ordered logistic regression coefficient = 0.47 [1.51–0.57 95%CI]). Study 3 found that athlete engagement with the monitoring system was low, with only 13% of athletes entering data across a 12-week period. Irrespective of low engagement, 62 injuries and illnesses were recorded. In Study 4, combat sport coaches and managers were found to be generally well informed of the risk and seriousness of injury and illness, however, illness risk perceptions changed after the workshop (p=0.048). Discussion and Conclusion: Currently, cross-sport comparisons are not possible due to varying data methodology and study quality. Based upon the results presented in this thesis, RPE can be used as a tool to quantify training load in the sport of judo. Longitudinal surveillance of training load, injury and illness in combat sport is not currently feasible within the Australian system, due to low uptake and engagement. However, the collection of data on a large number of injuries and illnesses indicates that athletes are experiencing multiple, repeated health problems. Coaches and managers are well informed about injury and illness risk and seriousness, indicating that injury and illness prevention education alone may not translate to a decrease in injury and illness incidence in combat sport.
- Description: Doctor of Philosophy
The translation of sports injury prevention and safety promotion knowledge : Insights from key intermediary organisations
- Bekker, Sheree, Paliadelis, Penny, Finch, Caroline
- 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
- Full Text:
- Reviewed:
- 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).
- 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
- Full Text:
- Reviewed:
- 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).