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Quantification of Achilles and patellar tendon structure on imaging does not enhance ability to predict self-reported symptoms beyond grey-scale ultrasound and previous history

- Docking, Sean, Rio, Ebonie, Cook, Jill, Carey, David, Fortington, Lauren

  • Authors: Docking, Sean , Rio, Ebonie , Cook, Jill , Carey, David , Fortington, Lauren
  • Date: 2019
  • Type: Text , Journal article
  • Relation: Journal of Science and Medicine in Sport Vol. 22, no. 2 (2019), p. 145-150
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  • Description: Background: Tendon pathology on imaging has been associated with an increased risk of developing symptoms. This evidence is based on classifying the tendon as normal or pathological. It is unclear whether the extent of tendon pathology is associated with the development or severity of symptoms. Objectives: To investigate whether the presence and extent of tendon pathology on ultrasound tissue characterisation (UTC), or a previous history of symptoms, were associated with the development of symptoms over a football season. Methods: 179 male Australian football players underwent UTC imaging of their Achilles and/or patellar tendon at the start of the pre-season. Players completed monthly OSTRC overuse questionnaires to quantify the presence and severity of Achilles and/or patellar tendon symptoms. Risk factor analysis was performed to identify associations between imaging and the development of symptoms. Results: A pathological Achilles tendon increased the risk of developing symptoms (RR = 3.2, 95%CI 1.7–5.9). Conversely, a pathological patellar tendon was not significantly associated with the development of symptoms (RR = 1.8, 95%CI 0.9–3.7). Quantification of tendon structure using UTC did not enhance the ability to identify athletes who developed symptoms. Previous history of symptoms was the strongest predictor for the development of symptoms (Achilles RR = 3.0 95%CI 1.8–4.8; patellar RR = 3.7 95%CI 2.2–6.1). Conclusion: Tendon pathology was associated with the development of self-reported symptoms; however previous history of symptoms was a stronger risk factor. The extent of disorganisation quantified by UTC should not be used as a marker for the presence or severity of current and future symptoms.

Seasonal time-loss match injury rates and burden in South African under-16 rugby teams

- Sewry, Nicola, Verhagen, Evert, Lambert, Mike, van Mechelen, Willem, Readhead, Clint, Viljoen, Wayne, Brown, James

  • Authors: Sewry, Nicola , Verhagen, Evert , Lambert, Mike , van Mechelen, Willem , Readhead, Clint , Viljoen, Wayne , Brown, James
  • Date: 2019
  • Type: Text , Journal article
  • Relation: Journal of Science and Medicine in Sport Vol. 22, no. 1 (2019), p. 54-58
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  • Description: Objectives: Youth rugby union is a popular sport with a high injury incidence density (IID) and burden. This high risk has called for further research into the factors affecting the injuries in youth rugby. The aim of the study was to analyse time-loss IID and burden in multiple schoolboy rugby teams over a season and the potential factors associated with injury. Design: Prospective cohort Methods: All time-loss injuries were recorded from three schools for the whole season. Overall IID and injury burden were calculated, as well as for injury event, type, location and the match quarter in which they occurred and Poisson regression analyses were performed to determine differences. Results: IID was 28.8 (18.9–38.6) injuries per 1000 player hours over the season, with an injury burden of 379.2 (343.6–414.9) days lost per 1000 player hours. The ball-carrier had a significantly higher IID (11.3 (5.2–17.5) per 1000 player hours) compared to other events, and the joint (non-bone)/ligament injuries were the most common (IID of 12.2 (5.8–18.6) per 1000 player hours) and severe type of injury (burden of 172.6 (148.5–196.6) days lost per 1000 player hours). Conclusions: The IID was similar to previous youth rugby studies, however the injury burden was much lower. The South African youth cohort showed similar factors associated with injury for inciting event (the tackle) and injury type (joint (non-bone)/ligament) and location (lower limb) as seen in other studies in both youth and senior players.

The behaviour change techniques used by Australian physiotherapists to promote non-treatment physical activity to patients with musculoskeletal conditions

- Kunstler, Breanne, Cook, Jill, Kemp, Joanne, O'Halloran, Paul, Finch, Caroline

  • Authors: Kunstler, Breanne , Cook, Jill , Kemp, Joanne , O'Halloran, Paul , Finch, Caroline
  • Date: 2019
  • Type: Text , Journal article
  • Relation: Journal of Science and Medicine in Sport Vol. 22, no. 1 (2019), p. 2-10
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  • Description: Objectives: To determine: (i) the behaviour change techniques used by a sample of Australian physiotherapists to promote non-treatment physical activity; and (ii) whether those behaviour change techniques are different to the techniques used to encourage adherence to rehabilitation exercises. Design: Cross-sectional survey. Method: An online self-report survey was advertised to private practice and outpatient physiotherapists treating patients with musculoskeletal conditions. The use of 50 behaviour change techniques were measured using five-point Likert-type scale questions. Results: Four-hundred and eighty-six physiotherapists responded to the survey, with 216 surveys fully completed. Most respondents (85.1%) promoted non-treatment physical activity often or all of the time. Respondents frequently used 29 behaviour change techniques to promote non-treatment physical activity or encourage adherence to rehabilitation exercises. A similar number of behaviour change techniques was frequently used to encourage adherence to rehabilitation exercises (n = 28) and promote non-treatment physical activity (n = 26). Half of the behaviour change techniques included in the survey were frequently used for both promoting non-treatment physical activity and encouraging adherence to rehabilitation exercises (n = 25). Graded tasks was the most, and punishment was the least, frequently reported technique used to promote non-treatment physical activity and encourage adherence to rehabilitation exercises. Conclusions: Respondents reported using similar behaviour change techniques to promote non-treatment physical activity and encourage adherence to rehabilitation exercises. The variability in behaviour change technique use suggests the behaviour the physiotherapist is promoting influences their behaviour change technique choice. Including the frequently-used behaviour change techniques in non-treatment physical activity promotion interventions might improve their efficacy. © 2018 Sports Medicine Australia

Validity of injury self-reports by novice runners : Comparison with reports by sports medicine physicians

- Smits, Dirk-Wouter, Backx, Frank, van der Worp, Henk, van Middelkoop, Marienke, Hartgens, Fred, Verhagen, Evert, Kluitenberg, Bas, Huisstede, Bionka

  • Authors: Smits, Dirk-Wouter , Backx, Frank , van der Worp, Henk , van Middelkoop, Marienke , Hartgens, Fred , Verhagen, Evert , Kluitenberg, Bas , Huisstede, Bionka
  • Date: 2019
  • Type: Text , Journal article
  • Relation: Research in Sports Medicine Vol. 27, no. 1 (2019), p. 72-87
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  • Description: This study examined the criterion validity of self-reported running-related injuries (RRI) by novice runners. Fifty-eight participants (41 females; age 46 ± 11 yrs) of the “Start-to-Run” program provided self-reports on their RRIs using an online questionnaire. Subsequently, they attended injury consultations with sports medicine physicians who provided physician-reports (blinded for the self-reports) as a reference standard. Self-reports and physician-reports included information on injury location (i.e., hip/groin, upper leg, knee, lower leg, and ankle/foot) and injury type (i.e., muscle-tendon unit, joint, ligament, or bone). Sensitivity, specificity, and positive predictive values were 100% for all five injury locations. For injury type, sensitivity was low (66% for muscle-tendon unit, 50% for ligament, and 40% for bone) and lowest for joint injuries (17%). In conclusion, the validity of self-reported RRIs by novice runners is good for injury locations but not for injury types. In particular for joint injuries, the validity of novice runners’ self-reports is low. Abbreviations: RRI: Running Related Injury; SMC: Sports Medicine Centre; MTU: Muscle Tendon Unit; PPV: Positive Predictive Value.

A 12-month prospective cohort study of symptoms of common mental disorders among professional rugby players

- Gouttebarge, Vincent, Hopley, Philip, Kerkhoffs, Gino, Verhagen, Evert, Viljoen, Wayne, Wylleman, Paul, Lambert, Mike

  • Authors: Gouttebarge, Vincent , Hopley, Philip , Kerkhoffs, Gino , Verhagen, Evert , Viljoen, Wayne , Wylleman, Paul , Lambert, Mike
  • Date: 2018
  • Type: Text , Journal article
  • Relation: European Journal of Sport Science Vol. 18, no. 7 (2018), p. 1004-1012
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  • Description: The primary aims were to determine the 12-month incidence (and comorbidity) of symptoms of common mental disorders (CMD) among male professional rugby players and to explore their association with potential stressors. A secondary aim was to explore the view of male professional rugby players about the consequences of symptoms of CMD and related medical support/needs. An observational prospective cohort study with three measurements over a 12-month period was conducted among male professional rugby players from several countries. Symptoms of CMD (distress, anxiety/depression, sleep disturbance, eating disorders and adverse alcohol use) and stressors (adverse life events, rugby career dissatisfaction) were assessed through validated questionnaires. A total of 595 players (mean age of 26 years; mean career duration of 6 years) were enrolled, of which 333 completed the follow-up period. The incidence of symptoms of CMD were: 11% for distress, 28% for anxiety/depression, 12% for sleep disturbance, 11% for eating disorders and 22% for adverse alcohol use (13% for two simultaneous symptoms of CMD). Professional rugby players reporting recent adverse life events or career dissatisfaction were more likely to report symptoms of CMD but statistically significant associations were not found. Around 95% of the participants stated that symptoms of CMD can negatively influence rugby performances, while 46% mentioned that specific support measures for players were not available in professional rugby. Supportive and preventive measures directed towards symptoms of CMD should be developed to improve not only awareness and psychological resilience of rugby players but also their rugby performance and quality-of-life. © 2018, © 2018 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

An updated subsequent injury categorisation model (SIC-2.0) : Data-driven categorisation of subsequent injuries in sport

- Toohey, Liam, Drew, Michael, Fortington, Lauren, Finch, Caroline, Cook, Jill

  • Authors: Toohey, Liam , Drew, Michael , Fortington, Lauren , Finch, Caroline , Cook, Jill
  • Date: 2018
  • Type: Text , Journal article
  • Relation: Sports Medicine Vol. 48, no. 9 (2018), p. 2199-2210
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  • Description: Background: Accounting for subsequent injuries is critical for sports injury epidemiology. The subsequent injury categorisation (SIC-1.0) model was developed to create a framework for accurate categorisation of subsequent injuries but its operationalisation has been challenging. Objectives: The objective of this study was to update the subsequent injury categorisation (SIC-1.0 to SIC-2.0) model to improve its utility and application to sports injury datasets, and to test its applicability to a sports injury dataset. Methods: The SIC-1.0 model was expanded to include two levels of categorisation describing how previous injuries relate to subsequent events. A data-driven classification level was established containing eight discrete injury categories identifiable without clinical input. A sequential classification level that sub-categorised the data-driven categories according to their level of clinical relatedness has 16 distinct subsequent injury types. Manual and automated SIC-2.0 model categorisation were applied to a prospective injury dataset collected for elite rugby sevens players over a 2-year period. Absolute agreement between the two coding methods was assessed. Results: An automated script for automatic data-driven categorisation and a flowchart for manual coding were developed for the SIC-2.0 model. The SIC-2.0 model was applied to 246 injuries sustained by 55 players (median four injuries, range 1–12), 46 (83.6%) of whom experienced more than one injury. The majority of subsequent injuries (78.7%) were sustained to a different site and were of a different nature. Absolute agreement between the manual coding and automated statistical script category allocation was 100%. Conclusions: The updated SIC-2.0 model provides a simple flowchart and automated electronic script to allow both an accurate and efficient method of categorising subsequent injury data in sport.

Assessment and monitoring practices of Australian fitness professionals

- Bennie, Jason, Wiesner, Glen, van Uffelen, Jannique, Harvey, Jack, Craike, Melinda, Biddle, Stuart

  • Authors: Bennie, Jason , Wiesner, Glen , van Uffelen, Jannique , Harvey, Jack , Craike, Melinda , Biddle, Stuart
  • Date: 2018
  • Type: Text , Journal article
  • Relation: Journal of Science and Medicine in Sport Vol. 21, no. 4 (2018), p. 433-438
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  • Description: Objectives: Assessment and monitoring of client health and fitness is a key part of fitness professionals’ practices. However, little is known about prevalence of this practice. This study describes the assessment/monitoring practices of a large sample of Australian fitness professionals. Design: Cross-sectional. Methods: In 2014, 1206 fitness professionals completed an online survey. Respondents reported their frequency (4 point-scale: [1] ‘never’ to [4] ‘always’) of assessment/monitoring of eight health and fitness constructs (e.g. body composition, aerobic fitness). This was classified as: (i) ‘high’ (‘always’ assessing/monitoring ≥5 constructs); (ii) ‘medium’ (1–4 constructs); (iii) ‘low’ (0 constructs). Classifications are reported by demographic and fitness industry characteristics. The odds of being classified as a ‘high assessor/monitor’ according to social ecological correlates were examined using a multiple-factor logistic regression model. Results: Mean age of respondents was 39.3 (±11.6) years and 71.6% were female. A total of 15.8% (95% CI: 13.7%–17.9%) were classified as a ‘high’ assessor/monitor. Constructs with the largest proportion of being ‘always’ assessed were body composition (47.7%; 95% CI: 45.0%–50.1%) and aerobic fitness (42.5%; 95% CI: 39.6%–45.3%). Those with the lowest proportion of being ‘always’ assessed were balance (24.0%; 95% CI: 24.7%–26.5%) and mental health (20.2%; 95% CI: 18.1%–29.6%). A perceived lack of client interest and fitness professionals not considering assessing their responsibility were associated with lower odds of being classified as a ‘high assessor/monitor’. Conclusions: Most fitness professionals do not routinely assess/monitor client fitness and health. Key factors limiting client health assessment and monitoring include a perceived lack of client interest and professionals not considering this their role. © 2017

Developing ‘good buggers’ : Global implications of the influence of culture on New Zealand club rugby coaches’ beliefs and practice

- Hassanin, Remy, Light, Richard, Macfarlane, Angus

  • Authors: Hassanin, Remy , Light, Richard , Macfarlane, Angus
  • Date: 2018
  • Type: Text , Journal article
  • Relation: Sport in Society Vol. 21, no. 8 (2018), p. 1223-1235
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  • Description: Despite recognition of how experience shapes sport coaches’ beliefs and practice empirical investigation into how this occurs is limited. This article redresses this gap in the literature by presenting the findings of a study that inquired into the influence of culture on three New Zealand rugby coaches’ beliefs and practice to identify the powerful influence of interaction between a ‘local’ traditional culture of club rugby in New Zealand shaped by the resilient ‘amateur ideal’, intensified by the perceived threat of professional rugby and the global culture of the sport industry to club rugby. © 2018,

Do neurocognitive SCAT3 baseline test scores differ between footballers (soccer) living with and without diability? A cross-sectional study

- Weiler, Richard, van Mechelen, Willem, Fuller, Colin, Ahmed, Osman, Verhagen, Evert

  • Authors: Weiler, Richard , van Mechelen, Willem , Fuller, Colin , Ahmed, Osman , Verhagen, Evert
  • Date: 2018
  • Type: Text , Journal article
  • Relation: Clinical Journal of Sport Medicine Vol. 28, no. 1 (2018), p. 43-50
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  • Description: OBJECTIVE:: To determine if baseline Sport Concussion Assessment Tool, third Edition (SCAT3) scores differ between athletes with and without disability. DESIGN:: Cross-sectional comparison of preseason baseline SCAT3 scores for a range of England international footballers. SETTING:: Team doctors and physiotherapists supporting England football teams recorded playersʼ SCAT 3 baseline tests from August 1, 2013 to July 31, 2014. PARTICIPANTS:: A convenience sample of 249 England footballers, of whom 185 were players without disability (male: 119; female: 66) and 64 were players with disability (male learning disability: 17; male cerebral palsy: 28; male blind: 10; female deaf: 9). ASSESSMENT AND OUTCOME MEASURES:: Between-group comparisons of median SCAT3 total and section scores were made using nonparametric Mann–Whitney–Wilcoxon ranked-sum test. MAIN RESULTS:: All footballers with disability scored higher symptom severity scores compared with male players without disability. Male footballers with learning disability demonstrated no significant difference in the total number of symptoms, but recorded significantly lower scores on immediate memory and delayed recall compared with male players without disability. Male blind footballersʼ scored significantly higher for total concentration and delayed recall, and male footballers with cerebral palsy scored significantly higher on balance testing and immediate memory, when compared with male players without disability. Female footballers with deafness scored significantly higher for total concentration and balance testing than female footballers without disability. CONCLUSIONS:: This study suggests that significant differences exist between SCAT3 baseline section scores for footballers with and without disability. Concussion consensus guidelines should recognize these differences and produce guidelines that are specific for the growing number of athletes living with disability.

Effectiveness of a nationwide intervention to increase helmet use in Dutch skiers and snowboarders : An observational cohort study

- Vriend, Ingrid, Hesselink, Arlette, Kemler, Ellen, Gouttebarge, Vincent, Van Mechelen, Willem, Verhagen, Evert

  • Authors: Vriend, Ingrid , Hesselink, Arlette , Kemler, Ellen , Gouttebarge, Vincent , Van Mechelen, Willem , Verhagen, Evert
  • Date: 2018
  • Type: Text , Journal article
  • Relation: Injury Prevention Vol. 24, no. 3 (2018), p. 205-212
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  • Description: Objective Helmet use in Dutch recreational skiers and snowboarders (DRSS) remains low. This study evaluated the effects of exposure to a nationwide intervention on relevant determinants of helmet use and helmet use in DRSS. Methods The intervention mapping protocol was used to develop an in-season intervention programme targeted at adult DRSS. A prospective single-cohort study was conducted to evaluate the impact of intervention exposure on determinants of helmet use (ie, knowledge about head injury risk and preventive measures, risk perception, attitudes to head injury risk and helmet use and intention to helmet use) and self-reported helmet use. A random sample of 363 DRSS from an existing panel participated in this study. Data were collected using online questionnaires before and immediately after the 2010/2011 intervention season. In a separate sample of 363 DRSS, intervention reach was assessed after the 2010/2011 season. Results Overall, no significant associations were found between intervention exposure and the determinants of helmet use. However, subgroup analyses revealed intervention effects on risk perception and knowledge in specific subpopulations. Intervention exposure had a significant, positive effect on helmet use in DRSS (β=0.23; 95% CI 0.017 to 0.44). Subgroup analyses revealed that this effect was found in: (1) skiers, (2) female DRSS, (3) young skiers and (4) intermediate skiers. Overall, intervention reach was 28.1%, with differences found between skiers and snowboarders. Conclusions Exposure to a nationwide intervention programme was associated with increased selfreported helmet use in DRSS. Differences were found in intervention effectiveness and reach between subpopulations. These differences must be taken into account when developing and evaluating future interventions.

Elite junior Australian football players experience significantly different loads across levels of competition and training modes

- Lathlean, Timothy, Gastin, Paul, Newstead, Stuart, Finch, Caroline

  • Authors: Lathlean, Timothy , Gastin, Paul , Newstead, Stuart , Finch, Caroline
  • Date: 2018
  • Type: Text , Journal article
  • Relation: Journal of strength and conditioning research Vol. 32, no. 7 (2018), p. 2031-2038
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  • Description: Lathlean, TJH, Gastin, PB, Newstead, S, and Finch, CF. Elite junior Australian football players experience significantly different loads across levels of competition and training modes. J Strength Cond Res 32(7): 2031-2038, 2018-Well-developed physical qualities such as high jumping ability, running endurance, acceleration, and speed can help aspiring junior elite Australian football (AF) players transition to the Australian Football League competition. To do so, players need to experience sufficient load to enhance their physical resilience without increasing their risk of negative outcomes in terms of impaired wellness or injury. The aim of this study was to investigate the differences in load for different levels of competition and training modes across one competitive season. Elite junior AF players (n = 562, aged 17.7 ± 0.3, range: 16-18 years) were recruited from 9 teams across the under-18 state league competition in Victoria. All players recorded their training and match intensities according to the session rating of perceived exertion method. Training sessions were categorized according to skills, strength, conditioning, and other activities, whereas matches were identified according to level of competition. The loads in U18 state league matches (656.7 ± 210.9 au) were significantly higher (p = 0.027) than those in school matches (643.3 ± 260.9 au) and those in U18 representative matches (617.2 ± 175.4). Players, who undertook more than one match per week, experienced significantly less load in subsequent matches (p < 0.001). Furthermore, U18 state league training sessions carried the most load when compared with other training modes. This article highlights that different combinations of training and match involvement affect overall player load, which may predispose players to negative outcomes such as impaired wellness or increased injury risk.

Epidemiology of injuries in women playing competitive team bat-or-stick sports : A systematic review and a meta-analysis

- Panagodage Perera, Nirmala, Joseph, Corey, Kemp, Joanne, Finch, Caroline

  • Authors: Panagodage Perera, Nirmala , Joseph, Corey , Kemp, Joanne , Finch, Caroline
  • Date: 2018
  • Type: Text , Journal article , Review
  • Relation: Sports Medicine Vol. 48, no. 3 (2018), p. 617-640
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  • Description: Background: Team bat-or-stick sports, including cricket, softball and hockey, are popular among women. However, little is known about the injury profile in this population. Objective: The aim was to describe the incidence, nature and anatomical location of injuries in bat-or-stick sports played by women in a competitive league. Methods: This review was prospectively registered (PROSPERO CRD42015026715). CINAHL, MEDLINE, PsycINFO, PubMed, SPORTDiscus were systematically searched from January 2000 to September 2016, inclusive. Peer-reviewed original research articles reporting the incidence, nature and anatomical location of injuries sustained by women aged 18 + years in competitive bat-or-stick sports were included. Two meta-analyses based on injury incidence proportions (injury IP) and injury rates per 1000 person-days of athletic exposure (AE) were performed. Results: A total of 37 studies satisfied the inclusion criteria, and five had low risk of bias. The weighted injury IP was 0.42 [95% confidence interval (CI) 0.39–0.45]. The weighted injury rate was 6.12 (95% CI 6.05–6.18) overall, and greater in games [15.79 (95% CI 15.65–15.93)] than in practice [3.07 (95% CI 2.99–3.15)]. The ankle was the most commonly injured anatomical location, followed by the hand (including wrist and fingers), knee and head. Soft tissue and ligament injuries were most common types of injuries. Conclusion: Injury prevention in women’s sports is a novel and emerging field of research interest. This review highlights that injury incidence is high among female bat-or-stick players, but little information is known about direct causal mechanisms. This review clearly establishes the need for enhancements to injury data collection. Without this information, it will not be possible to develop evidence-based injury prevention interventions. © 2017, Springer International Publishing AG, part of Springer Nature.

How much is enough in rehabilitation? High running workloads following lower limb muscle injury delay return to play but protect against subsequent injury

- Stares, Jordan, Dawson, Brian, Peeling, Peter, Drew, Michael, Heasman, Jarryd, Rogalski, Brent, Colby, Marcus

  • Authors: Stares, Jordan , Dawson, Brian , Peeling, Peter , Drew, Michael , Heasman, Jarryd , Rogalski, Brent , Colby, Marcus
  • Date: 2018
  • Type: Text , Journal article
  • Relation: Journal of Science and Medicine in Sport Vol. 21, no. 10 (2018), p. 1019-1024
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  • Description: Objectives: Examine the influence of rehabilitation training loads on return to play (RTP) time and subsequent injury in elite Australian footballers. Design: Prospective cohort study. Methods: Internal (sessional rating of perceived exertion: sRPE) and external (distance, sprint distance) workload and lower limb non-contact muscle injury data was collected from 58 players over 5 seasons. Rehabilitation periods were analysed for running workloads and time spent in 3 rehabilitation stages (1: off-legs training, 2: non-football running, 3: group football training) was calculated. Multi-level survival analyses with random effects accounting for player and season were performed. Hazard ratios (HR) and 95% confidence intervals (CI) for each variable were produced for RTP time and time to subsequent injury. Results: Of 85 lower limb muscle injuries, 70 were rehabilitated to RTP, with 30 cases of subsequent injury recorded (recurrence rate = 11.8%, new site injury rate = 31.4%). Completion of high rehabilitation workloads delayed RTP (distance: >49,775 m [reference: 34,613–49,775 m]: HR 0.12, 95%CI 0.04–0.36, sRPE: >1266 AU [reference: 852–1266 AU]: HR 0.09, 95%CI 0.03–0.32). Return to running within 4 days increased subsequent injury risk (3–4 days [reference: 5–6 days]: HR 25.88, 95%CI 2.06–324.4). Attaining moderate-high sprint distance (427–710 m) was protective against subsequent injury (154–426 m: [reference: 427–710 m]: HR 37.41, 95%CI 2.70–518.64). Conclusions: Training load monitoring can inform player rehabilitation programs. Higher rehabilitation training loads delayed RTP; however, moderate-high sprint running loads can protect against subsequent injury. Shared-decision making regarding RTP should include accumulated training loads and consider the trade-off between expedited RTP and lower subsequent injury risk.

Identifying high risk loading conditions for in-season injury in elite Australian football players

- Stares, Jordan, Dawson, Brian, Peeling, Peter, Heasman, Jarryd, Rogalski, Brent, Drew, Michael, Colby, Marcus, Dupont, Gregory, Lester, Leanne

  • Authors: Stares, Jordan , Dawson, Brian , Peeling, Peter , Heasman, Jarryd , Rogalski, Brent , Drew, Michael , Colby, Marcus , Dupont, Gregory , Lester, Leanne
  • Date: 2018
  • Type: Text , Journal article
  • Relation: Journal of Science and Medicine in Sport Vol. 21, no. 1 (2018), p. 46-51
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  • Description: Objectives To examine different timeframes for calculating acute to chronic workload ratio (ACWR) and whether this variable is associated with intrinsic injury risk in elite Australian football players. Design Prospective cohort study. Methods Internal (session rating of perceived exertion: sRPE) and external (GPS distance and sprint distance) workload and injury data were collected from 70 players from one AFL club over 4 seasons. Various acute (1–2 weeks) and chronic (3–8 weeks) timeframes were used to calculate ACWRs: these and chronic load categories were then analysed to determine the injury risk in the subsequent month. Poisson regression with robust errors within a generalised estimating equation were utilised to determine incidence rate ratios (IRR). Results Altering acute and/or chronic timeframes did not improve the ability to detect high injury risk conditions above the commonly used 1:4 week ACWR. Twenty-seven ACWR/chronic load combinations were found to be “high risk conditions” (IRR > 1, p < 0.05) for injury within 7 days. Most (93%) of these conditions occurred when chronic load was low or very low and ACWR was either low (<0.6) or high (>1.5). Once a high injury risk condition was entered, the elevated risk persisted for up to 28 days. Conclusions Injury risk was greatest when chronic load was low and ACWR was either low or high. This heightened risk remained for up to 4 weeks. There was no improvement in the ability to identify high injury risk situations by altering acute or chronic time periods from 1:4 weeks.

Injuries in Australian rules football : An overview of injury rates, patterns, and mechanisms across all levels of play

- Saw, Richard, Finch, Caroline, Samra, David, Baquie, Peter, Cardoso, Tanusha, Hope, Danielle, Orchard, John

  • Authors: Saw, Richard , Finch, Caroline , Samra, David , Baquie, Peter , Cardoso, Tanusha , Hope, Danielle , Orchard, John
  • Date: 2018
  • Type: Text , Journal article
  • Relation: Sports Health Vol. 10, no. 3 (2018), p. 208-216
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  • Description: Context: The nature of Australian rules football (Australian football) predisposes both unique and common injuries compared with those sustained in other football codes. The game involves a combination of tackling, kicking, high-speed running (more than other football codes), and jumping. Two decades of injury surveillance has identified common injuries at the professional level (Australian Football League [AFL]). Objective: To provide an overview of injuries in Australian rules football, including injury rates, patterns, and mechanisms across all levels of play. Study Design: A narrative review of AFL injuries, football injury epidemiology, and biomechanical and physiological attributes of relevant injuries. Results: The overall injury incidence in the 2015 season was 41.7 injuries per club per season, with a prevalence of 156.2 missed games per club per season. Lower limb injuries are most prevalent, with hamstring strains accounting for 19.1 missed games per club per season. Hamstring strains relate to the volume of high-speed running required in addition to at times having to collect the ball while running in a position of hip flexion and knee extension. Anterior cruciate ligament injuries are also prevalent and can result from contact and noncontact incidents. In the upper limb, shoulder sprains and dislocations account for 11.5 missed games per club per season and largely resulted from tackling and contact. Concussion is less common in AFL than other tackling sports but remains an important injury, which has notably become more prevalent in recent years, theorized to be due to a more conservative approach to management. Although there are less injury surveillance data for non-AFL players (women, community-level, children), many of these injuries appear to also be common across all levels of play. Clinical Relevance: An understanding of injury profiles and mechanisms in Australian football is crucial in identifying methods to reduce injury risk and prepare players for the demands of the game. © 2017,

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).

Knee flexion strength is significantly reduced following competition in semi-professional Australian Rules football athletes : Implications for injury prevention programs

- Charlton, Paula, Raysmith, Benjamin, Wollin, Martin, Rice, Simon, Purdam, Craig, Clark, Ross, Drew, Michael

  • Authors: Charlton, Paula , Raysmith, Benjamin , Wollin, Martin , Rice, Simon , Purdam, Craig , Clark, Ross , Drew, Michael
  • Date: 2018
  • Type: Text , Journal article
  • Relation: Physical Therapy in Sport Vol. 31, no. (2018), p. 9-14
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  • Description: Objectives: To evaluate strength and flexibility measures pre- and post- Australian Football (AF) competition to determine their potential utility as secondary prevention measures. Design: Cohort study. Setting: Semi-professional AF club. Participants: Ten male AF athletes (mean ± SD; age, 21.3 ± 2.2 years; height, 186.1 ± 6.3 cm; weight, 83.5 ± 8.6 kg). Main Outcome Measures: Maximal unilateral isometric knee flexion strength performed in 45 degrees of hip flexion and 30 degrees of knee flexion, flexibility measures of hip and knee extension and ankle dorsiflexion. All outcome measures were evaluated pre-match to determine baseline measurements and repeated acutely post-match and at 26, 50 and 74 h following. Comparisons were made between baseline measures and all other time points. Results: Knee flexion strength was significantly reduced at a group level acutely (−122.8N, 95%CI −156.2 to −89.4, p = 0.000) and at 26 h (−89.6N, 95%CI −122.9 to −56.2, p = 0.000) following competition. Hamstring flexibility was significantly reduced at all time periods following competition (all p < 0.05), however these values were not clinically meaningful. Conclusions: Knowledge that unilateral isometric knee flexion strength returns to pre-competition levels by 50 h following match-play in AF athletes is valuable for planning recovery time frames and may inform implementation of secondary prevention strategies. © 2018 Elsevier Ltd

Physiotherapists use a small number of behaviour change techniques when promoting physical activity : A systematic review comparing experimental and observational studies

- Kunstler, Breanne, Cook, Jill, Freene, Nicole, Finch, Caroline, Kemp, Joanne, O'Halloran, Paul, Gaida, James

  • Authors: Kunstler, Breanne , Cook, Jill , Freene, Nicole , Finch, Caroline , Kemp, Joanne , O'Halloran, Paul , Gaida, James
  • Date: 2018
  • Type: Text , Journal article , Review
  • Relation: Journal of Science and Medicine in Sport Vol. 21, no. 6 (2018), p. 609-615
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  • Description: Objectives: Physiotherapists promote physical activity as part of their practice. This study reviewed the behaviour change techniques physiotherapists use when promoting physical activity in experimental and observational studies. Design: Systematic review of experimental and observational studies. Methods: Twelve databases were searched using terms related to physiotherapy and physical activity. We included experimental studies evaluating the efficacy of physiotherapist-led physical activity interventions delivered to adults in clinic-based private practice and outpatient settings to individuals with, or at risk of, non-communicable diseases. Observational studies reporting the techniques physiotherapists use when promoting physical activity were also included. The behaviour change techniques used in all studies were identified using the Behaviour Change Technique Taxonomy. The behaviour change techniques appearing in efficacious and inefficacious experimental interventions were compared using a narrative approach. Results: Twelve studies (nine experimental and three observational) were retained from the initial search yield of 4141. Risk of bias ranged from low to high. Physiotherapists used seven behaviour change techniques in the observational studies, compared to 30 behaviour change techniques in the experimental studies. Social support (unspecified) was the most frequently identified behaviour change technique across both settings. Efficacious experimental interventions used more behaviour change techniques (n = 29) and functioned in more ways (n = 6) than did inefficacious experimental interventions (behaviour change techniques = 10 and functions = 1). Conclusions: Physiotherapists use a small number of behaviour change techniques. Less behaviour change techniques were identified in observational studies compared to experimental studies, suggesting physiotherapists use less BCTs clinically than experimentally.

Preventing recurrent ankle sprains : Is the use of an App more cost-effective than a printed Booklet? Results of a RCT

- 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
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  • 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.

Quantifying cricket fast-bowling skill

- Feros, Simon, Young, Warren, O’Brien, Brendan

  • Authors: Feros, Simon , Young, Warren , O’Brien, Brendan
  • Date: 2018
  • Type: Text , Journal article , Review
  • Relation: International Journal of Sports Physiology and Performance Vol. 13, no. 7 (2018), p. 830-838
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  • Description: Objectives: To evaluate the current evidence regarding the quantification of cricket fast-bowling skill. Methods: Studies that assessed fast-bowling skill (bowling speed and accuracy) were identified from searches in SPORTDiscus (EBSCO) in June 2017. The reference lists of identified papers were also examined for relevant investigations. Results: A total of 16 papers matched the inclusion criteria, and discrepancies in assessment procedures were evident. Differences in test environment, pitch, and cricket ball characteristics; the warm-up prior to test; test familiarization procedures; permitted run-up lengths; bowling spell length; delivery sequence; test instructions; collection of bowling speed data; and collection and reportage of bowling accuracy data were apparent throughout the literature. The reliability and sensitivity of fast-bowling skill measures have rarely been reported across the literature. Only 1 study has attempted to assess the construct validity of its skill measures. Conclusions: There are several discrepancies in how fast-bowling skill has been assessed and subsequently quantified in the literature to date. This is a problem, because comparisons between studies are often difficult. Therefore, a strong rationale exists for the creation of match-specific standardized fast-bowling assessments that offer greater ecological validity while maintaining acceptable reliability and sensitivity of the skill measures. If prospective research can act on the proposed recommendations from this review, then coaches will be able to make more informed decisions surrounding player selection, talent identification, return to skill following injury, and the efficacy of short- and long-term training interventions for fast bowlers.