Preventing Australian football injuries with a targeted neuromuscular control exercise programme: comparative injury rates from a training intervention delivered in a clustered randomised controlled trial
- Finch, Caroline, Twomey, Dara, Fortington, Lauren, Doyle, Tim, Elliott, Bruce, Akram, Muhammad, Lloyd, David
- Authors: Finch, Caroline , Twomey, Dara , Fortington, Lauren , Doyle, Tim , Elliott, Bruce , Akram, Muhammad , Lloyd, David
- Date: 2016
- Type: Text , Journal article
- Relation: Injury Prevention Vol. 22, no. 2 (Apr 2016), p. 123-128
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
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- Description: Background Exercise-based training programmes are commonly used to prevent sports injuries but programme effectiveness within community men's team sport is largely unknown. Objective To present the intention-to-treat analysis of injury outcomes from a clustered randomised controlled trial in community Australian football. Methods Players from 18 male, non-elite, community Australian football clubs across two states were randomly allocated to either a neuromuscular control (NMC) (intervention n=679 players) or standard-practice (control n=885 players) exercise training programme delivered as part of regular team training sessions (2x weekly for 8-week preseason and 18-week regularseason). All game-related injuries and hours of game participation were recorded. Generalised estimating equations, adjusted for clustering (club unit), were used to compute injury incidence rates (IIRs) for all injuries, lower limb injuries (LLIs) and knee injuries sustained during games. The IIRs were compared across groups with cluster-adjusted Injury Rate Ratios (IRRs). Results Overall, 773 game injuries were recorded. The lower limb was the most frequent body region injured, accounting for 50% of injuries overall, 96 (12%) of which were knee injuries. The NMC players had a reduced LLI rate compared with control players (IRR: 0.78 (95% CI 0.56 to 1.08), p=0.14.) The knee IIR was also reduced for NMC compared with control players (IRR: 0.50 (95% CI 0.24 to 1.05), p=0.07). Conclusions These intention-to-treat results indicate that positive outcomes can be achieved from targeted training programmes for reducing knee and LLI injury rates in men's community sport. While not statistically significant, reducing the knee injury rate by 50% and the LLI rate by 22% is still a clinically important outcome. Further injury reductions could be achieved with improved training attendance and participation in the programme.
- Authors: Finch, Caroline , Twomey, Dara , Fortington, Lauren , Doyle, Tim , Elliott, Bruce , Akram, Muhammad , Lloyd, David
- Date: 2016
- Type: Text , Journal article
- Relation: Injury Prevention Vol. 22, no. 2 (Apr 2016), p. 123-128
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
- Full Text:
- Reviewed:
- Description: Background Exercise-based training programmes are commonly used to prevent sports injuries but programme effectiveness within community men's team sport is largely unknown. Objective To present the intention-to-treat analysis of injury outcomes from a clustered randomised controlled trial in community Australian football. Methods Players from 18 male, non-elite, community Australian football clubs across two states were randomly allocated to either a neuromuscular control (NMC) (intervention n=679 players) or standard-practice (control n=885 players) exercise training programme delivered as part of regular team training sessions (2x weekly for 8-week preseason and 18-week regularseason). All game-related injuries and hours of game participation were recorded. Generalised estimating equations, adjusted for clustering (club unit), were used to compute injury incidence rates (IIRs) for all injuries, lower limb injuries (LLIs) and knee injuries sustained during games. The IIRs were compared across groups with cluster-adjusted Injury Rate Ratios (IRRs). Results Overall, 773 game injuries were recorded. The lower limb was the most frequent body region injured, accounting for 50% of injuries overall, 96 (12%) of which were knee injuries. The NMC players had a reduced LLI rate compared with control players (IRR: 0.78 (95% CI 0.56 to 1.08), p=0.14.) The knee IIR was also reduced for NMC compared with control players (IRR: 0.50 (95% CI 0.24 to 1.05), p=0.07). Conclusions These intention-to-treat results indicate that positive outcomes can be achieved from targeted training programmes for reducing knee and LLI injury rates in men's community sport. While not statistically significant, reducing the knee injury rate by 50% and the LLI rate by 22% is still a clinically important outcome. Further injury reductions could be achieved with improved training attendance and participation in the programme.
- Talpey, Scott, Young, Warren, Twomey, Dara, Doyle, Tim, Elliott, Bruce, Lloyd, David, Finch, Caroline
- Authors: Talpey, Scott , Young, Warren , Twomey, Dara , Doyle, Tim , Elliott, Bruce , Lloyd, David , Finch, Caroline
- Date: 2014
- Type: Text , Journal article
- Relation: Journal of Australian Strength & Conditioning Vol. 22, no. 5 (2014), p. 176-178
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- Description: The article presents research on the necessary data on change of direction (CODS), agility standards and sprint for Australian football (AF) coaches. Results of the study include the significance of specific information to AF players, the use of this information in highlighting the weaknesses and strengths among the players, and the implementation of certain training for CODS improvement.
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
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- 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.
What do community football players think about different exercise-training programmes? Implications for the delivery of lower limb injury prevention programmes
- Finch, Caroline, Doyle, Tim, Dempsey, Alasdair, Elliott, Bruce, Twomey, Dara, White, Peta, Diamantopoulou, Kathy, Young, Warren, Lloyd, David
- Authors: Finch, Caroline , Doyle, Tim , Dempsey, Alasdair , Elliott, Bruce , Twomey, Dara , White, Peta , Diamantopoulou, Kathy , Young, Warren , Lloyd, David
- Date: 2014
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 48, no. 8 (2014), p.702-707
- Relation: http://purl.org/au-research/grants/nhmrc/565900
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- Description: Background: Players are the targeted end-users and beneficiaries of exercise-training programmes implemented during coach-led training sessions, and the success of programmes depends upon their active participation. Two variants of an exercise-training programme were incorporated into the regular training schedules of 40 community Australian Football teams, over two seasons. One variant replicated common training practices, while the second was an evidence-based programme to alter biomechanical and neuromuscular factors related to risk of knee injuries. This paper describes the structure of the implemented programmes and compares players’ end-of-season views about the programme variants. Methods: This study was nested within a larger group-clustered randomised controlled trial of the effectiveness of two exercise-training programmes (control and neuromuscular control (NMC)) for preventing knee injuries. A post-season self-report survey, derived from Health Belief Model constructs, included questions to obtain players’ views about the benefits and physical challenges of the programme in which they participated. Results: Compared with control players, those who participated in the NMC programme found it to be less physically challenging but more enjoyable and potentially of more benefit. Suggestions from players about potential improvements to the training programme and its future implementation included reducing duration, increasing range of drills/exercises and promoting its injury prevention and other benefits to players. Conclusions: Players provide valuable feedback about the content and focus of implemented exercise-training programmes, that will directly inform the delivery of similar, or more successful, programmes in the future.
- Authors: Finch, Caroline , Doyle, Tim , Dempsey, Alasdair , Elliott, Bruce , Twomey, Dara , White, Peta , Diamantopoulou, Kathy , Young, Warren , Lloyd, David
- Date: 2014
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 48, no. 8 (2014), p.702-707
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: Background: Players are the targeted end-users and beneficiaries of exercise-training programmes implemented during coach-led training sessions, and the success of programmes depends upon their active participation. Two variants of an exercise-training programme were incorporated into the regular training schedules of 40 community Australian Football teams, over two seasons. One variant replicated common training practices, while the second was an evidence-based programme to alter biomechanical and neuromuscular factors related to risk of knee injuries. This paper describes the structure of the implemented programmes and compares players’ end-of-season views about the programme variants. Methods: This study was nested within a larger group-clustered randomised controlled trial of the effectiveness of two exercise-training programmes (control and neuromuscular control (NMC)) for preventing knee injuries. A post-season self-report survey, derived from Health Belief Model constructs, included questions to obtain players’ views about the benefits and physical challenges of the programme in which they participated. Results: Compared with control players, those who participated in the NMC programme found it to be less physically challenging but more enjoyable and potentially of more benefit. Suggestions from players about potential improvements to the training programme and its future implementation included reducing duration, increasing range of drills/exercises and promoting its injury prevention and other benefits to players. Conclusions: Players provide valuable feedback about the content and focus of implemented exercise-training programmes, that will directly inform the delivery of similar, or more successful, programmes in the future.
An Anterior cruciate ligament Injury prevention framework : Incorporating the recent evidence
- Donnelly, Cyril, Elliott, Bruce, Ackland, Timothy, Doyle, Tim, Beiser, Thor, Finch, Caroline, Cochrane, Jodie, Dempsey, Alasdair, Lloyd, David
- Authors: Donnelly, Cyril , Elliott, Bruce , Ackland, Timothy , Doyle, Tim , Beiser, Thor , Finch, Caroline , Cochrane, Jodie , Dempsey, Alasdair , Lloyd, David
- Date: 2012
- Type: Text , Journal article
- Relation: Research in Sports Medicine Vol. 20, no. 3/4 (2012), p. 239-262
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Relation: http://purl.org/au-research/grants/nhmrc/565907
- Full Text: false
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- Description: Anterior cruciate ligament (ACL) injury rates have increased by ∼50% over the last 10 years. These figures suggest that ACL focused research has not been effective in reducing injury rates among community level athletes. Training protocols designed to reduce ACL injury rates have been both effective (n = 3) and ineffective (n = 7). Although a rationale for the use of exercise to reduce ACL injuries is established, the mechanisms by which they act are relatively unknown. This article provides an injury prevention framework specific to noncontact ACL injuries and the design of prophylactic training protocols. It is also apparent that feedback within this framework is needed to determine how biomechanically relevant risk factors like peak joint loading and muscular support are influenced following training. It is by identifying these links that more effective ACL injury prevention training programs can be developed, and, in turn, lead to reduced ACL injury rates in the future.
Level of agreement between field-based data collectors in a large scale injury prevention randomised controlled trial
- Twomey, Dara, Finch, Caroline, Doyle, Tim, Elliott, Bruce, Lloyd, David
- Authors: Twomey, Dara , Finch, Caroline , Doyle, Tim , Elliott, Bruce , Lloyd, David
- Date: 2011
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 14, no. 2 (2011), p. 121-125
- Relation: http://purl.org/au-research/grants/nhmrc/565900
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- Description: In sports injury prevention field trials, data collectors are often club volunteers with considerable knowledge of the game but with limited detailed medical backgrounds or knowledge of formal scientific processes. The aim of this paper is to determine the agreement among trained primary data collectors (PDCs) with a sport science background and no prior involvement in data collection in a large randomised controlled trial. During the 'Preventing Australian Football Injury through eXercise' (PAFIX) project, player participation and injury data were collected by trained PDCs at training and games over the 2007 and 2008 playing seasons in 40 community level Australian football teams. PDC-collected data relating to player exposure and whether or not a player sustained an injury and subsequently left the field of play was compared to the same information from independent observers (IOs) who attended one randomly selected game for each of the 40 teams. There was 98% agreement between the PDC and the IO on game details (i.e., date, time, grade and score), 79% (ICC 0.9, 95% CI 0.85-0.95) agreement on the number of players per game and 76% (ICC 0.8, 95% CI 0.69-0.91) agreement on the number of injuries sustained in the games. There was 100% agreement on whether the player left the field for all injuries. This study found that exercise and sport science students are reliable data collectors in sports injury fieldwork studies. (C) 2010 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
- Authors: Twomey, Dara , Finch, Caroline , Doyle, Tim , Elliott, Bruce , Lloyd, David
- Date: 2011
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 14, no. 2 (2011), p. 121-125
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: In sports injury prevention field trials, data collectors are often club volunteers with considerable knowledge of the game but with limited detailed medical backgrounds or knowledge of formal scientific processes. The aim of this paper is to determine the agreement among trained primary data collectors (PDCs) with a sport science background and no prior involvement in data collection in a large randomised controlled trial. During the 'Preventing Australian Football Injury through eXercise' (PAFIX) project, player participation and injury data were collected by trained PDCs at training and games over the 2007 and 2008 playing seasons in 40 community level Australian football teams. PDC-collected data relating to player exposure and whether or not a player sustained an injury and subsequently left the field of play was compared to the same information from independent observers (IOs) who attended one randomly selected game for each of the 40 teams. There was 98% agreement between the PDC and the IO on game details (i.e., date, time, grade and score), 79% (ICC 0.9, 95% CI 0.85-0.95) agreement on the number of players per game and 76% (ICC 0.8, 95% CI 0.69-0.91) agreement on the number of injuries sustained in the games. There was 100% agreement on whether the player left the field for all injuries. This study found that exercise and sport science students are reliable data collectors in sports injury fieldwork studies. (C) 2010 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
Ground hardness and injury in community level Australian football
- Twomey, Dara, Finch, Caroline, Lloyd, David, Elliott, Bruce, Doyle, Tim
- Authors: Twomey, Dara , Finch, Caroline , Lloyd, David , Elliott, Bruce , Doyle, Tim
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol.15, no. (4), p.305-310
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
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- Description: Objective: To describe the risk and details of injuries associated with ground hardness in community level Australian football (AF). Design: Prospective injury surveillance with periodic objective ground hardness measurement. Methods: 112 ground hardness assessments were undertaken using a Clegg hammer at nine locations across 20 grounds, over the 2007 and 2008 AF seasons. Details of 352 injuries sustained by community level players on those grounds were prospectively collected as part of a large randomised controlled trial. The ground location of the injury was matched to the nearest corresponding ground hardness Clegg hammer readings, in gravities (g), which were classified from unacceptably low (<30 g) to unacceptably high hardness (>120 g). Results: Clegg hammer readings ranged from 25 to 301 g. Clegg hammer hardness categories from low/normal to high/normal were associated with the majority of injuries, with only 3.7% (13 injuries) on unacceptably high hardness and 0.3% (1 injury) on the unacceptably low hardness locations. Relative to the preferred range of hardness, the risk of sustaining an injury on low/normal hardness locations was 1.31 (95%CI: 1.06-1.62) times higher and 1.82 (95%CI: 1.17-2.85) times higher on locations with unacceptably high hardness. The more severe injuries occurred with low/normal ground hardness. Conclusions: Despite the low number of injuries, the risk of sustaining an injury on low/normal and unacceptably hard grounds was significantly greater than on the preferred range of hardness. Notably, the severity of the injuries sustained on unacceptably hard grounds was lower than for other categories of hardness. © 2012 Sports Medicine Australia.
- Authors: Twomey, Dara , Finch, Caroline , Lloyd, David , Elliott, Bruce , Doyle, Tim
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol.15, no. (4), p.305-310
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: Objective: To describe the risk and details of injuries associated with ground hardness in community level Australian football (AF). Design: Prospective injury surveillance with periodic objective ground hardness measurement. Methods: 112 ground hardness assessments were undertaken using a Clegg hammer at nine locations across 20 grounds, over the 2007 and 2008 AF seasons. Details of 352 injuries sustained by community level players on those grounds were prospectively collected as part of a large randomised controlled trial. The ground location of the injury was matched to the nearest corresponding ground hardness Clegg hammer readings, in gravities (g), which were classified from unacceptably low (<30 g) to unacceptably high hardness (>120 g). Results: Clegg hammer readings ranged from 25 to 301 g. Clegg hammer hardness categories from low/normal to high/normal were associated with the majority of injuries, with only 3.7% (13 injuries) on unacceptably high hardness and 0.3% (1 injury) on the unacceptably low hardness locations. Relative to the preferred range of hardness, the risk of sustaining an injury on low/normal hardness locations was 1.31 (95%CI: 1.06-1.62) times higher and 1.82 (95%CI: 1.17-2.85) times higher on locations with unacceptably high hardness. The more severe injuries occurred with low/normal ground hardness. Conclusions: Despite the low number of injuries, the risk of sustaining an injury on low/normal and unacceptably hard grounds was significantly greater than on the preferred range of hardness. Notably, the severity of the injuries sustained on unacceptably hard grounds was lower than for other categories of hardness. © 2012 Sports Medicine Australia.
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