Could targeted exercise programmes prevent lower limb injury in community Australian football?
- 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
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- 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
The translation of sports injury prevention and safety promotion knowledge : Insights from key intermediary organisations
- 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
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- 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).
Infographic : We have the programme, what next? Developing a plan of action to implement injury prevention exercise programmes in community sport
- Authors: Bekker, Sheree , Donaldson, Alex , Finch, Caroline
- Date: 2018
- Type: Text , Journal article
- Relation: British journal of sports medicine Vol. 52, no. 22 (2018), p. 1419-1420
- Full Text: false
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- Description: Exercise programmes to prevent injuries, such as lower-limb injuries that are common in community Australian Football
The fallacy of amelioration: Thinking through knowledge translation in sport and exercise medicine
- Authors: Bekker, Sheree , Paliadelis, Penny , Finch, Caroline
- Date: 2018
- Type: Text , Journal article
- Relation: Translational sports medicine Vol. 1, no. 4 (2018), p. 166-171
- Full Text: false
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- Description: Knowledge Translation, as a component of implementation science, has seen extensive popularization in Sport and Exercise Medicine (SEM) over recent years. However, in seeking better and more influential outcomes, much of SEM appears to be following Knowledge Translation fashion and fad, over ensuring function and form. This has meant that key concepts in Knowledge Translation have been conflated, the work oversimplified, and potential outcomes overhyped. In this manuscript, Knowledge Translation is, first, defined as a process. Next, we show how oversimplified versions of Knowledge Translation rely on the “fallacy of amelioration,” with problematic consequences and unintended outcomes. Finally, we move to rethinking Knowledge Translation in SEM by showing how the field can move forward through embracing Knowledge Translation as a complex process to maximize the influence and impact of its work.
A framework for the etiology of running-related injuries
- Authors: Bertelsen, Michael , Hulme, Adam , Petersen, Jesper , Brund, Rene , Sørensen, Henrik , Finch, Caroline , Parner, Erik , Nielsen, Rasmus
- Date: 2017
- Type: Text , Journal article , Review
- Relation: Scandinavian Journal of Medicine and Science in Sports Vol. 27, no. 11 (2017), p. 1170-1180
- Full Text: false
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- Description: The etiology of running-related injury is important to consider as the effectiveness of a given running-related injury prevention intervention is dependent on whether etiologic factors are readily modifiable and consistent with a biologically plausible causal mechanism. Therefore, the purpose of the present article was to present an evidence-informed conceptual framework outlining the multifactorial nature of running-related injury etiology. In the framework, four mutually exclusive parts are presented: (a) Structure-specific capacity when entering a running session; (b) structure-specific cumulative load per running session; (c) reduction in the structure-specific capacity during a running session; and (d) exceeding the structure-specific capacity. The framework can then be used to inform the design of future running-related injury prevention studies, including the formation of research questions and hypotheses, as well as the monitoring of participation-related and non-participation-related exposures. In addition, future research applications should focus on addressing how changes in one or more exposures influence the risk of running-related injury. This necessitates the investigation of how different factors affect the structure-specific load and/or the load capacity, and the dose-response relationship between running participation and injury risk. Ultimately, this direction allows researchers to move beyond traditional risk factor identification to produce research findings that are not only reliably reported in terms of the observed cause-effect association, but also translatable in practice. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Modelling the population-level impact of tai-chi on falls and fall-related injury among community-dwelling older people
- Authors: Day, Lesley , Finch, Caroline , Harrison, James , Hoareau, Effie , Segal, Leonie , Ullah, Shahid
- Date: 2010
- Type: Text , Journal article
- Relation: Injury Prevention Vol. 16, no. 5 (2010), p. 321-326
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text: false
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- Description: Objective: To model the population level impact of tai-chi on future rates of falls and fall-related injury in older people as a tool for policy development. Design: An epidemiological and economic model for estimating population-level effectiveness of tai-chi. Setting: Australia, 2009. Patients or subjects: Australian community-dwelling population aged 70+ years, ambulatory and without debilitating conditions or profound visual defects. Intervention: Group-based tai-chi, for 1 h twice weekly for 26 weeks, assuming no sustained effect beyond the intervention period. Main outcome measure: Total falls and fall-related hospitalisation prevented in 2009. Results: Population-wide tai-chi delivery would prevent an estimated 5440 falls and 109 fall-related hospitalisations, resulting in a 0.18% reduction in the fall related hospital admission rate for community-dwelling older people. The gross costs per fall and per fall-related hospital admission prevented were $ A4414 ((sic)3013) and $A220 712 ((sic)150 684), respectively. A total investment of $A24.01 million ((sic)16.39 million), equivalent to 4.2% of the cost of fall-related episodes of hospital care in 2003/4, would be required to provide tai-chi for 31 998 people and achieve this effect. Conclusions: Substantial investment in, and high population uptake of, tai-chi would be required to have a large effect on falls and fall-related hospitalisation rates. Although not accounted for in this study, investment in tai-chi is likely to be associated with additional significant health benefits beyond falls prevention. This approach could be applied to other interventions to assist selection of the most cost effective falls-prevention portfolio for Australia and other countries.
Sports injuries
- Authors: Dennis, Rebecca , Finch, Caroline
- Date: 2008
- Type: Text , Book chapter
- Relation: International Encyclopedia of Public Health p. 206-211
- Full Text: false
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- Description: Participation in sport is encouraged by government agencies and physical activity experts because participation provides health, physical, mental, social, and economic benefits to the individual and community. However, an increased level of participation in sport can increase exposure to the hazards and risks associated with injury. This overview of sports injury describes their epidemiology, the types of injuries that can be sustained, the activities most commonly associated with injury, and the potential risk factors. Injury prevention strategies are also described, with examples to demonstrate the range of approaches available to sports participants, coaches, referees, and administrators. © 2008 Copyright © 2008 Elsevier Inc. All rights reserved.
Changes in muscle activation following balance and technique training and a season of Australian football
- 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.
An Anterior cruciate ligament Injury prevention framework : Incorporating the recent evidence
- 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.
Sports Injury Surveillance Systems : A Review of Methods and Data Quality
- Authors: Ekegren, Christina , Gabbe, Belinda , Finch, Caroline
- Date: 2016
- Type: Text , Journal article
- Relation: Sports Medicine Vol. 46, no. 1 (2016), p. 49-65
- Relation: http://purl.org/au-research/grants/nhmrc/565907
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
- Full Text: false
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- Description: Background and Aims: Data from sports injury surveillance systems are a prerequisite to the development and evaluation of injury prevention strategies. This review aimed to identify ongoing sports injury surveillance systems and determine whether there are gaps in our understanding of injuries in certain sport settings. A secondary aim was to determine which of the included surveillance systems have evaluated the quality of their data, a key factor in determining their usefulness. Methods: A systematic search was carried out to identify (1) publications presenting methodological details of sports injury surveillance systems within clubs and organisations; and (2) publications describing quality evaluations and the quality of data from these systems. Data extracted included methodological details of the surveillance systems, methods used to evaluate data quality, and results of these evaluations. Results: Following literature search and review, a total of 15 sports injury surveillance systems were identified. Data relevant to each aim were summarised descriptively. Most systems were found to exist within professional and elite sports. Publications concerning data quality were identified for seven (47 %) systems. Validation of system data through comparison with alternate sources has been undertaken for only four systems (27 %). Conclusions: This review identified a shortage of ongoing injury surveillance data from amateur and community sport settings and limited information about the quality of data in professional and elite settings. More surveillance systems are needed across a range of sport settings, as are standards for data quality reporting. These efforts will enable better monitoring of sports injury trends and the development of sports safety strategies. © 2015, Springer International Publishing Switzerland.
OARSI Clinical Trials Recommendations : Design and conduct of clinical trials for primary prevention of osteoarthritis by joint injury prevention in sport and recreation
- 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
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- 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.
A sports setting matrix for understanding the implementation context for community sport
- Authors: Finch, Caroline , Donaldson, Alex
- Date: 2010
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 44, no. 13 (2010), p. 973-978
- Full Text: false
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- Description: There has been increasing recognition of the need for effectiveness research within the real-world intervention context of community sport. This is important because, even if interventions have been shown to be efficacious in controlled trials, if they are not also widely adopted and sustained, then it is unlikely that they will have a public health impact. There is very little information about how to best conduct such studies, but application of health promotion frameworks, such as the RE-AIM framework, to evaluate the public health impact of interventions could potentially help to understand the implementation context. Care needs to be taken when directly applying the RE-AIM framework, however, because the definitions for each of its dimensions will depend on the level/s the intervention is targeted at. This paper provides a novel extension to the RE-AIM framework (the RE-AIM SportsSetting Matrix (RE-AIM SSM)), which accounts for the fact that many sports injury interventions need to be targeted at multiple levels of sports delivery. Accordingly, the RE-AIM components also need to be measured across all tiers of possible influence on the rate of uptake and effectiveness. Specific examples are given for coach delivered exercise training interventions. The RE-AIM SSM is specific to the community sports setting implementation context and could be used to guide the delivery of future sports safety, and other health promotion, interventions in this area.
Trends in hospitalised sport/leisure injuries in New South Wales, Australia-Implications for the targetting of population-focussed preventive sports medicine efforts
- Authors: Finch, Caroline , Mitchell, Rebecca , Boufous, Soufiane
- Date: 2011
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 14, no. 1 (January 2011), p. 15-21
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text: false
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- Description: Sport/leisure injuries are a population health issue in Australia. Over 2003-2004 to 2007-2008, the rate of sport/leisure injury NSW hospitalisations was 195.5/100,000 residents. Males and children/young people had consistently highest rates of hospitalisation. There was no significant decline in rates over this period and no change in the profiles of the types of sport/leisure injuries. The extent to which effective preventive programs have been developed and implemented needs to be determined as current programs do not seem to be impacting on hospitalisation rates. Medical/health promotion agencies and sports bodies need to jointly formulate and implement policies to reduce sport/leisure injuries. This is one of the most significant challenges facing sports medicine professionals today.
The safety attitudes of people who use multi-purpose recreation facilities as a physical activity setting
- Authors: Finch, Caroline , Otago, Leonie , White, Peta , Donaldson, Alex , Mahoney, Mary
- Date: 2011
- Type: Text , Journal article
- Relation: International Journal of Injury Control and Safety Promotion Vol. 18, no. 2 (2011), p. 107-112
- Full Text: false
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- Description: Multi-purpose recreation facilities (MPRFs) are a popular setting for physical activity and it is therefore important that they are safe for all patrons. However, the attitudes of MPRF users towards safety are a potential barrier to the success of injury prevention programmes implemented within MPRFs. This article reports a survey of the safety attitudes of over 700 users of four indoor MPRFs. Factor analysis of 12 five-point Likert scale statements showed that the attitudes clustered around three major dimensions - the importance of safety, the benefits of safety and the perceptions of injury risk. Together, these three dimensions accounted for 49% of the variability in the attitudes. More than 85% of respondents agreed/strongly agreed that: safety was an important aspect of physical activity participation; being injured affected enjoyment of physical activity; people should adopt appropriate safety measures for all physical activity; and individuals were responsible for their own safety. The MPRF users, particularly women and older people, were generally safety conscious, believed in adopting safety measures, and were willing to take responsibility for their own safety. Facility managers can be confident that if they provide evidence-based injury prevention interventions in these settings, then users will respond appropriately and adopt the promoted behaviours. © 2011 Taylor & Francis.
Controlled ecological evaluation of an implemented exercise-training programme to prevent lower limb injuries in sport : Population-level trends in hospital-treated injuries
- 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
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- 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.
Whose research agenda is it? Reconciling the views of researchers and sports stakeholders
- Authors: Finch, Caroline
- Date: 2017
- Type: Text , Journal article , Editorial
- Relation: British Journal of Sports Medicine Vol. 51, no. 1 (2017), p. 3-4
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
- Full Text: false
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- Description: It is now widely recognised that it is important to involve a full range of stakeholders and other research end-users, from the outset when designing and implementing prevention programmes. As long ago as 2003, my team recognised that the views of those actively involved in sport should also be considered when setting research priorities. Findings from our survey of coaches and sports administrators have since informed the direction of much of our sports injury research over the following decade in community Australian Football. There will be similar examples from other sports, even if they have not been formally documented in the sports medicine literature.
Back to basics with some new tools : First ensure the safety of sporting environments
- Authors: Finch, Caroline , Brown, James , Readhead, Clint , Lambert, Mike , Viljoen, Wayne
- Date: 2017
- Type: Text , Journal article , Editorial
- Relation: British Journal of Sports Medicine Vol. 51, no. 15 (2017), p. 1109-1110
- Full Text: false
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When 'just doing it' is not enough: Assessing the fidelity of player performance of an injury prevention exercise program
- Authors: Fortington, Lauren , Donaldson, Alex , Lathlean, Tim , Young, Warren , Gabbe, Belinda , Lloyd, David , Finch, Caroline
- Date: 2014
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 18, no. 3 (May 2014 2014), p.272-277
- Relation: http://purl.org/au-research/grants/nhmrc/565907
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
- Relation: http://purl.org/au-research/grants/nhmrc/565900
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- Description: Objectives: To obtain benefits from sports injury prevention programs, players are instructed to perform the exercises as prescribed. We developed an observational checklist to measure the quality of exercise performance by players participating in FootyFirst, a coach-led, exercise-based, lower-limb injury prevention program in community Australian Football (AF). Design: Observational. Methods: The essential performance criteria for each FootyFirst exercise were described in terms of the technique, volume and intensity required to perform each exercise. An observational checklist was developed to evaluate each criterion through direct visual observation of players at training. The checklist was trialled by two independent raters who observed the same 70 players completing the exercises at eight clubs. Agreement between observers was assessed by Kappa-statistics. Exercise fidelity was defined as the proportion of observed players who performed all aspects of their exercises correctly. Results: The raters agreed on 61/70 observations (87%) (Kappa = 0.72, 95% CI: 0.55; 0.89). Of the observations with agreed ratings, 41 (67%) players were judged as performing the exercises as prescribed. Conclusions: The observational checklist demonstrated high inter-rater reliability. Many players observed did not perform the exercises as prescribed, raising concern as to whether they would be receiving anticipated program benefits. Where quality of exercise performance is important, evaluation and reporting of program fidelity should include direct observations of participants.
Concussion in community Australian football - epidemiological monitoring of the causes and immediate impact on play
- Authors: Fortington, Lauren , Twomey, Dara , Finch, Caroline
- Date: 2015
- Type: Text , Journal article
- Relation: Injury Epidemiology Vol. 2, no. 1 (2015), p. 1-6
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
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- Description: BACKGROUND: Head injuries, particularly concussion, are a major cause of concern in many sports, particularly the football codes, driving a need to better understand injury mechanisms and potential methods of prevention. The aim of this study was to describe the mechanisms and follow up care of concussion injuries sustained in adult male community Australian football to identify target areas for prevention and management. METHODS: Secondary analysis of injury data collected in a cluster randomised controlled trial in community Australian football across two states of Australia in 2007 and 2008. There were 1564 players from 18 clubs. The main outcome measures were the number and rate of head/neck/face (HNF) injuries and concussion sustained in games. A specific description of the mechanisms of the concussion injuries is presented along with the immediate return-to-play status of concussion cases. RESULTS: 143 HNF injuries were sustained by 132 players. The game HNF injury incidence was 4.9 per 1000 game hours (n = 138; 95 % confidence interval 4.1; 5.7). Just under a quarter (n = 34) of all HNF injuries were recorded as concussion. All concussions occurred during games (none in training), with all but one related to body contact with other players. Overall, 68 % of the concussions were considered within game rules, while 32 % were either outside of the rules or unclear. Most (88 %) players left the field immediately following concussion but 47 % later returned to play in the same game. CONCLUSIONS: Prevention strategies for concussion need to be based on knowledge of the mechanisms of injury. Most concussions in community Australian football occurred through body contact with other players or during tackling. Management of players post-concussion was generally poor with over half of the cases continuing to play in the same game. Therefore, new primary prevention strategies that target body-contact/tackling skills and improved secondary prevention measures relating to compliance with return-to-play protocols would be valuable.
A call to capture fatalities in consensus statements for sports injury/illness surveillance
- Authors: Fortington, Lauren , Kucera, Kristen , Finch, Caroline
- Date: 2017
- Type: Text , Journal article , Editorial
- Relation: British Journal of Sports Medicine Vol. 51, no. 14 (2017), p. 1052-1053
- Full Text: false
- Reviewed: