Associations between helmet use and brain injuries amongst injured pedal- and motor-cyclists: A case series analysis of trauma centre presentations
- Authors: McIntosh, Andrew , Curtis, Kate , Rankin, Tiffany , Cox, Marie , Pang, Toh Yen , McCrory, Paul , Finch, Caroline
- Date: 2013
- Type: Text , Journal article
- Relation: Journal of the Australasian College of Road Safety Vol. 24, no. 2 (April 2013), p. 11-20
- Relation: http://purl.org/au-research/grants/nhmrc/565900
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- Description: Abstract: A retrospective case-series study of pedal- and motorcyclists presenting to a major metropolitan trauma centre over an 18 month period was undertaken. The injury data were coded according to a number of outcome variables, including intracranial injury of AIS severity >/= 2. Helmet use was coded. After stratification by rider type, data were analysed to examine the relationships between helmet use and injury using logistic regression. A total of 220 injured motorcycle riders and 137 injured pedal cyclists met the study's inclusion criteria, with 195 motorcycle riders and passengers (88.6%) and 87 pedal cyclists (63.5%) wearing helmets. Helmets were associated with a significant reduction (p<0.05) in the likelihood of head and intracranial injury in both rider groups. Associated with helmet use was a reduction in intracranial injury likelihood of 66% for both helmeted motorcycle riders and pedal cyclists. The study is further evidence of the benefits offered by helmets.
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
High adherence to a neuromuscular injury prevention programme (FIFA 11+) improves functional balance and reduces injury risk in Canadian youth female football players : A cluster randomised trial
- Authors: Steffen, Kathrin , Emery, Carolyn , Romiti, Maria , Kang, Jian , Bizzini, Mario , Dvorak, Jiri , Finch, Caroline , Meeuwisse, Willem
- Date: 2013
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 47, no. 12 (2013), p. 794-802
- Relation: http://purl.org/au-research/grants/nhmrc/565900
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- Description: Background A protective effect on injury risk in youth sports through neuromuscular warm-up training routines has consistently been demonstrated. However, there is a paucity of information regarding the quantity and quality of coach-led injury prevention programmes and its impact on the physical performance of players. Objective The aim of this cluster-randomised controlled trial was to assess whether different delivery methods of an injury prevention programme (FIFA 11+) to coaches could improve player performance, and to examine the effect of player adherence on performance and injury risk. Method During the 2011 football season (May- August), coaches of 31 tiers 1-3 level teams were introduced to the 11+ through either an unsupervised website or a coach-focused workshop with and without additional on-field supervisions. Playing exposure, adherence to the 11+, and injuries were recorded for female 13-year-old to 18-year-old players. Performance testing included the Star Excursion Balance Test (SEBT), single-leg balance, triple hop and jumping-over-a-bar tests. Results Complete preseason and postseason performance tests were available for 226 players (66.5%). Compared to the unsupervised group, singleleg balance (OR=2.8; 95% CI 1.1 to 4.6) and the anterior direction of the SEBT improved significantly in the onfield supervised group of players (OR=4.7; 95% CI 2.2 to 7.1), while 2-leg jumping performance decreased (OR=-5.1; 95% CI -9.9 to -0.2). However, significant improvements in 5 of 6 reach distances in the SEBT were found, favouring players who highly adhered to the 11+. Also, injury risk was lower for those players (injury rate ratio, IRR=0.28, 95% CI 0.10 to 0.79). Conclusions Different delivery methods of the FIFA 11+ to coaches influenced players' physical performance minimally. However, high player adherence to the 11+ resulted in significant improvements in functional balance and reduced injury risk.
- Description: 2003011216
Injury reporting via SMS text messaging in community sport
- Authors: Ekegren, Christina , Gabbe, Belinda , Finch, Caroline
- Date: 2013
- Type: Text , Journal article
- Relation: Injury Prevention Vol.20, no.4 (2013), p.266-271.
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- Description: Background: The use of text messaging or short message service (SMS) for injury reporting is a recent innovation in sport and has not yet been trialled at the community level. Considering the lack of personnel and resources in community sport, SMS may represent a viable option for ongoing injury surveillance. The aim of this study was to evaluate the feasibility of injury self-reporting via SMS in community Australian football. Methods: A total of 4 clubs were randomly selected from a possible 22 men's community Australian football clubs. Consenting players received an SMS after each football round game asking whether they had been injured in the preceding week. Outcome variables included the number of SMS-reported injuries, players’ response rates and response time. Poisson regression was used to evaluate any change in response rate over the season and the association between response rate and the number of reported injuries. Results: The sample of 139 football players reported 167 injuries via SMS over the course of the season. The total response rate ranged from 90% to 98%. Of those participants who replied on the same day, 47% replied within 5 min. The number of reported injuries decreased as the season progressed but this was not significantly associated with a change in the response rate. Conclusions: The number of injuries reported via SMS was consistent with previous studies in community Australian football. Injury reporting via SMS yielded a high response rate and fast response time and should be considered a viable injury reporting method for community sports settings.
Intention to use sport concussion guidelines among community-level coaches and sports trainers
- Authors: Newton, Joshua , White, Peta , Ewing, Michael , Makdissi, Michael , Davis, Gavin , Donaldson, Alex , Sullivan, John , Seward, Hugh , Finch, Caroline
- Date: 2013
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol.17, no.5 (2013), p.469-473
- Relation: http://purl.org/au-research/grants/nhmrc/565900
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- Description: Objectives: Sporting bodies have developed guidelines for managing community-level players with suspected concussion in response to international consensus statements on concussion in sport. The purpose of this study was to examine the factors that influence the intended use of concussion guidelines among community-level coaches and sports trainers from two popular football codes in Australia: Australian football and rugby league. Design: Cross-sectional survey. Methods: The survey, based on an extended theory of planned behaviour model, was completed by 183 Australian football coaches, 121 Australian football sports trainers, 171 rugby league coaches, and 142 rugby league sports trainers. Results: Personal norms and self-efficacy were significant predictors of intention to use concussion guidelines, although the relationship between self-efficacy and intention was stronger among Australian football coaches than rugby league coaches. Analysis of the salient beliefs that underpin self-efficacy found that coaches, irrespective of football code, felt less familiar (2 = 25.70, p < 0.001) and less experienced (2 = 31.56, p < 0.001) than sports trainers in using the concussion guidelines. At the same time, Australian football personnel, irrespective oftheir team role, feltthatthey had insufficienttime (2 = 8.04, p < 0.01) and resources (2 = 12.31, p < 0.001) to implement the concussion guidelines relative to rugby league personnel. Conclusions: Programmes aimed at increasing the intended use of sport concussion guidelines should focus on enhancing self-efficacy and leveraging personal norms. Increasing coaches’ familiarity and experience in using the concussion guidelines would also be warranted, as would finding ways to overcome the perceived time and resource constraints identified among Australian football personnel.
Priorities for investment in injury prevention in community Australian football
- Authors: Finch, Caroline , Gabbe, Belinda , White, Peta , Lloyd, David , Twomey, Dara , Donaldson, Alex , Elliott, Bruce , Cook, Jill
- Date: 2013
- Type: Text , Journal article
- Relation: Clinical journal of sport medicine Vol. 23, no. 6 (November 2013 2013), p. 430-438
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Relation: http://purl.org/au-research/grants/nhmrc/565907
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- Description: Objective:High-quality sport-specific information about the nature, type, cause, and frequency of injuries is needed to set injury prevention priorities. This article describes the type, nature, and mechanism of injuries in community Australian Football (community AF) players, as collected through field-based monitoring of injury in teams of players.Data Sources:Compilation of published prospectively collected injury data from 3 studies in junior community AF (1202 injuries in 1950+ players) and 3 studies in adult community AF (1765 injuries in 2265 players). This was supplemented with previously unpublished data from the most recent adult community AF injury cohort study conducted in 2007 to 2008. Injuries were ranked according to most common body regions, nature of injury, and mechanism.Main Results:In all players, lower limb injuries were the most frequent injury in community AF and were generally muscle strains, joint sprains, and superficial injuries. These injuries most commonly resulted from incidental contact with other players, or from overexertion. Upper limb injuries were less common but included fractures, strains, and sprains that were generally caused by incidental contact between players and the result of players falling to the ground.Conclusions:Lower limb injuries are common in community AF and could have an adverse impact on sustained participation in the game. Based on what is known about their mechanisms, it is likely that a high proportion of lower limb injuries could be prevented and they should therefore be a priority for injury prevention in community AF.
Social marketing: why injury prevention needs to adopt this behaviour change approach
- Authors: Newton, Joshua , Ewing, Michael , Finch, Caroline
- Date: 2013
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 47, no. (2013), p. 665-667
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The Development of the Lunchtime Enjoyment of Activity and Play Questionnaire
- Authors: Hyndman, Brendon , Telford, Amanda , Finch, Caroline , Ullah, Shahid , Benson, Amanda
- Date: 2013
- Type: Text , Journal article
- Relation: Journal of School Health Vol. 83, no. 4 (2013), p. 256-264
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- Description: Background: Enjoyment of physical activity is as an important determinant of children's participation in physical activity. Despite this, there is an absence of reliable measures for assessing children's enjoyment of play activities during school lunchtime. The purpose of this study was to develop and assess the reliability of the Lunchtime Enjoyment of Activity and Play (LEAP) Questionnaire. Methods: Questionnaire items were categorized employing a social-ecological framework including intrapersonal (20 items), interpersonal (2 items), and physical environment/policy (17 items) components to identify the broader influences on children's enjoyment. An identical questionnaire was administered on 2 occasions, 10days apart, to 176 children aged 8-12years, attending a government elementary school in regional Victoria, Australia. RESULTS: Test-retest reliability confirmed that 35 of 39 LEAP Questionnaire items had at least moderate kappa agreement ranging from .44 to .78. Although 4 individual kappa values were low, median kappa scores for each aggregated social-ecological component reached at least moderate agreement (.44-.60). Conclusions: This study confirms the LEAP Questionnaire to be a reliable, context-specific instrument with sound content, and face validity that employs a social-ecological framework to assess children's enjoyment of school play and lunchtime activities. © 2013, American School Health Association.
- Description: 2003010857
The reach and adoption of a coach-led exercise training programme in community football
- Authors: Finch, Caroline , Diamantopoulou, Kathy , Twomey, Dara , Doyle, Tim , Lloyd, David , Young, Warren , Elliot, Bruce
- Date: 2013
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine. Vol. 48(8), p.718-723.
- Relation: http://purl.org/au-research/grants/nhmrc/565900
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- Description: Objective: To determine the reach and adoption of a coach-led exercise training programme for lower limb injury prevention. Design: Secondary analysis of data from a group-clustered randomised controlled trial. Setting: A periodised exercise training warm-up programme was delivered to players during training sessions over an 8-week preseason (weeks 1–8) and 18-week playing season. Participants: 1564 community Australian football players. Main outcome measurements: Reach, measured weekly, was the number of players who attended training sessions. Adoption was the number of attending players who completed the programme in full, partially or not at all. Reasons for partial or non-participation were recorded. Results: In week 1, 599 players entered the programme; 55% attended 1 training session and 45% attended > 1 session. By week 12, 1540 players were recruited but training attendance (reach) decreased to <50%. When players attended training, the majority adopted the full programme—ranging from 96% (week 1) to above 80% until week 20. The most common reasons for low adoption were players being injured, too sore, being late for training or choosing their own warm-up. Conclusions: The training programme's reach was highest preseason and halved at the playing season's end. However, when players attended training sessions, their adoption was high and remained close to 70% by season end. For sports injury prevention programmes to be fully effective across a season, attention also needs to be given to (1) encouraging players to attend formal training sessions and (2) considering the possibility of some form of programme delivery outside of formal training.
Understanding safety management system applicability in community sport
- Authors: Donaldson, Alex , Borys, David , Finch, Caroline
- Date: 2013
- Type: Text , Journal article
- Relation: Safety Science Vol. 60, no. (2013), p. 95-104
- Relation: http://purl.org/au-research/grants/nhmrc/565907
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- Description: Despite recent interest in understanding the implementation context for sports injury prevention interventions, little research attention has been paid to the management structures and processes of community sporting organisations. This study developed expert consensus about the importance of Occupational Health and Safety (OHS) setting-related safety management system (SMS) principles and performance indicators in the context of Australian community sporting organizations, and the feasibility of these organisations meeting the requirements for the SMS performance indicators. Twenty-nine sports injury prevention, community sports administration and OHS SMS experts participated in a three-round online Delphi study by rating the importance of 64 SMS performance indicators categorised under the five principles of Commitment and Policy; Planning; Implementation; Measurement and Evaluation; and Review and Improvement. Overall, consensus agreement - define as rated 'essential' or 'very important' on a five-point scale by ≥75% of the participants in Round 3 - was reached for 57 performance indicators. Ten (15%) performance indicators were rated as 'very difficult' or 'relatively difficult', and six (9%) were rated as 'very easy' or 'relatively easy' on a four-point scale, by ≥75% of participants. This research suggests that the guiding principles and associated performance indicators that underpin OHS safety management systems in the workplace are very relevant and applicable to community sporting organisations in Australia. However, considerable work is required to build organisational capacity to be able to develop and implement meaningfully and useful SMSs to prevent sports injuries in the most common setting in which they occur. © 2013 Elsevier Ltd. Funded by NHMRC.
- Description: 2003011206
Coding OSICS sports injury diagnoses in epidemiological studies : Does the background of the coder matter?
- Authors: Finch, Caroline , Orchard, John , Twomey, Dara , Saleem, Muhammad Saad , Ekegren, Christina , Lloyd, David , Elliott, Bruce
- Date: 2012
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine, Vol.48, p.552-556.
- Relation: http://purl.org/au-research/grants/nhmrc/565900
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- Description: Objective: To compare Orchard Sports Injury Classification System (OSICS-10) sports medicine diagnoses assigned by a clinical and non-clinical coder. Design: Assessment of intercoder agreement. Setting: Community Australian football. Participants: 1082 standardised injury surveillance records. Main outcome measurements: Direct comparison of the four-character hierarchical OSICS-10 codes assigned by two independent coders (a sports physician and an epidemiologist). Adjudication by a third coder (biomechanist). Results: The coders agreed on the first character 95% of the time and on the first two characters 86% of the time. They assigned the same four-digit OSICS-10 code for only 46% of the 1082 injuries. The majority of disagreements occurred for the third character; 85% were because one coder assigned a non-specific 'X' code. The sports physician code was deemed correct in 53% of cases and the epidemiologist in 44%. Reasons for disagreement included the physician not using all of the collected information and the epidemiologist lacking specific anatomical knowledge. Conclusions: Sports injury research requires accurate identification and classification of specific injuries and this study found an overall high level of agreement in coding according to OSICS-10. The fact that the majority of the disagreements occurred for the third OSICS character highlights the fact that increasing complexity and diagnostic specificity in injury coding can result in a loss of reliability and demands a high level of anatomical knowledge. Injury report form details need to reflect this level of complexity and data management teams need to include a broad range of expertise. Copyright Article author (or their employer) 2012.
Linked versus unlinked hospital discharge data on hip fractures for estimating incidence and comorbidity profiles
- Authors: Vu, Trang , Day, Lesley , Finch, Caroline
- Date: 2012
- Type: Text , Journal article
- Relation: BMC Medical Research Methodology Vol. 12, no. 113 (2012), p. 1-8
- Relation: http://purl.org/au-research/grants/nhmrc/565900
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- Description: Background: Studies comparing internally linked (person–identifying) and unlinked (episodes of care) hospital discharge data (HDD) on hip fractures have mainly focused on incidence overestimation by unlinked HDD, but little is known about the impact of overestimation on patient profiles such as comorbidity estimates. In view of the continuing use of unlinked HDD in hip fracture research and the desire to apply research results to hip fracture prevention, we concurrently assessed the accuracy of both incidence and comorbidity estimates derived from unlinked HDD compared to those estimated from internally linked HDD. Methods: We analysed unlinked and internally linked HDD between 01 July 2005 and 30 June 2008, inclusive, from Victoria, Australia to estimate the incidence of hospital admission for fall-related hip fracture in community-dwelling older people aged 65+ years and determine the prevalence of comorbidity in patients. Community-dwelling status was defined as living in private residence, supported residential facilities or special accommodation but not in nursing homes. We defined internally linked HDD as the reference standard and calculated measures of accuracy of fall-related hip fracture incidence by unlinked HDD using standard definitions. The extent to which comorbidity prevalence estimates by unlinked HDD differed from those by the reference standard was assessed in absolute terms. Results: The sensitivity and specificity of a standard approach for estimating fall-related hip fracture incidence using unlinked HDD (i.e. omitting records of in-hospital deaths, inter-hospital transfers and readmissions within 30 days of discharge) were 94.4% and 97.5%, respectively. The standard approach and its variants underestimated the prevalence of some comorbidities and altered their ranking. The use of more stringent selection criteria led to major improvements in all measures of accuracy as well as overall and specific comorbidity estimates. Conclusions: This study strongly supports the use of linked rather than unlinked HDD in injury research. In health systems where linked HDD are unavailable, current approaches for identifying incident hip fractures may be enhanced by incorporating additional evidence-based criteria.
Moving physical activity beyond the school classroom : A social-ecological insight for teachers of the facilitators and barriers to students' non-curricular physical activity
- Authors: Hyndman, Brendon , Telford, Amanda , Finch, Caroline , Benson, Amanda
- Date: 2012
- Type: Text , Journal article
- Relation: Australian Journal of Teacher Education Vol. 37, no. 2 (2012), p.1-24
- Relation: http://purl.org/au-research/grants/nhmrc/565900
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- Description: Non-curricular avenues such as active play during school breaks have been established as a major source for children’s physical and cognitive development, yet there is little information for teachers on the influences affecting primary and secondary school students’ non-curricular physical activity. During this study focus groups and drawing were used to explore the broader influences on primary (n=47) and secondary (n=29) school students’ physical activity behaviour beyond the classroom. Barriers and facilitators to children’s physical activity were categorised using a multi-level social-ecological framework incorporating intrapersonal, interpersonal, physical environment and policy factors. Based on the drawings, comparisons between students’ existing play spaces and their perception of their ideal play space were made. Additionally, students depicted what features within a play space would encourage them to be active. The findings of the study indicate secondary school play spaces may need to incorporate more features to facilitate physical activity. The barriers and facilitators identified in this study provide information for teachers and school decision makers to consider when targeting children’s physical activity beyond school classrooms.
A protocol for evidence-based targeting and evaluation of statewide strategies for preventing falls among community-dwelling older people in Victoria, Australia
- Authors: Day, Lesley , Finch, Caroline , Hill, Keith , Haines, Terry , Clemson, Lindy , Thomas, Margaret , Thompson, Catherine
- Date: 2011
- Type: Text , Journal article
- Relation: Injury Prevention Vol. 17, no. 2 (2011), p. 1-8
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Relation: http://purl.org/au-research/grants/nhmrc/546282
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- Description: Background: Falls are a significant threat to the safety, health and independence of older citizens. Despite the now substantial evidence about effective falls prevention interventions, translation into falls reductions has not yet been fully realised. While the hip fracture rate is decreasing, the number and rate of fall-related hospital admissions among older people is increasing. The challenge now is to deliver the most effective interventions efficiently at a population level, and for these interventions to be taken up by older people. Objective: To support the development, and evaluation of, effective falls prevention policy and practice in the state of Victoria, Australia. Methods: The RE-AIM model (Reach, Efficacy, Adoption, Implementation, Maintenance) was used to identify strategies for an effective programme. Research objectives were developed to support the strategies. These include: (1) identification of subgroups of older people most frequently admitted to hospital for falls; (2) examining the acceptability of established falls interventions; (3) identification of factors that encourage and support relevant lifestyle changes; (4) identifying opportunities to incorporate confirmed interventions in existing programmes and services; (5) developing guidelines for sustainability. The research results will subsequently guide strategy details for the falls prevention plan. RE-AIM will provide the framework for the evaluation structure. Outcome measures: Measures to monitor the implementation of the selected interventions will be determined for each intervention, based on the five key factors of the RE-AIM model. The overall effect of the falls prevention plan will be monitored by time series analysis of fall-related hospital admission rates for community-dwelling older people.
Air temperature and the incidence of fall-related hip fracture hospitalisations in older people
- Authors: Turner, R. M. , Hayen, Andrew , Dunsmuir, William , Finch, Caroline
- Date: 2011
- Type: Text , Journal article
- Relation: Osteoporosis International Vol. 22, no. 4 (2011), p. 1183-1189
- Relation: http://purl.org/au-research/grants/nhmrc/565900
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- Description: Observation-driven Poisson regression models were used to investigate mean daily air temperature and fall-related hip fracture hospitalisations. After adjustment for season, day-of-week effects, long-term trend and autocorrelation, hip fracture rates are higher in both males and females aged 75+ years when there is a lower air temperature. This study investigated whether there was an association between fall-related hip fracture hospitalisations and air temperature at a day-to-day level, after accounting for seasonal trend and autocorrelation. Observation-driven Poisson regression models were used to investigate mean daily air temperature and fall-related hip fracture hospitalisations for the period 1 July 1998 to 31 December 2004, inclusive, in the Sydney region of New South Wales, Australia, which has a population of 4 million people. Lower daily air temperature was significantly associated with higher fall-related hip fracture hospitalisations in 75+-year-olds: men aged 75-84 years, rate ratio (RR) for a 1A degrees C increase in temperature of 0.98 with 95% confidence interval (0.96, 0.99), men 85+ years RR = 0.98 (0.96, 1.00), women 75-84 years RR = 0.99 (0.98, 1.00), women 85+ years RR = 0.98 (0.97, 0.99). Moreover, there were fewer hospitalisations on weekends compared to weekdays ranging from RR = 0.81 (0.73, 0.90) in women aged 65-74 years to RR = 0.89 (0.80, 0.98) in men aged 85+ years. After adjustment for season, day-of-week effects, long-term trend and autocorrelation, fall-related hip fracture hospitalisation rates are higher in both males and females aged 75+ years when there is a lower air temperature.
Combining epidemiology and biomechanics in sports injury prevention research : A new approach for selecting suitable controls
- Authors: Finch, Caroline , Ullah, Shahid , McIntosh, Andrew
- Date: 2011
- Type: Text , Journal article
- Relation: Sports Medicine Vol. 41, no. 1 (2011), p. 59-72
- Relation: http://purl.org/au-research/grants/nhmrc/565900
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- Description: Several important methodological issues need to be considered when designing sports injury case-control studies. Major design goals for case-control studies include the accounting for prior injury risk exposure, and optimal definitions of both cases and suitable controls are needed to ensure this. This article reviews methodological aspects of published sports injury case-control studies, particularly with regard to the selection of controls. It argues for a new approach towards selecting controls for case-control studies that draws on an interface between epidemiological and biomechanical concepts. A review was conducted to identify sport injury case-control studies published in the peer-review literature during 1985-2008. Overall, 32 articles were identified, of which the majority related to upper or lower extremity injuries. Matching considerations were used for control selection in 16 studies. Specific mention of application of biomechanical principles in the selection of appropriate controls was absent from all studies, including those purporting to evaluate the benefits of personal protective equipment to protect against impact injury. This is a problem because it could lead to biased conclusions, as cases and controls are not fully comparable in terms of similar biomechanical impact profiles relating to the injury incident, such as site of the impact on the body. The strength of the conclusions drawn from case-control studies, and the extent to which results can be generalized, is directly influenced by the definition and recruitment of cases and appropriate controls. Future studies should consider the interface between epidemiological and biomechanical concepts when choosing appropriate controls to ensure that proper adjustment of prior exposure to injury risk is made. To provide necessary guidance for the optimal selection of controls in case-control studies of interventions to prevent sports-related impact injury, this review outlines a new case-control selection strategy that reflects the importance of biomechanical considerations, which ensures that controls are selected based on the presence of the same global injury mechanism as the cases. To summarize, the general biomechanical principles that should apply to the selection of controls in future case-control studies are as follows: (i) each control must have been exposed to the same global injury mechanism as the case, (e.g. head impact, fall onto outstretched arm); and (ii) intrinsic (individual) factors (e.g. age, sex, skill level) that might modify the person's response to the relevant biomechanical loads are adjusted when either selecting the controls or are in the analysis phase. The same considerations for control selection apply to other study designs such as matched cohort studies or case-crossover studies. © 2011 Adis Data Information BV. All rights reserved.
Implementing an exercise-training programme to prevent lower-limb injuries : Considerations for the development of a randomised controlled trial intervention delivery plan
- Authors: Finch, Caroline , White, Peta , Twomey, Dara , Ullah, Shahid
- Date: 2011
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 45, no. 10 (2011), p. 791-796
- Relation: http://purl.org/au-research/grants/nhmrc/565900
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- Description: Objective To identify important considerations for the delivery of an exercise training intervention in a randomised controlled trial to maximise subsequent participation in that randomised controlled trial and intervention uptake. Design A cross-sectional survey, with a theoretical basis derived from the Health Belief Model (HBM) and the Reach, Efficacy/Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework. Participants 374 male senior Australian Football players, aged 17-38 years. Main outcome measurements Beliefs about lowerlimb injury causation/prevention, and the relative value of exercise training for performance and injury prevention. The data are interpreted within HBM constructs and implications for subsequent intervention implementation considered within the RE-AIM framework. Ordinal logistic regression compared belief scores across player characteristics. Results 74.4% of players agreed that doing specific exercises during training would reduce their risk of lower-limb injury and would be willing to undertake them. However, 64.1% agreed that training should focus more on improving game performance than injury prevention. Younger players (both in terms of age and playing experience) generally had more positive views. Players were most supportive of kicking (98.9%) and ball-handling (97.0%) skills for performance and warm-up runs and cool-downs (both 91.5%) for injury prevention. Fewer than three-quarters of all players believed that balance (69.2%), landing (71.3%) or cutting/stepping (72.8) training had injury-prevention benefits. Conclusions Delivery of future exercise training programmes for injury prevention aimed at these players should be implemented as part of routine football activities and integrated with those as standard practice, as a means of associating them with training benefits for this sport.
Injury risk associated with ground hardness in junior cricket
- Authors: Twomey, Dara , White, Peta , Finch, Caroline
- Date: 2011
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol.15 , no.2 (2011), p.110-115
- Relation: http://purl.org/au-research/grants/nhmrc/565900
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- Description: To establish if there is an association between ground hardness and injury risk in junior cricket. Nested case-series of players who played matches on specific grounds with objective ground hardness measures, within a prospective cohort study of junior community club cricket players. Monitoring of injuries and playing exposure occurred during 434 matches over the 2007/2008 playing season. Objective assessment of the hardness of 38 grounds was undertaken using a Clegg hammer at 13 sites on 19 different junior cricket grounds on the match eve across the season. Hardness readings were classified from unacceptably low (<30 g) to unacceptably high (>120 g) and two independent raters assessed the likelihood of each injury being related to ground hardness. Injuries sustained on tested grounds were related to the ground hardness measures. Overall, 31 match injuries were reported; 6.5% were rated as likely to be related to ground hardness, 16.1% as possibly related and 74.2% as unlikely to be related and 3.2% unknown. The two injuries likely to be related to ground hardness were sustained while diving to catch a ball resulting, in a graze/laceration from contact with hard ground. Overall, 31/38 (82%) ground assessments were rated as having 'unacceptably high' hardness and all others as 'high/normal' hardness. Only one injury occurred on an objectively tested ground. It remains unclear if ground hardness is a contributing factor to the most common injury mechanism of being struck by the ball, and needs to be confirmed in future larger-scale studies. © 2011 Sports Medicine Australia.
Level of agreement between field-based data collectors in a large scale injury prevention randomised controlled trial
- 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.
Measuring children's self-reported sport participation, risk perception and injury history : Development and validation of a survey instrument
- Authors: Siesmaa, Emma , Blitvich, Jennifer , White, Peta , Finch, Caroline
- Date: 2011
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 14, no. 1 (2011), p. 22-26
- Relation: http://purl.org/au-research/grants/nhmrc/565900
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- Description: Despite the health benefits associated with children's sport participation, the occurrence of injury in this context is common. The extent to which sport injuries impact children's ongoing involvement in sport is largely unknown. Surveys have been shown to be useful for collecting children's injury and sport participation data; however, there are currently no published instruments which investigate the impact of injury on children's sport participation. This study describes the processes undertaken to assess the validity of two survey instruments for collecting self-reported information about child cricket and netball related participation, injury history and injury risk perceptions, as well as the reliability of the cricket-specific version. Face and content validity were assessed through expert feedback from primary and secondary level teachers and from representatives of peak sporting bodies for cricket and netball. Test-retest reliability was measured using a sample of 59 child cricketers who completed the survey on two occasions, 3-4 weeks apart. Based on expert feedback relating to face and content validity, modification and/or deletion of some survey items was undertaken. Survey items with low test-retest reliability (κ≤ 0.40) were modified or deleted, items with moderate reliability (κ=0.41-0.60) were modified slightly and items with higher reliability (κ≥ 0.61) were retained, with some undergoing minor modifications. This is the first survey of its kind which has been successfully administered to cricketers aged 10-16 years to collect information about injury risk perceptions and intentions for continued sport participation. Implications for its generalisation to other child sport participants are discussed. © 2010 Sports Medicine Australia.