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Infographic : We have the programme, what next? Developing a plan of action to implement injury prevention exercise programmes in community sport

Collecting health and exposure data in Australian olympic combat sports : Feasibility study utilizing an electronic system

  • Authors: Bromley, Sally , Drew, Michael , Talpey, Scott , McIntosh, Andrew , Finch, Caroline
  • Date: 2018
  • Type: Text , Journal article
  • Relation: Journal of Medical Internet Research Vol. 20, no. 10 (2018), p. 1-11
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  • Description: Background: Electronic methods are increasingly being used to manage health-related data among sporting populations. Collection of such data permits the analysis of injury and illness trends, improves early detection of injuries and illnesses, collectively referred to as health problems, and provides evidence to inform prevention strategies. The Athlete Management System (AMS) has been employed across a range of sports to monitor health. Australian combat athletes train across the country without dedicated national medical or sports science teams to monitor and advocate for their health. Employing a Web-based system, such as the AMS, May provide an avenue to increase the visibility of health problems experienced by combat athletes and deliver key information to stakeholders detailing where prevention programs May be targeted. Objective: The objectives of this paper are to (1) report on the feasibility of utilizing the AMS to collect longitudinal injury and illness data of combat sports athletes and (2) describe the type, location, severity, and recurrence of injuries and illnesses that the cohort of athletes experience across a 12-week period. Methods: We invited 26 elite and developing athletes from 4 Olympic combat sports (boxing, judo, taekwondo, and wrestling) to participate in this study. Engagement with the AMS was measured, and collected health problems (injuries or illnesses) were coded using the Orchard Sports Injury Classification System (version 10.1) and International Classification of Primary Care (version 2). Results: Despite >160 contacts, athlete engagement with online tools was poor, with only 13% compliance across the 12-week period. No taekwondo or wrestling athletes were compliant. Despite low overall engagement, a large number of injuries or illness were recorded across 11 athletes who entered data—22 unique injuries, 8 unique illnesses, 30 recurrent injuries, and 2 recurrent illnesses. The most frequent injuries were to the knee in boxing (n=41) and thigh in judo (n=9). In this cohort, judo players experienced more severe, but less frequent, injuries than boxers, yet judo players sustained more illnesses than boxers. In 97.0% (126/130) of cases, athletes in this cohort continued to train irrespective of their health problems. Conclusions: Among athletes who reported injuries, many reported multiple conditions, indicating a need for health monitoring in Australian combat sports. A number of factors May have influenced engagement with the AMS, including access to the internet, the design of the system, coach views on the system, previous experiences with the system, and the existing culture within Australian combat sports. To increase engagement, there May be a requirement for sports staff to provide relevant feedback on data entered into the system. Until the Barriers are addressed, it is not feasible to implement the system in its current form across a larger cohort of combat athletes.

'VisionZero': Is it achievable for rugby-related catastrophic injuries in South Africa?

Sport as a setting for promoting health

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

Identifying context-specific competencies required by community Australian Football sports trainers

  • Authors: Donaldson, Alex , Finch, Caroline
  • Date: 2012
  • Type: Text , Journal article
  • Relation: British Journal of Sports Medicine Vol. 46, no. 10 (August 2012 2012), p. 759-765
  • Relation: http://purl.org/au-research/grants/nhmrc/565900
  • Relation: http://purl.org/au-research/grants/nhmrc/565907
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  • Description: Background: First-aid is a recommended injury prevention and risk management strategy in community sport; however, little is known about the sport-specific competencies required by first-aid providers. Objective: To achieve expert consensus on the competencies required by community Australian Football (community-AF) sports trainers. Study design: A three-round online Delphi process. Setting: Community-AF. Participants: 16 Australian sports first-aid and community-AF experts. Outcome measures: Rating of competencies as either ‘essential’, ‘expected’, ‘ideal’ or ‘not required’. Results: After Round 3, 47 of the 77 (61%) competencies were endorsed as ‘essential’ or ‘expected’ for a sports trainer to effectively perform the activities required to the standards expected at a community-AF club by ≥75% of experts. These competencies covered: the role of the sports trainer; the responsibilities of the sports trainer; emergency management; injury and illness assessment and immediate management; taping; and injury prevention and risk management. Four competencies (5%) were endorsed as ‘ideal’ or ‘not required’ by ≥85% of experts and were excluded from further consideration. The 26 competencies where consensus was not reached were retained as second-tier, optional competencies. Conclusions: Sports trainers are important members of on-field first-aid teams, providing support to both injured players and other sports medicine professionals. The competencies identified in this study provide the basis of a proposed two-tiered community-AF–specific sports trainer education structure that can be implemented by the peak sports body. This includes six mandatory modules, relating to the ‘required’ competencies, and a further six optional modules covering competencies on which consensus was not reached.

Planning for implementation and translation : seek first to understand the end-users’ perspectives

  • Authors: Donaldson, Alex , Finch, Caroline
  • Date: 2012
  • Type: Text , Journal article
  • Relation: British Journal of Sports Medicine Vol. 46, no. 5 (April 2012), p. 306-307
  • Relation: http://purl.org/au-research/grants/nhmrc/565900
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  • Description: Translating research evidence into sustained improvements in population health outcomes is a current priority across many health research fields including sports medicine,1 injury prevention2 and physical activity promotion.3 Both the ‘traditional’ approach of publishing sports injury research findings in peer-reviewed journals and hoping for the best, and the more sophisticated approach of developing and disseminating consensus statements and related sport safety guidelines have been relatively unsuccessful to date.

Applying implementation science to sports injury prevention

  • Authors: Donaldson, Alex , Finch, Caroline
  • Date: 2013
  • Type: Text , Editorial , Journal article
  • Relation: British Journal of Sports Medicine Vol. 47, no. 8 (2013), p. 473-475
  • Relation: http://purl.org/au-research/grants/nhmrc/565900
  • Relation: http://purl.org/au-research/grants/nhmrc/565907
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  • Description: Recent commentary in the BJSM has argued that a key challenge for future sports injury prevention is to reduce the ‘research to practice’ gap. Unfortunately, very few examples of this type of research actually exist. In this issue, Myklebust et al describe their approach to anterior cruciate ligament (ACL) injury prevention in Norwegian Handball over the past 13 years. This is one of the first published papers on the long-term outcomes of a sports injury prevention intiative that has shown promising efficacy in controlled trials. While this paper describes an impressive intial research effort and outstanding example of long-term follow-up through an ACL Injury Surveillance Programme, it also highlights challenges associated with conducting sports injury prevention implementation research.
  • Description: Editorial
  • Description: 2003011041

Changes in knee joint biomechanics following balance and technique training and a season of Australian football

  • Authors: Donnelly, Cyril , Elliot, Bruce , Doyle, Tim , Finch, Caroline , Dempsey, Alasdair , Lloyd, David
  • Date: 2012
  • Type: Text , Journal article
  • Relation: British Journal of Sports Medicine Vol. 46, no. 13 (October 2012 2012), p. 917-922
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  • Description: Purpose: Determine if balance and technique training (BTT) implemented adjunct to normal Australian football (AF) training reduces external knee loading during sidestepping. Additionally, the authors determined if an athlete's knee joint kinematics and kinetics change over a season of AF. Methodology: Eight amateur-level AF clubs (n=1,001 males) volunteered to participate in either 28 weeks of BTT or a ‘sham’ training (ST) adjunct to their normal preseason and regular training. A subset of 34 athletes (BTT, n=20; ST, n=14) were recruited for biomechanical testing in weeks 1–7 and 18–25 of the 28-week training intervention. During biomechanical testing, participants completed a series running, preplanned (PpSS) and unplanned sidestepping (UnSS) tasks. A linear mixed model (a=0.05) was used to determine if knee kinematics and peak moments during PpSS and UnSS were influenced by BTT and/or a season of AF Results: Both training groups significantly (p=0.025) decreased their peak internal-rotation knee moments during PpSS, and significantly (p=0.022) increased their peak valgus knee moments during UnSS following their respective training interventions. Conclusions: BTT was not effective in changing an athlete's knee joint biomechanics during sidestepping when conducted in ‘real-world’ training environments. Following normal AF training, the players had different changes to their knee joint biomechanics during both preplanned and unplanned sidestepping. When performing an unplanned sidestepping task in the latter half of a playing season, athletes are at an increased risk of ACL injury. The authors therefore recommend both sidestepping tasks are performed during biomechanical testing when assessing the effectiveness of prophylactic training protocols.

Sports-related workload and injury risk : Simply knowing the risks will not prevent injuries : Narrative review

  • Authors: Drew, Michael , Cook, Jill , Finch, Caroline
  • Date: 2016
  • Type: Text , Journal article , Review
  • Relation: British Journal of Sports Medicine Vol. 50, no. 21 (2016), p. 1306-1309
  • Relation: http://purl.org/au-research/grants/nhmrc/1058737
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  • Description: Training loads contribute to sports injury risk but their mitigation has rarely been considered in a sports injury prevention framework. A key concept behind monitoring training loads for injury prevention is to screen for those at increased risk of injury so that workloads can be adjusted to minimise these risks. This review describes how advances in management of workload can be applied as a preventive measure. Primary prevention involves screening for preparticipation load risk factors, such as low training loads, prior to a training period or competition. Secondary prevention involves screening for workloads that are known to precede an injury developing so that modification can be undertaken to mitigate this risk. Tertiary prevention involves rehabilitation practices that include a graded return to training programme to reduce the risk of sustaining a subsequent injury. The association of training loads with injury incidence is now established. Prevention measures such as rule changes that affect the workload of an athlete are universal whereas those that address risk factors of an asymptomatic subgroup are more selective. Prevention measures, when implemented for asymptomatic individuals exhibiting possible injury risk factors, are indicated for an athlete at risk of developing a sports injury. Seven key indicated risks and associated prevention measures are proposed.

Trends in hospitalisation rates for road traffic injuries in child motor vehicle passengers in New South Wales, July 1998 June 2005

  • Authors: Du, Wei , Finch, Caroline , Hayen, Andrew , Hatfield, Julie
  • Date: 2007
  • Type: Text , Journal article
  • Relation: Medical Journal of Australia Vol. 187, no. 9 (Nov 2007), p. 515-518
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  • Description: Objective: To analyse changes in the incidence of injuries requiring hospitalisation for child passengers in motor vehicle crashes. Design, setting and participants: Population-based study of children (aged 0-15 years) residing in New South Wales and admitted to hospital for injuries resulting from a traffic crash in the period 1 July 1998 - 30 June 2005, identified from the NSW Inpatient Statistics Collection. Main outcome measures: Age-standardised rates of hospitalisation for injuries, and trends by inpatient demographics, severity of injuries, and injury sites and types. Results: 2297 children were hospitalised for injuries sustained in a motor vehicle crash over the study period. The overall hospitalisation rate for injuries was relatively constant, with a non-significant decline of -0.4% (95% Cl, -3.1% to 2.3%). The rate of hospitalisation for serious injuries also declined non-significantly (-5.5% [95% Cl, -11.8% to 1.1%]). Only hospitalisation rates for traumatic brain injuries declined significantly (-11.1% [95% Cl, -19.0% to -2.8%]) over the study period. Conclusion: The rate of hospitalisation for injuries to NSW-resident child motor vehicle passengers due to traffic crashes has not significantly decreased. High hospitalisation rates and the subsequent burden to the community and public health system make further injury prevention efforts for child motor vehicle passengers a priority.
  • Description: C1
  • Description: 2003005874

The IOC Centres of Excellence bring prevention to Sports Medicine

  • Authors: Engebretsen, Lars , Bahr, Roald , Cook, Jill , Derman, Wayne , Emery, Carolyn , Finch, Caroline , Meeuwisse, Willem , Schwellnus, Martin , Steffen, Kathrin
  • Date: 2014
  • Type: Text , Journal article
  • Relation: British Journal of Sports Medicine Vol. 48, no. 17 (2014), p. 1270-1275
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  • Description: The protection of an athlete's health and preventing injuries and illnesses in sport are top priorities for the IOC and its Medical Commission. The IOC therefore partners with selected research centres around the world and supports research in the field of sports medicine. This has enabled the IOC to develop an international network of expert scientists and clinicians in sports injury and disease prevention research. The IOC wants to promote injury and disease prevention and the improvement of physical health of the athlete by: (1) establishing long-term research programmes on injury and disease prevention (including studies on basic epidemiology, risk factors, injury mechanisms and intervention), (2) fostering collaborative relationships with individuals, institutions and organisations to improve athletes' health, (3) implementing and collaborating with applied, ongoing and novel research and development within the framework and long-term strategy of the IOC and (4) setting up knowledge translation mechanisms to share scientific research results with the field throughout the Olympic Movement and sports community and converting these results into concrete actions to protect the health of the athletes. In 2009, the IOC also identified four research centres that had an established track record in research, educational and clinical activities to achieve these ambitions: (1) the Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), Australia; (2) the Sport Injury Prevention Research Centre (SIPRC), Canada; (3) the Clinical Sport and Exercise Medicine Research (CSEM), South Africa and (4) the Oslo Sports Trauma Research Center (OSTRC), Norway. This paper highlights the work carried out by these four IOC Centres of Excellence over the past 6 years and their contribution to the world of sports medicine.

Sports injuries in Victoria, 2012-13 to 2014-15 : Evidence from emergency department records

  • Authors: Fernando, Tharanga , Berecki-Gisolf, Janneke , Finch, Caroline
  • Date: 2018
  • Type: Text , Journal article
  • Relation: Medical Journal of Australia Vol. 208, no. 6 (2018), p. 255-260
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  • Description: Objectives: To report the incidence of presentations to emergency departments (EDs) in Victoria for sport-and active recreation-related injuries; to establish which sports have the highest rates of injury per participant; to assess the effects of age and sport type on the rate of serious sport injury (resulting in admission to hospital). Design, setting and participants: Retrospective analysis of 171 541 ED presentations to 38 Victorian hospitals, 2012-13 to 2014-15. Sports-and active recreation-related injuries in people aged 5 years or more were identified from coded data and by text searches. Main outcome measures: Population rates of injuries by sport and ranking of sports by per participant injury rates (for people aged 15 years or more); proportions of presenting patients subsequently admitted to hospital (serious sport injuries) (for people aged 5 years or more). Results: During 2012-13 to 2014-15, there were 171 541 presentations to EDs with sports-related injuries. Sports most commonly associated with presentation by people aged 15 years or more were Australian football, motor sports, and cycling/ BMX; the highest per participant injury rates (people aged 15 or more) were for motor sports, rugby, and skateboarding/inline hockey/roller sports. 11% of ED patients aged 5 years or more were subsequently admitted to hospital; the odds of admission were highest for those with injuries from motor sports, horse riding, or cycling/BMX. Conclusions: Assessing sports injury rates corrected for participation rates and evaluating the relative severity of injuries is important for monitoring safety. Our findings can assist decisions about which sports should be the focus of injury prevention efforts.

Getting sports injury prevention on to public health agendas – addressing the shortfalls in current information sources

  • Authors: Finch, Caroline
  • Date: 2012
  • Type: Text , Journal article
  • Relation: British Journal of Sports Medicine Vol. 46, no. 1 (January 2012 2012), p. 70-74
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  • Description: Public health policy is a successful population-level strategy for injury prevention but it is yet to be widely applied to the sports sector. Such policy is generally coordinated by government health departments concerned with the allocation of limited resources to health service delivery and preventive programs for addressing large community health issues. Prioritisation of sports injury prevention (SIP) requires high-quality evidence about the size of the problem and its public health burden; identification of at-risk vulnerable groups; confirmed effective prevention solutions; evidence of intervention cost-effectiveness; and quantifi cation of both financial and policy implications of inaction. This paper argues that the major reason for a lack of sports injury policy by government departments for health or sport to date is a lack of relevant information available for policy makers to make their decisions. Key information gaps evident in Australia are used to highlight this problem. SIP policy does not yet rank highly because, relative to other health/injury issues, there is very little hard evidence to support: claims for its priority ranking, the existence of solutions that can be implemented and which will work, and potential cost-savings to government agencies. Moreover, policy action needs to be integrated across government portfolios, including sport, health and others. Until sports medicine research generates high-quality population-level information of direct relevance and importance to policy makers, especially intervention costing and implementation cost-benefit estimates, and fully engage in policy-informing partnerships, SIP will continue to be left off the public health agenda.

No longer lost in translation : The art and science of sports injury prevention implementation research

  • Authors: Finch, Caroline
  • Date: 2011
  • Type: Text , Journal article
  • Relation: British Journal of Sports Medicine Vol. 45, no. 16 (December 2011), p. 1253-1257
  • Relation: http://purl.org/au-research/grants/nhmrc/565900
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  • Description: It is now understood that sports injury interventions will not have significant public health impact if they are not widely accepted and adopted by target sports participants. Although there has been increasing recognition of the need for intervention studies conducted within the real-world context of sports delivery, very few studies have been conducted in this important area. A major reason for this is that there are significant challenges in conducting implementation research; the more traditional sports medicine approaches may not be fully appropriate and new ways of thinking about how to design, conduct and report such research is needed. Moreover, real-world implementation of sports injury interventions and evaluation of their effectiveness needs to start to take into account the broad ecological context in which they are introduced, as well as considering the best way to translate this knowledge to reach the audiences who most need to benefit from such research. This overview paper provides perspectives and guidance on the design, conduct and evaluation of sports injury intervention implementation studies, including better understanding of the complexity of the ecological settings for intervention delivery. Some conceptual approaches that could be adopted in future implementation studies are discussed; particular emphasis is given to Intervention Mapping as a tool to assist intervention development, Diffusion of Innovations Theory to guide the planning of intervention strategies and the RE-AIM (reach, effectiveness, adoption, implementation and maintenance) framework for programme evaluation and programme design. Finally, a broad agenda for this emerging important field of sports medicine research is outlined.

Implementation and dissemination research: the time has come!

  • Authors: Finch, Caroline
  • Date: 2011
  • Type: Text , Editorial , Journal article
  • Relation: British Journal of Sports Medicine Vol. 45, no. 10 (August 2011), p. 763-764
  • Relation: http://purl.org/au-research/grants/nhmrc/565900
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  • Description: In a provocative statement in a very recent issue of the American Journal of Preventive Medicine, Kessler and Glasgow have called for a 10-year moratorium on effi cacy randomised controlled trials (RCTs) in health and health services research. The authors argue that much intervention research has had minimal impact on both policy and practice because the very nature of effi cacy studies means that focus has had to be on a limited number of specifi c causal and preventive factors; this ignores both the complexity of real-world implementation and the multilevel ecological context in which interventions need to be conducted. I have also previously discussed those same limitations as they apply to sports injury prevention studies, most recently as part of my keynote address at the 2011 International Olympic Committee World Conference on The Prevention of Injury and Illness in Sport, to be published in a forthcoming issue of BJSM.

Concussion guidelines need to move from only expert content to also include implementation and dissemination strategies

  • Authors: Finch, Caroline , McCrory, Paul , Ewing, Michael , Sullivan, John
  • Date: 2013
  • Type: Text , Journal article
  • Relation: British Journal of Sports Medicine Vol. 47, no. 1 (2013), p. 12-14
  • Relation: http://purl.org/au-research/grants/nhmrc/565900
  • Full Text: false
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  • Description: Sport-related head injuries place a significant burden on the health service delivery systems needed to treat and assess them; the sport delivery systems responsible for providing safe sporting opportunities; and personally on the individuals who sustain them. The number of head injury occurrences, the anecdotally high levels of public concern about the risk of head injury in sport and the fact that there is so much public misinformation about their assessment, management and prevention make the prevention of sport-related head injury a health priority. The most recent international consensus statement on the management of concussion in sport stated that there is a need to develop guidelines, education resources and other health promotion approaches for the prevention of head injury and its adverse outcomes across all sports with a risk of serious head injury.4 However, while there is evidence that some educational resources and guidelines have been developed, these have had varying success because they have not incorporated social marketing approaches.

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.

What do community football players think about different exercise-training programmes? Implications for the delivery of lower limb injury prevention programmes

  • 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.

Back to basics with some new tools : First ensure the safety of sporting environments