Medical-attention injuries in community cricket : a systematic review
- Authors: McLeod, Geordie , O'Connor, Siobhan , Morgan, Damian , Kountouris, Alex , Finch, Caroline , Fortington, Lauren
- Date: 2020
- Type: Text , Journal article , Review
- Relation: BMJ Open Sport and Exercise Medicine Vol. 6, no. 1 (2020), p.
- Full Text:
- Reviewed:
- Description: Objectives The aim was to identify and describe outcomes from original published studies that present the number, nature, mechanism and severity of medically treated injuries sustained in community-level cricket. Design Systematic review. Methods Nine databases were systematically searched to December 2019 using terms "cricket
"It Doesn't Make Sense for Us Not to Have One" - Understanding reasons why community sports organizations chose to participate in a funded automated external defibrillator program
- Authors: Fortington, Lauren , Bekker, Sheree , Morgan, Damian , Finch, Caroline
- Date: 2019
- Type: Text , Journal article
- Relation: Clinical Journal of Sport Medicine Vol. 29, no. 4 (2019), p. 324-328
- Full Text: false
- Reviewed:
- Description: Objective: Implementation of automated external defibrillators (AEDs) in community sports settings is an important component of emergency medical planning. This study aimed to understand motivations for why sports organizations participated in a government-funded program that provided AEDs and associated first-aid training. Design: Face-to-face interviews. Setting: Community sports organizations in Victoria, Australia. Participants: Representatives from 14 organizations who participated in a government-funded AED program. Main Outcome Measures: Motivations to participate in the AED program were explored using a qualitative descriptive approach. Results: Two overarching themes emerged: awareness of the program and decision to apply. Awareness was gained indirectly through grant advertising in newsletters/emails/web sites and directly through their sporting associations. For most organizations, there was no decision process per se, rather, the opportunity to apply was the key determinant for participating in the program. A duty of care also emerged as a key driving factor, with recognition of AEDs as a valuable asset to communities broadly, not just the participants' immediate sports setting. Reflecting on participation in the program, these participants identified that it was important to increase awareness about AED ownership and use. The program benefits were clearly summed up as being best prepared for a worst-case scenario. Discussion: This study provides new understanding of why community sports organizations apply for an AED and training. The strongest reason was simply the opportunity to acquire this at no cost. Therefore, for wider implementation of AEDs, additional funding opportunities, targeted awareness of these opportunities, and continued promotion of AED importance are recommended.
A 2-year prospective study of injury epidemiology in elite Australian rugby sevens : Exploration of incidence rates, severity, injury type, and subsequent injury in men and women
- Authors: Toohey, Liam , Drew, Michael , Finch, Caroline , Cook, Jill , Fortington, Lauren
- Date: 2019
- Type: Text , Journal article
- Relation: American Journal of Sports Medicine Vol. 47, no. 6 (2019), p. 1302-1311
- Full Text: false
- Reviewed:
- Description: Background: Injuries are common in rugby sevens, but studies to date have been limited to short, noncontinuous periods and reporting of match injuries only. Purpose: To report the injury incidence rate (IIR), severity, and burden of injuries sustained by men and women in the Australian rugby sevens program and to provide the first longitudinal investigation of subsequent injury occurrence in rugby sevens looking beyond tournament injuries only. Study Design: Descriptive epidemiology study. Methods: Ninety international rugby sevens players (55 men and 35 women) were prospectively followed over 2 consecutive seasons (2015-2016 and 2016-2017). All medical attention injuries were reported irrespective of time loss. Individual exposure in terms of minutes, distance, and high-speed distance was captured for each player for matches and on-field training, with the use of global positioning system devices. The IIR and injury burden (IIR × days lost to injury) were calculated per 1000 player-hours, and descriptive analyses were performed. Results: Seventy-three players (81.1%) sustained 365 injuries at an IIR of 43.2 per 1000 player-hours (95% CI, 43.0-43.3). As compared with male players, female players experienced a lower IIR (incidence rate ratio, 0.91; 95% CI, 0.90-0.91). Female players also sustained a higher proportion of injuries to the trunk region (relative risk, 1.75; 95% CI, 1.28-2.40) but a lower number to the head/neck region (relative risk, 0.58; 95% CI, 0.37-0.93; P =.011). The majority (80.7%) of subsequent injuries were of a different site and nature than previous injuries. A trend toward a reduced number of days, participation time, distance, and high-speed distance completed before the next injury was observed after successive injury occurrence. Conclusion: Female players have a lower IIR than male players, with variation of injury profiles observed between sexes. With a surveillance period of 2 years, subsequent injuries account for the majority of injuries sustained in rugby sevens, and they are typically different from previous types of sustained injuries. After each successive injury, the risk profile for future injury occurrence appears to be altered, which warrants further investigation to inform injury prevention strategies in rugby sevens.
Implementing automated external defibrillators into community sports clubs/facilities : A cross-sectional survey of community club member preparedness for medical emergencies
- Authors: Fortington, Lauren , West, Liam , Morgan, Damian , Finch, Caroline
- Date: 2019
- Type: Text , Journal article
- Relation: BMJ Open Sport and Exercise Medicine Vol. 5, no. 1 (2019), p. 1-8
- Full Text:
- Reviewed:
- Description: Objective There is a growing focus on ensuring the availability of automated external defibrillators (AED) in sport settings to assist in preventing sudden cardiac death. For the AED to be most effective, understanding how best to integrate it with wider risk management and emergency action plans (EAP) is needed. The aim of this survey was to identify sports club/facility member knowledge of AED use and club EAPs, 6 months following participation in a government-funded AED provision and cardiopulmonary resuscitation training programme. Methods Cross-sectional survey of community sports clubs and facilities in Victoria, Australia. Included participants were members of sports club/facilities that had been provided with an AED and basic first aid training as part of a government programme to increase access to, and awareness of, AEDs. A descriptive analysis of availability of EAPs and AEDs, together with practical scenarios on AED use and maintenance, is presented. Results From 191 respondents, more than half (56%) had no previous training in AED use. Knowledge on availability of an EAP at the club/facility was varied: 53% said yes and knew where it was located, while 41% did not have, or did not know if they had, an EAP. Responses to clinical scenarios for use of AED were mostly accurate, with the exception of being unsure how to respond when 'participant falls to the ground and is making shaking movements.' Conclusions While there were positive outcomes from this programme, such as half of the respondents being newly trained in emergency first aid response, further improvements are required to assist members with embedding their AED into their club/facility EAP and practices.
Match injuries in Sri Lankan junior cricket : A prospective, longitudinal study
- Authors: Gamage, Prasanna , Fortington, Lauren , Kountouris, Alex , Finch, Caroline
- Date: 2019
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 22, no. 6 (2019), p. 647-652
- Full Text: false
- Reviewed:
- Description: Objectives: Understanding the nature of injuries in cricket is key to mitigate injury risks and prioritise preventive measures. This study aimed to identify the incidence and nature of match injuries among Sri Lankan junior cricketers. Design: Longitudinal follow-up study with prospective in-season data collection. Methods: A national survey of schoolboy, division-1 cricket teams in under-15 and under-17 age groups. Using a paper-based questionnaire, distributed to school-teams at the start of the 2016 cricket season, respondents recorded any injuries, including the site, type and mechanism. Match injury incidence rates (match-IIR) (injuries/100 match-player-days) were calculated overall, by position and for match time loss (MTL) and non-MTL injuries. Results: From 59 school-teams, 573 players responded, with 404 players reporting 744 injuries in 648 matches. The match-IIR was 28.0 injuries/100 match-player-days (95% CI = 26.0–30.2). The highest match-IIR was reported among fielders (46.0% of all injuries sustained; match-IIR = 12.9) compared with batters (25.4%; match-IIR = 7.1) and bowlers (20.3%; match-IIR = 5.7). Abrasions and bruises to the knee or elbow were the most common injuries among fielders, with the majority being non-MTL injuries. Conclusions: Almost half (46.0%) of all injuries were to fielders, and more research into their severity and mechanisms is needed to identify the need for, and design of, preventive measures. Batters sustained a relatively large number of facial-organ injuries from being struck by the ball, presenting a need to evaluate the use and appropriateness of helmets by Sri Lankan junior cricketers. Similar to other junior cricket studies, the most common injuries among bowlers were strains and sprains, mainly affecting the lower limbs and lower back. © 2018
Quantification of Achilles and patellar tendon structure on imaging does not enhance ability to predict self-reported symptoms beyond grey-scale ultrasound and previous history
- Authors: Docking, Sean , Rio, Ebonie , Cook, Jill , Carey, David , Fortington, Lauren
- Date: 2019
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 22, no. 2 (2019), p. 145-150
- Full Text: false
- Reviewed:
- Description: Background: Tendon pathology on imaging has been associated with an increased risk of developing symptoms. This evidence is based on classifying the tendon as normal or pathological. It is unclear whether the extent of tendon pathology is associated with the development or severity of symptoms. Objectives: To investigate whether the presence and extent of tendon pathology on ultrasound tissue characterisation (UTC), or a previous history of symptoms, were associated with the development of symptoms over a football season. Methods: 179 male Australian football players underwent UTC imaging of their Achilles and/or patellar tendon at the start of the pre-season. Players completed monthly OSTRC overuse questionnaires to quantify the presence and severity of Achilles and/or patellar tendon symptoms. Risk factor analysis was performed to identify associations between imaging and the development of symptoms. Results: A pathological Achilles tendon increased the risk of developing symptoms (RR = 3.2, 95%CI 1.7–5.9). Conversely, a pathological patellar tendon was not significantly associated with the development of symptoms (RR = 1.8, 95%CI 0.9–3.7). Quantification of tendon structure using UTC did not enhance the ability to identify athletes who developed symptoms. Previous history of symptoms was the strongest predictor for the development of symptoms (Achilles RR = 3.0 95%CI 1.8–4.8; patellar RR = 3.7 95%CI 2.2–6.1). Conclusion: Tendon pathology was associated with the development of self-reported symptoms; however previous history of symptoms was a stronger risk factor. The extent of disorganisation quantified by UTC should not be used as a marker for the presence or severity of current and future symptoms.
Risk perceptions for exertional heat illnesses in junior cricket in Sri Lanka
- Authors: Gamage, Prasanna , Fortington, Lauren , Finch, Caroline
- Date: 2019
- Type: Text , Journal article
- Relation: BMJ Open Sport and Exercise Medicine Vol. 5, no. 1 (2019), p. 1-7
- Full Text:
- Reviewed:
- Description: Objectives Exertional heat illnesses (EHI) can occur when sport is played in hot and humid environments, such as those common across Asia. Measures to reduce the risk of EHI are important; however, causal data on EHI occurrence are limited and challenging to capture. To gain an initial understanding of EHI risks, we aimed to assess the risk perceptions of EHI of youth cricketers. Methods A descriptive cross-sectional survey, comprised of 14 questions on EHI risks, was conducted with 365 Sri Lankan junior male cricketers (age=12.9±0.9 years) who typically play in hot and humid conditions. Results For climate related risks, relative humidity was perceived as having a low risk of EHI compared with ambient temperature. The EHI risk associated with wearing protective gear, as commonly used in cricket, was perceived as low. Most junior cricketers perceived a low level of risk associated with recommended preventive measures such as body cooling and heat-acclimatisation. Conclusion This is the first study to explore EHI risk perceptions in any sporting context. Young players may not be mindful of all risks. Therefore, leadership and initiative from competition organisers and parents is required to promote countermeasures.
Adaptation, translation and reliability of the Australian 'Juniors Enjoying Cricket Safely' injury risk perception questionnaire for Sri Lanka
- Authors: Gamage, Prasanna , Fortington, Lauren , Finch, Caroline
- Date: 2018
- Type: Text , Journal article
- Relation: BMJ Open Sport and Exercise Medicine Vol. 4, no. 1 (2018), p. 1-9
- Full Text:
- Reviewed:
- Description: Objectives Cricket is a very popular sport in Sri Lanka. In this setting there has been limited research; specifically, there is little knowledge of cricket injuries. To support future research possibilities, the aim of this study was to cross-culturally adapt, translate and test the reliability of an Australian-developed questionnaire for the Sri Lankan context. Methods The Australian 'Juniors Enjoying Cricket Safely' (JECS-Aus) injury risk perception questionnaire was cross-culturally adapted to suit the Sri Lankan context and subsequently translated into the two main languages (Sinhala and Tamil) based on standard forward-back translation. The translated questionnaires were examined for content validity by two language schoolteachers. The questionnaires were completed twice, 2 weeks apart, by two groups of school cricketers (males) aged 11-15 years (Sinhala (n=24), Tamil (n=30)) to assess reliability. Test-retest scores were evaluated for agreement. Where responses were <100% agreement, Cohen's kappa (κ) statistics were calculated. Questions with moderate-to-poor test-retest reliability (κ <0.6) were reconsidered for modification. Results Both the Sinhala and Tamil questionnaires had 100% agreement for questions on demographic data, and 88%-100% agreement for questions on participation in cricket and injury history. Of the injury risk perception questions, 72% (Sinhala) and 90% (Tamil) questions showed a substantial (κ =0.61-0.8) and almost perfect (κ =0.81-1.0) test-retest agreement. Conclusion The adapted and translated JECS-SL questionnaire demonstrated strong reliability. This is the first study to adapt the JECS-Aus questionnaire for use in a different population, providing an outcome measure for assessing injury risk perceptions in Sri Lankan junior cricketers.
An updated subsequent injury categorisation model (SIC-2.0) : Data-driven categorisation of subsequent injuries in sport
- Authors: Toohey, Liam , Drew, Michael , Fortington, Lauren , Finch, Caroline , Cook, Jill
- Date: 2018
- Type: Text , Journal article
- Relation: Sports Medicine Vol. 48, no. 9 (2018), p. 2199-2210
- Full Text: false
- Reviewed:
- Description: Background: Accounting for subsequent injuries is critical for sports injury epidemiology. The subsequent injury categorisation (SIC-1.0) model was developed to create a framework for accurate categorisation of subsequent injuries but its operationalisation has been challenging. Objectives: The objective of this study was to update the subsequent injury categorisation (SIC-1.0 to SIC-2.0) model to improve its utility and application to sports injury datasets, and to test its applicability to a sports injury dataset. Methods: The SIC-1.0 model was expanded to include two levels of categorisation describing how previous injuries relate to subsequent events. A data-driven classification level was established containing eight discrete injury categories identifiable without clinical input. A sequential classification level that sub-categorised the data-driven categories according to their level of clinical relatedness has 16 distinct subsequent injury types. Manual and automated SIC-2.0 model categorisation were applied to a prospective injury dataset collected for elite rugby sevens players over a 2-year period. Absolute agreement between the two coding methods was assessed. Results: An automated script for automatic data-driven categorisation and a flowchart for manual coding were developed for the SIC-2.0 model. The SIC-2.0 model was applied to 246 injuries sustained by 55 players (median four injuries, range 1–12), 46 (83.6%) of whom experienced more than one injury. The majority of subsequent injuries (78.7%) were sustained to a different site and were of a different nature. Absolute agreement between the manual coding and automated statistical script category allocation was 100%. Conclusions: The updated SIC-2.0 model provides a simple flowchart and automated electronic script to allow both an accurate and efficient method of categorising subsequent injury data in sport.
Communication techniques for improved acceptance and adherence with therapeutic footwear
- Authors: Van Netten, Jaap , Francis, Anthony , Morphet, Ashley , Fortington, Lauren , Postema, Klass , Williams, Anita
- Date: 2017
- Type: Text , Journal article
- Relation: Prosthetics and Orthotics International Vol. 41, no. 2 (2017), p. 201-204
- Full Text: false
- Reviewed:
- Description: Background and aim: Clients’ acceptance and adherence with orthoses can be influenced by a clinician’s communication skills. In this clinical note, we describe two communication techniques, in the context of therapeutic footwear. Technique: Person-centred communication involves engaging with and listening to the attitudes of the client towards their condition, as well as discussing acceptance and expectations, in a structured consultation. Building a relationship is crucial and requires clients to feel heard and understood. An important influence on the acceptance and adherence is that a client makes a conscious decision to receive their device. This active receipt can be facilitated through shared decision making, wherein clinicians give clear, relevant and meaningful examples, based on clinical evidence, and ensure this is understood. Discussion: Two communication techniques for clinicians providing therapeutic footwear are described. These can be adapted for use with provision of other assistive technologies to improve client acceptance and adherence. Clinical relevance: Small changes in how clinicians communicate to their clients in daily practice can have a big influence on the subsequent acceptance and adherence with therapeutic footwear and indeed other prescribed assistive technologies. © 2016, © The International Society for Prosthetics and Orthotics 2016.
Online news media reporting of football-related fatalities in Australia : A matter of life and death
- Authors: Fortington, Lauren , Bekker, Sheree , Finch, Caroline
- Date: 2017
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 21, no. 3 (2017), p. 245-249
- Full Text: false
- Reviewed:
- Description: Objectives: While deaths in sports settings are rare, they do occur. To develop an understanding of the sports and people most at risk, and to identify opportunities for prevention, routine and systematic data detailing the occurrence of these fatalities is required. There is currently no routine reporting of data of this nature in Australia. As there is often strong community interest in these incidents, the media offers an opportunity for surveillance. However before this can occur, understanding of the terminology used by the media is required. The aim of this study was to identify the terminology most frequently used in online Australian news media coverage of football-related deaths. Design: Retrospective review of online news media. Methods: Three databases were searched for online news media reports of people who died while participating in football (all football codes) in Australia. A descriptive analysis of terminology was undertaken to identify the common language applied. Results: Thirty-four football-related fatalities in Australia were identified between 2010-2016, via 149 separate articles. The most frequent terms identified in the media items were: Family; Club; Rugby; Football; Player; League; Died; Game; Death; Life; Loved; Hospital; Match; Young; Community; Playing; Friends; Sport; Heart; AFL [Australian Football League]. Conclusions: This study identified terminology used in reporting football-related fatalities in Australia, identifying common reference to terms relating to 'death' as metaphors and the frequent celebration of 'life.' The findings suggest that a reliance on researcher-generated terminology will be insufficient to reflect media discourse in prospective monitoring of sports deaths for surveillance.
Reporting multiple individual injuries in studies of team ball sports : A systematic review of current practice
- Authors: Fortington, Lauren , van der Worp, Henk , van den Akker-Scheek, Inge , Finch, Caroline
- Date: 2016
- Type: Text , Journal article
- Relation: Sports Medicine Vol. 47, no. 6 (2016), p. 1103-1122
- Full Text:
- Reviewed:
- Description: BACKGROUND: To identify and prioritise targets for injury prevention efforts, injury incidence studies are widely reported. The accuracy and consistency in calculation and reporting of injury incidence is crucial. Many individuals experience more than one injury but multiple injuries are not consistently reported in sport injury incidence studies. OBJECTIVE: The aim of this systematic review was to evaluate current practice of how multiple injuries within individuals have been defined and reported in prospective, long-term, injury studies in team ball sports. DATA SOURCES: A systematic search of three online databases for articles published before 2016. STUDY SELECTION: Publications were included if (1) they collected prospective data on musculoskeletal injuries in individual participants; (2) the study duration was >1 consecutive calendar year/season; and (3) individuals were the unit of analysis. DATA EXTRACTION: Key study features were summarised, including definitions of injury, how multiple individual injuries were reported and results relating to multiple injuries. RESULTS: Of the 71 publications included, half did not specifically indicate multiple individual injuries; those that did were largely limited to reporting recurrent injuries. Eight studies reported the number/proportion of athletes with more than one injury, and 11 studies presented the mean/number of injuries per athlete. CONCLUSIONS: Despite it being relatively common to collect data on individuals across more than one season, the reporting of multiple injuries within individuals is much more limited. Ultimately, better addressing of multiple injuries will improve the accuracy of injury incidence studies and enable more precise targeting and monitoring of the effectiveness of preventive interventions.
Shorter time to first injury in first year professional football players : A cross-club comparison in the Australian Football League
- Authors: Fortington, Lauren , Berry, Jason , Buttifant, David , Ullah, Shahid , Diamantopoulou, Kathy , Finch, Caroline
- Date: 2014
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 19, no. 1 (2014), p.18-23
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
- Full Text: false
- Reviewed:
- Description: AbstractObjectives Australian Football League (AFL) players have a high risk of injury. Anecdotally, this injury risk is greater in emerging players (i.e. those in their first year), compared with established players (with 3+ years of experience). This study aimed to conduct the first comparison of injury risk and playing experience in these two player groups across a large number of AFL clubs. Design Prospective, cohort. Methods Injuries, game participation and training participation were collected weekly by 8 AFL clubs for 61 emerging and 64 established players. Injury incidence rates (IIR) and Cox proportional hazard models for time to first injury, separately for games and training, were computed. Results The game IIR was significantly higher for emerging than established players: 45.6 (95% CI: 35.7, 57.6) versus 18.3 (95% CI: 13.1, 24.9) per 1000 game-hours. Emerging players also had a higher training IIR than did the established players: 9.6 (95% CI: 7.6, 11.9) versus 8.9 (95% CI: 7.0, 11.1) per 1000 training-hours. Emerging players were significantly less likely to remain injury free in games than established players (HR = 3.46, 95% CI: 1.27, 9.45). A similar outcome was seen in training sessions, although to a lesser degree (HR = 1.41, 95% CI: 1.19, 1.69). Conclusions Despite efforts to modify the playing/training program of emerging players, this group remain at greater risk of injury in games and training sessions, compared with established players. Continued efforts should be made toward understanding reasons for this increased risk to better prevent injury during the early years of a professional football career.
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
- Full Text:
- Reviewed:
- 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.
Change in health-related quality of life in the first 18 months after lower limb amputation: A prospective, longitudinal study
- Authors: Fortington, Lauren , Dijkstra, Pieter , Bosmans, Joline , Post, Wendy , Geertzen, Jan
- Date: 2013
- Type: Text , Journal article
- Relation: Journal of Rehabilitation Medicine Vol. 45, no. 6 (2013), p. 587-594
- Full Text:
- Reviewed:
- Description: Objective: To describe changes in health-related quality of life in people with lower limb amputation, from time of amputation to 18 months, taking into consideration the influence of age and walking distance. In addition, quality of life for people with amputation is compared with the Dutch population norm values. Design: Multicentre, longitudinal study. Subjects: All people undergoing first amputation: 106 were referred, of whom 82 were included, mean age 67.8 years (standard deviation; SD 13.0), 67% men. A total of 35 remained in the study at 18 months. Methods: Dutch language RAND-36 questionnaire (Research and Development Corporation measure of Quality of Life) was completed at time of amputation, 6 and 18 months after amputation. Results: Over time, a significant improvement was seen in physical function, social function, pain, vitality, and perceived change in health (all p < 0.001). Subjects over 65 years of age had a poorer outcome compared with people < 65 years for physical function only (p < 0.001). Walking distance was associated with improved scores in social function (p = 0.047). Conclusion: Quality of life improved significantly in 5 of 7 domains investigated; most change occurred in the first 6 months. Physical function remained well below population norm values. Different domains may be affected in different ways for older and younger age groups, but this requires further research. © 2013 Foundation of Rehabilitation Information.
- Description: C1
Lower limb amputation in Northern Netherlands: Unchanged incidence from 1991-1992 to 2003-2004
- Authors: Fortington, Lauren , Rommers, Gerardus , Postema, Klaas , Van Netten, Jaap , Geertzen, Jan , Dijkstra, Pieter
- Date: 2013
- Type: Text , Journal article
- Relation: Prosthetics and Orthotics International Vol. 37, no. 4 (August 2013 2013), p. 305-310
- Full Text: false
- Reviewed:
- Description: Background: Investigating population changes gives insight into effectiveness and need for prevention and rehabilitation services. Incidence rates of amputation are highly varied, making it difficult to meaningfully compare rates between studies and regions or to compare changes over time. Study Design: Historical cohort study of transtibial amputation, knee disarticulation, and transfemoral amputations resulting from vascular disease or infection, with/without diabetes, in 2003-2004, in the three Northern provinces of the Netherlands. Objectives: To report the incidence of first transtibial amputation, knee disarticulation, or transfemoral amputation in 2003-2004 and the characteristics of this population, and to compare these outcomes to an earlier reported cohort from 1991 to 1992. Methods: Population-based incidence rates were calculated per 100,000 person-years and compared across the two cohorts. Results: Incidence of amputation was 8.8 (all age groups) and 23.6 (≥45 years) per 100,000 person-years. This was unchanged from the earlier study of 1991-1992. The relative risk of amputation was 12 times greater for people with diabetes than for people without diabetes. Conclusions: Investigation is needed into reasons for the unchanged incidence with respect to the provision of services from a range of disciplines, including vascular surgery, diabetes care, and multidisciplinary foot clinics. Clinical relevance: This study shows an unchanged incidence of amputation over time and a high risk of amputation related to diabetes. Given the increased prevalence of diabetes and population aging, both of which present an increase in the population at risk of amputation, finding methods for reducing the rate of amputation is of importance.
- Description: C1
Rehabilitation in skilled nursing centres for elderly people with lower limb amputations: A mixed-methods, descriptive study
- Authors: Fortington, Lauren , Rommers, Gerardus , Wind-Kral, Anne , Dijkstra, Pieter , Geertzen, Jan
- Date: 2013
- Type: Text , Journal article
- Relation: Journal of Rehabilitation Medicine Vol. 45, no. 10 (2013), p. 1065-1070
- Full Text:
- Reviewed:
- Description: Objectives: To describe the current set-up, barriers and potential for providing rehabilitation to people with lower limb amputation in skilled nursing centres. Design: Survey and interviews. Subjects/participants: Elderly care physicians, physiotherapists. Methods: In 2011, clinicians from 34 skilled nursing centres participated in a semi-structured interview covering rehabilitation and daily care, personal skills and training, team work and communication, and discharge processes. Results: Each centre sees only a small proportion of people with amputation (a maximum of 3.6% of all admissions). This limited number of patients appears to be the main barrier in providing care, as it is difficult for clinicians to maintain knowledge, and resources are spread widely. Two main areas of improvement were suggested by participants: (i) use of guidelines in care; and (ii) collaboration with specialized team members. Conclusion: The spread of patients across many centres makes it difficult for professionals working in skilled nursing centres to obtain the necessary skills and knowledge for care of people with amputation. A designated skilled nursing centre for amputation rehabilitation is presented as a solution, but smaller clinical changes are also suggested, including improvements in communication and training.
- Description: C1