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.
SCAT3 changes from baseline and associations with X2 Patch measured head acceleration in amateur Australian football players
- Authors: Willmott, Catherine , McIntosh, Andrew , Howard, Teresa , Mitra, Biswadev , Dimech-Betancourt, Bleydy , Donovan, Jarrod , Rosenfeld, Jeffrey
- Date: 2018
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 21, no. 5 (2018), p. 442-446
- Full Text: false
- Reviewed:
- Description: Objectives: To investigate changes from baseline on SCAT3 as a result of football game exposure, and association with X2 Patch measured head acceleration events in amateur Australian footballers. Design: Prospective cohort. Methods: Peak linear acceleration (PLA) of the head (>10 g) was measured by wearable head acceleration sensor X2 Biosystems X-Patch in male (n = 34) and female (n = 19) Australian footballers. SCAT3 was administered at baseline (B) and post-game (PG). Results: 1394 head acceleration events (HEA) >10 g were measured. Mean and median HEA PLA were recorded as 15.2 g (SD = 9.2, range = 10.0–115.8) and 12.4 g (IQR = 11.0–15.6) respectively. No significant difference in median HEA PLA (g) was detected across gender (p = 0.55), however, more HEAs were recorded in males (p = 0.03). A greater number (p = 0.004) and severity (p < 0.001) of symptoms were reported PG than at B. No significant association between number of HEA or median PLA, and SCAT3 change scores (p > 0.05 for all), was identified for either gender. Conclusions: Increase in symptom severity post game was not associated with X2 measured HEA. Males sustained more HEA, however HEA PLA magnitude did not differ across gender. Further work on the validation of head acceleration sensors is required and their role in sports concussion research and medical management. © 2017 Sports Medicine Australia
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.
Use of video to facilitate sideline concussion diagnosis and management decision-making
- Authors: Davis, Gavin , Makdissi, Michael
- Date: 2016
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 19, no. 11 (2016), p. 898-902
- Full Text: false
- Reviewed:
- Description: Objectives: Video analysis can provide critical information to improve diagnostic accuracy and speed of clinical decision-making in potential cases of concussion. The objective of this study was to validate a hierarchical flowchart for the assessment of video signs of concussion, and to determine whether its implementation could improve the process of game day video assessment. Methods: All impacts and collisions potentially resulting in a concussion were identified during 2012 and 2013 Australian Football League (AFL) seasons. Consensus definitions were developed for clinical signs associated with concussion. A hierarchical flowchart was developed based on the reliability and validity of the video signs of concussion. Ninety videos were assessed, with 45 incidents of clinically confirmed concussion, and 45 cases where no concussion was sustained. Each video was examined using the hierarchical flowchart, and a single response was given for each video based on the highest-ranking element in the flowchart. Results: No protective action, impact seizure, motor incoordination or blank/vacant look were the highest ranked video signs in almost half of the clinically confirmed concussions, but in only 8.8% of non-concussed individuals. The presence of facial injury, clutching at the head and slow to get up were the highest ranked sign in 77.7% of non-concussed individuals. Conclusions: This study suggests that the implementation of a flowchart model could improve timely assessment of concussion, and it identifies the video signs that should trigger automatic removal from play. (C) 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
Using video analysis for concussion surveillance in Australian football
- Authors: Makdissi, Michael , Davis, Gavin
- Date: 2016
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 19, no. 12 (2016), p. 958-963
- Full Text: false
- Reviewed:
- Description: Objectives: The objectives of the study were to assess the relationship between various player and game factors and risk of concussion; and to assess the reliability of video analysis for mechanistic assessment of concussion in Australian football. Methods: All impacts and collisions resulting in concussion were identified during the 2011 Australian Football League season. An extensive list of factors for assessment was created based upon previous analysis of concussion in Australian Football League and expert opinions. The authors independently reviewed the video clips and correlation for each factor was examined. Results: A total of 82 concussions were reported in 194 games (rate: 8.7 concussions per 1000 match hours; 95% confidence interval: 6.9-10.5). Player demographics and game variables such as venue, timing of the game (day, night or twilight), quarter, travel status (home or interstate) or score margin did not demonstrate a significant relationship with risk of concussion; although a higher percentage of concussions occurred in the first 5 min of game time of the quarter (36.6%), when compared to the last 5 min (20.7%). Variables with good inter-rater agreement included position on the ground, circumstances of the injury and cause of the impact. The remainder of the variables assessed had fair-poor inter-rater agreement. Common problems included insufficient or poor quality video and interpretation issues related to the definitions used. Conclusions: Clear definitions and good quality video from multiple camera angles are required to improve the utility of video analysis for concussion surveillance in Australian football. (C) 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
A new way of categorising recurrent, repeat and multiple sports injuries for injury incidence studies - the subsequent injury categorisation (SIC) model
- Authors: Finch, Caroline , Cook, Jill , Gabbe, Belinda , Orchard, John
- Date: 2015
- Type: Text , Journal article
- Relation: Australasian Epidemiologist Vol. 22, no. 1 (2015), p. 22-25
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
- Full Text: false
- Reviewed:
- Description: Injuries are a major contributor to healthcare costs and individuals' health and disability status. In response to the overall public health burden, injuries were one of the first medical conditions identified as an Australian National Health Priority Area. Our previous epidemiological research has shown that sports injuries, especially those sustained through formal and highly competitive sport, are often associated with considerable pain and dysfunction. They have significant ongoing impact on quality of life and need for medical treatment, including in the hospital setting.They are also a major barrier towards both the uptake and continuance of health-generating physical activity guidance.
Implementation of concussion guidelines in community Australian Football and Rugby League - The experiences and challenges faced by coaches and sports trainers
- Authors: Kemp, Joanne , Newton, Joshua , White, Peta , Finch, Caroline
- Date: 2015
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 19, no. 4 (2015), p.305-310
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
- Full Text:
- Reviewed:
- Description: Objectives: While guidelines outlining the appropriate management of sport-related concussion have been developed and adapted for use within community sport, it remains unknown how they are experienced by those responsible for implementing them.: Design: Longitudinal study.: Methods: 111 coaches and sports trainers from community-level Australian Football and Rugby League teams completed pre- and post-season surveys assessing their attitudes towards using concussion guidelines. Participants also provided post-season feedback regarding their experiences in using the guidelines.: Results: 71% of participants reported using the guidelines in the preceding season. Post-season attitude was related to pre-season attitude (p = 0.002), football code (p = 0.015), and team role (p = 0.045). An interaction between team role and guideline use (p = 0.012) was also found, with coaches who had used the guidelines, and sports trainers who had not, reporting more positive post-season attitudes towards using the concussion guidelines. Implementation challenges included disputing of decisions about return-to-play by players, parents, and coaches, and a perceived lack of time. Recommendations for improved guideline materials included using larger fonts and providing for witnessing of advice given to players.: Conclusions: This is the first study to examine the implementation of concussion guidelines in community sport. Training of coaches/sports trainers needs enhancement. In addition, new education should be developed for parents/players about the importance of the return-to-play advice given to them by those who follow these guidelines. Information provided by those who attempted to use the guidelines will assist the refinement of implementation and dissemination processes around concussion guidelines across sports. © 2015 Sports Medicine Australia
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.
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
- Full Text:
- Reviewed:
- 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.