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.
Seven Steps for Developing and Implementing a Preventive Training Program: Lessons Learned from JUMP-ACL and Beyond
- Authors: Padua, Darin , Frank, Barnett , Donaldson, Alex , de la Motte, Sarah , Cameron, Kenneth , Beutler, Anthony , DiStefano, Lindsay , Marshall, Stephen
- Date: 2014
- Type: Text , Journal article
- Relation: Clinics in Sports Medicine Vol. 33, no. 4 (2014), p. 615-632
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- Description: Musculoskeletal injuries during military and sport-related training are common, costly, and potentially debilitating. There is a need to develop and implement evidence-based injury prevention strategies to reduce the burden of musculoskeletal injury. The lack of attention to implementation issues is a major factor limiting the ability to successfully reduce musculoskeletal injury rates using evidence-based injury prevention programs. This article proposes 7 steps that can be used to facilitate successful design and implementation of evidence-based injury prevention programs within the logical constraints of a real-world setting by identifying implementation barriers and associated solutions.
What are the most effective risk-reduction strategies in sport concussion?
- Authors: Benson, Brian , McIntosh, Andrew , Maddocks, David , Herring, Stanley , Raftery, Martin , Dvorak, Jiri
- Date: 2013
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 47, no. 5 (2013), p. 321-326
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- Description: Aim To critically review the evidence to determine the efficacy and effectiveness of protective equipment, rule changes, neck strength and legislation in reducing sport concussion risk. Methods Electronic databases, grey literature and bibliographies were used to search the evidence using Medical Subject Headings and text words. Inclusion/ exclusion criteria were used to select articles for the clinical equipment studies. The quality of evidence was assessed using epidemiological criteria regarding internal/external validity (eg, strength of design, sample size/power, bias and confounding). Results No new valid, conclusive evidence was provided to suggest the use of headgear in rugby, or mouth guards in American football, significantly reduced players' risk of concussion. No evidence was provided to suggest an association between neck strength increases and concussion risk reduction. There was evidence in ice hockey to suggest fair-play rules and eliminating body checking among 11-years-olds to 12-years-olds were effective injury prevention strategies. Evidence is lacking on the effects of legislation on concussion prevention. Equipment self-selection bias was a common limitation, as was the lack of measurement and control for potential confounding variables. Lastly, helmets need to be able to protect from impacts resulting in a head change in velocities of up to 10 and 7 m/s in professional American and Australian football, respectively, as well as reduce head resultant linear and angular acceleration to below 50 g and 1500 rad/s2, respectively, to optimise their effectiveness. Conclusions A multifactorial approach is needed for concussion prevention. Future well-designed and sportspecific prospective analytical studies of sufficient power are warranted.
Head injury mechanisms in FIS World Cup alpine and freestyle skiers and snowboarders
- Authors: Steenstrup, Sophie , Bakken, Arnhild , Bere, Tone , Patton, Declan , Bahr, Roald
- Date: 2018
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 52, no. 1 (2018), p. 61-69
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- Description: Introduction Head injuries represent a concern in skiing and snowboarding, with traumatic brain injuries being the most common cause of death. Aim To describe the mechanisms of head and face injuries among World Cup alpine and freestyle skiers and snowboarders. Methods We performed a qualitative analysis of videos obtained of head and face injuries reported through the International Ski Federation Injury Surveillance System during 10 World Cup seasons (2006-2016). We analysed 57 head impact injury videos (alpine n=29, snowboard n=13, freestyle n=15), first independently and subsequently in a consensus meeting. Results During the crash sequence, most athletes (84%) impacted the snow with the skis or board first, followed by the upper or lower extremities, buttocks/pelvis, back and, finally, the head. Alpine skiers had sideways (45%) and backwards pitching falls (35%), with impacts to the rear (38%) and side (35%) of the helmet. Freestyle skiers and snowboarders had backwards pitching falls (snowboard 77%, freestyle 53%), mainly with impacts to the rear of the helmet (snowboard 69%, freestyle 40%). There were three helmet ejections among alpine skiers (10% of cases), and 41% of alpine skiing injuries occurred due to inappropriate gate contact prior to falling. Athletes had one (47%) or two (28%) head impacts, and the first impact was the most severe (71%). Head impacts were mainly on snow (83%) on a downward slope (63%). Conclusion This study has identified several characteristics of the mechanisms of head injuries, which may be addressed to reduce risk.
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
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- 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.
What is the definition of sports-related concussion : A systematic review
- Authors: McCrory, Paul , Feddermann-Demont, Nina , Dvorak, Jiri , Cassidy, David , McIntosh, Andrew , Vos, Pieter , Echemendia, Ruben , Meeuwisse, Willem , Tarnutzer, Alexander
- Date: 2017
- Type: Text , Journal article , Review
- Relation: British Journal of Sports Medicine Vol. 51, no. 11 (2017), p. 877-887
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- Description: Objectives: Various definitions for concussion have been proposed, each having its strengths and weaknesses. We reviewed and compared current definitions and identified criteria necessary for an operational definition of sports-related concussion (SRC) in preparation of the 5th Concussion Consensus Conference (Berlin, Germany). We also assessed the role of biomechanical studies in informing an operational definition of SRC. Design: This is a systematic literature review. Data sources: Data sources include MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, Cochrane Central Register of Clinical Trials and SPORT Discus (accessed 14 September 2016). Eligibility criteria for selecting studies: Eligibility criteria were studies reporting (clinical) criteria for diagnosing SRC and studies containing SRC impact data. Results: Out of 1601 articles screened, 36 studies were included (2.2%), 14 reported on criteria for SRC definitions and 22 on biomechanical aspects of concussions. Six different operational definitions focusing on clinical findings and their dynamics were identified. Biomechanical studies were obtained almost exclusively on American football players. Angular and linear head accelerations linked to clinically confirmed concussions demonstrated considerable individual variation. Summary/conclusions: SRC is a traumatic brain injury that is defined as a complex pathophysiological process affecting the brain, induced by biomechanical forces with several common features that help define its nature. Limitations identified include that the current criteria for diagnosing SRC are clinically oriented and that there is no gold/standard to assess their diagnostic properties. A future, more valid definition of SRC would better identify concussed players by demonstrating high predictive positive/negative values. Currently, the use of helmet-based systems to study the biomechanics of SRC is limited to few collision sports. New approaches need to be developed to provide objective markers for SRC. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved.
The perception of injury risk and safety in triathlon competition: An exploratory focus group study
- Authors: Gosling, Cameron , Donaldson, Alex , Forbes, Andrew , Gabbe, Belinda
- Date: 2013
- Type: Text , Journal article
- Relation: Clinical Journal of Sport Medicine Vol. 23, no. 1 (2013), p. 70-73
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- Description: OBJECTIVE:: To explore stakeholder perceptions of triathlon competition safety and injury risk. DESIGN:: Qualitative focus group study. SETTING:: Triathlon stakeholders from Melbourne, Australia. PARTICIPANTS:: Competition organizers, coaches, and competitors of various skill levels, age, gender, and experience (n = 18). INTERVENTIONS:: Focus groups were conducted, recorded, and transcribed for analysis. MAIN OUTCOME MEASURES:: Key themes were identified using content analysis. RESULTS:: The perceived risk of serious injury was highest for cycling. Running was most commonly linked to minor injuries. Physical and environmental factors, including course turning points, funneling of competitors into narrow sections, and the weather, were perceived as contributing to injury. Experience, skill level, feelings of vulnerability, personal awareness, club culture, and gender issues were perceived as the competitor-related factors potentially contributing to injury. The cycling mount/dismount area, cycling, and swim legs were the race sections perceived as the riskiest for competitors. Competition organizers were considered to generally have the competitors' best interest as a priority. Triathlons were acknowledged as risky activities and individual competitors accepted this risk. CONCLUSIONS:: This study has highlighted the main risks and concerns perceived by triathlon competitors, coaches, and competition organizers, which will help identify potential, context-relevant intervention strategies to reduce injury risk. © 2013 by Lippincott Williams & Wilkins.
A preliminary video analysis of concussion in the National Rugby League
- Authors: Gardner, Andrew , Iverson, Grant , Quinn, Tanya , Makdissi, Michael , Levi, Christopher , Shultz, Sandy , Wright, David , Stanwell, Peter
- Date: 2015
- Type: Text , Journal article
- Relation: Brain Injury Vol. 29, no. 10 (2015), p. 1182-1185
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- Description: Primary objective: To conduct the first video analysis of concussion in the Australian National Rugby League (NRL) and describe player and injury characteristics, situational factors and time to return to play.Research design: Descriptive, observational case series.Methods and procedures: Video analysis of 20 medically diagnosed concussions for three consenting clubs during the 2013 NRL season.Main outcome and results: Most concussions (83%) occurred during a high tackle, and all injured ball carriers were hit high. Loss of consciousness was observed in 30% of cases. Common observable signs of injury included clutching of the head, balance problems or wobbly legs and a blank or vacant state. There were no post-concussive seizures. All players with loss of consciousness were removed from play. However, only half of the total sample was removed from play and one athlete who was removed returned to play in the same match. Of the players who were removed from play, the large majority returned the following week. Illegal play accounted for 25% of all concussions.Conclusions: Video analysis may be a useful method to study the incidence, mechanism and management of concussion in sports such as Rugby League. Future studies may include larger numbers to validate this preliminary data and may also investigate other levels of play and age ranges. © 2015 Taylor and Francis Group, LLC.
Intervention strategies used in sport injury prevention studies : A systematic review identifying studies applying the Haddon matrix
- Authors: Vriend, Ingrid , Gouttebarge, Vincent , Finch, Caroline , van Mechelen, Willem , Verhagen, Evert
- Date: 2017
- Type: Text , Journal article , Review
- Relation: Sports Medicine Vol. 47, no. 10 (2017), p. 2027-2043
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- Description: Background: Prevention of sport injuries is crucial to maximise the health and societal benefits of a physically active lifestyle. To strengthen the translation and implementation of the available evidence base on effective preventive measures, a range of potentially relevant strategies should be considered. Objective: Our aim was to identify and categorise intervention strategies for the prevention of acute sport injuries evaluated in the scientific literature, applying the Haddon matrix, and identify potential knowledge gaps. Methods: Five electronic databases were searched (PubMed, EMBASE, SPORTDiscus, CINAHL, Cochrane) for studies that evaluated the effect of interventions on the occurrence of acute sport injuries. Studies were required to include a control group/condition, prospective data collection, and a quantitative injury outcome measure. Results: A total of 155 studies were included, mostly randomised controlled trials (43%). The majority of studies (55%) focussed on strategies requiring a behavioural change on the part of athletes. Studies predominantly evaluated the preventive effect of various training programmes targeted at the ‘pre-event’ phase (n = 73) and the use of equipment to avoid injury in the ‘event phase’ (n = 29). A limited number of studies evaluated the preventive effect of strategies geared at rules and regulations (n = 14), and contextual modifications (n = 18). Studies specifically aimed at preventing re-injuries were a minority (n = 8), and were mostly related to ankle sprains (n = 5). Conclusions: Valuable insight into the extent of the evidence base of sport injury prevention studies was obtained for 20 potential intervention strategies. This approach can be used to monitor potential gaps in the knowledge base on sport injury prevention. © 2017, The Author(s).
Rural v metro : Geographical differences in sports injury hospital admissions across Victoria
- Authors: Shee, Anna Wong , Clapperton, Angela , Finch, Caroline
- Date: 2015
- Type: Text , Journal article , Short Report
- Relation: Medical Journal of Australia Vol. 203, no. 7 (2015), p. 288-288e.1
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
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- Description: Injury prevention is one of the Australian National Health Priority Areas.1 Injuries requiring medical attention place considerable demands on the health care system and are increasingly being recognised as a significant public health problem.2 Recent statewide data from Victoria show that the public health burden of sports injury, as a particular context for hospitalised injury, has increased significantly in recent times.3,4 Understanding whether sports injury rates vary by geographic regions in Vic would inform better health service delivery to redress identified health inequalities across regions and aid targeting of preventive programs.
Tackling reliability and construct validity : The systematic development of a qualitative protocol for skill and incident analysis
- Authors: Savage, Trevor , McIntosh, Andrew
- Date: 2017
- Type: Text , Journal article
- Relation: Journal of Sports Sciences Vol. 35, no. 5 (2017), p. 449-456
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- Description: It is important to understand factors contributing to and directly causing sports injuries to improve the effectiveness and safety of sports skills. The characteristics of injury events must be evaluated and described meaningfully and reliably. However, many complex skills cannot be effectively investigated quantitatively because of ethical, technological and validity considerations. Increasingly, qualitative methods are being used to investigate human movement for research purposes, but there are concerns about reliability and measurement bias of such methods. Using the tackle in Rugby union as an example, we outline a systematic approach for developing a skill analysis protocol with a focus on improving objectivity, validity and reliability. Characteristics for analysis were selected using qualitative analysis and biomechanical theoretical models and epidemiological and coaching literature. An expert panel comprising subject matter experts provided feedback and the inter-rater reliability of the protocol was assessed using ten trained raters. The inter-rater reliability results were reviewed by the expert panel and the protocol was revised and assessed in a second inter-rater reliability study. Mean agreement in the second study improved and was comparable (52-90% agreement and ICC between 0.6 and 0.9) with other studies that have reported inter-rater reliability of qualitative analysis of human movement.
Injuries of the head and face
- Authors: De Vos, Robert , McIntosh, Andrew
- Date: 2015
- Type: Text , Book chapter
- Relation: Nuclear Medicine and Radiologic Imaging in Sports Injuries p. 133-146
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- Description: Head and orofacial injuries in sports are common, but serious injuries are rare. At present, there is substantial interest in concussion and its management in sport. Many sports give rise to the potential for the athlete to be struck in the head or face, often by relatively rigid high-speed projectiles or body parts. The bony contours of the face combined with the soft tissue covering makes the face vulnerable to fractures and lacerations when it is exposed to impacts. The dimensions of many projectiles, e.g. squash balls and cricket balls, mean that they can impact the eye or damage the orbit. In the context of the range of normal impacts in team sports, skull fractures are not common. Head impacts against rigid pieces of infrastructure, e.g. posts, concrete footings and hard floors, can give rise to skull fractures. In powered sports or high-speed individual sports, e.g. cycling, skiing and horse racing, the unprotected head is exposed to a measurable risk of skull fracture and severe intracranial injury. The brain, however, is vulnerable to the range of head impact severities that athletes are exposed to in sport, with the most frequent manifestation being concussion. Consensus guidelines on the management of concussion indicate that athletes should not return to match play in the event in which they have been concussed and their future return to play must occur after resolution of symptoms and cognitive function. The application of risk management approaches to prevent head and facial injury is successful. The application of rules that prevent and limit head contact is important. Improving the infrastructure to remove hazards is another element. Personal protective equipment, such as helmets and mouthguards, has been shown in some sports to protect the head and mouth. Immediate medical management of injuries and evidence-based return-to-play processes are also essential. © Springer-Verlag Berlin Heidelberg 2015.
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.
Traumatic cricket-related fatalities in Australia : A historical review of media reports
- Authors: Brukner, Peter , Gara, Thomas , Fortington, Lauren
- Date: 2018
- Type: Text , Journal article
- Relation: Medical Journal of Australia Vol. 208, no. 6 (2018), p. 261-264
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- Description: The known The tragic death of Phillip Hughes in 2014 challenged the perception that cricket is a safe sport. The new 174 trauma-related deaths in cricket over 152 years were identified: 83 in organised settings, 91 in informal play. The number of fatalities appears to have dropped dramatically in the past 30 years, probably reflecting the adoption of helmets by batsmen and close-in fielders. All recent deaths were caused by chest and neck injuries. The implications Fatal injuries resulting fromdirect trauma in cricket are rare in Australia. Continued investigation of chest and neck protection is important for preventing further fatalities.
Injuries in field hockey players : A systematic review
- Authors: Barboza, Saulo , Joseph, Corey , Nauta, Joske , van Mechelen, Willem , Verhagen, Evert
- Date: 2018
- Type: Text , Journal article , Review
- Relation: Sports Medicine Vol. 48, no. 4 (2018), p. 849-866
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- Description: Background: To commence injury prevention efforts, it is necessary to understand the magnitude of the injury problem. No systematic reviews have yet investigated the extent of injuries in field hockey, despite the popularity of the sport worldwide. Objective: Our objective was to describe the rate and severity of injuries in field hockey and investigate their characteristics. Methods: We conducted electronic searches in PubMed, Embase, SPORTDiscus, and CINAHL. Prospective cohort studies were included if they were published in English in a peer-reviewed journal and observed all possible injuries sustained by field hockey players during the period of the study. Results: The risk of bias score of the 22 studies included ranged from three to nine of a possible ten. In total, 12 studies (55%) reported injuries normalized by field hockey exposure. Injury rates ranged from 0.1 injuries (in school-aged players) to 90.9 injuries (in Africa Cup of Nations) per 1000 player-hours and from one injury (in high-school women) to 70 injuries (in under-21 age women) per 1000 player-sessions. Studies used different classifications for injury severity, but—within studies—injuries were included mostly in the less severe category. The lower limbs were most affected, and contusions/hematomas and abrasions were common types of injury. Contact injuries are common, but non-contact injuries are also a cause for concern. Conclusions: Considerable heterogeneity meant it was not possible to draw conclusive findings on the extent of the rate and severity of injuries. Establishing the extent of sports injury is considered the first step towards prevention, so there is a need for a consensus on injury surveillance in field hockey. © 2018, The Author(s).