Setting our minds to implementation
- Authors: Verhagen, Evert , Finch, Caroline
- Date: 2011
- Type: Text , Editorial , Journal article
- Relation: British Journal of Sports Medicine Vol. 45, no. 13 (2011), p.1015-1016
- Relation: http://purl.org/au-research/grants/nhmrc/565900
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- Description: It is now well accepted that to prevent sports injuries we need more intervention studies. Therefore, it is somewhat alarming that most sports injury studies still only focus on the fi rst two steps of the four-step prevention sequence of van Mechelen et al: only counting injuries and describing causal factors. This has clearly been shown by Klügl et al, who reviewed approximately 5274 original sports injury publications, of which only 492 studies intended to establish the preventive value of a measure or programme. This review showed that although the number of efficacy/effectiveness studies has slowly increased over the years, this is still lagging behind the approximately 4000 descriptive and aetiological studies.
The impact of adherence on sports injury prevention effect estimates in randomised controlled trials : Looking beyond the CONSORT statement
- Authors: Verhagen, Evert , Huuperans, Maarten , Finch, Caroline , van Mechelen, Willem
- Date: 2011
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 14, no. 4 (July 2011 2011), p. 287-292
- Relation: http://purl.org/au-research/grants/nhmrc/565900
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- Description: Objective: To investigate estimated outcome effects of a sports injury prevention intervention when analysed by means of a per protocol (PP) analysis approach. Design: Randomised controlled trial (RCT) involving 522 athletes who sustained a lateral ankle sprain allocated to either an intervention (received a preventive programme in addition to usual care) or control group who were followed prospectively for one year. Methods: Secondary analysis of data relating to registered ankle sprain recurrences, exposure and adherence to the allocated intervention using a PP analysis approach. Results: Twenty-three percent of the RCT intervention group indicated to have fully adhered with the neuromuscular training programme. A per protocol analysis only considering fully adherent athletes and control athletes, showed a Hazard Ratio of 0.18 (95% CI: 0.07-0.43). Significantly fewer recurrent ankle sprains were found in the fully adherent group compared to the group that was not adherent (relative risk = 0.63; 95% CI: 0.43-0.99). Conclusions: A PP analysis on fully adherent athletes versus control group athletes showed that the established intervention effect was over threefold higher compared to an earlier intention-to-treat based analysis approach. This shows that outcomes of intervention studies are heavily biased by adherence to the allocated intervention.
A knowledge transfer scheme to bridge the gap between science and practice: An integration of existing research frameworks into a tool for practice
- Authors: Verhagen, Evert , Voogt, Nelly , Bruinsma, Anja , Finch, Caroline
- Date: 2014
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 48, no. 8 (April 2014), p. 698-701
- Relation: http://purl.org/au-research/grants/nhmrc/565900
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- Description: Evidence of effectiveness does not equal successful implementation. To progress the field, practical tools are needed to bridge the gap between research and practice and to truly unite effectiveness and implementation evidence. This paper describes the Knowledge Transfer Scheme integrating existing implementation research frameworks into a tool which has been developed specifically to bridge the gap between knowledge derived from research on the one side and evidence-based usable information and tools for practice on the other.
Effectiveness of an online tailored intervention on determinants and behaviour to prevent running related sports injuries: A randomised controlled trial
- Authors: Adriaensens, Lize , Hesselink, Arlette , Fabrie, M , Brugmans, Marco , Verhagen, Evert
- Date: 2014
- Type: Text , Journal article
- Relation: Schweizerische Zeitschrift fur Sportmedizin und Sporttraumatologie Vol. 62, no. 3 (September 2014), p. 6-13
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- Description: Methods. Runners between 18 and 35 years were randomly assigned to the intervention (n=109) or control group (n=105). Participants in the intervention group were invited to visit the website for 30 minutes. Those in the control group were invited to read magazines that did not contain information about running, injuries or other sport related issues for 30 minutes. Online questionnaires were completed just before (TO) and immediately after the intervention (Ti), and after 3 months (T2). Outcome measures were knowledge, risk perception, attitude, intention and injury prevention behaviour. Objective. Sports injuries are one of the most common injuries in the modern Western society. In line with the increased interest in eHealth, a tailor-based online injury prevention intervention was developed to influence determinants and actual sports injury preventive behaviour. An effect study was carried out among runners. Results. Immediately after the intervention (Tl) an effect was found on all outcome measures. After three months (T2) the effect remained only for behaviours relating to warm-up and frequency of shoe replacement. Conclusion. Short-term (3 months) effects were demonstrated on determinants and actual performance of sports injury prevention behaviour. These results confirm the value of online tailored interventions for the dissemination of injury prevention knowledge.
- Description: C1
Exercise-Based Injury Prevention in Child and Adolescent Sport: A Systematic Review and Meta-Analysis
- Authors: Rossler, Roland , Donath, Lars , Verhagen, Evert , Junge, Astrid , Schweizer, Thomas , Faude, Oliver
- Date: 2014
- Type: Text , Journal article
- Relation: Sports Medicine Vol. 44, no. 12 (2014), p. 1733-1748
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- Description: Background: The promotion of sport and physical activity (PA) for children is widely recommended to support a healthy lifestyle, but being engaged in sport bears the risk of sustaining injuries. Injuries, in turn, can lead to a reduction in current and future involvement in PA and, therefore, may negatively affect future health as well as quality of life. Thus, sports injury prevention is of particular importance in youth. Objective: The aim of this systematic review was to quantify the effectiveness of exercise-based injury prevention programs in child and adolescent sport in general, and with respect to different characteristics of the target group, injury prevention program, and outcome variables. Data Sources: An Internet-based literature search was conducted in six databases (CINAHL, Cochrane, EMBASE, ISI Web of Science, PubMed, SPORTDiscus) using the following search terms with Boolean conjunction: (sport injur* OR athletic injur* OR sport accident*) AND (prevent* OR prophylaxis OR avoidance) AND (child* OR adolescent OR youth). Study Selection: Randomized controlled trials and controlled intervention studies in organized sport, published in English in a peer-reviewed journal, analyzing the effects of an exercise-based injury prevention program in athletes younger than 19 years of age. Data Extraction: Two reviewers evaluated eligibility and methodological quality. Main outcome extracted was the rate ratio (RR). Statistical analyses were conducted using the inverse-variance random effects model. Results: Twenty-one trials, conducted on a total of 27,561 athletes (median age 16.7 years [range 10.7-17.8]), were included. The overall RR was 0.54 (95% CI 0.45-0.67) [p < 0.001]. Girls profited more from injury prevention than boys (p = 0.05). Both prevention programs with a focus on specific injuries (RR 0.48 [95% CI 0.37-0.63]) and those aiming at all injuries (RR 0.62 [95% CI 0.48-0.81]) showed significant reduction effects. Pre-season and in-season interventions were similarly beneficial (p = 0.93). Studies on programs that include jumping/plyometric exercises showed a significant better (p = 0.002) injury preventive effect (RR 0.45 [95 % CI 0.35-0.57], Z = 6.35, p < 0.001) than studies without such exercises (RR 0.74 [95% CI 0.61-0.90], Z = 3.03, p = 0.002). Conclusions: The results provide good evidence and clearly demonstrate beneficial effects of exercise-based injury prevention programs in youth sports as they can result in statistically significant and practically relevant injury reduction. In particular, multimodal programs including jumping/plyometric exercises can be recommended. However, there is a considerable lack of data for children (under 14 years of age) and for individual sports in general. Future research should include these groups and focus on the effect of specific exercises and compliance.
Caution this drug may cause serious harm! why we must report adverse effects of physical activity promotion
- Authors: Verhagen, Evert , Bolling, Caroline , Finch, Caroline
- Date: 2015
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 49, no. 1 (January 2015), p. 1-2
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Competing with injuries : Injuries prior to and during the 15th FINA World Championships 2013 (aquatics)
- Authors: Mountjoy, Margo , Junge, Astrid , Benjamen, Sarah , Boyd, Kevin , Diop, Mohamed , Gerrard, David , van den Hoogenband, Cees-Rein , Marks, Saul , Martinez-Ruiz, Enrique , Miller, Jim , Nanousis, Kyriakos , Shahpar, Farhad , Veloso, Jose , van Mechelen, Willem , Verhagen, Evert
- Date: 2015
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 49, no. 1 (2015), p. 37-43
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- Description: Background: Injury and illness surveillance is the foundation for the development of prevention strategies. Objective: To examine injuries among the aquatic disciplines in the 4 weeks prior to and during the 2013 FINA World Championships. Methods: The study was comprised of two components: (1) a retrospective athlete survey recording injuries in the 4 weeks prior to the Championships and (2) a prospective recording of injuries and illnesses by the medical teams of the participating countries and the local host medical team. Results: One-third of the 1116 responding athletes reported an injury/physical complaint in the 4 weeks prior to the Championships. Significantly more women (36.7%) than men (28.6%) reported injuries. Divers reported the highest rate of injury/physical complaints (55.7%). At the start of the Championships, 70% of injured respondents (n=258) were still symptomatic; however, full participation was expected by 76%. During the Championships, 186 new injuries were reported (8.3/100 registered athletes) with the highest injury incidence rate in water polo (15.3/100 registered athletes). The most common injured body part was the shoulder (21%). A total of 199 illnesses were reported during the Championships (9.0/100 registered athletes) with the most common diagnosis of illness being gastrointestinal infection. Environmental exposure (allergy, otitis and jellyfish stings) was responsible for 27% of all illnesses in open water swimming. Conclusions: Injuries pose a significant health risk for elite aquatic athletes. A prospective study would improve understanding of out-of-competition injuries. Future injury and illness surveillance at FINA World Championships is required to direct and measure the impact of prevention strategies.
Injury risk during different physical activity behaviours in children: A Systematic review with bias assessment
- Authors: Nauta, Joske , Martin-Diener, Eva , Martin, Brian , van Mechelen, Willem , Verhagen, Evert
- Date: 2015
- Type: Text , Journal article
- Relation: Sports Medicine Vol. 45, no. 3 (2015), p. 327-336
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- Description: Results: Eight studies were included. The risk of bias assessment resulted in two studies with a score that was higher than 75 %; risk bias of those two studies was considered low. The medically treated, injury incidence rate was reported to be between 0.15 and 0.27 injuries per 1,000 h of physical activity. The absolute number of injuries related to unorganised leisure time physical activity was higher than the absolute number of injuries reported in organised sports. The respective injury incidence rate expressed per 1,000 h exposure was, however, generally lower during unorganised leisure time than during organised sports. Reported injury incidence rates related to active commuting were comparable to those for unorganised leisure time physical activity. Conflicting injury incidence rates were reported for physical education. Subgroup analysis suggested that girls and children with low habitual levels of physical activity are at increased injury risk. A limitation of the review is that no standard bias assessment was available for this specific context.Conclusions: Children are at an inherent injury risk while participating in physical activities. Most injury prevention efforts have focussed on the sports setting, but our results suggest that many children sustain an injury during unorganised leisure time physical activities.Introduction: The current focus on a physically active lifestyle in children puts children at increased physical activity-related injury risk.Objective: To summarise, in a systematic review, the evidence for the injury risk of several physical activity behaviours in 6- to 12-year-old children.Methods: An electronic search was performed in three databases (Embase, PubMed and SPORTDiscus). Inclusion criteria were: age 6–12 years; report on injuries related to overall physical activity, active commuting, unorganised leisure time physical activity, physical education and/or organised sports; incidence rates expressed as injuries per hours of physical activity; and published after January 1st 2000. Risk of bias was assessed for all studies included. © 2014, Springer International Publishing Switzerland.
OARSI Clinical Trials Recommendations : Design and conduct of clinical trials for primary prevention of osteoarthritis by joint injury prevention in sport and recreation
- Authors: Emery, Carolyn , Roos, Ewa , Verhagen, Evert , Finch, Caroline , Bennell, Kim , Spindler, Kurt , Kemp, Joanne , Lohmander, Stefan
- Date: 2015
- Type: Text , Journal article
- Relation: Osteorthritis and Cartilage Vol. 23, no. 5 (2015), p. 815-825
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- Description: The risk of post-traumatic osteoarthritis (PTOA) substantially increases following joint injury. Research efforts should focus on investigating the efficacy of preventative strategies in high quality randomized controlled trials (RCT). The objective of these OARSI RCT recommendations is to inform the design, conduct and analytical approaches to RCTs evaluating the preventative effect of joint injury prevention strategies. Recommendations regarding the design, conduct, and reporting of RCTs evaluating injury prevention interventions were established based on the consensus of nine researchers internationally with expertise in epidemiology, injury prevention and/or osteoarthritis (OA). Input and resultant consensus was established through teleconference, face to face and email correspondence over a 1 year period. Recommendations for injury prevention RCTs include context specific considerations regarding the research question, research design, study participants, randomization, baseline characteristics, intervention, outcome measurement, analysis, implementation, cost evaluation, reporting and future considerations including the impact on development of PTOA. Methodological recommendations for injury prevention RCTs are critical to informing evidence-based practice and policy decisions in health care, public health and the community. Recommendations regarding the interpretation and conduct of injury prevention RCTs will inform the highest level of evidence in the field. These recommendations will facilitate between study comparisons to inform best practice in injury prevention that will have the greatest public health impact.
Prevalence and characteristics of asthma in the aquatic disciplines
- Authors: Mountjoy, Margo , Fitch, Ken , Boulet, Louis-Philippe , Bougault, Valerie , van Mechelen, Willem , Verhagen, Evert
- Date: 2015
- Type: Text , Journal article
- Relation: Journal of Allergy and Clinical Immunology Vol. 136, no. 3 (2015), p. 588-594
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- Description: Background Despite the health benefits of swimming as a form of exercise, evidence exists that both the swimming pool environment and endurance exercise are etiologic factors in the development of asthma. The prevalence of asthma in swimmers is high compared with that in participants in other Olympic sport disciplines. There are no publications comparing the prevalence of asthma in the 5 aquatic disciplines. Objective The purpose of this study is to examine and compare the prevalence of asthma in the aquatic disciplines and in contrast with other Olympic sports. Methods Therapeutic Use Exemptions containing objective evidence of athlete asthma/airway hyperresponsiveness (AHR) were collected for all aquatic athletes participating in swimming, diving, synchronized swimming, water polo, and open water swimming for major events during the time period from 2004-2009. The prevalence of asthma/AHR in the aquatic disciplines was analyzed for statistical significance (with 95% CIs) and also compared with that in other Olympic sports. Results Swimming had the highest prevalence of asthma/AHR in comparison with the other aquatic disciplines. The endurance aquatic disciplines have a higher prevalence of asthma/AHR than the aquatic nonendurance disciplines. Asthma/AHR is more common in Oceania, Europe, and North America than in Asia, Africa, and South America. In comparison with other Olympic sports, swimming, synchronized swimming, and open water swimming were among the top 5 sports for asthma/AHR prevalence. Conclusion Asthma/AHR in the endurance aquatic disciplines is common at the elite level and has a varied geographic distribution. Findings from this study demonstrate the need for development of aquatic discipline-specific prevention, screening, and treatment regimens. © 2015 American Academy of Allergy, Asthma & Immunology.
Protecting the health of the @hlete : how online technology may aid our common goal to prevent injury and illness in sport
- Authors: Verhagen, Evert , Bolling, Caroline
- Date: 2015
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 49, no. 18 (2015), p. 1174-1178
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- Description: Online technology dominates our era and eHealth has become a reality for sports clinicians and researchers. Contemporary online platforms enable self-monitoring and provide tailored feedback to the different stakeholders who play a role in the health and care of athletes. Innovations such as digital monitoring, mobile applications and connected hardware provide the critical tools to solve current enigmas in sports medicine research, and to streamline and facilitate injury prevention, management and rehabilitation. eHealth is not an emerging future of sports medicine-the technology to move our field forward in terms of research and practice is already available. This Analysis is based on Evert Verhagen's keynote presentation at the IOC World Conference on Injury and Illness Prevention in Sport (Monaco, 12 April 2014). It outlines the use of eHealth in research, implementation and practice, and provides an overview of possibilities and opportunities that existing and emerging eHealth solutions provide for sports and exercise medicine and physiotherapy.
A one-season prospective study of injuries and illness in elite junior tennis
- Authors: Pluim, Babette , Loeffen, F. , Clarsen, Ben , Bahr, Roald , Verhagen, Evert
- Date: 2016
- Type: Text , Journal article
- Relation: Scandinavian Journal of Medicine and Science in Sports Vol. 26, no. 5 (2016), p. 564-571
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- Description: The objective of this study was to estimate the incidence and prevalence of injury and illness among elite junior tennis players. A cohort of 73 players (11-14 years) in the 2012-2013 Dutch national high-performance program was followed for 32 weeks; all participants completed the study. The OSTRC Questionnaire on Health Problems was used to record self-reported injuries and illnesses and to record training and match exposure. Main outcome measures were average prevalence of overuse injury and illness and incidence density of acute injury. On average, players practiced 9.1h/week (SD 0.6; range 2.3-12.0) and had 2.2h of match play (SD 0.6; range 2.3-12.0). During the course of the study, 67 players reported a total of 187 health problems. The average weekly prevalence of all health problems was 21.3% (95% CI: 19.2-22.9), of which 12.1% (95% CI: 10.9-13.3) constituted overuse injuries and 5.8% (95% CI: 4.6-6.9) illnesses. The incidence of acute injuries was 1.2/1000h of tennis play (95% CI: 0.7-1.7). The high occurrence of overuse injuries among elite junior tennis players suggests that an early focus on preventative measures is warranted, with a particular focus on the monitoring and management of workload. © 2016 John Wiley & Sons A/S.
Children's route choice during active transportation to school : Difference between shortest and actual route
- Authors: Dessing, Dirk , de Vries, Sanne , Hegeman, Geerje , Verhagen, Evert , van Mechelen, Willem , Pierik, Frank
- Date: 2016
- Type: Text , Journal article
- Relation: International Journal of Behavioral Nutrition and Physical Activity Vol. 13, no. 1 (2016), p. 1-11
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- Description: Background: The purpose of this study is to increase our understanding of environmental correlates that are associated with route choice during active transportation to school (ATS) by comparing characteristics of actual walking and cycling routes between home and school with the shortest possible route to school. Methods: Children (n = 184; 86 boys, 98 girls; age range: 8-12 years) from seven schools in suburban municipalities in the Netherlands participated in the study. Actual walking and cycling routes to school were measured with a GPS-device that children wore during an entire school week. Measurements were conducted in the period April-June 2014. Route characteristics for both actual and shortest routes between home and school were determined for a buffer of 25 m from the routes and divided into four categories: Land use (residential, commercial, recreational, traffic areas), Aesthetics (presence of greenery/natural water ways along route), Traffic (safety measures such as traffic lights, zebra crossings, speed bumps) and Type of street (pedestrian, cycling, residential streets, arterial roads). Comparison of characteristics of shortest and actual routes was performed with conditional logistic regression models. Results: Median distance of the actual walking routes was 390.1 m, whereas median distance of actual cycling routes was 673.9 m. Actual walking and cycling routes were not significantly longer than the shortest possible routes. Children mainly traveled through residential areas on their way to school ( > 80 % of the route). Traffic lights were found to be positively associated with route choice during ATS. Zebra crossings were less often present along the actual routes (walking: OR = 0.17, 95 % CI = 0.05-0.58; cycling: OR = 0.31, 95 % CI = 0.14-0.67), and streets with a high occurrence of accidents were less often used during cycling to school (OR = 0.57, 95 % CI = 0.43-0.76). Moreover, percentage of visible surface water along the actual route was higher compared to the shortest routes (walking: OR = 1.04, 95 % CI = 1.01-1.07; cycling: OR = 1.03, 95 % CI = 1.01-1.05). Discussion: This study showed a novel approach to examine built environmental exposure during active transport to school. Most of the results of the study suggest that children avoid to walk or cycle along busy roads on their way to school. © 2016 Dessing et al.
Coaches' and referees' perceptions of the BokSmart injury prevention programme
- Authors: Brown, James , Verhagen, Evert , van Mechelen, Willem , Lambert, Mike , Draper, Catherine
- Date: 2016
- Type: Text , Journal article
- Relation: International Journal of Sports Science & Coaching Vol. 11, no. 5 (2016), p. 637-647
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- Description: The South African Rugby Union launched the BokSmart nationwide injury prevention programme to reduce rugby-related catastrophic injuries. The aim of this qualitative study was to evaluate the coaches and referees' perceptions of the implementation of BokSmart. Seven focus groups were conducted with coaches (n=43) and referees (n=7) from a variety of socioeconomic status and age groups. The RE-AIM framework was used to categorize the findings. There was consensus that BokSmart was capable of reducing catastrophic injuries in players. However, coaches' perceptions varied by socioeconomic status : mid/low socioeconomic status coaches described infrastructure-related barriers. Referees felt incapable of policing all BokSmart regulations. In general, most coaches, referees and trainers felt that the training course could be shorter and more practical. The barriers identified in this study could be hindering optimal BokSmart implementation. These barriers differed by role (coach/referee) and socioeconomic status of the coaches (high, mid or low).
Compliance with sport injury prevention interventions in randomised controlled trials : A systematic review
- Authors: van Reijen, Miriam , Vriend, Ingrid , van Mechelen, Willem , Finch, Caroline , Verhagen, Evert
- Date: 2016
- Type: Text , Journal article , Review
- Relation: Sports Medicine Vol. 46, no. 8 (2016), p. 1125-1139
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- Description: Introduction Sport injury prevention studies vary in the way compliance with an intervention is defined, measured and adjusted for. Objective The objective of this systematic review was to assess the extent to which sport injury prevention randomised controlled trials (RCTs) have defined, measured and adjusted results for compliance with an injury prevention intervention. Methods An electronic search was performed in MEDLINE, PubMed, the Cochrane Center of Controlled Trials, CINAHL (Cumulative Index to Nursing and Allied Health Literature), PEDro (Physiotherapy Evidence Database) and SPORTDiscus. English RCTs, quasi-RCTs and cluster-RCTs were considered eligible. Trials that involved physically active individuals or examined the effects of an intervention aimed at the prevention of sport-or physical activity-related injuries were included. Results Of the total of 100 studies included, 71.6 % mentioned compliance or a related term, 68.8 % provided details on compliance measurement and 51.4 % provided compliance data. Only 19.3 % analysed the effect of compliance rates on study outcomes. While studies used heterogeneous methods, pooled effects could not be presented. Conclusions Studies that account for compliance demonstrated that compliance significant affects study outcomes. The way compliance is dealt with in preventions studies is subject to a large degree of heterogeneity. Valid and reliable tools to measure and report compliance are needed and should be matched to a uniform definition of compliance.
Health and economic burden of running-related injuries in runners training for an event : A prospective cohort study
- Authors: Hespanhol Junior, Luiz , van Mechelen, Willem , Postuma, Eva , Verhagen, Evert
- Date: 2016
- Type: Text , Journal article
- Relation: Scandinavian Journal of Medicine and Science in Sports Vol. 26, no. 9 (2016), p. 1091-1099
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- Description: Prospective running-related injury (RRI) data from runners training for an event are scarce, especially with regard to RRI-associated costs. Therefore, the aim of this study was to investigate the prevalence and economic burden of RRIs in runners participating in an organized training program preparing them for an event. This was a prospective cohort study with 18 weeks of follow-up. Individuals aged 18 or older and registered to participate in an organized running program were eligible. Follow-up surveys were sent every 2 weeks to collect data about running exposure, RRIs, and costs. Of the 161 potential participants, 53 (32.9%) were included in this study. A total of 32 participants reported 41 RRIs. The mean prevalence during follow-up was 30.8% [95% confidence interval (CI) 25.6–36.0%]. Overuse was the main mechanism of RRI (85.4%, n = 35). An RRI was estimated to have an economic burden of €57.97 (95% CI €26.17–94.00) due to healthcare utilization (direct costs) and €115.75 (95% CI €10.37–253.73) due to absenteeism from paid work (indirect costs). These results indicate that the health and economic burden of RRIs may be considered significant for public health. Therefore, prevention programs are needed for runners participating in organized training programs. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Increasing compliance with neuromuscular training to prevent ankle sprain in sport : Does the 'Strengthen your ankle' mobile App make a difference? A randomised controlled trial
- Authors: van Reijen, Miriam , Vriend, Ingrid , Zuidema, Victor , van Mechelen, Willem , Verhagen, Evert
- Date: 2016
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 50, no. 19 (2016), p. 1200-1205
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- Description: Background: E-health has the potential to facilitate implementation of effective measures to prevent sports injuries. Aim: We evaluated whether an interactive mobile application containing a proven effective exercise programme to prevent recurrent ankle sprains resulted in higher compliance as compared with regular written exercise materials. Methods: 220 athletes participated in this randomised controlled trial with a follow-up of 8 weeks; 110 athletes received a booklet explaining an 8-week neuromuscular training programme; 110 athletes participated in the same programme in an interactive mobile App (Strengthen your ankle). The primary outcome was compliance with the exercise programme. Secondary outcome measure was the incidence density of self-reported recurrent ankle sprains. Results: The mean compliance to the exercise scheme was 73.3% (95% CI 67.7% to 78.1%) in the App group, compared with 76.7% (95% CI 71.9% to 82.3%) in the Booklet group. No significant difference in compliance was found between groups. The incidence densities of self-reported time-loss recurrences were not significantly different between both groups (HR 3.07; 95% CI 0.62 to 15.20). Summary: This study shows that the method of implementing the exercises by using an App or a Booklet does not lead to different compliance rates. New findings: The use of a mobile App or a Booklet lead to similar compliance and injury rates in the short term. Trial registration number: The Netherlands National Trial Register NTR 4027. The NTR is part of the WHO Primary Registries. © 2016, BMJ Publishing Group. All rights reserved.
Interventions preventing ankle sprains; previous injury and high-risk sport participation as predictors of compliance
- Authors: Janssen, Kasper , Van Der Zwaard, Babette , Finch, Caroline , van Mechelen, Willem , Verhagen, Evert
- Date: 2016
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 19, no. 6 (Jun 2016), p. 465-469
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- Description: Objectives: To describe the association between participants' person-related potential predictor variables and cumulative compliance with interventions for preventing ankle sprains: neuromuscular training, wearing an ankle brace, and a combined training and bracing. Design: Secondary analysis of compliance data from a randomized controlled trial (RCT) comparing measures preventing ankle ligament injuries. Methods: Ordinal regression with a backward selection method was used to obtain a descriptive statistical model linking participants' person-related potential predictor variables with the monthly cumulative compliance measurements for three interventions preventing ankle ligament injuries. Results: Having had a previous ankle injury was significantly associated with a higher compliance with all of the preventive measures trialed. Overall compliance with bracing and the combined intervention was significantly lower than the compliance with NM training. Per group analysis found that participating in a high-risk sport, like soccer, basketball, and volleyball, was significantly associated with a higher compliance with bracing, or a combined bracing and NM training. In contrast, participating in a high-risk sport was significantly associated with a lower per group compliance with NM training. Conclusions: Future studies should include at least registration of previous ankle sprains, sport participation (high- or low-risk), experience in NM training, and hours of sport exposure as possible predictors of compliance with interventions preventing ankle sprains. Practitioners should take into account these variables when prescribing preventive neuromuscular training or bracing. (C) 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
Risk and protective factors for middle- and long-distance running-related injury
- Authors: Hulme, Adam , Nielsen, Rasmus , Timpka, Toomas , Verhagen, Evert , Finch, Caroline
- Date: 2016
- Type: Text , Journal article
- Relation: Sports Medicine Vol. 47, no. 5 (2016), p. 869-886
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
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- Description: BACKGROUND: Despite a rapidly growing body of research, a systematic evidence compilation of the risk and protective factors for middle- and long-distance running-related injury (RRI) was lacking. OBJECTIVES: Our objective was to compile the evidence about modifiable and non-modifiable training-related and behavioral risk and protective factors for middle- and long-distance RRI. METHODS: We searched five databases (PubMed, CINAHL, MEDLINE, SPORTDiscus, and PsycINFO) for the dates 1 January 1970 to 31 December 2015, inclusive, for original peer-reviewed articles. The eligible designs were cross-sectional, case-control, longitudinal observational studies, and randomized controlled trials involving runners competing at distances from >/=800 m to =42.2 km. Outcomes were any specific and/or general RRI, and exposures included training-related and behavioral factors. We extracted authors and date, study design, injury type(s), descriptors and comparators for each exposure, and results and measures of association from the selected studies. Methodological quality was independently appraised using two separate checklists: a modified checklist for observational study designs and the Physiotherapy Evidence Database (PEDro) scale for randomized controlled trials. RESULTS: Among 73 articles eligible for inclusion, 19 (26.0%) and 30 (41.0%) were of high or satisfactory methodological quality, respectively. As a non-modifiable exposure, a history of previous injury was found to be associated with an increased risk of both general and specific RRI. In terms of modifiable exposures, irregular and/or absent menstruation was found to be associated with an increased risk of stress fracture development, whereas the use of oral contraceptives was found to be associated with a decreased risk. High clinical, methodological, and statistical heterogeneity meant it was not feasible to estimate a pooled effect size across similar studies. CONCLUSIONS: A history of previous injury was associated with an increased risk of both general and specific RRI. The use of oral contraceptives was found to be associated with a decreased risk of skeletal stress fracture. Conversely, irregular and/or absent menstruation was associated with an increased risk. The varied effect directions and/or a number of statistically insignificant results associated with the majority of factors hindered our ability to draw any definitive conclusions about their relationship to RRI risk.
Short-term absenteeism and health care utilization due to lower extremity injuries among novice runners : A prospective cohort study
- Authors: Smits, Dirk-Wouter , Huisstede, Bionka , Verhagen, Evert , van der Worp, Henk , Kluitenberg, Bas , van Middelkoop, Marienke , Hartgens, Fred , Backx, Frank
- Date: 2016
- Type: Text , Journal article
- Relation: Clinical Journal of Sport Medicine Vol. 26, no. 6 (2016), p. 502-509
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- Description: Objective: To describe absenteeism and health care utilization (HCU) within 6 weeks after occurrence of running-related injuries (RRIs) among novice runners and to explore differences relating to injury and personal characteristics. Participants: One thousand six hundred ninety-six novice runners (18-65 years) participating in a 6-week running program ("Start-to-Run"). Main Outcome Measures: Injury characteristics were assessed by weekly training logs and personal characteristics by a baseline questionnaire. Data on absenteeism and HCU were collected using questionnaires at 2 and 6 weeks after the RRI occurred. Results: A total of 185 novice runners (11%) reported an RRI during the 6-week program. Of these injured novice runners, 78% reported absence from sports, whereas only 4% reported absence from work. Fifty-one percent of the injured novice runners visited a health care professional, mostly physical therapists (PTs) rather than physicians. Absenteeism was more common among women than men and was also more common with acute RRIs than gradual-onset RRIs. As regards HCU, both the variety of professionals visited and the number of PT visits were higher among runners with muscle-tendon injuries in the ankle/foot region than among those with other RRIs. Conclusions: Among novice runners sustaining an RRI during a 6-week running program, over three quarters reported short-term absence from sports, whereas absence from work was very limited, and over half used professional health care. Both absence and HCU are associated with injury characteristics.