Preventing lower limb injuries : Is the latest evidence being translated into the football field?
- Twomey, Dara, Finch, Caroline, Roediger, E., Lloyd, David
- Authors: Twomey, Dara , Finch, Caroline , Roediger, E. , Lloyd, David
- Date: 2009
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 12, no. 4 (2009), p. 452-456
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: There is accumulating international evidence that lower limb injuries in sport can be prevented through targeted training but the extent to which this knowledge has been translated to real-world sporting practice is not known. A semi-structured questionnaire of all coaches from the nine Sydney Australian Football League Premier Division teams was conducted. Information was sought about their knowledge and behaviours in relation to delivering training programs, including their uptake of the latest scientific evidence for injury prevention. Direct observation of a sample of the coach-delivered training sessions was also undertaken to validate the questionnaire. Coaches ranked training session elements directly related to the game as being of most importance. They strongly favoured warming-up and cooling-down as injury prevention measures but changing direction and side-stepping training was considered to be of little/no importance for safety. Only one-third believed that balance training had some importance for injury prevention, despite accumulating scientific evidence to the contrary. Drills, set play, ball handling and kicking skills were all considered to be of least importance to injury prevention. These views were consistent with the content of the observed coach-led training sessions. In conclusion, current football training sessions do not give adequate attention to the development of skills most likely to reduce the risk of lower limb injury in players. There is a need to improve the translation of the latest scientific evidence about effective injury prevention into coaching practices. © 2008 Sports Medicine Australia.
- Description: 2003006500
- Finch, Caroline, Lloyd, David, Elliott, Bruce
- Authors: Finch, Caroline , Lloyd, David , Elliott, Bruce
- Date: 2009
- Type: Text , Journal article
- Relation: Injury Prevention Vol. 15, no. 3 (2009), p. 207
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text: false
- Reviewed:
- Description: Background: Knee injuries are a major injury concern for Australian Football players and participants of many other sports worldwide. There is increasing evidence from laboratory and biomechanically focused studies about the likely benefit of targeted exercise programmes to prevent knee injuries. However, there have been few international studies that have evaluated the effectiveness of such programmes in the real-world context of community sport that have combined epidemiological, behavioural and biomechanical approaches. Objective: To implement a fully piloted and tested exercise training intervention to reduce the number of football-related knee injuries. In so doing, to evaluate the intervention's effectiveness in the real-world context of community football and to determine if the underlying neural and biomechanical training adaptations are associated with decreased risk of injury. Setting: Adult players from community-level Australian Football clubs in two Australian states over the 2007-08 playing seasons. Methods: A group-clustered randomised controlled trial with teams of players randomly allocated to either a coach-delivered targeted exercise programme or usual behaviour (control). Epidemiological component: field- based injury surveillance and monitoring of training/game exposures. Behavioural component: evaluation of player and coach attitudes, knowledge, behaviours and com- pliance, both before and after the intervention is implemented. Biomechanical component: biomechanical, game mobility and neuromuscular parameters assessed to determine the fundamental effect of training on these factors and injury risk. Outcome measures: The rate and severity of injury in the intervention group compared with the control group. Changes, if any, in behavioural components. Process evaluation: coach delivery factors and likely sustainability.
- Description: 2003008199
The reach and adoption of a coach-led exercise training programme in community football
- Finch, Caroline, Diamantopoulou, Kathy, Twomey, Dara, Doyle, Tim, Lloyd, David, Young, Warren, Elliot, Bruce
- Authors: Finch, Caroline , Diamantopoulou, Kathy , Twomey, Dara , Doyle, Tim , Lloyd, David , Young, Warren , Elliot, Bruce
- Date: 2013
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine. Vol. 48(8), p.718-723.
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: Objective: To determine the reach and adoption of a coach-led exercise training programme for lower limb injury prevention. Design: Secondary analysis of data from a group-clustered randomised controlled trial. Setting: A periodised exercise training warm-up programme was delivered to players during training sessions over an 8-week preseason (weeks 1–8) and 18-week playing season. Participants: 1564 community Australian football players. Main outcome measurements: Reach, measured weekly, was the number of players who attended training sessions. Adoption was the number of attending players who completed the programme in full, partially or not at all. Reasons for partial or non-participation were recorded. Results: In week 1, 599 players entered the programme; 55% attended 1 training session and 45% attended > 1 session. By week 12, 1540 players were recruited but training attendance (reach) decreased to <50%. When players attended training, the majority adopted the full programme—ranging from 96% (week 1) to above 80% until week 20. The most common reasons for low adoption were players being injured, too sore, being late for training or choosing their own warm-up. Conclusions: The training programme's reach was highest preseason and halved at the playing season's end. However, when players attended training sessions, their adoption was high and remained close to 70% by season end. For sports injury prevention programmes to be fully effective across a season, attention also needs to be given to (1) encouraging players to attend formal training sessions and (2) considering the possibility of some form of programme delivery outside of formal training.
- Authors: Finch, Caroline , Diamantopoulou, Kathy , Twomey, Dara , Doyle, Tim , Lloyd, David , Young, Warren , Elliot, Bruce
- Date: 2013
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine. Vol. 48(8), p.718-723.
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: Objective: To determine the reach and adoption of a coach-led exercise training programme for lower limb injury prevention. Design: Secondary analysis of data from a group-clustered randomised controlled trial. Setting: A periodised exercise training warm-up programme was delivered to players during training sessions over an 8-week preseason (weeks 1–8) and 18-week playing season. Participants: 1564 community Australian football players. Main outcome measurements: Reach, measured weekly, was the number of players who attended training sessions. Adoption was the number of attending players who completed the programme in full, partially or not at all. Reasons for partial or non-participation were recorded. Results: In week 1, 599 players entered the programme; 55% attended 1 training session and 45% attended > 1 session. By week 12, 1540 players were recruited but training attendance (reach) decreased to <50%. When players attended training, the majority adopted the full programme—ranging from 96% (week 1) to above 80% until week 20. The most common reasons for low adoption were players being injured, too sore, being late for training or choosing their own warm-up. Conclusions: The training programme's reach was highest preseason and halved at the playing season's end. However, when players attended training sessions, their adoption was high and remained close to 70% by season end. For sports injury prevention programmes to be fully effective across a season, attention also needs to be given to (1) encouraging players to attend formal training sessions and (2) considering the possibility of some form of programme delivery outside of formal training.
When 'just doing it' is not enough: Assessing the fidelity of player performance of an injury prevention exercise program
- Fortington, Lauren, Donaldson, Alex, Lathlean, Tim, Young, Warren, Gabbe, Belinda, Lloyd, David, Finch, Caroline
- 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.
- 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.
- Twomey, Dara, Finch, Caroline, Doyle, Tim, Lloyd, David, Elliot, Bruce
- Authors: Twomey, Dara , Finch, Caroline , Doyle, Tim , Lloyd, David , Elliot, Bruce
- Date: 2013
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 16, no. Supplement 1 (2013), p. e24
- Full Text: false
- Reviewed:
- Description: Introduction: A full understanding of the ecological context is critical in the implementation of an effective sports injury prevention intervention. There are many complexities and challenges associated with the delivery of a successful intervention in a community team-based setting. Although the development and efficacy of interventions are regularly reported, rarely are the lessons learnt during the delivery of the intervention published. Therefore, the purpose of this paper is to describe the key issues experienced in the delivery of a lower limb injury prevention training program in community-level Australian football.
- Donaldson, Alex, Cook, Jill, Gabbe, Belinda, Lloyd, David, Young, Warren, Finch, Caroline
- Authors: Donaldson, Alex , Cook, Jill , Gabbe, Belinda , Lloyd, David , Young, Warren , Finch, Caroline
- Date: 2015
- Type: Text , Journal article
- Relation: Clinical Journal of Sport Medicine Vol.25, no.3, p.221-229
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Relation: http://purl.org/au-research/grants/nhmrc/565907
- Full Text: false
- Reviewed:
- Description: OBJECTIVE: To achieve expert consensus on the content of an exercise training program (known as FootyFirst) to prevent lower-limb injuries. DESIGN: Three-round online Delphi consultation process. SETTING: Community Australian Football (AF). PARTICIPANTS: Members of the Australian Football Leagues' Medical Officers (n = 94), physiotherapists (n = 50), and Sports Science (n = 19) Associations were invited to participate through e-mail. Five people with more general expertise in sports-related lower-limb injury prevention were also invited to participate. MAIN OUTCOME MEASURES: The primary outcome measure was the level of agreement on the appropriateness of the proposed exercises and progressions for inclusion in FootyFirst. Consensus was reached when ≥75% of experts who responded to each item agreed and strongly agreed, or disagreed and strongly disagreed, that an exercise or its progressions were appropriate to include in FootyFirst. RESULTS: Fifty-five experts participated in at least 1 Delphi round. In round 1, consensus was achieved that the proposed warm-up (run through and dynamic stretches) and the exercises and progressions for hamstring strength and for balance, landing, and changing direction were appropriate to include in FootyFirst. There was also consensus in round 1 that progressions for hip/core strength should be included in FootyFirst. Consensus was reached in round 2 that the revised groin strength and hip strength exercises should be included in FootyFirst. Consensus was reached for the progression of the groin strength exercises in round 3. CONCLUSIONS: The formal consensus development process has resulted in an evidence-informed, researcher-developed, exercise-based sports injury prevention program that is expert endorsed and specific to the context of AF. CLINICAL RELEVANCE: Lower-limb injuries are common in running, kicking, and contact sports like AF. These injuries are often costly to treat, and many have high rates of recurrence, making them challenging to treat clinically. Reducing these injuries is a high priority for players, teams, and medical staff. Exercise programs provide a method for primary prevention of lower-limb injuries, but they have to be evidence based, have currency with sports practitioners/clinicians, and utility for the context in which they are to be used. However, the comprehensive methods and clinical engagement processes used to develop injury prevention exercise programs have not previously been described in detail. This study describes the results of engaging clinicians and sport scientists in the development of a lower-limb sports injury prevention program for community AF, enabling the development of a program that is both evidence informed and considerate of expert clinical opinion.
Coding OSICS sports injury diagnoses in epidemiological studies : Does the background of the coder matter?
- Finch, Caroline, Orchard, John, Twomey, Dara, Saleem, Muhammad Saad, Ekegren, Christina, Lloyd, David, Elliott, Bruce
- Authors: Finch, Caroline , Orchard, John , Twomey, Dara , Saleem, Muhammad Saad , Ekegren, Christina , Lloyd, David , Elliott, Bruce
- Date: 2012
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine, Vol.48, p.552-556.
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: Objective: To compare Orchard Sports Injury Classification System (OSICS-10) sports medicine diagnoses assigned by a clinical and non-clinical coder. Design: Assessment of intercoder agreement. Setting: Community Australian football. Participants: 1082 standardised injury surveillance records. Main outcome measurements: Direct comparison of the four-character hierarchical OSICS-10 codes assigned by two independent coders (a sports physician and an epidemiologist). Adjudication by a third coder (biomechanist). Results: The coders agreed on the first character 95% of the time and on the first two characters 86% of the time. They assigned the same four-digit OSICS-10 code for only 46% of the 1082 injuries. The majority of disagreements occurred for the third character; 85% were because one coder assigned a non-specific 'X' code. The sports physician code was deemed correct in 53% of cases and the epidemiologist in 44%. Reasons for disagreement included the physician not using all of the collected information and the epidemiologist lacking specific anatomical knowledge. Conclusions: Sports injury research requires accurate identification and classification of specific injuries and this study found an overall high level of agreement in coding according to OSICS-10. The fact that the majority of the disagreements occurred for the third OSICS character highlights the fact that increasing complexity and diagnostic specificity in injury coding can result in a loss of reliability and demands a high level of anatomical knowledge. Injury report form details need to reflect this level of complexity and data management teams need to include a broad range of expertise. Copyright Article author (or their employer) 2012.
- Authors: Finch, Caroline , Orchard, John , Twomey, Dara , Saleem, Muhammad Saad , Ekegren, Christina , Lloyd, David , Elliott, Bruce
- Date: 2012
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine, Vol.48, p.552-556.
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: Objective: To compare Orchard Sports Injury Classification System (OSICS-10) sports medicine diagnoses assigned by a clinical and non-clinical coder. Design: Assessment of intercoder agreement. Setting: Community Australian football. Participants: 1082 standardised injury surveillance records. Main outcome measurements: Direct comparison of the four-character hierarchical OSICS-10 codes assigned by two independent coders (a sports physician and an epidemiologist). Adjudication by a third coder (biomechanist). Results: The coders agreed on the first character 95% of the time and on the first two characters 86% of the time. They assigned the same four-digit OSICS-10 code for only 46% of the 1082 injuries. The majority of disagreements occurred for the third character; 85% were because one coder assigned a non-specific 'X' code. The sports physician code was deemed correct in 53% of cases and the epidemiologist in 44%. Reasons for disagreement included the physician not using all of the collected information and the epidemiologist lacking specific anatomical knowledge. Conclusions: Sports injury research requires accurate identification and classification of specific injuries and this study found an overall high level of agreement in coding according to OSICS-10. The fact that the majority of the disagreements occurred for the third OSICS character highlights the fact that increasing complexity and diagnostic specificity in injury coding can result in a loss of reliability and demands a high level of anatomical knowledge. Injury report form details need to reflect this level of complexity and data management teams need to include a broad range of expertise. Copyright Article author (or their employer) 2012.
Changes in muscle activation following balance and technique training and a season of Australian football
- Donnelly, Cyril, Elliott, Bruce, Doyle, Tim, Finch, Caroline, Dempsey, Alasdair, Lloyd, David
- Authors: Donnelly, Cyril , Elliott, Bruce , Doyle, Tim , Finch, Caroline , Dempsey, Alasdair , Lloyd, David
- Date: 2014
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 18, no. 3 (2014), p.348-352
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: Objectives: Determine if balance and technique training implemented adjunct to 1001 male Australian football players' training influenced the activation/strength of the muscles crossing the knee during pre-planned and unplanned sidestepping. Design: Randomized Control Trial. Methods: Each Australian football player participated in either 28 weeks of balance and technique training or 'sham' training. Twenty-eight Australian football players (balance and technique training, n = 12; 'sham' training, n = 16) completed biomechanical testing pre-to-post training. Peak knee moments and directed co-contraction ratios in three degrees of freedom, as well as total muscle activation were calculated during pre-planned and unplanned sidestepping. Results: No significant differences in muscle activation/strength were observed between the 'sham' training and balance and technique training groups. Following a season of Australian football, knee extensor (p = 0.023) and semimembranosus (p = 0.006) muscle activation increased during both pre-planned sidestepping and unplanned sidestepping. Following a season of Australian football, total muscle activation was 30% lower and peak valgus knee moments 80% greater (p = 0.022) during unplanned sidestepping when compared with pre-planned sidestepping. Conclusions: When implemented in a community level training environment, balance and technique training was not effective in changing the activation of the muscles crossing the knee during sidestepping. Following a season of Australian football, players are better able to support both frontal and sagittal plane knee moments. When compared to pre-planned sidestepping, Australian football players may be at increased risk of anterior cruciate ligament injury during unplanned sidestepping in the latter half of an Australian football season.
- Authors: Donnelly, Cyril , Elliott, Bruce , Doyle, Tim , Finch, Caroline , Dempsey, Alasdair , Lloyd, David
- Date: 2014
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 18, no. 3 (2014), p.348-352
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: Objectives: Determine if balance and technique training implemented adjunct to 1001 male Australian football players' training influenced the activation/strength of the muscles crossing the knee during pre-planned and unplanned sidestepping. Design: Randomized Control Trial. Methods: Each Australian football player participated in either 28 weeks of balance and technique training or 'sham' training. Twenty-eight Australian football players (balance and technique training, n = 12; 'sham' training, n = 16) completed biomechanical testing pre-to-post training. Peak knee moments and directed co-contraction ratios in three degrees of freedom, as well as total muscle activation were calculated during pre-planned and unplanned sidestepping. Results: No significant differences in muscle activation/strength were observed between the 'sham' training and balance and technique training groups. Following a season of Australian football, knee extensor (p = 0.023) and semimembranosus (p = 0.006) muscle activation increased during both pre-planned sidestepping and unplanned sidestepping. Following a season of Australian football, total muscle activation was 30% lower and peak valgus knee moments 80% greater (p = 0.022) during unplanned sidestepping when compared with pre-planned sidestepping. Conclusions: When implemented in a community level training environment, balance and technique training was not effective in changing the activation of the muscles crossing the knee during sidestepping. Following a season of Australian football, players are better able to support both frontal and sagittal plane knee moments. When compared to pre-planned sidestepping, Australian football players may be at increased risk of anterior cruciate ligament injury during unplanned sidestepping in the latter half of an Australian football season.
What do community football players think about different exercise-training programmes? Implications for the delivery of lower limb injury prevention programmes
- Finch, Caroline, Doyle, Tim, Dempsey, Alasdair, Elliott, Bruce, Twomey, Dara, White, Peta, Diamantopoulou, Kathy, Young, Warren, Lloyd, David
- Authors: Finch, Caroline , Doyle, Tim , Dempsey, Alasdair , Elliott, Bruce , Twomey, Dara , White, Peta , Diamantopoulou, Kathy , Young, Warren , Lloyd, David
- Date: 2014
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 48, no. 8 (2014), p.702-707
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: Background: Players are the targeted end-users and beneficiaries of exercise-training programmes implemented during coach-led training sessions, and the success of programmes depends upon their active participation. Two variants of an exercise-training programme were incorporated into the regular training schedules of 40 community Australian Football teams, over two seasons. One variant replicated common training practices, while the second was an evidence-based programme to alter biomechanical and neuromuscular factors related to risk of knee injuries. This paper describes the structure of the implemented programmes and compares players’ end-of-season views about the programme variants. Methods: This study was nested within a larger group-clustered randomised controlled trial of the effectiveness of two exercise-training programmes (control and neuromuscular control (NMC)) for preventing knee injuries. A post-season self-report survey, derived from Health Belief Model constructs, included questions to obtain players’ views about the benefits and physical challenges of the programme in which they participated. Results: Compared with control players, those who participated in the NMC programme found it to be less physically challenging but more enjoyable and potentially of more benefit. Suggestions from players about potential improvements to the training programme and its future implementation included reducing duration, increasing range of drills/exercises and promoting its injury prevention and other benefits to players. Conclusions: Players provide valuable feedback about the content and focus of implemented exercise-training programmes, that will directly inform the delivery of similar, or more successful, programmes in the future.
- Authors: Finch, Caroline , Doyle, Tim , Dempsey, Alasdair , Elliott, Bruce , Twomey, Dara , White, Peta , Diamantopoulou, Kathy , Young, Warren , Lloyd, David
- Date: 2014
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 48, no. 8 (2014), p.702-707
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: Background: Players are the targeted end-users and beneficiaries of exercise-training programmes implemented during coach-led training sessions, and the success of programmes depends upon their active participation. Two variants of an exercise-training programme were incorporated into the regular training schedules of 40 community Australian Football teams, over two seasons. One variant replicated common training practices, while the second was an evidence-based programme to alter biomechanical and neuromuscular factors related to risk of knee injuries. This paper describes the structure of the implemented programmes and compares players’ end-of-season views about the programme variants. Methods: This study was nested within a larger group-clustered randomised controlled trial of the effectiveness of two exercise-training programmes (control and neuromuscular control (NMC)) for preventing knee injuries. A post-season self-report survey, derived from Health Belief Model constructs, included questions to obtain players’ views about the benefits and physical challenges of the programme in which they participated. Results: Compared with control players, those who participated in the NMC programme found it to be less physically challenging but more enjoyable and potentially of more benefit. Suggestions from players about potential improvements to the training programme and its future implementation included reducing duration, increasing range of drills/exercises and promoting its injury prevention and other benefits to players. Conclusions: Players provide valuable feedback about the content and focus of implemented exercise-training programmes, that will directly inform the delivery of similar, or more successful, programmes in the future.
An Anterior cruciate ligament Injury prevention framework : Incorporating the recent evidence
- Donnelly, Cyril, Elliott, Bruce, Ackland, Timothy, Doyle, Tim, Beiser, Thor, Finch, Caroline, Cochrane, Jodie, Dempsey, Alasdair, Lloyd, David
- Authors: Donnelly, Cyril , Elliott, Bruce , Ackland, Timothy , Doyle, Tim , Beiser, Thor , Finch, Caroline , Cochrane, Jodie , Dempsey, Alasdair , Lloyd, David
- Date: 2012
- Type: Text , Journal article
- Relation: Research in Sports Medicine Vol. 20, no. 3/4 (2012), p. 239-262
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Relation: http://purl.org/au-research/grants/nhmrc/565907
- Full Text: false
- Reviewed:
- Description: Anterior cruciate ligament (ACL) injury rates have increased by ∼50% over the last 10 years. These figures suggest that ACL focused research has not been effective in reducing injury rates among community level athletes. Training protocols designed to reduce ACL injury rates have been both effective (n = 3) and ineffective (n = 7). Although a rationale for the use of exercise to reduce ACL injuries is established, the mechanisms by which they act are relatively unknown. This article provides an injury prevention framework specific to noncontact ACL injuries and the design of prophylactic training protocols. It is also apparent that feedback within this framework is needed to determine how biomechanically relevant risk factors like peak joint loading and muscular support are influenced following training. It is by identifying these links that more effective ACL injury prevention training programs can be developed, and, in turn, lead to reduced ACL injury rates in the future.
Sports injury prevention: improving the outcomes
- Finch, Caroline, Gabbe, Belinda, Lloyd, David, Cook, Jill, Young, Warren, Nicholson, Matthew, Seward, Hugh, Donaldson, Alex, Doyle, Tim, White, Peta
- Authors: Finch, Caroline , Gabbe, Belinda , Lloyd, David , Cook, Jill , Young, Warren , Nicholson, Matthew , Seward, Hugh , Donaldson, Alex , Doyle, Tim , White, Peta
- Date: 2011
- Type: Text , Journal article
- Relation: Sport Health Vol. 29, no. 1 (2011), p. 34-37
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Relation: http://purl.org/au-research/grants/nhmrc/565907
- Full Text: false
- Reviewed:
- Description: In australia, the public health signifi cance of sports injuries has long been recognised with national and state-specifi c injury data collections demonstrating the magnitude of the population burden of such injuries, including their signifi cant impact on health service delivery and their potential to be associated with socio-demographic health inequalities. Moreover, health-related lifelong physical activity participation will only be sustained in the long-term if it is delivered in a safe way to minimise injury risk.
Towards a national sports safety strategy: Addressing facilitators and barriers towards safety guideline uptake
- Finch, Caroline, Gabbe, Belinda, Lloyd, David, Cook, Jill, Young, Warren, Nicholson, Matthew, Seward, Hugh, Donaldson, Alex, Doyle, Tim
- Authors: Finch, Caroline , Gabbe, Belinda , Lloyd, David , Cook, Jill , Young, Warren , Nicholson, Matthew , Seward, Hugh , Donaldson, Alex , Doyle, Tim
- Date: 2011
- Type: Text , Journal article
- Relation: Injury Prevention Vol. 17, no. 3 (2011), p. 1-10
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Relation: http://purl.org/au-research/grants/nhmrc/565907
- Full Text:
- Reviewed:
- Description: Background: Limited information exists about how best to conduct intervention implementation studies in community sport settings. Research should be directed towards understanding the context within which evidence-based injury prevention interventions are to be implemented, while continuing to build the evidencebase for the effectiveness of sports injury interventions. Objectives: To identify factors that influence the translation of evidence-based injury prevention interventions into practice in community sport, and to provide specific evidence for the effectiveness of an evidence-based exercise training programme for lower limb injury prevention in community Australian football. Setting: Community-level Australian football clubs, teams and players. Methods: An exercise-based lower limb injury prevention programme will be developed and evaluated in terms of the implementation context, infrastructure and resources needed for its effective translation into community sport. Analysis of the community sports safety policy context will be undertaken to understand the barriers and facilitators to policy development and uptake. A randomised group-clustered ecological study will be conducted to compare the reach, effectiveness, adoption, implementation and maintenance (RE-AIM) of the intervention over 2 years. Outcome Measures: The primary outcome will be evidence-based prevention guidelines that are fully supported by a comprehensively evaluated dissemination plan. The plan will detail the support structures and add-ons necessary to ensure sustainability and subsequent national implementation. Research outcomes will include new knowledge about how sports safety policy is set, how consensus is reached among sports safety experts in the community setting and how evidence-based safety guidelines are best developed, packaged and disseminated to community sport.
- Authors: Finch, Caroline , Gabbe, Belinda , Lloyd, David , Cook, Jill , Young, Warren , Nicholson, Matthew , Seward, Hugh , Donaldson, Alex , Doyle, Tim
- Date: 2011
- Type: Text , Journal article
- Relation: Injury Prevention Vol. 17, no. 3 (2011), p. 1-10
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Relation: http://purl.org/au-research/grants/nhmrc/565907
- Full Text:
- Reviewed:
- Description: Background: Limited information exists about how best to conduct intervention implementation studies in community sport settings. Research should be directed towards understanding the context within which evidence-based injury prevention interventions are to be implemented, while continuing to build the evidencebase for the effectiveness of sports injury interventions. Objectives: To identify factors that influence the translation of evidence-based injury prevention interventions into practice in community sport, and to provide specific evidence for the effectiveness of an evidence-based exercise training programme for lower limb injury prevention in community Australian football. Setting: Community-level Australian football clubs, teams and players. Methods: An exercise-based lower limb injury prevention programme will be developed and evaluated in terms of the implementation context, infrastructure and resources needed for its effective translation into community sport. Analysis of the community sports safety policy context will be undertaken to understand the barriers and facilitators to policy development and uptake. A randomised group-clustered ecological study will be conducted to compare the reach, effectiveness, adoption, implementation and maintenance (RE-AIM) of the intervention over 2 years. Outcome Measures: The primary outcome will be evidence-based prevention guidelines that are fully supported by a comprehensively evaluated dissemination plan. The plan will detail the support structures and add-ons necessary to ensure sustainability and subsequent national implementation. Research outcomes will include new knowledge about how sports safety policy is set, how consensus is reached among sports safety experts in the community setting and how evidence-based safety guidelines are best developed, packaged and disseminated to community sport.
Level of agreement between field-based data collectors in a large scale injury prevention randomised controlled trial
- Twomey, Dara, Finch, Caroline, Doyle, Tim, Elliott, Bruce, Lloyd, David
- Authors: Twomey, Dara , Finch, Caroline , Doyle, Tim , Elliott, Bruce , Lloyd, David
- Date: 2011
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 14, no. 2 (2011), p. 121-125
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: In sports injury prevention field trials, data collectors are often club volunteers with considerable knowledge of the game but with limited detailed medical backgrounds or knowledge of formal scientific processes. The aim of this paper is to determine the agreement among trained primary data collectors (PDCs) with a sport science background and no prior involvement in data collection in a large randomised controlled trial. During the 'Preventing Australian Football Injury through eXercise' (PAFIX) project, player participation and injury data were collected by trained PDCs at training and games over the 2007 and 2008 playing seasons in 40 community level Australian football teams. PDC-collected data relating to player exposure and whether or not a player sustained an injury and subsequently left the field of play was compared to the same information from independent observers (IOs) who attended one randomly selected game for each of the 40 teams. There was 98% agreement between the PDC and the IO on game details (i.e., date, time, grade and score), 79% (ICC 0.9, 95% CI 0.85-0.95) agreement on the number of players per game and 76% (ICC 0.8, 95% CI 0.69-0.91) agreement on the number of injuries sustained in the games. There was 100% agreement on whether the player left the field for all injuries. This study found that exercise and sport science students are reliable data collectors in sports injury fieldwork studies. (C) 2010 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
- Authors: Twomey, Dara , Finch, Caroline , Doyle, Tim , Elliott, Bruce , Lloyd, David
- Date: 2011
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 14, no. 2 (2011), p. 121-125
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: In sports injury prevention field trials, data collectors are often club volunteers with considerable knowledge of the game but with limited detailed medical backgrounds or knowledge of formal scientific processes. The aim of this paper is to determine the agreement among trained primary data collectors (PDCs) with a sport science background and no prior involvement in data collection in a large randomised controlled trial. During the 'Preventing Australian Football Injury through eXercise' (PAFIX) project, player participation and injury data were collected by trained PDCs at training and games over the 2007 and 2008 playing seasons in 40 community level Australian football teams. PDC-collected data relating to player exposure and whether or not a player sustained an injury and subsequently left the field of play was compared to the same information from independent observers (IOs) who attended one randomly selected game for each of the 40 teams. There was 98% agreement between the PDC and the IO on game details (i.e., date, time, grade and score), 79% (ICC 0.9, 95% CI 0.85-0.95) agreement on the number of players per game and 76% (ICC 0.8, 95% CI 0.69-0.91) agreement on the number of injuries sustained in the games. There was 100% agreement on whether the player left the field for all injuries. This study found that exercise and sport science students are reliable data collectors in sports injury fieldwork studies. (C) 2010 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
Priorities for investment in injury prevention in community Australian football
- Finch, Caroline, Gabbe, Belinda, White, Peta, Lloyd, David, Twomey, Dara, Donaldson, Alex, Elliott, Bruce, Cook, Jill
- Authors: Finch, Caroline , Gabbe, Belinda , White, Peta , Lloyd, David , Twomey, Dara , Donaldson, Alex , Elliott, Bruce , Cook, Jill
- Date: 2013
- Type: Text , Journal article
- Relation: Clinical journal of sport medicine Vol. 23, no. 6 (November 2013 2013), p. 430-438
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Relation: http://purl.org/au-research/grants/nhmrc/565907
- Full Text:
- Reviewed:
- Description: Objective:High-quality sport-specific information about the nature, type, cause, and frequency of injuries is needed to set injury prevention priorities. This article describes the type, nature, and mechanism of injuries in community Australian Football (community AF) players, as collected through field-based monitoring of injury in teams of players.Data Sources:Compilation of published prospectively collected injury data from 3 studies in junior community AF (1202 injuries in 1950+ players) and 3 studies in adult community AF (1765 injuries in 2265 players). This was supplemented with previously unpublished data from the most recent adult community AF injury cohort study conducted in 2007 to 2008. Injuries were ranked according to most common body regions, nature of injury, and mechanism.Main Results:In all players, lower limb injuries were the most frequent injury in community AF and were generally muscle strains, joint sprains, and superficial injuries. These injuries most commonly resulted from incidental contact with other players, or from overexertion. Upper limb injuries were less common but included fractures, strains, and sprains that were generally caused by incidental contact between players and the result of players falling to the ground.Conclusions:Lower limb injuries are common in community AF and could have an adverse impact on sustained participation in the game. Based on what is known about their mechanisms, it is likely that a high proportion of lower limb injuries could be prevented and they should therefore be a priority for injury prevention in community AF.
- Authors: Finch, Caroline , Gabbe, Belinda , White, Peta , Lloyd, David , Twomey, Dara , Donaldson, Alex , Elliott, Bruce , Cook, Jill
- Date: 2013
- Type: Text , Journal article
- Relation: Clinical journal of sport medicine Vol. 23, no. 6 (November 2013 2013), p. 430-438
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Relation: http://purl.org/au-research/grants/nhmrc/565907
- Full Text:
- Reviewed:
- Description: Objective:High-quality sport-specific information about the nature, type, cause, and frequency of injuries is needed to set injury prevention priorities. This article describes the type, nature, and mechanism of injuries in community Australian Football (community AF) players, as collected through field-based monitoring of injury in teams of players.Data Sources:Compilation of published prospectively collected injury data from 3 studies in junior community AF (1202 injuries in 1950+ players) and 3 studies in adult community AF (1765 injuries in 2265 players). This was supplemented with previously unpublished data from the most recent adult community AF injury cohort study conducted in 2007 to 2008. Injuries were ranked according to most common body regions, nature of injury, and mechanism.Main Results:In all players, lower limb injuries were the most frequent injury in community AF and were generally muscle strains, joint sprains, and superficial injuries. These injuries most commonly resulted from incidental contact with other players, or from overexertion. Upper limb injuries were less common but included fractures, strains, and sprains that were generally caused by incidental contact between players and the result of players falling to the ground.Conclusions:Lower limb injuries are common in community AF and could have an adverse impact on sustained participation in the game. Based on what is known about their mechanisms, it is likely that a high proportion of lower limb injuries could be prevented and they should therefore be a priority for injury prevention in community AF.
- Donnelly, Cyril, Elliot, Bruce, Doyle, Tim, Finch, Caroline, Dempsey, Alasdair, Lloyd, David
- Authors: Donnelly, Cyril , Elliot, Bruce , Doyle, Tim , Finch, Caroline , Dempsey, Alasdair , Lloyd, David
- Date: 2012
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 46, no. 13 (October 2012 2012), p. 917-922
- Full Text: false
- Reviewed:
- Description: Purpose: Determine if balance and technique training (BTT) implemented adjunct to normal Australian football (AF) training reduces external knee loading during sidestepping. Additionally, the authors determined if an athlete's knee joint kinematics and kinetics change over a season of AF. Methodology: Eight amateur-level AF clubs (n=1,001 males) volunteered to participate in either 28 weeks of BTT or a ‘sham’ training (ST) adjunct to their normal preseason and regular training. A subset of 34 athletes (BTT, n=20; ST, n=14) were recruited for biomechanical testing in weeks 1–7 and 18–25 of the 28-week training intervention. During biomechanical testing, participants completed a series running, preplanned (PpSS) and unplanned sidestepping (UnSS) tasks. A linear mixed model (a=0.05) was used to determine if knee kinematics and peak moments during PpSS and UnSS were influenced by BTT and/or a season of AF Results: Both training groups significantly (p=0.025) decreased their peak internal-rotation knee moments during PpSS, and significantly (p=0.022) increased their peak valgus knee moments during UnSS following their respective training interventions. Conclusions: BTT was not effective in changing an athlete's knee joint biomechanics during sidestepping when conducted in ‘real-world’ training environments. Following normal AF training, the players had different changes to their knee joint biomechanics during both preplanned and unplanned sidestepping. When performing an unplanned sidestepping task in the latter half of a playing season, athletes are at an increased risk of ACL injury. The authors therefore recommend both sidestepping tasks are performed during biomechanical testing when assessing the effectiveness of prophylactic training protocols.
- Ekegren, Christina, Gabbe, Belinda, Donaldson, Alex, Cook, Jill, Lloyd, David, Finch, Caroline
- Authors: Ekegren, Christina , Gabbe, Belinda , Donaldson, Alex , Cook, Jill , Lloyd, David , Finch, Caroline
- Date: 2014
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 18, no. 6 (2014), p.651-655
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
- Relation: http://purl.org/au-research/grants/nhmrc/565907
- Full Text: false
- Reviewed:
- Description: Objectives: Far fewer injury surveillance systems exist within community sport than elite sport. As a result, most epidemiological data on sports injuries have limited relevance to community-level sporting populations. There is potential for data from community club-based injury surveillance systems to provide a better understanding of community sports injuries. This study aimed to describe the incidence and profile of community-level Australian football injuries reported using a club-based injury surveillance system. Design: Prospective, epidemiological study. Methods: Sports trainers from five community-level Australian football leagues recorded injury data during two football seasons using the club-based system. An online surveillance tool developed by Sports Medicine Australia ('Sports Injury Tracker') was used for data collection. The injury incidence, profile and match injury rate were reported. Results: Injury data for 1205 players were recorded in season one and for 823 players in season two. There was significant variability in injury incidence across clubs. However, aggregated data were consistent across football seasons, with an average of 0.7 injuries per player per season and 38-39 match injuries per 1000. h match exposure. A large proportion of injuries occurred during matches, involved the lower limb and resulted from contact. Conclusions: Data from the club-based system provided a profile of injuries consistent with previous studies in community-level Australian football. Moreover, injury incidence was consistent with other studies using similar personnel to record data. However, injury incidence was lower than that reported in studies using player self-report or healthcare professionals and may be an underestimate of true values.
Ground hardness and injury in community level Australian football
- Twomey, Dara, Finch, Caroline, Lloyd, David, Elliott, Bruce, Doyle, Tim
- Authors: Twomey, Dara , Finch, Caroline , Lloyd, David , Elliott, Bruce , Doyle, Tim
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol.15, no. (4), p.305-310
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: Objective: To describe the risk and details of injuries associated with ground hardness in community level Australian football (AF). Design: Prospective injury surveillance with periodic objective ground hardness measurement. Methods: 112 ground hardness assessments were undertaken using a Clegg hammer at nine locations across 20 grounds, over the 2007 and 2008 AF seasons. Details of 352 injuries sustained by community level players on those grounds were prospectively collected as part of a large randomised controlled trial. The ground location of the injury was matched to the nearest corresponding ground hardness Clegg hammer readings, in gravities (g), which were classified from unacceptably low (<30 g) to unacceptably high hardness (>120 g). Results: Clegg hammer readings ranged from 25 to 301 g. Clegg hammer hardness categories from low/normal to high/normal were associated with the majority of injuries, with only 3.7% (13 injuries) on unacceptably high hardness and 0.3% (1 injury) on the unacceptably low hardness locations. Relative to the preferred range of hardness, the risk of sustaining an injury on low/normal hardness locations was 1.31 (95%CI: 1.06-1.62) times higher and 1.82 (95%CI: 1.17-2.85) times higher on locations with unacceptably high hardness. The more severe injuries occurred with low/normal ground hardness. Conclusions: Despite the low number of injuries, the risk of sustaining an injury on low/normal and unacceptably hard grounds was significantly greater than on the preferred range of hardness. Notably, the severity of the injuries sustained on unacceptably hard grounds was lower than for other categories of hardness. © 2012 Sports Medicine Australia.
- Authors: Twomey, Dara , Finch, Caroline , Lloyd, David , Elliott, Bruce , Doyle, Tim
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol.15, no. (4), p.305-310
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: Objective: To describe the risk and details of injuries associated with ground hardness in community level Australian football (AF). Design: Prospective injury surveillance with periodic objective ground hardness measurement. Methods: 112 ground hardness assessments were undertaken using a Clegg hammer at nine locations across 20 grounds, over the 2007 and 2008 AF seasons. Details of 352 injuries sustained by community level players on those grounds were prospectively collected as part of a large randomised controlled trial. The ground location of the injury was matched to the nearest corresponding ground hardness Clegg hammer readings, in gravities (g), which were classified from unacceptably low (<30 g) to unacceptably high hardness (>120 g). Results: Clegg hammer readings ranged from 25 to 301 g. Clegg hammer hardness categories from low/normal to high/normal were associated with the majority of injuries, with only 3.7% (13 injuries) on unacceptably high hardness and 0.3% (1 injury) on the unacceptably low hardness locations. Relative to the preferred range of hardness, the risk of sustaining an injury on low/normal hardness locations was 1.31 (95%CI: 1.06-1.62) times higher and 1.82 (95%CI: 1.17-2.85) times higher on locations with unacceptably high hardness. The more severe injuries occurred with low/normal ground hardness. Conclusions: Despite the low number of injuries, the risk of sustaining an injury on low/normal and unacceptably hard grounds was significantly greater than on the preferred range of hardness. Notably, the severity of the injuries sustained on unacceptably hard grounds was lower than for other categories of hardness. © 2012 Sports Medicine Australia.
Could targeted exercise programmes prevent lower limb injury in community Australian football?
- Andrew, Nadine, Gabbe, Belinda, Cook, Jill, Lloyd, David, Donnelly, Cyril, Nash, Clare, Finch, Caroline
- Authors: Andrew, Nadine , Gabbe, Belinda , Cook, Jill , Lloyd, David , Donnelly, Cyril , Nash, Clare , Finch, Caroline
- Date: 2013
- Type: Text , Journal article
- Relation: Sports Medicine Vol. 43, no. 8 (2013), p. 751-763
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Relation: http://purl.org/au-research/grants/nhmrc/565907
- Full Text:
- Reviewed:
- Description: Background: Australian football is a popular sport in Australia, at both the community and elite levels. It is a high-speed contact sport with a higher incidence of medically treated injuries when compared with most other organized sports. Hamstring injuries, ligament injuries to the knee or ankle, hip/groin injuries and tendinopathies are particularly common and often result in considerable time lost from sport. Consequently, the prevention of lower limb injuries is a priority for both community and elite Australian football organizations. There is considerable literature available on exercise programmes aimed at reducing lower limb injuries in Australian football and other running-related sports. The quality and outcomes of these studies have varied considerably, but indicate that exercise protocols may be an effective means of preventing lower limb injuries. Despite this, there has been limited high-quality and systematic evaluation of these data. Objective: The aim of this literature review is to systematically evaluate the evidence about the benefits of lower limb injury prevention exercise protocols aimed at reducing the most common severe lower limb injuries in Australian football. Methods: The Cochrane Central Register of Controlled Trials, the Cochrane Bone Joint and Muscle Trauma Group Specialized Register, MEDLINE and other electronic databases were searched, from January 1990 to December 2010. Papers reporting the results of randomized controlled trials (RCTs), quasi-RCTs, cohort and case-control studies were extracted. Primary outcomes were injury reduction or risk factor identification and/or modification. Secondary outcomes were adherence to any trialled interventions, injury severity and adverse effects such as secondary injuries and muscle soreness. The methodological quality of extracted manuscripts was assessed and results were collated. Results: Forty-seven papers were identified and reviewed of which 18 related to hamstring injury, eight related to knee or ankle ligament injury, five related to tendon injury and four were hip or groin injury related. Another 12 papers targeted general lower limb injuries. Most (n = 27 [57 %]) were observational studies, investigating injury risk factors. Twenty reported the results of intervention trials. Of these, 15 were efficacy trials reporting the effects of an intervention in reducing injury rates, four were biomechanical interventions in which the impact of the intervention on a known injury risk factor was assessed and one reported changes in injury risk factors as well as injury rates. The strength of the evidence base for exercise programmes for lower limb injury prevention was found to be limited, primarily due to the research methods employed, low adherence to interventions by the study participants and a lack of statistical power. Limited evidence obtained from a small number of RCTs suggests that balance and control exercises might be efficacious in preventing ankle ligament injuries and a programme involving a combination of balance and control exercises, eccentric hamstring, plyometrics and strength exercises could be efficacious in preventing all lower limb injuries. Conclusions: Overall, the evidence for exercise programmes as an efficacious lower limb injury prevention strategy is predominantly restricted to studies addressing injury aetiology and mechanisms. The findings of this review highlight the need to develop and test interventions in well designed population-based trials with an emphasis on promoting intervention uptake and adherence and, hence, intervention effectiveness. The results of this review can inform the development of the components of a future lower limb injury prevention exercise protocol for community-level Australian football. © 2013 Springer International Publishing Switzerland. Funded by the NHMRC.
- Description: 2003011215
- Authors: Andrew, Nadine , Gabbe, Belinda , Cook, Jill , Lloyd, David , Donnelly, Cyril , Nash, Clare , Finch, Caroline
- Date: 2013
- Type: Text , Journal article
- Relation: Sports Medicine Vol. 43, no. 8 (2013), p. 751-763
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Relation: http://purl.org/au-research/grants/nhmrc/565907
- Full Text:
- Reviewed:
- Description: Background: Australian football is a popular sport in Australia, at both the community and elite levels. It is a high-speed contact sport with a higher incidence of medically treated injuries when compared with most other organized sports. Hamstring injuries, ligament injuries to the knee or ankle, hip/groin injuries and tendinopathies are particularly common and often result in considerable time lost from sport. Consequently, the prevention of lower limb injuries is a priority for both community and elite Australian football organizations. There is considerable literature available on exercise programmes aimed at reducing lower limb injuries in Australian football and other running-related sports. The quality and outcomes of these studies have varied considerably, but indicate that exercise protocols may be an effective means of preventing lower limb injuries. Despite this, there has been limited high-quality and systematic evaluation of these data. Objective: The aim of this literature review is to systematically evaluate the evidence about the benefits of lower limb injury prevention exercise protocols aimed at reducing the most common severe lower limb injuries in Australian football. Methods: The Cochrane Central Register of Controlled Trials, the Cochrane Bone Joint and Muscle Trauma Group Specialized Register, MEDLINE and other electronic databases were searched, from January 1990 to December 2010. Papers reporting the results of randomized controlled trials (RCTs), quasi-RCTs, cohort and case-control studies were extracted. Primary outcomes were injury reduction or risk factor identification and/or modification. Secondary outcomes were adherence to any trialled interventions, injury severity and adverse effects such as secondary injuries and muscle soreness. The methodological quality of extracted manuscripts was assessed and results were collated. Results: Forty-seven papers were identified and reviewed of which 18 related to hamstring injury, eight related to knee or ankle ligament injury, five related to tendon injury and four were hip or groin injury related. Another 12 papers targeted general lower limb injuries. Most (n = 27 [57 %]) were observational studies, investigating injury risk factors. Twenty reported the results of intervention trials. Of these, 15 were efficacy trials reporting the effects of an intervention in reducing injury rates, four were biomechanical interventions in which the impact of the intervention on a known injury risk factor was assessed and one reported changes in injury risk factors as well as injury rates. The strength of the evidence base for exercise programmes for lower limb injury prevention was found to be limited, primarily due to the research methods employed, low adherence to interventions by the study participants and a lack of statistical power. Limited evidence obtained from a small number of RCTs suggests that balance and control exercises might be efficacious in preventing ankle ligament injuries and a programme involving a combination of balance and control exercises, eccentric hamstring, plyometrics and strength exercises could be efficacious in preventing all lower limb injuries. Conclusions: Overall, the evidence for exercise programmes as an efficacious lower limb injury prevention strategy is predominantly restricted to studies addressing injury aetiology and mechanisms. The findings of this review highlight the need to develop and test interventions in well designed population-based trials with an emphasis on promoting intervention uptake and adherence and, hence, intervention effectiveness. The results of this review can inform the development of the components of a future lower limb injury prevention exercise protocol for community-level Australian football. © 2013 Springer International Publishing Switzerland. Funded by the NHMRC.
- Description: 2003011215
Lessons learnt from implementing FootyFirst in 2012
- Donaldson, Alex, Gabbe, Belinda, Lloyd, David, Young, Warren, Ekegren, Christina, Finch, Caroline
- Authors: Donaldson, Alex , Gabbe, Belinda , Lloyd, David , Young, Warren , Ekegren, Christina , Finch, Caroline
- Date: 2012
- Type: Text , Journal article
- Relation: Sport Health Vol. 30, no. 3 (2012), p. 40-41
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Relation: http://purl.org/au-research/grants/nhmrc/565907
- Full Text: false
- Reviewed:
- Description: After we developed FootyFirst and produced a draft program manual, we actively sought input from community football coaches, players, administrators and sports trainers. Two focus groups were conducted to seek feedback on how the program was presented (general impressions, text, images, etc), potential barriers to the program being widely used in community football, and strategies to reduce/overcome these. Feedback indicated that the type and level of the exercises within FootyFirst had been pitched at the right level and that the program was easy to follow and understand. The main concern was it would take too much time for community football players to complete the FootyFirst program, particularly given that most community football teams train only twice a week for about 90 minutes. Focus group participants suggested that the maximum time available in a typical training session for this type of program would be about 20 minutes. A range of questions and concerns were also raised including; Will the program work? Why should it be done? Are players likely to become fatigued and more prone to injury in their regular football training after completing FootyFirst? The focus group participants also indicated that endorsement of FootyFirst by a highly respected individual or organisation from within the elite AFL community would be a powerful influence on community coaches and players.
Preventing Australian football injuries with a targeted neuromuscular control exercise programme: comparative injury rates from a training intervention delivered in a clustered randomised controlled trial
- Finch, Caroline, Twomey, Dara, Fortington, Lauren, Doyle, Tim, Elliott, Bruce, Akram, Muhammad, Lloyd, David
- Authors: Finch, Caroline , Twomey, Dara , Fortington, Lauren , Doyle, Tim , Elliott, Bruce , Akram, Muhammad , Lloyd, David
- Date: 2016
- Type: Text , Journal article
- Relation: Injury Prevention Vol. 22, no. 2 (Apr 2016), p. 123-128
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
- Full Text:
- Reviewed:
- Description: Background Exercise-based training programmes are commonly used to prevent sports injuries but programme effectiveness within community men's team sport is largely unknown. Objective To present the intention-to-treat analysis of injury outcomes from a clustered randomised controlled trial in community Australian football. Methods Players from 18 male, non-elite, community Australian football clubs across two states were randomly allocated to either a neuromuscular control (NMC) (intervention n=679 players) or standard-practice (control n=885 players) exercise training programme delivered as part of regular team training sessions (2x weekly for 8-week preseason and 18-week regularseason). All game-related injuries and hours of game participation were recorded. Generalised estimating equations, adjusted for clustering (club unit), were used to compute injury incidence rates (IIRs) for all injuries, lower limb injuries (LLIs) and knee injuries sustained during games. The IIRs were compared across groups with cluster-adjusted Injury Rate Ratios (IRRs). Results Overall, 773 game injuries were recorded. The lower limb was the most frequent body region injured, accounting for 50% of injuries overall, 96 (12%) of which were knee injuries. The NMC players had a reduced LLI rate compared with control players (IRR: 0.78 (95% CI 0.56 to 1.08), p=0.14.) The knee IIR was also reduced for NMC compared with control players (IRR: 0.50 (95% CI 0.24 to 1.05), p=0.07). Conclusions These intention-to-treat results indicate that positive outcomes can be achieved from targeted training programmes for reducing knee and LLI injury rates in men's community sport. While not statistically significant, reducing the knee injury rate by 50% and the LLI rate by 22% is still a clinically important outcome. Further injury reductions could be achieved with improved training attendance and participation in the programme.
- Authors: Finch, Caroline , Twomey, Dara , Fortington, Lauren , Doyle, Tim , Elliott, Bruce , Akram, Muhammad , Lloyd, David
- Date: 2016
- Type: Text , Journal article
- Relation: Injury Prevention Vol. 22, no. 2 (Apr 2016), p. 123-128
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
- Full Text:
- Reviewed:
- Description: Background Exercise-based training programmes are commonly used to prevent sports injuries but programme effectiveness within community men's team sport is largely unknown. Objective To present the intention-to-treat analysis of injury outcomes from a clustered randomised controlled trial in community Australian football. Methods Players from 18 male, non-elite, community Australian football clubs across two states were randomly allocated to either a neuromuscular control (NMC) (intervention n=679 players) or standard-practice (control n=885 players) exercise training programme delivered as part of regular team training sessions (2x weekly for 8-week preseason and 18-week regularseason). All game-related injuries and hours of game participation were recorded. Generalised estimating equations, adjusted for clustering (club unit), were used to compute injury incidence rates (IIRs) for all injuries, lower limb injuries (LLIs) and knee injuries sustained during games. The IIRs were compared across groups with cluster-adjusted Injury Rate Ratios (IRRs). Results Overall, 773 game injuries were recorded. The lower limb was the most frequent body region injured, accounting for 50% of injuries overall, 96 (12%) of which were knee injuries. The NMC players had a reduced LLI rate compared with control players (IRR: 0.78 (95% CI 0.56 to 1.08), p=0.14.) The knee IIR was also reduced for NMC compared with control players (IRR: 0.50 (95% CI 0.24 to 1.05), p=0.07). Conclusions These intention-to-treat results indicate that positive outcomes can be achieved from targeted training programmes for reducing knee and LLI injury rates in men's community sport. While not statistically significant, reducing the knee injury rate by 50% and the LLI rate by 22% is still a clinically important outcome. Further injury reductions could be achieved with improved training attendance and participation in the programme.