Compliance with sport injury prevention interventions in randomised controlled trials : A systematic review
- van Reijen, Miriam, Vriend, Ingrid, van Mechelen, Willem, Finch, Caroline, Verhagen, Evert
- 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.
- 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
- Full Text:
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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.
A prospective cohort study on symptoms of common mental disorders among Dutch elite athletes
- Gouttebarge, Vincent, Jonkers, Ruud, Moen, Maarten, Verhagen, Evert, Wylleman, Paul, Kerkhoffs, Gino
- Authors: Gouttebarge, Vincent , Jonkers, Ruud , Moen, Maarten , Verhagen, Evert , Wylleman, Paul , Kerkhoffs, Gino
- Date: 2017
- Type: Text , Journal article
- Relation: Physician and Sportsmedicine Vol. 45, no. 4 (2017), p. 426-432
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- Description: Objective: Scientific knowledge about symptoms of common mental disorders in elite sports is scarce. Consequently, the objectives of the study were to (i) establish the 12-month incidence of symptoms of common mental disorders (CMD; distress, anxiety/depression, sleep disturbance, adverse alcohol use, eating disorders) among Dutch elite athletes and (ii) explore their potential association with several stressors (being injured, recent life events, career dissatisfaction).Methods: A prospective cohort study with a 12-month follow-up period was conducted. The study used validated questionnaires to assess symptoms of common mental disorders (thus not clinically diagnosed) as well as several stressors; an electronic questionnaire was set up and repeatedly distributed.Results: A total of 203 elite athletes gave their written informed consent to participate in the study, from which 143 completed the 12-month follow-up period (follow-up rate of 70%). Incidence of symptoms of CMD ranged from 6% for adverse alcohol use to 57% for symptoms of anxiety/depression. Over the follow-up period, around 17% of the participants reported two simultaneous symptoms of CMD, and around 19% reported three simultaneous symptoms of CMD. Inferences between some stressors and symptoms of CMD were found but none of the associations were statistically significant.Conclusions: Substantial 12-month incidence rates of symptoms of CMD (self-reported and not clinically diagnosed) were found among Dutch elite athletes (especially for anxiety/depression), appearing similar to the ones found among athletes from other sports disciplines and the Dutch general population. Also, inferences between some stressors and symptoms of CMD were found but none of the associations were statistically significant. Supportive and preventive measures directed towards symptoms of CMD should be developed to improve awareness and psychological resilience of athletes, which would likely improve their performance and quality-of-life.
- Authors: Gouttebarge, Vincent , Jonkers, Ruud , Moen, Maarten , Verhagen, Evert , Wylleman, Paul , Kerkhoffs, Gino
- Date: 2017
- Type: Text , Journal article
- Relation: Physician and Sportsmedicine Vol. 45, no. 4 (2017), p. 426-432
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- Description: Objective: Scientific knowledge about symptoms of common mental disorders in elite sports is scarce. Consequently, the objectives of the study were to (i) establish the 12-month incidence of symptoms of common mental disorders (CMD; distress, anxiety/depression, sleep disturbance, adverse alcohol use, eating disorders) among Dutch elite athletes and (ii) explore their potential association with several stressors (being injured, recent life events, career dissatisfaction).Methods: A prospective cohort study with a 12-month follow-up period was conducted. The study used validated questionnaires to assess symptoms of common mental disorders (thus not clinically diagnosed) as well as several stressors; an electronic questionnaire was set up and repeatedly distributed.Results: A total of 203 elite athletes gave their written informed consent to participate in the study, from which 143 completed the 12-month follow-up period (follow-up rate of 70%). Incidence of symptoms of CMD ranged from 6% for adverse alcohol use to 57% for symptoms of anxiety/depression. Over the follow-up period, around 17% of the participants reported two simultaneous symptoms of CMD, and around 19% reported three simultaneous symptoms of CMD. Inferences between some stressors and symptoms of CMD were found but none of the associations were statistically significant.Conclusions: Substantial 12-month incidence rates of symptoms of CMD (self-reported and not clinically diagnosed) were found among Dutch elite athletes (especially for anxiety/depression), appearing similar to the ones found among athletes from other sports disciplines and the Dutch general population. Also, inferences between some stressors and symptoms of CMD were found but none of the associations were statistically significant. Supportive and preventive measures directed towards symptoms of CMD should be developed to improve awareness and psychological resilience of athletes, which would likely improve their performance and quality-of-life.
Incidence, aetiology and prevention of musculoskeletal injuries in volleyball : A systematic review of the literature
- Kilic, O., Maas, Mario, Verhagen, Evert, Zwerver, Johannes, Gouttebarge, Vincent
- Authors: Kilic, O. , Maas, Mario , Verhagen, Evert , Zwerver, Johannes , Gouttebarge, Vincent
- Date: 2017
- Type: Text , Journal article , Review
- Relation: European Journal of Sport Science Vol. 17, no. 6 (2017), p. 765-793
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- Description: Currently, there is no overview of the incidence and (volleyball-specific) risk factors of musculoskeletal injuries among volleyball players, nor any insight into the effect of preventive measures on the incidence of injuries in volleyball. This study aimed to review systematically the scientific evidence on the incidence, prevalence, aetiology and preventive measures of volleyball injuries. To this end, a highly sensitive search strategy was built based on two groups of keywords (and their synonyms). Two electronic databases were searched, namely Medline (biomedical literature) via Pubmed, and SPORTDiscus (sports and sports medicine literature) via EBSCOhost. The results showed that ankle, knee and shoulder injuries are the most common injuries sustained while playing volleyball. Results are presented separately for acute and overuse injuries, as well as for contact and non-contact injuries. Measures to prevent musculoskeletal injuries, anterior knee injuries and ankle injuries were identified in the scientific literature. These preventive measures were found to have a significant effect on decreasing the occurrence of volleyball injuries (for instance on ankle injuries with a reduction from 0.9 to 0.5 injuries per 1000 player hours). Our systematic review showed that musculoskeletal injuries are common among volleyball players, while effective preventive measures remain scarce. Further epidemiological studies should focus on other specific injuries besides knee and ankle injuries, and should also report their prevalence and not only the incidence. Additionally, high-quality studies on the aetiology and prevention of shoulder injuries are lacking and should be a focus of future studies. © 2017 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
- Authors: Kilic, O. , Maas, Mario , Verhagen, Evert , Zwerver, Johannes , Gouttebarge, Vincent
- Date: 2017
- Type: Text , Journal article , Review
- Relation: European Journal of Sport Science Vol. 17, no. 6 (2017), p. 765-793
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- Description: Currently, there is no overview of the incidence and (volleyball-specific) risk factors of musculoskeletal injuries among volleyball players, nor any insight into the effect of preventive measures on the incidence of injuries in volleyball. This study aimed to review systematically the scientific evidence on the incidence, prevalence, aetiology and preventive measures of volleyball injuries. To this end, a highly sensitive search strategy was built based on two groups of keywords (and their synonyms). Two electronic databases were searched, namely Medline (biomedical literature) via Pubmed, and SPORTDiscus (sports and sports medicine literature) via EBSCOhost. The results showed that ankle, knee and shoulder injuries are the most common injuries sustained while playing volleyball. Results are presented separately for acute and overuse injuries, as well as for contact and non-contact injuries. Measures to prevent musculoskeletal injuries, anterior knee injuries and ankle injuries were identified in the scientific literature. These preventive measures were found to have a significant effect on decreasing the occurrence of volleyball injuries (for instance on ankle injuries with a reduction from 0.9 to 0.5 injuries per 1000 player hours). Our systematic review showed that musculoskeletal injuries are common among volleyball players, while effective preventive measures remain scarce. Further epidemiological studies should focus on other specific injuries besides knee and ankle injuries, and should also report their prevalence and not only the incidence. Additionally, high-quality studies on the aetiology and prevention of shoulder injuries are lacking and should be a focus of future studies. © 2017 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
Health and economic burden of running-related injuries in Dutch trailrunners : A prospective cohort study
- Hespanhol Junior, Luiz, van Mechelen, Willem, Verhagen, Evert
- Authors: Hespanhol Junior, Luiz , van Mechelen, Willem , Verhagen, Evert
- Date: 2017
- Type: Text , Journal article
- Relation: Sports Medicine Vol. 47, no. 2 (2017), p. 367-377
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- Description: Background: Trailrunning is becoming very popular. However, the risk and burden of running-related injuries (RRI) in trailrunning is not well established. Objective: To investigate the prevalence, injury rate, severity, nature, and economic burden of RRIs in Dutch trailrunners. Methods: This prospective cohort study included 228 trailrunners aged 18 years or over (range 23–67), and was conducted between October 2013 and December 2014. After completing the baseline questionnaire, the Oslo Sports Trauma Research Center Questionnaire on Health Problems was administered every 2 weeks to collect data on RRIs. Participants who reported RRIs were asked about healthcare utilization (direct costs) and absenteeism from paid work (indirect costs). RRI was defined as disorders of the musculoskeletal system or concussions experienced or sustained during participation in running. Results: The mean prevalence of RRIs measured over time was 22.4 % [95 % confidence interval (CI) 20.9–24.0], and the injury rate was 10.7 RRIs per 1000 h of running (95 % CI 9.4–12.1). The prevalence was higher for overuse (17.7 %; 95 % CI 15.9–19.5) than for acute (4.1 %; 95 % CI 3.3–5.0) RRIs. Also, the injury rate was higher for overuse (8.1; 95 % CI 6.9–9.3) than for acute (2.7; 95 % CI 2.0–3.4) RRIs. The median of the severity score was 35.0 [25–75 %, interquartile range (IQR) 22.0–55.7], and the median of the duration of RRIs was 2.0 weeks (IQR 2.0–6.0) during the study. The total economic burden of RRIs was estimated at €172.22 (95 % CI 117.10–271.74) per RRI, and €1849.49 (95 % CI 1180.62–3058.91) per 1000 h of running. An RRI was estimated to have a direct cost of €60.92 (95 % CI 45.11–94.90) and an indirect cost of €111.30 (95 % CI 61.02–192.75). Conclusions: The health and economic burden of RRIs presented in this study are significant for trailrunners and for society. Therefore, efforts should be made in order to prevent RRIs in trailrunners. © 2016, The Author(s).
- Authors: Hespanhol Junior, Luiz , van Mechelen, Willem , Verhagen, Evert
- Date: 2017
- Type: Text , Journal article
- Relation: Sports Medicine Vol. 47, no. 2 (2017), p. 367-377
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- Reviewed:
- Description: Background: Trailrunning is becoming very popular. However, the risk and burden of running-related injuries (RRI) in trailrunning is not well established. Objective: To investigate the prevalence, injury rate, severity, nature, and economic burden of RRIs in Dutch trailrunners. Methods: This prospective cohort study included 228 trailrunners aged 18 years or over (range 23–67), and was conducted between October 2013 and December 2014. After completing the baseline questionnaire, the Oslo Sports Trauma Research Center Questionnaire on Health Problems was administered every 2 weeks to collect data on RRIs. Participants who reported RRIs were asked about healthcare utilization (direct costs) and absenteeism from paid work (indirect costs). RRI was defined as disorders of the musculoskeletal system or concussions experienced or sustained during participation in running. Results: The mean prevalence of RRIs measured over time was 22.4 % [95 % confidence interval (CI) 20.9–24.0], and the injury rate was 10.7 RRIs per 1000 h of running (95 % CI 9.4–12.1). The prevalence was higher for overuse (17.7 %; 95 % CI 15.9–19.5) than for acute (4.1 %; 95 % CI 3.3–5.0) RRIs. Also, the injury rate was higher for overuse (8.1; 95 % CI 6.9–9.3) than for acute (2.7; 95 % CI 2.0–3.4) RRIs. The median of the severity score was 35.0 [25–75 %, interquartile range (IQR) 22.0–55.7], and the median of the duration of RRIs was 2.0 weeks (IQR 2.0–6.0) during the study. The total economic burden of RRIs was estimated at €172.22 (95 % CI 117.10–271.74) per RRI, and €1849.49 (95 % CI 1180.62–3058.91) per 1000 h of running. An RRI was estimated to have a direct cost of €60.92 (95 % CI 45.11–94.90) and an indirect cost of €111.30 (95 % CI 61.02–192.75). Conclusions: The health and economic burden of RRIs presented in this study are significant for trailrunners and for society. Therefore, efforts should be made in order to prevent RRIs in trailrunners. © 2016, The Author(s).
A 12-month prospective cohort study of symptoms of common mental disorders among professional rugby players
- Gouttebarge, Vincent, Hopley, Philip, Kerkhoffs, Gino, Verhagen, Evert, Viljoen, Wayne, Wylleman, Paul, Lambert, Mike
- Authors: Gouttebarge, Vincent , Hopley, Philip , Kerkhoffs, Gino , Verhagen, Evert , Viljoen, Wayne , Wylleman, Paul , Lambert, Mike
- Date: 2018
- Type: Text , Journal article
- Relation: European Journal of Sport Science Vol. 18, no. 7 (2018), p. 1004-1012
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- Description: The primary aims were to determine the 12-month incidence (and comorbidity) of symptoms of common mental disorders (CMD) among male professional rugby players and to explore their association with potential stressors. A secondary aim was to explore the view of male professional rugby players about the consequences of symptoms of CMD and related medical support/needs. An observational prospective cohort study with three measurements over a 12-month period was conducted among male professional rugby players from several countries. Symptoms of CMD (distress, anxiety/depression, sleep disturbance, eating disorders and adverse alcohol use) and stressors (adverse life events, rugby career dissatisfaction) were assessed through validated questionnaires. A total of 595 players (mean age of 26 years; mean career duration of 6 years) were enrolled, of which 333 completed the follow-up period. The incidence of symptoms of CMD were: 11% for distress, 28% for anxiety/depression, 12% for sleep disturbance, 11% for eating disorders and 22% for adverse alcohol use (13% for two simultaneous symptoms of CMD). Professional rugby players reporting recent adverse life events or career dissatisfaction were more likely to report symptoms of CMD but statistically significant associations were not found. Around 95% of the participants stated that symptoms of CMD can negatively influence rugby performances, while 46% mentioned that specific support measures for players were not available in professional rugby. Supportive and preventive measures directed towards symptoms of CMD should be developed to improve not only awareness and psychological resilience of rugby players but also their rugby performance and quality-of-life. © 2018, © 2018 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
- Authors: Gouttebarge, Vincent , Hopley, Philip , Kerkhoffs, Gino , Verhagen, Evert , Viljoen, Wayne , Wylleman, Paul , Lambert, Mike
- Date: 2018
- Type: Text , Journal article
- Relation: European Journal of Sport Science Vol. 18, no. 7 (2018), p. 1004-1012
- Full Text:
- Reviewed:
- Description: The primary aims were to determine the 12-month incidence (and comorbidity) of symptoms of common mental disorders (CMD) among male professional rugby players and to explore their association with potential stressors. A secondary aim was to explore the view of male professional rugby players about the consequences of symptoms of CMD and related medical support/needs. An observational prospective cohort study with three measurements over a 12-month period was conducted among male professional rugby players from several countries. Symptoms of CMD (distress, anxiety/depression, sleep disturbance, eating disorders and adverse alcohol use) and stressors (adverse life events, rugby career dissatisfaction) were assessed through validated questionnaires. A total of 595 players (mean age of 26 years; mean career duration of 6 years) were enrolled, of which 333 completed the follow-up period. The incidence of symptoms of CMD were: 11% for distress, 28% for anxiety/depression, 12% for sleep disturbance, 11% for eating disorders and 22% for adverse alcohol use (13% for two simultaneous symptoms of CMD). Professional rugby players reporting recent adverse life events or career dissatisfaction were more likely to report symptoms of CMD but statistically significant associations were not found. Around 95% of the participants stated that symptoms of CMD can negatively influence rugby performances, while 46% mentioned that specific support measures for players were not available in professional rugby. Supportive and preventive measures directed towards symptoms of CMD should be developed to improve not only awareness and psychological resilience of rugby players but also their rugby performance and quality-of-life. © 2018, © 2018 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
Systematic development of a tennis injury prevention programme
- Pas, Haiko, Bodde, Stefan, Kerkhoffs, Gino, Pluim, Babette, Tiemessen, Ivo, Tol, Johannes, Verhagen, Evert, Gouttebarge, Vincent
- Authors: Pas, Haiko , Bodde, Stefan , Kerkhoffs, Gino , Pluim, Babette , Tiemessen, Ivo , Tol, Johannes , Verhagen, Evert , Gouttebarge, Vincent
- Date: 2018
- Type: Text , Journal article
- Relation: BMJ Open Sport and Exercise Medicine Vol. 4, no. 1 (2018), p. 1-7
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- Description: Introduction Despite an injury incidence of up to 3.0/1000 hours of play, there are no published tennis injury prevention programmes. This article aims to describe the developmental process of TennisReady, an e-health tennis-specific injury programme for adult recreational tennis players. Five-step approach A bottom-up, five-step approach was used with the Knowledge Transfer Scheme as a guideline. During the first step, a problem statement among targeted users was carried out. 475 (partially) completed surveys and group interviews (n=8) revealed a preference for an app-based prevention intervention of 10-15 min. As a second step, a systematic review was performed to identify prevention strategies in tennis. None were found. In step 3, during two expert group meetings (n=18), the findings of the first two steps were discussed and goals were formulated. Relevant and potential exercises for the programme were discussed. A subgroup of a total of six physical therapists, physicians and trainers developed the content of the programme in step 4. Step 5 included an evaluation of the exercises in 33 recreational tennis players. Participants evaluated the exercises during training sessions with trainers involved in the programme's development or their colleagues. Participants evaluated the programme through standardised surveys or group interviews. Based on this evaluation, the programme was adjusted by altering exercises and frequencies, and it was evaluated in a second target group (n=27). The second evaluation did not result in any major changes to the final prevention programme. Conclusion Through a five-step approach guided by the Knowledge Transfer Scheme, we developed an e-health tennis-specific prevention programme for adult tennis players. This 10 min intervention will require testing in a randomised controlled setting.
- Authors: Pas, Haiko , Bodde, Stefan , Kerkhoffs, Gino , Pluim, Babette , Tiemessen, Ivo , Tol, Johannes , Verhagen, Evert , Gouttebarge, Vincent
- Date: 2018
- Type: Text , Journal article
- Relation: BMJ Open Sport and Exercise Medicine Vol. 4, no. 1 (2018), p. 1-7
- Full Text:
- Reviewed:
- Description: Introduction Despite an injury incidence of up to 3.0/1000 hours of play, there are no published tennis injury prevention programmes. This article aims to describe the developmental process of TennisReady, an e-health tennis-specific injury programme for adult recreational tennis players. Five-step approach A bottom-up, five-step approach was used with the Knowledge Transfer Scheme as a guideline. During the first step, a problem statement among targeted users was carried out. 475 (partially) completed surveys and group interviews (n=8) revealed a preference for an app-based prevention intervention of 10-15 min. As a second step, a systematic review was performed to identify prevention strategies in tennis. None were found. In step 3, during two expert group meetings (n=18), the findings of the first two steps were discussed and goals were formulated. Relevant and potential exercises for the programme were discussed. A subgroup of a total of six physical therapists, physicians and trainers developed the content of the programme in step 4. Step 5 included an evaluation of the exercises in 33 recreational tennis players. Participants evaluated the exercises during training sessions with trainers involved in the programme's development or their colleagues. Participants evaluated the programme through standardised surveys or group interviews. Based on this evaluation, the programme was adjusted by altering exercises and frequencies, and it was evaluated in a second target group (n=27). The second evaluation did not result in any major changes to the final prevention programme. Conclusion Through a five-step approach guided by the Knowledge Transfer Scheme, we developed an e-health tennis-specific prevention programme for adult tennis players. This 10 min intervention will require testing in a randomised controlled setting.
Risk and protective factors for middle- and long-distance running-related injury
- Hulme, Adam, Nielsen, Rasmus, Timpka, Toomas, Verhagen, Evert, Finch, Caroline
- 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.
- 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
- Full Text:
- Reviewed:
- 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.
Intervention strategies used in sport injury prevention studies : A systematic review identifying studies applying the Haddon matrix
- Vriend, Ingrid, Gouttebarge, Vincent, Finch, Caroline, van Mechelen, Willem, Verhagen, Evert
- Authors: Vriend, Ingrid , Gouttebarge, Vincent , Finch, Caroline , van Mechelen, Willem , Verhagen, Evert
- Date: 2017
- Type: Text , Journal article , Review
- Relation: Sports Medicine Vol. 47, no. 10 (2017), p. 2027-2043
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- Description: Background: Prevention of sport injuries is crucial to maximise the health and societal benefits of a physically active lifestyle. To strengthen the translation and implementation of the available evidence base on effective preventive measures, a range of potentially relevant strategies should be considered. Objective: Our aim was to identify and categorise intervention strategies for the prevention of acute sport injuries evaluated in the scientific literature, applying the Haddon matrix, and identify potential knowledge gaps. Methods: Five electronic databases were searched (PubMed, EMBASE, SPORTDiscus, CINAHL, Cochrane) for studies that evaluated the effect of interventions on the occurrence of acute sport injuries. Studies were required to include a control group/condition, prospective data collection, and a quantitative injury outcome measure. Results: A total of 155 studies were included, mostly randomised controlled trials (43%). The majority of studies (55%) focussed on strategies requiring a behavioural change on the part of athletes. Studies predominantly evaluated the preventive effect of various training programmes targeted at the ‘pre-event’ phase (n = 73) and the use of equipment to avoid injury in the ‘event phase’ (n = 29). A limited number of studies evaluated the preventive effect of strategies geared at rules and regulations (n = 14), and contextual modifications (n = 18). Studies specifically aimed at preventing re-injuries were a minority (n = 8), and were mostly related to ankle sprains (n = 5). Conclusions: Valuable insight into the extent of the evidence base of sport injury prevention studies was obtained for 20 potential intervention strategies. This approach can be used to monitor potential gaps in the knowledge base on sport injury prevention. © 2017, The Author(s).
- Authors: Vriend, Ingrid , Gouttebarge, Vincent , Finch, Caroline , van Mechelen, Willem , Verhagen, Evert
- Date: 2017
- Type: Text , Journal article , Review
- Relation: Sports Medicine Vol. 47, no. 10 (2017), p. 2027-2043
- Full Text:
- Reviewed:
- Description: Background: Prevention of sport injuries is crucial to maximise the health and societal benefits of a physically active lifestyle. To strengthen the translation and implementation of the available evidence base on effective preventive measures, a range of potentially relevant strategies should be considered. Objective: Our aim was to identify and categorise intervention strategies for the prevention of acute sport injuries evaluated in the scientific literature, applying the Haddon matrix, and identify potential knowledge gaps. Methods: Five electronic databases were searched (PubMed, EMBASE, SPORTDiscus, CINAHL, Cochrane) for studies that evaluated the effect of interventions on the occurrence of acute sport injuries. Studies were required to include a control group/condition, prospective data collection, and a quantitative injury outcome measure. Results: A total of 155 studies were included, mostly randomised controlled trials (43%). The majority of studies (55%) focussed on strategies requiring a behavioural change on the part of athletes. Studies predominantly evaluated the preventive effect of various training programmes targeted at the ‘pre-event’ phase (n = 73) and the use of equipment to avoid injury in the ‘event phase’ (n = 29). A limited number of studies evaluated the preventive effect of strategies geared at rules and regulations (n = 14), and contextual modifications (n = 18). Studies specifically aimed at preventing re-injuries were a minority (n = 8), and were mostly related to ankle sprains (n = 5). Conclusions: Valuable insight into the extent of the evidence base of sport injury prevention studies was obtained for 20 potential intervention strategies. This approach can be used to monitor potential gaps in the knowledge base on sport injury prevention. © 2017, The Author(s).
Injuries in field hockey players : A systematic review
- Barboza, Saulo, Joseph, Corey, Nauta, Joske, van Mechelen, Willem, Verhagen, Evert
- Authors: Barboza, Saulo , Joseph, Corey , Nauta, Joske , van Mechelen, Willem , Verhagen, Evert
- Date: 2018
- Type: Text , Journal article , Review
- Relation: Sports Medicine Vol. 48, no. 4 (2018), p. 849-866
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- Description: Background: To commence injury prevention efforts, it is necessary to understand the magnitude of the injury problem. No systematic reviews have yet investigated the extent of injuries in field hockey, despite the popularity of the sport worldwide. Objective: Our objective was to describe the rate and severity of injuries in field hockey and investigate their characteristics. Methods: We conducted electronic searches in PubMed, Embase, SPORTDiscus, and CINAHL. Prospective cohort studies were included if they were published in English in a peer-reviewed journal and observed all possible injuries sustained by field hockey players during the period of the study. Results: The risk of bias score of the 22 studies included ranged from three to nine of a possible ten. In total, 12 studies (55%) reported injuries normalized by field hockey exposure. Injury rates ranged from 0.1 injuries (in school-aged players) to 90.9 injuries (in Africa Cup of Nations) per 1000 player-hours and from one injury (in high-school women) to 70 injuries (in under-21 age women) per 1000 player-sessions. Studies used different classifications for injury severity, but—within studies—injuries were included mostly in the less severe category. The lower limbs were most affected, and contusions/hematomas and abrasions were common types of injury. Contact injuries are common, but non-contact injuries are also a cause for concern. Conclusions: Considerable heterogeneity meant it was not possible to draw conclusive findings on the extent of the rate and severity of injuries. Establishing the extent of sports injury is considered the first step towards prevention, so there is a need for a consensus on injury surveillance in field hockey. © 2018, The Author(s).
- Authors: Barboza, Saulo , Joseph, Corey , Nauta, Joske , van Mechelen, Willem , Verhagen, Evert
- Date: 2018
- Type: Text , Journal article , Review
- Relation: Sports Medicine Vol. 48, no. 4 (2018), p. 849-866
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- Description: Background: To commence injury prevention efforts, it is necessary to understand the magnitude of the injury problem. No systematic reviews have yet investigated the extent of injuries in field hockey, despite the popularity of the sport worldwide. Objective: Our objective was to describe the rate and severity of injuries in field hockey and investigate their characteristics. Methods: We conducted electronic searches in PubMed, Embase, SPORTDiscus, and CINAHL. Prospective cohort studies were included if they were published in English in a peer-reviewed journal and observed all possible injuries sustained by field hockey players during the period of the study. Results: The risk of bias score of the 22 studies included ranged from three to nine of a possible ten. In total, 12 studies (55%) reported injuries normalized by field hockey exposure. Injury rates ranged from 0.1 injuries (in school-aged players) to 90.9 injuries (in Africa Cup of Nations) per 1000 player-hours and from one injury (in high-school women) to 70 injuries (in under-21 age women) per 1000 player-sessions. Studies used different classifications for injury severity, but—within studies—injuries were included mostly in the less severe category. The lower limbs were most affected, and contusions/hematomas and abrasions were common types of injury. Contact injuries are common, but non-contact injuries are also a cause for concern. Conclusions: Considerable heterogeneity meant it was not possible to draw conclusive findings on the extent of the rate and severity of injuries. Establishing the extent of sports injury is considered the first step towards prevention, so there is a need for a consensus on injury surveillance in field hockey. © 2018, The Author(s).
Acceptability and perceptions of end-users towards an online sports-health surveillance system
- Barboza, Saulo, Bolling, Caroline, Nauta, Joske, van Mechelen, Willem, Verhagen, Evert
- Authors: Barboza, Saulo , Bolling, Caroline , Nauta, Joske , van Mechelen, Willem , Verhagen, Evert
- Date: 2017
- Type: Text , Journal article
- Relation: BMJ Open Sport and Exercise Medicine Vol. 3, no. 1 (2017), p. 1-8
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- Description: Aim To describe the acceptability and the perceptions of athletes and staff members (ie, end-users) towards an online sports-health surveillance system. Methods A pilot study with a mixed-methods approach was pursued. Descriptive analysis was conducted to present the adherence of judo (n=34), swimming (n=21) and volleyball (n=14) athletes to an online registration of their sport exposure and any health complaints between April 2014 and January 2015. End-users' perceptions towards the system were investigated qualitatively with semistructured interviews (n=21). Qualitative analysis was based on the constant comparative method using principles of the grounded theory. Results The response rates of judo, swimming and volleyball athletes were 50% (SD 23), 61% (SD 27) and 56% (SD 25), respectively. Most athletes found it simple to register their sport exposure and health complaints online; however, personal communication was still preferred for this purpose. The system facilitated the communication between medical and trainer staff, who were able to identify in the system reports health complaints from athletes that were not necessarily communicated face-to-face. Therefore, staff members reported that they were able to intervene earlier to prevent minor health complaints from becoming severe health problems. However, staff members expected higher adherence of athletes to the online follow-ups, and athletes expected to receive feedback on their inputs to the system. Conclusion An online system can be used in sporting settings complementary to regular strategies for monitoring athletes' health. However, providing feedback on athletes' inputs is important to maintain their adherence to such an online system.
- Authors: Barboza, Saulo , Bolling, Caroline , Nauta, Joske , van Mechelen, Willem , Verhagen, Evert
- Date: 2017
- Type: Text , Journal article
- Relation: BMJ Open Sport and Exercise Medicine Vol. 3, no. 1 (2017), p. 1-8
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- Description: Aim To describe the acceptability and the perceptions of athletes and staff members (ie, end-users) towards an online sports-health surveillance system. Methods A pilot study with a mixed-methods approach was pursued. Descriptive analysis was conducted to present the adherence of judo (n=34), swimming (n=21) and volleyball (n=14) athletes to an online registration of their sport exposure and any health complaints between April 2014 and January 2015. End-users' perceptions towards the system were investigated qualitatively with semistructured interviews (n=21). Qualitative analysis was based on the constant comparative method using principles of the grounded theory. Results The response rates of judo, swimming and volleyball athletes were 50% (SD 23), 61% (SD 27) and 56% (SD 25), respectively. Most athletes found it simple to register their sport exposure and health complaints online; however, personal communication was still preferred for this purpose. The system facilitated the communication between medical and trainer staff, who were able to identify in the system reports health complaints from athletes that were not necessarily communicated face-to-face. Therefore, staff members reported that they were able to intervene earlier to prevent minor health complaints from becoming severe health problems. However, staff members expected higher adherence of athletes to the online follow-ups, and athletes expected to receive feedback on their inputs to the system. Conclusion An online system can be used in sporting settings complementary to regular strategies for monitoring athletes' health. However, providing feedback on athletes' inputs is important to maintain their adherence to such an online system.
Sport injuries sustained by athletes with disability : A systematic review
- Weiler, Richard, van Mechelen, Willem, Fuller, Colin, Verhagen, Evert
- Authors: Weiler, Richard , van Mechelen, Willem , Fuller, Colin , Verhagen, Evert
- Date: 2016
- Type: Text , Journal article , Review
- Relation: Sports Medicine Vol. 46, no. 8 (2016), p. 1141-1153
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- Description: Background Fifteen percent of the world's population live with disability, and many of these individuals choose to play sport. There are barriers to sport participation for athletes with disability and sports injury can greatly impact on daily life, which makes sports injury prevention additionally important. Objective The purpose of this review is to systematically review the definitions, methodologies and injury rates in disability sport, which should assist future identification of risk factors and development of injury prevention strategies. A secondary aim is to highlight the most pressing issues for improvement of the quality of injury epidemiology research for disability sport. Methods A search of NICE, AMED, British Nursing Index, CINAHL, EMBASE and Medline was conducted to identify all publications up to 16 June 2015. Of 489 potentially relevant articles and reference searching, a total of 15 studies were included. Wide study sample heterogeneity prevented data pooling and meta-analysis. Results Results demonstrated an evolving field of epidemiology, but with wide differences in sports injury definition and with studies focused on short competitions. Background data were generally sparse; there was minimal exposure analysis, and no analysis of injury severity, all of which made comparison of injury risk and injury severity difficult. Conclusion There is an urgent need for consensus on sports injury definition and methodology in disability sports. The quality of studies is variable, with inconsistent sports injury definitions, methodologies and injury rates, which prevents comparison, conclusions and development of injury prevention strategies. The authors highlight the most pressing issues for improvement of the quality in injury epidemiology research for disability sport.
- Authors: Weiler, Richard , van Mechelen, Willem , Fuller, Colin , Verhagen, Evert
- Date: 2016
- Type: Text , Journal article , Review
- Relation: Sports Medicine Vol. 46, no. 8 (2016), p. 1141-1153
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- Description: Background Fifteen percent of the world's population live with disability, and many of these individuals choose to play sport. There are barriers to sport participation for athletes with disability and sports injury can greatly impact on daily life, which makes sports injury prevention additionally important. Objective The purpose of this review is to systematically review the definitions, methodologies and injury rates in disability sport, which should assist future identification of risk factors and development of injury prevention strategies. A secondary aim is to highlight the most pressing issues for improvement of the quality of injury epidemiology research for disability sport. Methods A search of NICE, AMED, British Nursing Index, CINAHL, EMBASE and Medline was conducted to identify all publications up to 16 June 2015. Of 489 potentially relevant articles and reference searching, a total of 15 studies were included. Wide study sample heterogeneity prevented data pooling and meta-analysis. Results Results demonstrated an evolving field of epidemiology, but with wide differences in sports injury definition and with studies focused on short competitions. Background data were generally sparse; there was minimal exposure analysis, and no analysis of injury severity, all of which made comparison of injury risk and injury severity difficult. Conclusion There is an urgent need for consensus on sports injury definition and methodology in disability sports. The quality of studies is variable, with inconsistent sports injury definitions, methodologies and injury rates, which prevents comparison, conclusions and development of injury prevention strategies. The authors highlight the most pressing issues for improvement of the quality in injury epidemiology research for disability sport.
Seasonal time-loss match injury rates and burden in South African under-16 rugby teams
- Sewry, Nicola, Verhagen, Evert, Lambert, Mike, van Mechelen, Willem, Readhead, Clint, Viljoen, Wayne, Brown, James
- Authors: Sewry, Nicola , Verhagen, Evert , Lambert, Mike , van Mechelen, Willem , Readhead, Clint , Viljoen, Wayne , Brown, James
- Date: 2019
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 22, no. 1 (2019), p. 54-58
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- Description: Objectives: Youth rugby union is a popular sport with a high injury incidence density (IID) and burden. This high risk has called for further research into the factors affecting the injuries in youth rugby. The aim of the study was to analyse time-loss IID and burden in multiple schoolboy rugby teams over a season and the potential factors associated with injury. Design: Prospective cohort Methods: All time-loss injuries were recorded from three schools for the whole season. Overall IID and injury burden were calculated, as well as for injury event, type, location and the match quarter in which they occurred and Poisson regression analyses were performed to determine differences. Results: IID was 28.8 (18.9–38.6) injuries per 1000 player hours over the season, with an injury burden of 379.2 (343.6–414.9) days lost per 1000 player hours. The ball-carrier had a significantly higher IID (11.3 (5.2–17.5) per 1000 player hours) compared to other events, and the joint (non-bone)/ligament injuries were the most common (IID of 12.2 (5.8–18.6) per 1000 player hours) and severe type of injury (burden of 172.6 (148.5–196.6) days lost per 1000 player hours). Conclusions: The IID was similar to previous youth rugby studies, however the injury burden was much lower. The South African youth cohort showed similar factors associated with injury for inciting event (the tackle) and injury type (joint (non-bone)/ligament) and location (lower limb) as seen in other studies in both youth and senior players.
- Authors: Sewry, Nicola , Verhagen, Evert , Lambert, Mike , van Mechelen, Willem , Readhead, Clint , Viljoen, Wayne , Brown, James
- Date: 2019
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 22, no. 1 (2019), p. 54-58
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- Description: Objectives: Youth rugby union is a popular sport with a high injury incidence density (IID) and burden. This high risk has called for further research into the factors affecting the injuries in youth rugby. The aim of the study was to analyse time-loss IID and burden in multiple schoolboy rugby teams over a season and the potential factors associated with injury. Design: Prospective cohort Methods: All time-loss injuries were recorded from three schools for the whole season. Overall IID and injury burden were calculated, as well as for injury event, type, location and the match quarter in which they occurred and Poisson regression analyses were performed to determine differences. Results: IID was 28.8 (18.9–38.6) injuries per 1000 player hours over the season, with an injury burden of 379.2 (343.6–414.9) days lost per 1000 player hours. The ball-carrier had a significantly higher IID (11.3 (5.2–17.5) per 1000 player hours) compared to other events, and the joint (non-bone)/ligament injuries were the most common (IID of 12.2 (5.8–18.6) per 1000 player hours) and severe type of injury (burden of 172.6 (148.5–196.6) days lost per 1000 player hours). Conclusions: The IID was similar to previous youth rugby studies, however the injury burden was much lower. The South African youth cohort showed similar factors associated with injury for inciting event (the tackle) and injury type (joint (non-bone)/ligament) and location (lower limb) as seen in other studies in both youth and senior players.
Do neurocognitive SCAT3 baseline test scores differ between footballers (soccer) living with and without diability? A cross-sectional study
- Weiler, Richard, van Mechelen, Willem, Fuller, Colin, Ahmed, Osman, Verhagen, Evert
- Authors: Weiler, Richard , van Mechelen, Willem , Fuller, Colin , Ahmed, Osman , Verhagen, Evert
- Date: 2018
- Type: Text , Journal article
- Relation: Clinical Journal of Sport Medicine Vol. 28, no. 1 (2018), p. 43-50
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- Description: OBJECTIVE:: To determine if baseline Sport Concussion Assessment Tool, third Edition (SCAT3) scores differ between athletes with and without disability. DESIGN:: Cross-sectional comparison of preseason baseline SCAT3 scores for a range of England international footballers. SETTING:: Team doctors and physiotherapists supporting England football teams recorded playersʼ SCAT 3 baseline tests from August 1, 2013 to July 31, 2014. PARTICIPANTS:: A convenience sample of 249 England footballers, of whom 185 were players without disability (male: 119; female: 66) and 64 were players with disability (male learning disability: 17; male cerebral palsy: 28; male blind: 10; female deaf: 9). ASSESSMENT AND OUTCOME MEASURES:: Between-group comparisons of median SCAT3 total and section scores were made using nonparametric Mann–Whitney–Wilcoxon ranked-sum test. MAIN RESULTS:: All footballers with disability scored higher symptom severity scores compared with male players without disability. Male footballers with learning disability demonstrated no significant difference in the total number of symptoms, but recorded significantly lower scores on immediate memory and delayed recall compared with male players without disability. Male blind footballersʼ scored significantly higher for total concentration and delayed recall, and male footballers with cerebral palsy scored significantly higher on balance testing and immediate memory, when compared with male players without disability. Female footballers with deafness scored significantly higher for total concentration and balance testing than female footballers without disability. CONCLUSIONS:: This study suggests that significant differences exist between SCAT3 baseline section scores for footballers with and without disability. Concussion consensus guidelines should recognize these differences and produce guidelines that are specific for the growing number of athletes living with disability.
- Authors: Weiler, Richard , van Mechelen, Willem , Fuller, Colin , Ahmed, Osman , Verhagen, Evert
- Date: 2018
- Type: Text , Journal article
- Relation: Clinical Journal of Sport Medicine Vol. 28, no. 1 (2018), p. 43-50
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- Description: OBJECTIVE:: To determine if baseline Sport Concussion Assessment Tool, third Edition (SCAT3) scores differ between athletes with and without disability. DESIGN:: Cross-sectional comparison of preseason baseline SCAT3 scores for a range of England international footballers. SETTING:: Team doctors and physiotherapists supporting England football teams recorded playersʼ SCAT 3 baseline tests from August 1, 2013 to July 31, 2014. PARTICIPANTS:: A convenience sample of 249 England footballers, of whom 185 were players without disability (male: 119; female: 66) and 64 were players with disability (male learning disability: 17; male cerebral palsy: 28; male blind: 10; female deaf: 9). ASSESSMENT AND OUTCOME MEASURES:: Between-group comparisons of median SCAT3 total and section scores were made using nonparametric Mann–Whitney–Wilcoxon ranked-sum test. MAIN RESULTS:: All footballers with disability scored higher symptom severity scores compared with male players without disability. Male footballers with learning disability demonstrated no significant difference in the total number of symptoms, but recorded significantly lower scores on immediate memory and delayed recall compared with male players without disability. Male blind footballersʼ scored significantly higher for total concentration and delayed recall, and male footballers with cerebral palsy scored significantly higher on balance testing and immediate memory, when compared with male players without disability. Female footballers with deafness scored significantly higher for total concentration and balance testing than female footballers without disability. CONCLUSIONS:: This study suggests that significant differences exist between SCAT3 baseline section scores for footballers with and without disability. Concussion consensus guidelines should recognize these differences and produce guidelines that are specific for the growing number of athletes living with disability.
- Nauta, Joske, Martin-Diener, Eva, Martin, Brian, van Mechelen, Willem, Verhagen, Evert
- 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.
- Verhagen, Evert, Huuperans, Maarten, Finch, Caroline, van Mechelen, Willem
- 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.
- Rossler, Roland, Donath, Lars, Verhagen, Evert, Junge, Astrid, Schweizer, Thomas, Faude, Oliver
- 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.
- Badenhorst, Marelise, Verhagen, Evert, Lambert, Michael, van Mechelen, Willem, Brown, James
- Authors: Badenhorst, Marelise , Verhagen, Evert , Lambert, Michael , van Mechelen, Willem , Brown, James
- Date: 2019
- Type: Text , Journal article
- Relation: Injury Prevention Vol. 25, no. 4 (2019), p. 313-320
- Full Text: false
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- Description: Background Though rare, rugby union carries a risk for serious injuries such as acute spinal cord injuries (ASCI), which may result in permanent disability. Various studies have investigated injury mechanisms, prevention programmes and immediate medical management of these injuries. However, relatively scant attention has been placed on the player's experience of such an injury and the importance of context. Aim The aim of this study was to explore the injury experience and its related context, as perceived by the catastrophically injured player. Methods A qualitative approach was followed to explore the immediate, postevent injury experience. Semi-structured interviews were conducted with 48 (n=48) players who had sustained a rugby-related ASCI. Results Four themes were derived from the data. Participants described the context around the injury incident, which may be valuable to help understand the mechanism of injury and potentially minimise risk. Participants also described certain contributing factors to their injury, which included descriptions of foul play and aggression, unaccustomed playing positions, pressure to perform and unpreparedness. The physical experience included signs and symptoms of ASCI that is important to recognise by first aiders, fellow teammates, coaches and referees. Lastly, participants described the emotional experience which has implications for all ASCI first responders. Significance All rugby stakeholders, including players, first responders, coaches and referees, may gain valuable information from the experiences of players who have sustained these injuries. This information is also relevant for rugby safety initiatives in shaping education and awareness interventions.
Is risk-taking in talented junior tennis players related to overuse injuries?
- Van der Sluis, Alien, Brink, Michel, Pluim, Babette, Verhagen, Evert, Elferink-Gemser, Marije, Visscher, Chris
- Authors: Van der Sluis, Alien , Brink, Michel , Pluim, Babette , Verhagen, Evert , Elferink-Gemser, Marije , Visscher, Chris
- Date: 2017
- Type: Text , Journal article
- Relation: Scandinavian Journal of Medicine & Science in Sports Vol. 27, no. 11 (2017), p. 1347-1355
- Full Text: false
- Reviewed:
- Description: Overuse injuries are a serious problem in junior tennis. Gaining insight in age-specific risk factors can contribute to prevention. The developmental cognitive processes that take place during adolescence make talented players more inclined to take risks. This may be even more pronounced in the high performance culture in which they move. Therefore, this study focuses on the relationship between risk-taking and overuse injuries in talented tennis players. Seventy-three talented tennis players (45 boys and 28 girls, age 11-14years) were monitored for 32weeks, using the Oslo Sports Trauma Research Centre Questionnaire on Health Problems. Risk-taking was measured at the start of the season with the Iowa Gambling Task. Linear regression analyses were executed to predict (a) overuse injuries, (b) time loss overuse injuries and (c) overuse severity, by risk-taking, exposure time, and injury history. In boys, risk-taking contributed significantly to time loss overuse injuries [F(1,39) = 7.764, P = 0.008, R-2 = 0.15] and to overuse severity [F(1,39) = 5.683, P = 0.022, with an R-2 of 0.13] In girls, time loss overuse injuries [F(1,23) = 6.889, P = 0.018, R-2 = 0.20] and overuse severity [F(1,23) = 7.287, P = 0.013, R-2 = 0.24] were predicted by exposure time. Coaches and trainers should be aware that talented male tennis players who are inclined to take risks, are more likely to maintain risky behavioral patterns related to overuse injuries.
- Janssen, Kasper, Van Der Zwaard, Babette, Finch, Caroline, van Mechelen, Willem, Verhagen, Evert
- 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
- Full Text: false
- Reviewed:
- 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.
- van Reijen, Miriam, Vriend, Ingrid, van Mechelen, Willem, Verhagen, Evert
- Authors: van Reijen, Miriam , Vriend, Ingrid , van Mechelen, Willem , Verhagen, Evert
- Date: 2018
- Type: Text , Journal article
- Relation: Scandinavian Journal of Medicine & Science in Sports Vol. 28, no. 2 (2018), p. 641-648
- Full Text: false
- Reviewed:
- Description: Recurrent ankle sprains can be reduced by following a neuromuscular training (NMT) program via a printed Booklet or a mobile application. Regarding the high incidence of ankle sprains, cost-effectiveness regarding implementation can have a large effect on total societal costs. In this economic analysis, we evaluated whether the method of implementing a proven effective NMT program using an App or a Booklet resulted in differences in injury incidence rates leading to costs and hence to differences in cost-effectiveness. In total, 220 athletes with a previous ankle sprain were recruited for this randomized controlled trial with a follow-up of 12 months. Half of the athletes used the freely available “Strengthen your ankle” App and the other half received a printed Booklet. After the 8-week program, athletes were questioned monthly on their recurrent injuries. Primary outcome measures were incidence density of ankle injury and incremental cost-effectiveness ratio (ICER). During follow-up, 31 athletes suffered from a recurrent ankle sprain that led to costs resulting in a hazard ratio of 1.13 (95% CI: 0.56-2.27). The incremental cost-effectiveness ratio of the App group in comparison with the Booklet group was €361.52. The CE plane shows that there was neither a difference in effects nor in costs between both intervention methods. This study showed that the method of implementing the NMT program using an App or a Booklet led to similar cost-effectiveness ratios and the same occurrence of recurrent injuries leading to costs. Both the App and the Booklet can be used to prevent recurrent ankle injuries, showing no differences in (cost-) effectiveness at 12-month follow-up.