'In a blink of an eye your life can change ' : Experiences of players sustaining a rugby-related acute spinal cord injury
- 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
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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.
Seasonal time-loss match injury rates and burden in South African under-16 rugby teams
- 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.
Self-regulatory skills : Are they helpful in the prevention of overuse injuries in talented tennis players?
- Authors: Van der Sluis, Alien , Brink, Michel , Pluim, Babette , Verhagen, Evert , Elferink-Gemser, Marije , Visscher, Chris
- Date: 2019
- Type: Text , Journal article
- Relation: Scandinavian Journal of Medicine and Science in Sports Vol. 29, no. 7 (2019), p. 1050-1058
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- Description: Talented athletes use metacognitive skills to improve their performance. Also, it is known that these skills are important for managing one's health. The goal of this study was to identify the relationship between metacognitive skills and overuse injuries in talented tennis players. Metacognitive skills were measured in 73 talented tennis players (45 boys and 28 girls, age 11-14) at the start of the season, using the Self-Regulation of Learning Self-Report Scale. Overuse injuries were monitored for one season using the Oslo Sports Trauma Research Centre Questionnaire on Health Problems. Ordinal regression indicated that moderate or low selfmonitoring skills (compared to high selfmonitoring) (OR 4.555, CI 1.096-18.927, P = 0.037) and exposure time (OR 1.380, CI 1.106-1.721, P = 0.004) were associated with more time loss overuse injuries. A second analysis showed that this was the case in girls (OR 10.757, CI 1.845-62.714, P = 0.008), but not in boys. Linear regression revealed that higher reflection scores and exposure time predicted overuse severity (F(5,58) = 2.921, P = 0.020, R2 = 0.201). Possibly, selfmonitoring can help players to prevent themselves from time loss overuse injuries. Coaches should be aware that players can differ in selfmonitoring ability and thus in the ability to prevent overuse injuries. The role of reflection needs more research.
Validity of injury self-reports by novice runners : Comparison with reports by sports medicine physicians
- Authors: Smits, Dirk-Wouter , Backx, Frank , van der Worp, Henk , van Middelkoop, Marienke , Hartgens, Fred , Verhagen, Evert , Kluitenberg, Bas , Huisstede, Bionka
- Date: 2019
- Type: Text , Journal article
- Relation: Research in Sports Medicine Vol. 27, no. 1 (2019), p. 72-87
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- Description: This study examined the criterion validity of self-reported running-related injuries (RRI) by novice runners. Fifty-eight participants (41 females; age 46 ± 11 yrs) of the “Start-to-Run” program provided self-reports on their RRIs using an online questionnaire. Subsequently, they attended injury consultations with sports medicine physicians who provided physician-reports (blinded for the self-reports) as a reference standard. Self-reports and physician-reports included information on injury location (i.e., hip/groin, upper leg, knee, lower leg, and ankle/foot) and injury type (i.e., muscle-tendon unit, joint, ligament, or bone). Sensitivity, specificity, and positive predictive values were 100% for all five injury locations. For injury type, sensitivity was low (66% for muscle-tendon unit, 50% for ligament, and 40% for bone) and lowest for joint injuries (17%). In conclusion, the validity of self-reported RRIs by novice runners is good for injury locations but not for injury types. In particular for joint injuries, the validity of novice runners’ self-reports is low. Abbreviations: RRI: Running Related Injury; SMC: Sports Medicine Centre; MTU: Muscle Tendon Unit; PPV: Positive Predictive Value.
When this happens, you want the best care : Players' experiences of barriers and facilitators of the immediate management of rugby-related acute spinal cord injury
- Authors: Badenhorst, Marelise , Verhagen, Evert , Lambert, Mike , van Mechelen, Willem , Brown, James
- Date: 2019
- Type: Text , Journal article
- Relation: Qualitative Health Research Vol. 29, no. 13 (2019), p. 1862-1876
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- Description: Most contact sports, including rugby union, carry a risk of injury. Although acute spinal cord injuries (ASCIs) in rugby are rare, the consequences of such injuries are far-reaching. Optimal management of these injuries is challenging, and a detailed understanding of the different barriers and facilitators to optimal care is needed. In this study, we aimed to describe the perception of players, regarding factors related to the optimal immediate management of a catastrophic injury in a developing country with socioeconomic and health care inequities. The most frequently reported barriers were transportation delays after injury and admission to appropriate medical facilities. Other barriers included inadequate equipment, the quality of first aid care, and barriers within the acute hospital setting. Barriers were more prevalent in rural and lower socioeconomic areas. These findings are relevant for all rugby stakeholders and may help shape education, awareness, and future policy around the immediate management of ASCIs.
A 12-month prospective cohort study of symptoms of common mental disorders among professional rugby players
- 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.
Do neurocognitive SCAT3 baseline test scores differ between footballers (soccer) living with and without diability? A cross-sectional study
- 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.
Effectiveness of a nationwide intervention to increase helmet use in Dutch skiers and snowboarders : An observational cohort study
- Authors: Vriend, Ingrid , Hesselink, Arlette , Kemler, Ellen , Gouttebarge, Vincent , van Mechelen, Willem , Verhagen, Evert
- Date: 2018
- Type: Text , Journal article
- Relation: Injury Prevention Vol. 24, no. 3 (2018), p. 205-212
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- Description: Objective Helmet use in Dutch recreational skiers and snowboarders (DRSS) remains low. This study evaluated the effects of exposure to a nationwide intervention on relevant determinants of helmet use and helmet use in DRSS. Methods The intervention mapping protocol was used to develop an in-season intervention programme targeted at adult DRSS. A prospective single-cohort study was conducted to evaluate the impact of intervention exposure on determinants of helmet use (ie, knowledge about head injury risk and preventive measures, risk perception, attitudes to head injury risk and helmet use and intention to helmet use) and self-reported helmet use. A random sample of 363 DRSS from an existing panel participated in this study. Data were collected using online questionnaires before and immediately after the 2010/2011 intervention season. In a separate sample of 363 DRSS, intervention reach was assessed after the 2010/2011 season. Results Overall, no significant associations were found between intervention exposure and the determinants of helmet use. However, subgroup analyses revealed intervention effects on risk perception and knowledge in specific subpopulations. Intervention exposure had a significant, positive effect on helmet use in DRSS (β=0.23; 95% CI 0.017 to 0.44). Subgroup analyses revealed that this effect was found in: (1) skiers, (2) female DRSS, (3) young skiers and (4) intermediate skiers. Overall, intervention reach was 28.1%, with differences found between skiers and snowboarders. Conclusions Exposure to a nationwide intervention programme was associated with increased selfreported helmet use in DRSS. Differences were found in intervention effectiveness and reach between subpopulations. These differences must be taken into account when developing and evaluating future interventions.
Effectiveness of online tailored advice to prevent running-related injuries and promote preventive behaviour in Dutch trail runners : A pragmatic randomised controlled trial
- Authors: Hespanhol, Luiz , van Mechelen, Willem , Verhagen, Evert
- Date: 2018
- Type: Text , Journal article
- Relation: British journal of sports medicine Vol. 52, no. 13 (2018), p. 851-858
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- Description: BACKGROUND: Trail running is popular worldwide, but there is no preventive intervention for running-related injury (RRI). AIM: To evaluate the effectiveness of adding online tailored advice (TrailS6 ) to general advice on (1) the prevention of RRIs and (2) the determinants and actual preventive behaviour in Dutch trail runners. METHODS: Two-arm randomised controlled trial over 6 months. 232 trail runners were randomly assigned to an intervention or control group. All participants received online general advice on RRI prevention 1 week after baseline. Every 2 weeks, participants in the intervention group received specific advice tailored to their RRI status. The control group received no further intervention. Bayesian mixed models were used to analyse the data. RESULTS: Trail runners in the intervention group sustained 13% fewer RRIs compared with those in the control group after 6 months of follow-up (absolute risk difference -13.1%, 95% Bayesian highest posterior credible interval (95% BCI) -23.3 to -3.1). A preventive benefit was observed in one out of eight trail runners who had received the online tailored advice for 6 months (number needed to treat 8, 95% BCI 3 to 22). No significant between-group difference was observed on the determinants and actual preventive behaviours. CONCLUSIONS: Online tailored advice prevented RRIs among Dutch trail runners. Therefore, online tailored advice may be used as a preventive component in multicomponent RRI prevention programmes. No effect was observed on determinants and actual preventive behaviours. TRIAL REGISTRATION NUMBER: The Netherlands National Trial Register (NTR5431).
Injuries in field hockey players : A systematic review
- Authors: Barboza, Saulo , Joseph, Corey , Nauta, Joske , van Mechelen, Willem , Verhagen, Evert
- Date: 2018
- Type: Text , Journal article , Review
- Relation: Sports Medicine Vol. 48, no. 4 (2018), p. 849-866
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- Description: Background: To commence injury prevention efforts, it is necessary to understand the magnitude of the injury problem. No systematic reviews have yet investigated the extent of injuries in field hockey, despite the popularity of the sport worldwide. Objective: Our objective was to describe the rate and severity of injuries in field hockey and investigate their characteristics. Methods: We conducted electronic searches in PubMed, Embase, SPORTDiscus, and CINAHL. Prospective cohort studies were included if they were published in English in a peer-reviewed journal and observed all possible injuries sustained by field hockey players during the period of the study. Results: The risk of bias score of the 22 studies included ranged from three to nine of a possible ten. In total, 12 studies (55%) reported injuries normalized by field hockey exposure. Injury rates ranged from 0.1 injuries (in school-aged players) to 90.9 injuries (in Africa Cup of Nations) per 1000 player-hours and from one injury (in high-school women) to 70 injuries (in under-21 age women) per 1000 player-sessions. Studies used different classifications for injury severity, but—within studies—injuries were included mostly in the less severe category. The lower limbs were most affected, and contusions/hematomas and abrasions were common types of injury. Contact injuries are common, but non-contact injuries are also a cause for concern. Conclusions: Considerable heterogeneity meant it was not possible to draw conclusive findings on the extent of the rate and severity of injuries. Establishing the extent of sports injury is considered the first step towards prevention, so there is a need for a consensus on injury surveillance in field hockey. © 2018, The Author(s).
No association between rate of torque development and onset of muscle activity with increased risk of hamstring injury in elite football
- Authors: van Dyk, Nicol , Bahr, Roald , Burnett, Angus , Verhagen, Evert , Von Tiggelen, D. , Witvrouw, Erik
- Date: 2018
- Type: Text , Journal article
- Relation: Scandinavian Journal of Medicine and Science in Sports Vol. 28, no. 10 (2018), p. 2153-2163
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- Description: Hamstring injuries remain a significant burden in sports that involve high-speed running. In elite male football, hamstring injury has repeatedly been identified as the most common non-contact injury, representing 12% of all injuries. As the incidence remains high, investigations are aimed at better understanding how to improve prevention efforts. Intrinsic risk factors such as strength have been investigated extensively in a cohort of professional football players; however, other intrinsic measures of neuromuscular function have not been studied in this cohort. This study aims to investigate the association between timing of hamstring muscle activity onset and the rate of torque development during the early phase of isokinetic strength testing with risk of hamstring injury in professional football players in a prospective cohort study. All teams (n = 18) eligible to compete in the premier football league in Qatar underwent a comprehensive strength assessment during their annual periodic health evaluation at Aspetar Orthopaedic and Sports Medicine Hospital in Doha, Qatar. Variables included rate of torque development and timing of muscle activity onset. A total of 367 unique players (60.6% of all QSL players) competed for 514 player seasons (103 players competed both seasons) and sustained 65 hamstring injuries. There was no difference in the onset of muscle activity between the biceps femoris and medial hamstrings comparing the injured to uninjured players. For both onset of muscle activity and rate of torque development, there were no significant differences between any of the variables (P >.05), with small effect sizes detected across all the different variables (d < 0.3). Rate of torque development and onset of muscle activity were not associated with a risk of future hamstring injury. The use of these measures as part of a periodic health evaluation to identify risk of hamstring injury is unsupported.
Preventing recurrent ankle sprains : Is the use of an App more cost-effective than a printed Booklet? Results of a RCT
- 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
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- 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.
Quality of life among individuals with rugby-related spinal cord injuries in South Africa : A descriptive cross-sectional study
- Authors: Badenhorst, Marelise , Brown, James , Lambert, Mike , van Mechelen, Willem , Verhagen, Evert
- Date: 2018
- Type: Text , Journal article
- Relation: BMJ Open Vol. 8, no. 6 (2018), p. 1-12
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- Description: Objectives Rugby-related spinal cord injuries (SCIs) are rare but life altering and traumatic events. Little is known about the long-term consequences and outcomes of players who have sustained these injuries. This study investigated current quality of life (QoL) and factors associated with QoL, among individuals with rugby-related SCI in South Africa, by using the International Classification of Functioning, Disability and Health (ICF) framework. Design Descriptive cross-sectional study. Setting Rugby-related SCI population of South Africa, as captured in the BokSmart/Chris Burger Petro Jackson Players' Fund database. Participants Ninety (n=90) of the 102 eligible players on the database agreed to participate in the study. Main outcome measure The relationship between QoL, as measured with the WHO Quality of Life questionnaire (WHOQOL-BREF) and specific independent variables (demographic information, level of independence and participation in various activities and life roles) was investigated. Variables that were significantly associated with QoL in bivariate analyses were included in multiple linear regression analyses. Results The mean score and SD of the WHOQOL-BREF was 15.1±2.3 arbitrary units. Participation (an ICF framework construct) and income were significantly associated with overall QoL (p<0.001). Participation was the only variable significantly associated with all QoL subdomains (p<0.001). Additionally, number of health concerns, type of healthcare (public vs private) and level of education were significantly associated with various QoL domains (p<0.001). Conclusions On average, these individuals with rugby-related SCI presented with higher QoL scores than other comparable SCI studies. However, lower levels of participation and income, certain levels of education, increased health concerns and use of public healthcare were associated with lower levels of QoL. Sporting bodies have a responsibility to optimise player welfare, by acting on the modifiable factors associated with QoL.
Systematic development of a tennis injury prevention programme
- 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.
Trends in time-loss injuries during the 2011-2016 South African rugby youth weeks
- Authors: Sewry, Nicola , Verhagen, Evert , Lamvert, Michael , van Mechelen, Willem , Marsh, J. , Readhead, Clint , Viljoen, Wayne , Brown, James
- Date: 2018
- Type: Text , Journal article
- Relation: Scandinavian Journal of Medicine & Science in Sports Vol. 28, no. 9 (2018), p. 2066-2073
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- Description: Youth rugby is a popular sport in South Africa (SA) with a high injury incidence. The annual SA Rugby Youth Week tournaments attract the top age-group players in the country providing a sample of players for reliable injury surveillance. The aim of the study was to analyze the changes in time-loss injury rates at the SA Rugby Youth Week tournaments between 2011 and 2016, differences between age-groups, and to investigate associated injury risk factors. All confirmed time-loss injuries at the 4 age-group tournaments (under-13, under-16, and 2 under-18) from 2011 to 2016 were recorded. Injury incidence densities (IID) for years, tournaments, and injury risk factors were calculated and Poisson regression analyses were performed to determine differences. Time-loss injuries (n = 494) were reported over 24 240 exposure hours, with an overall IID of 20.4 (18.6-22.2) injuries per 1000 player hours. The year 2013 had a significantly lower IID compared to 2011. Injury risk decreased with increasing age; under-13 and under-16 had significantly higher IID compared to under-18 Craven Week. Tackling was the phase of play at highest risk, with an IID of 7.4 (6.3-8.5) injuries per 1000 player hours. Central/peripheral nervous system (CNS/PNS) and, therefore, the head/neck were the most commonly occurring injuries/location injured. In conclusion, within the SA Rugby tournament structure, the older players had a decreased rate of injury. The tackle event was still the phase of play with the highest injury incidence regardless of age. This increase in incidence is largely due to an increase in CNS/PNS injuries.
Using principles of motor learning to enhance ACL injury prevention programs
- Authors: Gokeler, Alli , Benjaminse, Anne , Seil, Romain , Kerkhoffs, Gino , Verhagen, Evert
- Date: 2018
- Type: Text , Journal article , Review
- Relation: Sports Orthopaedics and Traumatology Vol. 34, no. 1 (2018), p. 23-30
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- Description: Findings from efficacy studies have shown decreased in ACL injury rates in (predominantly female) athletes participating in prevention programs. Given the inherent higher ACL injury risk for females, the majority of intervention studies, have focused on female athletes. Subsequently, the content of exercises in ACL prevention programs is directed to target the modifiable ACL injury risk factors for female athletes. The literature is generally scarce regarding the efficacy of prevention programs to reduce ACL injuries in male athletes. In general, reduction of ACL injury rates seem to be limited to (young) female athletes and male athletes playing at low level of sports. Typically, ACL injury prevention programs entail a combination of plyometrics, strength training, agility and balance exercises. A problem is that improvements of movement patterns are not sustained over time. The reason may be related to the type of instructions given during training. Encouraging athletes to consciously control knee movements during exercises may not be optimal for the acquisition of complex motor skills. In the motor learning domain, these type of instructions are defined as an internal attentional focus. An internal focus, on one's own movements results in a more conscious type of control that may hamper motor learning. It has been established in numerous studies that an external focus of attention facilitates motor learning more effectively due to the utilization of automatic motor control. Subsequently, the athlete has more recourses available to anticipate on situations on the field and take appropriate feed forward directed actions. The purpose of this manuscript was to present methods to optimize motor skill acquisition of athletes and elaborate on athletes’ behavior.
We dare to ask new questions. Are we also brave enough to change our approaches?
- Authors: Verhagen, Evert , Bolling, Caroline
- Date: 2018
- Type: Text , Journal article
- Relation: Translational sports medicine Vol. 1, no. 1 (2018), p. 54-55
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- Description: Over the past decades research within the field of sports medicine has yielded a large amount of evidence of the prevention and treatment of athletic injuries. Despite the availability of high quality evidence, compliance to interventions that protect athletes’ health is low. Consequently, evidence‐based programs are not achieving their optimal effect in real‐life athletic situations. Implementation and knowledge translation are the contemporary incantations to resolve this apparent gap between science and practice. This has provided us novel research questions and challenges that follow on efficacious outcomes. Most of these questions are not answered through quantifiable outcomes measures as they revolve around user behaviors. This editorial argues that if we want to know why athletes and coaches behave as they do, and what barriers there may be to changing their behavior, qualitative research can be used to give athletes and coaches a voice.
Working towards more effective implementation, dissemination and scale-up of lower-limb injury-prevention programs : Insights from community Australian football coaches
- Authors: McGlashan, Angela , Verrinder, Glenda , Verhagen, Evert
- Date: 2018
- Type: Text , Journal article
- Relation: International Journal of Environmental Research and Public Health Vol. 15, no. 2 (2018), p. 1-23
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- Description: Disseminating lower-limb injury-prevention exercise programs (LL-IPEPs) with strategies that effectively reach coaches across sporting environments is a way of preventing lower-limb injuries (LLIs) and ensuring safe and sustainable sport participation. The aim of this study was to explore community-Australian Football (community-AF) coaches’ perspectives on the strategies they believed would enhance the dissemination and scale-up of LL-IPEPs. Using a qualitative multiple case study design, semi-structured interviews with community-AF coaches in Victoria, Australia, were conducted. Overall, coaches believed a range of strategies were important including: coach education, policy drivers, overcoming potential problem areas, a ‘try before you buy approach’, presenting empirical evidence and guidelines for injury-prevention exercise programs (IPEPs), forming strategic collaboration and working in partnership, communication and social marketing, public meetings, development of a coach hotline, and targeted multi-focused approaches. A shift to a culture whereby evidence-based IPEP practices in community-AF will take time, and persistent commitment by all involved in the sport is important. This will support the creation of strategies that will enhance the dissemination and scale-up of LL-IPEPs across community sport environments. The focus of research needs to continue to identify effective, holistic and multi-level interventions to support coaches in preventing LLIs. This could lead to the determination of successful strategies such as behavioural regulation strategies and emotional coping resources to implement LL-IPEPs into didactic curricula and practice. Producing changes in practice will require attention to which strategies are a priority and the most effective. © 2018 by the authors. Licensee MDPI, Basel, Switzerland.
A 12-month prospective cohort study of symptoms of common mental disorders among European professional footballers
- Authors: Gouttebarge, Vincent , Aoki, Haruhito , Verhagen, Evert , Kerkhoffs, Gino
- Date: 2017
- Type: Text , Journal article
- Relation: Clinical Journal of Sport Medicine Vol. 27, no. 5 (2017), p. 487-492
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- Description: Objective: To determine the 12-month incidence and comorbidity of symptoms of common mental disorders (CMD) among European professional footballers and to explore the association of potential stressors with the health conditions under study among those European professional footballers. Design: Observational prospective cohort study with a follow-up period of 12 months. Participants: Male professional footballers from 5 European countries (n = 384 at baseline). Assessment of Risk Factors: Adverse life events, conflicts with trainer/coach, and career dissatisfaction were explored by using validated questionnaires. Main Outcome Measures: Symptoms of distress, anxiety/depression, sleep disturbance, and adverse alcohol use were assessed using validated questionnaires. Results: A total of 384 players (mean age of 27 years old; mean career duration of 8 years) were enrolled, of which 262 completed the follow-up period. The incidence of symptoms of CMD were 12% for distress, 37% for anxiety/depression, 19% for sleep disturbance, and 14% for adverse alcohol use. Over the follow-up period of 12 months, approximately 13% of the participants reported 2 symptoms, 5% three symptoms, and 3% four symptoms. Professional footballers reporting recent adverse life events, a conflict with trainer/coach, or career dissatisfaction were more likely to report symptoms of CMD, but statistically significant associations were not found. Conclusions: The 12-month incidence of symptoms of CMD among European professional footballers ranged from 12% for symptoms of distress to 37% for symptoms of anxiety/depression. A professional football team typically drawn from a squad of 25 players can expect symptoms of CMD to occur among at least 3 players in one season.
A prospective cohort study on symptoms of common mental disorders among Dutch elite athletes
- 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.