Concussion guidelines need to move from only expert content to also include implementation and dissemination strategies
- Authors: Finch, Caroline , McCrory, Paul , Ewing, Michael , Sullivan, John
- Date: 2013
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 47, no. 1 (2013), p. 12-14
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text: false
- Reviewed:
- Description: Sport-related head injuries place a significant burden on the health service delivery systems needed to treat and assess them; the sport delivery systems responsible for providing safe sporting opportunities; and personally on the individuals who sustain them. The number of head injury occurrences, the anecdotally high levels of public concern about the risk of head injury in sport and the fact that there is so much public misinformation about their assessment, management and prevention make the prevention of sport-related head injury a health priority. The most recent international consensus statement on the management of concussion in sport stated that there is a need to develop guidelines, education resources and other health promotion approaches for the prevention of head injury and its adverse outcomes across all sports with a risk of serious head injury.4 However, while there is evidence that some educational resources and guidelines have been developed, these have had varying success because they have not incorporated social marketing approaches.
Crash characteristics of helmeted motorcyclists
- Authors: Mclntosh, Andrew , Pang, Toh Yen , Thai, Kim , Schilter, Edgar , Rechnitzer, George , Finch, Caroline , McCrory, Paul
- Date: 2010
- Type: Text , Conference paper
- Relation: Proceeding of the Australasian Road Safety Research, Policing and Education Conference
- Full Text: false
- Reviewed:
- Description: The preliminary results of a prospective study ofmotorcycle crashes are reported. Motorcyclists were recruited from three major trauma centres in Sydney and through motorcycle organisations. The main sample criteria were that the cyclist crashed, and that they hit their head while wearing a helmet. Injury andnon-injury cases were collected. Case sampling occurred over a period of l8 months. The response rate through hospitals was approximately l4Yo for those meeting the selection criteria. All motorcyclists were interviewed and the helmets were examined. Characteristics such as environment (road type), vehicle (vehicle damage and interaction) and human factors were recorded. The location of helmet impacts and patterns of helmet damage were recorded. Injuries were documented and rated according to severity. The relationships between the crash characteristics, helmet use and injury will be presented.
Crash characteristics of helmeted pedal cyclists
- Authors: Mclntosh, Andrew , Pang, Toh Yen , Thai, Kim , Schilter, Edgar , Rechnitzer, George , Finch, Caroline , McCrory, Paul
- Date: 2010
- Type: Text , Conference paper
- Relation: Proceeding of the Australasian Road Safety Research, Policing and Education Conference
- Full Text: false
- Reviewed:
- Description: The results of a prospective study of pedal cycle crashes are reported. Cyclists were recruited from three major trauma centres in Sydney and through cycle organisations. The main sample criteria were that the cyclist crashed, and that they hit their head while wearing a helmet. Injury and non-injury cases were collected. Case sampling occurred over a period of 18 months. The response rate through hospitals was approximately 14% for those meeting the selection criteria. All cyclists were interviewed and the helmets were examined. Characteristics such as crash characteristics and injury are reported. The relationships between the crash characteristics, helmet use and injury are presented. The paper reports on 98 cases and excludes fatal cases. Half of the cyclists did not experience a head injury.
Does padded headgear prevent head injury in rugby union football?
- Authors: McIntosh, Andrew , McCrory, Paul , Finch, Caroline , Best, John , Chalmers, David , Wolfe, Rory
- Date: 2009
- Type: Text , Journal article
- Relation: Medicine and Science in Sports and Exercise Vol. 41, no. 2 (2009), p. 306-313
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text: false
- Reviewed:
- Description: BACKGROUND: Concussion is a serious problem in many contact sports, including rugby union football. The study's primary aim was to measure the efficacy of padded headgear in reducing the rates of head injury or concussion. METHODS: A cluster randomized controlled trial with three arms was conducted with rugby union football teams as the unit of randomization. Teams consisted of males participating in under 13-, 15-, 18-, and 20-yr age group competitions. The interventions were "standard" and "modified" padded headgear. Headgear wearing and injury were measured for each study team at each game over two seasons. RESULTS: Eighty-two teams participated in year 1 and 87 in year 2. A total of 1493 participants (10,040 player hours) were in the control group, 1128 participants (8170 player hours) were assigned to the standard headgear group, and 1474 participants (10,650 player hours) were assigned to the modified headgear group. The compliance rates were low in all groups, but 46% of participants wore standard headgear. An intention-to-treat analysis showed no differences in the rates of head injury or concussion between controls and headgear arms. Incidence rate ratios for standard headgear wearers referenced to controls were 0.95 and 1.02 for game and missed game injuries. Analyses of injury rates based on observed wearing patterns also showed no significant differences. Incidence rate ratios for standard headgear wearers referenced to nonwearers were 1.11 and 1.10 for game and missed game injuries. CONCLUSIONS: Padded headgear does not reduce the rate of head injury or concussion. The low compliance rates are a limitation. Although individuals may choose to wear padded headgear, the routine or mandatory use of protective headgear cannot be recommended. © 2009 by the American College of Sports Medicine.
- Description: 2003008190
Head, face and neck injury in youth rugby: Incidence and risk factors
- Authors: McIntosh, Andrew , McCrory, Paul , Finch, Caroline , Wolfe, Rory
- Date: 2010
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 44, no. 3 (2010), p. 188-193
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text: false
- Reviewed:
- Description: OBJECTIVES: In this study, the incidence of head, neck and facial injuries in youth rugby was determined, and the associated risk factors were assessed. DESIGN: Data were extracted from a cluster randomised controlled trial of headgear with the football teams as the unit of randomisation. No effect was observed for headgear use on injury rates, and the data were pooled. SETTING: General school and club-based community competitive youth rugby in the 2002 and 2003 seasons. PARTICIPANTS: Young male rugby union football players participating in under-13, under 15, under 18 and under 21 years competitions. Eighty-two teams participated in year 1 and 87 in year 2. MAIN OUTCOME MEASURES: Injury rates for all body regions combined, head, neck and face calculated for game and missed game injuries. RESULTS: 554 head, face and neck injuries were recorded within a total of 28 902 h of rugby game exposure. Level of play and player position were related to injury risk. Younger players had the lowest rates of injury; forwards, especially the front row had the highest rate of neck injury; and inside backs had the highest rate of injuries causing the player to miss a game. Contact events, including the scrum and tackle, were the main events leading to injury. CONCLUSION: Injury prevention must focus on the tackle and scrum elements of a youth rugby game.
Increasing incidence of hospitalisation for sport-related concussion in Victoria, Australia
- Authors: Finch, Caroline , Clapperton, Angela , McCrory, Paul
- Date: 2013
- Type: Text , Journal article
- Relation: Medical Journal of Australia Vol. 198, no. 8 (2013), p. 427-430
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text: false
- Reviewed:
- Description: Objective: To describe trends in hospitalisation for sport-related concussion. Design, setting and patients: Analysis of routinely collected hospital admissions data from all Victorian hospitals (public and private) over the 2002-03 to 2010-11 financial years for patients aged ≥15 years with a diagnosis of concussion and an ICD-10-AM external cause activity code indicating sport. Main outcome measures: Number and cost of hospitalisations; rate of hospitalisation per 100000 participants overall and for specific sports; and percentage change in frequency and hospitalisation rate per 100000 participants over 9 years. Results: There were 4745 hospitalisations of people aged ≥15 years for sport-related concussion, with a total hospital treatment cost of $17944799. The frequency of hospitalisation increased by 60.5% (95% CI, 41.7%-77.3%) over the 9 years, but could only partially be explained by increases in sports participation, as the rate per 100000 participants also increased significantly, by 38.9% (95% CI, 17.5%-61.7%). After adjustment for participation, rates were highest for motor sports, equestrian activities, Australian football, rugby and roller sports. The greatest significant increases in rates were seen in roller sports, rugby, soccer and cycling. Conclusions: The frequency and participation-adjusted rate of hospitalisation for sport-related concussion, both overall and across several sports, increased significantly over the 9 years. These findings, along with high levels of public concern, make prevention of head injury in sport a population health priority in Australia.
- Description: 2003011025
Towards the reduction of injury and illness in athletes : Defining our research priorities
- Authors: Finch, Caroline , Bahr, Roald , Drezner, Jonathan , Dvorak, Jiri , Engebretsen, Lars , Hewett, Timothy , Junge, Astrid , Khan, Karim , Macauley, Domhnall , Matheson, Gordon , McCrory, Paul , Verhagen, Evert
- Date: 2017
- Type: Text , Journal article , Review
- Relation: British Journal of Sports Medicine Vol. 51, no. 16 (2017), p. 1178-1182
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
- Full Text: false
- Reviewed:
Translating Guidelines for the Diagnosis and Management of Sports-Related Concussion Into Practice
- Authors: Donaldson, Alex , Newton, Joshua , McCrory, Paul , White, Peta , Davis, Gavin , Makdissi, Michael , Finch, Caroline
- Type: Text , Journal article
- Relation: American Journal of Lifestyle Medicine, Volume 10, Issue 2, (2016) p.120-135
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text: false
- Reviewed:
- Description: Sports injuries are a significant clinical and public health concern. There is a growing call to improve the translation of available evidence-based and expert-informed sports injury prevention interventions into sustained use in practice by physicians and others (eg, athletic trainers, coaches, and parents) who care for injured athletes. This article provides a brief overview of the current sport injury prevention implementation literature before focusing specifically on the translation of guidelines (including consensus and position statements) developed to assist physicians and others diagnose and manage athletes with sport-related concussion and the associated return-to-play decisions. The outcomes of more than 20 published studies indicate that physician, athletic trainer, coach, parent, and athlete knowledge, use of, and compliance with sport-related concussion guidelines are limited. More concerted, coordinated, and theory-informed efforts are required to facilitate the widespread dissemination, translation, and implementation of such guidelines. An example is provided of how implementation drivers could be used to inform the development of a comprehensive, multilevel implementation strategy targeting the individual, organizational, and system-level changes necessary to support the translation of available sport-related concussion guidelines in both the clinical and sports settings.
Use of rule changes to reduce injury in the Australian Football League
- Authors: Orchard, John , McCrory, Paul , Makdissi, Michael , Seward, Hugh , Finch, Caroline
- Date: 2014
- Type: Text , Journal article
- Relation: Orotpedica e Traumatologica Vol. 65, no. 6 (December 2014), p. 355-364
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
- Full Text: false
- Reviewed:
- Description: AIM: Injuries are common in all professional football codes (including soccer, rugby league and union, American football, Gaelic Football and Australian football). The aim of the present study was to assess the potential effect that rule changes can have on injuries in professional football. METHODS: The Australian Football League (AFL) conducts an annual audit of injuries and makes regular rule changes on a semi-annual basis. An injury was defined as “any physical or medical condition that causes a player to miss a match in the regular season or finals” with ongoing records kept and publicly released over the decade 2004-2013. RESULTS: Over the ten years from 2004-2013, the AFL Commission made 26 rule changes, of which eight were considered to have potential impact on injury rates. The 2005 centre circle rule has significantly reduced rates of posterior cruciate ligament (PCL) injury in ruckmen. The rates of head and neck injuries dropped after initial rule changes, but rates of concussion and other head and neck injuries have increased since 2011, since a rule change that players could not re-enter the game after suffering concussion. Rates of hamstring and groin injuries have significantly fallen since the substitute rule was instituted in 2011, but rates of other lower limb injuries have risen over the same time period. CONCLUSION: Rule changes have, in some instances, had a beneficial effect on the rates of specific injuries over the last decade. However, the overall injury incidence in the AFL has not fallen, possibly because of a concurrent background increase in the speed of player movement across the decade. The AFL is in a fortunate position of being able to easily institute rule changes as it is the peak body of the sport which does not have to consider international competitions. The well established annual injury survey is able to monitor the effects of any rule changes on injury rates in a timely manner.