Combining epidemiology and biomechanics in sports injury prevention research : A new approach for selecting suitable controls
- Authors: Finch, Caroline , Ullah, Shahid , McIntosh, Andrew
- Date: 2011
- Type: Text , Journal article
- Relation: Sports Medicine Vol. 41, no. 1 (2011), p. 59-72
- Relation: http://purl.org/au-research/grants/nhmrc/565900
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- Description: Several important methodological issues need to be considered when designing sports injury case-control studies. Major design goals for case-control studies include the accounting for prior injury risk exposure, and optimal definitions of both cases and suitable controls are needed to ensure this. This article reviews methodological aspects of published sports injury case-control studies, particularly with regard to the selection of controls. It argues for a new approach towards selecting controls for case-control studies that draws on an interface between epidemiological and biomechanical concepts. A review was conducted to identify sport injury case-control studies published in the peer-review literature during 1985-2008. Overall, 32 articles were identified, of which the majority related to upper or lower extremity injuries. Matching considerations were used for control selection in 16 studies. Specific mention of application of biomechanical principles in the selection of appropriate controls was absent from all studies, including those purporting to evaluate the benefits of personal protective equipment to protect against impact injury. This is a problem because it could lead to biased conclusions, as cases and controls are not fully comparable in terms of similar biomechanical impact profiles relating to the injury incident, such as site of the impact on the body. The strength of the conclusions drawn from case-control studies, and the extent to which results can be generalized, is directly influenced by the definition and recruitment of cases and appropriate controls. Future studies should consider the interface between epidemiological and biomechanical concepts when choosing appropriate controls to ensure that proper adjustment of prior exposure to injury risk is made. To provide necessary guidance for the optimal selection of controls in case-control studies of interventions to prevent sports-related impact injury, this review outlines a new case-control selection strategy that reflects the importance of biomechanical considerations, which ensures that controls are selected based on the presence of the same global injury mechanism as the cases. To summarize, the general biomechanical principles that should apply to the selection of controls in future case-control studies are as follows: (i) each control must have been exposed to the same global injury mechanism as the case, (e.g. head impact, fall onto outstretched arm); and (ii) intrinsic (individual) factors (e.g. age, sex, skill level) that might modify the person's response to the relevant biomechanical loads are adjusted when either selecting the controls or are in the analysis phase. The same considerations for control selection apply to other study designs such as matched cohort studies or case-crossover studies. © 2011 Adis Data Information BV. All rights reserved.
What is a Sports Injury?
- Authors: Timpka, Toomas , Jacobsson, Jenny , Bickenbach, Jerome , Finch, Caroline , Ekberg, Joakim , Nordenfelt, Lennart
- Date: 2014
- Type: Text , Journal article
- Relation: Sports Medicine Vol. 44, no. 4 (2014), p. 423-428
- Relation: http://purl.org/au-research/grants/nhmrc/565900
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- Description: Current sports injury reporting systems lack a common conceptual basis. We propose a conceptual foundation as a basis for the recording of health problems associated with participation in sports, based on the notion of impairment used by the World Health Organization. We provide definitions of sports impairment concepts to represent the perspectives of health services, the participants in sports and physical exercise themselves, and sports institutions. For each perspective, the duration of the causative event is used as the norm for separating concepts into those denoting impairment conditions sustained instantly and those developing gradually over time. Regarding sports impairment sustained in isolated events, 'sports injury' denotes the loss of bodily function or structure that is the object of observations in clinical examinations; 'sports trauma' is defined as an immediate sensation of pain, discomfort or loss of functioning that is the object of athlete self-evaluations; and 'sports incapacity' is the sidelining of an athlete because of a health evaluation made by a legitimate sports authority that is the object of time loss observations. Correspondingly, sports impairment caused by excessive bouts of physical exercise is denoted as 'sports disease' (overuse syndrome) when observed by health service professionals during clinical examinations, 'sports illness' when observed by the athlete in self-evaluations, and 'sports sickness' when recorded as time loss from sports participation by a sports body representative. We propose a concerted development effort in this area that takes advantage of concurrent ontology management resources and involves the international sporting community in building terminology systems that have broad relevance.
The Implementation of Musculoskeletal Injury-Prevention Exercise Programmes in Team Ball Sports : A Systematic Review Employing the RE-AIM Framework
- Authors: O'Brien, James , Finch, Caroline
- Date: 2014
- Type: Text , Journal article
- Relation: Sports Medicine Vol. 44, no. 9 (2014), p. 1305-1318
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
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- Description: Background Team ball sports such as soccer, basketball and volleyball have high participation levels worldwide. Musculoskeletal injuries are common in team ball sports and are associated with significant treatment costs, participation loss and long-term negative side effects. The results of recent randomized controlled trials provide support for the protective effect of injury-prevention exercise programmes (IPEPs) in team ball sports, but also highlight that achieving adequate compliance can be challenging. A key process in enhancing the ultimate impact of team ball sport IPEPs is identifying the specific implementation components that influence the adoption, execution and maintenance of these interventions. Despite this, no systematic review focussing on the specific implementation components of team ball sport IPEPs has been conducted. Objectives Our objective was to assess the reporting of specific implementation components in the published literature on team ball sport IPEPs using the Reach Efficacy Adoption Implementation Maintenance (RE-AIM) framework. Methods Six electronic databases were systematically searched from inception to December 2012 for papers reporting team ball sport IPEP trials. All eligible papers were independently evaluated by two raters before reaching consensus on the reporting of individual RE-AIM items, using the RE-AIM Model Dimension Items Checklist (RE-AIM MDIC). Results A total of 60 papers, reporting 52 unique intervention trials, met eligibility criteria. Before consensus, the level of agreement across all trials between reviewers using the RE-AIM MDIC ranged from 81 to 91 %. The RE-AIM MDIC dimension of 'efficacy' had the highest level of reporting, with the five individual items in this dimension reported in 19-100 % of eligible trials (mean 58 %). The RE-AIM MDIC dimension 'maintenance-setting level' had the lowest level of reporting, with none of the four individual items in this dimension reported. For other dimensions, the mean level of reporting and range across items were 'reach' 34 % (12-60 %); 'adoption-setting level' 1 % (0-2 %); 'adoption-delivery agent level' 7 % (4-10 %); 'implementation' 36 % (13-63 %) and 'maintenance individual level' 1 % (0-4 %). Conclusion Information on the specific implementation components of team ball sport IPEPs in published studies is scarce. In particular, major reporting gaps exist regarding the adoption and maintenance of these programmes. The RE-AIM MDIC can be successfully applied to reviewing literature in this context.
An Anterior cruciate ligament Injury prevention framework : Incorporating the recent evidence
- Authors: Donnelly, Cyril , Elliott, Bruce , Ackland, Timothy , Doyle, Tim , Beiser, Thor , Finch, Caroline , Cochrane, Jodie , Dempsey, Alasdair , Lloyd, David
- Date: 2012
- Type: Text , Journal article
- Relation: Research in Sports Medicine Vol. 20, no. 3/4 (2012), p. 239-262
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Relation: http://purl.org/au-research/grants/nhmrc/565907
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- Description: Anterior cruciate ligament (ACL) injury rates have increased by ∼50% over the last 10 years. These figures suggest that ACL focused research has not been effective in reducing injury rates among community level athletes. Training protocols designed to reduce ACL injury rates have been both effective (n = 3) and ineffective (n = 7). Although a rationale for the use of exercise to reduce ACL injuries is established, the mechanisms by which they act are relatively unknown. This article provides an injury prevention framework specific to noncontact ACL injuries and the design of prophylactic training protocols. It is also apparent that feedback within this framework is needed to determine how biomechanically relevant risk factors like peak joint loading and muscular support are influenced following training. It is by identifying these links that more effective ACL injury prevention training programs can be developed, and, in turn, lead to reduced ACL injury rates in the future.
Could targeted exercise programmes prevent lower limb injury in community Australian football?
- Authors: Andrew, Nadine , Gabbe, Belinda , Cook, Jill , Lloyd, David , Donnelly, Cyril , Nash, Clare , Finch, Caroline
- Date: 2013
- Type: Text , Journal article
- Relation: Sports Medicine Vol. 43, no. 8 (2013), p. 751-763
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Relation: http://purl.org/au-research/grants/nhmrc/565907
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- Description: Background: Australian football is a popular sport in Australia, at both the community and elite levels. It is a high-speed contact sport with a higher incidence of medically treated injuries when compared with most other organized sports. Hamstring injuries, ligament injuries to the knee or ankle, hip/groin injuries and tendinopathies are particularly common and often result in considerable time lost from sport. Consequently, the prevention of lower limb injuries is a priority for both community and elite Australian football organizations. There is considerable literature available on exercise programmes aimed at reducing lower limb injuries in Australian football and other running-related sports. The quality and outcomes of these studies have varied considerably, but indicate that exercise protocols may be an effective means of preventing lower limb injuries. Despite this, there has been limited high-quality and systematic evaluation of these data. Objective: The aim of this literature review is to systematically evaluate the evidence about the benefits of lower limb injury prevention exercise protocols aimed at reducing the most common severe lower limb injuries in Australian football. Methods: The Cochrane Central Register of Controlled Trials, the Cochrane Bone Joint and Muscle Trauma Group Specialized Register, MEDLINE and other electronic databases were searched, from January 1990 to December 2010. Papers reporting the results of randomized controlled trials (RCTs), quasi-RCTs, cohort and case-control studies were extracted. Primary outcomes were injury reduction or risk factor identification and/or modification. Secondary outcomes were adherence to any trialled interventions, injury severity and adverse effects such as secondary injuries and muscle soreness. The methodological quality of extracted manuscripts was assessed and results were collated. Results: Forty-seven papers were identified and reviewed of which 18 related to hamstring injury, eight related to knee or ankle ligament injury, five related to tendon injury and four were hip or groin injury related. Another 12 papers targeted general lower limb injuries. Most (n = 27 [57 %]) were observational studies, investigating injury risk factors. Twenty reported the results of intervention trials. Of these, 15 were efficacy trials reporting the effects of an intervention in reducing injury rates, four were biomechanical interventions in which the impact of the intervention on a known injury risk factor was assessed and one reported changes in injury risk factors as well as injury rates. The strength of the evidence base for exercise programmes for lower limb injury prevention was found to be limited, primarily due to the research methods employed, low adherence to interventions by the study participants and a lack of statistical power. Limited evidence obtained from a small number of RCTs suggests that balance and control exercises might be efficacious in preventing ankle ligament injuries and a programme involving a combination of balance and control exercises, eccentric hamstring, plyometrics and strength exercises could be efficacious in preventing all lower limb injuries. Conclusions: Overall, the evidence for exercise programmes as an efficacious lower limb injury prevention strategy is predominantly restricted to studies addressing injury aetiology and mechanisms. The findings of this review highlight the need to develop and test interventions in well designed population-based trials with an emphasis on promoting intervention uptake and adherence and, hence, intervention effectiveness. The results of this review can inform the development of the components of a future lower limb injury prevention exercise protocol for community-level Australian football. © 2013 Springer International Publishing Switzerland. Funded by the NHMRC.
- Description: 2003011215
Sport-specific factors predicting player retention in junior cricket
- Authors: Talpey, Scott , Croucher, Tom , Bani-Mustafa, Ahmed , Finch, Caroline
- Date: 2017
- Type: Text , Journal article
- Relation: European Journal of Sport Science Vol. 17, no. 3 (2017), p. 264-270
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
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- Description: Understanding factors that motivate young athletes to continue participation in sport can help key stakeholders cultivate an environment that fosters long-term participation. This investigation sought to determine the performance and participation factors that influenced continued participation in junior cricket. Administration-level data were collected each annual season across a seven-year period by a community-level junior cricket association in Australia and analysed to identify the performance and participation-based predictors of player retention. All players were males aged <16 years. Players were categorised according to whether they remained in (or departed from) the association at the end of each playing season. A multivariate logistic regression model with a stepwise variable selection was employed to identify significant independent predictors of player retention. The number of innings batted and overs bowled were significant participation-related contributors to junior cricket player retention. Performance factors such as the number of wickets taken and the number of runs scored also significantly influenced player retention. Finally, team age group, the number of previous seasons played and age were also significant factors in player retention. This demonstrates that sufficient opportunity for children to participate in the game and expression of skills competence are key factors for retention in cricket.
- Description: Understanding factors that motivate young athletes to continue participation in sport can help key stakeholders cultivate an environment that fosters long-term participation. This investigation sought to determine the performance and participation factors that influenced continued participation in junior cricket. Administration-level data were collected each annual season across a seven-year period by a community-level junior cricket association in Australia and analysed to identify the performance and participation-based predictors of player retention. All players were males aged <16 years. Players were categorised according to whether they remained in (or departed from) the association at the end of each playing season. A multivariate logistic regression model with a stepwise variable selection was employed to identify significant independent predictors of player retention. The number of innings batted and overs bowled were significant participation-related contributors to junior cricket player retention. Performance factors such as the number of wickets taken and the number of runs scored also significantly influenced player retention. Finally, team age group, the number of previous seasons played and age were also significant factors in player retention. This demonstrates that sufficient opportunity for children to participate in the game and expression of skills competence are key factors for retention in cricket. © 2016 European College of Sport Science.