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.
Epidemiology of hospital-treated injuries sustained by fitness participants
- Authors: Gray, Shannon , Finch, Caroline
- Date: 2015
- Type: Text , Journal article
- Relation: Research Quarterly for Exercise and Sport Vol. 86, no. 1 (2015), p. 81-87
- Relation: http://purl.org/au-research/grants/nhmrc/565900
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- Description: Purpose: The purpose of this study was to provide an epidemiological profile of injuries sustained by participants in fitness activities in Victoria, Australia, based on hospital admissions and emergency department (ED) presentations and to identify the most common types, causes, and sites of these injuries. Method: Hospital-treated fitness activity-related injury cases were identified from International Classification of Disease activity codes (for admissions) and from text narratives of injury events (for ED presentations) from 2003 to 2010, inclusive. Cases were categorized as being associated with aerobics/group exercise (n = 252), resistance/weight training (n = 830) or "other equipment" (motorized and general gym equipment; n = 1,156). Participation information was taken from the Exercise, Recreation and Sport Survey. Results: Overall, 2,238 cases were identified and 11.6% of all patients with ED presentations were subsequently hospitalized. Those participants with aerobics cases were generally female (76.6%) and aged 25 to 34 years old (35.3%), with injuries to the lower limbs (59.1%) and due to falls (57.9%). Resistance-training injuries increased significantly during the 8-year period (by 215.7%; 95% CI [133.5, 326.9]) and generally occurred in male participants (78.0%), in people aged 15 to 24 years old (36.4%), and with injuries to the upper limbs (45.1%) caused by being hit, struck, or crushed by weights or fellow exercisers (71.4%). The "other equipment" cases were equally distributed by gender; they occurred most commonly in people aged 15 to 24 years old (27.8%), with injuries to the lower limbs (41.5%) and due to falls (57.6%). Across all categories, dislocations, sprains, and strains were the most common injury types. Conclusions: Fitness activity-related injury prevention strategies should be targeted at different subgroups according to the type of fitness activity being undertaken.
- Description: Purpose: The purpose of this study was to provide an epidemiological profile of injuries sustained by participants in fitness activities in Victoria, Australia, based on hospital admissions and emergency department (ED) presentations and to identify the most common types, causes, and sites of these injuries. Method: Hospital-treated fitness activity-related injury cases were identified from International Classification of Disease activity codes (for admissions) and from text narratives of injury events (for ED presentations) from 2003 to 2010, inclusive. Cases were categorized as being associated with aerobics/group exercise (n = 252), resistance/weight training (n = 830) or “other equipment†(motorized and general gym equipment; n = 1,156). Participation information was taken from the Exercise, Recreation and Sport Survey. Results: Overall, 2,238 cases were identified and 11.6% of all patients with ED presentations were subsequently hospitalized. Those participants with aerobics cases were generally female (76.6%) and aged 25 to 34 years old (35.3%), with injuries to the lower limbs (59.1%) and due to falls (57.9%). Resistance-training injuries increased significantly during the 8-year period (by 215.7%; 95% CI [133.5, 326.9]) and generally occurred in male participants (78.0%), in people aged 15 to 24 years old (36.4%), and with injuries to the upper limbs (45.1%) caused by being hit, struck, or crushed by weights or fellow exercisers (71.4%). The “other equipment†cases were equally distributed by gender; they occurred most commonly in people aged 15 to 24 years old (27.8%), with injuries to the lower limbs (41.5%) and due to falls (57.6%). Across all categories, dislocations, sprains, and strains were the most common injury types. Conclusions: Fitness activity-related injury prevention strategies should be targeted at different subgroups according to the type of fitness activity being undertaken.
Injury risk during different physical activity behaviours in children: A Systematic review with bias assessment
- 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.
Associations between behavior regulation, competence, physical activity, and health for adolescent females
- Authors: Craike, Melinda , Polman, Remco , Eime, Rochelle , Symons, Caroline , Harvey, Jack , Payne, Warren
- Date: 2014
- Type: Text , Journal article
- Relation: Journal of Physical Activity and Health Vol. 11, no. 2 (2014), p. 410-418
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Are We Having Fun Yet?: Fostering Adherence to Injury Preventive Exercise Recommendations in Young Athletes
- Authors: Keats, Melanie , Emery, Carolyn , Finch, Caroline
- Date: 2012
- Type: Text , Journal article
- Relation: Sports Medicine Vol. 42, no. 3 (March 2012), p. 175-184
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- Description: Sport and recreational activities are the leading cause of injury in youth, yet there is increasing evidence that many sport-related injuries are preventable. For injury prevention strategies to be effective, individuals must understand, adopt and adhere to the recommended prevention strategy or programme. Despite the recognized importance of a behavioural approach, the inclusion of behavioural change strategies in sport injury prevention has been historically neglected. The purpose of this commentary is to outline the rationale for the inclusion and application of behavioural science in reducing the burden of injury by increasing adherence to proven prevention strategies. In an effort to provide an illustrative example of a behavioural change approach, the authors suggest a specific plan for the implementation of a neuromuscular training strategy to reduce the risk of lower limb injury in youth sport. Given the paucity of evidence in the sport injury prevention setting, and the lack of application of theoretical frameworks to predicting adoption and adherence to injury preventive exercise recommendations in youth sport, data from the related physical activity promotion domain is utilized to describe how sound, theory-based injury prevention exercise interventions in youth may be developed. While the question of how to facilitate behavioural change and optimize adherence to preventive exercise recommendations remains an ongoing challenge, the authors detail several strategies based on two prominent behavioural theories to aid the reader in conceptualizing, designing and implementing effective interventions. Despite the minimal application of behavioural theory within the field of sport injury prevention in youth, behavioural science has the potential to make a significant impact on the understanding and prevention of youth sport injury. Appropriate evaluation of adherence and maintenance components based on models of behavioural change should be a critical component of future injury prevention research and practice.
Children's enjoyment of play during school lunchtime breaks : An examination of intraday and interday reliability
- Authors: Hyndman, Brendon , Telford, Amanda , Ullah, Shahid , Benson, Amanda , Finch, Caroline
- Date: 2014
- Type: Text , Journal article
- Relation: Journal of Physical Activity & Health Vol. 11, no. 1 (January 2014 2014), p. 109-117
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- Description: Background: Enjoyment and play during school lunchtime are correlated with children's physical activity. Despite this, there is an absence of studies reporting children's enjoyment of play during school lunchtime breaks. The purpose of this study was to examine the intraday and interday reliability of children's enjoyment of school lunchtime play. Methods: Surveys used to assess children's enjoyment of lunchtime play were distributed to and completed by 197 children (112 males, 85 females), aged 8-12 years attending an elementary school in Victoria, Australia. Children completed the surveys during class before lunch (expected enjoyment) and after lunch (actual enjoyment) for 5 days. The intra- and interday enjoyment of school lunchtime play reliability were determined using a weighted kappa. Results: Intraday kappa values ranged from fair (0.31) to substantial (0.75) within each of the 5 days (median kappa = 0.41). In comparison, "expected" (0.09-0.40; median 0.30) and "actual" (0.05-0.46; median 0.28) interday enjoyment of lunchtime play displayed low reliability. Conclusions: Children's enjoyment of lunchtime play appears to be more consistent within days than across days. The findings suggest that assessment of children's enjoyment of lunchtime play once on a single day would be representative of a particular day but not necessarily that particular school week.
The potential use and abuse of thymosin-4 in sport and exercise science
- Authors: Davison, Gareth , Brown, Stephen
- Date: 2013
- Type: Text , Journal article
- Relation: Journal of Sports Sciences Vol. 31, no. 9 (May 2013), p. 917-918
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- Description: C2
Activity profiles of the Australian female netball team players during international competition: Implications for training practice
- Authors: Fox, Aaron , Spittle, Michael , Otago, Leonie , Saunders, Natalie
- Date: 2013
- Type: Text , Journal article
- Relation: Journal of Sports Sciences Vol. 31, no. 14 (2013), p. 1588-1595
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- Description: In elite sport, to remain competitive at the international level, it is critical to understand the game demands on players to ensure sport specific training programmes are designed for optimal athlete preparation and conditioning. In netball, recent research examining the activity patterns of players at the elite level is lacking, with only one study undertaken on this level of competition in the past 30 years. Therefore, the aim of this study was to provide coaches with up to date knowledge of player activity patterns as a basis for the design of optimal sport specific training programmes. The Australian female netball team were analysed using video footage of three international test matches. Player activity was categorised into five movement and eight game-based activities; and further classified as work or rest. Results suggest that differences in the current game exist when compared to the previous analysis. Positional differences were also found with regard to player activity confirming the need for an individualised component of training based on player position. © 2013 Copyright © 2013 Taylor & Francis.
- Description: C1
Understanding the contexts of adolescent female participation in sport and physical activity
- Authors: Eime, Rochelle , Harvey, Jack , Sawyer, Neroli , Craike, Melinda , Symons, Caroline , Polman, Remco , Payne, Warren
- Date: 2013
- Type: Text , Journal article
- Relation: Research quarterly for exercise and sport Vol. 84, no. 2 (2013), p. 157-166
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- Description: Purpose: Participation in physical activity (PA) is reported to decline in adolescence, particularly for girls. However, we do not know if this decline in PA is consistent across modes and settings or whether there are transfers of participation between modes and settings. Nor do we understand the changes in specific types of PA or the interaction between types of participation and different modes/settings. This study investigated contexts of PA participation for female adolescents at two life transition points. Method: A survey of 489 Year 7 and 243 Year 11 adolescent girls was conducted, incorporating a measure of overall PA level and participation rates in seven modes/settings and in specific types of sport and PA. Results: Less than half of the respondents met or exceeded the recommended level of moderate or vigorous PA-60 min or more-on the previous day, and there was no statistically significant difference in the proportions in Years 7 and 11 (39.5% vs. 45.9%; p > .05). However, older adolescents shifted their participation away from organized, competitive modes and settings toward nonorganized and noncompetitive modes and settings and individual types of PA. Conclusions: An understanding of the changes in PA modes and settings identified here can inform the planning of policies and implementation of programs for the promotion of PA by adolescent girls.
Dose-response of women's health-related quality of life (HRQOL) and life satisfaction to physical activity
- Authors: Eime, Rochelle , Harvey, Jack , Payne, Warren
- Date: 2014
- Type: Text , Journal article
- Relation: Journal of Physical Activity and Health Vol. 11, no. 2 (2014), p. 330-338
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- Description: Background: To examine the dose-response relationship between health related quality of life (HRQoL) and life satisfaction (outcomes) and duration of recreational physical activity (exposure). Further, to explore whether these relationships depend on type of physical activity (PA). Methods: 793 Australian rural-living women self-reported on duration of recreational PA; HRQoL via SF-36 Mental Component Summary (MCS) and Physical Component Summary (PCS); and a life satisfaction scale. ANOVAs and ANCOVAs investigated differences in outcomes (MCS, PCS, and life satisfaction) between tertiles of exposure to recreational PA, and types of PA (club sport, gymnasium, walking), with adjustment for potential confounders. Results: A significant positive dose-response relationship was found between PCS and level of PA. Furthermore, this relationship depended on type of PA, with club-sport participants recording higher PCS than non-club-sport participants in all but the highest tertile of exposure. Life satisfaction and MCS were not significantly related to level of PA. Conclusion: Physical health was positively associated with level of recreational PA, with club sport participation contributing greater benefits at low to moderate exposures than participation in gymnasium or walking activities. © 2014 Human Kinetics, Inc.
Assessment of decision-making performance and in-game physical exertion of Australian football umpires
- Authors: Larkin, Paul , O'Brien, Brendan , Mesagno, Christopher , Berry, Jason , Harvey, Jack , Spittle, Michael
- Date: 2014
- Type: Text , Journal article
- Relation: Journal of Sports Sciences Vol. 32, no. 15 (2014), p. 1446-1453
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- Description: The aim of this study is to investigate the effects of in-game physical exertion on decision-making performance of Australian football umpires. Fifteen Australian football umpires (Mage = 36, s = 13.5 years; Mgames umpired = 235.2, s = 151.3) volunteered to participate in the study. During five competitive Australian football pre-season games, measures of in-game physical exertion (blood lactate levels, global positioning system [GPS]) and decision-making performance (video-based test) were obtained. There were no significant correlations between physical exertion in a particular quarter and decision-making performance in either the same quarter or any other quarter. Video-based decision-making performance was effected by time in game χ2(3) = 24.24, P = 0.001, with Quarter 4 performance significantly better than both Quarter 2 and Quarter 3. In-game physical exertion (blood lactate) significantly decreased over the course of the game χ2(3) = 11.58, P = 0.009. Results indicate no definable link between in-game physical exertion and decision-making performance. It is, however, presumed that decision-making performance may be affected by the time or context of the game. Future research is warranted to explore the relationship between physical exertion and decision-making performance to potentially inform Australian football umpire training programmes that replicate in-game physical and decision-making demands.
Exercise-Based Injury Prevention in Child and Adolescent Sport: A Systematic Review and Meta-Analysis
- 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.
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
Left ventricular speckle tracking-derived cardiac strain and cardiac twist mechanics in athletes : A systematic review and meta-analysis of controlled studies
- Authors: Beaumont, Alexander , Grace, Fergal , Richards, Joanna , Hough, John , Oxborough, David , Sculthorpe, Nicholas
- Date: 2017
- Type: Text , Journal article
- Relation: Sports Medicine Vol. 47, no. 6 (2017), p. 1145-1170
- Full Text: false
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Sprint interval training and the school curriculum : Benefits upon cardiorespiratory fitness, physical activity profiles, and cardiometabolic risk profiles of healthy adolescents
- Authors: Martin-Smith, Rhona , Buchan, Duncan , Baker, Julien , Macdonald, Mhairi , Sculthorpe, Nicholas , Easton, Chris , Knox, Allan , Grace, Fergal
- Date: 2019
- Type: Text , Journal article
- Relation: Pediatric Exercise Science Vol. 31, no. 3 (2019), p. 296-305
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- Description: Background: This study examined the impact of a 4-week school-based sprint interval training program on cardiorespiratory fitness (CRF), daily physical activity (PA) behavior, and cardiometabolic risk (CMR) outcomes in adolescents. Methods: A total of 56 adolescents (22 females) were allocated to either an intervention (n = 22; 17.0 [0.3] y) or control group (n = 30; 16.8 [0.5] y). Intervention group performed 5 to 6, 30 second "all out" running sprints, interspersed with 30-second rest intervals, 3 times per week, for 4 consecutive weeks, whereas control group performed their normal physical education lessons. CRF was estimated from the 20-m multistage fitness test and PA behavior was determined using accelerometry. Fasting blood samples were obtained to measure biochemical markers of CMR. Results: Significant group x time interactions were observed for CRF (5.03 [1.66 to 8.40]; P < .001; d = 0.95), sedentary time (136.15 [91.91 to 180.39]; P = .004; d = 1.8), moderate PA (57.20 [32.17 to 82.23]; P < .001; d = 1.5), vigorous PA (5.40 [4.22 to 6.57]; P < .001; d = 1.2), fasting insulin (0.37 [-0.48 to 1.21]; P = .01; d = 1.0), homeostasis model of assessment-insulin resistance (0.26 [0.15 to 0.42]; P < .001; d = 0.9), and clustered CMR score (0.22 [-0.05 to 0.68]; P < .001; d = 10.63). Conclusion: Findings of this study indicate that 4 weeks of school-based sprint interval training improves CRF, improves PA profiles, and maintains CMR in adolescents during the school term.
An updated subsequent injury categorisation model (SIC-2.0) : Data-driven categorisation of subsequent injuries in sport
- Authors: Toohey, Liam , Drew, Michael , Fortington, Lauren , Finch, Caroline , Cook, Jill
- Date: 2018
- Type: Text , Journal article
- Relation: Sports Medicine Vol. 48, no. 9 (2018), p. 2199-2210
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- Description: Background: Accounting for subsequent injuries is critical for sports injury epidemiology. The subsequent injury categorisation (SIC-1.0) model was developed to create a framework for accurate categorisation of subsequent injuries but its operationalisation has been challenging. Objectives: The objective of this study was to update the subsequent injury categorisation (SIC-1.0 to SIC-2.0) model to improve its utility and application to sports injury datasets, and to test its applicability to a sports injury dataset. Methods: The SIC-1.0 model was expanded to include two levels of categorisation describing how previous injuries relate to subsequent events. A data-driven classification level was established containing eight discrete injury categories identifiable without clinical input. A sequential classification level that sub-categorised the data-driven categories according to their level of clinical relatedness has 16 distinct subsequent injury types. Manual and automated SIC-2.0 model categorisation were applied to a prospective injury dataset collected for elite rugby sevens players over a 2-year period. Absolute agreement between the two coding methods was assessed. Results: An automated script for automatic data-driven categorisation and a flowchart for manual coding were developed for the SIC-2.0 model. The SIC-2.0 model was applied to 246 injuries sustained by 55 players (median four injuries, range 1–12), 46 (83.6%) of whom experienced more than one injury. The majority of subsequent injuries (78.7%) were sustained to a different site and were of a different nature. Absolute agreement between the manual coding and automated statistical script category allocation was 100%. Conclusions: The updated SIC-2.0 model provides a simple flowchart and automated electronic script to allow both an accurate and efficient method of categorising subsequent injury data in sport.
Compliance with sport injury prevention interventions in randomised controlled trials : A systematic review
- 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.
Accelerometers for the assessment of concussion in male athletes : A systematic review and meta-analysis
- Authors: Brennan, James , Mitra, Biswadev , Synnot, Anneliese , McKenzie, Joanne , Willmott, Catherine , McIntosh, Andrew , Maller, Jerome , Rosenfeld, Jeffrey
- Date: 2017
- Type: Text , Journal article , Review
- Relation: Sports Medicine Vol. 47, no. 3 (2017), p. 469-478
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- Description: Background Concussion is common in the sporting arena and is often challenging to diagnose. The development of wearable head impact measurement systems has enabled measurement of head kinematics in contact sports. Objectives The objective of this systematic review was to determine the characteristics of head kinematics measured by an accelerometer system among male athletes diagnosed with concussion. Methods A systematic search was conducted in July 2015. Inclusion criteria were English-language studies published after 1990 with a study population of male athletes, in any sport, where objectively measured biomechanical forces were reported in the setting of a concussive event. The random effects meta-analysis model was used to combine estimates of biomechanical force measurements in concussed athletes. Results Thirteen studies met the inclusion criteria, the majority of which were conducted with high school and college football teams in the US. Included studies measured a combination of linear and rotational acceleration. The meta-analysed mean peak linear head acceleration associated with a concussive episode was 98.68 g (95 % CI 82.36-115.00) and mean peak rotational head acceleration was 5776.60 rads/s 2 (95 % CI 4583.53-6969.67). The estimates of the biomechanical forces were consistent across studies, with I 2 values of 0 % for both metaanalyses. Conclusions Head impact monitoring through accelerometery has been shown to be useful with regard to characterising the kinematic load to the head associated with concussion. Future research with improved clinical outcome measures and head kinematic data may improve accuracy when evaluating concussion, and may assist with both interpretation of biomechanical data and the development and utilisation of implementation strategies for the technology.