Theoretical perspectives on using epidemiology and systems thinking to better understand the aetiology and prevention of distance running-related injury
- Authors: Hulme, Adam
- Date: 2017
- Type: Text , Thesis , PhD
- Full Text:
- Description: On a global scale, the sporting activity of distance running has increased in popularity. This is likely attributable to a growing societal concern for the documented rise in several lifestyle-related chronic diseases. As a form of exercise, running provides significant beneficial effects on a range of biomedical health indices, and is the preferred physical activity of choice for many people given its high accessibility and relatively low financial cost. Notwithstanding the many health-related benefits associated with running, the risk of sustaining a distance running-related injury (RRI) can be high. Therefore, from an injury prevention perspective, understanding why runners sustain RRI is of primary scientific importance. Over the last fifty years, the science behind RRI causation and prevention has attracted considerable interest amongst sports injury prevention researchers. During that time, there has been a concerted scholarly effort to understand the aetiology of RRI from an epidemiological and clinical research-based standpoint. Traditional scientific approaches have attempted to identify the effect of discrete trainingrelated, behavioural, and/or biomechanical exposures on the risk of developing either general or specific RRI. Despite what is now a considerable body of work, several descriptive and systematic reviews have found a history of previous injury to be the only definitive risk factor for subsequent RRI development. Alongside the continuing application of traditional scientific approaches, this PhD thesis promotes the use of a complementary ‘systems thinking’ theoretical perspective for better understanding the development and prevention of RRI. There are several contained chapters, the first of which is a systematic review of the RRI aetiological literature. After examining in closer detail the causal mechanism underpinning RRI development, a series of papers urge injury prevention scientists to consider drawing on alternative philosophical perspectives when planning and designing research. In building on the preceding arguments, the final chapters involve the construction of a systems ergonomics control structure model of the Australian distance running system, including the way RRI is managed and controlled.
- Description: Doctor of Philosophy
- Authors: Hulme, Adam
- Date: 2017
- Type: Text , Thesis , PhD
- Full Text:
- Description: On a global scale, the sporting activity of distance running has increased in popularity. This is likely attributable to a growing societal concern for the documented rise in several lifestyle-related chronic diseases. As a form of exercise, running provides significant beneficial effects on a range of biomedical health indices, and is the preferred physical activity of choice for many people given its high accessibility and relatively low financial cost. Notwithstanding the many health-related benefits associated with running, the risk of sustaining a distance running-related injury (RRI) can be high. Therefore, from an injury prevention perspective, understanding why runners sustain RRI is of primary scientific importance. Over the last fifty years, the science behind RRI causation and prevention has attracted considerable interest amongst sports injury prevention researchers. During that time, there has been a concerted scholarly effort to understand the aetiology of RRI from an epidemiological and clinical research-based standpoint. Traditional scientific approaches have attempted to identify the effect of discrete trainingrelated, behavioural, and/or biomechanical exposures on the risk of developing either general or specific RRI. Despite what is now a considerable body of work, several descriptive and systematic reviews have found a history of previous injury to be the only definitive risk factor for subsequent RRI development. Alongside the continuing application of traditional scientific approaches, this PhD thesis promotes the use of a complementary ‘systems thinking’ theoretical perspective for better understanding the development and prevention of RRI. There are several contained chapters, the first of which is a systematic review of the RRI aetiological literature. After examining in closer detail the causal mechanism underpinning RRI development, a series of papers urge injury prevention scientists to consider drawing on alternative philosophical perspectives when planning and designing research. In building on the preceding arguments, the final chapters involve the construction of a systems ergonomics control structure model of the Australian distance running system, including the way RRI is managed and controlled.
- Description: Doctor of Philosophy
Epidemiology, injury and illness prevention in Olympic combat sports
- Authors: Bromley, Sally
- Date: 2018
- Type: Text , Thesis , PhD
- Full Text:
- Description: Background: Olympic combat sports are commonly considered dangerous, however injury rates for these sports are not well understood. Isolated studies in combat sports have investigated injury, however these are mainly during competition, and therefore are unlikely to include significant or persistent injury which prevents athletes competing and participating in data collection. This thesis was undertaken as a series of linked studies, to provide further detail into the types, mechanisms and aetiology of injuries in combat sports. Methods: Study 1 was a systematic review that utilised the PRISMA guidelines to investigate the current evidence. Study 2 was a repeated measures study to examine the reliability of training load measures. Study 3 employed a longitudinal study design to assess the feasibility of injury, illness and training load monitoring. Finally, Study 4 was a cross-sectional cohort study that gathered perspectives of combat sport coaches and managers before and after an injury and illness prevention workshop. Results: Study 1 found one high-quality epidemiological study with low risk of bias in Judo. Variation in injury and illness definitions prevented cross-sport comparisons, however the injury incidence was comparable to other sports. In Study 2, rating of perceived exertion (RPE) was shown to have good stability across sessions (ICC=0.84), and no significant differences were found between coach (observed) and athlete (experienced) RPE (ordered logistic regression coefficient = 0.47 [1.51–0.57 95%CI]). Study 3 found that athlete engagement with the monitoring system was low, with only 13% of athletes entering data across a 12-week period. Irrespective of low engagement, 62 injuries and illnesses were recorded. In Study 4, combat sport coaches and managers were found to be generally well informed of the risk and seriousness of injury and illness, however, illness risk perceptions changed after the workshop (p=0.048). Discussion and Conclusion: Currently, cross-sport comparisons are not possible due to varying data methodology and study quality. Based upon the results presented in this thesis, RPE can be used as a tool to quantify training load in the sport of judo. Longitudinal surveillance of training load, injury and illness in combat sport is not currently feasible within the Australian system, due to low uptake and engagement. However, the collection of data on a large number of injuries and illnesses indicates that athletes are experiencing multiple, repeated health problems. Coaches and managers are well informed about injury and illness risk and seriousness, indicating that injury and illness prevention education alone may not translate to a decrease in injury and illness incidence in combat sport.
- Description: Doctor of Philosophy
- Authors: Bromley, Sally
- Date: 2018
- Type: Text , Thesis , PhD
- Full Text:
- Description: Background: Olympic combat sports are commonly considered dangerous, however injury rates for these sports are not well understood. Isolated studies in combat sports have investigated injury, however these are mainly during competition, and therefore are unlikely to include significant or persistent injury which prevents athletes competing and participating in data collection. This thesis was undertaken as a series of linked studies, to provide further detail into the types, mechanisms and aetiology of injuries in combat sports. Methods: Study 1 was a systematic review that utilised the PRISMA guidelines to investigate the current evidence. Study 2 was a repeated measures study to examine the reliability of training load measures. Study 3 employed a longitudinal study design to assess the feasibility of injury, illness and training load monitoring. Finally, Study 4 was a cross-sectional cohort study that gathered perspectives of combat sport coaches and managers before and after an injury and illness prevention workshop. Results: Study 1 found one high-quality epidemiological study with low risk of bias in Judo. Variation in injury and illness definitions prevented cross-sport comparisons, however the injury incidence was comparable to other sports. In Study 2, rating of perceived exertion (RPE) was shown to have good stability across sessions (ICC=0.84), and no significant differences were found between coach (observed) and athlete (experienced) RPE (ordered logistic regression coefficient = 0.47 [1.51–0.57 95%CI]). Study 3 found that athlete engagement with the monitoring system was low, with only 13% of athletes entering data across a 12-week period. Irrespective of low engagement, 62 injuries and illnesses were recorded. In Study 4, combat sport coaches and managers were found to be generally well informed of the risk and seriousness of injury and illness, however, illness risk perceptions changed after the workshop (p=0.048). Discussion and Conclusion: Currently, cross-sport comparisons are not possible due to varying data methodology and study quality. Based upon the results presented in this thesis, RPE can be used as a tool to quantify training load in the sport of judo. Longitudinal surveillance of training load, injury and illness in combat sport is not currently feasible within the Australian system, due to low uptake and engagement. However, the collection of data on a large number of injuries and illnesses indicates that athletes are experiencing multiple, repeated health problems. Coaches and managers are well informed about injury and illness risk and seriousness, indicating that injury and illness prevention education alone may not translate to a decrease in injury and illness incidence in combat sport.
- Description: Doctor of Philosophy
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