Description:
The significant cost of injury rehabilitation to the individual and the community combined with the funding provided for injury prevention (IP) research over the past decade demands some measurement of the effectiveness of IP programs. The measurement of IP strategies is a complex issue because injury prevention relies on the behaviours of the sports people involved. This study involved qualitative analyses of interviews conducted with ten netball players and seven football players. The players were selected from the highest and lowest senior grades of a semi-rural community level club. Data collected from the interviews were transcribed and analysed using themes to categorise the information. The findings highlight the different structural issues faced by community level netball and Australian Rules football players. Players who had been exposed to higher levels of competition appeared to have an increased use of and better attitude towards the use of IP measures. Some of the contrasts highlighted were the structure, access and availability of IP measures to players. Netball players did not have access to sports trainers or protective equipment and the choice to use IP strategies was a more personal choice. In contrast, the football clubs had sports trainers and protective equipment was offered to players at no cost. The most significant theme emerging from the study related to the social influences at the community level. The players’ attitudes and beliefs were directly attributable to the acceptance and promotion of IP strategies by significant people within the clubs.
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.
Description:
There has been increasing recognition of the need for effectiveness research within the real-world intervention context of community sport. This is important because, even if interventions have been shown to be efficacious in controlled trials, if they are not also widely adopted and sustained, then it is unlikely that they will have a public health impact. There is very little information about how to best conduct such studies, but application of health promotion frameworks, such as the RE-AIM framework, to evaluate the public health impact of interventions could potentially help to understand the implementation context. Care needs to be taken when directly applying the RE-AIM framework, however, because the definitions for each of its dimensions will depend on the level/s the intervention is targeted at. This paper provides a novel extension to the RE-AIM framework (the RE-AIM SportsSetting Matrix (RE-AIM SSM)), which accounts for the fact that many sports injury interventions need to be targeted at multiple levels of sports delivery. Accordingly, the RE-AIM components also need to be measured across all tiers of possible influence on the rate of uptake and effectiveness. Specific examples are given for coach delivered exercise training interventions. The RE-AIM SSM is specific to the community sports setting implementation context and could be used to guide the delivery of future sports safety, and other health promotion, interventions in this area.
Description:
Sport and recreation settings have been used to encourage healthier behaviours through a legislative and policy approach to health promotion via the replacement of tobacco industry sponsorship with health-focused sponsorship. Few studies have used standard and rigorous evaluation tools to identify health promotion policies and practices in sport settings. This study identified health promotion changes within Sport Governing Organisations (SGOs) with respect to the implementation of sport-related health promotion policies and practices in the context of SGO-organised events and in terms of the support provided by SGOs to their affiliated clubs. The Health Promotion and Sport Assessment Tool (HP-SAT) was used to measure health promotion policies and practices regarding smoke-free environments, responsible serving of alcohol, healthy eating, sun protection, injury prevention, club management, and a miscellaneous “other” category (e.g., engagement of health inequality groups). The HP-SAT has moderate to excellent reliability (0.41–0.99). Participants completed the HP-SAT in two phases—first they identified their SGOs current health promotion policies and practices (2007); and second they reflected of their SGO's health promotion policies and practices prior to funding from a health promotion body (2003). For each substantive area in the HP-SAT (e.g. smoke-free environments) a composite score was calculated by summing the numerically coded responses to each item pertaining to the particular area. The scores represented the existence and implementation of health promotion policies and practices and were expressed on a scale of 0-100. Paired samples t-tests were used to test for differences in the scores between the two time points. The mean existence and implementation scores for sport-related health promotion policies and practices for SGO-organised events ranged from 42.9 to 77.6 at the retrospective survey, and increased significantly for the current survey (range: 67.8–90.6; p < 0.05) for all composite scores except sun protection and injury prevention policies. The mean existence and implementation score for sport-related health promotion policies and practices for SGO affiliated clubs ranged from 20.8 to 64.7 at the retrospective survey and 46.3–88.5 at the current survey. Statistically significant increases were found for all composite scores except sun protection and injury prevention (p < 0.05). The existence and implementation of items relating to healthy eating were lowest for both surveys; whilst responses for club management and injury prevention were highest for both surveys. These data indicate that sport has increased its capacity and role in promoting good health since 2003.
Description:
Background: Minimising the likelihood of injury to the anterior cruciate ligament (ACL) during abrupt deceleration requires proper synchrony of the quadriceps and hamstring muscles. However, it is not known whether simple verbal instructions can alter landing muscle activity to protect the knee. Objective: To assess the efficacy of verbal instructions to alter landing muscle activity. Methods: Twenty four athletes landed abruptly in single limb stance. Sagittal plane motion was recorded with an optoelectric device, and ground reaction force and surface electromyographic data were recorded for the rectus femoris, vastus lateralis, biceps femoris, and semimembranosus muscles. Subjects performed 10 landings per condition: normal landing (N); repeat normal landing (R); landing after instruction to increase knee flexion (K); and landing after instruction to recruit hamstring muscles earlier (M). Muscle bursts immediately before landing were analysed relative to initial foot-ground contact (IC). Results: The K condition resulted in significantly (p0.05) greater knee flexion at IC compared with the other conditions. The M condition did not result in earlier hamstring muscle activity, but instead caused significantly (p0.05) earlier rectus femoris onset relative to IC, with a similar trend for the vastus lateralis. As these muscles are ACL antagonists, earlier onset times would be detrimental to the ACL. Conclusions: Subjects successfully increased knee flexion during landing following the K condition instruction. However, further research is warranted to establish the efficacy of more extensive lower limb muscle retraining programmes to ensure landings that decrease susceptibility to ACL injury.
Description:
Introduction: Neuromuscular control during high-risk sports tasks is viewed as a primary risk factor in ACL injury. Attention has also been given to the role of the hip as a possible explanation contributing to ACL injury rates. Typically neuromuscular predictors of ACL injury have arisen from lab-based assessments; however it is possible that this approach excludes important components of actual game-play that may contribute directly to injury risk. The current study therefore, examined muscle recruitment patterns (MRP) during game-play and lab-based conditions that included hip musculature, to consider strategies for lower limb control. Methods: Nine female subjects had EMG data recorded continuously during a netball game. At a subsequent session, in the lab, EMG data was also recorded for three landing conditions. Bilateral EMG was collected via telemetry for rectus femoris, biceps femoris, medial hamstring and gluteus medius. Muscle onset relative to initial contact and the subsequent pattern/s of onset for each land, for each subject, were examined. Results and discussion: Results indicate that the average number of MRP across subjects was 3.6 and 5.8 for the game-play and the lab-based conditions, respectively. When muscles crossing the knee joint were examined only, results revealed that the average number of MRP across subjects was 2.1 and 2.4 for the game-play and the lab-based conditions, respectively. Differences exist when comparing game-play and lab-based measures and the role of the hip musculature in affecting lower limb control warrants ongoing investigation in relation to ACL injury risk.
Description:
Introduction: In Australia, the National League competition (Commonwealth BankTrophy (CBT)) provided an opportunity to gain an understanding of injuries sustained at the elite level. The purpose of this review therefore is to examine the injury incidence in the CBT competition (2003–2005) and considerations for future injury prevention strategies. Methods: All players in the CBT competition are included in the injury data surveillance scheme. Each team physiotherapist is responsible for assessing, treating and recording injuries within the team. An injury is defined as any netball related physical damage that caused the athlete to miss or modify one or more training sessions, matches or both, and/or required a consultation with a health professional. Results and discussion: The exposure to risk has been estimated from the data supplied for CBT games only to be 71.4, 61.8 and 66.7 injuries per 1000 participations for 2003–2005 respectively. Game injuries account for the majority of injuries with the ankle remaining the most common site of injury across the 3-year period, despite the fact that the majority of players wear ankle tape. The knee was the second highest recorded site of injury for 2004 (14.9%) and 2005 (14%). The majority of injuries are new injuries with three most common mechanisms of injury being collision with a player, landing and overuse injury. Ongoing injury prevention strategies are warranted to reduce injuries resulting from a non-contact mechanism. In addition, training exposure is required to accurately assess the overall risk of injury in netball.
Description:
Introduction: Published netball data have indicated that the ankle and knee are common sites for injury, often as a result of incorrect landing technique. Promising results have been demonstrated across various sports using training intervention studies designed to reduce lower limb injury rates. This qualitative study examines the barriers and facilitators towards the implementation of a 6-week landing intervention program (“Down to Earth”) by coaches of junior netball teams. Methodology: Coaches of junior teams (n = 30) were recruited prior to the competition season (October 2007 to March 2008) and attended a workshop where the coaching requirements of the program were demonstrated. Coaches were instructed to implement the program at training, noting any issues regarding program compliance. Pre- and post-season surveys modelled on the Theory of Planned Behaviour were used to indicate coaches’ attitudes, perceived social norms and behavioural control towards safe landing programs in netball. Retention of correct landing principles was assessed and barriers and facilitators for broader implementation among junior netball coaches were determined. Results and discussion: Results will be presented to indicate how coaches’ attitudes and knowledge towards landing intervention programs can assist in the development of an effective implementation strategy of a training injury prevention intervention, to a broader netball community. An example of feedback provided was”…we have noticed quite an improvement in the kids, and their landing and balancing, so it is all been worth while. We were also discussing…about including the program into our junior training next year and how best to do this”.
Description:
Employees in the Victorian thoroughbred horseracing industry who work closely with horses are exposed to a significant risk of traumatic injury. Although jockeys are the main focus of attention in this industry sector and in the literature, a large number of injuries are sustained by track riders and stable attendants. Exploratory research into the nature of the injury problem was undertaken and it was found that there is a culture in the Victorian thoroughbred horseracing sector that leads to a greater focus on horses and their performance rather than on the health, safety and wellbeing of employees. Workers are exposed to a significant risk of injury as a result of shortcomings with regard to OHS management, the work environment, equipment, rules and procedures, and training and education. There appears to be little understanding of the mutual responsibilities at shared workplaces and a low level of responsiveness by those in a position to control hazards at training tracks and racetracks.
Description:
Employees in the Victorian thoroughbred horseracing industry who work closely with horses are exposed to a significant risk of traumatic injury. Although jockeys are the main focus of attention in this industry sector and in the literature, a large number of injuries are sustained by track riders and stable attendants. Exploratory research into the nature of the injury problem was undertaken and it was found that there is a culture in the Victorian thoroughbred horseracing sector that leads to a greater focus on horses and their performance rather than on the health, safety and wellbeing of employees. Workers are exposed to a significant risk of injury as a result of shortcomings with regard to OHS management, the work environment, equipment, rules and procedures, and training and education. There appears to be little understanding of the mutual responsibilities at shared workplaces and a low level of responsiveness by those in a position to control hazards at training tracks and racetracks.
Description:
Within this chapter we have focused almost exclusively on the actions of teachers of HPE. Every state version of the national curriculum in Australia makes reference to students learning about themselves and caring for the wellbeing of themselves and others. Our intention here is to suggest that in providing safety education and involving students in considering this safety lens, teaching HPE can help prevent foreseeable and immediate injury. The basis of this chapter has been to suggest that changes in community beliefs and the development of a risk society has created a new risk framework regarding injuries in which teachers of HPE must work.
Description:
Objective: To model the population level impact of tai-chi on future rates of falls and fall-related injury in older people as a tool for policy development. Design: An epidemiological and economic model for estimating population-level effectiveness of tai-chi. Setting: Australia, 2009. Patients or subjects: Australian community-dwelling population aged 70+ years, ambulatory and without debilitating conditions or profound visual defects. Intervention: Group-based tai-chi, for 1 h twice weekly for 26 weeks, assuming no sustained effect beyond the intervention period. Main outcome measure: Total falls and fall-related hospitalisation prevented in 2009. Results: Population-wide tai-chi delivery would prevent an estimated 5440 falls and 109 fall-related hospitalisations, resulting in a 0.18% reduction in the fall related hospital admission rate for community-dwelling older people. The gross costs per fall and per fall-related hospital admission prevented were $ A4414 ((sic)3013) and $A220 712 ((sic)150 684), respectively. A total investment of $A24.01 million ((sic)16.39 million), equivalent to 4.2% of the cost of fall-related episodes of hospital care in 2003/4, would be required to provide tai-chi for 31 998 people and achieve this effect. Conclusions: Substantial investment in, and high population uptake of, tai-chi would be required to have a large effect on falls and fall-related hospitalisation rates. Although not accounted for in this study, investment in tai-chi is likely to be associated with additional significant health benefits beyond falls prevention. This approach could be applied to other interventions to assist selection of the most cost effective falls-prevention portfolio for Australia and other countries.
Description:
Objective: To evaluate a sports safety-focused risk-management training programme. Design: Controlled before and after test. Setting: Four community soccer associations in Sydney, Australia. Participants: 76 clubs (32 intervention, 44 control) at baseline, and 67 clubs (27 intervention, 40 control) at post-season and 12-month follow-ups. Intervention: SafeClub, a sports safety-focused risk-management training programme (362 hour sessions) based on adult-learning principles and injury-prevention concepts and models. Main outcome measures: Changes in mean policy, infrastructure and overall safety scores as measured using a modified version of the Sports Safety Audit Tool. Results: There was no significant difference in the mean policy, infrastructure and overall safety scores of intervention and control clubs at baseline. Intervention clubs achieved higher post-season mean policy (11.9 intervention vs 7.5 controls), infrastructure (15.2 vs 10.3) and overall safety (27.0 vs 17.8) scores than did controls. These differences were greater at the 12-month follow-up: policy (16.4 vs 7.6); infrastructure (24.7 vs 10.7); and overall safety (41.1 vs 18.3). General linear modelling indicated that intervention clubs achieved statistically significantly higher policy (p, 0.001), infrastructure (p, 0.001) and overall safety (p, 0.001) scores compared with control clubs at the post-season and 12-month follow-ups. There was also a significant linear interaction of time and group for all three scores: policy (p, 0.001), infrastructure (p, 0.001) and overall safety (p, 0.001). Conclusions: SafeClub effectively assisted community soccer clubs to improve their sports safety activities, particularly the foundations and processes for good risk-management practice, in a sustainable way.
Description:
Objective: To evaluate a sports safety-focused risk-management training programme. Design: Controlled before and after test. Setting: Four community soccer associations in Sydney, Australia. Participants: 76 clubs (32 intervention, 44 control) at baseline, and 67 clubs (27 intervention, 40 control) at post-season and 12-month follow-ups. Intervention: SafeClub, a sports safety-focused risk-management training programme (362 hour sessions) based on adult-learning principles and injury-prevention concepts and models. Main outcome measures: Changes in mean policy, infrastructure and overall safety scores as measured using a modified version of the Sports Safety Audit Tool. Results: There was no significant difference in the mean policy, infrastructure and overall safety scores of intervention and control clubs at baseline. Intervention clubs achieved higher post-season mean policy (11.9 intervention vs 7.5 controls), infrastructure (15.2 vs 10.3) and overall safety (27.0 vs 17.8) scores than did controls. These differences were greater at the 12-month follow-up: policy (16.4 vs 7.6); infrastructure (24.7 vs 10.7); and overall safety (41.1 vs 18.3). General linear modelling indicated that intervention clubs achieved statistically significantly higher policy (p, 0.001), infrastructure (p, 0.001) and overall safety (p, 0.001) scores compared with control clubs at the post-season and 12-month follow-ups. There was also a significant linear interaction of time and group for all three scores: policy (p, 0.001), infrastructure (p, 0.001) and overall safety (p, 0.001). Conclusions: SafeClub effectively assisted community soccer clubs to improve their sports safety activities, particularly the foundations and processes for good risk-management practice, in a sustainable way.
Description:
In Australia, the vast majority of sport is played at the community level rather than at an elite level. This paper will explore the congruence of participants’ beliefs about various aspects of sports injury at the community level and their injury prevention (IP) practices. The results of the study will help to direct our efforts as injury prevention researchers and practitioners in the field. The study used survey data of 165 basketball and hockey players to explore attitudes to injury prevention using the health belief model. The study explored the benefits and barriers to injury prevention strategies such as the use of mouthguards, shin pads, taping/bracing and warming-up and cooling-down. Hockey players felt that they were significantly more susceptible to injury than basketball players. The perception of benefits and barriers as factors in injury prevention use was significantly different between the groups. Hockey players demonstrated more positive attitudes to IP use and this is borne out in their behaviours. The significant predictor of IP usage in basketball games was the number of injuries sustained. The Health Belief Model does not appear to be useful in predicting IP use in basketball. It may be possible to influence the uptake of IP use in basketball by incorporating educational programs which relate the realistic potential for individuals to be injured. In hockey, perceived barriers were the most important predictors of IP gear use, with barriers to mouthguard use being significant. The more positively participants viewed mouthguards, the more IP strategies they employed overall.