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:
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:
Hamstring injuries remain a significant burden in sports that involve high-speed running. In elite male football, hamstring injury has repeatedly been identified as the most common non-contact injury, representing 12% of all injuries. As the incidence remains high, investigations are aimed at better understanding how to improve prevention efforts. Intrinsic risk factors such as strength have been investigated extensively in a cohort of professional football players; however, other intrinsic measures of neuromuscular function have not been studied in this cohort. This study aims to investigate the association between timing of hamstring muscle activity onset and the rate of torque development during the early phase of isokinetic strength testing with risk of hamstring injury in professional football players in a prospective cohort study. All teams (n = 18) eligible to compete in the premier football league in Qatar underwent a comprehensive strength assessment during their annual periodic health evaluation at Aspetar Orthopaedic and Sports Medicine Hospital in Doha, Qatar. Variables included rate of torque development and timing of muscle activity onset. A total of 367 unique players (60.6% of all QSL players) competed for 514 player seasons (103 players competed both seasons) and sustained 65 hamstring injuries. There was no difference in the onset of muscle activity between the biceps femoris and medial hamstrings comparing the injured to uninjured players. For both onset of muscle activity and rate of torque development, there were no significant differences between any of the variables (P >.05), with small effect sizes detected across all the different variables (d < 0.3). Rate of torque development and onset of muscle activity were not associated with a risk of future hamstring injury. The use of these measures as part of a periodic health evaluation to identify risk of hamstring injury is unsupported.
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:
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:
Lung inflammation and impaired alveolarization are hallmarks of bronchopulmonary dysplasia (BPD). We hypothesize that human amnion epithelial cells (hAECs) are anti-inflammatory and reduce lung injury in preterm lambs born after antenatal exposure to inflammation. Pregnant ewes received either intra-amniotic lipopolysaccharide (LPS, from E.coli 055:B5 4mg) or saline (Sal) on day 126 of gestation. Lambs were delivered by cesarean section at 128 d gestation (term ~150 d). Lambs received intravenous hAECs (LPS/hAECs: n = 7 30x10.sup.6 cells) or equivalent volumes of saline (LPS/Sal, n = 10 or Sal/Sal, n = 9) immediately after birth. Respiratory support was gradually de-escalated, aimed at early weaning from mechanical ventilation towards unassisted respiration. Lung tissue was collected 1 week after birth. Lung morphology was assessed and mRNA levels for inflammatory mediators were measured. Respiratory support required by LPS/hAEC lambs was not different to Sal/Sal or LPS/Sal lambs. Lung tissue:airspace ratio was lower in the LPS/Sal compared to Sal/Sal lambs (P<0.05), but not LPS/hAEC lambs. LPS/hAEC lambs tended to have increased septation in their lungs versus LPS/Sal (P = 0.08). Expression of inflammatory cytokines was highest in LPS/hAECs lambs. Postnatal administration of a single dose of hAECs stimulates a pulmonary immune response without changing ventilator requirements in preterm lambs born after intrauterine inflammation.
Description:
Lung inflammation and impaired alveolarization are hallmarks of bronchopulmonary dysplasia (BPD). We hypothesize that human amnion epithelial cells (hAECs) are anti-inflammatory and reduce lung injury in preterm lambs born after antenatal exposure to inflammation. Pregnant ewes received either intra-amniotic lipopolysaccharide (LPS, from E.coli 055:B5 4mg) or saline (Sal) on day 126 of gestation. Lambs were delivered by cesarean section at 128 d gestation (term ~150 d). Lambs received intravenous hAECs (LPS/hAECs: n = 7 30x10.sup.6 cells) or equivalent volumes of saline (LPS/Sal, n = 10 or Sal/Sal, n = 9) immediately after birth. Respiratory support was gradually de-escalated, aimed at early weaning from mechanical ventilation towards unassisted respiration. Lung tissue was collected 1 week after birth. Lung morphology was assessed and mRNA levels for inflammatory mediators were measured. Respiratory support required by LPS/hAEC lambs was not different to Sal/Sal or LPS/Sal lambs. Lung tissue:airspace ratio was lower in the LPS/Sal compared to Sal/Sal lambs (P<0.05), but not LPS/hAEC lambs. LPS/hAEC lambs tended to have increased septation in their lungs versus LPS/Sal (P = 0.08). Expression of inflammatory cytokines was highest in LPS/hAECs lambs. Postnatal administration of a single dose of hAECs stimulates a pulmonary immune response without changing ventilator requirements in preterm lambs born after intrauterine inflammation.
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:
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:
Introduction Many disability prevention strategies are focused on acute injuries and brief illness episodes, but there will be growing challenges for employers to manage circumstances of recurrent, chronic, or fluctuating symptoms in an aging workforce. The goal of this article is to summarize existing peer-review research in this area, compare this with employer discourse in the grey literature, and recommend future research priorities. Methods The authors participated in a year-long sponsored collaboration that ultimately led to an invited 3-day conference, “Improving Research of Employer Practices to Prevent Disability”, held October 14–16, 2015, in Hopkinton, Massachusetts, USA. The collaboration included a topical review of the scientific and industry literature, group discussion to identify key areas and challenges, drafting of initial documents, and feedback from peer researchers and a special panel of experts with employer experience. Results Cancer and mental illness were chosen as examples of chronic or recurring conditions that might challenge conventional workplace return-to-work practices. Workplace problems identified in the literature included fatigue, emotional exhaustion, poor supervisor and co-worker support, stigma, discrimination, and difficulties finding appropriate accommodations. Workplace intervention research is generally lacking, but there is preliminary support for improving workplace self-management strategies, collaborative problem-solving, and providing checklists and other tools for job accommodation, ideas echoed in the literature directed toward employers. Research might be improved by following workers from an earlier stage of developing workplace concerns. Conclusions Future research of work disability should focus on earlier identification of at-risk workers with chronic conditions, the use of more innovative and flexible accommodation strategies matched to specific functional losses, stronger integration of the workplace into on-going rehabilitation efforts, and a better understanding of stigma and other social factors at work.
Description:
Objectives: To present the first comprehensive epidemiological profile of hospital-treated injuries sustained by female cricketers from 2002-2003 to 2013-2014 in Victoria, Australia. Design: Analysis of routinely collected hospital data (detailed case-series). Methods: A retrospective analysis of hospital-treatment data associated with cricket injuries sustained by women between 1 July 2002 and 30 June 2014, inclusive were extracted from databases held by the Victorian Injury Surveillance Unit in Australia. Results: Over the 12-year period, 668 cases were treated in Victoria. Of these, 547 were emergency department (ED)-presentations. There were 121 hospital-admissions, of which, the length of stay was <2 days for 78.5% cases. All cases were treated and released, and no fatalities were reported. The 10-14 year age group most frequently presented to ED (19.9%) and were most commonly admitted to hospital (16.5% of the total admissions). Fractures were the most common cause of hospital-admissions (47.1%) but only accounted for 17.2% of the ED-presentations. Dislocations, sprains and strains, were the most common (36.4%) cause of ED-presentations. The head was the most commonly injured anatomical location (27.8% of ED-presentations and 28.1% of hospital-admissions), followed by the wrist and hand (27.8% ED-presentations and 17.4% hospital-admissions). Conclusions: These findings provide the first overview of the nature of injuries requiring hospital attendance in female cricketers, and a foundation to inform the development of targeted injury prevention programs for female cricketers. (C) 2019 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
Description:
Objectives: To obtain benefits from sports injury prevention programs, players are instructed to perform the exercises as prescribed. We developed an observational checklist to measure the quality of exercise performance by players participating in FootyFirst, a coach-led, exercise-based, lower-limb injury prevention program in community Australian Football (AF). Design: Observational. Methods: The essential performance criteria for each FootyFirst exercise were described in terms of the technique, volume and intensity required to perform each exercise. An observational checklist was developed to evaluate each criterion through direct visual observation of players at training. The checklist was trialled by two independent raters who observed the same 70 players completing the exercises at eight clubs. Agreement between observers was assessed by Kappa-statistics. Exercise fidelity was defined as the proportion of observed players who performed all aspects of their exercises correctly. Results: The raters agreed on 61/70 observations (87%) (Kappa = 0.72, 95% CI: 0.55; 0.89). Of the observations with agreed ratings, 41 (67%) players were judged as performing the exercises as prescribed. Conclusions: The observational checklist demonstrated high inter-rater reliability. Many players observed did not perform the exercises as prescribed, raising concern as to whether they would be receiving anticipated program benefits. Where quality of exercise performance is important, evaluation and reporting of program fidelity should include direct observations of participants.
Description:
Objectives: To obtain benefits from sports injury prevention programs, players are instructed to perform the exercises as prescribed. We developed an observational checklist to measure the quality of exercise performance by players participating in FootyFirst, a coach-led, exercise-based, lower-limb injury prevention program in community Australian Football (AF). Design: Observational. Methods: The essential performance criteria for each FootyFirst exercise were described in terms of the technique, volume and intensity required to perform each exercise. An observational checklist was developed to evaluate each criterion through direct visual observation of players at training. The checklist was trialled by two independent raters who observed the same 70 players completing the exercises at eight clubs. Agreement between observers was assessed by Kappa-statistics. Exercise fidelity was defined as the proportion of observed players who performed all aspects of their exercises correctly. Results: The raters agreed on 61/70 observations (87%) (Kappa = 0.72, 95% CI: 0.55; 0.89). Of the observations with agreed ratings, 41 (67%) players were judged as performing the exercises as prescribed. Conclusions: The observational checklist demonstrated high inter-rater reliability. Many players observed did not perform the exercises as prescribed, raising concern as to whether they would be receiving anticipated program benefits. Where quality of exercise performance is important, evaluation and reporting of program fidelity should include direct observations of participants.
Description:
Knowledge Translation, as a component of implementation science, has seen extensive popularization in Sport and Exercise Medicine (SEM) over recent years. However, in seeking better and more influential outcomes, much of SEM appears to be following Knowledge Translation fashion and fad, over ensuring function and form. This has meant that key concepts in Knowledge Translation have been conflated, the work oversimplified, and potential outcomes overhyped. In this manuscript, Knowledge Translation is, first, defined as a process. Next, we show how oversimplified versions of Knowledge Translation rely on the “fallacy of amelioration,” with problematic consequences and unintended outcomes. Finally, we move to rethinking Knowledge Translation in SEM by showing how the field can move forward through embracing Knowledge Translation as a complex process to maximize the influence and impact of its work.
Description:
Talented athletes use metacognitive skills to improve their performance. Also, it is known that these skills are important for managing one's health. The goal of this study was to identify the relationship between metacognitive skills and overuse injuries in talented tennis players. Metacognitive skills were measured in 73 talented tennis players (45 boys and 28 girls, age 11-14) at the start of the season, using the Self-Regulation of Learning Self-Report Scale. Overuse injuries were monitored for one season using the Oslo Sports Trauma Research Centre Questionnaire on Health Problems. Ordinal regression indicated that moderate or low selfmonitoring skills (compared to high selfmonitoring) (OR 4.555, CI 1.096-18.927, P = 0.037) and exposure time (OR 1.380, CI 1.106-1.721, P = 0.004) were associated with more time loss overuse injuries. A second analysis showed that this was the case in girls (OR 10.757, CI 1.845-62.714, P = 0.008), but not in boys. Linear regression revealed that higher reflection scores and exposure time predicted overuse severity (F(5,58) = 2.921, P = 0.020, R2 = 0.201). Possibly, selfmonitoring can help players to prevent themselves from time loss overuse injuries. Coaches should be aware that players can differ in selfmonitoring ability and thus in the ability to prevent overuse injuries. The role of reflection needs more research.