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Gill SD, Anagnostelos L, Stella J, Lowry N, Kloot K, Reade T, Baker T, Hayden G, Ryan M, Seward H, Page RS. Wrist, hand and finger injuries in Australian football: A prospective observational study of emergency department presentations. Emerg Med Australas 2023. [PMID: 36682734 DOI: 10.1111/1742-6723.14171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 12/17/2022] [Accepted: 12/19/2022] [Indexed: 01/24/2023]
Abstract
OBJECTIVES Investigate the characteristics of wrist, hand and finger (WHF) injuries in Australian footballers presenting to EDs and determine if injury profiles differed between females and males, and between children and adults. METHODS In this prospective observational study that took place during an entire football season, patients attended 1 of 10 EDs in Victoria, Australia with a WHF injury sustained while playing Australian football. Data were extracted from patient medical records by trained researchers. Data included injury type (e.g. fracture), body part (e.g. metacarpal) and mechanism of injury. Males versus females, and children versus adults were compared using chi-squared tests or Fisher's exact tests. RESULTS In total, 528 patients had a WHF injury, of which 105 (19.9%) were female and 308 (59.2%) were children. Fractures and sprains were the most common injury types (45.3% and 38.6%, respectively). Fingers were more often injured than wrists or hands (62.5%, 23.5% and 15.0%, respectively). Ball contact was the most common mechanism of injury (38.1% of injuries). Females were more likely than males to (i) have a sprain/strain injury, (ii) injure a finger (rather than wrist or hand) and (iii) injure themselves through ball contact. Children were more likely to injure their wrists, have a sprain/strain injury, or be injured falling to the ground. Adults were more likely to dislocate a joint or injure their hands. CONCLUSIONS Differences in injury type, location and mechanism between females and males, and children and adults, suggest an opportunity for customised injury prevention and management strategies by sex and age.
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Affiliation(s)
- Stephen D Gill
- Barwon Centre for Orthopaedic Research and Education, Geelong, Victoria, Australia.,School of Medicine, Deakin University, Warrnambool, Victoria, Australia.,St John of God Geelong Hospital, Geelong, Victoria, Australia
| | - Lambros Anagnostelos
- Barwon Centre for Orthopaedic Research and Education, Geelong, Victoria, Australia.,School of Medicine, Deakin University, Warrnambool, Victoria, Australia.,St John of God Geelong Hospital, Geelong, Victoria, Australia
| | - Julian Stella
- Emergency Department, University Hospital Geelong, Geelong, Victoria, Australia
| | - Nicole Lowry
- Emergency Department, University Hospital Geelong, Geelong, Victoria, Australia
| | - Kate Kloot
- School of Medicine, Deakin University, Warrnambool, Victoria, Australia
| | - Tom Reade
- Emergency Department, University Hospital Geelong, Geelong, Victoria, Australia
| | - Tim Baker
- Centre for Rural Emergency Medicine, School of Medicine, Deakin University, Warrnambool, Victoria, Australia
| | - Georgina Hayden
- St John of God Geelong Hospital, Geelong, Victoria, Australia
| | - Matthew Ryan
- Emergency Department, Epworth Hospital Geelong, Geelong, Victoria, Australia
| | - Hugh Seward
- Newtown Medical Centre, Geelong, Victoria, Australia
| | - Richard S Page
- Barwon Centre for Orthopaedic Research and Education, Geelong, Victoria, Australia.,School of Medicine, Deakin University, Warrnambool, Victoria, Australia.,St John of God Geelong Hospital, Geelong, Victoria, Australia
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2
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Gill SD, Stella J, Chatterton ML, Lowry N, Kloot K, Reade T, Baker T, Hayden G, Ryan M, Seward H, Page RS. Economic consequences of injury in female Australian footballers: A prospective observational study of emergency department presentations. Emerg Med Australas 2023; 35:496-503. [PMID: 36623933 DOI: 10.1111/1742-6723.14156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 12/06/2022] [Accepted: 12/06/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Investigate the economic consequences of injuries to female Australian footballers from a health sector and societal perspective. METHODS This prospective observational study invited 242 females to complete an online questionnaire 3-6 months following an Australian football injury which involved presentation to an ED in Victoria, Australia. The questionnaire inquired regarding healthcare use, time off work, return to playing football and extent of recovery following injury. Relevant information was also extracted from respondents' medical records regarding injury-type, body part injured, investigations and treatments. Healthcare costs were determined for each respondent's ED presentation, hospital admission/s (when relevant), and subsequent healthcare use. Societal costs were determined as lost income to the respondent and/or carer. RESULTS A total of 108 people responded to the questionnaire. Sprains/strains and fractures accounted for 84.2% of respondents' injuries. Sixteen respondents (14.8%) required admission to hospital at the time of injury and 81 (75.0%) required subsequent healthcare appointments following discharge from the ED or hospital. Time off work or school following the injury was common (64.8% of respondents) and 27.8% of respondents had a carer take time off work. More than 80% of respondents missed training and matches following the injury. The median healthcare cost per respondent was AUD$753 and the median cost due to work absence was AUD$1393. One-quarter of respondents reported a full recovery. CONCLUSIONS Injuries to female Australian footballers can produce substantial healthcare and societal costs, which has important implications for healthcare provision and prioritising and implementing injury prevention programmes and post-injury rehabilitation.
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Affiliation(s)
- Stephen D Gill
- Barwon Centre for Orthopaedic Research and Education, School of Medicine, Deakin University and St John of God Geelong Hospital, Geelong, Victoria, Australia.,Emergency Department, University Hospital Geelong, Geelong, Victoria, Australia
| | - Julian Stella
- Emergency Department, University Hospital Geelong, Geelong, Victoria, Australia
| | - Mary Lou Chatterton
- Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Deakin University, Geelong, Victoria, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Nicole Lowry
- Emergency Department, University Hospital Geelong, Geelong, Victoria, Australia
| | - Kate Kloot
- School of Medicine, Deakin University, Warrnambool, Victoria, Australia
| | - Tom Reade
- Emergency Department, University Hospital Geelong, Geelong, Victoria, Australia
| | - Tim Baker
- Centre for Rural Emergency Medicine, School of Medicine, Deakin University, Warrnambool, Victoria, Australia
| | - Georgina Hayden
- Emergency Department, St John of God Geelong Hospital, Geelong, Victoria, Australia
| | - Matthew Ryan
- Emergency Department, Epworth Hospital Geelong, Geelong, Victoria, Australia
| | - Hugh Seward
- Newtown Medical Centre, Geelong, Victoria, Australia
| | - Richard S Page
- Barwon Centre for Orthopaedic Research and Education, School of Medicine, Deakin University and St John of God Geelong Hospital, Geelong, Victoria, Australia
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3
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Gill SD, Stella J, Lowry N, Kloot K, Reade T, Baker T, Hayden G, Ryan M, Seward H, Page RS. Gender differences in female and male Australian Football injuries - A prospective observational study of emergency department presentations. J Sci Med Sport 2021; 24:670-676. [PMID: 33707157 DOI: 10.1016/j.jsams.2021.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 02/15/2021] [Accepted: 02/16/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To compare injury-profiles of females and males presenting to Emergency Departments (EDs) with an Australian Football injury. DESIGN Prospective observational study. METHODS All patients presenting to one of 10 EDs in Victoria, Australia, with an Australian Football injury were included in the study. Data were prospectively collected over a 10 month period, coinciding with a complete Australian Football season, including pre-season training and practice matches. Relevant information was extracted from patient medical records regarding injury-type, body part injured, investigations and treatments required. Female and male data were compared with chi-squared and Fisher's exact tests. RESULTS 1635 patients were included, of whom 242 (14.8%) were female. Females had a higher proportion of hand/finger injuries (34.3% v 23.4%), neck injuries (6.6% v 2.5%) and patella dislocations (2.9% v 0.6%). Males had a higher proportion of shoulder injuries (11.5% v 5.8%), skin lacerations (8.0% v 1.7%), and thorax/abdominal/pelvic injuries (5.7% v 2.1%). Concussion rates were similar between the genders, occurring in 14.1% of all patients. Anterior cruciate ligament injuries were infrequent (1.0%) and not significantly different between genders. Females received more imaging investigations (83.1% v 74.7%) and analgesia (62.4% v 48.5%). A higher proportion of males required admission to hospital (5.0% v 2.1%), usually for surgery. CONCLUSION Australian Football injury profiles differed between females and males. Gender-specific injury prevention and management programs would be indicated based on the study findings.
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Affiliation(s)
- Stephen D Gill
- Barwon Centre for Orthopaedic Research and Education (B-CORE), School of Medicine, Deakin University and St John of God Hospital, Australia.
| | - Julian Stella
- Emergency Department, University Hospital Geelong, Australia
| | - Nicole Lowry
- Emergency Department, University Hospital Geelong, Australia
| | - Kate Kloot
- Centre for Rural Emergency Medicine, School of Medicine, Deakin University, Australia
| | - Tom Reade
- Emergency Department, University Hospital Geelong, Australia
| | - Tim Baker
- Centre for Rural Emergency Medicine, School of Medicine, Deakin University, Australia
| | | | | | | | - Richard S Page
- Barwon Centre for Orthopaedic Research and Education (B-CORE), School of Medicine, Deakin University and St John of God Hospital, Australia
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4
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Simma L, Palmer CS, Ngo A, Jowett HE, Teague WJ. An evaluation of the presentation and severity of Australian football injury in children. TRAUMA-ENGLAND 2021. [DOI: 10.1177/1460408620941335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction Child participation in sport is important for physical, cognitive and psychosocial wellbeing. Australian rules football has high participation, but also carries a high risk of injury due to the contact nature of the sport. This study aimed to evaluate changes in the presentation and hospital admission of paediatric Australian rules football-related injuries, and to compare the severity of these injuries with those from other team ball sports. Materials and methods At an Australian paediatric major trauma service, ED and hospital trauma registry data relating to Australian rules football injury between 2009 and 2015 were obtained. Data from other common team ball sports with a shared field of play were also identified. Results During the study period, there were 10,003 ED presentations, and 1110 admissions resulting from team ball sports. With 4751 ED presentations and 616 admissions, Australian rules football accounted for almost one-third of all sports-related presentations and admissions, and around half of the team ball sports cohort. Compared to other team ball sports patients, Australian rules football-related patients were 40% more likely to be admitted, and nearly twice as likely to be classified as severe injury. Australian rules football players presented with different injury patterns were compared to other team ball sports players; admitted players were significantly more likely to have sustained head or neck injuries, and were more than twice as likely to sustain truncal injury. Conclusions Australian rules football is a common cause of ED presentations and results in substantial morbidity, both overall and when compared with other team ball sports. Australian rules football should remain a focus for ongoing and active research into strategies which reduce injury risk.
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Affiliation(s)
- Leopold Simma
- Trauma Service, The Royal Children's Hospital, Melbourne, Australia
- Emergency Department, The Royal Children's Hospital, Melbourne, Australia
- Children's Hospital Lucerne, Lucerne, Switzerland
| | - Cameron S Palmer
- Trauma Service, The Royal Children's Hospital, Melbourne, Australia
- Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, Australia
| | - Alan Ngo
- Trauma Service, The Royal Children's Hospital, Melbourne, Australia
- Emergency Department, The Royal Children's Hospital, Melbourne, Australia
| | - Helen E Jowett
- Trauma Service, The Royal Children's Hospital, Melbourne, Australia
| | - Warwick J Teague
- Trauma Service, The Royal Children's Hospital, Melbourne, Australia
- Surgical Research Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
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5
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Reyes J, Mitra B, McIntosh A, Clifton P, Makdissi M, Nguyen JVK, Harcourt P, Howard TS, Cameron PA, Rosenfeld JV, Willmott C. An Investigation of Factors Associated With Head Impact Exposure in Professional Male and Female Australian Football Players. Am J Sports Med 2020; 48:1485-1495. [PMID: 32255667 DOI: 10.1177/0363546520912416] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Exposure to head acceleration events (HAEs) has been associated with player sex, player position, and player experience in North American football, ice hockey, and lacrosse. Little is known of these factors in professional Australian football. Video analysis allows HAE verification and characterization of important determinants of injury. PURPOSE To characterize verified HAEs in the nonhelmeted contact sport of professional Australian football and investigate the association of sex, player position, and player experience with HAE frequency and magnitude. STUDY DESIGN Descriptive epidemiology study. METHODS Professional Australian football players wore a nonhelmeted accelerometer for 1 match, with data collected across 14 matches. HAEs with peak linear accelerations (PLAs) ≥30g were verified with match video. Verified HAEs were summarized by frequency and median PLA and compared between the sexes, player position, and player experience. Characterization of match-related situations of verified HAEs was conducted, and the head impact rate per skill execution was calculated. RESULTS 92 male and 118 female players were recruited during the 2017 season. Male players sustained more HAEs (median, 1; IQR, 0-2) than female players (median, 0; IQR, 0-1; P = .007) during a match. The maximum PLAs incurred during a match were significantly higher in male players (median, 61.8g; IQR, 40.5-87.1) compared with female players (median, 44.5g; IQR, 33.6-74.8; P = .032). Neither player position nor experience was associated with HAE frequency. Of all verified HAEs, 52% (n = 110) occurred when neither team had possession of the football, and 46% (n = 98) were caused by contact from another player attempting to gain possession of the football. A subset of HAEs (n = 12; 5.7%) resulted in players seeking medical aid and/or being removed from the match (median PLA, 58.8g; IQR, 34.0-89.0), with 2 (male) players diagnosed with concussion after direct head impacts and associated PLAs of 62g and 75g, respectively. In the setting of catching (marking) the football, female players exhibited twice the head impact rate (16 per 100 marking contests) than male players (8 per 100 marking contests). CONCLUSION Playing situations in which players have limited control of the football are a common cause of impacts. Male players sustained a greater exposure to HAEs compared with female players. Female players, however, sustained higher exposure to HAEs than male players during certain skill executions, possibly reflecting differences in skill development. These findings can therefore inform match and skill development in the emerging professional women's competition of Australian football.
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Affiliation(s)
- Jonathan Reyes
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton Campus, Melbourne, Australia
| | - Biswadev Mitra
- National Trauma Research Institute, The Alfred Hospital, Melbourne, Australia.,Emergency & Trauma Centre, The Alfred Hospital, Melbourne, Australia.,Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, Australia
| | - Andrew McIntosh
- Monash University Accident Research Centre, Monash University, Melbourne, Australia.,School of Engineering and Australian Collaboration for Research Into Injury in Sport and Its Prevention, Edith Cowan University, Joondalup, Australia
| | | | - Michael Makdissi
- Florey Institute of Neuroscience and Mental Health, Austin Campus, Melbourne Brain Centre, Heidelberg, Victoria, Australia.,Olympic Park Sports Medicine Centre, Melbourne, Australia
| | - Jack V K Nguyen
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton Campus, Melbourne, Australia
| | | | - Teresa S Howard
- National Trauma Research Institute, The Alfred Hospital, Melbourne, Australia.,Department of Surgery, Monash University, Melbourne, Australia
| | - Peter A Cameron
- National Trauma Research Institute, The Alfred Hospital, Melbourne, Australia.,Emergency & Trauma Centre, The Alfred Hospital, Melbourne, Australia.,Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, Australia
| | - Jeffrey V Rosenfeld
- Department of Surgery, Monash University, Melbourne, Australia.,Department of Neurosurgery, The Alfred Hospital, Melbourne, Australia.,Department of Surgery, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Catherine Willmott
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton Campus, Melbourne, Australia.,Monash-Epworth Rehabilitation Research Centre, Epworth Hospital, Melbourne, Australia
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6
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McLeod G, O'Connor S, Morgan D, Kountouris A, Finch CF, Fortington LV. Medical-attention injuries in community cricket: a systematic review. BMJ Open Sport Exerc Med 2020; 6:e000670. [PMID: 32231790 PMCID: PMC7101051 DOI: 10.1136/bmjsem-2019-000670] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2020] [Indexed: 12/30/2022] Open
Abstract
Objectives The aim was to identify and describe outcomes from original published studies that present the number, nature, mechanism and severity of medically treated injuries sustained in community-level cricket. Design Systematic review. Methods Nine databases were systematically searched to December 2019 using terms "cricket*" and "injur*". Original, peer-reviewed studies reporting injury for at least one injury descriptor (body region, nature of injury and/or mechanism of injury) in community-level cricketers of all ages were included. Qualitative synthesis, critical appraisal and descriptive summary results are reported within the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Results Six studies were included: five reported hospital-treated data and one reported insurance claims data. Two had a low risk of bias. In hospital-based studies, fractures were the most frequent injury type. Upper and lower limb injuries (age ≥15 years) and injuries to the head (age <15 years) were the most common body region injured. Being struck by the ball was the most common mechanism for injury presenting to hospitals. Children were also commonly struck by equipment. One study using insurance claims data reported soft tissue injuries as the main of injury type. Conclusion Hospital treatment data were most prominent, which emphasised injuries of a more serious nature or requiring acute care. These injuries were primarily fractures, dislocation/sprain and strains, bruising and open wounds with the majority resulting from players being struck by the ball. Research into whether properly fitted protective equipment, at an approved standard, is worn and is effective, is recommended.
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Affiliation(s)
- Geordie McLeod
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Siobhán O'Connor
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Damian Morgan
- Federation Business School, Federation University Australia, Ballarat, Victoria, Australia
| | - Alex Kountouris
- Sports Science and Sports Medicine, Cricket Australia, Melbourne, Victoria, Australia
| | - Caroline F Finch
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Lauren V Fortington
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
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7
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Finch CF, Gray SE, Akram M, Donaldson A, Lloyd DG, Cook JL. Controlled ecological evaluation of an implemented exercise-training programme to prevent lower limb injuries in sport: population-level trends in hospital-treated injuries. Br J Sports Med 2018; 53:487-492. [PMID: 30217833 PMCID: PMC6579505 DOI: 10.1136/bjsports-2018-099488] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2018] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Exercise-training programmes have reduced lower limb injuries in trials, but their population-level effectiveness has not been reported in implementation trials. This study aimed to demonstrate that routinely collected hospital data can be used to evaluate population-level programme effectiveness. METHOD A controlled ecological design was used to evaluate the effect of FootyFirst, an exercise-training programme, on the number of hospital-treated lower limb injuries sustained by males aged 16-50 years while participating in community-level Australian Football. FootyFirst was implemented with 'support' (FootyFirst+S) or 'without support' (FootyFirst+NS) in different geographic regions of Victoria, Australia: 22 clubs in region 1: FootyFirst+S in 2012/2013; 25 clubs in region 2: FootyFirst+NS in 2012/2013; 31 clubs region 3: control in 2012, FootyFirst+S in 2013. Interrupted time-series analysis compared injury counts across regions and against trends in the rest of Victoria. RESULTS After 1 year of FootyFirst+S, there was a non-statistically significant decline in the number of lower limb injuries in region 1 (2012) and region 3 (2013); this was not maintained after 2 years in region 1. Compared with before FootyFirst in 2006-2011, injury count changes at the end of 2013 were: region 1: 20.0% reduction (after 2 years support); region 2: 21.5% increase (after 2 years without support); region 3: 21.8% increase (after first year no programme, second year programme with support); rest of Victoria: 12.6% increase. CONCLUSION Ecological analyses using routinely collected hospital data show promise as the basis of population-level programme evaluation. The implementation and sustainability of sports injury prevention programmes at the population-level remains challenging.
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Affiliation(s)
- Caroline F Finch
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.,Australian Centre for Research into Injury in Sport and its Prevention, Federation University Australia, Ballarat, Victoria, Australia
| | - Shannon E Gray
- Victorian Injury Surveillance Unit, Monash Injury Research Institute, Monash University, Melbourne, Victoria, Australia
| | - Muhammad Akram
- Australian Centre for Research into Injury in Sport and its Prevention, Federation University Australia, Ballarat, Victoria, Australia.,Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Alex Donaldson
- Australian Centre for Research into Injury in Sport and its Prevention, Federation University Australia, Ballarat, Victoria, Australia.,Centre for Sport and Social Impact, LaTrobe University, Melbourne, Victoria, Australia
| | - David G Lloyd
- Gold Coast Orthopaedic Research and Education alliance (GCORE), Menzies Health Institute Queensland, Gold Coast, Queensland, Australia.,School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
| | - Jill L Cook
- Australian Centre for Research into Injury in Sport and its Prevention, Federation University Australia, Ballarat, Victoria, Australia.,La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia
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8
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Appendicular fracture epidemiology of children and adolescents: a 10-year case review in Western Australia (2005 to 2015). Arch Osteoporos 2018; 13:63. [PMID: 29860609 DOI: 10.1007/s11657-018-0478-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 05/15/2018] [Indexed: 02/03/2023]
Abstract
UNLABELLED Fracture incidence data of Australian children and adolescents have not been reported in the literature. A 10-year case review of fracture presentations in Western Australia is provided. Between 2005 and 2015, fracture incidence increased relative to population growth. This is concerning, and interventions are required to reverse this trend. PURPOSE Fracture incidence in 0-16-year-olds is high and varies between countries. Boys have a 1.5:1 ratio of fracture incidence compared to girls. There are no specific data for Australia. Western Australia is a state with unique geography and population distribution having only a single tertiary paediatric hospital (Princess Margaret Hospital, PMH, in Perth) managing the majority of children and adolescents with fractures in the Emergency Department (ED). The aims of this study were to characterise fracture presentations to PMH-ED and compare the incidence to population data. METHODS A database audit of fracture presentations between 2005 and 2015 for fracture rates with a sub-analysis for gender, fracture site and age and a comparison to Perth Metropolitan and Western Australian population data was performed. RESULTS Analysis included 31,340 presentations. Fracture incidence, adjusted for the annual population size, increased from 0.63% in 2005 to 0.85% in 2015 (p < 0.001). The month of May reported the highest fracture rate (p < 0.001) corresponding with the start of the winter sports season. Males had a 1.5 times higher fracture incidence than females (p < 0.001), with upper limb fractures three times more common than lower limb fractures (p < 0.001). Fracture incidence increased with age until the early teenage years (15 years for males; 12 years for females) when a decline occurred. CONCLUSIONS Increased fracture incidence in Western Australia between 2005 and 2015 identifies a concerning trend for bone health in children and adolescents. Further research is needed to identify potential lifestyle factors that impact fracture incidence translating into evidence-based strategies to reverse these trends and improve bone health.
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9
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Saw R, Finch CF, Samra D, Baquie P, Cardoso T, Hope D, Orchard JW. Injuries in Australian Rules Football: An Overview of Injury Rates, Patterns, and Mechanisms Across All Levels of Play. Sports Health 2017; 10:208-216. [PMID: 28825878 PMCID: PMC5958447 DOI: 10.1177/1941738117726070] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
CONTEXT The nature of Australian rules football (Australian football) predisposes both unique and common injuries compared with those sustained in other football codes. The game involves a combination of tackling, kicking, high-speed running (more than other football codes), and jumping. Two decades of injury surveillance has identified common injuries at the professional level (Australian Football League [AFL]). OBJECTIVE To provide an overview of injuries in Australian rules football, including injury rates, patterns, and mechanisms across all levels of play. STUDY DESIGN A narrative review of AFL injuries, football injury epidemiology, and biomechanical and physiological attributes of relevant injuries. RESULTS The overall injury incidence in the 2015 season was 41.7 injuries per club per season, with a prevalence of 156.2 missed games per club per season. Lower limb injuries are most prevalent, with hamstring strains accounting for 19.1 missed games per club per season. Hamstring strains relate to the volume of high-speed running required in addition to at times having to collect the ball while running in a position of hip flexion and knee extension. Anterior cruciate ligament injuries are also prevalent and can result from contact and noncontact incidents. In the upper limb, shoulder sprains and dislocations account for 11.5 missed games per club per season and largely resulted from tackling and contact. Concussion is less common in AFL than other tackling sports but remains an important injury, which has notably become more prevalent in recent years, theorized to be due to a more conservative approach to management. Although there are less injury surveillance data for non-AFL players (women, community-level, children), many of these injuries appear to also be common across all levels of play. CLINICAL RELEVANCE An understanding of injury profiles and mechanisms in Australian football is crucial in identifying methods to reduce injury risk and prepare players for the demands of the game.
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Affiliation(s)
- Richard Saw
- Olympic Park Sports Medicine Centre,
Melbourne, Victoria, Australia
| | - Caroline F. Finch
- Australian Collaboration for Research
into Injury in Sport and Its Prevention, Federation University Australia, Ballarat,
Victoria, Australia
| | - David Samra
- The Stadium Sports Medicine Clinic,
Sydney, New South Walesm Australia
| | - Peter Baquie
- Olympic Park Sports Medicine Centre,
Melbourne, Victoria, Australia
| | - Tanusha Cardoso
- Alphington Sports Medicine Clinic,
Melbourne, Victoria, Australia
| | - Danielle Hope
- Peak Sports Medicine Clinic, Melbourne,
Victoria, Australia
| | - John W. Orchard
- School of Public Health, University of
Sydney, Sydney, New South Wales, Australia
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10
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Fortington LV, Finch CF. Priorities for injury prevention in women's Australian football: a compilation of national data from different sources. BMJ Open Sport Exerc Med 2016; 2:e000101. [PMID: 27900171 PMCID: PMC5117074 DOI: 10.1136/bmjsem-2015-000101] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2016] [Indexed: 11/26/2022] Open
Abstract
Background/aim Participation in Australian football (AF) has traditionally been male dominated and current understanding of injury and priorities for prevention are based solely on reports of injuries in male players. There is evidence in other sports that indicates that injury types differ between males and females. With increasing participation in AF by females, it is important to consider their specific injury and prevention needs. This study aimed to provide a first injury profile from existing sources for female AF. Methods Compilation of injury data from four prospectively recorded data sets relating to female AF: (1) hospital admissions in Victoria, 2008/09–13/14, n=500 injuries; (2) emergency department (ED) presentations in Victoria, 2008/09–2012/13, n=1,879 injuries; (3) insurance claims across Australia 2004–2013, n=522 injuries; (4) West Australian Women's Football League (WAWFL), 2014 season club data, n=49 injuries. Descriptive results are presented as injury frequencies, injury types and injury to body parts. Results Hospital admissions and ED presentations were dominated by upper limb injuries, representing 47% and 51% of all injuries, respectively, primarily to the wrist/hand at 32% and 40%. Most (65%) insurance claim injuries involved the lower limb, 27% of which were for knee ligament damage. A high proportion of concussions (33%) were reported in the club-collected data. Conclusions The results provide the first compilation of existing data sets of women's AF injuries and highlight the need for a rigorous and systematic injury surveillance system to be instituted.
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Affiliation(s)
- Lauren V Fortington
- Australian Collaboration for Research into Injury in Sport and its Prevention (ACRISP) , Federation University Australia , Ballarat, Victoria , Australia
| | - Caroline F Finch
- Australian Collaboration for Research into Injury in Sport and its Prevention (ACRISP) , Federation University Australia , Ballarat, Victoria , Australia
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High prevalence of dysfunctional, asymmetrical, and painful movement in elite junior Australian Football players assessed using the Functional Movement Screen. J Sci Med Sport 2016; 20:134-138. [PMID: 27531528 DOI: 10.1016/j.jsams.2016.05.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 04/18/2016] [Accepted: 05/13/2016] [Indexed: 01/15/2023]
Abstract
OBJECTIVES The purpose of this study was to describe the prevalence of dysfunctional, asymmetrical, and painful movement in junior Australian Football players using the Functional Movement Screen (FMS). DESIGN Cross-sectional study. METHODS Elite junior male Australian Football players (n=301) aged 15-18 years completed pre-season FMS testing. The FMS consists of 7 sub-tests: deep squat, hurdle step, in-line lunge, shoulder mobility, active straight leg raise, trunk stability push-up (TSPU) and rotary stability. The shoulder mobility, TSPU, and rotary stability tests were combined with an accompanying clearing test to assess pain. Each sub-test was scored on an ordinal scale from 0 to 3 and summed to give a composite score out of 21. Composite scores ≤14 were operationally defined as indicating dysfunctional movement. Players scoring differently on left and right sides were considered asymmetrical. Players reported whether they missed any games due to injury in the preceding 22 game season. RESULTS Sixty percent of players (n=182) had composite scores ≤14, 65% of players (n=196) had at least one asymmetrical sub-test, and 38% of players (n=113) had at least one painful sub-test. Forty-two percent of players (n=126) missed at least one game in the previous season due to injury. Previous injury did not influence composite score (p=0.951) or asymmetry (p=0.629). Players reporting an injury during the previous season were more likely to experience pain during FMS testing (odds ratio 1.97, 95% confidence interval 1.23-3.18; p=0.005). CONCLUSIONS Junior Australian Football players demonstrate a high prevalence of dysfunctional, asymmetrical, and painful movement during FMS testing.
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Fortington LV, Donaldson A, Finch CF. Self-reported worst injuries in women's Australian football identify lower limb injuries as a prevention priority. BMJ Open Sport Exerc Med 2016; 2:e000112. [PMID: 27900178 PMCID: PMC5117071 DOI: 10.1136/bmjsem-2016-000112] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2016] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Increasing participation by women in Australian football (AF) has made understanding their specific injury prevention needs a priority. In other sports, men and women have different injury profiles. This study aims to provide the first overview of self-reported injuries in women's AF. METHODS Nationwide survey of women aged 17+ years who played in an AF competition was conducted following the 2014 playing season. The players' self-reported worst injury from the 2014 season is presented according to injury type, body part injured, treatment sought and games/training missed. RESULTS Three-quarters of 553 respondents (n=431, 78%) reported at least 1 injury. Over half (n=235, 55%) of injuries were to the lower limb. Ankle ligament tears/sprains (n=50, 12% of all injuries) and knee ligament tears/sprains (n=45, 10%) were most frequent lower limb injuries reported. Two-thirds (65%) of all lower limb injuries led to at least 1 missed game. Of 111 (26% of all injuries) upper limb injuries reported, over half (n=57, 62%) were to the hand/fingers/thumb, including fractures (n=28, 6% of all injuries), ligament tears/sprains (n=18, 4%) and dislocations (n=11, 3%). Half of the upper limb injuries (51%) resulted in players missing matches/training. CONCLUSIONS The most frequent self-reported worst injuries for women playing AF were joint damage to the ankle and knee. A prospective injury study is needed to confirm the causes and rate of these lower limb injuries to identify the most suitable prevention interventions.
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Affiliation(s)
- Lauren V Fortington
- Australian Collaboration for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia , Ballarat, Victoria , Australia
| | - Alex Donaldson
- Australian Collaboration for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia , Ballarat, Victoria , Australia
| | - Caroline F Finch
- Australian Collaboration for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia , Ballarat, Victoria , Australia
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Finch CF, Twomey DM, Fortington LV, Doyle TLA, Elliott BC, Akram M, Lloyd DG. Preventing Australian football injuries with a targeted neuromuscular control exercise programme: comparative injury rates from a training intervention delivered in a clustered randomised controlled trial. Inj Prev 2015; 22:123-8. [PMID: 26399611 PMCID: PMC4819647 DOI: 10.1136/injuryprev-2015-041667] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 08/24/2015] [Indexed: 11/03/2022]
Abstract
BACKGROUND Exercise-based training programmes are commonly used to prevent sports injuries but programme effectiveness within community men's team sport is largely unknown. OBJECTIVE To present the intention-to-treat analysis of injury outcomes from a clustered randomised controlled trial in community Australian football. METHODS Players from 18 male, non-elite, community Australian football clubs across two states were randomly allocated to either a neuromuscular control (NMC) (intervention n=679 players) or standard-practice (control n=885 players) exercise training programme delivered as part of regular team training sessions (2× weekly for 8-week preseason and 18-week regular-season). All game-related injuries and hours of game participation were recorded. Generalised estimating equations, adjusted for clustering (club unit), were used to compute injury incidence rates (IIRs) for all injuries, lower limb injuries (LLIs) and knee injuries sustained during games. The IIRs were compared across groups with cluster-adjusted Injury Rate Ratios (IRRs). RESULTS Overall, 773 game injuries were recorded. The lower limb was the most frequent body region injured, accounting for 50% of injuries overall, 96 (12%) of which were knee injuries. The NMC players had a reduced LLI rate compared with control players (IRR: 0.78 (95% CI 0.56 to 1.08), p=0.14.) The knee IIR was also reduced for NMC compared with control players (IRR: 0.50 (95% CI 0.24 to 1.05), p=0.07). CONCLUSIONS These intention-to-treat results indicate that positive outcomes can be achieved from targeted training programmes for reducing knee and LLI injury rates in men's community sport. While not statistically significant, reducing the knee injury rate by 50% and the LLI rate by 22% is still a clinically important outcome. Further injury reductions could be achieved with improved training attendance and participation in the programme.
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Affiliation(s)
- Caroline F Finch
- Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, Ballarat, Victoria, Australia
| | - Dara M Twomey
- Faculty of Health, Federation University Australia, Ballarat, Victoria, Australia
| | - Lauren V Fortington
- Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, Ballarat, Victoria, Australia
| | - Tim L A Doyle
- Centre for Musculoskeletal Research, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Bruce C Elliott
- School of Sport Science, Exercise and Health, the University of Western Australia, Perth, Western Australia, Australia
| | - Muhammad Akram
- Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, Ballarat, Victoria, Australia
| | - David G Lloyd
- Centre for Musculoskeletal Research, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia School of Sport Science, Exercise and Health, the University of Western Australia, Perth, Western Australia, Australia
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Finch CF, Kemp JL, Clapperton AJ. The incidence and burden of hospital-treated sports-related injury in people aged 15+ years in Victoria, Australia, 2004-2010: a future epidemic of osteoarthritis? Osteoarthritis Cartilage 2015; 23:1138-43. [PMID: 25749009 DOI: 10.1016/j.joca.2015.02.165] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2014] [Revised: 01/29/2015] [Accepted: 02/23/2015] [Indexed: 02/02/2023]
Abstract
OBJECTIVES Previous sports injury is a known risk factor for subsequent osteoarthritis (OA), but population-based rates of sports injury are unknown. The aims of this study were to: (1) describe the trends in the population incidence and burden of all hospital-treated sports injury in Victoria, Australia in adults aged 15+ years; (2) determine the incidence of lower limb and knee injuries; and (3) quantify their population health burden as average direct hospital costs per injury and lengths of stay. METHODS Health sector data relating to adults aged 15+ years, for 2004-2010 inclusive, was extracted from the Victorian Admitted Episodes Dataset (VAED) and Victorian Emergency Minimum Dataset (VEMD). Data relating to sports injuries were identified using activity codes in each dataset Trends in injury frequency and rates were determined, and economic burden was calculated. RESULTS The overall annual rate of hospital treated sports injuries increased by 24% (P = 0.001), and lower limb injuries by 26% (P = 0.001) over the 7 years. The associated accumulated economic burden was $265 million for all sports injuries and $110 million for lower limb injuries over the 7-years. CONCLUSIONS The findings of this study show a significant increase in sports injuries in the state of Victoria, Australia over a 7-year period. As previous sports injury is a risk factor for the development of OA, the future incidence of OA will escalate, placing an even greater burden on health care systems. Population-wide preventative strategies that reduce the risk of sports injury are urgently required in order to reduce the future burden of OA.
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Affiliation(s)
- C F Finch
- Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), 1 of the 9 International Olympic Committee (IOC) Research Centres for the Prevention of Injury and Promotion of Health in Athletes Federation University Australia, SMB Campus, PO Box 668, Ballarat, VIC 3353, Australia.
| | - J L Kemp
- Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), 1 of the 9 International Olympic Committee (IOC) Research Centres for the Prevention of Injury and Promotion of Health in Athletes Federation University Australia, SMB Campus, PO Box 668, Ballarat, VIC 3353, Australia.
| | - A J Clapperton
- Data Systems, Data Requests and Reports, Victorian Injury Surveillance Unit (VISU), Monash Injury Research Institute, Building 70, Monash University, Australia.
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