2018 International Consensus Statement on Golf and Health to guide action by people, policymakers and the golf industry

Injury incidence in golf-a systematic review and meta-analysis

OBJECTIVE

There is a lack of comprehensive analysis of injuries in golf per exposure time. Thus, the aim was to report the pooled incidence of injuries in golf.

METHODS

We searched PubMed, Scopus, SPORTDiscus, and Web of Science databases in March 2024 for this systematic review and meta-analysis. We included observational studies reporting the number of injuries per exposure time. A random-effects model was used to calculate the pooled injury incidence per 1000 athlete exposures (18 holes of golf) with 95% confidence intervals (CI). Incidences were separately analyzed for men, women, amateurs, professionals, and special athletes.

RESULTS

A total of 999 studies were screened, 29 full texts were assessed, and 7 studies with 269,754 athlete exposures were included. Seven studies assessed the overall incidence of injury, and the pooled estimate was 2.5 per 1000 athlete exposures (CI 0.9-7.5). The incidence was higher in special athletes (21.0, CI 7.7-45.1; one study) than among professionals (8.5, CI 7.6-9.4; one study), or in amateurs (1.3, CI 0.5-4.0; five studies). The injury incidence was 2.6 per 1000 athlete exposures (CI 0.7-9.6; four studies) in women and 1.4 per 1000 athlete exposures (CI 0.4-5.2; three studies) in men. A sensitivity analysis without special athletes had an incidence of 1.9 (CI 0.7-4.9; six studies).

CONCLUSION

The injury incidence in golf is 2.5 injuries per 1000 athlete exposures (18 holes of golf). Reporting was limited as only one study reported injuries per exposure time in professionals, and in total, only seven studies were found. More research is needed in all levels and age groups to better estimate the injury incidence and associated risk factors in golf.

Perceived Facilitators and Barriers to Participation in Golf for People With Vision Impairment: A Qualitative Study

OBJECTIVES

This study aimed to identify facilitators and barriers to participation in vision impaired golf.

DESIGN

Semistructured interviews were conducted with 12 vision impaired golfers, 10 guides, and 5 novices during the British VI Golf Open tournament in August 2021.

RESULTS

Qualitative content analysis identified the benefits, facilitators, and challenges of playing vision impaired golf. The role of guides and future developments of the sport were furthermore identified. The benefits extend beyond those related to health, including personal development and a sense of purpose for players and of reward for guides. Facilitators were largely organizational and having appropriate support and a guide. The challenges to playing and guiding were practical, financial, and logistical. The need to attract a more diverse range of players, along with a reconsideration of the eligibility criteria, was central to the perceived sustainability of vision impaired golf.

CONCLUSIONS

These results highlight the practical, financial, and logistical challenges contributing to vision impaired golf activity limitations and participation restrictions. Because of the health, personal, and psychosocial benefits, ways of providing practical, financial, and support networks to facilitate engagement in vision impaired golf should be sought. An evidence-based, sport-specific eligibility system was thought to be critical for the future promotion of vision impaired golf.

The seasonal variation of physical activity and quality of life during the first wave of the COVID-19 pandemic in Finnish older golfers: A cross-sectional study

Background and Aims

The COVID-19 pandemic was associated with reduced physical activity and increased sedentary behavior. Golf is a health-enhancing outdoor exercise and is associated with low risk of viral transmission. The purpose of this study was to describe the seasonal differences in physical activity and quality of life during the first wave of COVID-19 pandemic in 2020 in Finnish older golfers.

Methods

Older golfers (n = 325) from eight golf clubs retrospectively responded to a questionnaire in summer 2020 on their physical activity and golf activity in winter 2019/20 (pre-COVID-19 winter season) and summer season 2020. In addition, they reported their quality of life after the first wave of pandemic in summer 2020. To evaluate the seasonal differences in physical activity, life quality and its association with golf activity, the data were analyzed using the Mann-Whitney U test, Wilcoxon signed-rank test, Spearman's correlation test, and linear regression analysis.

Results

Despite COVID-19 restrictions, golfers' physical activity increased by 24% (p < 0.001) during the COVID-19 restrictions in the summer of 2020. Moderate physical activity increased by 37% (p < 0.001), walking activity increased by 26% (p < 0.001), and sitting decreased by 21% (p < 0.001) compared with the pre-COVID-19 winter season. The full 18-hole golf round activity was positively associated with moderate physical activity both in the summer and winter season, and with walking in the summer season. Over 90% of golfers reported good quality of life during the 2020 summer restrictions.

Conclusion

In contrast to physical activity levels generally decreasing during the first wave of pandemic, physical activity levels in Finnish golfers increased, and these golfers reported a good quality of life. Golf can provide health enhancing physical activity and older golfers seems to be physically active throughout the year.

Australian golfers with and without osteoarthritis report reduced psychological distress and improved general health compared to a general population-based sample

OBJECTIVES

To (i) evaluate psychological distress and general health in Australian golfers and compare with a general population-based sample, and (ii) explore the relationship between playing golf, psychological distress and general health in individuals with osteoarthritis.

DESIGN

Cross sectional.

METHODS

A cross-sectional survey collected outcomes in 459 Australian Golfers (Kessler-10 Psychological Distress Scale, Short-Form 12 (Health Status), International Physical Activity Questionnaire, osteoarthritis status). Outcomes were compared between Australian golfers and a general population-based sample (Australian Health Survey, n = 16,370). Modified Poisson regression estimated the relationship between playing golf and general health in all participants and a subgroup with osteoarthritis (n = 128 golfers, n = 2216 general population). All analyses were adjusted for age, sex, education and smoking status.

RESULTS

Playing golf was associated with lower psychological distress (adjusted mean difference (95 % confidence interval) -2.5 (-4.1 to -0.9)) and a greater likelihood of reporting good to excellent general health (adjusted relative risk (95 % confidence interval) 1.09 (1.05 to 1.13)) compared to the general population. Amongst people with osteoarthritis, playing golf was associated with lower psychological distress (adjusted mean difference -4.0 (95 % confidence interval -6.5 to -1.5)) and a greater likelihood of reporting good to excellent general health (adjusted relative risk (95 % confidence interval) 1.3 (1.2 to 1.4)).

CONCLUSIONS

Golfers had lower levels of psychological distress and better general health than the general population, and this relationship was strongest in individuals with osteoarthritis.

Maximising and evaluating the uptake, use and impact of golf and health studies

INTRODUCTION

The dissemination of research, and evaluation of its impact is an increasing priority for the scientific community and funders. We take the topic of golf and health and aim to outline processes that may contribute to improved research uptake, use and impact proposing a research impact (RI) tool. We then evaluate our published research using the Research Contributions Framework (RCF).

METHODS

Building on existing research and frameworks we i) assessed the need for, ii) carried out and iii) published research, before iv) creating digital resources, v) sharing these resources widely and vi) evaluating our research.To evaluate uptake, use and impact of our three principal golf and health research outputs, we performed a contributions analysis, using the RCF first proposed by Morton.

RESULTS/DISCUSSION

We developed a specific six-step Research Impact tool. Having implemented this, research uptake and use included over 300 press articles, a dedicated website and social media channels. Golf's global industry leadership dispersed information across >150 countries, embedded golf and health into curricula for industry professionals and used leading tournaments to promote health. National policy makers hosted dedicated meetings regarding golf and health and began to implement policy change.

CONCLUSION

To date, strong uptake and use can be demonstrated for these studies, while a final contribution to impact requires further time to determine.Frameworks we used aiming to maximise impact (Research Impact tool) and evaluate its contribution to uptake, use and impact (Research Contribution Framework) could potentially add value to public health/sports medicine researchers.

Sport Spectatorship and Health Benefits: A Case of a Japanese Professional Golf Tournament

It has been well-argued that professional sport or mega sport events could serve as a catalyst for sport participation behaviors through direct and indirect trickle-down effects. However, there is limited research exploring the impact of spectator services during sport events on personal and collective well-being. Elaborating on the social-ecological model and the concept of market demand, this study attempted to fill the gap in the literature by measuring core product (player attraction, event attractiveness, and course characteristics) and peripheral spectator services (event services, event information, event amenity, and parking and transportation) of a professional golf tournament hosted in Japan and examining how these services factors would influence spectators’ length of stay at a golf event, physical activity as measured by step counts, self-rated health, and life satisfaction. Following the administration of a questionnaire to spectators at a Japanese professional golf tournament (n = 306) and conducting confirmatory factor analyses (CFA) and structural equation modeling (SEM) analyses, research findings revealed that the tournament-related spectator services would have an influence on physical activity, which could in turn influence self-rated health and subsequently impact life satisfaction. That is, emphasizing the sense of accomplishment fulfilled in sport spectatorship is recommended for the well-being of the spectators. The findings of this study shed light on the significance of promoting golf spectatorship as an effective means to facilitate a healthy lifestyle and in the meantime provide golf event marketers with a unique, positive benefit through which their events can be promoted.

International consensus statement: methods for recording and reporting of epidemiological data on injuries and illnesses in golf

Epidemiological studies of injury in elite and recreational golfers have lacked consistency in methods and definitions employed and this limits comparison of results across studies. In their sports-generic statement, the Consensus Group recruited by the IOC (2020) called for sport-specific consensus statements. On invitation by International Golf Federation, a group of international experts in sport and exercise medicine, golf research and sports injury/illness epidemiology was selected to prepare a golf-specific consensus statement. Methodological stages included literature review and initial drafting, online feedback from the consensus group, revision and second draft, virtual consensus meetings and completion of final version. This consensus statement provides golf-specific recommendations for data collection and research reporting including: (i) injury and illness definitions, and characteristics with golf-specific examples, (ii) definitions of golf-specific exposure measurements and recommendations for the calculation of prevalence and incidence, (iii) injury, illness and exposure report forms for medical staff and for golfers, and (iv) a baseline questionnaire. Implementation of the consensus methodology will enable comparison among golf studies and with other sports. It facilitates analysis of causative factors for injuries and illness in golf, and can also be used to evaluate the effects of prevention programmes to support the health of golfers.

Do golf fans walk the talk? Follow-up of spectators' beliefs and self-reported physical activity 3 months after they attended a professional golf tournament in the UK

Background

Previous research of spectators at professional golf tournaments has highlighted that obtaining exercise/physical activity (PA) can be a motivator to attend, and that spectators can engage in health-enhancing PA while at the event. We assessed whether attending a golf event and receiving an intervention improve knowledge and change attitudes related to physical activity, and self-reported physical activity 3 months later.

Methods

Follow-up observational study. Spectators at a European Tour Golf event were given a leaflet about physical activity and health. Three months after that event, we emailed a questionnaire to all 326 spectators who had participated in the original study and provided us their contact details.

Results

135 spectators (41.4%) completed the questionnaire. Among responders, 68.0% ‘agreed/strongly agreed’ that their knowledge relating to PA had increased, 65.1% agreed/strongly agreed that receiving this information at the event made them consider increasing physical activity in daily life and 40.4% reported that they had increased their physical activity during the 3 months after the golf tournament.

Principal findings/conclusions

Golf spectators may contemplate/prepare to increase PA in daily life while a smaller number self-report an increase in PA during the 3 months post intervention at a golf tournament. Spectators’ preferred method for receiving information about ‘active spectating’ is via a big screen. These findings are presented with caution, as respondents may not be representative of all golf spectators.

Golf habits among physicians and surgeons: observational cohort study

OBJECTIVES

To examine patterns of golfing among physicians: the proportion who regularly play golf, differences in golf practices across specialties, the specialties with the best golfers, and differences in golf practices between male and female physicians.

DESIGN

Observational study.

SETTING

Comprehensive database of US physicians linked to the US Golfing Association amateur golfer database.

PARTICIPANTS

41 692 US physicians who actively logged their golf rounds in the US Golfing Association database as of 1 August 2018.

MAIN OUTCOME MEASURES

Proportion of physicians who play golf, golf performance (measured using golf handicap index), and golf frequency (number of games played in previous six months).

RESULTS

Among 1 029 088 physicians, 41 692 (4.1%) actively logged golf scores in the US Golfing Association amateur golfer database. Men accounted for 89.5% of physician golfers, and among male physicians overall, 5.5% (37 309/683 297) played golf compared with 1.3% (4383/345 489) among female physicians. Rates of golfing varied substantially across physician specialties. The highest proportions of physician golfers were in orthopedic surgery (8.8%), urology (8.1%), plastic surgery (7.5%), and otolaryngology (7.1%), whereas the lowest proportions were in internal medicine and infectious disease (<3.0%). Physicians in thoracic surgery, vascular surgery, and orthopedic surgery were the best golfers, with about 15% better golf performance than specialists in endocrinology, dermatology, and oncology.

CONCLUSIONS

Golfing is common among US male physicians, particularly those in the surgical subspecialties. The association between golfing and patient outcomes, costs of care, and physician wellbeing remain unknown.