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Ross A, Kim J, McKay M, Pappas E, Hardaker N, Whalan M, Peek K. The economics of a national anterior cruciate ligament injury prevention program for amateur football players: a Markov model analysis. Med J Aust 2024; 221:149-155. [PMID: 38992929 DOI: 10.5694/mja2.52385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 01/15/2024] [Indexed: 07/13/2024]
Abstract
OBJECTIVES To estimate the long term cost savings, return on investment, and gain in quality-adjusted life years (QALYs) that could be achieved by a national anterior cruciate ligament (ACL) injury prevention program for amateur football (soccer) players in Australia. STUDY DESIGN Markov model decision analysis. SETTING, PARTICIPANTS Two hypothetical scenarios including all amateur football players in Australia (340 253 players): no intervention, and a national ACL injury prevention program. Transitions between health states, including ACL rupture, meniscal injury, knee osteoarthritis, and total knee replacement were made in one-year cycles over 35 years from a societal perspective. MAIN OUTCOME MEASURES Cost savings, return on investment, and QALY gain achieved in the prevention program scenario relative to control scenario, by age group (10-17, 18-34, 35 years or older) and gender. SECONDARY OUTCOMES incidence of ACL rupture, knee osteoarthritis, total knee replacement, and total knee replacement revision. RESULTS The total mean cost of an ACL injury was estimated to be $30 665. The national injury prevention program was projected to save $52 539 751 in medical and societal costs caused by ACL ruptures in amateur footballers over 35 years; the estimated return on each dollar invested in the program was $3.51. Over this period, the number of players with ruptured ACLs could be reduced by 4385 (9%), the number of knee osteoarthritis cases by 780 (8.1%), and the number of total knee replacements by 121 (8.1%); 445 QALYs were gained. CONCLUSION Our findings support investing in a national, evidence-based program for the primary prevention of ACL injuries in amateur football players.
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Affiliation(s)
- Andrew Ross
- The University of Sydney, Sydney, NSW
- Victoria University, Melbourne, VIC
| | - Joosup Kim
- Southern Clinical School, Monash University, Melbourne, VIC
| | - Marnee McKay
- Sydney School of Health Sciences, University of Sydney, Sydney, NSW
| | - Evangelos Pappas
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW
| | - Natalie Hardaker
- Sports Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, Auckland, New Zealand
- Accident Compensation Corporation, Wellington, New Zealand
| | - Matt Whalan
- Centre of Medical and Exercise Physiology, University of Wollongong, Wollongong, NSW
- Football Australia, Sydney, NSW
| | - Kerry Peek
- Sydney School of Health Sciences, University of Sydney, Sydney, NSW
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Ross AG, Agresta B, McKay M, Pappas E, Cheng T, Peek K. Financial burden of anterior cruciate ligament reconstructions in football (soccer) players: an Australian cost of injury study. Inj Prev 2023; 29:474-481. [PMID: 37666517 DOI: 10.1136/ip-2023-044885] [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: 02/24/2023] [Accepted: 08/02/2023] [Indexed: 09/06/2023]
Abstract
OBJECTIVES To estimate the financial burden of anterior cruciate ligament (ACL) reconstructions in amateur football (soccer) players in Australia over a single year, including both direct and indirect cost. METHODS Available national direct and indirect cost data were applied to the annual incidence of ACL reconstructions in Australia. Age-adjusted and sex-adjusted total and mean costs (ACL and osteoarthritis (OA)) were calculated for amateur football (soccer) players in Australia using an incidence-based approach. RESULTS The estimated cost of ACL reconstructions for amateur football players is $A69 623 211 with a mean total cost of $A34 079. The mean indirect costs are 19.8% higher than the mean direct costs. The mean indirect costs are lower in female (11.5%, $A28 628) and junior (15.3%, $A29 077) football players. The mean ACL costs are 3-4-fold greater than the mean OA costs ($A27 099 vs $A6450, respectively), remaining consistent when stratified by sex and age group. Our model suggests that for every 10% increase in adherence to injury prevention programmes, which equates to approximately 102 less ACL injuries per year, $A9 460 224 in ACL costs could be saved. CONCLUSION While the number of ACL reconstructions per year among football players in Australia is relatively small, the annual financial burden is high. Our study suggests that if injury prevention exercises programmes are prioritised by stakeholders in football, significant cost-savings are possible.
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Affiliation(s)
- Andrew George Ross
- Discipline of Physiotherapy, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Blaise Agresta
- Health Economics and Health Technology Assessment, NHMRC Clinical Trials Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Marnee McKay
- Discipline of Physiotherapy, The University of Sydney, Sydney, New South Wales, Australia
| | - Evangelos Pappas
- School of Medicine and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - Tegan Cheng
- Faculty of Medicine and Health & Children's Hospital at Westmead, University of Sydney School of Health Sciences, Sydney, New South Wales, Australia
| | - Kerry Peek
- Discipline of Physiotherapy, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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Teahan C, Whyte EF, O'Connor S. Gaelic games players' awareness and use of, and attitudes towards injury prevention exercise programmes. Phys Ther Sport 2023; 64:17-26. [PMID: 37647826 DOI: 10.1016/j.ptsp.2023.08.003] [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: 02/22/2023] [Revised: 08/14/2023] [Accepted: 08/16/2023] [Indexed: 09/01/2023]
Abstract
OBJECTIVE The aim was to determine the awareness of and use of injury prevention exercise programmes (IPEPs) among adult Gaelic games players and to investigate Gaelic games players' attitudes to injury prevention and barriers and facilitators to successful IPEPs use. METHODS A recruitment email was sent to all clubs and county boards throughout Ireland (whose email was available online) and the survey was advertised on social media platforms. Adult players completed an anonymous survey, including awareness, use, and attitudes towards injury prevention and injuries. Frequencies and descriptive statistics were conducted, a chi-squared test was used to assess any differences in awareness and use of IPEPs, a Mann-Whitney U test was used to examine differences between groups for attitudes to injury prevention (men vs women; elite vs non-elite). RESULTS A third of players (32.4%) stated awareness of IPEPs. However, only 13.4% correctly identified one. A significantly greater number of men (35.7%) used IPEPs compared to women (26.5%) (p = 0.04). The Activate (65.5%) and GAA15 (32.5%) were most used. Players had a positive attitude towards injury prevention but agreed that injuries were an issue (68.2%) and stated that their coach didn't have enough knowledge how to use IPEPs was a large barrier (41.6%). CONCLUSION Despite this positive attitude to injury prevention and believing injuries are an issue, adoption remains low. Organisations/clubs should educate players on the benefits of using IPEPs and support structures put in place to gain greater implementation, which is critical to mitigating the risk of injury.
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Affiliation(s)
- Calvin Teahan
- Centre for Injury Prevention and Performance, School of Health and Human Performance, Dublin City University, Dublin, Ireland.
| | - Enda F Whyte
- Centre for Injury Prevention and Performance, School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Siobhán O'Connor
- Centre for Injury Prevention and Performance, School of Health and Human Performance, Dublin City University, Dublin, Ireland
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Lindblom H, Sonesson S, Forslind J, Waldén M, Hägglund M. Implementation of the injury prevention exercise programme Knee Control+: a cross-sectional study after dissemination efforts within a football district. Inj Prev 2023; 29:399-406. [PMID: 37258153 PMCID: PMC10579513 DOI: 10.1136/ip-2023-044863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 05/05/2023] [Indexed: 06/02/2023]
Abstract
BACKGROUND The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework can be used for evaluation of implementation initiatives in sports injury prevention. The aim was to evaluate the implementation of the injury prevention exercise programme Knee Control+ among amateur clubs and coaches in one regional football district using all five dimensions of the RE-AIM framework. METHODS Dissemination of Knee Control+ during the 2021 season with information and webinars within one regional football district. This was followed by a cross-sectional study with questionnaires to club personnel and coaches after the season. RESULTS The reach of Knee Control+ was fair to high, 83% of club personnel and 66% of coaches knew about the programme. 41% of club personnel and 51% of coaches had adopted it. Perceived programme effectiveness was high (6 on a 1-7 Likert scale) among coaches. Regarding implementation and maintenance, 27% of club personnel had informed coaches about Knee Control+ and 57% planned to inform coaches. The coaches had implemented the programme mainly as recommended, but half used the programme once per week or less. Intention to maintain use of the programme was high (7 on a 1-7 Likert scale) among coaches. CONCLUSION The reach of Knee Control+ was fair to high, and adoption was fair in clubs, but there was a lack of policies for preventive training. Active strategies probably need to accompany dissemination of programme material. Reach, perceived effectiveness, adoption, implementation and planned maintenance were positive among coaches, but further studies are needed to analyse long-term maintenance.
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Affiliation(s)
- Hanna Lindblom
- Unit of Physiotherapy, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Sport Without Injury ProgrammE (SWIPE), Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Sofi Sonesson
- Unit of Physiotherapy, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Sport Without Injury ProgrammE (SWIPE), Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Josefin Forslind
- Unit of Physiotherapy, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Sport Without Injury ProgrammE (SWIPE), Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Markus Waldén
- Sport Without Injury ProgrammE (SWIPE), Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Capio Ortho Center Skåne, Malmö, Sweden
| | - Martin Hägglund
- Unit of Physiotherapy, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Sport Without Injury ProgrammE (SWIPE), Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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Lindblom H, Waldén M, Hägglund M. Adherence to Injury Prevention Exercise Programmes in Amateur Adolescent and Adult Football: A Detailed Description of Programme Use from a Randomised Study. SPORTS MEDICINE - OPEN 2023; 9:57. [PMID: 37452894 DOI: 10.1186/s40798-023-00608-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 07/04/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND Injury prevention exercise programmes (IPEPs) efficaciously reduce injuries. However, it is challenging to achieve sufficient adherence across a season. The main aim was to describe adherence to IPEPs in three groups of coaches and players partaking in a cluster randomised trial. Secondary aims were to describe perceptions of IPEPs, use of programme material, and overall preventive strategies. METHODS This is a sub-study analysing data from a three-armed randomised trial with teams randomised to use either a comprehensive IPEP (extended Knee Control) or an adductor strength programme, and non-randomised teams that already used a self-chosen IPEP regularly at study start (comparison group). Teams were instructed to use their respective intervention across the 2020 football season. Male and female, adolescent (≥ 14 years of age), and adult amateur players took part. Coaches and players responded to weekly and end-of-season questionnaires. Data were presented descriptively. RESULTS Weekly player data were reported by 502 players (weekly response rate 65%), 289 (58%) responded to end-of-season questionnaires. Teams in the extended Knee Control and comparison group used their respective IPEP in 483/529 (91%) and 585/641 (91%) of training sessions, and teams in the adductor group in in 199/315 (63%) sessions. Regarding utilisation fidelity, 42-52% of players in each group used 1-10 repetitions per exercise. Seven out of 17 teams in the adductor group had progressed as recommended in terms of number of repetitions. Two teams (10%) in the extended Knee Control group, and 7/24 of comparison teams used the same exercises across the season. Coaches accessed the IPEPs by different means (printed material, films, workshops, etc.), but half did not use the provided digital material. The players appreciated that the IPEPs could reduce injury risk and that they improved their exercise performance, but disliked that they had less time for football and that the exercises were boring. Forty-nine players had experienced pain during IPEP performance. CONCLUSIONS Adherence with the IPEPs was generally high. To meet different coach needs, programme material should be available via different digital and printed resources. The number of players reporting pain during IPEP performance is a noteworthy finding. TRIAL REGISTRATION Clinical Trials gov identifier: NCT04272047. Registered February 17, 2020. https://clinicaltrials.gov/ct2/show/NCT04272047 .
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Affiliation(s)
- Hanna Lindblom
- Unit of Physiotherapy, Division of Prevention, Rehabilitation and Community Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, 581 83, Linköping, Sweden.
- Sport Without Injury ProgrammE (SWIPE), Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
| | - Markus Waldén
- Sport Without Injury ProgrammE (SWIPE), Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Capio Ortho Center Skåne, Malmö, Sweden
| | - Martin Hägglund
- Unit of Physiotherapy, Division of Prevention, Rehabilitation and Community Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, 581 83, Linköping, Sweden
- Sport Without Injury ProgrammE (SWIPE), Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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Lindblom H, Sonesson S, Torvaldsson K, Waldén M, Hägglund M. Extended Knee Control programme lowers weekly hamstring, knee and ankle injury prevalence compared with an adductor strength programme or self-selected injury prevention exercises in adolescent and adult amateur football players: a two-armed cluster-randomised trial with an additional comparison arm. Br J Sports Med 2023; 57:83-90. [PMID: 36316115 PMCID: PMC9872240 DOI: 10.1136/bjsports-2022-105890] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2022] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To evaluate the preventive efficacy of an extended version of the Knee Control injury prevention exercise programme (IPEP) compared with an adductor strength programme and to a comparison group using a self-selected IPEP in amateur adolescent and adult male and female football players. METHODS Two-armed cluster-randomised trial with an additional non-randomised arm. All 251 amateur teams (players 14-46 years) in one regional football district were approached. Teams meeting inclusion criteria were randomised to (1) extended Knee Control or (2) an adductor strength programme. Teams already using an IPEP were allocated to a comparison group and received no new intervention. Players responded to weekly questionnaires about football exposures and injuries during a 7-month season. RESULTS Seventeen teams in the extended Knee Control, 12 in the adductor and 17 in the comparison group participated, with 502 players. For the primary outcomes, no difference in injury incidence in three lower-limb injury locations combined (hamstring, knee and ankle) was seen between extended Knee Control and the adductor group, whereas extended Knee Control had 29% lower incidence than the comparison group (incidence rate ratio 0.71, 95% CI 0.52 to 0.98). No between-group differences in groin injury incidence were seen. The weekly injury prevalence rates in the three lower limb locations combined (hamstring, knee and ankle) were 17% lower (prevalence rate ratio (PRR) 0.83, 95% CI 0.69 to 1.00) and 26% lower (PRR 0.74, 95% CI 0.63 to 0.87) in extended Knee Control compared with the adductor and comparison groups, respectively. CONCLUSION No difference in injury incidence was seen between the extended Knee Control and the adductor programme whereas extended Knee Control reduced injury incidence by nearly one-third compared with a self-selected IPEP. Players in extended Knee Control had lower injury prevalence compared with an adductor or self-selected IPEP. TRIAL REGISTRATION NUMBER NCT04272047; Clinical trials.
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Affiliation(s)
- Hanna Lindblom
- Unit of Physiotherapy, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden,Sport Without Injury ProgrammE (SWIPE). Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Sofi Sonesson
- Unit of Physiotherapy, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden,Sport Without Injury ProgrammE (SWIPE). Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Kalle Torvaldsson
- Unit of Physiotherapy, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden,Sport Without Injury ProgrammE (SWIPE). Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Markus Waldén
- Sport Without Injury ProgrammE (SWIPE). Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden,GHP Ortho & Spine Center Skåne, Malmö, Sweden
| | - Martin Hägglund
- Unit of Physiotherapy, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden,Sport Without Injury ProgrammE (SWIPE). Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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Lutter C, Seil R, Best R, Gokeler A, Patt T, Krutsch W, Grim C, Tischer T. Results of a tri-national online survey on the current status of sports injury prevention among members of the German-Speaking Orthopaedic Sports Medicine Society (GOTS). SPORTVERLETZUNG-SPORTSCHADEN 2021; 35:80-87. [PMID: 33957676 DOI: 10.1055/a-1397-0710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To assess the current opinions and state of knowledge in primary sports injury prevention among members of the German-Speaking Society for Orthopaedic and Traumatologic Sports Medicine (GOTS). METHODS On 21 August 2019, a web-based questionnaire was sent to the members of the tri-national society GOTS (Austria, Germany and Switzerland). The survey was online until 21 November 2019 and included twenty-two questions, which were divided into five sections: 1) general importance of prevention (n = 4), 2) specifications of the study population (n = 3), 3) implementation of prevention (n = 8), 4) improvement opportunities in prevention (n = 4) and 5) future research areas (n = 3). RESULTS A total of 272 participants completed the survey, representing a total survey participation of 17.7 % of all members. The study population consisted of orthopaedic surgeons (55 % with surgical and 21 % with non-operative orientation), medical students (10 %), physical therapists (8 %) and sports scientists (4 %). Ninety-four percent of all participants stated that they considered the importance of sports injury prevention to be "very high" (68 %) or "high" (26 %). However, almost 70 % of all participants stated that they spend less than one hour per week on injury prevention work. The term "prevention" was clearly defined and practicable for only 40 %, understandable but difficult to implement for 51 %, and unclear and difficult to implement for 9 % of the participants. Seventy-two percent of respondents were aware of existing prevention programs such as "Stop-X" or "FIFA 11 +", whereas 28 % of participants were uninformed regarding these programs. CONCLUSIONS A strong divergence was identified between participants' perception of the importance of sports injury prevention and the existing implementation of preventive measures. Future funding of prevention programs, expansion of research strategies for injury prevention and better financial reimbursement are of utmost importance.
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Affiliation(s)
- Christoph Lutter
- Department of Orthopedics, University Medical Center, Rostock, Germany
| | - R Seil
- Department of Orthopaedic Surgery, Centre Hospitalier de Luxembourg-Clinique d'Eich, Luxembourg, Luxembourg.,Luxembourg Institute of Health, Luxembourg
| | - R Best
- Sportklinik Stuttgart, Stuttgart, Germany
| | - A Gokeler
- Department Exercise & Health, Exercise Science and Neuroscience, University of Paderborn, Paderborn, Germany
| | - T Patt
- Bergman Clinics, Delft, Netherlands
| | - W Krutsch
- SportDocsFranken, Nürnberg; Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany
| | - C Grim
- Department of Orthopedic, Trauma and Hand Surgery, Klinikum Osnabrück, Germany
| | - T Tischer
- Department of Orthopedics, University Medical Center, Rostock, Germany
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Ross AG, Donaldson A, Poulos RG. Nationwide sports injury prevention strategies: A scoping review. Scand J Med Sci Sports 2020; 31:246-264. [PMID: 33080079 DOI: 10.1111/sms.13858] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 08/19/2020] [Accepted: 10/13/2020] [Indexed: 12/26/2022]
Abstract
National strategies to prevent sports injuries can potentially improve health outcomes at a population level and reduce medical costs. To date, a compilation of the strategies that countries have attempted, and their effectiveness, does not exist. This scoping review sets out to: identify nationwide attempts at implementing sports injury prevention strategies; examine the impact of these strategies; and map them onto the Translating Research into Injury Prevention Practice (TRIPP) framework. Using Levac's scoping review method, we: (a) identified the research questions, (b) identified relevant studies, (c) identified the study selection criteria, (d) charted the data, and (e) reported the results. A search of MEDLINE, Scopus, SPORTDiscus, CINAHL, and Web of Science databases for articles published pre-June 2019 was conducted. We identified 1794 studies and included 33 studies (of 24 strategies). The USA (n = 7), New Zealand (n = 4), Canada (n = 3), the Netherlands (n = 3), Switzerland (n = 2), Belgium (n = 1), France (n = 1), Ireland (n = 1), South Africa (n = 1), and Sweden (n = 1) have implemented nationwide sports injury prevention strategies with 29 (88%) of the included studies demonstrating positive results. Mapping the strategies onto the TRIPP framework highlighted that only four (17%) of the 24 included strategies reported on the implementation context (TRIPP Stage 5), suggesting an important reporting gap. Nationwide sports injury prevention efforts are complex, requiring a multidimensional approach. Future research should report intervention implementation data; examine the implementation context early in the research process to increase the likelihood of real-world implementation success; and could benefit from incorporating qualitative or mixed research methods.
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Affiliation(s)
- Andrew G Ross
- School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Alex Donaldson
- Centre for Sport and Social Impact, La Trobe University, Melbourne, Vic., Australia
| | - Roslyn G Poulos
- School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia
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Crossley KM, Patterson BE, Culvenor AG, Bruder AM, Mosler AB, Mentiplay BF. Making football safer for women: a systematic review and meta-analysis of injury prevention programmes in 11 773 female football (soccer) players. Br J Sports Med 2020; 54:1089-1098. [PMID: 32253193 PMCID: PMC7497572 DOI: 10.1136/bjsports-2019-101587] [Citation(s) in RCA: 86] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2020] [Indexed: 01/27/2023]
Abstract
Objective To evaluate the effects of injury prevention programmes on injury incidence in any women’s football code; explore relationships between training components and injury risk; and report injury incidence for women’s football. Design Systematic review and meta-analysis. Data sources Nine databases searched in August 2019. Eligibility criteria Randomised controlled trials evaluating any injury prevention programme (eg, exercise, education, braces) were included. Study inclusion criteria were: ≥20 female football players in each study arm (any age, football code or participation level) and injury incidence reporting. Results Twelve studies, all in soccer, met inclusion criteria, with nine involving adolescent teams (aged <18 years). All studies (except one) had a high risk of bias. Eleven studies examined exercise-based programmes, with most (9/11) including multiple (≥2) training components (eg, strength, plyometric, balance exercises). Multicomponent exercise programmes reduced overall (any reported) injuries (incidence rate ratio (IRR) 0.73, 95% CI 0.59 to 0.91) and ACL injuries (IRR 0.55, 95% CI 0.32 to 0.92). For exercise-based strategies (single-component and multicomponent), hamstring injuries were also reduced (IRR 0.40, 95% CI 0.17 to 0.95). While exercise-based strategies resulted in less knee, ankle and hip/groin injuries, and the use of multiple training components was associated with greater reductions in overall and knee injuries, further studies would be required to increase the precision of these results. The incidence of overall injuries in women’s football was 3.4 per 1000 exposure hours; with ankle injuries most common. Conclusion In women’s football, there is low-level evidence that multicomponent, exercise-based programmes reduce overall and ACL injuries by 27% and 45%, respectively. PROSPERO registration number CRD42018093527.
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Affiliation(s)
- Kay M Crossley
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Brooke E Patterson
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Adam G Culvenor
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Andrea M Bruder
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Andrea B Mosler
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Benjamin F Mentiplay
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia
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Witwit W, Thoreson O, Swärd Aminoff A, Todd C, Jonasson P, Laxdal G, Hebelka H, Baranto A. Young football players have significantly more spinal changes on MRI compared to non‐athletes. TRANSLATIONAL SPORTS MEDICINE 2020. [DOI: 10.1002/tsm2.144] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Wisam Witwit
- Institute of Clinical Sciences at Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Department of Radiology St. Joseph Mercy Oakland Hospital Pontiac Michigan
| | - Olof Thoreson
- Institute of Clinical Sciences at Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
| | - Anna Swärd Aminoff
- Institute of Clinical Sciences at Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
| | - Carl Todd
- Institute of Clinical Sciences at Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
| | - Pàll Jonasson
- Institute of Clinical Sciences at Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Orkuhúsið Orthopedic Clinic Reykjavik Iceland
| | | | - Hanna Hebelka
- Institute of Clinical Sciences at Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Department of Radiology Sahlgrenska University Hospital Gothenburg Sweden
| | - Adad Baranto
- Institute of Clinical Sciences at Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Department of Orthopaedics Sahlgrenska University Hospital Gothenburg Sweden
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11
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Similar risk of ACL graft revision for alpine skiers, football and handball players: the graft revision rate is influenced by age and graft choice. Br J Sports Med 2019; 54:33-37. [DOI: 10.1136/bjsports-2018-100020] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2019] [Indexed: 11/03/2022]
Abstract
ObjectivesThe risk of graft revision following ACL reconstruction may depend on the sport type the individuals are engaged in. The purpose of this study was to report the ACL graft revision rate in alpine skiers, football and handball players.Materials and methodsPrimary ACL reconstructions and graft revision data from 2004 to December 2016 were obtained from the Norwegian Cruciate Ligament Registry. The graft survival rates were calculated for individuals in each of the three sport types, for bone patellar tendon bone (BPTB) and hamstring tendons (HT) grafts separately, and related to age at primary operation and sex.ResultsA total of 711 grafts in 14 201 primary ACL reconstructions were revised (5.0%) after median 6 years, 3.8% in alpine skiers, 5.0% in soccer and 6.1% in handball players (p<0.001). Adjusted Cox regression showed similar ACL graft survival rates in the three groups. The HR for graft revision was 5 times higher for individuals aged ≤18 years than for those aged ≥35 years (p<0.001). The corresponding HR for graft type was 1.8 times higher for HT than for BPTB grafts (p<0.001), but 2.8 times higher for individuals aged ≤18 years (p<0.001). The 12 years survival of BPTB grafts was 96% compared with 93% for HT grafts (p <0.001).ConclusionThe revision rate for ACL grafts was similar among alpine skiers, football and handball players, and the results support the use of BPTB grafts in young athletes with closed growth zones in the knee.Study designCohort study; level of evidence, 2.
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Ljunggren G, Perera NKP, Hägglund M. Inter-rater Reliability in Assessing Exercise Fidelity for the Injury Prevention Exercise Programme Knee Control in Youth Football Players. SPORTS MEDICINE - OPEN 2019; 5:35. [PMID: 31392441 PMCID: PMC6686029 DOI: 10.1186/s40798-019-0209-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 07/29/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND To receive maximum benefits from injury prevention exercise programmes (IPEP) such as Knee Control, players need to perform the exercises as prescribed. But, exercise fidelity in IPEPs is seldom evaluated. We developed a checklist to assess exercise fidelity in the Knee Control IPEP, and the primary aim was to evaluate its inter-rater reliability. The secondary aim was to study Knee Control exercise fidelity in youth football players and compare sex differences. METHODS This observational study included 11 teams with male and female youth players (11-18 years). On average, the players trained with the Knee Control IPEP for 7 weeks (SD 1.4, range 6-10 weeks). After the training period, two physiotherapists attended a team training session to observe players executing exercises and individually assessed their performance of these exercises as correct or incorrect based on standardised criteria set in the fidelity checklist. Agreement between observers was assessed using Cohen's kappa coefficient. RESULTS The observers agreed on 144 out of 160 (90%) observations (Kappa = 0.80, substantial agreement). Both observers agreed on correct exercise performance for 69 out of 144 observations (exercise fidelity 48%). Exercise fidelity was higher in females (56%) than males (40%), but the difference was not statistically significant (p = 0.18). CONCLUSION The Knee Control exercise fidelity checklist had high inter-rater reliability with substantial agreement. The exercise fidelity was low, which could hamper the preventive effects of an IPEP. Understanding the reasons for low exercise fidelity is important and more effort should focus on increasing exercise fidelity alongside the implementation of IPEPs.
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Affiliation(s)
- Gustav Ljunggren
- Department of Orthopaedics and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Nirmala Kanthi Panagodage Perera
- Division of Physiotherapy, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
- Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, United Kingdom Latrobe Sports and Exercise Medicine Research Centre, College of Science, Health and Engineering, Latrobe University, Bundoora, VIC 3086 Australia
| | - Martin Hägglund
- Division of Physiotherapy, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
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Review of Musculoskeletal Injury Prevention in Female Soccer Athletes. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2019. [DOI: 10.1007/s40141-019-00230-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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