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Hassanmirzaei B, Schumacher Y, Tabben M, Bahr R. Developing a data-driven multimodal injury and illness prevention programme in male professional football based on a risk management model: the IP2 NetWork. BMJ Open Sport Exerc Med 2024; 10:e002101. [PMID: 39381415 PMCID: PMC11459307 DOI: 10.1136/bmjsem-2024-002101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Accepted: 09/25/2024] [Indexed: 10/10/2024] Open
Abstract
Background Current injury prevention programmes in football are limited by a one-size-fits-all approach, which predominantly focuses on preventive exercise programmes while ignoring differences in risk profiles between individuals and teams. Objective To address this gap, we developed a new data-driven, customisable approach based on the principles of risk management. We collaborated with key stakeholders to identify focus areas for injury and illness prevention and determine their priorities. Setting The team medical and coaching staff included members from 17 professional football clubs, the national team and a youth football academy in Qatar. Methods In 2015, we launched a series of annual workshops under the Aspetar Sports Injury and Illness Prevention Programme. The workshops included club medical personnel and fitness coaches in a process to develop team-specific programmes for injury and illness prevention based on the principle of risk management. Over 2 years, workshops refined focus areas through discussions, surveys and small-group presentations, culminating in the creation a novel programme for football injury prevention. Results Out of 44 focus areas first identified, 23 were selected as priorities for inclusion in multimodal injury and illness prevention programmes. The identified focus areas represent a variety of aspects, including social/behavioural/lifestyle, exercise programmes/training, load management, recovery and equipment. The top priorities included communication, the Nordic hamstring exercise, training load, recovery strategies, nutrition, sleep, warm-up, the Copenhagen adduction exercise and core and dynamic stability. Conclusion We have developed a comprehensive framework for preventing injuries and illnesses in football grounded in the general principles of risk management. This framework has proven feasible and led to the creation of a new multicomponent programme, The Aspetar IP2 (Injury and Illness Prevention for Performance) NetWork, focusing on a range of areas beyond preventive exercise programmes only.
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Affiliation(s)
- Bahar Hassanmirzaei
- Aspetar Sports Injury and Illness Prevention Programme (ASPREV), Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo Sports Trauma Research Center, Oslo, Norway
| | - Yorck Schumacher
- Aspetar Sports Injury and Illness Prevention Programme (ASPREV), Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Montassar Tabben
- Aspetar Sports Injury and Illness Prevention Programme (ASPREV), Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Roald Bahr
- Aspetar Sports Injury and Illness Prevention Programme (ASPREV), Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo Sports Trauma Research Center, Oslo, Norway
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Staley K, Donaldson A, Mosler AB, O'Halloran P, Seal E, Forsyth A, Nicholson M, Forsdike K, Bruder AM. Understanding the challenges of injury in providing sport programmes for physically inactive women: concept mapping insights from programme deliverers. Inj Prev 2024; 30:400-409. [PMID: 38307715 DOI: 10.1136/ip-2023-045028] [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: 07/03/2023] [Accepted: 01/18/2024] [Indexed: 02/04/2024]
Abstract
OBJECTIVES Injury/poor health is an important barrier to women's participation in sport and physical activity. This study aimed to identify perceived challenges sport programme deliverers face when supporting physically inactive women to prevent/manage injury. METHODS Sport programme deliverers, targeting physically inactive women in Victoria, participated in concept mapping to brainstorm, sort and rate (impact on their ability to prevent/manage injury, frequency of and difficulty to overcome the challenge on a 1 (low)-5 (high) scale) the challenges faced. Analysis included multidimensional scaling, hierarchical cluster analysis and descriptive statistics (eg, mean ratings). RESULTS Twenty-five deliverers brainstormed 82 injury prevention/management-related challenges. An eight cluster map was considered the most appropriate representation of the participants' sorting data (mean cluster impact, frequency and difficulty to overcome rating (1-5)): time constraints (3.42, 3.69, 3.12); perceived competence in injury prevention/management (3.36, 3.50, 3.27); navigating participant perceptions and knowledge (3.35, 3.74, 3.49); information and responsibility (3.32, 3.50, 3.26); session planning and structure (3.25, 3.45, 3.07); participant engagement (3.13, 3.47, 3.08); responding to individual needs (3.07, 3.42, 2.92) and access to injury management resources (2.87, 3.25, 3.17). CONCLUSION Limited time created injury prevention/management challenges for programme deliverers when planning and modifying sport programmes for physically inactive women. Injury prevention/management should be integrated into programme design and delivery principles. Programme deliverers need education/training and access to injury prevention/management resources (eg, activity modification) and engagement/communication strategies tailored for physically inactive women. Public health funders, coaching course accreditors, programme designers and deliverers can use these insights to develop strategies to minimise injury risk and effect systemic change in sport programme delivery.
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Affiliation(s)
- Kiera Staley
- Centre for Sport and Social Impact, La Trobe University, Melbourne, Victoria, Australia
- La Trobe Business School, La Trobe University, Melbourne, Victoria, Australia
| | - Alex Donaldson
- Centre for Sport and Social Impact, La Trobe University, Melbourne, Victoria, Australia
- La Trobe Business School, La Trobe University, Melbourne, Victoria, Australia
| | - Andrea B Mosler
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Paul O'Halloran
- Centre for Sport and Social Impact, La Trobe University, Melbourne, Victoria, Australia
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Emma Seal
- School of Global, Urban and Social Studies, RMIT University, Melbourne, Victoria, Australia
| | - Adrienne Forsyth
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
- School of Behavioural and Health Sciences, Australian Catholic University, Fitzroy, Victoria, Australia
| | - Matthew Nicholson
- Centre for Sport and Social Impact, La Trobe University, Melbourne, Victoria, Australia
- Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
| | - Kirsty Forsdike
- Centre for Sport and Social Impact, La Trobe University, Melbourne, Victoria, Australia
- La Trobe Business School, La Trobe University, Melbourne, Victoria, Australia
| | - Andrea Maree Bruder
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia
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Fortington LV, Cassidy JD, Castellani RJ, Gardner AJ, McIntosh AS, Austen M, Kerr ZY, Quarrie KL. Epidemiological Principles in Claims of Causality: An Enquiry into Repetitive Head Impacts (RHI) and Chronic Traumatic Encephalopathy (CTE). Sports Med 2024:10.1007/s40279-024-02102-4. [PMID: 39277838 DOI: 10.1007/s40279-024-02102-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2024] [Indexed: 09/17/2024]
Abstract
Determining whether repetitive head impacts (RHI) cause the development of chronic traumatic encephalopathy (CTE)-neuropathological change (NC) and whether pathological changes cause clinical syndromes are topics of considerable interest to the global sports medicine community. In 2022, an article was published that used the Bradford Hill criteria to evaluate the claim that RHI cause CTE. The publication garnered international media attention and has since been promoted as definitive proof that causality has been established. Our counterpoint presents an appraisal of the published article in terms of the claims made and the scientific literature used in developing those claims. We conclude that the evidence provided does not justify the causal claims. We discuss how causes are conceptualised in modern epidemiology and highlight shortcomings in the current definitions and measurement of exposures (RHI) and outcomes (CTE). We address the Bradford Hill arguments that are used as evidence in the original review and conclude that assertions of causality having been established are premature. Members of the scientific community must be cautious of making causal claims until the proposed exposures and outcomes are well defined and consistently measured, and findings from appropriately designed studies have been published. Evaluating and reflecting on the quality of research is a crucial step in providing accurate evidence-based information to the public.
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Affiliation(s)
- Lauren V Fortington
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.
| | - J David Cassidy
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Rudolph J Castellani
- Division of Neuropathology, Northwestern University Feinberg School of Medicine and Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Chicago, IL, USA
| | - Andrew J Gardner
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Andrew S McIntosh
- Monash University Accident Research Centre, Monash University, Clayton, VIC, Australia
| | - Michael Austen
- Australasian Faculty of Occupational and Environmental Medicine, Royal Australasian College of Physicians, Sydney, Australia
- Royal New Zealand College of Urgent Care, Auckland, New Zealand
- High Court of New Zealand, Auckland, New Zealand
| | - Zachary Yukio Kerr
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kenneth L Quarrie
- New Zealand Rugby, 100 Molesworth Street, Wellington, New Zealand
- Sports Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, Auckland, New Zealand
- Auckland Bioengineering Institute (ABI), The University of Auckland, Auckland, Auckland, New Zealand
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Bonell Monsonís O, Verhagen E, Spörri J, Gouttebarge V, Bolling C. 'Every turn can be the last one I do' - Perceptions of injury risk in high-performance snow sports and its implication for injury prevention. Inj Prev 2024; 30:341-349. [PMID: 38195657 DOI: 10.1136/ip-2023-045084] [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: 08/22/2023] [Accepted: 12/15/2023] [Indexed: 01/11/2024]
Abstract
OBJECTIVES High-performance snow sports (HPSS) athletes compete in a performance-driven context with a high risk of injury. While there is a lack of evidence on effective prevention measures in snow sports, this study explored the perspectives and perceptions of HPSS stakeholders on sports injury prevention. METHODS We conducted an exploratory qualitative study based on the grounded theory principles through 11 semistructured interviews with athletes, coaches and healthcare providers from different national teams about sports injury prevention. The interviews were inductively analysed through constant comparative data analysis. RESULTS Participants defined risk management as a central concept in which they approached injury prevention by assessing, managing and sometimes accepting risks. Many factors, such as athlete-related and external factors, are considered in this process, ultimately influencing their decision-making. Participants acknowledged the value of experience when managing and dealing with risks, a key aspect of their learning process and career development. Within this context, open and trustworthy communication and shared responsibilities among all stakeholders influenced and shaped injury prevention strategies and behaviours. Understanding and balancing out speed and risks was considered pivotal in their daily practice. Therefore, injury prevention awareness, ownership, communication, teamwork and shared responsibilities may contribute to the success of sports injury prevention in HPSS. CONCLUSION These findings substantiate the significance of such contextual factors in sports injury prevention. Considering the high-risk nature of HPSS, injury prevention suggests a shift towards risk management strategies, with a strong emphasis on contextual factors and their interactions. Young athletes might benefit from educational interventions centred on developing skills to assess and manage risks.
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Affiliation(s)
- Oriol Bonell Monsonís
- Amsterdam Collaboration on Health & Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, University Medical Centres - Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam Movement Sciences, Musculoskeletal Health & Sports, Amsterdam, Netherlands
| | - Evert Verhagen
- Amsterdam Collaboration on Health & Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, University Medical Centres - Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam Movement Sciences, Musculoskeletal Health & Sports, Amsterdam, Netherlands
| | - Jörg Spörri
- Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- University Centre for Prevention and Sports Medicine, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Vincent Gouttebarge
- Amsterdam Movement Sciences, Musculoskeletal Health & Sports, Amsterdam, Netherlands
- Amsterdam UMC location University of Amsterdam, Orthopaedic Surgery and Sports Medicine, Amsterdam, Netherlands
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Caroline Bolling
- Amsterdam Collaboration on Health & Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, University Medical Centres - Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam UMC location University of Amsterdam, Orthopaedic Surgery and Sports Medicine, Amsterdam, Netherlands
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5
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Andersen TR, Drevsfeldt A, Möller S, Møller M. Injuries in male youth football: a one season prospective cohort study of 223 Danish elite players. Front Sports Act Living 2023; 5:1250223. [PMID: 38164442 PMCID: PMC10757927 DOI: 10.3389/fspor.2023.1250223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 11/22/2023] [Indexed: 01/03/2024] Open
Abstract
Objectives This study prospectively investigated injury prevalence, incidence, and burden in male elite under-17 football players (N = 223) during a full season. Methods The players weekly completed a standardized web-based injury survey (OSTRC-H2) and a physical exposure report throughout the study. Results Average weekly response rate was 89.5%. Football exposure accounted for 52.4% of total physical exposure. On average (±SD), the players participated in individual football, strength, and rehabilitation practices for 1.2 ± 1.5, 3.0 ± .2.1, and 1.9 ± 3.4 h/week, respectively. In total, 742 health problems were reported. Mean weekly prevalence of health problems, injuries and illnesses were 20.1%, 16.5% and 3.8%, respectively. The injury incidence per 1,000 h of football exposure, match play and team practice were 8.28 (95% CI: 7.54-9.08), 16.77 (95% CI: 13.65-20.4), and 7.24 (95% CI: 6.5-8.04), respectively. Sudden-onset and gradual-onset injuries accounted for 36.7% and 43.4% of the total proportion of health problems. Hip/groin injuries had the highest incidence (1.58/1,000 h), whereas knee injuries had the highest burden (20.86 days lost/1,000 h). On average, the players experienced 3.33 health problems (average duration: 7.8 days). On average pr. player, 2.7 (95% CI: 2.2-3.3) wks of football exposure were lost. Conclusion Sudden and gradual-onset injuries influenced player availability during the season. Health problem prevalence fluctuated markedly, and injury incidence was higher during match play than training. The players had substantial volumes of training beyond football-specific training and matches. Our findings could assist medical and sports science practitioneers in enhancing training and recovery processes to maximize player availability.
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Affiliation(s)
- Thomas Rostgaard Andersen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Danish Football Association, Brondby, Denmark
| | - Andreas Drevsfeldt
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Sören Möller
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Open Patient Data Explorative Network, Odense University Hospital, Odense, Denmark
| | - Merete Møller
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
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6
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Bailey SJ, Martindale R, Engebretsen L, Robson JP, Palmer D. Epidemiology of International Match Injuries in Scottish Rugby: A Prospective Cohort Study. Int J Sports Med 2023; 44:805-812. [PMID: 37279793 DOI: 10.1055/a-2038-3452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Fifteen-a-side rugby union ("rugby") is a full-contact sport played separately by men and women, with large injury incidences reported previously. Context specific injury surveillance fulfils governing bodies' duty of care to understand risks to player welfare, yet no contemporary match injury epidemiology studies exist for international players in Scotland. The current study therefore aimed to describe the incidence, severity, burden and nature of match injuries sustained by Scotland's men's and women's national teams. A prospective cohort study of injuries recorded in matches across the 2017/18 and 2018/19 seasons was undertaken, with injury and exposure definitions in line with the international consensus for injury surveillance in rugby. Injury incidence was 120.0 (men) and 166.7/1,000 player match hours (women), injury severity was 12.0 (median) and 31.2 days (mean) for men, and 11.0 (median) and 30.2 days (mean) for women. Injury burden was 3,745 (men) and 5,040 days absence/1,000 player match hours (women). Concussion was the most common specific injury for men (22.5/1,000 hours) and women (26.7/1,000 hours). No statistical differences were found for incidence or severity measures between sexes. Injury incidence was greater than recent Rugby World Cup studies. High incidences of concussion reinforces the need for prevention strategies targeting this injury.
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Affiliation(s)
- Stuart John Bailey
- School of Applied Sciences, Edinburgh Napier University, Edinburgh, United Kingdom of Great Britain and Northern Ireland
| | - Russell Martindale
- School of Applied Sciences, Edinburgh Napier University, Edinburgh, United Kingdom of Great Britain and Northern Ireland
| | - Lars Engebretsen
- Orthopedic Clinic, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Oslo Sports Trauma Research Center, Norwegian School of Sports Sciences, Oslo, Norway
| | - James Peter Robson
- Sport Medicine, Scottish Rugby Union, Edinburgh, United Kingdom of Great Britain and Northern Ireland
| | - Debbie Palmer
- Edinburgh Sports Medicine Research Network, University of Edinburgh Institute for Sport Physical Education and Health Sciences, Edinburgh, United Kingdom of Great Britain and Northern Ireland
- School of Medicine, University of Nottingham School of Medicine, Nottingham, United Kingdom of Great Britain and Northern Ireland
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7
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Shill IJ, West SW, Brown J, Wilson F, Palmer D, Pike I, Hendricks S, Stokes KA, Hagel BE, Emery CA. How to harness and improve on video analysis for youth rugby player safety: a narrative review. BMJ Open Sport Exerc Med 2023; 9:e001645. [PMID: 37780130 PMCID: PMC10537827 DOI: 10.1136/bmjsem-2023-001645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2023] [Indexed: 10/03/2023] Open
Abstract
Video analysis is a useful tool for injury surveillance in rugby union. There are few video analysis studies in the professional female game, with most studies published in the male elite/professional settings. Moreover, there is a sparsity of literature in youth rugby settings. The following narrative review outlines the strengths and limitations of the current video analysis literature for injury surveillance in youth rugby union, highlights the importance of video analysis for youth rugby player safety and welfare, and discusses recommendations for using video analysis to inform player safety in youth rugby.
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Affiliation(s)
- Isla J Shill
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Stephen W West
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Centre for Health, and Injury & Illness Prevention in Sport, Department of Health, University of Bath, Bath, UK
- UK Collaborating Centre on Injury and Illness Prevention in Sport, University of Bath, Bath, UK
| | - James Brown
- Carnegie Applied Rugby Research (CARR) centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Institute of Sport and Exercise Medicine (ISEM), Department of Exercise, Sport and Lifestyle Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
- Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town and the Sports Science Institute of South Africa, Cape Town, South Africa
| | - Fiona Wilson
- School of Medicine, Discipline of Physiotherapy, Trinity College Dublin, Trinity College Dublin, Dublin, Ireland
| | - Debbie Palmer
- UK Collaborating Centre on Injury and Illness Prevention in Sport, University of Edinburgh, Edinburgh, UK
- Edinburgh Sports Medicine Research Network, Institute for Sport, PE and Health Sciences, University of Edinburgh, Edinburgh, UK
| | - Ian Pike
- Department of Pediatrics, The University of British Columbia, Vancouver, British Columbia, Canada
- BC Injury Research and Prevention Unit, BC Children’s Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Sharief Hendricks
- Carnegie Applied Rugby Research (CARR) centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town and the Sports Science Institute of South Africa, Cape Town, South Africa
| | - Keith A Stokes
- Centre for Health, and Injury & Illness Prevention in Sport, Department of Health, University of Bath, Bath, UK
- UK Collaborating Centre on Injury and Illness Prevention in Sport, University of Bath, Bath, UK
- Rugby Football Union, Twickenham, UK
| | - Brent E Hagel
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- O’Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
| | - Carolyn A Emery
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- O’Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
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Why Median Severity and Ordinal Scale Severity Values should not be used for Injury Burden Results: A Critical Review. Int J Sports Med 2023; 44:313-319. [PMID: 36669525 DOI: 10.1055/a-1983-0040] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Injury burden is a composite measure of injury incidence and mean severity; this parameter has been reported as an output measure from injury surveillance studies in rugby for over 20 years. The benefits of reporting injury burden results have, more recently, been recognised in other sports. This wider use of injury burden as an output measure from injury surveillance studies has, however, highlighted misunderstandings about how to calculate, present and interpret injury burden data. The aim of this critical review is to explain why median severity and ordinal severity scales should not be used to calculate and report injury burden results in injury surveillance studies. Equations are presented to show how injury burden results should be calculated, and graphs and tables are presented to explain the errors that are introduced when median severity and ordinal scales of severity are used instead of mean severity. This critical review is intended to highlight the correct procedures for calculating, reporting and interpreting injury burden results in order to avoid incorrect results, conclusions and injury prevention recommendations being published.
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Bom HSH, Jeong YH, Cho S. Injuries and Illness during the 2019 Gwangju FINA and Masters World Championships in Elite and Amateur Athletes. Chonnam Med J 2023; 59:83-86. [PMID: 36794242 PMCID: PMC9900224 DOI: 10.4068/cmj.2023.59.1.83] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 12/14/2022] [Accepted: 12/15/2022] [Indexed: 02/01/2023] Open
Abstract
Comparative analysis of injury and illness prevalence in elite and amateur athletes provides the basis for the development of tailored prevention programs. The authors analyzed the differences in frequency and characteristics of injuries and illnesses which occurred in elite and amateur athletes during the 2019 Gwangju Federation Internationale de Natation (FINA) and Masters World Championships. The 2019 FINA World Championships hosted 3095 athletes in the disciplines of swimming, diving, high diving, artistic swimming, water polo, and open water swimming. While the 2019 Masters World Championships hosted 4032 athletes in swimming, diving, artistic swimming, water polo, and open water swimming. All medical records were electrically recorded in every venue as well as the central medical center located at the athlete's village. More elite athletes visited clinics than amateur athletes during the events (15.0 vs 8.6%, p<0.05) despite the ages of amateur athletes being higher than elite athletes (41.0±15.0 vs 22.4±5.6 years, p<0.01). Elite athletes complained mainly of musculoskeletal problems (69%), while amateur athletes complained of both musculoskeletal (38%) and cardiovascular (8%) problems. The most frequent injury in elite athletes was due to overuse in the shoulder joints, while that of amateur athletes was traumatic injuries involving feet and hands. The most common illness was respiratory infection in both elite and amateur athletes, while cardiovascular events occured only in amateur athletes. As the risk of injury varies in elite and amateur athletes, tailored preventive measures should be prepared. Furthermore, preventive measures of cardiovascular events should focus on amateur sports events.
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Affiliation(s)
- Hee-Seung Henry Bom
- Department of Nuclear Medicine, Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Yong Hoon Jeong
- Department of Emergency Medicine, Chonnam National University Hospital, Gwangju, Korea
| | - Soohyung Cho
- Department of Emergency Medicine, Chosun University Hospital, Gwangju, Korea
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10
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A Qualitative Exploration of Parents' Perceptions of Risk in Youth Contact Rugby. Behav Sci (Basel) 2022; 12:bs12120510. [PMID: 36546993 PMCID: PMC9774146 DOI: 10.3390/bs12120510] [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: 11/02/2022] [Revised: 12/10/2022] [Accepted: 12/12/2022] [Indexed: 12/15/2022] Open
Abstract
The purpose of this study was to explore the understandings and perceptions of risk related to brain trauma amongst parents of children that play contact rugby. A qualitative approach was taken, using semi-structured interviews with 7 mothers and 27 fathers of children that participate in contact rugby. A thematic analysis of data suggests that parents used two primary cognitive strategies to process the risk they consented to with their children's participation in rugby; (1) minimalizing rugby risk to be equivalent to less injurious sports; and (2) elevating physical and social advantages above what they think other sports are capable of providing. From the findings it is suggested that parents who permit their children to play contact rugby are both aware of the high risks of injury in the sport, but simultaneously utilize two cognitive distortion techniques to rectify the dissonance caused between their choice to have their children play, and the salient number of concussions they observe. These results suggest that it will take properly informed consent, inclusive of concussion rates compared to other sports, in order to reduce cognitive distortion and effectively communicate risks associated with participation in contact rugby.
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11
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Lu D, McCall A, Jones M, Duffield R. The relationship between team-level and league-level injury rate, type and location in a professional football league. J Sci Med Sport 2022; 25:564-568. [DOI: 10.1016/j.jsams.2022.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 02/08/2022] [Accepted: 03/28/2022] [Indexed: 10/18/2022]
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12
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Risk Assessment of Alpine Skiing Events Based on Knowledge Graph: A Focus on Meteorological Conditions. ISPRS INTERNATIONAL JOURNAL OF GEO-INFORMATION 2021. [DOI: 10.3390/ijgi10120835] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The alpine skiing event is particularly vulnerable to changes in meteorological conditions as a winter sport held outdoors. The commonly used risk assessment methods cannot be inflexible and cannot be dynamically adjusted to combine multiple risk factors and actual conditions. A knowledge graph can organize data resources in the risk domain as structured knowledge systems. This paper combines a knowledge graph and risk assessment to effectively assess the risk status. First of all, we introduce the relevant literature review of sports event risk assessment, combining the characteristics of alpine skiing events. Then, we summarize the risk types of alpine skiing events and related risk knowledge. Secondly, a model is proposed to introduce an event risk assessment model based on the RippleNet framework combined with the characteristics of large-scale sports events. Moreover, the validity of the model is verified. The results show that the RippleNet-based event risk assessment model can be used to assess the risk of alpine skiing events. In order to effectively deal with the large-scale sports events that occur with a variety of risks, the smooth implementation of large-scale sports events provides a strong guarantee.
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Gilbert AW, Bering JM, Anderson LC. Addressing head injury risk in youth football: are heading guidelines the answer? SCI MED FOOTBALL 2021; 6:340-346. [DOI: 10.1080/24733938.2021.1967435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Alexander W. Gilbert
- 133 Union Street East, Dunedin
- Centre for Science Communication, University of Otago, Dunedin, New Zealand
| | - Jesse M. Bering
- Centre for Science Communication, University of Otago, Dunedin, New Zealand
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Porsanger L, Magnussen LI. Risk and Safety Management in Physical Education: A Study of Teachers' Practice Perspectives. Front Sports Act Living 2021; 3:663676. [PMID: 33937754 PMCID: PMC8085588 DOI: 10.3389/fspor.2021.663676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 03/08/2021] [Indexed: 11/13/2022] Open
Abstract
The aim of this article is to explore and understand teachers' risk and safety management (RSM) practices in physical education (PE) programs in Norway. A survey questionnaire and semistructured interviews were therefore used to generate quantitative data on trends from a larger sample of teachers (n = 698) and rich in-depth qualitative data concerning teachers' (n = 17) practices. By providing the teachers' perspectives, a better understanding of the complexity of RSM in PE may be possible. The results from both the survey and interviews suggest that teachers employ multiple strategies: from safety procedures, complying to compulsory risk measures, to the use of common sense in their RSM practices. The interviewees, on the other hand, initially claim that their RSM practice is quite scarce and, in some respects, not appropriate for PE. They emphasize measures that cater to the students' needs and modification to physical activities in their teaching. However, the interview data suggest that teachers do not primarily conceptualize this part of their practice as RSM but as measures of other pedagogical concerns. Combined, the results from both the survey and the interviews may characterize a RSM practice that relies on teaching experience and the use of discretion. The results in this article both converge and diverge and emphasize the importance of multiple data sources in investigating teachers' RSM practices.
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Affiliation(s)
- Lise Porsanger
- Department of Teacher Education, Norwegian University of Science and Technology, Trondheim, Norway
| | - Leif Inge Magnussen
- Department of Business, History and Social Sciences, University of Southeastern Norway, Borre, Norway
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15
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Xu Y, Yang C, Yang Y, Zhang X, Zhang S, Zhang M, Liu L, Fu W. A Narrative Review of Injury Incidence, Location, and Injury Factor of Elite Athletes in Snowsport Events. Front Physiol 2021; 11:589983. [PMID: 33488394 PMCID: PMC7820716 DOI: 10.3389/fphys.2020.589983] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 12/10/2020] [Indexed: 11/13/2022] Open
Abstract
Snowsport athletes face a high injury risk both during training and in competitions. Reducing injury incidence is crucial for athletes to achieve breakthroughs. This narrative review aimed to summarize and analyze injury data of elite athletes in snowsports and provide references for injury prevention and health security for these athletes and their coaches. A total of 39 studies that investigated snowsport injury were analyzed in the present study. On the basis of injury data of elite athletes in snowsports events, this narrative review focused on four aspects, namely, injury incidence, severity, location and causes. The findings of this review were as follows. (1) The highest injury incidence was recorded in freestyle skiing, followed by alpine skiing and snowboarding, the majority of which were moderate and severe injuries. (2) The proportion of injury in competitions and during training was similar. However, more injuries occurred in official training during the Winter Olympic Games; by contrast, injury proportion was higher in competitions during World Cup/World Championships. (3) The most commonly and severely injured body parts were the knees (29.9%), head and face (12.1%), shoulders and clavicula (10.5%), and lower back (8.9%). The most common injury types were joint and ligament injury (41.5%), fracture and bone stress (24.4%), concussion (11.1%), and muscle/tendon injury (10.7%). (4) The main causes of snowsport injury were collisions, falls, and non-contact injuries. Snowsport injury was also influenced by the skill level of the athletes, gender, course setup and equipment. Future studies should further explore the influence of event characteristics and intrinsic and extrinsic risk factors on snowsport injury. An injury or trauma reconstruction may be developed to predict athletic injuries and provide effective prevention strategies.
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Affiliation(s)
- Yongxin Xu
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Chenhao Yang
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Yang Yang
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Xini Zhang
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Shen Zhang
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Mingwen Zhang
- Beijing Institute of Fashion Technology, Beijing, China.,Institute for Frontier Materials, Deakin University, Geelong, VIC, Australia
| | - Li Liu
- Beijing Institute of Fashion Technology, Beijing, China
| | - Weijie Fu
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
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16
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Fuller CW, Taylor A. Eight-season epidemiological study of match injuries in women's international rugby sevens. J Sports Sci 2020; 39:865-874. [PMID: 33225825 DOI: 10.1080/02640414.2020.1850616] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This study aimed to describe anthropometry and incidence, nature and causes of match injuries in women's international rugby sevens and to compare these with results reported previously for men's international rugby sevens. The study comprised an 8-season, prospective study of World Rugby's women's Sevens World Series. Over the eight seasons, the overall incidence of injury was 105.6 (95% CI: 96.0 to 116.3) injuries/1000 player-match-hours with a mean injury severity of 53.4 (95% CI: 46.9 to 59.9) days-absence. There were no statistically significant trends for backs or forwards in the incidence (backs: p = 0.470; forwards: p = 0.242) or mean severity (backs: p = 0.098; forwards: p = 0.544) of injuries sustained over the 8-season period. Head/face (20.8%), knee (19.7%), ankle (11.3%) and shoulder/clavicle (8.4%) were the most common injury locations while ligament sprain (31.7%), concussion (15.6%), haematoma/bruise (11.5%) and fracture (11.5%) were the most common types of injury sustained. Being-tackled (35.4%), tackling (26.3%), collisions (13.8%) and rucks (8.8%) were the match events responsible for most injuries. The study indicates that injury burden in women's international rugby sevens (5,640 days-absence/1000 player-match-hours; 95% CI: 5,123 to 6,209) is similar to that reported previously for men's international rugby sevens (5,263 days-absence/1000 player-match-hours; 95% CI: 5,000 to 5,540).
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Affiliation(s)
- Colin W Fuller
- Colin Fuller Consultancy Ltd, Sutton Bonington, UK.,World Rugby, Dublin, Ireland
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17
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Quarrie K, Gianotti S, Murphy I. Injury Risk in New Zealand Rugby Union: A Nationwide Study of Injury Insurance Claims from 2005 to 2017. Sports Med 2020; 50:415-428. [PMID: 31506903 PMCID: PMC6985044 DOI: 10.1007/s40279-019-01176-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Objectives The Accident Compensation Corporation is a compulsory, 24-h, no-fault personal injury insurance scheme in New Zealand. The purpose of this large-scale retrospective cohort study was to use Accident Compensation Corporation records to provide information about rugby injury epidemiology in New Zealand, with a focus on describing differences in risk by age and gender. Methods A total of 635,657 rugby injury claims were made to the Accident Compensation Corporation for players aged 5–40 years over the period 2005–2017. Information about player numbers and estimates of player exposure was obtained from New Zealand Rugby, the administrative organisation for rugby in New Zealand. Results Over three quarters of claims (76%) were for soft-tissue injuries, with 11% resulting from fractures or dislocations, 6.7% from lacerations, 3.1% from concussions and 2.0% from dental injuries. Body regions injured included shoulder (14%), knee (14%), wrist/hand (13%), neck/spine (13%), head/face (12%), leg (11%) and ankle (10%). The probability of a player making at least one injury claim in a season (expressed as a percentage) was calculated under the assumption that the incidence of claims follows a Poisson distribution. Players aged 5–6 years had a probability of making at least one claim per season of 1.0%, compared to 8.3% for players aged 7–12 years, 35% for age 13–17 years, 53% for age 18–20 years, 57% for age 21–30 years and 47% for age 31–40 years. The overall probability of making at least one claim per season across all age groups was 29%. The relative claim rate for adults (players aged 18 years and over) was 3.92 (90% confidence interval 3.90–3.94) times that of children. Ten percent of players were female, and they sustained 6% of the injuries. Overall, the relative claim rate for female players was 0.57 times that of male players (90% confidence interval 0.56–0.58). The relative claim rate of female to male players tended to increase with age. There were very few female players aged over 30 years; however, those who did play had higher claim rates than male players of the same age group (1.49; 90% confidence interval 1.45–1.53). Conclusions Injuries resulting from rugby are distributed across the body, and most of the claims are for soft-tissue injuries. Rates of injury increase rapidly through the teenage years until the early 20 s; for male players they then decrease until the mid-30 s. For female players, the injury rate does not decrease as players move into their 30 s. Combining Accident Compensation Corporation injury claim data with national player registration data provides useful information about the risks faced by New Zealand’s community rugby players, and the insights derived are used in the development of rugby injury prevention programme content. Electronic supplementary material The online version of this article (10.1007/s40279-019-01176-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Simon Gianotti
- Accident Compensation Corporation, Wellington, New Zealand
| | - Ian Murphy
- New Zealand Rugby, Wellington, New Zealand
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18
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Hall ECR, Larruskain J, Gil SM, Lekue JA, Baumert P, Rienzi E, Moreno S, Tannure M, Murtagh CF, Ade JD, Squires P, Orme P, Anderson L, Whitworth-Turner CM, Morton JP, Drust B, Williams AG, Erskine RM. An injury audit in high-level male youth soccer players from English, Spanish, Uruguayan and Brazilian academies. Phys Ther Sport 2020; 44:53-60. [PMID: 32416582 DOI: 10.1016/j.ptsp.2020.04.033] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 04/24/2020] [Accepted: 04/25/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To identify the most common injury types/locations in high-level male youth soccer players (YSP). DESIGN Prospective cohort surveillance study. SETTING Professional soccer club academies. PARTICIPANTS Six hundred and twenty-four high-level male YSP [Under 9 (U9) to U23 year-old age groups] from academies in England, Spain, Uruguay and Brazil. MAIN OUTCOME MEASURES Injury type, location and severity were recorded during one season. Injury severity was compared between age groups, while injury type and location were compared between nations. RESULTS Four hundred and forty-three training or match injuries were recorded, giving an injury rate of 0.71 per player. Non-contact injuries were most common (58.5%), with most (44.2%) resolved between 8 and 28 days. Most injuries (75.4%) occurred in the lower limbs, with muscle (29.6%) the most commonly injured tissue. U14 and U16 suffered a greater number of severe injuries relative to U12 and U19/U20/U23/Reserves. Tendon injury rate was higher in Brazil vs. Spain (p < 0.05), with low back/sacrum/pelvis injury rate highest in Spain (p < 0.05). CONCLUSIONS The proportion of severe injuries in U14 and U16 suggests YSP injury risk is maturation-dependent. Minimal differences in type and location between high-level YSP from four different countries suggest injury rates in this population are geographically similar.
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Affiliation(s)
- Elliott C R Hall
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK; Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester, UK
| | | | - Susana M Gil
- Department of Genetics, Physical Anthropology and Animal Physiology, Faculty of Science and Technology, University of the Basque Country (UPV/EHU), Leioa, Spain
| | | | - Philipp Baumert
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Edgardo Rienzi
- Club Atlético Peñarol, Estadio Campeón del Siglo, Montevideo, Uruguay
| | - Sacha Moreno
- Club Atlético Peñarol, Estadio Campeón del Siglo, Montevideo, Uruguay
| | | | - Conall F Murtagh
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK; Liverpool Football Club, Liverpool, UK
| | - Jack D Ade
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK; Liverpool Football Club, Liverpool, UK
| | | | | | - Liam Anderson
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK; Crewe Alexandra Football Club, Crewe, UK
| | | | - James P Morton
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Barry Drust
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Alun G Williams
- Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester, UK; Institute of Sport, Exercise and Health, University College London, London, UK
| | - Robert M Erskine
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK; Institute of Sport, Exercise and Health, University College London, London, UK.
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19
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Bahr R, Clarsen B, Derman W, Dvorak J, Emery CA, Finch CF, Hägglund M, Junge A, Kemp S, Khan KM, Marshall SW, Meeuwisse W, Mountjoy M, Orchard JW, Pluim B, Quarrie KL, Reider B, Schwellnus M, Soligard T, Stokes KA, Timpka T, Verhagen E, Bindra A, Budgett R, Engebretsen L, Erdener U, Chamari K. International Olympic Committee consensus statement: methods for recording and reporting of epidemiological data on injury and illness in sport 2020 (including STROBE Extension for Sport Injury and Illness Surveillance (STROBE-SIIS)). Br J Sports Med 2020; 54:372-389. [PMID: 32071062 PMCID: PMC7146946 DOI: 10.1136/bjsports-2019-101969] [Citation(s) in RCA: 416] [Impact Index Per Article: 104.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2020] [Indexed: 12/16/2022]
Abstract
Injury and illness surveillance, and epidemiological studies, are fundamental elements of concerted efforts to protect the health of the athlete. To encourage consistency in the definitions and methodology used, and to enable data across studies to be compared, research groups have published 11 sport-specific or setting-specific consensus statements on sports injury (and, eventually, illness) epidemiology to date. Our objective was to further strengthen consistency in data collection, injury definitions and research reporting through an updated set of recommendations for sports injury and illness studies, including a new Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist extension. The IOC invited a working group of international experts to review relevant literature and provide recommendations. The procedure included an open online survey, several stages of text drafting and consultation by working groups and a 3-day consensus meeting in October 2019. This statement includes recommendations for data collection and research reporting covering key components: defining and classifying health problems; severity of health problems; capturing and reporting athlete exposure; expressing risk; burden of health problems; study population characteristics and data collection methods. Based on these, we also developed a new reporting guideline as a STROBE Extension-the STROBE Sports Injury and Illness Surveillance (STROBE-SIIS). The IOC encourages ongoing in- and out-of-competition surveillance programmes and studies to describe injury and illness trends and patterns, understand their causes and develop measures to protect the health of the athlete. Implementation of the methods outlined in this statement will advance consistency in data collection and research reporting.
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Affiliation(s)
- Roald Bahr
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Ben Clarsen
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
| | - Wayne Derman
- Institute of Sport and Exercise Medicine, Division of Orthopaedic Surgery, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Jiri Dvorak
- Spine Unit, Swiss Concussion Center and Swiss Golf Medical Center, Schulthess Clinic, Zurich, Switzerland
| | - Carolyn A Emery
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Pediatrics and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Caroline F Finch
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Martin Hägglund
- Department of Medical and Health Sciences, Division of Physiotherapy, Linköping University, Linköping, Sweden
| | - Astrid Junge
- Medical School Hamburg, Hamburg, Germany
- Swiss Concussion Centre, Schulthess Clinic, Zurich, Switzerland
| | - Simon Kemp
- Rugby Football Union, London, UK
- Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Karim M Khan
- Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada
- British Journal of Sports Medicine, London, UK
| | - Stephen W Marshall
- Injury Prevention Research Center and Department of Epidemiology at the Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Willem Meeuwisse
- Sport Injury Prevention Research Centre, University of Calgary, Calgary, Alberta, Canada
- National Hockey League, Calgary, Alberta, Canada
| | - Margo Mountjoy
- Department of Family Medicine (Sport Medicine), McMaster University, Hamilton, Ontario, Canada
- FINA Bureau (Sport Medicine), Lausanne, Switzerland
| | - John W Orchard
- School of Public Health, University of Sydney, New South Wales, Sydney, Australia
| | - Babette Pluim
- Department of Sports Medicine, Royal Netherlands Lawn Tennis Association, Amstelveen, The Netherlands
- Amsterdam Collaboration on Health & Safety in Sports (ACHSS), AMC/VUmc IOC Research Center of Excellence, Amsterdam, The Netherlands
- Faculty of Health Sciences, University of Pretoria, Hatfield, South Africa
| | - Kenneth L Quarrie
- New Zealand Rugby, Wellington, New Zealand
- Sports Performance Research Institute New Zealand, AUT University, Auckland, New Zealand
| | - Bruce Reider
- Department of Orthopaedic Surgery and Rehabilitation, University of Chicago, Chicago, Illinois, USA
| | - Martin Schwellnus
- Sport, Exercise Medicine and Lifestyle Research Institute (SEMLI), University of Pretoria, Hatfield, South Africa
| | - Torbjørn Soligard
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, Calgary, Alberta, Canada
| | - Keith A Stokes
- Department for Health, University of Bath, Bath, UK
- Rugby Football Union, Twickenham, UK
| | - Toomas Timpka
- Athletics Research Center, Linköping University, Linköping, Sweden
- Centre for Healthcare Development, Region Östergötland, Linköping, Sweden
| | - Evert Verhagen
- Amsterdam Collaboration on Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam UMC, Amsterdam, The Netherlands
| | - Abhinav Bindra
- Athlete Commission, International Olympic Committee, Lausanne, Switzerland
| | - Richard Budgett
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | - Lars Engebretsen
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | - Uğur Erdener
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | - Karim Chamari
- Aspetar Sports Medicine and Orthopedic Hospital, Doha, Qatar
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20
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Hoffman DT, Dwyer DB, Bowe SJ, Clifton P, Gastin PB. Is injury associated with team performance in elite Australian football? 20 years of player injury and team performance data that include measures of individual player value. Br J Sports Med 2020; 54:475-479. [PMID: 31242988 DOI: 10.1136/bjsports-2018-100029] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2019] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To determine whether specific injury measures were associated with team performance in the Australian Football League (AFL). METHODS 15 289 injuries caused players from 18 teams to miss 51 331 matches between 1997 and 2016. Data were aggregated to the team level. We analysed the associations among injury measures and team performance (reaching finals/playoffs and specific ladder/table position). Injury measures per team included: injury incidence, injury severity, injury burden, player match availability and percentage of the full player roster injured. We also weighted injury measures by five measures of player value. RESULTS AFL teams' injury burden and player match availability were associated with final table position (r2=0.03, p<0.05). Player value weighted injury burden was different between finalists and non-finalists (mean difference=-8, p<0.001) and explained 12% of the variation in the table position of teams (p<0.001). For a team, nine missed matches due to injury (burden weighted by a best and fairest player rating system) was associated with one lower table position. Player match availability weighted by player value was higher for finalists than non-finalists (mean difference=1.7, p<0.01) and explained 7% of the variation in the table position of teams (p<0.001). DISCUSSION AND POTENTIAL IMPLICATIONS The impact of injury (burden weighted by best and fairest) explained up to 12% of the variation in final table position-this is particularly relevant to making/not making playoffs as well as home ground/travel advantages for those teams that make the one-game format of AFL playoffs (not home-away or best of seven format).
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Affiliation(s)
| | - Dan Brian Dwyer
- Centre for Sport Research, Deakin University, Geelong, Victoria, Australia
| | - Steven J Bowe
- Biostatistics Unit, Deakin University, Geelong, Victoria, Australia
| | - Patrick Clifton
- Football Operations, Australian Football League, Melbourne, Victoria, Australia
| | - Paul B Gastin
- Centre for Sport Research, Deakin University, Geelong, Victoria, Australia
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia
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21
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Bahr R, Clarsen B, Derman W, Dvorak J, Emery CA, Finch CF, Hägglund M, Junge A, Kemp S, Khan KM, Marshall SW, Meeuwisse W, Mountjoy M, Orchard JW, Pluim B, Quarrie KL, Reider B, Schwellnus M, Soligard T, Stokes KA, Timpka T, Verhagen E, Bindra A, Budgett R, Engebretsen L, Erdener U, Chamari K. International Olympic Committee Consensus Statement: Methods for Recording and Reporting of Epidemiological Data on Injury and Illness in Sports 2020 (Including the STROBE Extension for Sports Injury and Illness Surveillance (STROBE-SIIS)). Orthop J Sports Med 2020; 8:2325967120902908. [PMID: 32118084 PMCID: PMC7029549 DOI: 10.1177/2325967120902908] [Citation(s) in RCA: 96] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 01/03/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Injury and illness surveillance, and epidemiological studies, are fundamental elements of concerted efforts to protect the health of the athlete. To encourage consistency in the definitions and methodology used, and to enable data across studies to be compared, research groups have published 11 sport- or setting-specific consensus statements on sports injury (and, eventually, illnesses) epidemiology to date. OBJECTIVE To further strengthen consistency in data collection, injury definitions, and research reporting through an updated set of recommendations for sports injury and illness studies, including a new Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist extension. STUDY DESIGN Consensus statement of the International Olympic Committee (IOC). METHODS The IOC invited a working group of international experts to review relevant literature and provide recommendations. The procedure included an open online survey, several stages of text drafting and consultation by working groups, and a 3-day consensus meeting in October 2019. RESULTS This statement includes recommendations for data collection and research reporting covering key components: defining and classifying health problems, severity of health problems, capturing and reporting athlete exposure, expressing risk, burden of health problems, study population characteristics, and data collection methods. Based on these, we also developed a new reporting guideline as a STROBE extension-the STROBE Sports Injury and Illness Surveillance (STROBE-SIIS). CONCLUSION The IOC encourages ongoing in- and out-of-competition surveillance programs and studies to describe injury and illness trends and patterns, understand their causes, and develop measures to protect the health of the athlete. The implementation of the methods outlined in this statement will advance consistency in data collection and research reporting.
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Affiliation(s)
| | - Roald Bahr
- Roald Bahr, MD, PhD, Department of Sports Medicine, Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, PB 4014 Ullevål Stadion, 0806 Oslo, Norway ()
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22
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Badenhorst M, Verhagen E, Lambert M, van Mechelen W, Brown J. When This Happens, You Want the Best Care: Players' Experiences of Barriers and Facilitators of the Immediate Management of Rugby-Related Acute Spinal Cord Injury. QUALITATIVE HEALTH RESEARCH 2019; 29:1862-1876. [PMID: 30864491 DOI: 10.1177/1049732319834930] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Most contact sports, including rugby union, carry a risk of injury. Although acute spinal cord injuries (ASCIs) in rugby are rare, the consequences of such injuries are far-reaching. Optimal management of these injuries is challenging, and a detailed understanding of the different barriers and facilitators to optimal care is needed. In this study, we aimed to describe the perception of players, regarding factors related to the optimal immediate management of a catastrophic injury in a developing country with socioeconomic and health care inequities. The most frequently reported barriers were transportation delays after injury and admission to appropriate medical facilities. Other barriers included inadequate equipment, the quality of first aid care, and barriers within the acute hospital setting. Barriers were more prevalent in rural and lower socioeconomic areas. These findings are relevant for all rugby stakeholders and may help shape education, awareness, and future policy around the immediate management of ASCIs.
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Affiliation(s)
- Marelise Badenhorst
- University of Cape Town, Cape Town, South Africa
- Amsterdam UMC, VU University, Amsterdam, The Netherlands
| | - Evert Verhagen
- University of Cape Town, Cape Town, South Africa
- Amsterdam UMC, VU University, Amsterdam, The Netherlands
- Federation University Australia, Ballarat, Victoria, Australia
| | - Mike Lambert
- University of Cape Town, Cape Town, South Africa
- Amsterdam UMC, VU University, Amsterdam, The Netherlands
| | - Willem van Mechelen
- University of Cape Town, Cape Town, South Africa
- Amsterdam UMC, VU University, Amsterdam, The Netherlands
- The University of Queensland, Brisbane, Queensland, Australia
- University College Dublin, Dublin, Ireland
| | - James Brown
- Stellenbosch University, Stellenbosch, South Africa
- International Olympic Committee Research Centre, Cape Town, South Africa
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23
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Smyth EA, Piromalli L, Antcliff A, Newman P, Waddington G, Weissensteiner JR, Drew MK. A prospective study of health problems at the 2018 17/U and 19/U Australian National Netball Championships with comparison of surveillance methodology. J Sci Med Sport 2019; 23:215-221. [PMID: 31704027 DOI: 10.1016/j.jsams.2019.10.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 09/04/2019] [Accepted: 10/07/2019] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To investigate the incidence, site, nature and cause of injuries sustained during and four weeks following the 2018 Australian National Netball Championships (ANNC's) using medical attention and self-report surveillance tools. DESIGN Prospective cohort study. METHOD Injuries were recorded prospectively using medical attention and self-report data collection methods. One hundred and ninety-two athletes competed at the 2018 ANNC's with 96 athletes in each age group (17/U & 19/U). RESULTS There were 103 medical attention injuries sustained by 80 athletes resulting in an incidence rate of 89.4 per 1000 player hours. The most frequently recorded medical attention injury diagnoses across both age groups were lateral ankle ligament sprain (n=14, 13.6%), foot blisters (n=11, 10.7%), and lumbar pain (n=10, 9.7%). Ankle sprains (n=4), anterior cruciate ligament (ACL) ruptures (n=3) and concussion (n=3) recorded as the highest sports incapacity injuries. The self-report data collection revealed that 46 (27.2%) athletes arrived at the tournament with an existing self-reported injury/illness and 57 (39.3%) athletes had a self-reported injury/illness at the conclusion of the ANNC (RR 1.44 95%CI 1.05-1.99, p=0.030). CONCLUSION There are no recent studies reporting injury rates specifically in pre-elite netball players. This study found an incidence rate of 89.4 per 1000 player hours. Ankle sprains are the highest medical attention and sports-incapacity injury in pre-elite netball athletes. Foot blisters and low back pain also feature in the highest medical attention injuries and ACL rupture and concussion were high sports incapacity injuries at the ANNC's. Finally, combining both the medical attention and self-report injury/illness data collection methods identified more injuries/illnesses than the use of one method alone.
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Affiliation(s)
- Erin A Smyth
- Athlete Availability Program, Australian Institute of Sport, Australia; Research Institute for Sport and Exercise, University of Canberra, Australia.
| | | | | | - Phillip Newman
- Research Institute for Sport and Exercise, University of Canberra, Australia; Faculty of Health, University of Canberra, Australia
| | - Gordon Waddington
- Athlete Availability Program, Australian Institute of Sport, Australia; Research Institute for Sport and Exercise, University of Canberra, Australia
| | | | - Michael K Drew
- Athlete Availability Program, Australian Institute of Sport, Australia; Australian Collaboration for Research into Injury in Sport and its Prevention (ACRISP), Australia
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Quarrie K, Gianotti S, Murphy I, Harold P, Salmon D, Harawira J. RugbySmart: Challenges and Lessons from the Implementation of a Nationwide Sports Injury Prevention Partnership Programme. Sports Med 2019; 50:227-230. [PMID: 31506902 DOI: 10.1007/s40279-019-01177-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
| | | | - Ian Murphy
- New Zealand Rugby, Wellington, New Zealand
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Augustovičová D, Lystad RP, Arriaza R. Time-Loss Injuries in Karate: A Prospective Cohort Study of 4 Consecutive World Karate Championships. Orthop J Sports Med 2019; 7:2325967119865866. [PMID: 31489331 PMCID: PMC6710676 DOI: 10.1177/2325967119865866] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background: Prospective studies on injuries in martial arts competitions are scarce, especially those involving time-loss injuries. The upsurge of karate athletes competing in top-level karate competitions warrants elucidation of the time-loss injury risk. Purpose: To determine the time-loss injury proportion and incidence rate, describe the injury pattern among elite senior karate athletes, and compare the risk of time-loss injuries in male versus female athletes and in individual (ie, weight categories) versus team competitions (free-weight category). Study Design: Descriptive epidemiology study. Methods: Data were collected at 4 consecutive World Karate Championships (2010, 2012, 2014, and 2016). Injury incidence rates were calculated per 1000 athlete-exposures (IIRAE) and per 1000 minutes of exposure (IIRME), with 95% CIs. Subgroups were compared by calculating their rate ratios with 95% CIs. Results: A total of 506 injuries were recorded, of which 51 were time-loss injuries (10%). The overall time-loss injury rate was significantly lower for female versus male athletes and slightly lower for team versus individual competitions. Overall, 1.4% of all athletes sustained a time-loss injury, and the IIRAE and IIRME were 5.13 (95% CI, 3.82-6.74) and 1.98 (95% CI, 1.47-2.60), respectively. The most common type of time-loss injury was fracture (41%), followed by dislocation (20%) and concussion (12%). Conclusion: The time-loss injury incidence rate for top-level karate competitions found in this prospective study was relatively low. Comprehensive knowledge about the incidence of time-loss injuries during karate competitions represents an essential basis to develop effective strategies for injury prevention. Thus, the introduction of a uniform injury surveillance system in martial arts is of utmost importance.
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Affiliation(s)
- Dušana Augustovičová
- Faculty of Physical Education and Sports, Comenius University, Bratislava, Slovakia
- Dušana Augustovičová, PhD, Faculty of Physical Education and Sports, Comenius University, Nábrežie armádneho generála Ludvíka Svobodu 9, Bratislava 814 69, Slovakia ()
| | - Reidar P. Lystad
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Rafael Arriaza
- Physical Education and Sports School, University of A Coruña, A Coruña, Spain
- Instituto Médico Arriaza y Asociados, A Coruña, Spain
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Bolling C, Delfino Barboza S, van Mechelen W, Pasman HR. Letting the cat out of the bag: athletes, coaches and physiotherapists share their perspectives on injury prevention in elite sports. Br J Sports Med 2019; 54:871-877. [DOI: 10.1136/bjsports-2019-100773] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2019] [Indexed: 11/03/2022]
Abstract
ObjectivesTo explore how sports injury prevention takes place in elite sport practice and to describe the perspectives of athletes, coaches and physiotherapists regarding the most critical factors that help prevent injury in the elite sports context.MethodsQualitative study. Semistructured interviews with 19 international level athletes, coaches and physiotherapists, from different Olympic sports. Interviews were transcribed verbatim and analysed using comparative data analysis based on Grounded Theory.ResultsThe participants perceived injury risk as an inherent part of elite sports, because athletes try to enhance performance by pushing their limits. Participants described injury prevention as a learning process that changed over time, based on their sports experience and the injuries that they had sustained along their career. Communication among the athletes, coaches and physiotherapists was described as a key component of the injury prevention process. Study participants emphasised the relevance of teamwork and shared responsibility. Performance was presented as the core of the athlete’s daily practice, indicating that injury prevention can be a means to that end but is not a goal in itself for this community.ConclusionParticipants perceive injury prevention as part of elite sports and thus embrace the need for injury prevention. Injury prevention strategies in elite sports were described as a learning process, following the dynamic nature of training for maximal performance. Performance is the participants’ main goal.
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Tendon and Ligament Injuries in Elite Rugby: The Potential Genetic Influence. Sports (Basel) 2019; 7:sports7060138. [PMID: 31167482 PMCID: PMC6628064 DOI: 10.3390/sports7060138] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 05/29/2019] [Accepted: 05/30/2019] [Indexed: 01/13/2023] Open
Abstract
This article reviews tendon and ligament injury incidence and severity within elite rugby union and rugby league. Furthermore, it discusses the biological makeup of tendons and ligaments and how genetic variation may influence this and predisposition to injury. Elite rugby has one of the highest reported injury incidences of any professional sport. This is likely due to a combination of well-established injury surveillance systems and the characteristics of the game, whereby high-impact body contact frequently occurs, in addition to the high intensity, multispeed and multidirectional nature of play. Some of the most severe of all these injuries are tendon and ligament/joint (non-bone), and therefore, potentially the most debilitating to a player and playing squad across a season or World Cup competition. The aetiology of these injuries is highly multi-factorial, with a growing body of evidence suggesting that some of the inter-individual variability in injury susceptibility may be due to genetic variation. However, little effort has been devoted to the study of genetic injury traits within rugby athletes. Due to a growing understanding of the molecular characteristics underpinning the aetiology of injury, investigating genetic variation within elite rugby is a viable and worthy proposition. Therefore, we propose several single nucleotide polymorphisms within candidate genes of interest; COL1A1, COL3A1, COL5A1, MIR608, MMP3, TIMP2, VEGFA, NID1 and COLGALT1 warrant further study within elite rugby and other invasion sports.
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28
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Mountjoy M, Junge A, Budgett R, Doerr D, Leglise M, Miller S, Moran J, Foster J. Health promotion by International Olympic Sport Federations: priorities and barriers. Br J Sports Med 2019; 53:1117-1125. [DOI: 10.1136/bjsports-2018-100202] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2019] [Indexed: 12/21/2022]
Abstract
ObjectiveTo identify changes in International Federations’ priorities and the barriers to implementing athlete and global health initiatives. Results should influence the work of the International Federation medical committees, the IOC and the Association of Summer Olympic International Federation.MethodsThe 28 Summer and 7 Winter International Federations participating in the most recent Olympic Games (2016; 2018) were surveyed to (i) identify the importance of 27 health topics, (ii) assess their progress on implementation health-related programmes and (iii) the barriers to implementation of these programmes. We compared International Federations’ activities in 2016 and 2017.ResultsThe response rate was 83%. Health topics which most International Federations regarded as important and in which the International Federations felt insufficiently active were ‘team physician certification’, ‘prevention of harassment and abuse’, ‘eating disorders/disordered eating’, ‘mental health’ and ‘injury surveillance’. Compared with 2016, there was a decrease in International Federations’ activities in ‘injury surveillance’, ‘nutritional supplements’ and ‘hyperandrogenism’. The main barrier to implementing health-related programmes was ‘International Federation political support/willingness’, followed by ‘knowledge’. ‘Time’ and ‘coach support’ were more often reported than ‘finances’, or ‘IOC or Association of Summer Olympic International Federations partnership’.ConclusionIf International Federations are going to promote health of athletes and global health promotion through physical activity (sport), International Federation leadership must change their focus and provide greater political support for related initiatives. Improving coach and athlete knowledge of the health issues could also facilitate health programme delivery. Time constraints could be mitigated by sharing experiences among the International Federations, Association of Summer Olympic International Federations and the IOC. International Federations should focus on those health-related topics that they identified as being important, yet rate as having insufficient activity.
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Assessing the Return on Investment of Injury Prevention Procedures in Professional Football. Sports Med 2019; 49:621-629. [PMID: 30838519 DOI: 10.1007/s40279-019-01083-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
INTRODUCTION The aim of this study was to develop a quick and simple screening procedure for evaluating the return on investment provided by injury prevention programmes in professional football. Injury prevention in sport has usually been considered in isolation of other management responsibilities, and interventions are published irrespective of whether their impact is worthwhile and irrespective of the return on players' time investment in the programme. This approach is naive from a business perspective and is not an approach normally adopted by commercial organisations. METHODS In professional football, the overwhelming cost associated with implementing an injury prevention programme is the players' time commitment, and the major benefit is the players' increased availability, achieved through the reduction in the number of injuries. A comparison of these time-based costs and benefits provides the basis for the evaluation process presented. RESULTS Applying the evaluation process to a number of published injury prevention programmes recommended for football demonstrates that they are unlikely to provide an adequate return on investment. CONCLUSIONS Researchers should focus on developing injury prevention programmes that provide an adequate return on players' time investment, otherwise there is no incentive for clubs to implement the programmes. Reporting that an injury prevention programme produces a statistically significant reduction in the incidence of injury, for example, is insufficient information. Injury prevention programmes should focus on 'at risk' players to increase the return on investment, and researchers should evaluate and report on the utility of prevention programmes within the intended sports setting.
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30
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Injury Risk (Burden), Risk Matrices and Risk Contours in Team Sports: A Review of Principles, Practices and Problems. Sports Med 2019; 48:1597-1606. [PMID: 29623603 DOI: 10.1007/s40279-018-0913-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The aim of this review was to provide insights into and a critical assessment of injury burden, risk matrices and risk contours in the context of team sports. Injury burden is the product of injury incidence and mean severity, and is normally reported as days' absence/1000 player-hours. An important feature of injury burden is that equal values can reflect quite different numerical combinations of injury incidence and severity. The timeframe over which injury burden affects a team depends on the incidence and severity values of the injuries sustained. Injury burden is evaluated through the use of risk matrices and risk contours. The main benefits of using risk matrices, and the reasons for their widespread acceptance, are the minimal data inputs required, the ease of understanding the visual data presentation, the transparent nature of the evaluation criteria and the simplicity with which the conclusions can be communicated to stakeholders. Injury burden is most often used for the identification of injuries that cause the greatest loss of time for players, ranking the importance of injury risk factors and prioritising injury prevention plans. Although risk matrices are commonly used for evaluating risks during the risk assessment process, there is little evidence to demonstrate that they improve decision-making, as they have a number of limitations, including potential inconsistencies and discrepancies when evaluating and ranking risks. These limitations suggest that physicians, physiotherapists and sports scientists should only use injury burden, risk matrices and risk contours when they fully understand their strengths and weaknesses.
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Abstract
BACKGROUND Injuries in team sports are normally characterised by the incidence, severity, and location and type of injuries sustained: these measures, however, do not provide an insight into the variable injury-burden experienced during a season. Injury burden varies according to the team's match and training loads, the rate at which injuries are sustained and the time taken for these injuries to resolve. At the present time, this time-based variation of injury burden has not been modelled. OBJECTIVES To develop a kinetic model describing the time-based injury burden experienced by teams in elite team sports and to demonstrate the model's utility. METHODS Rates of injury were quantified using a large eight-season database of rugby injuries (5253) and exposure (60,085 player-match-hours) in English professional rugby. Rates of recovery from injury were quantified using time-to-recovery analysis of the injuries. RESULTS The kinetic model proposed for predicting a team's time-based injury burden is based on a composite rate equation developed from the incidence of injury, a first-order rate of recovery from injury and the team's playing load. The utility of the model was demonstrated by examining common scenarios encountered in elite rugby. CONCLUSIONS The kinetic model developed describes and predicts the variable injury-burden arising from match play during a season of rugby union based on the incidence of match injuries, the rate of recovery from injury and the playing load. The model is equally applicable to other team sports and other scenarios.
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Affiliation(s)
- Colin W Fuller
- Colin Fuller Consultancy Ltd, Main Street, Sutton Bonington, LE12 5PE, UK.
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32
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O’Brien J, Finch CF, Pruna R, McCall A. A new model for injury prevention in team sports: the Team-sport Injury Prevention (TIP) cycle. SCI MED FOOTBALL 2018. [DOI: 10.1080/24733938.2018.1512752] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- James O’Brien
- Research & Development Department, FC Red Bull Salzburg, Salzburg, Austria
- School of Health and Life Sciences, Federation University Australia, Ballarat, Australia
| | - Caroline F. Finch
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
| | - Ricard Pruna
- Medical Department, FC Barcelona,Ciutat Esportiva Joan Gamper, Barcelona, Spain
| | - Alan McCall
- Sport, Exercise and Health Sciences, School of Applied Sciences, Edinburgh Napier University, Edinburgh, UK
- Research & Development Department, Arsenal Football Club, London, UK
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33
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Mountjoy M, Miller J, Junge A. Analysis of water polo injuries during 8904 player matches at FINA World Championships and Olympic games to make the sport safer. Br J Sports Med 2018; 53:25-31. [PMID: 30194222 DOI: 10.1136/bjsports-2018-099349] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2018] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To analyse injuries of water polo players reported during four Summer Olympic Games (2004, 2008, 2012, 2016) and four Federation Internationale de Natation World Championships (2009, 2013, 2015, 2017). METHODS Injuries during training and matches were reported daily by the team physicians and the local medical staff at the sports venues using an established surveillance system. RESULTS A total of 381 injuries were reported, equivalent to 14.1 injuries per 100 players (95% CI ±1.42). The most frequent diagnoses were laceration (12.7%) and contusion (10.9%) of head, followed by (sub-)luxation/sprain of hand (9.5%) and contusion of trunk (6.5%) or hand (6.2%). More than half of the injuries (57.0%) occurred due to contact with another player. A quarter of the injuries (25.4%) were expected to result in absence from training or match; 10 (2.9%) resulted in an estimated time-loss of 3 or more weeks. About three-quarters of injuries (75.6%) occurred during matches, 86 during training. The incidence of match injuries was on average 56.2 injuries per 1000 match hours (95% CI ±6.74). The incidence of time-loss match injuries (14.7; 95% CI ±3.44) was significantly higher in men than in women. CONCLUSIONS A critical review of water polo in-competition rules and the implementation of a Fair Play programme may help to mitigate the high incidence of contact injuries incurred during matches. A water polo-specific concussion education programme including recognition, treatment and return to play is recommended. Finally, a prospective injury surveillance programme would help to better define water polo injuries outside of the competition period.
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Affiliation(s)
- Margo Mountjoy
- McMaster University Hamilton, Hamilton, Ontario, Canada.,Federation Internationale de Natation (FINA), Lausanne, Switzerland.,International Olympic Committee (IOC), Games Group Lausanne, Lausanne, Switzerland
| | - Jim Miller
- Federation Internationale de Natation (FINA), Lausanne, Switzerland.,Medicine Department, University of Virginia, Charlottesville, Virginia, USA.,Virginia Commonwealth University, Richmond, Virginia, USA
| | - Astrid Junge
- Medical School Hamburg, Hamburg, Germany.,Swiss Concussion Centre, Schulthess Clinic, Zurich, Switzerland
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34
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Abstract
OBJECTIVE To identify the locations and types of injury that result in players not being immediately removed from the field of play when injured and to quantify the magnitude of the situation. DESIGN Prospective cohort epidemiological study with definitions and procedures compliant with the international consensus statement for studies in rugby. SETTING Sevens World Series (SWS) (2008-2016) and Rugby World Cup (RWC) (2007, 2011, 2015). PARTICIPANTS Players from 17 countries taking part in the SWS and 22 countries taking part in the RWC. MAIN OUTCOME MEASURES Location, type, and mean severity of injury, period of match when the injury occurred and whether players were removed from the field of play when injured. RESULTS Injured players (51.5%) in the SWS and 33.1% of injured players in the RWC were immediately removed from the field of play at the time of injury. The percentages of players immediately removed varied from 16.7% for hand fractures (severity: 71 days) to 96.7% for shoulder dislocations/subluxations (severity: 105 days) during the SWS and from 4.5% for shoulder ligament sprains (severity: 25 days) to 65.9% for concussions (severity: 9 days) during the RWC. The percentage of players immediately removed from play when injured was not related to the severity of the injury sustained. CONCLUSIONS A high proportion of players continue to play (in the same game) after sustaining an injury although the likelihood of being removed from play is not dependent on injury severity.
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35
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Abstract
Alpine ski racing is known to be a sport with a high risk of injury and a high proportion of time-loss injuries. In recent years, substantial research efforts with regard to injury epidemiology, injury etiology, potential prevention measures, and measures’ evaluation have been undertaken. Therefore, the aims of this review of the literature were (i) to provide a comprehensive overview of what is known about the aforementioned four steps of injury prevention research in the context of alpine ski racing; and (ii) to derive potential perspectives for future research. In total, 38 injury risk factors were previously reported in literature; however, a direct relation to injury risk was proven for only five factors: insufficient core strength/core strength imbalance, sex (depending on type of injury), high skill level, unfavorable genetic predisposition, and the combination of highly shaped, short and wide skis. Moreover, only one prevention measure (i.e. the combination of less-shaped and longer skis with reduced profile width) has demonstrated a positive impact on injury risk. Thus, current knowledge deficits are mainly related to verifying the evidence of widely discussed injury risk factors and assessing the effectiveness of reasonable prevention ideas. Nevertheless, the existing knowledge should be proactively communicated and systematically implemented by sport federations and sport practitioners.
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36
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Abstract
OBJECTIVES To develop a time-based model of injury-burden for international rugby sevens teams and to demonstrate its utility. DESIGN Descriptive, cohort study. METHODS Injury data recorded during seven seasons of the Sevens World Series were used to quantify the rate of injury and the rate at which injured players recovered from injury. An equation describing the rate at which injuries were sustained was combined with an equation for the rate at which injured players recovered from injury to produce a time-based equation for the injury-burden of rugby sevens players at any point in time during a season. RESULTS The overall rates at which match and training injuries were sustained (incidence of injury) were 108.6 (95% confidence interval: 101.6-116.1) injuries/1000 player-match-hours and 0.91 (95% CI: 0.65-1.27) injuries/1000 player-training-hours, respectively. Injured players recovered from injury according to a first-order rate equation with a rate constant of 0.0257 days-1 calculated from the median severity of injuries sustained (27 days). The time-based injury-burden values predicted from the proposed kinetic model of injury-burden closely matched the values recorded in the Sevens World Series. CONCLUSIONS For governing bodies in rugby, the proposed model provides a way to examine the consequences of changes in the number and timing of international rugby sevens tournaments. For individual teams, the model provides a means to forecast and manage the team's injury-burden as a function of the team's scheduled match and training loads throughout a season.
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37
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Bahr R, Clarsen B, Ekstrand J. Why we should focus on the burden of injuries and illnesses, not just their incidence. Br J Sports Med 2017; 52:1018-1021. [PMID: 29021247 DOI: 10.1136/bjsports-2017-098160] [Citation(s) in RCA: 151] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2017] [Indexed: 02/01/2023]
Affiliation(s)
- Roald Bahr
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.,Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Benjamin Clarsen
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Jan Ekstrand
- Division of Community Medicine, Department of Medical and Health Sciences, Football Research Group, Linköping University, Linköping, Sweden
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38
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Mountjoy M, Costa A, Budgett R, Dvorak J, Engebretsen L, Miller S, Moran J, Foster J, Carr J. Health promotion through sport: international sport federations’ priorities, actions and opportunities. Br J Sports Med 2017; 52:54-60. [DOI: 10.1136/bjsports-2017-097900] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2017] [Revised: 05/14/2017] [Accepted: 05/17/2017] [Indexed: 11/03/2022]
Abstract
ObjectiveTo identify areas of priority and activity for international sportsfederations (IFs) with respect to athlete health and safety, and global health. Results serve to direct the work of the Association of Summer Olympic IF Medical and Scientific Consultative Group, the International Olympic Committee and to influence IFs’ planning and priorities.MethodsThe 28 IFs participating in the Summer Olympic Games (2016) were asked to rank the relative importance of 11 health-related topics and to report their activities or research initiatives on 27 identified topics using an electronic survey. A comparison with a similar survey (2012) was made.ResultsThe response rate was 100%. In general, the ‘fight against doping’ had the highest priority followed by ‘image as a safe sport’. The topics with the lowest importance ratings were ‘increasing the number of elite athletes’, and ‘health of the general population’. Despite ranking ‘health of your athletes,’ as a top priority, IFs are not addressing all aspects of athlete health. In comparison with 2012, there was a significant decrease in priority for IFs is ‘health of the general population’.ConclusionDespite the widespread knowledge of the importance of the promotion of physical activity (sport) on global health, the decreasing priority and programming of the IFs on physical activity promotion is concerning. Although IFs have prioritised the protection of the health of elite athletes, there are gaps in programming demonstrating that IFs are missing important areas of athlete health. Improving recreational athlete health programming could also benefit population health as well as improve IF fan base and sport participation.
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Pollock AM, White AJ, Kirkwood G. Evidence in support of the call to ban the tackle and harmful contact in school rugby: a response to World Rugby. Br J Sports Med 2017; 51:1113-1117. [PMID: 28701366 DOI: 10.1136/bjsports-2016-096996] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2017] [Indexed: 11/03/2022]
Abstract
In a paper published in BJSM (June 2016), World Rugby employees Ross Tucker and Martin Raftery and a third coauthor Evert Verhagen took issue with the recent call to ban tackling in school rugby in the UK and Ireland. That call (to ban tackling) was supported by a systematic review published in BJSM Tucker et al claim that: (1) the mechanisms and risk factors for injury along with the incidence and severity of injury in youth rugby union have not been thoroughly identified or understood; (2) rugby players are at no greater risk of injury than other sports people, (3) this is particularly the case for children under 15 years and (4) removing the opportunity to learn the tackle from school pupils might increase rates of injuries. They conclude that a ban 'may be unnecessary and may also lead to unintended consequences such as an increase in the risk of injury later in participation.' Here we aim to rebut the case by Tucker et al We share new research that extends the findings of our original systematic review and meta-analysis. A cautionary approach requires the removal of the tackle from school rugby as the quickest and most effective method of reducing high injury rates in youth rugby, a public health priority.
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Affiliation(s)
- Allyson M Pollock
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Adam John White
- Department of Sport and Exercise, University of Winchester, Winchester, Hampshire, UK
| | - Graham Kirkwood
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
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40
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A comparison of catastrophic injury incidence rates by Provincial Rugby Union in South Africa. J Sci Med Sport 2017; 20:643-647. [DOI: 10.1016/j.jsams.2017.01.232] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 11/17/2016] [Accepted: 01/02/2017] [Indexed: 11/22/2022]
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41
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Finch CF, Brown JC, Readhead C, Lambert M, Viljoen W. Back to basics with some new tools: first ensure the safety of sporting environments. Br J Sports Med 2016; 51:1109-1110. [DOI: 10.1136/bjsports-2016-097043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2016] [Indexed: 11/04/2022]
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42
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Ham DW, Jee YS. Yachters in Korea suffer considerable injuries. J Exerc Rehabil 2016; 12:226-31. [PMID: 27419119 PMCID: PMC4934968 DOI: 10.12965/jer.1632612.306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 05/20/2016] [Indexed: 11/30/2022] Open
Abstract
Although there is a limited amount of data regarding injuries incurred from yachting, identifying important trends can assist clinicians and yachters in the successful evaluation, treatment, and rehabilitation of injuries. Similar to other research studies related to sailing, the majority of injuries consist of orthopedic problems, with the highest rate of injury occurring in the lower legs and trunk. The most prevalent causes of injury were due to ‘over-action,’ followed by ‘insufficient practice,’ and lastly, ‘insufficient skill’ according to the responses among yachters. Gaining a better understanding of the causes of injury and the affected sites of injury will assist in developing a fitness training program for injury prevention and creating a rehabilitation program to ensure optimal conditions and safety for yachters.
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Affiliation(s)
- Do-Woong Ham
- Department of Marine Sports, Hanseo University, Seosan, Korea
| | - Yong-Seok Jee
- Department of Physical Activity Design, Hanseo University, Seosan, Korea
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43
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Menaspà P. Are rolling averages a good way to assess training load for injury prevention? Br J Sports Med 2016; 51:618-619. [DOI: 10.1136/bjsports-2016-096131] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2016] [Indexed: 11/04/2022]
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Look Before You Leap: What Are the Obstacles to Risk Calculation in the Equestrian Sport of Eventing? Animals (Basel) 2016; 6:ani6020013. [PMID: 26891334 PMCID: PMC4773740 DOI: 10.3390/ani6020013] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 01/08/2016] [Accepted: 02/02/2016] [Indexed: 11/23/2022] Open
Abstract
Simple Summary This paper examines a number of methods for calculating injury risk for riders in the equestrian sport of eventing, and suggests that the primary locus of risk is the action of the horse jumping, and the jump itself. The paper argues that risk calculation should therefore focus first on this locus. Abstract All horse-riding is risky. In competitive horse sports, eventing is considered the riskiest, and is often characterised as very dangerous. But based on what data? There has been considerable research on the risks and unwanted outcomes of horse-riding in general, and on particular subsets of horse-riding such as eventing. However, there can be problems in accessing accurate, comprehensive and comparable data on such outcomes, and in using different calculation methods which cannot compare like with like. This paper critically examines a number of risk calculation methods used in estimating risk for riders in eventing, including one method which calculates risk based on hours spent in the activity and in one case concludes that eventing is more dangerous than motorcycle racing. This paper argues that the primary locus of risk for both riders and horses is the jump itself, and the action of the horse jumping. The paper proposes that risk calculation in eventing should therefore concentrate primarily on this locus, and suggests that eventing is unlikely to be more dangerous than motorcycle racing. The paper proposes avenues for further research to reduce the likelihood and consequences of rider and horse falls at jumps.
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45
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Mountjoy M, Junge A, Alonso JM, Clarsen B, Pluim BM, Shrier I, van den Hoogenband C, Marks S, Gerrard D, Heyns P, Kaneoka K, Dijkstra HP, Khan KM. Consensus statement on the methodology of injury and illness surveillance in FINA (aquatic sports): Table 1. Br J Sports Med 2015; 50:590-6. [DOI: 10.1136/bjsports-2015-095686] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2015] [Indexed: 11/03/2022]
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Abstract
Rugby Union (rugby) is a sport that evolved from and resembles other forms of football but is unique in many respects and presents distinctive clinical challenges. This article discusses those aspects of rugby that are different from other sports and those injuries that have specific significance to the game as a result of it being a global collision sport with an increasing focus on serious injury prevention. Injury screening and intervention programs, neck injuries, rugby's contribution to evolving concussion protocols, contact and travel-related illnesses, and rugby's drug intervention protocols are discussed.
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Affiliation(s)
- Jon S Patricios
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa, Department of Emergency Medicine, and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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47
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Brown JC, Verhagen E, Knol D, Van Mechelen W, Lambert MI. The effectiveness of the nationwide BokSmart rugby injury prevention program on catastrophic injury rates. Scand J Med Sci Sports 2015; 26:221-5. [PMID: 25640752 DOI: 10.1111/sms.12414] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2014] [Indexed: 11/29/2022]
Abstract
Rugby Union ("rugby") participants have a higher than average risk of injury compared with participants of other popular team sports. BokSmart, a nationwide injury prevention program was launched in South Africa in mid-2009, with the goal of reducing catastrophic head/neck (serious) injuries in players. The program provides injury prevention information to coaches and referees. This study investigated if BokSmart has been associated with a reduction in these injuries. The BokSmart program collected data on all South African rugby-related serious injuries since 2008. Using a Poisson regression, injury numbers were compared pre-BokSmart (2008-2009) to the years post-implementation (2010-2013). Player numbers were assumed to be constant throughout this evaluation: junior = 529,483; senior = 121,663. In junior players, the "post-BokSmart" period had 2.5 less annual serious injuries than "pre-BokSmart" (incidence rate ratio: 0.6, 95% confidence interval: 0.5-0.7, P < 0.000). In contrast, there was no significant difference in these periods in seniors. The absence of effect in seniors may be a result of fewer players or of differences in effectiveness of BokSmart in this group--future studies should investigate these questions.
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Affiliation(s)
- J C Brown
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.,Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - E Verhagen
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - D Knol
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - W Van Mechelen
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.,Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - M I Lambert
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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48
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Brown JC, Gardner-Lubbe S, Lambert MI, Van Mechelen W, Verhagen E. The BokSmart intervention programme is associated with improvements in injury prevention behaviours of rugby union players: an ecological cross-sectional study. Inj Prev 2014; 21:173-8. [PMID: 25416466 DOI: 10.1136/injuryprev-2014-041326] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Accepted: 11/03/2014] [Indexed: 11/04/2022]
Abstract
BACKGROUND/AIM Participants of rugby union ('rugby') have an above-average risk of injury compared with other popular sports. Thus, BokSmart, a nationwide injury prevention programme for rugby, was introduced in South Africa in 2009. Improvements in injury-preventing behaviour of players are critical to the success of an intervention. The aim of this study was to assess whether BokSmart has been associated with improvements in rugby player behaviour. METHODS An anonymous knowledge, attitude and self-reported behaviour questionnaire was completed by junior (under-18) and senior (adult) tournament players who attended merit-based tournaments (2008-2012). The questionnaire was completed by 2279 junior players (99% of total estimated population) from 111 teams and 1642 senior players (96% of population) from 81 teams. A generalised linear model assessed behavioural changes over this time period. RESULTS Nine (50%) of the behaviours improved significantly (p<0.005) between 2008 and 2012 and the remaining behaviours remained unchanged. Improved behaviours included the targeted, catastrophic injury-preventing behaviours of the intervention: practising of tackling (adjusted overall improvement in odds: 56%) and scrummaging, in forwards only (58%), techniques. Other behaviours that improved significantly were postinjury compression and elevation as well as alcohol avoidance, mouthguard use (training and matches) and cooling down (training and matches). Practising of safe rucking techniques; warming up before training/matches; ice use; heat, massage and alcohol avoidance postinjury; and preseason and off-season conditioning remained unchanged. CONCLUSIONS BokSmart is associated with improvements in targeted injury-preventing behaviours in players. Future research should ascertain whether self-reported behaviours reflect actual behaviour and whether the observed improvements translate into changes in injury rates.
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Affiliation(s)
- James C Brown
- UCT/MRC Research Unit for Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa Department of Public & Occupational Health and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Sugnet Gardner-Lubbe
- Department of Statistical Sciences, Faculty of Science, University of Cape Town, Cape Town, South Africa
| | - Michael Ian Lambert
- UCT/MRC Research Unit for Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Willem Van Mechelen
- UCT/MRC Research Unit for Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa Department of Public & Occupational Health and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Evert Verhagen
- Department of Public & Occupational Health and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
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49
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Mountjoy M, Junge A, Benjamen S, Boyd K, Diop M, Gerrard D, van den Hoogenband CR, Marks S, Martinez-Ruiz E, Miller J, Nanousis K, Shahpar FM, Veloso J, van Mechelen W, Verhagen E. Competing with injuries: injuries prior to and during the 15th FINA World Championships 2013 (aquatics). Br J Sports Med 2014; 49:37-43. [PMID: 25326096 DOI: 10.1136/bjsports-2014-093991] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Injury and illness surveillance is the foundation for the development of prevention strategies. OBJECTIVE To examine injuries among the aquatic disciplines in the 4 weeks prior to and during the 2013 FINA World Championships. METHODS The study was comprised of two components: (1) a retrospective athlete survey recording injuries in the 4 weeks prior to the Championships and (2) a prospective recording of injuries and illnesses by the medical teams of the participating countries and the local host medical team. RESULTS One-third of the 1116 responding athletes reported an injury/physical complaint in the 4 weeks prior to the Championships. Significantly more women (36.7%) than men (28.6%) reported injuries. Divers reported the highest rate of injury/physical complaints (55.7%). At the start of the Championships, 70% of injured respondents (n=258) were still symptomatic; however, full participation was expected by 76%. During the Championships, 186 new injuries were reported (8.3/100 registered athletes) with the highest injury incidence rate in water polo (15.3/100 registered athletes). The most common injured body part was the shoulder (21%). A total of 199 illnesses were reported during the Championships (9.0/100 registered athletes) with the most common diagnosis of illness being gastrointestinal infection. Environmental exposure (allergy, otitis and jellyfish stings) was responsible for 27% of all illnesses in open water swimming. CONCLUSIONS Injuries pose a significant health risk for elite aquatic athletes. A prospective study would improve understanding of out-of-competition injuries. Future injury and illness surveillance at FINA World Championships is required to direct and measure the impact of prevention strategies.
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Affiliation(s)
- Margo Mountjoy
- Department of Family Medicine, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Canada Fédération Internationale de Natation (FINA), Lausanne, Switzerland International Olympic Committee (IOC), Lausanne, Switzerland
| | - Astrid Junge
- Fédération Internationale de Football Association (FIFA) Medical Assessment and Research Centre (F-MARC), Zürich, Switzerland Schulthess Klinik, Zürich, Switzerland Hamburg Medical School (MSH), Germany
| | | | - Kevin Boyd
- Fédération Internationale de Natation (FINA), Lausanne, Switzerland University Hospitals of Leicester NHS Trust, Leicester, Great Britain
| | - Mohamed Diop
- Fédération Internationale de Natation (FINA), Lausanne, Switzerland
| | - David Gerrard
- Fédération Internationale de Natation (FINA), Lausanne, Switzerland Medicine Department, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | | | - Saul Marks
- Fédération Internationale de Natation (FINA), Lausanne, Switzerland Department of Psychiatry, University of Toronto, Toronto, Canada
| | | | - Jim Miller
- Fédération Internationale de Natation (FINA), Lausanne, Switzerland Medicine Department, University of Virginia, Charlottesville, and Virginia Commonwealth University, Richmond, Virginia, USA
| | | | - Farhad Moradi Shahpar
- Fédération Internationale de Natation (FINA), Lausanne, Switzerland Department of Sport Medicine, Faculty of Physical Education and Sports Sciences, University of Isfahan, Isfahan, Iran
| | - Jose Veloso
- Fédération Internationale de Natation (FINA), Lausanne, Switzerland Faculty of Biological Sciences, Catholic University of Uruguay, Montevideo, Uruguay
| | - William van Mechelen
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Evert Verhagen
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, SMB Campus, Ballarat, Victoria, Australia
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50
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Burger N, Lambert MI, Viljoen W, Brown JC, Readhead C, Hendricks S. Tackle-related injury rates and nature of injuries in South African Youth Week tournament rugby union players (under-13 to under-18): an observational cohort study. BMJ Open 2014; 4:e005556. [PMID: 25116454 PMCID: PMC4139639 DOI: 10.1136/bmjopen-2014-005556] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES The tackle situation is most often associated with the high injury rates in rugby union. Tackle injury epidemiology in rugby union has previously been focused on senior cohorts but less is known about younger cohorts. The aim of this study was to report on the nature and rates of tackle-related injuries in South African youth rugby union players representing their provinces at national tournaments. DESIGN Observational cohort study. SETTING Four South African Youth Week tournaments (under-13 Craven Week, under-16 Grant Khomo Week, under-18 Academy Week, under-18 Craven Week). PARTICIPANTS Injury data were collected from 3652 youth rugby union players (population at risk) in 2011 and 2012. OUTCOME MEASURES Tackle-related injury severity ('time-loss' and 'medical attention'), type and location, injury rate per 1000 h (including 95% CIs). Injury rate ratios (IRR) were calculated and modelled using a Poisson regression. A χ(2) analysis was used to detect linear trends between injuries and increasing match quarters. RESULTS The 2012 under-13 Craven Week had a significantly greater 'time-loss' injury rate when compared with the 2012 under-18 Academy Week (IRR=4.43; 95% CI 2.13 to 9.21, p<0.05) and under-18 Craven Week (IRR=3.52; 95% CI 1.54 to 8.00, p<0.05). The Poisson regression also revealed a higher probability of 'overall' ('time-loss' and 'medical attention' combined) and 'time-loss' tackle-related injuries occurring at the under-13 Craven Week. The proportion of 'overall' and 'time-loss' injuries increased significantly with each quarter of the match when all four tournaments were combined (p<0.05). CONCLUSIONS There was a difference in the tackle-related injury rate between the under-13 tournament and the two under-18 tournaments, and the tackle-related injury rate was higher in the final quarter of matches. Ongoing injury surveillance is required to better interpret these findings. Injury prevention strategies targeting the tackle may only be effective once the rate and nature of injuries have been accurately determined.
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Affiliation(s)
- Nicholas Burger
- Faculty of Health Sciences, UCT/MRC Research Unit for Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town, South Africa
| | - Mike I Lambert
- Faculty of Health Sciences, UCT/MRC Research Unit for Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town, South Africa
| | - Wayne Viljoen
- South African Rugby Union (SARU), Cape Town, South Africa
| | - James C Brown
- Faculty of Health Sciences, UCT/MRC Research Unit for Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town, South Africa
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Clint Readhead
- South African Rugby Union (SARU), Cape Town, South Africa
| | - Sharief Hendricks
- Faculty of Health Sciences, UCT/MRC Research Unit for Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town, South Africa
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