Collecting Health and Exposure Data in Australian Olympic Combat Sports: Feasibility Study Utilizing an Electronic System

'After they see what you have, they contact you': a qualitative study of national team football players', coaches' and clinicians' experiences in engaging with a context-specific injury surveillance system

BACKGROUND

Sports injury surveillance systems aid injury prevention, but their development without considering end-users' perspectives has led to low adherence and honesty in self-reporting by players, compromising their effectiveness. Context-specific injury surveillance systems have been proposed to address these challenges, but there is a limited understanding of stakeholders' perceptions and experiences in using them.

OBJECTIVE

Following the implementation of a context-specific injury surveillance system with 100% player adherence over 60 weeks, the study aimed to investigate Under-21 Maltese national football team players', coaches' and clinicians' experiences of how and why they engaged with the system.

METHOD

Seventeen semi-structured interviews with Under-21 Maltese male national football team players (n = 12), their coaches (n = 3) and clinicians (n = 2) were conducted. Data were analysed using reflexive thematic analysis.

RESULTS

Participants highlighted questionnaire-related factors that motivated engagement with the context-specific injury surveillance system (theme 1) and factors influencing further engagement with the system based on stakeholders' actions (theme 2). Perceived outcomes experienced as a result of engaging with the injury surveillance system (theme 3), in turn, motivated players to continue reporting and engaging with the system.

CONCLUSION

To encourage players' sustained reporting, injury-related information collected from well-designed questionnaires should serve to stimulate communication and teamwork among stakeholders, to prevent injuries and enhance performance.

Year-round longitudinal health surveillance in UK Olympic Summer Sport Athletes 2016-2019

OBJECTIVES

To identify the priority injury and illness types across UK summer Olympic World Class Programme sports to inform development, implementation and evaluation of associated injury risk mitigation and management initiatives.

METHODS

Four years (2016-2019) of electronic medical records of 1247 athletes from 22 sports were analysed and reported using methods based on the 2020 International Olympic Committee consensus statement for epidemiological recording and reporting.

RESULTS

3562 injuries and 1218 illness were recorded, accounting for 146 156 and 27 442 time-loss days. Overall, 814 (65%) athletes reported at least one injury, while 517 (41%) reported at least one illness. There were 1.3 injuries per athlete year resulting in a mean burden of 54.1 days per athlete year. The lumbar/pelvis, knee, ankle and shoulder body regions had the highest incidence and burden. Athletes reported 0.5 illnesses per athlete year, resulting in a mean burden of 10.4 days per athlete year, with most composed of respiratory illness and gastroenteritis. Injuries within sport groups were representative of the injury risk profile for those sports (eg, knee, hand and head injuries had the highest incidence in combat sports), but respiratory illnesses were consistently the greatest problem for each sport group.

CONCLUSIONS

To optimise availability for training and performance, systematic risk mitigation and management initiatives should target priority injury problems occurring in the lumbar/pelvis, knee, ankle and shoulder, and respiratory illness. Follow-up analysis should include identification of sport-specific priority health problems and associated risk factors.

Injury surveillance in community cricket: A new inning for South Africa

Published injury rates amongst elite and club-level youth cricketers highlight the need to implement injury risk-reducing strategies amongst the youth cricketing population. Data from sports injury surveillance systems are a prerequisite for the development and evaluation of strategies to reduce injury risk. Therefore, collecting injury surveillance data is a positive move towards reducing injuries in cricket. In South Africa, a systematic, standardised, evidence-informed injury surveillance system currently does not exist for community levels of play, namely, in cricket-playing high schools and cricket clubs. Although injury surveillance systems exist at elite levels, the obvious differences in elite versus community cricket settings mean that these systems cannot be implemented in their current form at community-level cricket. An innovative model is required to implement an injury surveillance system in community cricket.

Clinical implications

This article proposes and describes a new research-practice partnership model to implement a systematic, standardised, evidence-informed injury surveillance system at cricket-playing high schools or cricket clubs within South Africa. Once this model has been employed, database systems will need to be established to allow long-term data management and sharing.

A Cross Sectional Survey of International Horse-Racing Authorities on Injury Data Collection and Reporting Practices For Professional Jockeys

Jockey injuries are common in professional horse-racing and can result in life-threatening or career-ending outcomes. Robust injury data are essential to understand the circumstances of injury occurrence and ultimately identify prevention opportunities. This study aimed to identify jockey injury surveillance practices of international horse-racing authorities (HRAs) and the specific data items collected and reported by each HRA. A cross-sectional survey of representatives (e.g. Chief Medical Officer) from international HRAs was conducted. An online and paper questionnaire was designed comprised of 32 questions. Questions considered the barriers and facilitators to data collection within each HRA, and where available, what data were collected and reported by HRAs. Representatives from 15 international racing jurisdictions were included, of which 12 reported collection of race day injuries or falls, using varied definitions of medical attention and time loss. Six HRAs did not have a definition for a jockey injury, and eight HRAs had no parameters for describing injury severity. Race day exposure was collected by two HRAs. Results were commonly presented by HRAs as the number of injuries (n = 9/15) or proportion of injured jockeys (n = 6/15). The lack of a designated role for collection, collation and reporting of data was the main barrier for injury surveillance. Twelve HRAs agreed that mandatory collection would be a strong facilitator to improving practice. Enhancement and standardization of international jockey injury surveillance is required to move forward with evidence informed prevention. Concurrent investigation of how reporting practices can be best supported within existing HRA structures is recommended.

Changes in Perceived Exertion, Well-Being, and Recovery During Specific Judo Training: Impact of Training Period and Exercise Modality

The present study investigated the effect of intense and tapering training periods using different exercise modalities (i.e., Randori – grip dispute practice without throwing technique, Uchi-komi – technique repetition training, and sprinting) on rating of perceived exertion (RPE), well-being indices, recovery state, and physical enjoyment in judo athletes. Sixty-one adolescent male and female judo athletes (age: 15 ± 1 years) were randomly assigned to one of three experimental or one control groups. Experimental groups (Randori, Uchi-komi, and running) trained four times per week for 4 weeks of intense training (in addition to their usual technical-tactical judo training; control group underwent only such a training) followed by 12 days of tapering. RPE, well-being indices [i.e., sleep, stress, fatigue, and delayed onset muscle soreness (DOMS)], total quality of recovery (TQR), and physical enjoyment were measured every session. RPE, sleep, stress, fatigue, DOMS, Hooper index (HI; sum of wellbeing indices), and TQR were lower in the tapering compared with the intensified training period (P < 0.001). Moreover, the running group showed better values for sleep (P < 0.001), stress (P < 0.001), fatigue (P = 0.006), DOMS (P < 0.001), and HI (P < 0.001) in comparison with the other training groups, indicating a more negative state of wellbeing. The Randori and Uchi-komi groups showed higher values for TQR and physical enjoyment (both P < 0.001) than the running group, whereas RPE was lower in the control compared with all training groups (P < 0.001). Coaches should use more specific training modalities (i.e., Randori and Uchi-komi) during intensified training and should monitor well-being indices, RPE, and TQR during training periods. Moreover, for all variables, 12 days tapering period are beneficial for improving wellbeing and recovery after 4 weeks of intense training.

'In search of lost time': Identifying the causative role of cumulative competition load and competition time-loss in professional tennis using a structural nested mean model

Injury prevention is critical to the achievement of peak performance in elite sport. For professional tennis players, the topic of injury prevention has gained even greater importance in recent years as multiple of the best male players have been sidelined owing to injury. Identifying potential causative factors of injury is essential for the development of effective prevention strategies, yet such research is hampered by incomplete data, the complexity of injury etiology, and observational study biases. The present study attempts to address these challenges by focusing on competition load and time-loss to competition-a completely observable risk factor and outcome-and using a structural nested mean model (SNMM) to identify the potential causal role of cumulative competition load on the risk of time-loss. Using inverse probability of treatment weights to balance exposure histories with respect to player ability, past injury, and consecutive competition weeks at each time point; the SNMM analysis of 389 professional male players and 55,773 weeks of competition found that total load significantly increases the risk of time-loss (HR = 1.05 per 1,000 games of additional load 95% CI 1.01-1.10) and this effect becomes magnified with age. Standard regression showed a protective effect of load, highlighting the value of more robust causal methods in the study of dynamic exposures and injury in sport and the need for further applications of these methods for understanding how time-loss and injuries of elite athletes might be prevented in the future.

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))

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.

Improved reporting of overuse injuries and health problems in sport: an update of the Oslo Sport Trauma Research Center questionnaires

In 2013, the Oslo Sports Trauma Research Center Overuse Injury Questionnaire (OSTRC-O) was developed to record the magnitude, symptoms and consequences of overuse injuries in sport. Shortly afterwards, a modified version of the OSTRC-O was developed to capture all types of injuries and illnesses-The Oslo Sports Trauma Research Center Questionnaire on Health Problems (OSTRC-H). Since then, users from a range of research and clinical environments have identified areas in which these questionnaires may be improved. Therefore, the structure and content of the questionnaires was reviewed by an international panel consisting of the original developers, other user groups and experts in sports epidemiology and applied statistical methodology. Following a review panel meeting in October 2017, several changes were made to the questionnaires, including minor wording alterations, changes to the content of one question and the addition of questionnaire logic. In this paper, we present the updated versions of the questionnaires (OSTRC-O2 and OSTRC-H2), assess the likely impact of the updates on future data collection and discuss practical issues related to application of the questionnaires. We believe this update will improve respondent adherence and improve the quality of collected data.

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))

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.

A prospective study of health problems at the 2018 17/U and 19/U Australian National Netball Championships with comparison of surveillance methodology

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.

End-user experiences with two incident and injury reporting systems designed for led outdoor activities - challenges for implementation of future data systems

Background

Injury and incident (near miss) prevention is heavily dependent upon robust and high-quality data systems. Evaluations of surveillance systems designed to report factors associated with incidents and injuries are essential to understand their value, as well as to improve their performance and efficiency. Despite, this there have been few such evaluations published in the peer-review literature.

Methods

The attitudes and experiences of industry representatives who used one of two variants of an incident and injury surveillance system to collect injury and incident data for the led outdoor activity setting were obtained through an online self-report survey following a 12-month trial. Survey respondents were 18 representatives of 33 organisations who were users of a comprehensive incident reporting and surveillance system – the Understanding and Preventing Led Outdoor Accidents Data System Software Tool (UPLOADS-ST) - and six out of 11 users of a modified system (UPLOADS-Lite). The survey collected information on user experiences in relation to system training, accessibility, ease of use, security, feedback and perceived value to the sector of collating and reporting data across organisations.

Findings

Only four UPLOADS-ST responding users found the system easy to use and just three considered entering incident reports to be easy. However, many considered the training on reporting incidents to be sufficient and that the incident reports contained relevant details. Fewer than half of respondents (seven for UPLOADS-ST, three for UPLOADS-Lite) believed entering data was a good use of staff time and resources. Nonetheless, a majority of respondents (seven for UPLOADS-ST, five for UPLOADS-Lite) found the reporting format easy to read and felt the information provided was useful for their organisation.

Conclusions

Usability barriers to incident reporting were identified, particularly for UPLOADS-ST, including time constraints and user friendliness. The majority of users believed aggregating and reporting incident and injury data across organisations would be of value in making the led outdoor activity sector safer. Improving the utility of the surveillance systems will assist in ensuring their sustainability in the led outdoor activity sector.