Implementing Injury Prevention Research Articles

Injury Risk and Prevention Strategies Among Saudi and Irish Amateur Women Soccer Players – A qualitative study

Abstract This qualitative study aimed to explore how Saudi and Irish women amateur soccer players perceive soccer-related injury risk and prevention, including barriers and facilitators to the implementation of prevention strategies. Online interviews were conducted with 36 amateur women soccer players (20 Saudi and 16 Irish) of 18 years and older. Findings were analysed using Reflexive Thematic Analysis. Three main themes were identified; (1) “we don’t have enough knowledge about injury prevention” (2) implementing injury prevention measures varies across players and teams, and (3) “we love the game…but we are undervalued”. The biopsychosocial characteristics of the players influenced their experiences on injury prevention in all three themes. Tailored educational programmes for women, their coaches, and parents of younger players, as well as provision of the required support for amateur teams are recommended to encourage participation and implementation of evidence-based injury prevention strategies, taking player’s biopsychosocial characteristics into account.

‘More than likely the men come first. That’s just very frustrating’. A qualitative exploration of contextual factors affecting the implementation of injury prevention initiatives and the provision of effective injury management in elite-level women’s club football in Ireland

ObjectivesThe aim of our study was to explore the contextual factors that affect the implementation of football injury prevention initiatives and the provision of effective injury management in the Irish...

Advancements for the Future: A National Survey of Fastpitch Softball Coaches' Perspectives on Injury Prevention Programming.

Approximately 50 percent of softball injuries are the result of overuse or chronic conditions. However, research exploring preventative measures for softball players is limited and usage of injury prevention strategies among softball coaches is unknown. This survey aimed to investigate if softball coaches are implementing injury prevention programs to reduce injury and improve the performance of their players. The secondary purpose was to identify barriers to the implementation of injury prevention programs. Finally, this survey explored the coaches' knowledge of injury risk factors and their views on design and usage of preventative programs. Descriptive cross-sectional survey. A 35-item survey was sent to approximately 14,000 high school and collegiate fastpitch softball coaches throughout the United States. Data were collected over a three-month period with an overall response rate of 1.2%. Among responding coaches, 45.9% (n=79/172) reported implementing injury prevention programs. Coaches who implement injury prevention strategies most frequently utilize team-based programs (68.8%, n=52/93) compared to group-based (19.0%, n=15/93) or individualized programs (15.2%, n=12/93). Coaches who do not use preventative programming reported that being unsure of what program to perform (53.8%, n=50/93) and not having enough staff (20.4%, n=19/93) were the greatest barriers to implementation. Although over 50% of coaches recognized arm fatigue/overuse (27.9%, n=48/172) and decreased core strength (22.7%, n=39/172) were important risk factors, 36% (n=94/172) "disagree" that softball pitchers should adhere to pitch counts and 90% (n=83/92) believe that preventative programming for pitchers and position players should be similar. Less than 50 percent of softball coaches implement exercise programs to prevent injury. Limited familiarity with effective program design, inadequate staffing, and inconsistent risk factor awareness are the major contributors to lacking implementation. Collaboration between rehabilitation professionals and softball coaches regarding preventative programming should be considered. Level 3©The Author(s).

Obstacles and opportunities for injury prevention in professional football in Qatar: exploring the implementation reality

BackgroundResearch focusing on reducing the risk of injuries has increased over the last two decades showing that prevention implementation in real life is challenging.ObjectiveTo explore the experience and opinions of...

Characterization of Achilles Tendon Ruptures in Collegiate Women's Gymnastics.

Collegiate female gymnasts are at high risk of Achilles tendon injuries. Achilles tendon ruptures can negatively impact an athlete's ability to return to competitive sport. Understanding the natural history of Achilles tendon tears in collegiate female gymnasts is important in the development of preventive treatment. To expand our knowledge of the natural history of Achilles tendon ruptures among collegiate female gymnasts, a REDCap retrospective survey was emailed to athletic trainers on all 80 National Collegiate Athletic Association (NCAA) women's gymnastics teams. The survey gathered information regarding number of Achilles tendon injuries, pain prior to injuries, events and skills on which injuries occurred, and functional outcome after injuries among athletes competing in the 2013 to 2018 NCAA seasons. Forty-two of 80 (52.5%) programs responded to the survey. Seventy-one Achilles tendon ruptures were reported between 2013 and 2018. Among these, 46% had antecedent pain. Gymnasts sustained 95% of Achilles tendon ruptures while performing on floor exercise, with 98% of ruptures occurring during the take-off portion of a tumbling skill. Of the 61% of gymnasts who were able to return to competition, 59% were able to achieve the same level of function after injury. Achilles tendon ruptures in collegiate female gymnasts primarily occur during the take-off motion while tumbling on the floor exercise. Future studies should evaluate degenerative Achilles tendon changes in collegiate female gymnasts. A collaborative effort among gymnasts, coaches, judges, and medical experts is required to identify at-risk athletes and develop and implement injury prevention programs. [Orthopedics. 2023;46(4):205-210.].

Approaches to the Effective Prevention of Road Traffic Injuries in Sub-Saharan Africa: A Systematic Review

Introduction: Road traffic injuries (RTI) are projected to become the 7th leading cause of mortality worldwide by the year 2030. It is projected that 90% of the global road traffic injury burden will be borne by Low and Middle-Income countries (LMICs), including sub-Saharan Africa. We undertook a systematic literature review to assess the effectiveness of implemented traffic injury prevention initiatives in sub-Saharan Africa. Methodology: A systematic review of the English literature was undertaken per the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Studies were identified by searching the electronic databases Embase, Pubmed, Medline, The Cochrane Library and an additional review of reference lists. In addition, published studies from 1990 to 2020 were extracted and analysed. Results: The literature search generated 638 articles. Twenty-two duplicates were removed, and after title and abstract screening and full-text screening, 22 articles were retained. The interventions were broadly categorised into education, enforcement, Legislation, speed control, road safety and combined interventions. Conclusion: Combined multi-faceted injury prevention strategies are most effective in Sub-Saharan Africa. Enforcement of safety regulations ensures compliance and sustainability of prevention interventions. Speed control measures are useful in calming vehicular speeds, but poor design and citing can endanger road users. Road safety, education and Legislation have little to no effect when implemented alone; however, when combined with other measures, they can lead to significant reductions in road traffic injuries and fatalities.

Coding and applying injury claims data to implement and sustain effective safe patient handling and mobility solutions

Investigating and accurately categorizing employee injury claims are essential for identifying trends and implementing effective solutions. This process is especially important for injuries associated with patient handling injuries (PHIs) for which data is often lacking. This study summarizes how improved coding of injuries for 15 years of workers’ compensation (WC) data was used to improve system-wide injury prevention efforts, in particular those related to safe patient handling and mobility (SPHM) practices across an 11-hospital region within the system. Accurate coding of caregiver injuries and implementing SPHM solutions based on this data had a significant impact on accurately identifying risk, implementing injury prevention strategies, and decreasing frequency and severity of employee injuries related to outdated manual patient handling practices.

Sustainable prevention in construction health and safety (H&S): An economic approach

The persistent health and safety (H&S) problem in the construction industry exerts an enormous economic burden on workers, society, and employers. With shrinking budgets, the contribution of H&S to productivity and business profits increasingly influences the decision to implement injury prevention programmes. Despite this, the economic perspective of H&S is missing in public discourse pertaining to injury prevention in developing countries. The purpose of this study was to investigate the perceptions of construction professionals in Zimbabwe with regards to the degree of importance of economic factors for preventing / reducing occupational injuries, fatalities, and disease, and the extent to which economic factors / practices are applied in H&S management to prevent / reduce occupational injuries, fatalities, and disease in the construction industry. The quantitative method was adopted for the study, which entailed the completion of a self-administered questionnaire. The data analysis entailed the computation of frequencies, and a measure of central tendency in the form of mean scores (MSs) to enable interpretation of the findings and the ranking of factors. The salient findings of the study are that financial provision, setting realistic production targets and timelines, balancing production economy and H&S objectives, integration of H&S into business plans and responsible procurement are the main economic factors / practices for enhancing sustainable prevention of H&S problems. Despite this, the results show that the economic factors are marginally applied to construction H&S management in Zimbabwe. While the findings are consistent with extant literature, they provide important insights to construction stakeholders relative to the potential source of the persistent H&S problems and the interventions that may be required to improve the H&S situation. To promote the integration of economic thinking into the H&S strategy, there is a need for more awareness and education among construction stakeholders relative to the importance of addressing H&S issues from an economic perspective. Further research is required to develop models and frameworks for assisting construction practitioners to generate the required economic data to inform decision making.

2023 Resolutions: It's time to revamp your pressure injury prevention programs.

The success of any quality improvement project begins with acknowledging problems, defining and addressing each issue in detail, and setting goals. In the case of pressure injuries, the answer is fairly simple. Reduce the number of pressure injuries. Yet, the process yielding a "means to the end" is quite complex. It not only requires a team of interdisciplinary healthcare providers and leaders to ensure success; it requires continuous effort. The intention of this article is to highlight the importance of a comprehensive Pressure Injury Prevention (PIP) program and offer guidance based on evidence. Utilizing an organized framework for planning will help healthcare providers ensure all critical steps are completed. The Standardized Pressure Injury Prevention Protocol (SPIPP) provides detail surrounding the necessary steps toward compliance with best practice guidelines. A comprehensive checklist provided within the SPIPP article is designed to discuss specific details of the PIP program. The author of this article offers a broader framework and checklist, The Pressure Injury Prevention Implementation Checklist (PIPIC) based on blending several quality improvement methodologies. Challenges associated with pressure injuries continue to affect the lives of both patients and caregivers. Entering a new year, new month, or even new day brings the opportunity for change and improvement. Revamping a PIP program requires careful thought, planning, and dedication, but it is not insurmountable. Organizing a team to address the issues and approach the task with an organized, evidence-based plan will improve the overall PIP program success.

Peculiarities of the Relationships between Anxiety, Psychological Skills, and Injuries in Cuban Athletes

Background: In the present research, the general and specific relationships of anxiety and psychological skills with the history of injuries in a heterogeneous population of Cuban high-performance athletes are analyzed. Methods: Through a correlational and cross-sectional study, the Villa Clara basketball, baseball, soccer, and softball preselection’s were studied between 2019 and 2022. To obtain data on injuries, a specific questionnaire was applied. The state of the psychological variables was determined by means of the Competition State Anxiety Inventory and the Sports Execution Psychological Inventory. Data were analyzed using empirical frequency distribution, descriptive statistics, the Kolmogorov-Smirnov test, and Kendall's Tau_b nonparametric correlation coefficient. Results and Discussion: High anxiety and psychological skills to compete prevailed. Most of the athletes had been injured with remarkable frequency, severity and in competitions. Lower motivational level, attention and emotional control are related to the occurrence of injuries. The most serious injuries are related to high levels of anxiety, less control of attention and negative coping, while the occurrence in competition is related to less control of attitude. The relationships between variables differ between the sports analyzed. Conclusion: A lower degree of psychological preparation makes the athlete vulnerable to injury, however, the psychological risk factors are established specifically in each sport. These differences must be considered for the design and implementation of injury prevention.

Context of injury prevention strategies in Swiss basketball: survey of athletes, medical staff and coaches

ObjectivesThis project aims to assess opinions, attitudes, knowledge, beliefs, practices and perceived barriers and facilitators of injury prevention (IP) strategies in Swiss basketball teams.MethodsAn online survey was sent to athletes,...

Barriers and facilitators to implementing the Activate injury prevention exercise programme – A qualitative study of schoolboy rugby coaches

The rugby-specific Activate injury prevention exercise programme was deemed efficacious in a randomised controlled trial and subsequently disseminated nationwide by the Rugby Football Union (English rugby union governing body) in 2017. However, no assessment has been made of the factors influencing Activate implementation in an applied setting. Consequently, this study sought to assess the barriers and facilitators to coaches implementing Activate in English schoolboy rugby. This qualitative study adopted a framework approach, using four a-priori themes influencing injury prevention implementation: awareness, motivational determinants, volitional determinants and socio-environmental factors. A purposive sample of schoolboy rugby coaches were recruited from schools nationwide, participating in semi-structured, one-on-one interviews (n = 10). Transcripts were thematically coded. Participants had positive perceptions towards Activate, although only six adopted the programme. Participants reported that players were generally unaware of the programme, with some suggesting this was not an issue as coaches made the decision to adopt Activate. Participants focused heavily upon the use of resources to develop coaches’ awareness, knowledge and confidence. No participant implemented Activate as initially designed, influenced by time and engagement, instead incorporating it within training drills rather than as a block at the beginning of the session. Participants adapted the programme to make it suitable for multiple sports. Some participants reported asking players to deliver Activate, despite their lack of awareness, raising concerns around implementation. Participants heavily adapted Activate delivery to suit their contexts. How this affects the effectiveness of Activate to reduce injury risk is unknown and should be investigated. Player-specific dissemination strategies should be considered if these individuals act as delivery-agents.

The knowledge and attitudes of field hockey athletes to injury, injury reporting and injury prevention: A qualitative study

ObjectivesResearchers have often struggled to successfully implement injury prevention strategies in real-world practice. This is despite such strategies proving successful in reducing overall injury incidence and burden. It has been hypothesised that this may be because the behavioural and contextual factors related to sports injury are not fully understood. Such factors stem from multiple key stakeholders, including the athlete. The primary aim of this study was to investigate athletes' knowledge and attitudes towards injury, injury reporting and prevention, as well as some of the barriers that may impact the future implementation of prevention strategies. DesignQualitative; with semi-structured interviews following an interpretivist approach. MethodsTwenty-two field hockey athletes, playing in the top-tier Irish Hockey League were interviewed. Data were analysed using reflexive thematic analysis, with three general dimensions containing six higher-order themes. ResultsThe findings highlighted that athletes have a varied understanding of injury, which tends to improve with experience. The reporting of injuries by athletes to members of the coaching staff was relatively poor. This may be due to limited resources and supports available to athletes which also cause challenges to injury prevention. ConclusionsFuture injury prevention strategies in field hockey need to account for athletes' varied understanding of what constitutes an injury. Furthermore, policy changes to influence potential barriers to injury may assist in preventing or reducing the number of injuries being sustained by athletes.

Stakeholder-Engaged Development of a Theory-Driven, Feasible, and Acceptable Approach to Concussion Education.

Concussion education is widely mandated and largely ineffective. Recent consensus guidance on concussion education asserts the importance of (1) theory-driven programming that targets the team as a system and (2) working with end users throughout the development process, and considering issues such as feasibility, acceptability, and sustainability. Consistent with this guidance, and in collaboration with youth sport stakeholders in two regions of the United States, we developed a novel approach to concussion education: Pre-game safety huddles. Safety huddles have the following two core components: (1) athletes, coaches, and other stakeholders come together before the start of each game and (2) opinion leaders (coaches, referees) affirm the importance of care seeking for suspected concussion. The aim of this article is to provide an overview of the collaborative process through which we refined the safety huddle concept into an acceptable and feasible intervention with potential for sustainable implementation in diverse youth sports settings with minimal resource demands. In describing our process and discussing challenges and opportunities, we hope to provide an example for others seeking to develop and implement injury prevention interventions in youth sports settings.

Evaluation of Infant Injury Prevention Education Provided during Antenatal Classes after Two Years: A Pilot Prospective Cohort Study.

This study examined the long-term effects of an infant injury prevention program implemented during an antenatal class of 131 mothers. Questionnaires were completed 2 years postpartum to assess the incidence of injury (medically attended or home-care), mothers’ perception of injury prevention, implementation of safety practices, and active attitudes toward injury prevention. Responses were obtained from 68 (51.9%) mothers (intervention group, 40; control group, 28), including 24 who reported medically attended injuries and 55 who reported home-care injuries. The incidence of medically attended injuries did not differ between groups. The incidence of home-care injuries was also not significantly different, but was lower in the intervention group (72.5% vs. 92.9%, p = 0.050). Significantly fewer children in the intervention group experienced “injury due to being caught between objects” (12.5% vs. 39.3%, p = 0.014). Mothers in the intervention group were significantly more aware of injury prevention than those in the control group (p = 0.033). The risk of home-care injuries was inversely related to mothers’ injury-prevention perception (odds ratio [OR]: 0.55, p = 0.035). This study suggests that group education during pregnancy regarding injury prevention increases mothers’ perception of injury prevention. These findings support implementing injury prevention education during antenatal classes.

Cocreating injury prevention training for youth team handball: bridging theory and practice

Although it is advocated that end-users are engaged in developing evidence-based injury prevention training to enhance the implementation, this rarely happens. The ‘Implementing injury Prevention training ROutines in TEams and...

"Yeah, I Mean, You're Going to Handball, so You Want to Use Balls as Much as Possible at Training": End-Users' Perspectives of Injury Prevention Training for Youth Handball Players.

Young handball players experience high injury rates. Specific injury prevention programs reduce injury rates but are not well implemented into youth players’ training. The ‘Implementing injury Prevention training ROutines in TEams and Clubs in youth Team handball (I-PROTECT)’ project addresses this challenge. The aim of this study was to investigate how youth handball coaches and players experienced the recently developed I-PROTECT GO pilot program, by focusing on barriers and facilitators. Three focus group interviews were conducted with coaches and players, and their answers were analyzed using a general inductive approach. The participants appreciated the program and found it useful for their context. The participants’ statements about facilitators and barriers centered around the categories of resources, exercises, program design, and learning. Facilitators that emerged were motivating exercises (e.g., handball-specific), a helpful set-up (e.g., variation), having a clear purpose of exercises, the possibility to fulfil basic psychological needs while training, receiving instructions and feedback, and having role models. Barriers that emerged were limited space and material, difficulties with exercises, an unhelpful set-up (e.g., too repetitive), and undisciplined training. It is important to address perceived barriers and facilitators among coaches and players when developing injury prevention training programs to enhance the uptake of such training.

Effect of Weather and Game Factors on Injury Rates in Professional Baseball Players

Background: Injury rates in baseball players of all ages are increasing. Identifying modifiable risk factors is paramount to implementing injury prevention programs. Purpose/Hypothesis: The purpose was to evaluate the influence of weather (temperature, humidity, atmospheric pressure, and heat index) and game factors (start time, duration, single vs doubleheader) on injury rates in professional baseball players. We hypothesized that colder temperatures would be associated with significantly more injuries per game. Study Design: Case-control study; Level of evidence, 3. Methods: This was a retrospective database study. Two data sets were combined: 1 containing all injuries in Major and Minor League Baseball between 2011 and 2017 and 1 containing all games played in Major and Minor League Baseball during the same period to determine the number of injuries per game. Temperature, humidity, atmospheric pressure, and heat index were determined for each game using the data from the US Environmental Protection Agency. Additional game variables included the level of play, the turf type (natural vs artificial grass), the stadium type (open vs dome vs retractable), the game start time, the game duration, and whether the game was a doubleheader. Then, a multivariate analysis was conducted to determine which factors were associated with the number of injuries per game. Results: In total, our analysis included 33,587 injuries and 76,747 games. A total of 25,776 (33.6%) games contained an injury, and 41% of injuries occurred as multiples per game, with up to 9 injuries per game. The multivariate analysis identified significant associations between game duration and injuries per game (P < .001; effect size, 0.013) and the level of play and injuries per game (P < .001; effect size, 0.011). There were significant associations between the venue type (P < .001), the game start time (P < .001), humidity (P < .001), the turf type (P = .016), and barometric pressure (P = .031); however, the effect size for each was <0.001, suggesting that these factors are clinically unimportant. Our overall model produced an R2 of 0.04, indicating that these variables only predicted 4% of the variance in injury risk. Conclusion: In professional baseball, the weather is not associated with injury risk; however, game duration may contribute to injury risk.

Barriers and Facilitators of Implementing Injury Prevention Practices by Massage Therapists.

Massage therapy involves pervasive ergonomic hazards with the majority of massage therapists (MTs) experiencing adverse musculoskeletal health issues. A variety of barriers and facilitators exist that can impact the efficacy of safety programs. A longitudinal study to characterize individual and organizational barriers and facilitators that influence the implementation of self-care techniques designed to reduce musculoskeletal health issues. MTs who reported time as abarrier implemented 0.9 fewer selfcare items despite wanting to make these changes (P = 0.003) and 1.4 fewer self-care items when management was identified as a barrier (P < 0.001). Almost 20% of the MTs reported switching jobs which was associated with implementing 1.1 fewer self-care items (P = 0.002). Our findings show that organizational factors plays a critical role in workplace safety which can be used to improve working conditions faced by MTs.

Assessing the effectiveness of an app-based child unintentional injury prevention intervention for caregivers of rural Chinese preschoolers: protocol for a cluster randomized controlled trial

BackgroundCompared to urban children, children living in rural areas of most countries, including China, are at higher risk of suffering unintentional injuries. Most proven injury prevention interventions, however, are rarely implemented in rural China due to lack of resources. Mobile health interventions are low-cost and easy-to-implement, facilitating implementing injury prevention in resource-limited areas (e.g., rural areas). This study is designed and implemented to examine the effectiveness of an app-based intervention for unintentional injury prevention among rural preschoolers in China.MethodsA single-blind, 18-month, parallel-group cluster randomized controlled trial with 1:1 allocation ratio will be implemented in 2 rural areas of China (Yang County, Shaanxi Province, and Shicheng County, Jiangxi Province). In total, at least 3508 rural caregivers of preschoolers aged 3–6 years old who own a smartphone will be recruited from 24 preschools. Clusters will be randomized at the preschool level and allocated to the control group (receiving routine school-based education plus app-based parenting education excluding unintentional injury prevention) or the intervention group (receiving routine school-based education plus app-based parenting education including unintentional injury prevention). External support strategies will be adopted by local partners to minimize user fatigue, non-compliance, and attrition. Data collection will be conducted at baseline and then every 3 months during the 18-month follow-up time period. Intention-to-treat data analysis will be implemented. Missing values will be imputed by using the Expectation Maximization algorithm. Generalized estimating equation will test the overall effectiveness of the app-based intervention. A per-protocol sensitivity analysis will be conducted to test the robustness of results. Subgroup analyses will follow the strategies for primary analyses. The primary outcome measure is the incidence rate of unintentional injury among preschoolers during the study period. Secondary outcome measures comprise longitudinal changes in caregiver’s attitudes, caregiver-reported supervision behaviors, and caregiver-assessed home environment safety surrounding child unintentional injury prevention in the last week using a standardized audit instrument.DiscussionThe app-based intervention is expected to be feasible and effective over the 18-month intervention period. If the app is demonstrated effective as hypothesized, we will initiate processes to generalize and popularize it broadly to rural child caregivers across China.Trial registrationChiCTR2000037606, registered on August 29, 2020.