Implementation Of Injury Prevention Programs Research Articles

The Ability of the Landing Error Scoring System to Detect Changes in Landing Mechanics: A Critically Appraised Topic

Clinical Question:Is there evidence to suggest that the Landing Error Scoring System (LESS) is able to detect functional changes in landing mechanics in healthy individuals after participation in an injury prevention program (IPP)?Clinical Bottom Line:In a healthy, physically active population, there is strong evidence to support the use of the LESS as an outcome measure for changes in landing mechanics after the implementation of IPPs. Clinicians should consider the LESS as an evaluative tool for measuring the efficacy of IPPs in clinical practice.

Implementation of an evidence-based injury prevention program in professional and semi-professional soccer

The ideal implementation of soccer injury prevention programs is essential knowledge for soccer coaches. The objective of this study was to investigate and compare the implementation of injury prevention programs, specially the FIFA 11+ program, among Australian and Saudi Arabian soccer coaches. A Web-based survey was used to obtain information regarding the coaches’ implementation of injury prevention programs, the FIFA 11+ program, the Nordic hamstring exercise, pre- and post-training exercises. Sixty coaches—30 from both selected countries—responded to the survey (response rate = 75%). In Australia, 93% of the coaches implemented an injury prevention program; while 73% implemented the FIFA 11+ program, only 51% implemented all the FIFA 11+ exercise components as recommended. In Saudi Arabia, 70% of the coaches stated that they followed an injury prevention program, but only 40% followed the FIFA 11+ program. However, 70% reported using all the FIFA 11+ exercise components in their current practices, which they may have adapted from different exercise-based injury prevention programs. The Australian coaches were significantly more likely to implement injury prevention programs ( p = 0.020) and the FIFA 11+ program ( p = 0.009). Nonetheless, no significant difference in the full implementation of the FIFA 11+ exercises components was found ( p = 0.114). The Australian coaches had greater awareness of injury prevention programs and more familiarity with the FIFA 11+ program than the Saudi Arabian coaches. Nevertheless, there was a gap between the coaches’ knowledge and their actual practice.

We have the programme, what next? Planning the implementation of an injury prevention programme

Background and aimThe impact of any injury prevention programme is a function of the programme and its implementation. However, real world implementation of injury prevention programmes is challenging. Lower limb...

Prevention and rehabilitation of paediatric anterior cruciate ligament injuries.

To review the current knowledge on anterior cruciate ligament (ACL) injury prevention and ACL rehabilitation in individuals who have not yet reached musculoskeletal maturity. This is a narrative review based on a targeted and systematic literature search for paediatric ACL injury risk factors, injury prevention and rehabilitation. The search strategies resulted in 119 hits on risk factor studies, 57 hits on prevention and 37 hits on rehabilitation. Modifiable risk factors for ACL injury are largely unknown in the paediatric population. ACL injury prevention using neuromuscular training is highly successful in the adolescent population, and existing injury prevention programmes are cost-effective. The efficacy of ACL injury prevention programmes in children is, however, investigated to a markedly lesser degree. Paediatric ACL injury rehabilitation is poorly described, although supervised active rehabilitation progressed through phases with functional milestones is generally encouraged. Although limited, current evidence supports implementation of injury prevention programmes in female football players from the age of 12. Supervised active rehabilitation where progression is guided by functional milestones is also advocated. Future identification of modifiable risk factors is needed to design prevention programmes for younger children. There is a need for international multicentre studies on treatment algorithms and rehabilitation to increase knowledge on the short- and long-term outcomes following existing algorithms. Narrative review, level III.

Adolescent anterior cruciate ligament injuries – a 10 year review

Results: 817 (90%) questionnaires were completed, 59 (78%) subjects completed all twelve questionnaires. Injury incidence rate equalled 1.68 per 1000 exposure hours. The cumulative incidence was 95% with 72 new LBP episodes reported. 52.6% of subjects experienced at least one new episode of LBP. The point prevalence of LBP was 13.7%. Of these injuries, 45% were incidental, 29% were minor, 18% weremoderate and 9%were severe. There was a significantly positive high correlation between new LBP and total training hours per month (r= 0.83, p= 0.001). Previous history of LBP was found to be the most significant risk factor in developing new LBP (OR 2.03, p= 0.01). Age of the subjects was also a risk factor with the likelihood of developing a new low back injury increasing for every year in age (OR 1.07, p= 0.04. Subjects who had anMCS score of 16 or more out of 21 were more likely to develop LBP than those with a score of 15 or less out of 21; however this was not a statistically significant finding (OR 1.58, p= 0.08). Conclusion(s): LBP is a common injury among New Zealand representative rowers. There is a strong relationship between training load and the development on LBP. Implications: The ability to reduce injuries in sports requires a good knowledge of the current injury status. Implementing screening tools to identify risk factors is the next stage. A further stage requires the implementation of injury prevention programmes with appropriate follow up and evaluation to see if the injury rate has reduced. This methodology is useful for any sports injury prevention programme.

Pain, Injury and Related Behaviours among Footballers Partaking in Tournaments

This study sought to determine the prevalence of self-reported pain and/or injury (SRPI) experienced by Caribbean footballers and the associated behaviours associated with SRPI. The prevalence of SRPI among footballers was 46.2%, with 71.5% and 36%, respectively, of players admitting having played one game previously with an injury, and having used a painkiller before playing at least one game previously. Female players were more likely to hide an injury from the coaching staff in order to play a game (OR = 2.9, 95% CI (1.7, 4.8)) and attempt to use a banned substance in order to get fit to play (OR = 4.2, 95% CI (1.2, 14.3)) than males, but males were more likely to use a painkiller before playing games than females (OR = 2.2, 95% CI (1.9, 3.9)). Education of players on analgesics and basic injury management together with the implementation of injury prevention programs are needed for these players.

High levels of coach intent to integrate a ACL injury prevention program into training does not translate to effective implementation.

Evaluate the effect of a anterior cruciate ligament injury prevention program coaching workshop on elite-level youth soccer coaches' behavioral determinants to implement a injury prevention program and describe coaches' subsequent injury prevention program implementation compliance. Descriptive study. We evaluated a soccer club's coaches' behavioral determinants regarding injury prevention programming implementation before and after a coaching workshop using pre- and post-workshop surveys. We then described the club's coaches' subsequent adoption of and implementation compliance with the injury prevention programming during the following season. The injury prevention workshop increased coaches' attitudes toward conducting a program at the beginning of practice (p<0.05), substituting the program for a warm-up prior to practice (p<0.05), and improving player cutting and landing technique by implementing the program (p<0.05). The injury prevention program workshop increased coaches' perceived behavioral control; feeling more comfortable in their ability to teach their team a program (p<0.05), and more confident leading a program if given instructions (p<0.05). The injury prevention program workshop increased coaches' intent to implement a program the next season (p<0.05), to implement a program for 15min (p<0.05), and 20min (p<0.05) prior to the start of a training session. Only 53% of the club's teams implemented the injury prevention program, with implementers demonstrating high variability in program fidelity. Coaching workshops can effectively increase coach attitudes, perceived behavioral control, and intent to implement a injury prevention program. However, high levels of behavioral determinants do not appear to translate to high levels of implementation compliance.

Quantitative analysis of injury characteristics in victims of interpersonal violence: An emergency department perspective

Violence runs into the fabric of society. In recent years, violence has been identified as an important health problem in industrialised societies. In the present study, conducted to analyze injury characteristics, 813 victims of interpersonal violence presenting to emergency department at a Government Medical College and Hospital from a major city in Central India were interviewed and examined over a period of one year. Central to the quantitative analysis of the data collected was the extraction of specific injury characteristics from the sample population. The group included 606 men and 207 females, most of them were resident of urban areas, aged between 11 and 30 years. Most of attacks occurred at nights, with minimal seasonal variation. Males were more commonly attacked outdoors by a single stranger male while females were mostly attacked indoors by spouse. Blunt trauma was more commonly seen in females as compared to males. Head neck and face region was the most preferred anatomical site by the assailants. Hard and blunt weapons were used more commonly at homes (184 of 269 incidents) than at streets (301 of 561 incidents). Sharp edged and pointed weapons were most commonly used at streets. Firearms were rarely used. Occurrence of physical assaults in this region more or less follows the pattern seen in other parts of the world with local and socio-cultural differences that need to be further delved into and considered during the planning and implementation of injury prevention programs.

Youth Coaches’ Perspective on Injury Prevention Program Implementation

Youth Coaches’ Perspective on Injury Prevention Program Implementation

Prediction of in-season shoulder injury from preseason testing in division I collegiate football players.

Background:Collegiate football is a high-demand sport in which shoulder injuries are common. Research has described the incidence of these injuries, with little focus on causative factors or injury prevention.Hypothesis:Football athletes who score lower on preseason strength and functional testing are more likely to sustain an in-season shoulder injury.Study Design:Prospective, cohort study.Level of Evidence:Level 2.Methods:Twenty-six collegiate football players underwent preseason testing with a rotational profile for shoulder range of motion, isometric strength of the rotator cuff at 90° elevation and external rotation in the 90/90 position, fatigue testing (prone-Y, scaption, and standing cable press), and the Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST). Data collected postseason included the type of shoulder injury and the side injured. Logistic regression was used to determine if the testing measures predicted injury, and a receiver operating characteristic curve was constructed to examine the relationship of CKCUEST to injury.Results:Six athletes sustained shoulder injuries during the season. Predictor variables could significantly predict whether that player would sustain an injury during the season for both the right and left shoulders (P < 0.05). The variables that were significantly correlated with injury of the right side were forward elevation strength, prone-Y to fatigue, and the CKCUEST (P < 0.05); on the left, only the CKCUEST was significant (P < 0.05). The area under the receiver operating characteristic curve for the CKCUEST was 0.86 (ϵ = 0.87, P = 0.01). Using a score of 21 touches, the CKCUEST had a sensitivity of 0.83, a specificity of 0.79, and an odds ratio of 18.75 in determining whether a player sustained a shoulder injury.Conclusion:For this sample, the combination of preseason strength, fatigue, and functional testing was able to identify football players who would sustain a shoulder injury during the season.Clinical Relevance:Using a battery of strength, fatigue, and functional testing may be helpful in identifying football players during preseason who are at a higher risk for sustaining a shoulder injury. This information can be used to optimize preseason testing and implementation of injury prevention programs.

Science and Medicine Applied to Soccer Refereeing

Soccer referees are required to keep up with play at all times to ensure optimal positioning in making key decisions. While the physiological aspects of soccer refereeing have been extensively reviewed, other key areas of preparation and performance have yet to be considered in detail. We present a contemporary examination of methodological considerations for the interpretation of referees' match activities, the validation of fitness testing and training protocols, match and training injury profiles, and the understanding and development of perceptual-cognitive expertise. A referee covers approximately 11 km during a match, with ∼900 m of high-speed running and, consequently, the demands of match play represent a significant physical challenge. The analyses of within-match activity profiles have attempted to assess the possible occurrence of referee fatigue, with equivocal findings. However, researchers have demonstrated that referees' physical performances are interrelated with those of the players during the same match. Therefore, the evaluation of referees' match activity profiles should be made in the context of the players' performances. High match-to-match variability in key variables, namely, high-speed running and sprinting, along with age-related reductions in match running are other factors that require due consideration when interpreting physical performances. Fitness testing is used by national and international referee governing bodies as part of their match selection criteria. Therefore, the tests need to reflect the physical task of refereeing, yet for the recent fitness tests introduced by the Fédération Internationale de Football Association--a 20 × 150 m high-intensity and 6 × 40 m repeated-sprint test - only the repeated-sprint test possesses the appropriate construct validity for assessment of match-related running capacity. Also, the performance standards of the tests have not been validated. Consequently, the scientific rationale behind the tests and their associated standards is not clear. Soccer referees dedicate a large proportion of their overall training to the development of physical capacity and researchers have demonstrated that high-intensity (>85% maximal heart rate) training protocols are effective for improving fitness and match running performance. These high training loads combined with increasing age could, in part, explain an incidence of non-contact match injuries (18 injuries per 1000 match hours) similar to players, with lower leg muscle strains being the most common type of non-contact injuries in referees. The implementation of injury prevention programmes along with the careful monitoring of training and match loads may help minimize referee's injury incidence. The perceptual-cognitive demands of soccer refereeing are significant, yet there remains limited research examining the perceptual and cognitive processes informing referees' decisions. As such, a three-step approach for the study of expertise in soccer referees is proposed. First, objective and reliable markers of decision making should be established, with due consideration to the development of naturalistic test situations while maintaining experimental control. Second, process-tracing measures can be used to identify the perceptual and cognitive mechanisms involved in accurate decision making. Finally, research is required to help understand the acquisition of superior decision making and whether such expertise can be developed via training programmes.

Incidence and Cost of Serious Fall-Related Injuries in Nursing Homes

Fall-related injuries (FRIs) result in morbidity and mortality for patients, as well as unnecessary expense to health care institutions. (a) Estimate the incidence of falls and FRIs with a nursing home as the source of admission in Veterans Administration (VA) and non-VA facilities. (b) Estimate the cost of hospitalizations for each level of FRI severity. Retrospective analysis of falls and FRI resulting in a hospitalization whose source of admission was a VA nursing home. Falls and FRIs were obtained from Minimum Data Set (MDS) reports (January 2007-June 2009). Costs were obtained from the VA Decision Support System reports and Agency for Healthcare Research and Quality (AHRQ) Healthcare Cost and Utilization Project (HCUP) reports (2000-2006). Incidence of falls, fracture incidence, number of hospitalizations for FRIs, and costs associated with hospitalization for by level of FRI severity. Fall incidence was 10.6% in VA and 13.1% in CMS facilities. Fracture incidence was 0.9% in VHA and 1.65% in CMS facilities. Over a 3-year period, there were 2,400 admissions to VHA hospitals for FRI, with 55.4% hip fractures and10.1% intracranial injuries, with an average cost of US$23,723 per admission. Over a 9-year period, there were 141,308 admissions from nursing homes to non-VA hospitals for FRIs, with 38.8% hip fractures, 35.7% other fractures, and 11.1% intracranial injuries, with an average cost of US$31,507 per admission. Prevention program emphasis should shift away from a focus on preventing falls as a measure of quality care to decreasing FRIs. These findings support implementation of injury prevention programs for the elderly that reduces risk for injury as the primary outcome.

Preventing injuries in water polo: have we scored?

BackgroundInjury surveillance over time is the basis for the identification of injury trends and the development of injury prevention programs.ObjectiveTo analyse the injury trends in water polo over a 5...

Working Safe in Aboriginal Communities

Aboriginal enterprises work in a unique political, social and economic context. This research project was designed to assess how that unique context influenced the development and implementation of injury prevention programs in Aboriginal enterprises. We hypothesized that these contextual factors would telegraph into the workplace, both complicating and limiting the operations of occupational health and safety programs, in ways that are not found in in-Aboriginal firms. In general, we found support for this hypothesis, although we also found that these unique contextual factors were also a positive influence in some circumstances.

Coaches' perspectives on implementing an evidence-informed injury prevention programme in junior community netball

ObjectiveFor effective sports injury prevention, information is needed about the implementation context for interventions. This study describes coaches' feedback on the implementation of an evidence-informed injury prevention programme in community...

City-level violence prevention – an overview of local and international literature

A growing body of evidence has recognised cities as optimum sites in which to conduct injury prevention research. However, there appears to be an absence of a systematic review of city-level studies in the literature. International experience has shown that injury prevention programmes coordinated at city level can have a significant impact in reducing injuries, and this has important implications for local economic growth and business investment. This overview includes available South African and international city-level studies emphasising those city-level initiatives that focused on the prevention and control of violence. It also highlights the challenges and opportunities that have emerged from the implementation of injury prevention programmes at city level. A key finding is that documented city-level injury prevention initiatives are scarce, and that evaluation, a critical component of any injury prevention programme, is missing from those articles that do exist. Without an evaluation of the implemented initiative there is no accurate way to accurately the initiative's success in reducing injury-related morbidity and mortality, or its ability to enhance the adoption of safety practices. This indicates a clear need for more investment in evaluating injury prevention strategies at city level. Intervention methods piloted at city level were not reflected in the literature, illustrating a lack of collaboration between science and society, policing and research, and the prevention sector in general. By drawing on the lessons provided by international city-level injury prevention initiatives, the article concludes by suggesting the possible replication of cost-effective preventive measures, and evaluates some of the strategies for the conceptualisation and implementation of city-level injury prevention initiatives in South Africa.

Evaluating Injury Prevention Programs: The Oklahoma City Smoke Alarm Project

Evaluation of injury prevention programs is critical for measuring program effects on reducing injury-related morbidity and mortality or on increasing the adoption of safety practices. During the planning and implementation of injury prevention programs, evaluation data also can be used to test program strategies and to measure the program's penetration among the target population. The availability of this early data enables program managers to refine a program, increasing the likelihood of successful outcomes. The Oklahoma City Smoke Alarm Project illustrates how an evaluation was designed to inform program decisions by providing methodologically sound data on program processes and outcomes. This community intervention trial was instituted to reduce residential fire-related injuries and deaths in a geographic area of Oklahoma City that was disproportionately affected by this problem. The distribution of free smoke alarms in targeted neighborhoods was accompanied by written educational pamphlets and home-based follow-up to test whether the alarms were functioning correctly. Early evaluation during the planning and implementation phases of the program allowed for midcourse corrections that increased the program's impact on desired outcomes. During the six years following the project, the residential fire-related injury rate decreased 81% in the target population but only 7% in the rest of Oklahoma City. This dramatic decline in fire-related injuries in the target area is largely attributed to the free smoke alarm distribution as well as to educational efforts promoting awareness about residential fires and their prevention.

Measuring the implementation of injury prevention programs in state health agencies.

OBJECTIVE: Injury prevention programs have been implemented with varying degrees of success in the United States. The objective of this study was to identify the variables that influence the successful...

A review of fatal injuries associated with downhill skiing.

Reviewed here are those circumstances surrounding 18 downhill skiing deaths in Alberta, Canada. Variables that elevate the risk of injury and death are highlighted. This study profiles the fatally injured skier. The individual most likely to die while downhill skiing is an experienced male skier, average age 31 years. He loses control while skiing too fast and strikes an object, resulting in fatal blunt trauma injuries. The ability to define characteristics of the individual at risk of a fatal ski injury is important to the design and implementation of injury prevention programs. Public education targeted to those at risk may reduce the incidence of death and injury in downhill skiing.

Recruitment order of motor units on voluntary contraction: changes induced by proprioceptive afferent activity.

<h3>Background and aim</h3> The impact of any injury prevention programme is a function of the programme and its implementation. However, real world implementation of injury prevention programmes is challenging. Lower limb injuries (LLIs) are common in community Australian football (community-AF) and it is likely that many could be prevented by implementing exercise-based warm-up programmes for players. This paper describes a systematic, evidence-informed approach used to develop the implementation plan for a LLI prevention programme in community-AF in Victoria, Australia. <h3>Methods</h3> An ecological approach, using Step 5 of the Intervention Mapping health promotion programme planning protocol, was taken. <h3>Results</h3> An implementation advisory group was established to ensure the implementation plan and associated strategies were relevant to the local context. Coaches were identified as the primary programme adopters and implementers within an ecological system including players, other coaches, first-aid providers, and club and league administrators. Social Cognitive Theory was used to identify likely determinants of programme reach, adoption and implementation among coaches (eg, knowledge, beliefs, skills and environment). Diffusion of Innovations theory, the Implementation Drivers framework and available research evidence were used to identify potential implementation strategies including the use of multiple communication channels, programme resources, coach education and mentoring. <h3>Conclusions</h3> A strategic evidence-informed approach to implementing interventions will help maximise their population impact. The approach to implementation planning described in this study relied on an effective researcher-practitioner partnership and active engagement of stakeholders. The identified implementation strategies were informed by theory, evidence and an in-depth understanding of the implementation context.