Balance tests are commonly used in clinical practice with applicability in injury prevention and return to sport decisions. While most sports injuries occur in a changing environment where reacting to a non-planned stimulus is of great importance, these balance tests only evaluate pre-planned movements without taking these dynamics environmental aspects into account. Therefore, the goal of this paper was to describe the development of a clinician-friendly test that respects these contextual interactions and to describe the test protocol of an adapted Y-balance test that includes environmental perception and decision-making.
Talented athletes use metacognitive skills to improve their performance. Also, it is known that these skills are important for managing one's health. The goal of this study was to identify the relationship between metacognitive skills and overuse injuries in talented tennis players.
Large volumes of sitting time have been associated with multiple health risks. To reduce sitting time of office workers working for a Dutch insurance company, the Dynamic Work intervention was developed. In a study protocol we describe in detail the content and evaluation of the Dynamic Work study. This study protocol is published now in BMC Public Health.
Better late than never .. this one was published some months ago, but we failed to share it yet. The “Strengthen Your Ankle” neuromuscular training program has been thoroughly studied over the past 8 years. This process evaluation is a part of a randomized controlled trial that examined both the short- and long-term effectiveness of this particular program. Although it was shown previously that the program, available both in a printed booklet and as a mobile app, is able to effectively reduce the number of recurrent ankle sprains, participants’ compliance with the program is an ongoing challenge. This process evaluation explored participants’ opinions regarding both methods of delivery.
Overweight and obesity are enormous problems for society and health care. However, having too much fat starts before birth, in the womb. Obese pregnant women often give birth to babies with too much fat, and these babies are more likely to be fat as children and adolescents, increasing their risk of developing type 2 diabetes. Therefore, prevention of overweight and obesity starts during or before pregnancy! We published recently in Diabetologia a manuscript on the influence of a lifestyle interventions during pregnancy on the offspring.
Another one of our qualitative studies just got published. It is good to see that the value and importance of this important methodology is gaining attention. In this study Marelise Badenhorst applied a qualitative approach to describe rugby players’ perceptions of the immediate management of rugby-related acute spinal cord injuries (ASCIs). These findings are relevant for all rugby stakeholders and may help shape education, awareness, and future policy around the immediate management of ASCIs.
Hot off the press is our recent endeavor to apply systems thinking towards understating the injury and injury prevention context. We undertook this qualitative study within an international circus company—Cirque du Soleil—to explore the narrative of artists and the artistic team in regards to injuries and their prevention and to describe the prevention of injuries from a systems thinking lens. The outcomes show the need for a broader view on preventive interventions, and as we speak we are validating this in elite and professional sports as well (stay tuned for those outcomes).
Just published in Sports Medicine, this systematic review was to identify prospective studies that used a criteria-based return to sport (RTS) decision-making process for patients with lateral ankle sprain (LAS) injury. We found that currently there are no published evidence-based criteria to inform RTS decisions for patients with an LAS injury. A narrative synthesis proposed a number of variables that could be used to develop a criteria-based RTS decision paradigm.
A better understanding of what drives behaviour change in obese pregnant overweight women is needed to improve the effectiveness of lifestyle interventions in this group at risk for gestational diabetes (GDM). We published in Nutrients a manuscript on the factors that mediated behaviour change in the Vitamin D and Lifestyle Intervention for GDM Prevention (DALI) Lifestyle Study.
Just recently our own Nicola Sewry successfully defended her thesis “The Effectiveness and Implementation of the BokSmart Safe Six Injury Prevention Programme”. In her project - which was a joint effort between the University of Capetown and our group - she set out to investigate whether the SA Rugby SafeSix injury prevention program was effective for the prevention of rugby related injuries in South African Youth Rugby. Positive results .. but some more work needs to be done on this horizon.
Reducing sitting time as well as increasing physical activity in inactive people is beneficial for their health. Today we published an Article in PLoS Medicine about the effects of the European Fans in Training (EuroFIT) programme to improve physical activity and sedentary time in male football fans, delivered through the professional football setting.
Last Tuesday Miriam van Reijen successfully defense her PhD Thesis “Preventing recurrent ankle sprains: the implementation effectiveness of the ‘strengthen your ankle’ app”. In her project she set out to investigate whether an effective intervention disseminated through an app helps to increase compliance to the prescribed program. Turns it does not help as much as much as we imagined.
While the year is almost at end, we still have a number of studies published that we have not shared. Amongst those, this cost-effectiveness analysis of the 11+Kids Football Injury Prevention Program. Not your straightforward cost-effectiveness analysis … this one looks broader and evaluates the potential reduction in injury related healthcare costs on a national level (Swiss in this case) when implementing the ’11+ Kids’ injury prevention programme.
Though rare, rugby union carries a risk for serious injuries such as acute spinal cord injuries (ASCI), which may result in permanent disability. Various studies have investigated injury mechanisms, prevention programmes and immediate medical management of these injuries. However, relatively scant attention has been placed on the player's experience of such an injury and the importance of context. Therefore, the aim of this study was to explore the injury experience and its related context, as perceived by the catastrophically injured player.
Injury definition is a relevant topic in sports injury prevention, however we don't know if the theoretical sports injury definitions current applied in literature also align with the perspectives of the main stakeholders in an elite sports setting. What if we ask them? That was the aim of the study: to explore how athletes, coaches, and physiotherapists define a sports injury, and how the elite sport context influences their perception of injury.
This one is fresh out and describes the incidence and risk factors of medial tibial stress syndrome: in Physical Education Teacher Education students. Medial tibial stress syndrome (MTSS) is a common lower extremity overuse injury often causing long-term reduction of sports participation. This study aimed to investigate the incidence and risk factors of MTSS in first-year Dutch Physical Education Teacher Education (PETE) students.
A secondary analysis of the ’11+ Kids’ trial showed a large preventive effect on severe injuries by investing only 15 to 20 min per training session. There was a reduction of severe overall (HR 0.42, 95% CI 0.24 to 0.72), match (0.41, 0.17 to 0.95) and training injuries (0.42, 0.21 to 0.86) in INT. The present study should raise clinicians’ and coaches’ awareness towards the ‘11+ Kids’ as an effective injury prevention programme.
Relationships between load, load capacity, performance and health are topics of contemporary interest. At what intensity should an athlete train to achieve the best physiological response? How much (or little) can an athlete train without detri- mentally affecting health? Most studies addressing such questions have used a reductionist approach wherein factors were studied in isolation, thereby ignoring the complex inter-relationships and balance between factors. This editorial discusses the association between load and load capacity, and their relationship with athlete performance and health. It illustrates the practical use of a model for the management of athlete performance and health, and provide directions for future practice and research.
Until now, there is no clear overview of how fidelity is assessed in school-based obesity prevention programmes. This review aimed to gain insight in the concepts and methods employed to measure fidelity and to gain insight into the quality of measuring fidelity in school-based obesity prevention programmes.
Just out in the Journal of Medical Internet Research, our mixed-methods process evaluation of the "Strengthen Your Ankle" neuromuscular training program. The current evaluation is a part of a randomised controlled trial that examined both the short- and long-term effectiveness of the program delivered through an App. Although it was shown previously that the program, available both in a printed booklet and as a mobile app, is able to effectively reduce the number of recurrent ankle sprains, participants' compliance with the program is an ongoing challenge.
Despite the availability of high quality evidence, compliance to interventions that protect athletes’ health is low. Consequently, evidence-based programs are not achieving their optimal effect in real-life athletic situations. Implementation and knowledge translation are the contemporary incantations to resolve this apparent gap between science and practice. This has provided us novel research questions and challenges that follow on efficacious outcomes. Most of these questions are not answered through quantifiable outcomes measures as they revolve around user behaviors. This editorial argues that if we want to know why athletes and coaches behave as they do, and what barriers there may be to changing their behavior, qualitative research can be used to give athletes and coaches a voice.
We are excited to have been a partner in this important editorial that touches the core of our views and recent approaches to injury prevention (also read this). This editorial highlights the importance of adherence in sport injury prevention research and practice, and provides a framework to raise the bar for sport injury prevention adherence research.
We are riding a streak of rugby related manuscripts this week. This one just appeared at BMJ Open today. Rugby-related spinal cord injuries (SCIs) are rare but life altering and traumatic events. Little is known about the long-term consequences and outcomes of players who have sustained these injuries. This descriptive cross-sectional study investigated current quality of life (QoL) and factors associated with QoL, among individuals with rugby-related SCI in South Africa.
Fresh from the press, out of our collaboration with the University of Capetown. Youth rugby union is a popular sport with a high injury incidence density (IID) and burden. This high risk has called for further research into the factors affecting the injuries in youth rugby. The aim of the study was to analyse time-loss IID and burden in multiple schoolboy rugby teams over a season and the potential factors associated with injury.
This time a more methodologically oriented manuscript that aims to aid the clinician to make better sense of research methodology on injury prevention. We hope this manuscript will help clinicians to better assess whether a published research finding is valid and applicable for their context. Accordingly, this article is meant to be a resource for sport clinicians to understand and interpret (1) study design, (2) outcome measures, and (3) statistics in sports injuries prevention research. This should provide a foundation of knowledge for clinicians on the decision-making process to apply research findings in the area of injury prevention in practice.
We are proud of this one .. just popped up online today. It is possible to prevent sports injuries. Unfortunately, the demonstrated efficacy and effectiveness of injury prevention approaches are not translated into lasting real-world effects. Contemporary views in sports medicine and injury prevention suggest that sports injuries are ‘complex’ phenomena. If the problem we aim to prevent is complex, then the first step in the ‘sequence of prevention’ that defines the ‘injury problem’ already needs to have considered this. The purpose of this paper was to revisit the first step of the ‘sequence of prevention’, and to explore new perspectives that acknowledge the complexity of the sports injury problem.
Exercise-based injury prevention strategies in sports have been frequently evaluated. The majority of trials have been conducted in team sports, such as basketball, volleyball, football (soccer) and tackle collision ball sports (eg, rugby union). For individual sports, the literature is limited to running athletes. Given the global individual sports participation exceeds team participation, the lack of evidence-based prevention intervention is a call for action. Previously, intervention mapping (IM) was commonly applied for the development of preventive interventions. However, a novel programme, the Knowledge Transfer Scheme (KTS), was recently published. The KTS is a practical five-step tool for developing intervention strategies in sports. The fundament of the KTS is the direct translation of evidence into practice. Prospected users are involved throughout the KTS process. The KTS can thus lead to a more evidence-based and user-friendly product or programme. Using KTS, in this project an e-health intervention was developed for recreational tennis players in the Netherlands.
We are very pleased to have been involved in this one. This guideline aimed to advance current understandings regarding the diagnosis, prevention and therapeutic interventions for ankle sprains by updating the existing guideline and incorporate new research. A secondary objective was to provide an update related to the cost-effectiveness of diagnostic procedures, therapeutic interventions and prevention strategies. It was posited that subsequent interaction of clinicians with this guideline could help reduce health impairments and patient burden associated with this prevalent musculoskeletal injury.
Implementation of an effective ankle injury prevention program through either an interactive App or a Booklet, showed similar outcomes on the short and the long run. Not only did both methods result in comparable compliance rates during the 8 weeks of the program, both methods also led to comparable ankle sprain recurrence rates and costs after one year of follow-up. Both the App and the Booklet can be used successfully and with the same cost efficiency. Apps are, as such, not necessarily always better.
Our latest study provides knowledge on the magnitude, severity, and nature of injuries experienced by elite field-hockey players. While injuries may hamper players’ performance and availability for training and competing, prevention is essential in field-hockey, and the use of protective equipment has been encouraged in previous studies. The use of protective equipment is important for injury prevention. However, the present study shows that non- contact injuries, that may not be preventable with protective gear, are also a burden on field hockey players' health. In sports, these injuries may be prevented with structured exercise, and load management. Therefore, the investigation of such strategies is encouraged in elite field-hockey.