We got the opportunity to contribute with our thoughts on implementation in a special edition of Best Practice & Research Clinical Rheumatology. Although safety in sports and physical activity is an important prerequisite for continuing participation and maintenance of a healthy, physically active lifestyle, to date little effort has been placed upon moving evidence into preventive practice. Amongst researchers it is still often assumed that a program will disseminate itself after proven to be effective. Recently, however, there has been an increased recognition of the importance of theory-driven approaches to enhance implementation research. This manuscript aims to provide guidance for sports and physical activity injury researchers and practitioners to perform implementation research and practice.
Hot off the press comes this publication by our own Caroline Bolling. Proud to say her qualitative work has created waves and found its way to the British Journal of Sports Medici e. This particular study explored how sports injury prevention takes place in elite sport practice and to describe the perspectives of athletes, coaches and physiotherapists regarding the most critical factors that help prevent injury in the elite sports context.
Sports participation and a physically active lifestyle have been advocated for its health and social benefits and increased quality of life, both in able-bodied individuals and those with physical disabilities. Although sports participation lags behind in the latter group, it has increased over the past years. Sports injuries do pose problems for all athletes and impact society, but often go hand-in-hand with additional problems in individuals with a disability as injuries can impose upon an already restricted lifestyle. With the relevance of studies on injury surveillance and epidemiology for preventive efforts widely acknowledged, there is a limited number of these studies in disability sports. Injury prevention is relevant to enable long-time sports participation and continuation of activities of daily living.
This latest article to which we contributed, assessed knee health in retired female football players, using magnetic resonance imaging (MRI) and self-report. The focus of analysis were degenerative changes of the tibiofemoral joint, and their relationship to osteoarthritis symptoms and previous knee injury. Serious degenerative changes were found in a high number of former elite female football players knees as soon as 10years after their professional career with a significant impact on their QOL.
Our own Lorraine Landais got the opportunity to present parts of her PhD project at the last ISBNPA conference. Choice architecture (CA) is considered a promising approach to change health behaviors; however, its effectiveness in increasing physical activity and reducing sedentary behavior, especially after its removal, remains unclear.This systematic literature review aims to provide an overview of the effectiveness of CA interventions that promote physical activity or reduce sedentary behavior.
Relatively little is known about how total sedentary time is accumulated in different domains and if correlates of sedentary time differ across domains. Time use surveys present a unique opportunity to study sedentary time in more detail. One of our latest studies aimed to use the 2006 Dutch time use survey to 1) describe the (sedentary) time use of Dutch adults, and to 2) explore socio-demographic and health-related correlates of total (non-occupational) and domain-specific sedentary time.
Field hockey is a popular sport worldwide. However, it entails a risk of injury. Injuries hamper players’ participation in the sport and impose a burden on public health. Our latest study - just published in the Journal of Athletic Training - investigated the effectiveness of a structured exercise program among youth field hockey players on the injury rate, severity, and burden.
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.