scholarly journals Controlled ecological evaluation of an implemented exercise-training programme to prevent lower limb injuries in sport: population-level trends in hospital-treated injuries

2018 ◽  
Vol 53 (8) ◽  
pp. 487-492
Author(s):  
Caroline F Finch ◽  
Shannon E Gray ◽  
Muhammad Akram ◽  
Alex Donaldson ◽  
David G Lloyd ◽  
...  

ObjectiveExercise-training programmes have reduced lower limb injuries in trials, but their population-level effectiveness has not been reported in implementation trials. This study aimed to demonstrate that routinely collected hospital data can be used to evaluate population-level programme effectiveness.MethodA controlled ecological design was used to evaluate the effect of FootyFirst, an exercise-training programme, on the number of hospital-treated lower limb injuries sustained by males aged 16–50 years while participating in community-level Australian Football. FootyFirst was implemented with ‘support’ (FootyFirst+S) or ‘without support’ (FootyFirst+NS) in different geographic regions of Victoria, Australia: 22 clubs in region 1: FootyFirst+S in 2012/2013; 25 clubs in region 2: FootyFirst+NS in 2012/2013; 31 clubs region 3: control in 2012, FootyFirst+S in 2013. Interrupted time-series analysis compared injury counts across regions and against trends in the rest of Victoria.ResultsAfter 1 year of FootyFirst+S, there was a non-statistically significant decline in the number of lower limb injuries in region 1 (2012) and region 3 (2013); this was not maintained after 2 years in region 1. Compared with before FootyFirst in 2006–2011, injury count changes at the end of 2013 were: region 1: 20.0% reduction (after 2 years support); region 2: 21.5% increase (after 2 years without support); region 3: 21.8% increase (after first year no programme, second year programme with support); rest of Victoria: 12.6% increase.ConclusionEcological analyses using routinely collected hospital data show promise as the basis of population-level programme evaluation. The implementation and sustainability of sports injury prevention programmes at the population-level remains challenging.

Author(s):  
Nicolás Martínez-Velilla ◽  
Mikel L Sáez de Asteasu ◽  
Robinson Ramírez-Vélez ◽  
Fabricio Zambom-Ferraresi ◽  
Antonio García-Hermoso ◽  
...  

Abstract Background During the period of hospitalization patients can develop functional decline. The main aim of our study was to assess the natural trajectory of each Activity of Daily Living (ADL) and to assess how in-hospital exercise could influence short-term trajectory of ADLs. Methods Acutely hospitalized patients (n=297, 56.5% women) were randomly assigned to the intervention or control (usual care) group within the first 48 hours of admission. An exercise training programme was prescribed in two daily sessions (morning and evening) of 20 minutes duration during 5–7 consecutive days for the intervention group. The primary end-point was the change in every ADL (assessed with the Barthel Index) from 2 weeks before admission to hospital discharge. Results Acute hospitalization per se led to significant in-patient’s functional ability impairment in ADLs during hospitalization, whereas the exercise intervention reversed this trend (3.7 points; 95% CI, 0.5 to 6.8 points). After analyzing the trajectory of each one of the ADLs, patients in the control group significantly worsened all activities, but with a different degree of loss. For the between-group analysis, significant differences were obtained in many ADLs including bathing, dressing, grooming, bladder control, toilet use, transfers, mobility and climbing stairs (p<0.05). The control group had the greatest impairment in all domains analyzed (i.e., feeding, bathing, dressing, grooming, bowel control, bladder control, toilet use, transfers, mobility, and climbing stairs), p<0.05. Conclusions An individualized multicomponent exercise training programme in older adults is effective to reverse the loss of specific ADLs that frequently occurs during hospitalization. Each patient profile should receive an individualized prescription of exercise during hospitalizations.


2021 ◽  
Author(s):  
Narelle Hall ◽  
Maria Constantinou ◽  
Mark Brown ◽  
Belinda Beck ◽  
Suzanne Kuys

ABSTRACT Introduction Army recruit injuries occurring during basic training can lead to high personal and organizational burdens potentially threatening deployment capability. Previous military surveillance describing recruit injury as defined by physical therapy presentations is limited to 1-year duration or includes only male infantry recruits or trained personnel. Research describing injury incidence and trends specific to New Zealand Army basic training recruits over a longer period will better inform future injury prevention programs. Aims To identify the incidence and patterns of injuries reported from physical therapy presentations for New Zealand Army recruits undertaking basic training over a 4-year period. Materials and Methods This retrospective observational study identified injuries from physical therapy service presentations in New Zealand Army recruits from 2008 to 2011. All male and female New Zealand Army recruits who presented to physical therapy, following medical triage, were included. Recruit physical therapy presentations for injury and respiratory and other conditions were collated. Injury incidence was grouped by body region (upper limbs, lower limbs, and combined spinal regions) and site (joint or segment), and cumulative and injury incidence rates were calculated. Results One thousand eight hundred and ninety-six (1,697 males and 199 females) New Zealand Army recruits commenced basic training between 2008 and 2011. One thousand six hundred and eighty-three physical therapy presentations occurred for recruit injury during New Zealand Army basic training over 4 years. Lower limb injuries accounted for over 75% (n = 1,285) of the overall demand for physical therapy service during recruit basic training. Injuries sustained at the knee and below accounted for 67% of all reported injury presentations. Conclusion Four years of injury surveillance using physical therapy presentations identified the lower limb, with the knee and below as the most commonly injured regions in New Zealand Army recruits. Injury prevention interventions for New Zealand Army recruits should aim to reduce lower limb injuries. Future research on injury surveillance would benefit from incorporating clear injury and severity definitions, established injury classification systems, and standardized incidence calculations.


Injury ◽  
2014 ◽  
Vol 45 (12) ◽  
pp. 1996-2001 ◽  
Author(s):  
Carrie Teicher ◽  
Nancy L. Foote ◽  
Ali M.K. Al Ani ◽  
Majd S. Alras ◽  
Sufyan I. Alqassab ◽  
...  

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