scholarly journals Implementation of the Activate injury prevention exercise programme in English schoolboy rugby union

2021 ◽  
Vol 7 (2) ◽  
pp. e001018
Author(s):  
Craig Barden ◽  
Keith A Stokes ◽  
Carly D McKay
Keyword(s):  
Injury Prevention ◽  
Injury Risk ◽  
Behavioural Change ◽  
Exercise Programme ◽  
Rugby Union ◽  
Support Staff ◽  
Barriers To Implementation ◽  
Common Barriers ◽  
Perceptions Of School ◽  
Intervention Uptake

ObjectivesThe implementation of the Activate injury prevention exercise programme has not been assessed in an applied context. This study aimed to (1) describe the knowledge and perceptions of school rugby coaches and players towards injury risk, prevention and Activate and (2) evaluate Activate implementation in schoolboy rugby using the reach, effectiveness, adoption, implementation and maintenance framework.MethodsBespoke electronic surveys were administered to coaches (including support staff) and players at participating English schools (2018–2020). Most questions and statements were answered using a 7-point Likert scale. At baseline, participants detailed their Activate awareness and perceptions of injury risk and prevention in schoolboy rugby. At postseason, participants reported Activate use throughout the study and their perceptions towards the programme.ResultsAt baseline, significant differences existed between coaches (n=106) and players (n=571) in Activate awareness (75% and 13% respectively; χ2=173.5, p<0.001). Coaches perceived rugby had a significantly greater injury risk than players, while holding more positive perceptions towards injury prevention. At postseason, coaches reported greater Activate adoption compared with players (76% and 18% respectively; χ2=41.8, p<0.001); 45% of players were unaware if they used the programme. Median session adherence was twice weekly, with a median duration of 10–15 min. This suggests Activate was not implemented as intended, with recommendations of three 20 min sessions per week. Both groups identified common barriers to implementation, such as lack of time and inclusion of a ball.ConclusionCoaches are instrumental in the decision to implement Activate. Targeting behavioural change in these individuals is likely to have the greatest impact on intervention uptake.

scholarly journals Utilising a Behaviour Change Model to Improve Implementation of the Activate Injury Prevention Exercise Programme in Schoolboy Rugby Union

2021 ◽  
Vol 18 (11) ◽  
pp. 5681
Author(s):  
Craig Barden ◽  
Keith A. Stokes ◽  
Carly D. McKay
Keyword(s):  
Injury Prevention ◽  
Behaviour Change ◽  
Injury Risk ◽  
Exercise Programme ◽  
Rugby Union ◽  
Baseline Survey ◽  
Change Model ◽  
Programme Implementation ◽  
Health Action ◽  
Action Process

The Health Action Process Approach (HAPA) is a behaviour change model showing promise in positively changing youth sport coaches’ injury prevention behaviours. This study incorporated the HAPA model into coach training workshops for Activate, an efficacious rugby injury prevention programme. Primary aims were to investigate the effect of the workshop on schoolboy rugby union coaches’ (1) perceptions towards injury risk and prevention, (2) Activate adoption and adherence. Secondary aims were to (3) assess the differences in post-season HAPA constructs between workshop attendees and non-attendees, (4) explore associations between HAPA constructs and Activate adherence. In the pre-season, all participants (n = 76) completed a baseline survey, with 41 coaches electing to attend a workshop. Participants completed a post-season survey assessing HAPA constructs and Activate adoption and adherence throughout the season. The workshop did not affect coach perceptions of injury risk and prevention. Attendees had significantly greater rates of Activate adoption (95% vs. 54% χ2 = 17.42, p < 0.01) and adherence (median = 2 sessions vs. ≤1 session per week; z = 3.45, p = 0.03) than non-attendees. At post-season, attendees had significantly greater task self-efficacy (z = −3.46, p < 0.05) and intention (z = −4.33, p < 0.05) to use Activate. These results support the delivery of coach workshops that utilise a behaviour change model to maximise programme implementation.

Tackler and ball-carrier technique during moderate and severe injuries (≥8 days lost) compared with player-matched and team-matched injury-free controls in Elite Rugby Union

2021 ◽  
pp. bjsports-2020-103759
Author(s):  
Vincent Meintjes ◽  
Pip Forshaw ◽  
Steve den Hollander ◽  
Lindsay Starling ◽  
Michael Ian Lambert ◽  
...  
Keyword(s):  
Injury Prevention ◽  
Video Analysis ◽  
Effect Size ◽  
Injury Risk ◽  
Rugby Union ◽  
Prevention Strategies ◽  
Severe Injuries ◽  
Technical Proficiency ◽  
Proficiency Scores

ObjectiveTo analyse tackler and ball-carrier technical proficiency during moderate and severe contact injuries (≥8 days lost) in professional rugby union, and compare it with injury-free event-matched controls from the same player and from the same team.MethodsTechnical proficiency for 74 (n=74) (moderate and severe; ≥8 days lost) tackler and ball-carrier injuries during The Currie Cup (2014–2018) and 623 matched non-injury events (253 own controls, 370 team controls) were examined through video analysis using a standardised list of technical criteria.ResultsMean technical proficiency score for injured tacklers during front-on tackles was 6.19/16 (arbitrary units (AU) 95% CI 4.89 to 7.48), which was significantly different to their own controls (8.90/16 AU, 95% CI 8.37 to 9.43, p<0.001, effect size (ES)=1.21, large) and team controls (9.93/16 AU, 95% CI 9.50 to 10.40, p<0.001, ES=1.71, large). Mean technical proficiency score for injured ball-carriers during front-on tackles was 5.60/14 AU (95% CI 4.65 to 6.55), which was significantly different to their own controls (8.08/14 AU, 95% CI 7.56 to 8.60, p<0.001, ES=1.16, moderate) and team controls (8.16/14 AU, 95% CI 7.75 to 8.57, p<0.001, ES=1.25, large).ConclusionFor the tackler and ball-carrier, for both front-on and side-on/behind tackles, overall technical proficiency scores were significantly lower for the injury-causing event, when compared with the player’s own injury-free tackles and the team’s injury-free tackles. Through analysing player and team controls, player technique deficiencies for the injured player and player technique deficiencies that expose all players to injury were highlighted, which may inform injury prevention strategies and policies, and assist coaches in optimising training to reduce tackle injury risk.

scholarly journals Evaluating the Implementation of Injury Prevention Strategies in Rugby Union and League: A Systematic Review using the RE-AIM Framework

2020 ◽  
Author(s):  
Craig Barden ◽  
Sheree Bekker ◽  
James Craig Brown ◽  
Keith A Stokes ◽  
Carly D. McKay
Keyword(s):  
Systematic Review ◽  
Injury Prevention ◽  
Injury Risk ◽  
English Language ◽  
Journal Article ◽  
Rugby Union ◽  
Research Field ◽  
Original Research ◽  
Inclusion Criteria ◽  
Prevention Strategies

AbstractRugby (union and league) has come under intense scrutiny due to its injury risk. Various interventions have been introduced to protect players from injury, with many deemed efficacious and advocated for use across various worldwide contexts. However, their implementation is less clear. The objective of this systematic review was to determine whether injury prevention interventions in rugby have evaluated their ‘reach’, ‘effectiveness’, ‘adoption’, ‘implementation’ and ‘maintenance’ as per the RE-AIM Multi-Dimension Item Checklist. Six electronic databases were searched in November 2019. Inclusion criteria included: English language, peer-reviewed journal article, original research, field-based rugby code, prospective intervention. Of the 4253 studies identified, 74 met the full inclusion criteria. Protective equipment, predominately mouthguards, was the intervention of interest in 44 studies. Other interventions included multimodal national injury prevention programmes, law changes and neuromuscular training programmes. ‘Effectiveness’ was the highest scoring RE-AIM dimension (55%), followed by ‘reach’ (26%). All other RE-AIM dimensions scored below 20%. Research currently focuses on determining intervention ‘effectiveness’. For injury prevention strategies to have their desired impact, there must be a shift to address all determinants associated with implementation. Consideration should be given to how this can be achieved by adopting specific reporting checklists, research frameworks and study designs.

scholarly journals Efficacy of a movement control injury prevention programme in adult men’s community rugby union: a cluster randomised controlled trial

2017 ◽  
Vol 52 (6) ◽  
pp. 368-374 ◽  
Author(s):  
Matthew J Attwood ◽  
Simon P Roberts ◽  
Grant Trewartha ◽  
Mike E England ◽  
Keith A Stokes
Keyword(s):  
Injury Prevention ◽  
Lower Limb ◽  
Controlled Trial ◽  
Movement Control ◽  
Exercise Programme ◽  
Rugby Union ◽  
Injury Incidence ◽  
Time Loss ◽  
Cluster Randomised ◽  
Injury Prevention Programme

BackgroundExercise programmes aimed at reducing injury have been shown to be efficacious for some non-collision sports, but evidence in adult men’s collision sports such as rugby union is lacking.ObjectiveTo evaluate the efficacy of a movement control injury prevention exercise programme for reducing match injuries in adult men’s community rugby union players.Methods856 clubs were invited to participate in this prospective cluster randomised (single-blind) controlled trial where clubs were the unit of randomisation. 81 volunteered and were randomly assigned (intervention/control). A 42-week exercise programme was followed throughout the season. The control programme reflected ‘normal practice’ exercises, whereas the intervention focused on proprioception, balance, cutting, landing and resistance exercises.Outcome measures were match injury incidence and burden for: (1) all ≥8 days time-loss injuries and (2) targeted (lower limb, shoulder, head and neck, excluding fractures and lacerations) ≥8 days time-loss injuries.ResultsPoisson regression identified no clear effects on overall injury outcomes. A likely beneficial difference in targeted injury incidence (rate ratio (RR), 90% CI=0.6, 0.4 to 1.0) was identified, with a 40% reduction in lower-limb incidence (RR, 90% CI=0.6, 0.4 to 1.0) and a 60% reduction in concussion incidence (RR, 90% CI=0.4, 0.2 to 0.7) in the intervention group. Comparison between arms for clubs with highest compliance (≥median compliance) demonstrated very likely beneficial 60% reductions in targeted injury incidence (RR, 90% CI=0.4, 0.2 to 0.8) and targeted injury burden (RR, 90% CI=0.4, 0.2 to 0.7).ConclusionsThe movement control injury prevention programme resulted in likely beneficial reductions in lower-limb injuries and concussion. Higher intervention compliance was associated with reduced targeted injury incidence and burden.

scholarly journals Lay of the land: narrative synthesis of tackle research in rugby union and rugby sevens

2020 ◽  
Vol 6 (1) ◽  
pp. e000645 ◽  
Author(s):  
Nicholas Burger ◽  
Mike Lambert ◽  
Sharief Hendricks
Keyword(s):  
Risk Factors ◽  
Injury Prevention ◽  
Injury Risk ◽  
Rugby Union ◽  
Narrative Synthesis ◽  
Eligibility Criteria ◽  
English Only ◽  
Technical Ability ◽  
Performance Determinants ◽  
And Performance

ObjectivesThe purpose of this review was to synthesise both injury prevention and performance tackle-related research to provide rugby stakeholders with information on tackle injury epidemiology, including tackle injury risk factors and performance determinants, and to discuss potential preventative measures.DesignSystematic review and narrative synthesis.Data sourcesPubMed, Scopus and Web of Science.Eligibility criteriaLimited to peer-reviewed English-only publications between January 1995 and October 2018.ResultsA total of 317 studies were identified, with 177 in rugby union and 13 were in rugby sevens. The tackle accounted for more than 50% of all injuries in rugby union and rugby sevens, both at the professional level and at the lower levels, with the rate of tackle injuries higher at the professional level (mean 32/1000 player-hours) compared with the lower levels (mean 17/1000 player-hours). A player’s tackle actions and technical ability were identified as major risk factors for injury and a key determinant of performance.Summary/conclusionEvidence-based education, progressive tackle technique training with a high potential to transfer and law changes have been proposed as key modifiers of player tackle actions and technical ability. Conceivably, all three modifiers working in unison (as opposed to separately) will have a higher potential at reducing tackle injury risk while enhancing performance. With the guidance of tackle injury and performance studies, as well as stakeholder engagement, experiential and explorative tackle research has the potential to inspire innovative injury prevention and performance strategies.

Injury prevention knowledge, beliefs and strategies in elite female footballers at the FIFA Women’s World Cup France 2019

2021 ◽  
pp. bjsports-2020-103131
Author(s):  
Celeste Geertsema ◽  
Liesel Geertsema ◽  
Abdulaziz Farooq ◽  
Joar Harøy ◽  
Chelsea Oester ◽  
...  
Keyword(s):  
Risk Factors ◽  
Injury Prevention ◽  
Injury Risk ◽  
Risk Level ◽  
Attitudes And Beliefs ◽  
Implementation Barriers ◽  
World Cup ◽  
Positive Attitudes ◽  
High Level ◽  
Women's Football

ObjectivesThis study assessed knowledge, beliefs and practices of elite female footballers regarding injury prevention.MethodsA survey was sent to players participating in the FIFA Women’s World Cup France 2019. Questions covered three injury prevention domains: (1) knowledge; (2) attitudes and beliefs; (3) prevention practices in domestic clubs. Additionally, ACL injury history was assessed.ResultsOut of 552 players, 196 women responded (35.5%). More than 80% of these considered injury risk to be moderate or high. Players listed knee, ankle, thigh, head and groin as the most important injuries in women’s football. The most important risk factors identified were low muscle strength, followed by poor pitch quality, playing on artificial turf, too much training, reduced recovery and hard tackles. In these elite players, 15% did not have any permanent medical staff in their domestic clubs, yet more than 75% had received injury prevention advice and more than 80% performed injury prevention exercises in their clubs. Players identified the two most important implementation barriers as player motivation and coach attitude. Two-thirds of players used the FIFA 11+ programme in their clubs.ConclusionsThis diverse group of elite players demonstrated good knowledge of risk level and injury types in women’s football. Of the risk factors emphasised by players, there was only one intrinsic risk factor (strength), but several factors out of their control (pitch quality and type, training volume and hard tackles). Still players had positive attitudes and beliefs regarding injury prevention exercises and indicated a high level of implementation, despite a lack of medical support.

scholarly journals Efficacy of interventions to increase physical activity for people with heart failure: a meta-analysis

Open Heart ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. e001687
Author(s):  
Aliya Amirova ◽  
Theodora Fteropoulli ◽  
Paul Williams ◽  
Mark Haddad
Keyword(s):  
Physical Activity ◽  
Heart Failure ◽  
Meta Analysis ◽  
Behavioural Change ◽  
Mode Of Delivery ◽  
Random Effect ◽  
Random Effect Model ◽  
Action Planning ◽  
Exercise Programme ◽  
Effect Model

ObjectivesThis meta-analysis aims to (1) evaluate the efficacy of physical activity interventions in heart failure and (2) to identify intervention characteristics significantly associated with the interventions’ efficacy.MethodsRandomised controlled trials reporting intervention effects on physical activity in heart failure were combined in a meta-analysis using a random-effect model. Exploratory meta-analysis was performed by specifying the general approach (eg, cardiac rehabilitation), strategies used (eg, action planning), setting (eg, centre based), mode of delivery (eg, face to face or online), facilitator (eg, nurse), contact time and behavioural change theory use as predictors in the random-effect model.ResultsInterventions (n=21) had a significant overall effect (SMD=0.54, 95% CI (0.13 to 0.95), p<0.0005). Combining an exercise programme with behavioural change intervention was found efficacious (SMD=1.26, 95% CI (0.26 to 2.26), p<0.05). Centre-based (SMD=0.98, 95% CI (0.35 to 1.62), and group-based (SMD=0.89, 95% CI (0.29 to 1.50),) delivery by a physiotherapist (SMD=0.84, 95% CI (0.03 to 1.65),) were significantly associated with efficacy. The following strategies were identified efficacious: prompts/cues (SMD=3.29, 95% CI (1.97 to 4.62)), credible source (standardised mean difference, SMD=2.08, 95% CI (0.95;3.22)), adding objects to the environment (SMD=1.47, 95% CI (0.41 to 2.53)), generalisation of the target behaviour SMD=1.32, 95% CI (0.22 to 2.41)), monitoring of behaviour by others without feedback (SMD=1.02, 95% CI (0.05 to 1.98)), self-monitoring of outcome(s) of behaviour (SMD=0.79, 95% CI (0.06 to 1.52), graded tasks (SMD=0.73, 95% CI (0.22 to 1.24)), behavioural practice/rehearsal (SMD=0.72, 95% CI (0.26 to 1.18)), action planning (SMD=0.62, 95% CI (0.03 to 1.21)) and goal setting (behaviour) (SMD=0.56, 95% CI (0.03 to 1.08)).ConclusionThe meta-analysis suggests intervention characteristics that may be suitable for promoting physical activity in heart failure. There is moderate evidence in support of an exercise programme combined with a behavioural change intervention delivered by a physiotherapist in a group-based and centre-based settings.PROSPERO registerationCRD42015015280.

scholarly journals Shoe cushioning, body mass and running biomechanics as risk factors for running injury: a study protocol for a randomised controlled trial

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e017379 ◽  
Author(s):  
Laurent Malisoux ◽  
Nicolas Delattre ◽  
Axel Urhausen ◽  
Daniel Theisen
Keyword(s):  
Risk Factors ◽  
Randomised Controlled Trial ◽  
Injury Prevention ◽  
Body Mass ◽  
Injury Risk ◽  
Cox Regression ◽  
Controlled Trial ◽  
Study Groups ◽  
Self Report ◽  
Randomised Controlled

IntroductionRepetitive loading of the musculoskeletal system is suggested to be involved in the underlying mechanism of the majority of running-related injuries (RRIs). Accordingly, heavier runners are assumed to be at a higher risk of RRI. The cushioning system of modern running shoes is expected to protect runners again high impact forces, and therefore, RRI. However, the role of shoe cushioning in injury prevention remains unclear. The main aim of this study is to investigate the influence of shoe cushioning and body mass on RRI risk, while exploring simultaneously the association between running technique and RRI risk.Methods and analysisThis double-blinded randomised controlled trial will involve about 800 healthy leisure-time runners. They will randomly receive one of two running shoe models that will differ in their cushioning properties (ie, stiffness) by ~35%. The participants will perform a running test on an instrumented treadmill at their preferred running speed at baseline. Then they will be followed up prospectively over a 6-month period, during which they will self-report all their sports activities as well as any injury in an internet-based database TIPPS (Training and Injury Prevention Platform for Sports). Cox regression analyses will be used to compare injury risk between the study groups and to investigate the association among training, biomechanical and anatomical risk factors, and injury risk.Ethics and disseminationThe study was approved by the National Ethics Committee for Research (Ref: 201701/02 v1.1). Outcomes will be disseminated through publications in peer-reviewed journals, presentations at international conferences, as well as articles in popular magazines and on specialised websites.Trial registration numberNCT03115437, Pre-results.

scholarly journals Two Training-Load Paradoxes: Can We Work Harder and Smarter, Can Physical Preparation and Medical Be Teammates?

2017 ◽  
Vol 12 (s2) ◽  
pp. S2-50-S2-54 ◽  
Author(s):  
Tim J. Gabbett ◽  
Rod Whiteley
Keyword(s):  
Decision Making ◽  
Injury Risk ◽  
Early Stage ◽  
Support Staff ◽  
Training Load ◽  
Shared Decision ◽  
The Relationship ◽  
And Training ◽  
Physical Preparation

The authors have observed that in professional sporting organizations the staff responsible for physical preparation and medical care typically practice in relative isolation and display tension as regards their attitudes toward training-load prescription (much more and much less training, respectively). Recent evidence shows that relatively high chronic training loads, when they are appropriately reached, are associated with reduced injury risk and better performance. Understanding this link between performance and training loads removes this tension but requires a better understanding of the relationship between the acute:chronic workload ratio (ACWR) and its association with performance and injury. However, there remain many questions in the area of ACWR, and we are likely at an early stage of our understanding of these parameters and their interrelationships. This opinion paper explores these themes and makes recommendations for improving performance through better synergies in support-staff approaches. Furthermore, aspects of the ACWR that remain to be clarified—the role of shared decision making, risk:benefit estimation, and clearer accountability—are discussed.

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