MacManus, A., Stevenson, M., Finch, C. F., Elliott, B., Hamer, P., Lower, A., and Bulsara, M. (2004). Incidence and Risk Factors for Injury in Non-Elite Australian Football. Journal of Science and Medicine in Sport, Vol. 7 (3), p. 384-391.

DOI: 10.1016/S1440-2440(04)80033-1

ISSN: 1440-2440

While rates of regular physical activity are increasing among Australians, there is potential for an increase in the number of injuries. It is important therefore to consider the benefits attributed to participation in sport and recreational pursuits in the light of the increased physical risks.1

Until now, there has been a lack of valid, reliable, and recent data on the incidence and up to date costs of sports injuries in Australia. Furthermore, much of the research has focused on elite participants,2 with a paucity of research among non-elite sports participants, despite the fact that most sports participants play at a non-elite level.3 As the risk of injury and the concomitant rate of injury are likely to be different in elite and non-elite sports participants, there was a need for research that could be translated into injury prevention policy and practice for non-elite sports participants.

A proposal to establish the first Australian longitudinal population based study of sports injuries—the Western Australian sports injury study—was developed in collaboration with the peak non-government organisation for sports medicine in Australia—Sports Medicine Australia—and the authors. The broad aims of the study were to:

-determine the magnitude of the sports injury problem at the non-elite level of participation in Western Australia;

-determine the cost of sports injuries to the Western Australian community;

-provide an evidence base for the enhancement and upgrading of existing sports injury prevention and education programmes.

Key Points about the NGT

* A group decision making process

* A cost effective and time efficient method for data collection

* Has utility with service providers and consumers alike, so may be particularly beneficial in addressing clinical practice issues in physiotherapy

* A mixed method approach that can employ both qualitative and quantitative analytical processes

* Currently underutilised in physiotherapy research

Results: On the basis of total work (TW), performance in sprint 11 (79.8 +/- 4.8 J-kg^-1) was not significantly different to performance in sprint 4 (80.3 +/- 5.3 J-kg^-1; P = 0.81). The decrease in TW for the five sprints after sprint 4 (i.e., sprints 4 to 8) averaged 14.5% (P < 0.001), which was significantly less than the decrement in TW from sprints 11 to 15 (20.3%; P < 0.05). Despite no significant differences in TW values achieved in sprints 4 and 11, the amplitude of the electromyogram (EMG) signal (i.e., root mean square (RMS)) recorded during sprint 11 (0.398 +/- 0.03 V) was 12.0% lower (P < 0.05) than in sprint 4 (0.452 +/- 0.02 V). In contrast, values of EMG median frequency (MF) recorded during sprint 4 (85.5 +/- 5.5 Hz) and 11 (89.3 +/- 7.2 Hz) were not significantly different (P = 0.33). However, the rate of decrease in EMG activity (i.e., RMS and MF) was similar for the two set of sprints.

Conclusions: These findings suggest that previous fatiguing repeated-sprint exercise, followed by a rest period, induces greater fatigability during subsequent repeated-sprint exercise, regardless of the initial mechanical output, and that these changes are associated with acute neuromuscular adjustments.

Methods: Bone mineral density (BMD) and bone mineral content (BMC) was monitored in 9 RAAF trainee fighter pilots completing an 8-mo flight training course on a PC-9 and 10 age-height-weight-matched controls.

Results: At completion of the course, the pilots had a significant increase in cervical spine BMD and total body BMC. No significant changes were found for the control group.

Conclusions: This study demonstrated that the physical environment associated with flight training may have contributed to a significant increase in cervical spine bone mass in the trainee PC-9 pilots. The increase in bone mass was possibly a response to the strain generated by the daily wearing of helmet and mask assembly under the influence of positive sustained accelerative forces.

Methods: A total of 43 elderly community-dwelling volunteers were recruited and randomly allocated to a conventional exercise intervention, a holistic exercise intervention, or a control group. The interventions were performed 2 days per week for 10 weeks. Falls efficacy was measured at baseline and at the completion of the interventions using the Modified Falls Efficacy Scale (MFES).

Results: Within group comparisons between baseline and follow-up indicated no significant improvements in falls efficacy, however, the difference for the conventional exercise group approached statistical significance (baseline 8.9 to follow-up 9.3; P = 0.058). Within group comparisons of mean difference MFES scores showed a significant difference between the conventional exercise group and the control group (conventional exercise group 0.4 vs control group −0.6; P < 0.05).

Conclusion: Given the lack of significant improvements in falls efficacy found for any of the groups, it cannot be concluded whether a conventional or a holistic exercise intervention is the best approach for improving falls efficacy. It is possible that the characteristics of the exercise interventions including specificity, intensity, frequency and duration need to be manipulated if the purpose is to bring about improvements in falls efficacy.

Methods: The cohort consisted of 32 age-height-weight matched participants, divided into two experimental groups; the Multi-Cervical Unit (MCU) and Thera-Band tubing groups (THER), and a control (CTRL) group. Ten weeks of training were undertaken and pre-and post isometric strength testing for all groups was performed on the MCU. Comparisons between the three groups were made using a Kruskal-Wallis test and effect sizes between the MCU and the THER groups and the THER and CTRL groups were also calculated.

Results: The MCU group displayed the greatest increase in isometric strength (flexion 64.4%, extension 62.9%, left lateral flexion 53.3%, right lateral flexion 49.1%) and differences were only statistically significant (p<0.05) when compared to the CTRL group. Increases in neck strength for the THER group were lower than that shown in the MCU group (flexion 42.0%, extension 29.9%, left lateral flexion 26.7%, right lateral flexion 24.1%). Moderate to large effect sizes were found between the MCU and THER as well as the THER and CTRL groups.

Conclusions: This study demonstrated that the MCU was the most effective training modality to increase isometric cervical muscle strength. Thera-Band tubing did however, produce moderate gains in isometric neck strength.

Design: A multi-centre prospective observational study. Participants: Five tertiary level university-affiliated intensive care units.

Outcome measures: All physiotherapy intervention in five intensive care units over a three month period. When certain specified changes occurred during physiotherapy intervention, details were noted including diagnosis of patient, intervention, vital signs, radiological changes, co-morbidities, chemical pathology, and fluid balance.

Results: 12 281 physiotherapy interventions were completed with 27 interventions resulting in adverse physiological changes (0.2%). This incidence was significantly lower than a previous study of adverse physiological changes (663 events in 247 patients over a 24-hour period); the incidence during physiotherapy intervention was lower than during general intensive care. Common factors in the patients who had an adverse physiological change were a deterioration in cardiovascular status (ie, decrease in blood pressure or arrhythmia) in patients on medium to high doses of inotropes/vasopressors, unstable baseline hemodynamic values, previous cardiac co-morbidities and intervention consisting of positive pressure or right side lying.

Conclusion: The incidence of adverse events during physiotherapy intervention in these five tertiary hospitals was low, demonstrating that physiotherapy intervention in intensive care is safe.

Background: Patient falls are a significant cause of preventable injury and death, particularly in older patients. Best practice principles mandate that hospitals identify those patients at risk of falling and implement interventions to prevent or minimize them.

Methods:  A before and after design was used for the study. All patients admitted to three medical wards and a geriatric evaluation management unit were enrolled over a six-month period. Patients’ risk of falling was assessed using a falls risk assessment tool and appropriate interventions implemented using a falls care plan. Data related to the number and severity of falls were obtained from the Australian Incident Monitoring System database used at the study site.

Results: In this study, 1357 patient admissions were included. According to their risk category, 37% of patients (n = 496) were grouped as low risk (score = 1–10), 58% (n = 774) medium risk (score = 11–20) and 5% (n = 63) high risk (score = 21–33) for falls. The incidence of falls (per average occupied bed day) was eight per 1000 bed days for the study period. Compared with the same months in 2002/2003, there was a significant reduction in falls from 0·95 to 0·80 (95% CI for the difference −0·14 to −0·16, P < 0·001).

Conclusion:  We evaluated a systematic, coordinated approach to falls management that included a falls risk assessment tool and falls care plan in the acute care setting. Although a significant reduction in falls was found in this study, it could not be attributed to any specific interventions.

Relevance to clinical practice: Preventing falls where possible is essential. Assessment of risk and use of appropriate interventions can reduce the incidence of falls.