Injury Prevention Screening and Programs Flashcards
What is worth considering when viewing injury data?
Injury skewed by participation rates.
Summarise the role of a physiotherapist in injury reduction and prevention?
- Identify and reduce risk: screening for risk and programs
- Prevention program: warm-up, training
- Equipment
- Rule changes
What is risk, absolute risk and relative risk?
- Risk = severity x incidence
- Absolute risk: risk of something happening in a certain time
- Relative risk: risk in two different groups of people
What is the hazard ratio?
Measure of an effect of intervention on an outcome of interest over time
- Hazard (intervention)/ Hazard (control)
What is the process to finding the risk for your athlete?
- identify sport and type of player
- Search literature (high quality) - age, sex, playing level
- If nothing, search texts and articles relating to that sport and player type
- Find papers on similar sports
- Sit and think it through
What are the challenges in researching risk factors for injury?
- Some injuries of study quality
- Hard to recruit participant numbers
- Much of research skewed to elite athletes and males
- May use equipment or resources not readily available
- Do not always find useful predictors
What are intrinsic risks to athletes?
o Biomechanics o Technique o Previous injury o Anatomy o Fitness
What are extrinsic risks to athletes?
o Other players
o Environmental
o Rules
What are some environmental risks?
• Terrain o Field of play quality – private/public o Time of year (field hardness) o Type of turf • Lighting of venue • Timing of event o Early morning vs later start o Summer vs winter • Type of event o Duration and intensity of the event
What do you need to plan for to manage risks?
o Plan rests
o Water/electrolyte/snack stations
o Player briefings
o Heightened vigilance and medical staff briefing of risk, necessary supplies
What are some questions/considerations about screening protocols?
o Does it align with known injury rates/types?
o What are the relative risk factors for that sport?
o Are the tests reliable and valid for your population?
o Is there evidence for the predictive value of the risk factor/ finding on screening
o Decide if you agree that the test/outcome is important
What are limitations of screening?
- Risk factors only identify those who are higher risk => no definite outcomes
- Many risk are unforeseeable or cannot be screened
- Many risk can be identified but not changed
What are strategies/training types that make up prevention programs?
o Neuromuscular training
o Warm-up programs
o Functional movement screen related
o Stretching programs
What is neuromuscular training?
o General (fundamental movements) and o Specific S&C such as resistance, dynamic stability, balance, core strength, plyometric, and agility exercises
Recall injury prevention statistics for Fifa 11+
Females 13-17 year old Norewegian atheltes (Soligard et al 2010)
o Higher compliance had 35% lower risk of all injuries
Amateur male soccer players Switzerland (Junge et al, 2010)
o Teams that used the program had 11.5% lower risk of match injuries; 23.5% risk of training injuries; non-contact injuries were particularly reduced
Male 14-19 year old Nigerian athletes (Owoeye et al 2014)
o 40% reduction in injuries
SR including 6344 players – 30% injury reduction rate (Sadigursky et al 2018)
What was the impact of 11+ kids vs regular warm-up
• 11+ Kids program reduced healthcare costs by 51% and was dominant (i.e. the INT group had lower costs and a lower injury risk) compared with a usual warmup
Why do we tape?
o Prevention of injury/further injury
o Injury rehabilitation
o Player preference
What is the evidence for rigid taping on ankle sprains
o Overall taping, bracing and neuromuscular training were all effective for prevention of ankle-sprain recurrences
What is the evidence for bracing for injury prevention?
• Moderate evidence for prophylactic ankle braces adolescents in football and basketball
o Farwell et al 2013
What is the process to changing a rule to prevent injury?
- Complete injury rate surveillance to understand rates and severity of injuries
- Look into/observe predictive variables
- Recommendations to governing bodies
- Trial of new rules
- Implementation of new rules
- Repeat injury rate surveillance
