Search

Purpose: To investigate the association between player wellness and injury in elite junior Australian football players over 1 competitive season. Methods: Prospective cohort study. Elite junior Australian football players (N = 196, average age = 17.7 y, range = 16–18 y) were recruited in the under-18 state league competition in Victoria, Australia. They recorded their wellness (sleep, fatigue, soreness, stress, and mood) according to a 5-point Likert scale 3 times weekly, with injuries (missed match/training session) entered into an online sport-injury surveillance system. A logistic generalized estimating equation was used to examine the association (expressed as odds ratio [OR]) between wellness and injury (yes/no). Results: Soreness was associated with injury at each time point across the week, with the strongest association evident for soreness reported 6 d postmatch (OR = 1.30; 95% confidence interval [CI], 1.17–1.44; P <.001). Stress and injury were associated with injury for average stress values across the week, as well as specifically on day 1 postmatch (OR = 1.10; 95% CI, 1.01–1.21; P =.038). Mood reported in the middle of the week (3 d postmatch) was associated with injury (OR = 0.87; 95% CI, 0.78–0.97; P =.014), as was fatigue (OR = 1.10; 95% CI, 1.00–1.22; P =.044). Conclusions: This study demonstrates key associations between wellness and injury in elite junior Australian football, specifically soreness, stress, fatigue, and mood. Monitoring strategies help identify injury-risk profiles, which can help decision makers (coaches or medical staff) intervene when relevant to reduce injury risk. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the association between training and match loads and injury in elite junior Australian football players over 1 competitive season. Methods: Elite junior Australian football players (n = 290, age 17.7 [0.3] y, range 16–18 y) were recruited from the under-18 state league competition in Victoria to report load and injury information. One-week load (session rating of perceived exertion multiplied by duration) and all time-loss injuries were reported using an online sport-injury surveillance system. Absolute load measures (weekly sums) enabled the calculation of relative measures such as the acute:chronic workload ratio. Load measures were modeled against injury outcome (yes/no) using a generalized estimating equation approach, with a 1-wk lag for injury. Results: Low (<300 arbitrary units [au]) and high (>4650 au) 1-wk loads were associated with significantly higher risk of injury. Furthermore, low (<100 au) and high (>850 au) session loads were associated with a higher risk of injury. High strain values (>13,000) were associated with up to a 5-fold increase in the odds of injury. There was a relatively flat-line association between the acute:chronic workload ratio and injury. Conclusions: This study is the first investigation of elite junior athletes demonstrating linear and nonlinear relationships between absolute and relative load measures and injury. Coaches should focus player loads on, or at least close to, the point at which injury risk starts to increase again (2214 au for 1-wk load and 458 au for session load) and use evidence-based strategies across the week and month to help reduce the risk of injury. [ABSTRACT FROM AUTHOR]

Background: Elite junior Australian football players experience high training loads across levels of competition and training. This, in conjunction with impaired wellness, can predispose athletes to injury. Hypothesis: Elite junior Australian football players exposed to high loads with poor wellness are more likely to be at risk of injury than those with improved wellness. Study Design: Longitudinal prospective cohort study. Level of Evidence: Level 3. Methods: Data were collected and analyzed from 280 players across the 2014 season. Internal load was measured via session rating of perceived exertion. Player wellness was reported according to ratings of sleep quality, fatigue, soreness, stress, and mood. Week- and month-based training load measures were calculated, representing a combination of absolute and relative load variables. Principal component analysis factor loadings, based on 17 load and wellness variables, were used to calculate summed variable covariates. Injury was defined as "any injury leading to a missed training session or competitive match." Associations between covariates and injury risk (yes/no) were determined via logistic generalized estimating equations. Results: A significant interaction term between load and wellness on injury was found [odds ratio (OR) 0.76; 95% CI 0.62-0.92; P < 0.01), indicating that wellness acts as a "dimmer switch" of load on injury. Further, there was evidence of moderated mediation (OR 0.71; 95% CI 0.57-0.87; P < 0.01). When wellness was low, injury risk started to increase substantially at a 1-week load of 3250 au. Conclusions: Subjective measures of training load are associated with injury risk through a nonlinear relationship. This relationship is further influenced by player wellness, which can amplify the risk of injury. There is evidence that higher stress is linked with injury and that soreness and sleep mediate any stress-injury relationship. Clinical Relevance: Coaching efforts to manage training load and player adaptive responses, including wellness, may reduce the risk of injury, with stress, soreness, and sleep particularly relevant at this level. [ABSTRACT FROM AUTHOR]

Purpose: To investigate associations between load (training and competition) and wellness in elite junior Australian Football players across l competitive season. Methods: A prospective cohort study was conducted during the 2014 playing season in 562 players from 9 teams. Players recorded their training and match intensities according to the session-rating-of-perceivedexertion (sRPE) method. Based on sRPE player loads, a number of load variables were quantified, including cumulative load and the change in load across different periods of time (including the acute-to-chronic load ratio). Wellness was quantified using a wellness index including sleep, fatigue, soreness, stress, and mood on a Likert scale from 1 to 5. Results: Players spent an average of 85 (21) min in each match and 65 (31) min per training session. Average match loads were 637 (232) arbitrary units, and average training loads were 352 (233) arbitrary units. Over the 24 wk of the 2014 season, overall wellness had a significant linear negative association with 1-wk load (B = -0.152; 95% confidence interval, -0.261 to -0.043; P = .006) and an inverse (U-curve relationship with session load (B = -0.078; 95% confidence interval, 0.143 to 0.014; P = .018). Mood, stress, and soreness were all found to have associations with load. Conclusions: This study demonstrates that load (within a session and across the week) is important in managing the wellness of elite junior Australian Football players. Quantifying loads and wellness at this level will help optimize player management and has the potential to reduce the risk of adverse events such as injury. [ABSTRACT FROM AUTHOR]

Abstract Background To determine factors predicting the duration of time away from work following acute orthopaedic non life threatening trauma Methods Prospective cohort study conducted at four hospitals in Victoria, Australia. The cohort comprised 168 patients aged 18-64 years who were working prior to the injury and sustained a range of acute unintentional orthopaedic injuries resulting in hospitalization. Baseline data was obtained by survey and medical record review. Multivariate Cox proportional hazards regression analysis was used to examine the association between potential predictors and the duration of time away from work during the six month study. The study achieved 89% follow-up. Results Of the 168 participants recruited to the study, 68% returned to work during the six month study. Multivariate Cox proportional hazards regression analysis identified that blue collar work, negative pain attitudes with respect to work, high initial pain intensity, injury severity, older age, initial need for surgery, the presence of co-morbid health conditions at study entry and an orthopaedic injury to more than one region were associated with extended duration away from work following the injury. Participants in receipt of compensation who reported high social functioning at two weeks were 2.58 times more likely to have returned to work than similar participants reporting low social functioning. When only those who had returned to work were considered, the participant reported reason for return to work " to fill the day" was a significant predictor of earlier RTW [RR 2.41 (95% C.I 1.35-4.30)] whereas "financial security" and "because they felt able to" did not achieve significance. Conclusions Many injury-related and psycho social factors affect the duration of time away from work following orthopaedic injury. Some of these are potentially modifiable and may be amenable to intervention. Further consideration of the reasons provided by participants for returning to work may provide important opportunities for social marketing approaches designed to alleviate the financial and social burden associated with work disability.

Abstract: The study quantifies the association between a range of bio-psychosocial factors and the presence of persistent pain, pain severity and pain interfering with normal work activities in a cohort of 168 patients with a range of non-life-threatening orthopaedic injuries. Participants were recruited following presentation to 1 of 4 Victoria hospitals for treatment for their injury and followed until 6 months postinjury. Multivariate analysis was employed to determine factors associated with pain outcomes, 6 months postinjury. The prevalence of pain was common; 54% of participants reported the presence of persistent pain at 6 months, with the majority (87%) reporting that pain interfered to an extent with their normal work activities. High initial pain, external attributions of responsibility for the injury, and psychological distress were found to be significant independent predictors of the presence of all 3 outcomes. In addition, poor recovery expectations was found to be a significant predictor of pain-related work disability and being injured at work a significant predictor of pain severity. Many of these factors are potentially modifiable and should alert the clinician about the need for interventions in order to prevent the development of pain chronicity. Perspective: This study has quantified determinants of pain, 6 months after non-life-threatening acute orthopaedic trauma. Psychosocial factors strongly predicted persistent pain, pain-related work disability, and pain severity. These findings may assist clinicians to determine the need for, and likely effectiveness of, individual pain-management approaches in this population. [Copyright &y& Elsevier]

Background: To determine factors predicting the duration of time away from work following acute orthopaedic non life threatening trauma Methods: Prospective cohort study conducted at four hospitals in Victoria, Australia. The cohort comprised 168 patients aged 18-64 years who were working prior to the injury and sustained a range of acute unintentional orthopaedic injuries resulting in hospitalization. Baseline data was obtained by survey and medical record review. Multivariate Cox proportional hazards regression analysis was used to examine the association between potential predictors and the duration of time away from work during the six month study. The study achieved 89% follow-up. Results: Of the 168 participants recruited to the study, 68% returned to work during the six month study. Multivariate Cox proportional hazards regression analysis identified that blue collar work, negative pain attitudes with respect to work, high initial pain intensity, injury severity, older age, initial need for surgery, the presence of co-morbid health conditions at study entry and an orthopaedic injury to more than one region were associated with extended duration away from work following the injury. Participants in receipt of compensation who reported high social functioning at two weeks were 2.58 times more likely to have returned to work than similar participants reporting low social functioning. When only those who had returned to work were considered, the participant reported reason for return to work "to fill the day" was a significant predictor of earlier RTW [RR 2.41 (95% C.I 1.35- 4.30)] whereas "financial security" and "because they felt able to" did not achieve significance. Conclusions: Many injury-related and psycho social factors affect the duration of time away from work following orthopaedic injury. Some of these are potentially modifiable and may be amenable to intervention. Further consideration of the reasons provided by participants for returning to work may provide important opportunities for social marketing approaches designed to alleviate the financial and social burden associated with work disability. [ABSTRACT FROM AUTHOR]

Consumer crash test programs provide comparative information on the crashworthiness of new vehicles which, in turn, should predict the performance of the same vehicles in real-world crashes. However, the detail and quality of available information from tests and real-world crashes differ widely, so identifying meaningful relationships between crash test results and real-world crashworthiness can be difficult. Despite these data limitations, studies in the late 1980s and mid-1990s reported positive correlations between dummy injury measures from the U.S. New Car Assessment Program (USNCAP) and real-world fatality rates. More recent analyses of results from Australian crash tests and real-world crashes also have found positive correlations. This article considers relationships between recent U.S. frontal crash test results from the Insurance Institute for Highway Safety (IIHS) and USNCAP, and real-world crash injury risk estimates computed from police-reported crash data from three U.S. states. The frontal crash test results include dummy injury measures by body region from both IIHS offset tests and USNCAP full-width barrier tests plus measures of structural performance from the IIHS offset tests. Individually, results from the full-width and offset tests were not significantly correlated with the real-world injury risk estimates. Stronger relationships were found when a combination of overall ratings from the full-frontal and offset tests was used. However, the current results find only weak correlations between both full-front and offset frontal crash test performance and the real-world injury risk estimates. These weak relationships likely reflect the lack of detail and fundamental difference in injury information in police crash reports compared to that used in deriving crashworthiness ratings from the crash tests. [ABSTRACT FROM AUTHOR]

Objectives:Modeling crash risk in urban areas is more complicated than in rural areas due to the complexity of the environment and the difficulty obtaining data to fully characterize the road and surrounding environment. Knowledge of factors that impact crash risk and severity in urban areas can be used for countermeasure development and the design of risk assessment tools for practitioners. This research aimed to identify the characteristics of the road and roadside, surrounding environment, and sociodemographic factors associated with single-vehicle crash (SVC) frequency and severity in complex urban environments, namely, strip shopping center road segments. Methods:A comprehensive evidence-based list of data required for measuring the influence of the road, roadside, and other factors on crash risk was developed. The data included a broader range of factors than those traditionally considered in accident prediction models. One hundred and forty-two strip shopping segments located on arterial roads in metropolitan Melbourne, Australia, were identified. Police-reported casualty data were used to determine how many SVC occurred on the segments between 2005 and 2009. Data describing segment characteristics were collected from a diverse range of sources; for example, administrative government databases (traffic volume, speed limit, pavement condition, sociodemographic data, liquor licensing), detailed maps, on-line image sources, and digital images of arterial roads collected for the Victorian state road authority. Regression models for count data were used to identify factors associated with SVC frequency. Logistic regression was used to determine factors associated with serious and fatal outcomes. Results:One hundred and seventy SVC occurred on the 142 selected road segments during the 5-year study period. A range of factors including traffic exposure, road cross section (curves, presence of median), road type, requirement for sharing the road with other vehicle types (trams and bicycles), roadside poles, and local amenities were associated with SVC frequency. A different set of risk factors was associated with the odds of a crash leading to a severe outcome: segment length, road cross section (curves, carriageway width), pavement condition, local amenities and vehicle, and driver factors. The presence of curves was the only factor associated with both SVC frequency and severity. Conclusions:A range of risk factors were associated with SVC frequency and severity in complex urban areas (metropolitan shopping strips), including traditionally studied characteristics such as traffic density and road design but also less commonly studied characteristics such as local amenities. Future behavioral research is needed to further investigate how and why these factors change the risk and severity of crashes before effective countermeasures can be developed. [ABSTRACT FROM PUBLISHER]