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Introduction: Injury surveillance studies in adolescent rugby show varied injury incidence and injury risk factors, supporting further exploration in this cohort.1 Focus on the tackle as the mechanism of injury has grown, with an introduction of lower tackle height in community games.2 Objectives: Describe injury incidence, site, mechanism, and severity in senior schoolboy rugby players in Leinster, Ireland. Study design: Prospective cohort study Methods: Leinster senior schoolboy rugby players competing in the 2022-23 season were recruited. Injury recording included site, mechanism and severity following rugby injury surveillance consensus statements (3). Match frequency and training duration were recorded to calculate exposure.3 Data were collected in Kitman Lab's Athlete application. Results: 297 participants (median age 17 years (IQR:16-17), mean height 181±6 cm, median weight 80.2kg (IQR:73.1-90.1)) in nine schools provided data over 24 weeks. 73 injuries (51 match, 22 training) were reported. Match injury incidence (per 1000 player hours) was 25.8 (95% confidence interval (CI):19.2-33.9), and training injury incidence was 1.2 (95% CI:0.5-1.1). Match injury severity was a median time-loss of 27 days (95% CI:22.4-33), and a median of 18 days (95% CI:12-33) for training injuries. Most common reported match injury sites included head (n=15, 29%) and shoulder (n=11, 22%), and training injury sites were shoulder (n=6, 27%) and ankle (n=5, 23%). The tackle was the most common mechanism of injury (tackling n=19, 26%; tackled n=17, 23%). Conclusions: Match injury incidence was lower in Leinster schoolboys than a recent meta-analysis (39.76; 95% CI:10.18- 69.33), but similar to a previous season (2019-2020) in Leinster (SCRUm phase 1). Most common regions injured were similar across both phases and to other youth rugby studies (1). Similar to other studies, the tackle is the most common mechanism of injury (1). This research was funded by the Irish Rugby Football Union Charitable Trust. [ABSTRACT FROM AUTHOR]

Introduction: Management of training load (TL) including contact load, are receiving increased attention in relation to injury risk, but few studies have explored TL in adolescent rugby players and its link to injury.1 Objectives: * Monitor TL in senior schoolboy rugby players in Leinster, Ireland. * Explore relationship between TL and injury risk. Study design: Prospective cohort study Methods: Leinster senior schoolboy rugby players competing in the 2022-23 season were recruited. Injury recording followed rugby injury surveillance consensus statements.2 Training load was calculated using duration (minutes) multiplied by intensity (rate of perceived exertion) and reported as an arbitrary unit (AU) of load.1 Data were collected in Kitman Lab's Athlete application. Mean weekly TL categories included <500, 500 to <750, 750 to <1000, 1000 to <1250 and >1250 AUs. Adjusted logistic regression models, accounting for the correlation between players within schools, were used to explore potential relationships between player characteristics, training type, and TL and odds of an injury. Missing RPE data was imputed where possible, from team mean & median RPE or the previous session RPE. Results: 273 participants (mean age 17±2 years, height 181±6 cm, weight 82±13 kg) from eight schools provided data over 24 weeks. 61 players reported an injury during the season. 5614 training sessions were recorded. Adjusted logistic regression analysis revealed higher odds ratios (OR) for sustaining an injury, with mean weekly TL<500 AUs (OR:1.2, 95%CI:0.14-10.6) or higher than 750 to <1000 (OR:9.1, 95%CI:1.33-61.6), 1000 to <1250 (OR:18.2, 95%CI:1.1-294.3) and >1250 AUs (OR:63.4, 95%CI: 3.1-1288.1); in comparison to 500 to <750 AUs (reference value). Conclusions: A quadratic relationship between TL and injury was evident, with lower risk of injury associated with mean weekly 500 to <750 AUs, compared to higher or lower TL. This research was funded by the Irish Rugby Football Union Charitable Trust. [ABSTRACT FROM AUTHOR]

Abstract Background Osteoarthritis (OA) of the hip is a major cause of functional disability and reduced quality of life. Management options aim to reduce pain and improve or maintain physical functioning. Current evidence indicates that therapeutic exercise has a beneficial but short-term effect on pain and disability, with poor long-term benefit. The optimal content, duration and type of exercise are yet to be ascertained. There has been little scientific investigation into the effectiveness of manual therapy in hip OA. Only one randomized controlled trial (RCT) found greater improvements in patient-perceived improvement and physical function with manual therapy, compared to exercise therapy. Methods and design An assessor-blind multicentre RCT will be undertaken to compare the effect of a combination of manual therapy and exercise therapy, exercise therapy only, and a waiting-list control on physical function in hip OA. One hundred and fifty people with a diagnosis of hip OA will be recruited and randomly allocated to one of 3 groups: exercise therapy, exercise therapy with manual therapy and a waiting-list control. Subjects in the intervention groups will attend physiotherapy for 6–8 sessions over 8 weeks. Those in the control group will remain on the waiting list until after this time and will then be re-randomised to one of the two intervention groups. Outcome measures will include physical function (WOMAC), pain severity (numerical rating scale), patient perceived change (7-point Likert scale), quality of life (SF-36), mood (hospital anxiety and depression scale), patient satisfaction, physical activity (IPAQ) and physical measures of range of motion, 50-foot walk and repeated sit-to stand tests. Discussion This RCT will compare the effectiveness of the addition of manual therapy to exercise therapy to exercise therapy only and a waiting-list control in hip OA. A high quality methodology will be used in keeping with CONSORT guidelines. The results will contribute to the evidence base regarding the clinical efficacy for physiotherapy interventions in hip OA. Trial Registration Number: NCT00709566

PURPOSE: The aim of this study was to examine the relationship between gait analysis measures associated with crouch gait, functional health status and daily activity in ambulant cerebral palsy (CP). METHODS: Three-dimensional gait analysis was carried out on 35 ambulant participants with bilateral CP crouch gait (knee flexion at mid-stance (KFMS) ⩾ 19 0). KFMS, knee-flexion at initial contact, gait speed and step-lengths were extracted for analysis. Steps/day and sedentary time/day were assessed using an ActivPAL accelerometer. Functional health status was assessed using the five relevant domains of the Pediatric Outcomes Data Collection Instrument (PODCI) questionnaire. Associations between variables were assessed with correlation coefficients and multivariable linear regression. RESULTS: There were no significant correlations between KFMS and PODCI domains (ρ = - 0.008–0.110) or daily activity (ρ = - 0.297–0.237) variables. In contrast, multivariable analysis found that step-length was independently associated with the Sports and Physical Function (p = 0.030), Transfers and Basic Mobility (p = 0.041) and Global Function (< 0.001) domains of the PODCI assessment. Gait speed was independently associated with mean steps/day (p < 0.001). CONCLUSIONS: Step length and gait speed are more strongly associated with functional health status and daily activity than knee flexion during stance in children and adolescents with CP crouch gait. [ABSTRACT FROM AUTHOR]

Aim Method Results Interpretation To identify, describe, and synthesize available evidence on the longitudinal relationship between hip displacement and hip function, using the International Classification of Functioning, Disability and Health (ICF) framework, in children and adolescents with cerebral palsy (CP) aged up to 18 years.Five databases were searched systematically from inception to May 2022. Study and sample characteristics, and hip displacement and hip function measures, mapped to the ICF domains, were extracted for narrative synthesis.Twenty‐nine studies were included: four longitudinal registry‐based studies; 12 prospective studies; 12 retrospective studies; and one randomized controlled trial. Sample size ranged from 11 to 267. Twenty‐seven (93%) studies entailed an intervention: surgery (n = 16); rehabilitation (n = 2); nerve block or botulinum neurotoxin A injection (n = 4); and combined surgery and injection (n = 2). Twenty‐six studies (90%) reported outcomes at the body structure and function and impairment domain of the ICF; 17 (59%) reported outcomes in the activity domain; and three (10%) included participation measures. The most common hip displacement measure was Reimers' migration percentage (79%).Because of the inclusion of interventions in most studies, and the preponderance of retrospective studies, the relationship between hip displacement and hip function in CP is unclear. More high‐quality prospective evidence on the natural history of hip displacement, and its effect on function, is needed to improve population‐wide screening of children with CP. [ABSTRACT FROM AUTHOR]

AimIntegrated multidisciplinary primary healthcare is still in a relatively early stage of development in Ireland, with significant restructuring occurring in the past decade. Musculoskeletal physiotherapy services traditionally provided in acute hospital settings have been relocated into the primary care setting where the physiotherapist works as part of the multidisciplinary team. This study aimed to explore physiotherapy managers’ experiences of managing musculoskeletal physiotherapy services in primary care to gain an insight into the opportunities and challenges in service delivery, changing roles and ongoing professional development needs of staff.ParticipantsQualitative design using semi-structured interviews with primary care physiotherapy managers in the Republic of Ireland was employed.ResultsFive interviews took in a mix of rural and urban areas nationally. The relationship with the GP was an important one in musculoskeletal physiotherapy services in primary care. Physiotherapists were well skilled but opportunities for professional and career development were restricted. Methods of optimising resources in the face of staffing restrictions were identified. Whilst there were many examples of innovations in service delivery, various barriers negatively impacted on optimal service including resource constraints and national strategy.ConclusionsA number of factors that impact on musculoskeletal service delivery in primary care from the perspective of physiotherapy managers were identified in this study. Future research should explore the views of other stakeholders to provide a more thorough understanding of the relevant issues affecting musculoskeletal physiotherapy service provision in primary care in Ireland. [ABSTRACT FROM PUBLISHER]