Search

Rugby union has a high incidence of match injuries. However, there is limited information regarding the incidence and characteristics of match injuries in male amateur players. In particular, there is a lack of information regarding injury rates per match quarter. Investigating this may inform injury prevention strategies. The aim is to determine whether the rate and characteristics of injury vary with match quarter in male amateur rugby union players, regardless of whether the injury resulted in time loss from play. This prospective cohort study recorded and examined the number and characteristics of injuries during match quarters across a season of amateur rugby union. Team match exposure was recorded. Injuries were recorded by a team physiotherapist consistent with Rugby Injury Consensus Group guidelines. Matches were divided into quarters for data analysis, and statistical significance was determined using Chi-square analysis. 127 players sustained 207 injuries across 18 games. The injury incidence was 164 injuries/1000 match hours. There was a significant (p < .001) difference in the number of injuries between match quarters, with the greatest number in the fourth, followed by the second, third, and first quarter. Forwards had a statistically significant higher rate of injury between quarters. Injury incidence in amateur rugby is higher than previously reported. Injury rates in amateur male rugby increase at the end of each match half, peaking in the fourth quarter. These findings contribute to the understanding of the aetiology of injury in amateur rugby union. [ABSTRACT FROM AUTHOR]

Background. The ulnar nerve upper limb neurodynamic test (ULNT3) uses upper limb positioning to investigate symptoms arising from the ulnar nerve. It is proposed to selectively increase tension of the nerve; however, this property of the test is not well established. Objective. The aim of this study was to determine the upper limb position that results in: (1) the greatest tension of the ulnar nerve and (2) the greatest difference in tension between the ulnar nerve and the other 2 major nerves of the upper limb: median and radial. Design. This was an observational cadaver study. Methods. Tension (in newtons) of the ulnar, median, and radial nerves was measured simultaneously using 3 buckle force transducers in 5 upper limb positions in 10 embalmed human cadavers (N=20 limbs). Repeated-measures analysis of variance (ANOVA) with Bonferroni post hoc tests determined differences in tension among nerves and among limb positions. Results. The addition of shoulder horizontal abduction (H.Abd; 12.62 N; 95% confidence interval [95% Cl] = 10.76, 14.47) and combined shoulder abduction and internal rotation (H.Abd + IR; 11.86 N; 95% CI=9.96, 13-77) to ULNT3 (scapular depression, shoulder abduction and external rotation, elbow flexion, forearm pro nation, and wrist and finger extension) produced significantly greater ulnar nerve tension compared with the ULNT3 alone (8.71 N; 95% CI=7.25, 10.17). The ULNT3+H.Abd test demonstrated the greatest difference in tension among nerves (mean difference between ulnar and median nerves= 11.87 N; 95% CI=9.80, 13.92; mean difference between ulnar and radial nerves=8.47 N; 95% CI=6.4l, 10.53). Limitations. These results pertain only to the biomechanical plausibility of the ulnar nerve neurodynamic test and do not account for other factors that may affect the clinical application of this test. Conclusions. The ULNT3 +H.Abd is a biomechanically plausible test for detecting peripheral neuropathic pain related to the ulnar nerve. In situations where the shoulder complex will not tolerate the combination of shoulder external rotation in abduction, performing upper limb neurodynamic tests with internal rotation instead of external rotation is a biomechanically plausible alternative. [ABSTRACT FROM AUTHOR]

Objectives: To develop a physiotherapist-led consensus statement on the definition and provision of high-value care for people with musculoskeletal conditions., Design: We performed a three-stage study using Research And Development/University of California Los Angeles Appropriateness Method methodology. We reviewed evidence about current definitions through a rapid literature review and then performed a survey and interviews with network members to gather consensus. Consensus was finalised in a face-to-face meeting., Setting: Australian primary care., Participants: Registered physiotherapists who are members of a practice-based research network (n=31)., Results: The rapid review revealed two definitions, four domains of high value care and seven themes of high-quality care. Online survey responses (n=26) and interviews (n=9) generated two additional high-quality care themes, a definition of low-value care, and 21 statements on the application of high value care. Consensus was reached for three working definitions (high value, high-quality and low value care), a final model of four high value care domains (high-quality care, patient values, cost-effectiveness, reducing waste), nine high-quality care themes and 15 statements on application., Conclusion: High value care for musculoskeletal conditions delivers most value for the patient, and the clinical benefits outweigh the costs to the individual or system providing the care. High-quality care is evidence based, effective and safe care that is patient-centred, consistent, accountable, timely, equitable and allows easy interaction with healthcare providers and healthcare systems., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)