The prevalence and impact of low back pain in pre-professional and professional dancers: a prospective study

Objectives To determine the prevalence of low back pain (LBP) in pre-professional and professional dancers and its impact on dance participation, care-seeking and medication use. Design Prospective cohort study. Setting One pre-professional ballet school, two pre-professional university dance programs, and a professional ballet company. Participants Male and female classical ballet and contemporary dancers. Main outcome measures An initial questionnaire collected demographic and LBP history data. The monthly prevalence of LBP (all episodes, activity limiting episodes and chronic LBP) and impact (activity limitation, care-seeking, and medication use) was collected over a nine-month period. Results 119 dancers participated, which represented 54% of those invited. Activity limiting LBP was reported by 52% of dancers, while chronic LBP was reported by 24%. Seventeen percent of all episodes of LBP resulted in some form of dance activity being completely missed. One-third of the sample reported care-seeking and one-fifth of the sample used medication. A history of LBP was associated with activity limiting LBP (p < 0.01; adjusted odds ratio: 3.98; 95% confidence interval: 1.44, 11.00). Conclusions LBP in dancers was common and had multiple impacts. This study reinforces the need for dancer access to healthcare professionals with expertise in evidence-based LBP prevention and management

Multi-segment spine kinematics: Relationship with dance training and low back pain

Background: Spine posture, range of motion (ROM) and movement asymmetry can contribute to low back pain (LBP). These variables may have greater impact in populations required to perform repetitive spine movements, such as dancers; however, there is limited evidence to support this. Research question: What is the influence of dance and LBP on spinal kinematics? Methods: In this cross-sectional study, multi-segment spinal kinematics were examined in 60 female participants, including dancers (n = 21) and non-dancers (n = 39) with LBP (n = 33) and without LBP (n = 27). A nine-camera motion analysis system sampling at 100 Hz was used to assess standing posture, as well as ROM and movement asymmetry for side bend and trunk rotation tasks. A two-way ANOVA was performed for each of the outcome variables to detect any differences between dancers and non-dancers, or individuals with and without LBP. Results: Compared to non-dancers, dancers displayed a flatter upper lumbar angle when standing (p  0.05) or movement asymmetry (p > 0.05). There was no main effect for LBP symptoms on any kinematic measures, and no interaction effect for dance group and LBP on spinal kinematics (p > 0.05). Significance: Female dancers displayed a flatter spine posture and increased spine ROM compared to non-dancers for a select number of spine segments and movement tasks. However, the overall number of differences was small, and no relationship was observed between LBP and spinal kinematics. This suggests that these simple, static posture, ROM, and asymmetry measures often used in clinical practice can provide only limited generalisable information about the impact of dance or LBP on spinal kinematics

Incidence, Costs and Predictors of Non-Union, Delayed Union and Mal-Union Following Long Bone Fracture

Fracture healing complications are common and result in significant healthcare burden. The aim of this study was to determine the rate, costs and predictors of two-year readmission for surgical management of healing complications (delayed, mal, non-union) following fracture of the humerus, tibia or femur. Humeral, tibial and femoral (excluding proximal) fractures registered by the Victorian Orthopaedic Trauma Outcomes Registry over five years (n = 3962) were linked with population-level hospital admissions data to identify two-year readmissions for delayed, mal or non-union. Study outcomes included hospital length-of-stay (LOS) and inpatient costs. Multivariable logistic regression was used to determine demographic and injury-related factors associated with admission for fracture healing complications. Of the 3886 patients linked, 8.1% were readmitted for healing complications within two years post-fracture, with non-union the most common complication and higher rates for femoral and tibial shaft fractures. Admissions for fracture healing complications incurred total costs of $4.9 million AUD, with a median LOS of two days. After adjusting for confounders, patients had higher odds of developing complications if they were older, receiving compensation or had tibial or femoral shaft fractures. Patients who are older, with tibial and femoral shaft fractures should be targeted for future research aimed at preventing complications

Coding OSICS sports injury diagnoses in epidemiological studies : Does the background of the coder matter?

Objective: To compare Orchard Sports Injury Classification System (OSICS-10) sports medicine diagnoses assigned by a clinical and non-clinical coder. Design: Assessment of intercoder agreement. Setting: Community Australian football. Participants: 1082 standardised injury surveillance records. Main outcome measurements: Direct comparison of the four-character hierarchical OSICS-10 codes assigned by two independent coders (a sports physician and an epidemiologist). Adjudication by a third coder (biomechanist). Results: The coders agreed on the first character 95% of the time and on the first two characters 86% of the time. They assigned the same four-digit OSICS-10 code for only 46% of the 1082 injuries. The majority of disagreements occurred for the third character; 85% were because one coder assigned a non-specific 'X' code. The sports physician code was deemed correct in 53% of cases and the epidemiologist in 44%. Reasons for disagreement included the physician not using all of the collected information and the epidemiologist lacking specific anatomical knowledge. Conclusions: Sports injury research requires accurate identification and classification of specific injuries and this study found an overall high level of agreement in coding according to OSICS-10. The fact that the majority of the disagreements occurred for the third OSICS character highlights the fact that increasing complexity and diagnostic specificity in injury coding can result in a loss of reliability and demands a high level of anatomical knowledge. Injury report form details need to reflect this level of complexity and data management teams need to include a broad range of expertise. Copyright Article author (or their employer) 2012

Determinants of Sports Injury in Young Female Swedish Competitive Figure Skaters

Introduction: Although figure skating attracts several hundred thousand participants worldwide, there is little knowledge about physical health and sports injuries among young skaters. The present study aimed to describe the health status of a geographically defined Swedish population of licensed competitive figure skaters and to examine injury determinants.Methods: All licensed competitive skaters in the southeastern region of Sweden were in April 2019 invited to participate in a cross-sectional study using an online questionnaire. Multiple binary logistic regression was used for the examination of injury determinants. The primary outcome measure was the 1-year prevalence of a severe sports injury episode (time loss &gt;21 days). The secondary outcome measure was the point prevalence of an ongoing injury. The determinants analyzed were age, skating level, relative energy deficiency indicators, and training habits.Results: In total, 142 (36%) skaters participated, 137 (96%) girls [mean (SD) age: 12.9 (SD 3.0) years]. Participating boys (n = 5) were excluded from further analysis. The 1-year prevalence of a severe sports injury episode was 31%. The most common injury locations for these injuries were the knee (25%), ankle (20%), and hip/groin (15%). In the multiple model, having sustained a severe injury episode was associated with older age (OR 1.2, 95% CI 1.1–1.4; p = 0.002) and an increased number of skipped meals per week (OR 1.1, 95% CI 1.0–1.3; p = 0.014). The point prevalence of an ongoing injury episode was 19%. The most common locations were the knee (24%), ankle (24%), and foot (24%). Having an ongoing injury episode was associated with older age (OR 1.4, 95% CI 1.2–1.7; p &lt; 0.001) and an increased number of skipped meals per week (OR 1.1, 95% CI 1.0–1.3; p = 0.049).Conclusion: One-third of young female Swedish competitive figure skaters had sustained a severe injury episode during the past year, and a fifth reported an ongoing episode. Older age and an increased number of skipped meals per week were associated with a sports injury episode. Long-term monotonous physical loads with increasing intensity and insufficient energy intake appear to predispose for injury in young female figure skaters. Further examination of injury determinants among competitive figure skaters is highly warranted

Agreement and validity of observational risk screening guidelines in evaluating ACL injury risk factors

Study Design: Methodological study. Objectives: To examine the agreement and validity of using observational risk screening guidelines to evaluate ACL injury risk factors. Background: Post-pubescent females have an increased risk of anterior cruciate ligament (ACL) injury compared with their male counterparts partly due to their high-risk landing and cutting strategies. There are currently no scientifically-tested methods to screen for these high risk strategies in the clinic or on the field. Methods and Measures: Three physiotherapists used observational risk screening guidelines to rate the neuromuscular characteristics of 40 adolescent female soccer players. Drop jumps were rated as high risk or low risk based on the degree of knee abduction. Side hops and side cuts were rated on the degree of lower limb 'reaching'. Ratings were evaluated for intrarater and interrater agreement using kappa coefficients. 3D motion analysis was used as a gold standard for determining the validity of ratings. Results: Acceptable intrarater and interrater agreement (k≥0.61) were attained for the drop jump and the side hop, with kappa coefficients ranging from 0.64 to 0.94. Acceptable sensitivity (≥0.80) was attained for the side hop and the side cut, with values ranging from 0.88 to 1.00. Acceptable specificity (≥0.50) was attained for the drop jump, with values ranging from 0.64 to 0.72. Conclusion: Observational risk screening is a practical and cost-effective method of screening for ACL injury risk. Based on levels of agreement and sensitivity, the side hop appears to be a suitable screening task. Agreement was acceptable for the drop jump but its validity needs further investigation.Medicine, Faculty ofGraduat

Implementation and evaluation of a club-based injury surveillance system within a community sport setting

Despite a high frequency of injuries, there is no systematic injury data collection within Australian community sport. Most epidemiological data on sports injuries have been collected on professional and elite athletes and have limited relevance to community-level sporting populations. As a result, it has been difficult to develop effective injury prevention strategies for community sport settings. There is potential for injury surveillance systems based within community sports clubs to address this knowledge gap; however, there is a need to better understand the contextual challenges presented by community sport settings for conducting injury surveillance. It is also necessary to determine whether club-based personnel, such as sports trainers, are capable of recording accurate injury data. To focus the scope of this investigation, the research was conducted within the context of adult community-level Australian football. Community-level Australian football has a large participant base in Australia, a high frequency of injuries and a relatively well-organised approach to first-aid staffing. This setting therefore provided an ideal context for implementing and evaluating an injury surveillance system within community sport in order to determine its feasibility at a broader level. Data collection was carried out over the 2012 and 2013 football seasons, during which clubs from five community-level Australian football leagues used an online injury surveillance system, Sports Injury Tracker, to record their players’ injuries. The degree of system implementation was evaluated using the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation and Maintenance). Semi-structured interviews of club-based personnel were used to gather qualitative information about the facilitators and barriers to the implementation of the system. Concurrently collected self-reported injury data obtained from players via short message service (SMS) were used to validate the club-based surveillance data. Finally, injury data recorded by club personnel over both 2012 and 2013 football seasons were pooled to determine the consistency of these data with previous studies in community-level Australian football. The research identified a range of barriers to implementing injury surveillance systems in community sport settings, including doubt about the importance of such endeavours, a shortage of time to record data amongst club personnel and a lack of organisational leadership. Data quality evaluations showed that while the profile of injuries was consistent with self-reported injury data and with previous studies in community-level Australian football, reported injury frequencies and rates were highly variable between clubs and, overall, lower than expected for this population. Club-based injury surveillance has the potential to provide important information about the types of injuries that occur in community sport and so could help inform injury prevention priorities. However, at present, recorded injury data have limited capacity to accurately estimate the public health burden of community sports injuries or to evaluate the effectiveness of injury prevention programs. Based on this knowledge, a range of recommendations has been made to improve the future implementation and quality of injury surveillance systems in community sport settings

Implementation and evaluation of a club-based injury surveillance system within a community sport setting

Despite a high frequency of injuries, there is no systematic injury data collection within Australian community sport. Most epidemiological data on sports injuries have been collected on professional and elite athletes and have limited relevance to community-level sporting populations. As a result, it has been difficult to develop effective injury prevention strategies for community sport settings. There is potential for injury surveillance systems based within community sports clubs to address this knowledge gap; however, there is a need to better understand the contextual challenges presented by community sport settings for conducting injury surveillance. It is also necessary to determine whether club-based personnel, such as sports trainers, are capable of recording accurate injury data. To focus the scope of this investigation, the research was conducted within the context of adult community-level Australian football. Community-level Australian football has a large participant base in Australia, a high frequency of injuries and a relatively well-organised approach to first-aid staffing. This setting therefore provided an ideal context for implementing and evaluating an injury surveillance system within community sport in order to determine its feasibility at a broader level. Data collection was carried out over the 2012 and 2013 football seasons, during which clubs from five community-level Australian football leagues used an online injury surveillance system, Sports Injury Tracker, to record their players’ injuries. The degree of system implementation was evaluated using the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation and Maintenance). Semi-structured interviews of club-based personnel were used to gather qualitative information about the facilitators and barriers to the implementation of the system. Concurrently collected self-reported injury data obtained from players via short message service (SMS) were used to validate the club-based surveillance data. Finally, injury data recorded by club personnel over both 2012 and 2013 football seasons were pooled to determine the consistency of these data with previous studies in community-level Australian football. The research identified a range of barriers to implementing injury surveillance systems in community sport settings, including doubt about the importance of such endeavours, a shortage of time to record data amongst club personnel and a lack of organisational leadership. Data quality evaluations showed that while the profile of injuries was consistent with self-reported injury data and with previous studies in community-level Australian football, reported injury frequencies and rates were highly variable between clubs and, overall, lower than expected for this population. Club-based injury surveillance has the potential to provide important information about the types of injuries that occur in community sport and so could help inform injury prevention priorities. However, at present, recorded injury data have limited capacity to accurately estimate the public health burden of community sports injuries or to evaluate the effectiveness of injury prevention programs. Based on this knowledge, a range of recommendations has been made to improve the future implementation and quality of injury surveillance systems in community sport settings

Medical-attention injuries in community Australian football: A review of 30 years of surveillance data from treatment-sources

Introduction: Australian football (AF) consistently outranks other team sports in the frequency of hospitalisations and emergency department (ED) presentations for sports injury treatment. Understanding the profile of these and other ‘medical-attention’ injuries is important for developing preventative strategies and thereby reducing the health-care burden resulting from AF injuries. Currently, hospital and ED surveillance systems provide the only ongoing source of epidemiological data on community sports injuries at the population level. The purpose of this review was to describe the frequency and profile of medical-attention injuries resulting from AF reported in hospital, ED and other treatment-source datasets

Injury reporting via SMS text messaging in community sport

Background: The use of text messaging or short message service (SMS) for injury reporting is a recent innovation in sport and has not yet been trialled at the community level. Considering the lack of personnel and resources in community sport, SMS may represent a viable option for ongoing injury surveillance. The aim of this study was to evaluate the feasibility of injury self-reporting via SMS in community Australian football. Methods: A total of 4 clubs were randomly selected from a possible 22 men's community Australian football clubs. Consenting players received an SMS after each football round game asking whether they had been injured in the preceding week. Outcome variables included the number of SMS-reported injuries, players’ response rates and response time. Poisson regression was used to evaluate any change in response rate over the season and the association between response rate and the number of reported injuries. Results: The sample of 139 football players reported 167 injuries via SMS over the course of the season. The total response rate ranged from 90% to 98%. Of those participants who replied on the same day, 47% replied within 5 min. The number of reported injuries decreased as the season progressed but this was not significantly associated with a change in the response rate. Conclusions: The number of injuries reported via SMS was consistent with previous studies in community Australian football. Injury reporting via SMS yielded a high response rate and fast response time and should be considered a viable injury reporting method for community sports settings