A cross sectional survey of international horse-racing authorities on injury data collection and reporting practices for professional jockeys

Jockey injuries are common in professional horse-racing and can result in life-threatening or career-ending outcomes. Robust injury data are essential to understand the circumstances of injury occurrence and ultimately identify prevention opportunities. This study aimed to identify jockey injury surveillance practices of international horse-racing authorities (HRAs) and the specific data items collected and reported by each HRA. A cross-sectional survey of representatives (e.g. Chief Medical Officer) from international HRAs was conducted. An online and paper questionnaire was designed comprised of 32 questions. Questions considered the barriers and facilitators to data collection within each HRA, and where available, what data were collected and reported by HRAs. Representatives from 15 international racing jurisdictions were included, of which 12 reported collection of race day injuries or falls, using varied definitions of medical attention and time loss. Six HRAs did not have a definition for a jockey injury, and eight HRAs had no parameters for describing injury severity. Race day exposure was collected by two HRAs. Results were commonly presented by HRAs as the number of injuries (n = 9/15) or proportion of injured jockeys (n = 6/15). The lack of a designated role for collection, collation and reporting of data was the main barrier for injury surveillance. Twelve HRAs agreed that mandatory collection would be a strong facilitator to improving practice. Enhancement and standardization of international jockey injury surveillance is required to move forward with evidence informed prevention. Concurrent investigation of how reporting practices can be best supported within existing HRA structures is recommended

Coach and player views towards injury prevention exercise programs in camogie: A cross sectional survey

Purpose: To identify the awareness and use of injury prevention exercise programs (IPEPs) by camogie coaches and players, compare coach and player attitudes to IPEPs, and explore the willingness and perceived ability of coaches to implement an IPEP within their teams, as reported by coaches and players. Methods: Adult camogie coaches (n = 98) and players (n = 187) completed an anonymous online survey. Three main outcome scales are presented: attitudes toward IPEPs, willingness to conduct an IPEP, and perceived ability to implement an IPEP. Frequencies and descriptive statistics were conducted with Mann-Whitney U tests used to examine differences between groups (coach vs player, men vs women, and elite vs community). Results: Overall, 34 % of coaches and 11.8 % of players were using an IPEP. Coaches (92.2 %) and players (82.9 %) would like further education on IPEPs. Coaches and players were willing to support an IPEP, but few coaches reported having sufficient knowledge (30 %), experience (22.6 %), or skills (43.1 %) to do so. Female coaches had a lower perceived ability to implement an IPEP than male coaches (P = .004). Conclusions: The uptake of IPEPs in camogie to date has been relatively unsuccessful. Coaches and players demonstrate positive attitudes and willingness to use IPEPs. To achieve a real-world reduction in injuries in this sport, a camogie IPEP should be supported with an implementation plan to improve its adoption and use

Running related Injuries of Irish runners

The popularity of recreational running continues to grow nationally. Previous international research has demonstrated a very high risk of running related injuries (RRIs) in recreational runners. These injuries pose a barrier to continued training, as well as to the physical and mental health benefits associated with running. Currently, there is a paucity of epidemiological information on Irish recreational runners. Therefore, the aim of this study is to gain an understanding of the prevalence, location, type and severity of RRI’s in recreational runners in Ireland

A prospective investigation of the association between isometric muscle strength and running related Injury among novice and recreational runners

Introduction Recreational running has many health, social and psychological benefits. However, there is a considerable risk of developing a running related injury (RRI) (1). Therefore, understanding the aetiology of these injuries, with a view to reducing the risk of their development is of paramount importance. Deficits in muscle strength is a proposed risk factor in developing RRIs, though conflicting evidence exists to support this claim (2,3). The majority of this research has been retrospective, limiting the ability to establish a causal relationship. Furthermore, many studies have had small sample sizes, low relative numbers of injured participants or employed isokinetic machines, which have practical limitations. This study aims to prospectively investigate the impact of isometric muscle strength on the likelihood of sustaining a RRI. Methods: One hundred and seventy six injury-free recreational and novice runners (66 females, 110 males, 42.5±9.2 yrs) were recruited. During a single baseline session, three measures of the maximum isometric strength, normalised to body mass, of the following five muscle actions were recorded bilaterally using a hand-held dynamometer (HHD) (J-Tech, USA); hip abduction and extension, knee flexion and extension and ankle plantar flexion. A RRI was defined as any lower limb and back injury persisting for at least 7 days or 3 consecutive training sessions, causing restriction of running or requiring medical consultation (4). RRIs were tracked prospectively via email for a period of six months. Backwards logistic regression analysis was performed to investigate the impact of isometric muscle strength on the likelihood of sustaining a RRI. Multicollinearity was assessed and highly related variables were removed. Results: Fifty-nine participants reported a RRI over the six-month period (INJ: 35 male, 24 female, 43.6±9.5 yrs; UNINJ: 75 male, 42 female 40.3±8.0 yrs). A statistically significant model was able to be generated to predict injury (χ2 =2.57, p=.023), which correctly classified 66.7% of cases with high specificity (95.7%). This was a relatively low improvement on the null hypothesis model, which predicted 66.1% of cases correctly. The model only explained 4.3-5.9% of the variance and the sensitivity was very low (10.2%). Only age (OR=.97, 95% CI:.93-1.0) and hip extension strength (OR=1.5, 95% CI:.89-2.52 ) remained in the model. Conclusions: Isometric muscle strength, as assessed in this study, may not be able to accurately predict a future RRI. Strength measures may not reflect the ability to effectively implement an injury-resistant running technique or may not reflect tissue strength. Given that injuries are caused by high loading relative to tissue strength, future research should examine strength and localised loading during running as combined factors in predicting RRI

Prospective reporting of injury in community-level cricket: A systematic review to identify research priorities

© 2020 Sports Medicine Australia Objectives: Cricket is a popular sport enjoyed worldwide. Injuries in cricket are not well understood at community level but are important to understand for prevention to ensure the game continues to be enjoyed safely. This systematic review was designed to assess the quality of data collection and reporting, and to summarise the injury data, in studies of community cricket players. Design: Systematic review. Methods: Nine databases were searched to November 2018 using the terms “cricket*” and “injur*”. A nine-item critical appraisal and three-item likelihood-of-bias evaluation was conducted on included studies. Data completeness was evaluated against recommendations in the international cricket consensus statement for recording/reporting injury and the Australian Sports Injury Data Dictionary (ASIDD). Descriptive injury data (n,%) are presented in tabular format for different subgroups (activity, position, population). Results: Thirteen studies were included, of which eight were rated as unclear, one as high and three having a low likelihood-of-bias. The mean score for completeness of data against the consensus statement was 3.5/10 (95%C.I. 2.8–4.2). The mean score for completeness of data against the ASIDD was 4.4/6 (95%C.I. 3.9–5.0). Bruising and inflammation was the most common injury in junior cricket. Stress fractures were most common in studies of bowlers. Where studies included all activities, batting accounted for most injuries (7–49%). Conclusions: The included studies inconsistently addressed recommended items for injury surveillance in community sport and cricket. Most studies focused on junior levels or adolescent bowlers, with bruising/inflammation and stress fractures being most common, respectively

Using body mass index to estimate individualised patient radiation dose in abdominal computed tomography

Background: The size-specific dose estimate (SSDE) is a dose-related metrics that incorporates patient size into its calculation. It is usually derived from the volume computed tomography dose index (CTDIvol) by applying a conversion factor determined from manually measured anteroposterior and lateral skin-to-skin patient diameters at the midslice level on computed tomography (CT) localiser images, an awkward, time-consuming, and not highly reproducible technique. The objective of this study was to evaluate the potential for the use of body mass index (BMI) as a size-related metrics alternative to the midslice effective diameter (DE) to obtain a size-specific dose (SSDE) in abdominal CT. Methods: In this retrospective study of patients who underwent abdominal CT for the investigation of inflammatory bowel disease, the DE was measured on the midslice level on CT-localiser images of each patient. This was correlated with patient BMI and the linear regression equation relating the quantities was calculated. The ratio between the internal and the external abdominal diameters (DRATIO) was also measured to assess correlation with radiation dose. Pearson correlation analysis and linear regression models were used. Results: There was good correlation between DE and patient BMI (r = 0.88). An equation allowing calculation of DE from BMI was calculated by linear regression analysis as follows: DE = 0.76 (BMI) + 9.4. A weak correlation between radiation dose and DRATIO was demonstrated (r = 0.45). Conclusions: Patient BMI can be used to accurately estimate DE, obviating the need to measure anteroposterior and lateral diameters in order to calculate a SSDE for abdominal CT

Computed tomography dose optimisation in cystic fibrosis: A review.

Cystic fibrosis (CF) is the most common autosomal recessive disease of the Caucasian population worldwide, with respiratory disease remaining the most relevant source of morbidity and mortality. Computed tomography (CT) is frequently used for monitoring disease complications and progression. Over the last fifteen years there has been a six-fold increase in the use of CT, which has lead to a growing concern in relation to cumulative radiation exposure. The challenge to the medical profession is to identify dose reduction strategies that meet acceptable image quality, but fulfil the requirements of a diagnostic quality CT. Dose-optimisation, particularly in CT, is essential as it reduces the chances of patients receiving cumulative radiation doses in excess of 100 mSv, a dose deemed significant by the United Nations Scientific Committee on the Effects of Atomic Radiation. This review article explores the current trends in imaging in CF with particular emphasis on new developments in dose optimisation

Fear Avoidance After Injury and Readiness to Return to Sport in Collegiate Male and Female Gaelic Games Players

BACKGROUND: Injuries are common in collegiate Gaelic games, and negative psychological responses to injury, such as fear avoidance and a lack of psychological readiness to return to sport, can affect players during their rehabilitation and their subsequent return to sport. Thus, identifying these responses in players can allow clinicians to address these issues during rehabilitation. This study aimed to examine fear avoidance and psychological readiness to return to sport in collegiate Gaelic games players. HYPOTHESIS: Collegiate Gaelic games players will experience similar levels of fear avoidance and psychological readiness to return to sport as other adult athletes. STUDY DESIGN: Cohort study. LEVEL OF EVIDENCE: Level 3. METHODS: Male (n = 150) and female (n = 76) players from 1 Irish collegiate institution were recruited. Players that were injured over 1 collegiate season completed the Athlete Fear Avoidance Questionnaire (AFAQ) immediately after the injury and the Injury-Psychological Readiness to Return to Sport (I-PRRS) Scale once cleared to return to sport. An injury report form was also completed. The overall AFAQ (sum of 10 items) and I-PRRS (sum of 6 items/10) scores were calculated. RESULTS: Seventy-three injuries (n = 73) occurred, and injured players had a mean overall AFAQ and I-PRRS score of 22.6 ± 5.3 and 46.4 ± 8.8, respectively. Just less than half (47.9%) of players were deemed psychologically unready to return to sport when cleared physically. After severe injuries, significantly higher overall AFAQ scores than mild injuries ( = 0.01) and lower overall I-PRRS than moderate injuries ( \u3c 0.0001) was noted. For the overall scores, no gender differences were observed. CONCLUSION: Fear avoidance and lowered confidence levels before return to sport occurs in collegiate Gaelic games players similar to other student-athletes. CLINICAL RELEVANCE: Identification of fear avoidance or low readiness to return to sport, particularly after serious injury, is important to implement psychosocial support during their rehabilitation

Role of radiologic imaging in irritable bowel syndrome: evidence-based review

Purpose: To critically evaluate the current literature in an effort to establish the current role of radiologic imaging (computed tomography, magnetic resonance imaging, ultrasonography [US], fluoroscopy, conventional film radiography) in irritable bowel syndrome (IBS). Materials and Methods: The term “irritable bowel syndrome” was used to search Clinical Evidence, UpToDate, Cochrane Library, TRIP, and National Institute for Health and Clinical Excellence databases and the American College of Physicians Journal Club and Evidence-Based Medicine online. PubMed was searched by using medical subject headings (“irritable bowel syndrome;” “colonic diseases, functional;” “diagnosis;” “colonography;” “computed tomographic (CT)”) and the dates January 1, 1985 to July 1, 2010. Appraisal was independently performed by two reviewers who followed the Oxford Centre for Evidence Based Medicine practice criteria. Results: No systematic review (SR) specifically examined radiologic imaging in IBS; however, in the secondary literature, five relevant SRs or guidelines partially addressed this topic. A PubMed search identified 1451 articles, 111 of which at least partially addressed radiologic imaging. Of these, seven valid articles (two SRs and five primary research articles) were identified. The five primary research articles examined either colonic investigations (colonoscopy and barium enema examination) (n = 5) or US (n = 2) or both (n = 2). Structural disease found infrequently in patients with IBS-type symptoms included diverticulosis, colorectal cancer, celiac disease, inflammatory bowel disease, and ovarian cancer. The incidence of structural disease in patients with concerning symptoms was low. Conclusion: Although widely used, there is a surprising paucity of evidence guiding radiologic imaging in IBS. Radiologic imaging may not be required in patients with IBS without potentially concerning symptoms but should be considered where such symptoms exist, and choice of imaging study should be influenced by predominant symptoms. Definitive recommendations must await further research