Utilising a Behaviour Change Model to Improve Implementation of the Activate Injury Prevention Exercise Programme in Schoolboy Rugby Union.
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ABSTRACT:
SUBMITTER: Barden C
PROVIDER: S-EPMC8199066 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Exercise programmes aimed at reducing injury have been shown to be efficacious for some non-collision sports, but evidence in adult men's collision sports such as rugby union is lacking.To evaluate the efficacy of a movement control injury prevention exercise programme for reducing match injuries in adult men's community rugby union players.856 clubs were invited to participate in this prospective cluster randomised (single-blind) controlled trial where clubs were the unit of randomisation. 81 volunteered and were randomly assigned (intervention/control). A 42-week exercise programme was followed throughout the season. The control programme reflected 'normal practice' exercises, whereas the intervention focused on proprioception, balance, cutting, landing and resistance exercises.Outcome measures were match injury incidence and burden for: (1) all ?8 days time-loss injuries and (2) targeted (lower limb, shoulder, head and neck, excluding fractures and lacerations) ?8 days time-loss injuries.Poisson regression identified no clear effects on overall injury outcomes. A likely beneficial difference in targeted injury incidence (rate ratio (RR), 90% CI=0.6, 0.4 to 1.0) was identified, with a 40% reduction in lower-limb incidence (RR, 90% CI=0.6, 0.4 to 1.0) and a 60% reduction in concussion incidence (RR, 90% CI=0.4, 0.2 to 0.7) in the intervention group. Comparison between arms for clubs with highest compliance (?median?compliance) demonstrated very likely beneficial 60% reductions in targeted injury incidence (RR, 90% CI=0.4, 0.2 to 0.8) and targeted injury burden (RR, 90% CI=0.4, 0.2 to 0.7).The movement control injury prevention programme resulted in likely beneficial reductions in lower-limb injuries and concussion. Higher intervention compliance was associated with reduced targeted injury incidence and burden.
| S-EPMC5867421 | biostudies-literature
Project description:BackgroundExercise Referral Schemes have been delivered worldwide in developed countries to augment physical activity levels in sedentary patients with a range of health issues, despite their utility being questioned. Understanding the implementation mechanisms of behaviour change practices is important to avoid inappropriate decommissioning and support future service planning. The aim of this study was to develop initial theories to understand what influences the behaviour change practices of Exercise Referral practitioners within the United Kingdom.MethodsAn eight-month focused ethnography was undertaken, to carry out the first phase of a realist evaluation, which included participant observation, interviews, document analysis, and reflexive journaling. A comprehensive implementation framework (Consolidated Framework for Implementation Research) was adopted providing an extensive menu of determinants. Mechanisms were categorised based on the Theoretical Domains Framework (within the Capability, Opportunity, Motivation, Behaviour model) providing an explanatory tool linking the levels of the framework.ResultsThree programme theories are proposed. Firstly, motivation and capability are influenced when behaviour change oriented planning and training are in place. Secondly, motivation is influenced if leadership is supportive of behaviour change practice. Lastly, integration between health professionals and practitioners will influence motivation and capability. The conditions necessary to influence motivation and capability include a person-centred climate, cognizant practitioners, and established communities of practice.ConclusionsThe findings are the first to articulate the necessary elements for the implementation of behaviour change practices in Exercise Referral services. These results outline emerging theories about the conditions, resources, and explanations of behaviour change implementation that can inform service development.
| S-EPMC8045303 | biostudies-literature
Project description:IntroductionFalling in older age is a serious and costly problem. At least one in three older people fall annually. Although exercise is recognised as an effective fall prevention intervention, low numbers of older people engage in suitable programmes. Health and exercise professionals play a crucial role in addressing fall risk in older adults. This trial aims to evaluate the effect of participation in a fall prevention educational programme, compared with a wait-list control group, on health and exercise professionals' knowledge about fall prevention and the effect on fall prevention exercise prescription behaviour and confidence to prescribe the exercises to older people.Methods and analysisA randomised controlled trial involving 220 consenting health and exercise professionals will be conducted. Participants will be individually randomised to an intervention group (n=110) to receive an educational workshop plus access to internet-based support resources, or a wait-list control group (n=110). The two primary outcomes, measured 3 months after randomisation, are: (1) knowledge about fall prevention and (2) self-perceived change in fall prevention exercise prescription behaviour. Secondary outcomes include: (1) participants' confidence to prescribe fall prevention exercises; (2) the proportion of people aged 60+ years seen by trial participants in the past month who were prescribed fall prevention exercise; and (3) the proportion of fall prevention exercises prescribed by participants to older people in the past month that comply with evidence-based guidelines. Outcomes will be measured with a self-report questionnaire designed specifically for the trial.Ethics and disseminationThe trial protocol was approved by the Human Research Ethics Committee, The University of Sydney, Australia. Trial results will be disseminated via peer reviewed journals, presentations at international conferences and participants' newsletters.Trial registration numberTrial protocol was registered with the Australian and New Zealand Clinical Trials Registry (Number ACTRN12614000224628) on 3 March 2014.
| S-EPMC4244414 | biostudies-literature
Project description:BACKGROUND:Implementation strategies are needed to ensure that evidence-based healthcare interventions are adopted successfully. However, strategies are generally poorly described and those used in everyday practice are seldom reported formally or fully understood. Characterising the active ingredients of existing strategies is necessary to test and refine implementation. We examined whether an implementation strategy, delivered across multiple settings targeting different stakeholders to support a fall prevention programme, could be characterised using the Behaviour Change Technique (BCT) Taxonomy. METHODS:Data sources included project plans, promotional material, interviews with a purposive sample of stakeholders involved in the strategy's design and delivery and observations of staff training and information meetings. Data were analysed using TIDieR to describe the strategy and determine the levels at which it operated (organisational, professional, patient). The BCT Taxonomy identified BCTs which were mapped to intervention functions. Data were coded by three researchers and finalised through consensus. RESULTS:We analysed 22 documents, 6 interviews and 4 observation sessions. Overall, 21 out a possible 93 BCTs were identified across the three levels. At an organisational level, identifiable techniques tended to be broadly defined; the most common BCT was restructuring the social environment. While some activities were intended to encourage implementation, they did not have an immediate behavioural target and could not be coded using BCTs. The largest number and variety of BCTs were used at the professional level to target the multidisciplinary teams delivering the programme and professionals referring to the programme. The main BCTs targeting the multidisciplinary team were instruction on how to perform the (assessment) behaviour and demonstration of (assessment) behaviour; the main BCT targeting referrers was adding objects to the environment. At the patient level, few BCTs were used to target attendance. CONCLUSION:In this study, several behaviour change techniques were evident at the individual professional level; however, fewer techniques were identifiable at an organisational level. The BCT Taxonomy was useful for describing components of a multilevel implementation strategy that specifically target behaviour change. To fully and completely describe an implementation strategy, including components that involve organisational or systems level change, other frameworks may be needed.
| S-EPMC6102850 | biostudies-literature
Project description:BackgroundCollisions in rugby union and sevens have a high injury incidence and burden, and are also associated with player and team performance. Understanding the frequency and intensity of these collisions is therefore important for coaches and practitioners to adequately prepare players for competition. The aim of this review is to synthesise the current literature to provide a summary of the collision frequencies and intensities for rugby union and rugby sevens based on video-based analysis and microtechnology.MethodsA systematic search using key words was done on four different databases from 1 January 1990 to 1 September 2021 (PubMed, Scopus, SPORTDiscus and Web of Science).ResultsSeventy-three studies were included in the final review, with fifty-eight studies focusing on rugby union, while fifteen studies explored rugby sevens. Of the included studies, four focused on training-three in rugby union and one in sevens, two focused on both training and match-play in rugby union and one in rugby sevens, while the remaining sixty-six studies explored collisions from match-play. The studies included, provincial, national, international, professional, experienced, novice and collegiate players. Most of the studies used video-based analysis (n = 37) to quantify collisions. In rugby union, on average a total of 22.0 (19.0-25.0) scrums, 116.2 (62.7-169.7) rucks, and 156.1 (121.2-191.0) tackles occur per match. In sevens, on average 1.8 (1.7-2.0) scrums, 4.8 (0-11.8) rucks and 14.1 (0-32.8) tackles occur per match.ConclusionsThis review showed more studies quantified collisions in matches compared to training. To ensure athletes are adequately prepared for match collision loads, training should be prescribed to meet the match demands. Per minute, rugby sevens players perform more tackles and ball carries into contact than rugby union players and forwards experienced more impacts and tackles than backs. Forwards also perform more very heavy impacts and severe impacts than backs in rugby union. To improve the relationship between matches and training, integrating both video-based analysis and microtechnology is recommended. The frequency and intensity of collisions in training and matches may lead to adaptations for a "collision-fit" player and lend itself to general training principles such as periodisation for optimum collision adaptation. Trial Registration PROSPERO registration number: CRD42020191112.
| S-EPMC8776953 | biostudies-literature
Project description:BackgroundElite rugby players experience poor sleep quality and quantity. This lack of sleep could compromise post-exercise recovery. Therefore, it appears central to encourage sleep in order to improve recovery kinetics. However, the effectiveness of an acute ergogenic strategy such as sleep extension on recovery has yet to be investigated among athletes.AimTo compare the effects of a single night of sleep extension to an active recovery session (CON) on post-exercise recovery kinetics.MethodsIn a randomised cross-over design, 10 male rugby union players participated in two evening training sessions (19:30) involving collision activity, 7-days apart. After each session, participants either extended their sleep to 10 hours or attended an early morning recovery session (07:30). Prior to (PRE), immediately after (POST 0 hour [h]), 14h (POST 14) and 36h (POST 36) post training, neuromuscular, perceptual and cognitive measures of fatigue were assessed. Objective sleep parameters were monitored two days before the training session and over the two-day recovery period.ResultsThe training session induced substantial decreases in countermovement jump mean power and wellness across all time points, while heart rate recovery decreased at POST 0 in both conditions. Sleep extension resulted in greater total sleep time (effect size [90% confidence interval]: 5.35 [4.56 to 6.14]) but greater sleep fragmentation than CON (2.85 [2.00 to 3.70]). Between group differences highlight a faster recovery of cognitive performance following sleep extension (-1.53 [-2.33 to -0.74]) at POST 14, while autonomic function (-1.00 [-1.85 to -0.16]) and upper-body neuromuscular function (-0.78 [-1.65 to 0.08]) were better in CON. However, no difference in recovery status between groups was observed at POST 36.ConclusionThe main finding of this study suggests that sleep extension could affect cognitive function positively but did not improve neuromuscular function the day after a late exercise bout.
| S-EPMC9387860 | biostudies-literature
Project description:Objectives:The purpose of this review was to synthesise both injury prevention and performance tackle-related research to provide rugby stakeholders with information on tackle injury epidemiology, including tackle injury risk factors and performance determinants, and to discuss potential preventative measures. Design:Systematic review and narrative synthesis. Data sources:PubMed, Scopus and Web of Science. Eligibility criteria:Limited to peer-reviewed English-only publications between January 1995 and October 2018. Results:A total of 317 studies were identified, with 177 in rugby union and 13 were in rugby sevens. The tackle accounted for more than 50% of all injuries in rugby union and rugby sevens, both at the professional level and at the lower levels, with the rate of tackle injuries higher at the professional level (mean 32/1000 player-hours) compared with the lower levels (mean 17/1000 player-hours). A player's tackle actions and technical ability were identified as major risk factors for injury and a key determinant of performance. Summary/conclusion:Evidence-based education, progressive tackle technique training with a high potential to transfer and law changes have been proposed as key modifiers of player tackle actions and technical ability. Conceivably, all three modifiers working in unison (as opposed to separately) will have a higher potential at reducing tackle injury risk while enhancing performance. With the guidance of tackle injury and performance studies, as well as stakeholder engagement, experiential and explorative tackle research has the potential to inspire innovative injury prevention and performance strategies.
| S-EPMC7254146 | biostudies-literature
Project description:The purpose of this study was to quantify movement demands of elite international age grade (U20) rugby union players during competitive tournament match play. Forty elite professional players from an U20 international performance squad were monitored using 10 Hz global positioning systems (GPS) during 15 international tournament matches during the 2014/15 and 2015/16 seasons. Data on distances, velocities, accelerations, decelerations, high metabolic load (HML) distance and efforts, and number of sprints were derived. Data files from players who played over 60 min (n = 161) were separated firstly into Forwards and Backs, and more specifically into six positional groups; FR--Front Row (prop & hooker), SR--Second Row, BR--Back Row (Flankers & No.8), HB--Half Backs (scrum half & outside half), MF--Midfield (centres), B3--Back Three (wings & full back) for match analysis. Analysis revealed significant differences between forwards and backs positions. Backs scored higher on all variables measured with the exception of number of moderate accelerations, decelerations (no difference). The centres covered the greatest total distance with the front row covering the least (6.51 ± 0.71 vs 4.97 ± 0.75 km, p < 0.001). The front row also covered the least high speed running (HSR) distance compared to the back three (211.6 ± 112.7 vs 728.4 ± 150.2 m, p < 0.001) who covered the most HSR distance, affirming that backs cover greater distances but forwards have greater contact loads. These findings highlight for the first time differences in the movement characteristics of elite age grade rugby union players specific to positional roles.
| S-EPMC4824470 | biostudies-other
Project description:This study explored the anthropometric and body composition characteristics of elite female rugby union players, comparing between and within different playing positions. Thirty elite female rugby union players (25.6 ± 4.3 y, 171.3 ± 7.7 cm, 83.5 ± 13.9 kg) from New Zealand participated in this study. Physical characteristics were assessed using anthropometric (height, body mass, skinfolds) and body composition (dual-energy X-ray absorptiometry) measures. Forwards were significantly taller (p < 0.01; d = 1.34), heavier (p < 0.01; d = 2.19), and possessed greater skinfolds (p < 0.01; d = 1.02) than backs. Forwards also possessed significantly greater total (p < 0.01; d = 1.83-2.25) and regional (p < 0.01; d = 1.50-2.50) body composition measures compared to backs. Healthy bone mineral density values were observed in both forwards and backs, with significantly greater values observed at the arm (p < 0.01; d = 0.92) and femoral neck (p = 0.04; d = 0.77) sites for forwards. Tight-five players were significantly heavier (p = 0.02; d = 1.41) and possessed significantly greater skinfolds (p < 0.01; d = 0.97) than loose-forwards. Tight-five also possessed significantly greater total body composition measures (p < 0.05; d = 0.97-1.77) and significantly greater trunk lean mass (p = 0.04; d = 1.14), trunk fat mass (p < 0.01; d = 1.84), and arm fat mass (p = 0.02; d = 1.35) compared to loose-forwards. Specific programming and monitoring for forwards and backs, particularly within forward positional groups, appear important due to such physical characteristic differences.
| S-EPMC7557873 | biostudies-literature
Project description:OBJECTIVES:Evaluation of the demonstrator phase and first wave roll-out of the National Health Service (NHS) Diabetes Prevention Programme (DPP) in England. To examine: (1) intervention design, provision and fidelity assessment procedures; (2) risk assessment and recruitment pathways and (3) data collection for monitoring and evaluation. To provide recommendations informing decision makers on programme quality, improvements and future evaluation. DESIGN:We reviewed programme documents, mapping against the NHS DPP specification and National Institute for Health and Care Excellence (NICE) public health guideline: Type 2 diabetes (T2D) prevention in people at high risk (PH38), conducted qualitative research using individual interviews and focus group discussions with stakeholders and examined recruitment, fidelity and data collection procedures. SETTING:Seven NHS DPP demonstrator sites and, subsequently, 27 first wave areas across England. INTERVENTIONS:Intensive behavioural intervention with weight loss, diet and physical activity goals. The national programme specifies at least 13 sessions over 9?months, delivered face to face to groups of 15-20 adults with non-diabetic hyperglycaemia, mainly recruited from primary care and NHS Health Checks. PARTICIPANTS:Participants for qualitative research were purposively sampled to provide a spread of stakeholder experience. Documents for review were provided via the NHS DPP Management Group. FINDINGS:The NHS DPP specification reflected current evidence with a clear framework for service provision. Providers, with national capacity to deliver, supplied intervention plans compliant with this framework. Stakeholders highlighted limitations in fidelity assessment and recruitment and retention challenges, especially in reach and equity, that could adversely impact on implementation. Risk assessment for first wave eligibility differed from NICE guidance. CONCLUSIONS:The NHS DPP provides an evidence-based behavioural intervention for prevention of T2D in adults at high risk, with capacity to deliver nationally. Framework specification allows for balance between consistency and contextual variation in intervention delivery, with session details devolved to providers. Limitations in fidelity assurance, data collection procedures and recruitment issues could adversely impact on intervention effectiveness and restrict evaluation.
| S-EPMC5855311 | biostudies-other