Post on 14-Jul-2018
SAFETY IN SPORT – DELIVERY OF SAFE TEAM SPORTS FOR
CHILDREN
Professor Caroline FinchNHMRC Principal Research FellowAccident Research Centre, Monash UniversityCaroline.Finch@monash.edu
JUNIOR SPORT SAFETY RESEARCH• Most community-level participation is
by children• Lack of data on junior sport
• Much derived from studies in adults or highly competitive athletes Source: Finch, Sport Health, 2007
Adult74%
Children12%
All ages14%
Australian studies 2001-2006
IMPLICATIONS FOR JUNIOR SPORTS INJURY STUDIES
• Reasons for participation
• Children are not “little” adults– physical– cognitive– social
• Nature of sport is very different
• Injury risk and rates are different
IMPLICATIONS FOR JUNIOR SPORTS SAFETY
• Delivery of sport very different
• Translation of safety information very different
• Major role of coaches/teachers and other significant others in sports and sports safety behaviours
COHORT STUDIES OF INJURY RISK IN
3 TEAM-BASED JUNIOR
COMMUNITY SPORTS
AIM OF TALK
• To present latest evidence from 3 junior team sports in Australia
– Australian football– cricket– netball
• Implications of the findings for junior team sport
• Resources available
THE JUNIOR AUSTRALIAN FOOTBALL SAFETY STUDY (JAFSS)
Source: Romiti, Finch & Gabbe; British Journal of Sports Medicine; 2008; 42:441-445
• Partnership with the AFL, Victorian FL, AFL Sydney
• Players from Eastern FL (Vic), Northside AFL (NSW)
• Injury risk/safety in relation to game development in relation to
• Assess the safety of junior game versions
• Specific recommendations for updated game development manuals for coaches
JUNIORS ENJOYING NETBALL SAFELY EVALUATION PROJECT
(JENSEP)
• Partnership with Netball Victoria and Netball Australia
• Funded by Dept Health & Ageing, SRV, SMA
• Important information about injury risk in relation to game development
• Context of junior community sport –players and coaches
• Cues to sustainability of a safety program in community sport
Source: Finch, Otago, Saunders, Romiti, White, Donaldson. 2008. UB HMSS Research Report
JUNIORS ENJOYING CRICKET SAFELY (JECS)
• Partnership with Cricket Victoria, Cricket Australia, Ballarat Cricket Association
• Funded by Dept Health & Ageing, SRV, SMA
• Context of junior community sport• Important information about injury risk
in relation to game development stages• Impact of ground conditions• Player risk perceptions and safety
attitudesSource: Finch, White, Dennis, Twomey, Hayen; Journal of Science and Medicine in Sport; 2010 13(5): 489-495
STANDARDISED METHODOLOGY
SAMPLING METHODOLOGY
• Prospective (group clustered) cohort studies– Clubs– Teams– Players
• JAFSS – 54 teams (12-20 players); 40,208 hours
• JENSEP – 510 players, 1,300 hours
• JECS - 410 players, 2,255 hours
• Games and training
Ballarat Cricket Association clubs
19 *
clubs with U12 teams nominated
7
clubs with U14 teams nominated
13
clubs with U16 teams nominated
10
U16 teams recruited13 out of 21
(62%)
U14 teams recruited19 out of 34
(56%)
U12 teams recruited13 out of 26
(50%)
U12 teams after drop outs
9
U14 teams afterdrop outs
19
U16 teams after drop outs
12
U12 players 118
U14 players 268
U16 players 156
consenting U12 players79
(67% of players)
consenting U14 players210
(78% of players)
consenting U16 players121
(78% of players)
Recruitment sampling plan
INJURY DEFINITION
• JECS/JENSEP– an event which requires the provision of medical
attention, either on or off the field, and/or results in missed participation during the match or training session
• JAFSS– any trauma causing disability and/or pain– JECS/JENSEP definition as subset
DATA COLLECTION
• On-field injuries of any severity– left field?– stayed-off field?– received treatment?– sent to hospital?– body region– nature and mechanism of injury
Severity Indicators
Leave field?
Receive treatment?
Return to field?
Advised to seek medical advice?
Taken to hospital?
DATA COLLECTION
•––––––
• Participation attendance
PLAYER SURVEYS• Attitudes, knowledge, self-reported behaviours
• Injury risk perceptions
• Guided by– Theory of Planned Behaviour– specific game features– specific safety concerns
• Reliability, content validity, internal consistency demonstrated
Source: Siesmaa, Blitvich, White, Finch; Journal of Science and Medicine in Sport; 2010
CHILD INJURY RISK PERCEPTIONS
Source: Siesmaa, Blitvich, White, Finch; Journal of Science and Medicine in Sport; 2010
CHILD INJURY RISK PERCEPTIONS
Source: White, Dennis, Siesmaa, Finch; Journal of Science and Medicine in Sport; 2010
FACT 1CHILDREN ENJOY
THEIR SPORT, SKILLS AND
PERFORMANCE ARE SECONDARY
REASONS WHY CHILDREN CHOOSE TO PLAY CRICKET (N=279)
Source: Finch, Siesmaa, Blitvich, White, Telford; SKIDO report; UB HMSS; 2009
FACT 2
RELATIVESAFETY OF
JUNIOR SPORT
INJURY RATE COMPARISONS
0
5
10
15
20
25
rate
per
100
0 pl
ayer
hou
rs
Adults(WASIS)
Children(JAFSS)
Australian Football
0
5
10
15
20
25
Adults (WASIS)
Children (JENSEP)
rate
per
100
0 pl
ayer
hou
rs
Netball
Source: WASIS results: McManus, Stevenson, Finch; Journal of Science and Medicine in Sport; 2004 & 2006
FACT 3
INJURY RATES VARY BY AGE GROUP AND
GAME DEVELOPMENT
INJURY RATES IN JUNIOR AUSTRALIAN FOOTBALL PLAYERS
44.940.1
76.6
30.8
20.1 19.5
49.3
44.043.9
3.86.02.30.86.3
1.02.33.53.30
10
20
30
40
50
60
70
80
90
U9 U10 U11 U12 U13 U14 U15 U16 U18
Level of play
Inju
ry ra
te (p
er 1
000
hour
s of
exp
osur
e)
Game injury rate Training injury rate
Source: Romiti, Finch & Gabbe; British Journal of Sports Medicine; 2008; 42:441-445
RATES OF INJURY (PER 1000 PARTICIPATIONS) IN MATCHES ACCORDING
TO AGE LEVEL OF PLAY
MatchAge
groupBatting
IR 95% CIBowlingIR 95% CI
FieldingIR 95% CI
U12 0 - 0 - 3.0 0.0-8.9
U14 6.1 2.1-10.1 2.2 0.1-4.4 2.7 0.5-4.8
U16 1.4 0.0-4.2 3.2 0.0-7.7 8.0 2.1-13.6
Note: Rates are a function of the participations for each playing position separately
Source: Finch, White, Dennis, Twomey, Hayen; Journal of Science and Medicine in Sport; 2010 13(5): 489-495
FACT 4
INJURY PATTERNS AND CAUSES
DIFFERENT TO THOSE OF ADULTS
JUNIOR AUSTRALIAN FOOTBALL
• Adults– fast pace of game– overuse, running injuries– hamstring, groins, quads
• Children– incidental body contact– ball handling– introduction of tackling– knees and hands/fingers
Source: Romiti, Finch & Gabbe; British Journal of Sports Medicine; 2008; 42:441-445
JUNIOR NETBALL
• Adults– ankle/knee injuries– landing in sport– poor conditioning
• Children– ankle/knee/elbow– grazes/sprains– struck by ball/player– ball handling– landing problems for older children
Source: Finch, Otago, Saunders, Romiti, White, Donaldson. 2008. UB HMSS Research Report
JUNIOR CRICKET
• Adults– fast bowlers– overuse– backs/shoulders
• Children– batters, bowlers, fielders– ball handling– impacts from ball– thighs, hands/fingers– overuse only in oldest players
Source: Finch, White, Dennis, Twomey, Hayen; Journal of Science and Medicine in Sport; 2010 13(5): 489-495
CRICKET INJURIES BY PLAYING POSITION
Children
• Batting 34%
• Bowling 33%
• Fielding 32%
Adults
• Bowling >>2X (batting + fielding combined)
Source: Finch, White, Dennis, Twomey, Hayen; Journal of Science and Medicine in Sport; 2010 13(5): 489-495
FACT 5
RISKPERCEPTIONS
ALSO VARYBY AGE
PERCEIVED RISK OF INJURY IN JUNIOR CRICKETERS
• Lower for self than others → optimistic bias
• Higher for batting and fielding
• Higher for facing fast bowler and fielding close to batter
• Higher for U12 and U14 except for bowling
Source: White, Dennis, Siesmaa, Finch; Journal of Science and Medicine in Sport; 2010
PERCEIVED RISK ACROSS VARIOUS WICKET KEEPING SITUATIONS
Keeping to a Spin Bowler
0% 20% 40% 60% 80% 100%
U12
U14
U16
With Helmet
U12
U14
U16
No Helmet
Percent of players in each age group
Don't know No Chance Small Chance High Chance
Keeping to a Fast Bowler
0% 20% 40% 60% 80% 100%
U12
U14
U16
With Helmet
U12
U14
U16
No Helmet
Percent of players in each age group
Don't Know No Chance Small Chance High Chance
Source: White, Dennis, Siesmaa, Finch; Journal of Science and Medicine in Sport; 2010
PERCEIVED RISK ACROSS DIFFERENT GROUND CONDITIONS
0% 20% 40% 60% 80% 100%
U12
U14
U16
Playing on grass
U12
U14
U16
Playing on hard ground
U12
U14
U16
Playing on bumpy ground
Percent of players in each age group
Don’t know No chance A small chance A high chance
Source: White, Dennis, Siesmaa, Finch; Journal of Science and Medicine in Sport; 2010
FACT 5
HIGH DUTY OF CARE WITH
JUNIOR SPORT DELIVERY
JUNIOR AUSTRALIAN FOOTBALL
Source: Romiti, Finch & Gabbe; British Journal of Sports Medicine; 2008; 42:441-445
JUNIOR NETBALL
Severity of injuries reported (game and training combined) reported as rates per 1000 hrs/participation
8.7
6.7
3.72.8
0.6
0
2
4
6
8
10
12
all injuries left court did not return tocourt
advised to seekaid
advised to go tohospital
inju
ry r
ate
(per
100
0 h
rs)
Source: Finch, Otago, Saunders, Romiti, White, Donaldson. 2008. UB HMSS Research Report
JUNIOR CRICKET
3.7
2.1 2.0
0.6 0.50.2
0.0
0.5
1.0
1.5
2.0
2.5
3.0
3.5
4.0in
jury
rat
e p
er 1
000
par
tici
pat
ion
s
All injuries
Left field
Received treatment
Remained off field
Advised to seek medical assistance
Taken to hospital
Source: Finch, White, Dennis, Twomey, Hayen; Journal of Science and Medicine in Sport; 2010 13(5): 489-495
IMPLICATIONS FOR INJURY
PREVENTION
JUNIOR SPORT ADVANTAGES
• Provides opportunities for all to play• Much safer than adult versions• Perhaps use as a strategy to help prevent
other injury/health issues
• High level of duty of care • Graduated physical skills and contact
JUNIOR SPORT SAFETY
• Injuries related to– lack of skill/skill development– ball handling– little overuse
• Strategies for adult sport not always relevant because
– different injuries– different causes– different priorities
RESEARCH NEEDS
• Very little information about school sport– rate of injury not known– are the age and level of play effects the same?– best approaches for game development to maximise
safety?– are the risk perceptions, safety beliefs and sources of
information the same?
SPORTS SAFETY ADVICE
• Major role of teachers, coaches and other significant others in sports safety behaviours
• Continue to remind junior players of injury risk and correct technique for injury prevention
• Inform players that of how/why/where/when injuries can occur & include skills practice accordingly
– needs to be age specific and all positions
• Ensure information junior players receive is based on evidence and not just media hype
RECOMMENDATIONS
SMARTPLAY
• Smartplay Program• Delivered nationally since
2001• Sports Medicine Australia• Readily available
resources– fact sheets– guidelines– newsletters
NATIONAL SAFETY GUIDELINES
Source: http://www.smartplay.com.au/ImageLibraryAssets/resources/national/childrensafetyguidelines-fulldoc.pdf
PREVENTION STRATEGIES
• The environment
• Equipment
• Grounds and facilities
Source: http://www.smartplay.com.au/ImageLibraryAssets/resources/national/childrensafetyguidelines-fulldoc.pdf
INJURY AND MEDICAL CONSIDERATIONS
• Pre-participation screening
• Medical record keeping• Illness and
participation• Medical conditions and
participation
Source: http://www.smartplay.com.au/ImageLibraryAssets/resources/national/childrensafetyguidelines-fulldoc.pdf
PARTICIPATION CONSIDERATIONS
• Training sessions• Warm-up, cool-down,
stretch• Amount and intensity of
activity• Balanced competitions• Strength training• Recovery• Injury management and
return to play
RESPONSIBILITIES
• Clubs, schools other providers
• Safety personnel• Coaches and
teachers• Officials• Parents
Source: http://www.smartplay.com.au/ImageLibraryAssets/resources/national/childrensafetyguidelines-fulldoc.pdf
Source: http://www.smartplay.com.au/ImageLibraryAssets/resources/national/childrensafetyguidelines-fulldoc.pdf
THE SMARTPLAY PRINCIPLES (1)
• WARM UP• Be prepared for the
activity– facility– equipment– student– coach/teacher
Source: http://www.smartplay.com.au/Pub/pStart.asp
THE SMARTPLAY PRINCIPLES (2)
• GEAR UP• Use the appropriate
equipment– facilities– playing equipment– personal protective
equipment
Source: http://www.smartplay.com.au/Pub/pStart.asp
THE SMARTPLAY PRINCIPLES (3)
• DRINK UP– drink plenty– avoid dehydration– avoid heat stress
Source: http://www.smartplay.com.au/Pub/pStart.asp
www.smartplay.com.au
• Downloadable resources– safety fact sheets/guidelines– sport specific guidelines– media text for newsletters– teacher resources– others
• latest research, other initiatives