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      Closing the gap on injury prevention: the Oslo Sports Trauma Research Centre four-platform model for translating research into practice

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          Abstract

          Multiple studies across multiple sports have demonstrated that tailored exercise programmes reduce the risk of sport injuries by about 50%.1–3 These programmes typically include exercises to improve balance and neuromuscular control, optimise landing and turning techniques, and increase muscle strength and endurance. The ‘proof is in the pudding’ Despite the well-documented positive effects on injury risk,1–3 far too few athletes implement injury prevention exercises and programmes in their daily training.4–6 Real-life implementation in the field is poor, with high injury rates across most sports as a consequence. Medical personnel around the world are concerned because sports injuries represent a major reason why many children and youth quit sport. They may develop a more sedentary lifestyle, with higher health burdens and costs to both society and the individual.7 Today, organised sports represent the most important source for promoting good health through physical activity in children and youth.8 Reducing the risk of injury from sports participation should, therefore, be a priority for all stakeholders including medical professionals, coaches, strength and conditioning specialists, parents and athletes. In order to obtain the cost-effective effects from injury prevention training, it is important to successfully implement these programmes at the grass roots level, reaching the majority of young individuals active in sports. There is an urgent need to translate science into action and increase everyday injury prevention training for children and youth across all sports, by reaching out and involving coaches, athletes and parents, as well as key stakeholders in sport at the organisational level. The goal is to establish good training routines from an early age, with preventive programmes as a natural, integrated part of practice and training. The Oslo Sports Trauma Research Centre four-platform model for translating research into practice The Oslo Sports Trauma Research Centre was established in May 2000 as an interdisciplinary research centre focusing on methods to prevent sports injuries (and other health problems) with both sports and medical expertise and as the hub in the wheel for a national research network. In collaboration with the International Olympic Committee, we developed the free mobile application Skadefri (Get Set) and the website www.skadefri.no (fittoplay.org) to translate science into action, spreading the word on the significant potential benefits from injury prevention training at the individual, team, club and societal level. During the past 2 years, we have identified four main focus areas to promote knowledge translation, as described below (figure 1). Figure 1 The Oslo Sports Trauma Research Centre four-platform model for translating research into practice. National coach certification programmes Coaches play a key role in the implementation of injury prevention. We have developed a 2-hour e-learning course, ‘Sports without injuries’, discussing the most important aspects of injury prevention and injury prevention training. This is a basic course, directed at all coaches, particularly for children and youth. We will also develop further sport-specific educational in-person workshops for coaches, to increase their knowledge and confidence in planning and conducting injury prevention training for their athletes. Sport club events These 2-hour in-person workshops aim to reach coaches, athletes, parents and sports club staff at the local, grass roots level. They are held by Skadefri-educated sports physiotherapists and physicians throughout the country, delivered according to a standardised template, covering both the theoretical background as well as practical injury prevention sessions for everyday training. The local sport club events contribute towards creating a national sport movement that is safer, more sustainable and inclusive by creating safer sports organisations and environments for athletes involved at all levels. Sport academy high school educational programmes Our national Olympic committee recognises specialised national sport academy high schools to develop talented youth elite athletes at the highest level. Through a 10-hour specialised educational programme, our aim is to create more resilient youth elite athletes. This programme is athlete-centred and includes practical and theoretical sessions on relevant sport-specific physiological and psychological demands with modules adapted to each of the grade levels from 8th through 13th grade. The programme is anchored within the national educational school system with a commitment from management and coaches at each school. Social media (some) The SoMe channels give us the opportunity to translate and produce credible, engaging and relevant content of value for the sporting community at all levels. Instagram and Facebook are our main channels. Many small inputs over time, on different areas, increases knowledge and the likelihood of behavioural change through adoption and maintenance of injury prevention training. Through SoMe, we reach our target groups directly in a natural, unforced and self-determined setting. We use videos, exercises and ‘did you know’—posts to educate and enhance knowledge on injury prevention by translating research into practice in an informal and entertaining way. Skadefri (Get Set) aims to contribute to promote sport for all and to the fundamental principles in the field of sport and education, by supporting athlete health and integrity at all levels of sport. It promotes safe sport, educates young people, their coaches and their parents and addresses issues of safeguarding, healthy lifestyles and injury prevention training. We believe the combination of e-learning, in-person grass roots workshops, specialised programmes where appropriate, and engaging SoMe content provide the framework to increase implementation and close the gap on injury prevention.

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          The effectiveness of exercise interventions to prevent sports injuries: a systematic review and meta-analysis of randomised controlled trials.

          Physical activity is important in both prevention and treatment of many common diseases, but sports injuries can pose serious problems.
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            Neuromuscular training for sports injury prevention: a systematic review.

            The aim of this systematic review was to assess the effectiveness of proprioceptive/neuromuscular training in preventing sports injuries by using the best available evidence from methodologically well-conducted randomized controlled trials and controlled clinical trials without randomization. Two independent researchers performed a literature search in various electronic databases and reference lists. The reviewers independently assessed trials for inclusion criteria and methodological quality and extracted the data. Focusing on studies of high methodological quality, relative risks (RR) and 95% confidence intervals (CI) were used to estimate treatment effects. From a total of 32 relevant studies, 7 methodologically well-conducted studies were considered for this review. Pooled analysis revealed that multi-intervention training was effective in reducing the risk of lower limb injuries (RR = 0.61, 95% CI = 0.49-0.77, P < 0.01), acute knee injuries (RR = 0.46, 95% CI = 0.28-0.76, P < 0.01), and ankle sprain injuries (RR = 0.50, 95% CI = 0.31-0.79, P < 0.01). Balance training alone resulted in a significant risk reduction of ankle sprain injuries (RR = 0.64, 95% CI = 0.46-0.9, P < 0.01) and a nonsignificant risk reduction for injuries overall (RR = 0.49, 95% CI = 0.13-1.8, P = 0.28). Exercise interventions were more effective in athletes with a history of sports injury than in those without. On the basis of the results of seven high-quality studies, this review showed evidence for the effectiveness of proprioceptive/neuromuscular training in reducing the incidence of certain types of sports injuries among adolescent and young adult athletes during pivoting sports. Future research should focus on the conduct of comparative trials to identify the most appropriate and effective training components for preventing injuries in specific sports and populations.
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              Physical Activity and Sports—Real Health Benefits: A Review with Insight into the Public Health of Sweden

              Positive effects from sports are achieved primarily through physical activity, but secondary effects bring health benefits such as psychosocial and personal development and less alcohol consumption. Negative effects, such as the risk of failure, injuries, eating disorders, and burnout, are also apparent. Because physical activity is increasingly conducted in an organized manner, sport’s role in society has become increasingly important over the years, not only for the individual but also for public health. In this paper, we intend to describe sport’s physiological and psychosocial health benefits, stemming both from physical activity and from sport participation per se. This narrative review summarizes research and presents health-related data from Swedish authorities. It is discussed that our daily lives are becoming less physically active, while organized exercise and training increases. Average energy intake is increasing, creating an energy surplus, and thus, we are seeing an increasing number of people who are overweight, which is a strong contributor to health problems. Physical activity and exercise have significant positive effects in preventing or alleviating mental illness, including depressive symptoms and anxiety- or stress-related disease. In conclusion, sports can be evolving, if personal capacities, social situation, and biological and psychological maturation are taken into account. Evidence suggests a dose–response relationship such that being active, even to a modest level, is superior to being inactive or sedentary. Recommendations for healthy sports are summarized.
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                Author and article information

                Journal
                Br J Sports Med
                Br J Sports Med
                bjsports
                bjsm
                British Journal of Sports Medicine
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                0306-3674
                1473-0480
                May 2022
                7 February 2022
                : 56
                : 9
                : 482-483
                Affiliations
                [1] departmentDepartment of Sports Medicine , Norwegian School of Sports Sciences , Oslo, Norway
                Author notes
                [Correspondence to ] Hege Heiestad, Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway; hegeheiestad@ 123456gmail.com
                Author information
                http://orcid.org/0000-0003-4127-0878
                Article
                bjsports-2021-104998
                10.1136/bjsports-2021-104998
                9016234
                35131749
                56711a27-c17b-44e1-9c02-288b02e4120c
                © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See:  https://creativecommons.org/licenses/by/4.0/.

                History
                : 21 January 2022
                Categories
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                Sports medicine
                sporting injuries,sports,sports medicine
                Sports medicine
                sporting injuries, sports, sports medicine

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