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      Context Matters: Revisiting the First Step of the ‘Sequence of Prevention’ of Sports Injuries

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          Abstract

          It is possible to prevent sports injuries. Unfortunately, the demonstrated efficacy and effectiveness of injury prevention approaches are not translated into lasting real-world effects. Contemporary views in sports medicine and injury prevention suggest that sports injuries are ‘complex’ phenomena. If the problem we aim to prevent is complex, then the first step in the ‘sequence of prevention’ that defines the ‘injury problem’ already needs to have considered this. The purpose of this paper is to revisit the first step of the ‘sequence of prevention’, and to explore new perspectives that acknowledge the complexity of the sports injury problem. First, this paper provides a retrospective of the ‘sequence of prevention’, acknowledging contemporary views on sports injuries and their prevention. Thereafter, from the perspective of the socioecological model, we demonstrate the need for taking into account the complex nature of sports injuries in the first step. Finally, we propose an alternative approach to explore and understand injury context through qualitative research methods. A better understanding of the injury problem in context will guide more context-sensitive studies, thus providing a new perspective for sports injury prevention research.

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          Most cited references31

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          The RE-AIM framework: a systematic review of use over time.

          We provided a synthesis of use, summarized key issues in applying, and highlighted exemplary applications in the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. We articulated key RE-AIM criteria by reviewing the published literature from 1999 to 2010 in several databases to describe the application and reporting on various RE-AIM dimensions. After excluding nonempirical articles, case studies, and commentaries, 71 articles were identified. The most frequent publications were on physical activity, obesity, and disease management. Four articles reported solely on 1 dimension compared with 44 articles that reported on all 5 dimensions of the framework. RE-AIM was broadly applied, but several criteria were not reported consistently.
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            Incidence, severity, aetiology and prevention of sports injuries. A review of concepts.

            Notwithstanding the healthy influence of sporting activities on risk factors, in particular those of cardiovascular disease, it is becoming increasingly apparent that sports can present a danger to health in the form of sports injuries. The extent of the sports injury problem calls for preventative action based on the results of epidemiological research. For the interpretation of these facts uniform definitions are needed and limitations of research designs should be known. Measures to prevent sports injuries form part of what is called the 'sequence of prevention'. Firstly the extent of the sports injury problem must be identified and described. Secondly the factors and mechanisms which play a part in the occurrence of sports injuries have to be identified. The third step is to introduce measures that are likely to reduce the future risk and/or severity of sports injuries. This measure should be based on the aetiological factors and the mechanism as identified in the second step. Finally the effect of the measures must be evaluated by repeating the first step. In this review some aspects of the first and second step of the sequence of prevention are discussed. The extent of the sports injury problem is often described by injury incidence and by indicators of the severity of sports injuries. Sports injury incidence should preferably be expressed as the number of sports injuries per exposure time (e.g. per 1000 hours of sports participation) in order to facilitate the comparability of research results. However, one should realise that the outcome of research applying this definition of sports injury incidence is highly dependent on the definitions of 'sports injury' and 'sports participation'. The outcome of such research also depends on the applied research design and research methodology. The incidence of sports injuries depends on: the method used to count injuries (e.g. prospective vs retrospective); the method used to establish the population at risk; and on the representativeness of the sample. Severity of sports injuries can be described on the basis of 6 criteria: the nature of the sports injury; the duration and nature of treatment; sporting time lost; working time lost; permanent damage; and cost. Here also uniform definitions are important and necessary in order to enhance the comparability of research data. In the second step of the 'sequence of prevention' the aetiological factors that play a role in the occurrence of a sports injury have to be identified by epidemiological studies. Epidemiological research on the aetiology of sports injuries requires a conceptual model.(ABSTRACT TRUNCATED AT 400 WORDS)
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              Nature-nurture reconceptualized in developmental perspective: a bioecological model.

              In response to Anastasi's (1958) long-standing challenge, the authors propose an empirically testable theoretical model that (a) goes beyond and qualifies the established behavioral genetics paradigm by allowing for nonadditive synergistic effects, direct measures of the environment, and mechanisms of organism-environment interaction, called proximal processes, through which genotypes are transformed into phenotypes; (b) hypothesizes that estimates of heritability (e.g., h2) increase markedly with the magnitude of proximal processes; (c) demonstrates that heritability measures the proportion of variation in individual differences attributable only to actualized genetic potential, with the degree of nonactualized potential remaining unknown; (d) proposes that, by enhancing proximal processes and environments, it is possible to increase the extent of actualized genetic potentials for developmental competence.
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                Author and article information

                Contributors
                hrw.pasman@vumc.nl
                Journal
                Sports Med
                Sports Med
                Sports Medicine (Auckland, N.z.)
                Springer International Publishing (Cham )
                0112-1642
                1179-2035
                28 June 2018
                28 June 2018
                2018
                : 48
                : 10
                : 2227-2234
                Affiliations
                [1 ]ISNI 0000 0004 0435 165X, GRID grid.16872.3a, Amsterdam Collaboration for Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, , VU University Medical Center, ; Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
                [2 ]ISNI 0000 0004 1937 1151, GRID grid.7836.a, UCT/MRC Research Unit for Exercise Science and Sports Medicine (ESSM), Department of Human Biology, Faculty of Health Sciences, , University of Cape Town, ; Cape Town, South Africa
                [3 ]ISNI 0000 0001 0768 2743, GRID grid.7886.1, School of Public Health, Physiotherapy and Population Sciences, , University College Dublin, ; Dublin, Ireland
                [4 ]ISNI 0000 0000 9320 7537, GRID grid.1003.2, School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, , University of Queensland, ; Brisbane, QLD Australia
                Author information
                http://orcid.org/0000-0002-7607-4765
                Article
                953
                10.1007/s40279-018-0953-x
                6132444
                29956077
                8d39f7d6-d208-49e1-92db-74a97633acc4
                © The Author(s) 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100003545, Ministério da Ciência, Tecnologia e Inovação;
                Award ID: 202242/2015-3
                Award Recipient :
                Categories
                Review Article
                Custom metadata
                © Springer Nature Switzerland AG 2018

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