Background Identification of risk factors for lower extremity (LE) injury in sport and military/first-responder occupations is required to inform injury prevention strategies. Objective To determine if poor movement quality is associated with LE injury in sport and military/first-responder occupations. Material and methods Five electronic databases were systematically searched. Studies selected included: original data; analytic design; movement quality outcome (qualitative rating of functional compensation, asymmetry, impairment or efficiency of movement control); LE injury sustained with sport or military/first-responder occupation. The PRISMA guidelines were followed. Two independent authors assessed the quality [Downs and Black (DB) criteria] and level of evidence (Oxford Centre of Evidence-Based Medicine model). Results Of 4361 potential studies, 17 were included. The majority were low quality cohort studies (level 4 evidence). Median DB score was 11/33 (range 3–15). Heterogeneity in methodology and injury definition precluded meta-analyses. The Functional Movement Screen was the most common outcome investigated (15/17 studies). Four studies considered interrelationships between risk factors, seven reported diagnostic accuracy and none tested an intervention program targeting individuals identified as high-risk. There is inconsistent evidence that poor movement quality is associated with increased risk of LE injury in sport and military/first-responder occupations. Conclusions Future research should focus on high quality cohort studies to identify the most relevant movement quality outcomes for predicting injury risk followed by developing and evaluating pre-participation screening and LE injury prevention programs through high quality randomized controlled trials targeting individuals at greater risk of injury based upon screening tests with validated test properties.

Compared to modern uncemented femoral stem designs, cemented stems yield lower rates of periprosthetic fracture requiring re-operation, without increasing risk of all-cause mortality. Tapered-wedge stems had similar rates of re-operation due to periprosthetic fracture as reamed uncemented stems.

Purpose – The purpose of this case study is to highlight the complexities involved in conducting a social return on investment (SROI) forecast in a small social enterprise, The Wooden Canal Boat Society. Design/methodology/approach – This SROI forecast was a collaborative exercise between Tameside Metropolitan Borough Council and the Wooden Canal Boat Society. A case study methodology has been adopted in order to allow the voice of the first author, from the Local Authority, to come through. Findings – The findings highlight that the process of scoping; gathering and analysing information; engaging with stakeholders and assigning evidence against proxies (London centric) is challenging and exhausting, yet it provides a rich learning experience for all those involved. The accuracy of the ratio is compromised and implicated by the time and resources that are available to invest the subjectivity of the data behind the ratio the judgements and decisions over who and how to include/exclude individuals from the SROI forecast. In short, the Wooden Canal Boat Society SROI forecast proved to be the tipping point in a successful grant application. However, SROI is not something the Local Authority are set to embrace more widely or would particularly recommend for the vast majority of their local social economy organisations. Research limitations/implications – As a case study paper, the authors do not seek to generalise. The case provides the reader with a stakeholder informed account of the experiences of being involved in a forecast SROI from the perspective of the first author from the Local Authority. In times of political change and economic austerity the climate in the UK social economy has significantly altered, particularly in the marketisation of services and funding provisions for health and social care. One implication of this shift that is reflected in the paper is Local Authority thinking in light of the Social Value Act, which passed through the UK Parliament in 2012. Originality/value – The value of this case study provides academics and practitioners with an alternative perspective and rich commentary of the first author's narrative and reflections on the process of SROI and the dynamics involved in arriving at the ratio.

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