No abstract

The Netherlands National Trial Register NTR 4027. The NTR is part of the WHO Primary Registries.

BackgroundAnkle sprains continue to pose a significant burden to the individual athlete, as well as to society as a whole. However, despite ankle sprains being the single most common sports injury and despite an active approach by various Dutch organisations in implementing preventive measures, large-scale community uptake of these preventive measures, and thus actual prevention of ankle sprains, is lagging well behind. In an attempt to bridge this implementation gap, the Dutch Consumer Safety Institute VeiligheidNL developed a freely available interactive App (‘Strenghten your ankle’ translated in Dutch as: ‘Versterk je enkel; available for iOS and Android) that contains - next to general advice on bracing and taping - a proven cost-effective neuromuscular program. The ‘Strengthen your ankle’ App has not been evaluated against the ‘regular’ prevention approach in which the neuromuscular program is advocated through written material. The aim of the current project is to evaluate the implementation value of the ‘Strengthen your ankle’ App as compared to the usual practice of providing injured athletes with written materials. In addition, as a secondary outcome measure, the cost-effectiveness will be assessed against usual practice.Methods/DesignThe proposed study will be a randomised controlled trial. After stratification for medical caregiver, athletes will be randomised to two study groups. One group will receive a standardized eight-week proprioceptive training program that has proven to be cost-effective to prevent recurrent ankle injuries, consisting of a balance board (machU/ MSG Europe BVBA), and a traditional instructional booklet. The other group will receive the same exercise program and balance board. However, for this group the instructional booklet is exchanged by the interactive ‘Strengthen your ankle’ App.DiscussionThis trial is the first randomized controlled trial to study the implementation effectiveness of an App for proprioceptive balance board training program in comparison to a traditional printed instruction booklet, with the recurrence of ankle sprains among athletes as study outcome. Results of this study could possibly lead to changes in practical guidelines on the treatment of ankle sprains and in the use of mobile applications for injury prevention. Results will become available in 2014.Trial registrationThe Netherlands National Trial Register NTR4027. The NTR is part of the WHO Primary Registries.

ObjectiveThis article describes the systematic development of an intervention for the prevention of lower extremity injuries in field hockey and the assessment of its feasibility.MethodsThe intervention was developed according to the first four steps of the intervention mapping and knowledge transfer scheme processes, mostly based on focus group interviews with experts in field hockey and injury prevention (needs assessment; objective and target groups; content selection; development). Subsequently, a quasi-experimental research (one-group post-test design) was conducted among 35 young field hockey players and 7 coaches. Participants were asked to use the intervention for 3 weeks, and the degrees of relevancy, suitability, satisfaction and usability of the intervention were assessed by means of a questionnaire and a group interview.ResultsFirst, the needs assessment conducted among the main actors within recreational field hockey revealed that an injury prevention intervention was needed, ideally delivered through videos via an application for smartphone/tablet or website. Second, the objective and target groups of the intervention were defined, namely to prevent or reduce the occurrence of lower extremity injuries among both young and adult recreational field hockey players. Third, warming-up exercises were selected as preventive measures and strategies (eg, core stability, strength, coordination). Last, the ‘Warming-Up Hockey’ intervention was developed, consisting of a warm-up programme (delivered by coaches including more than 50 unique exercises). The relevancy, satisfaction and usability of ‘Warming-Up Hockey’ were positively evaluated, but two main alterations were made: the duration of the ‘Warming-up Hockey’ was reduced from 16 to 12  min and a match-specific warm-up was added.ConclusionThe feasibility of ‘Warming-Up Hockey’ was positively assessed by players and coaches. Prior to its nationwide implementation, the effectiveness of the intervention on injury reduction among field hockey players should be conducted.

BackgroundMusculoskeletal injuries in the lower limbs are common in pivoting team sports such as field hockey. Consequently, the Royal Dutch Hockey Federation (KNHB) aims to prevent the occurrence of these injuries among hockey players.ObjectiveTo develop an evidence-based intervention to prevent musculoskeletal injuries in the lower limbs among youth/adult hockey players and to explore its feasibility and limited efficacy.DesignThe KNHB intervention was developed in accordance to a scientific framework (Intervention Mapping). Then, a pilot-implementation based on a single-group repeated-measures design was conducted.SettingRoyal Dutch Hockey Federation (KNHB).Patients (or Participants)A total of 168 hockey coaches/trainers were enrolled in a pilot-implementation of 12 weeks.Interventions (or Assessment of Risk Factors)The KNHB intervention was developed according to (i) scientific literature, (ii) view of experts in hockey and injury prevention, and (iii) needs of hockey players and hockey coaches/trainers. The KNHB intervention is an age- and gender-specific warming-up programme involving more than 50 exercises divided in three phases of 4–5 minutes (preparation, motor skills, hockey skills). The KNHB intervention is available through a website and an application for smartphone/tablet in which all exercises are described with texts, pictures and video's.Main Outcome MeasurementsUse/feasibility of the KNHB intervention as well as level of knowledge and skills of hockey coaches/trainers about injury prevention and the KNHB intervention (Visual Analogue Scale).ResultsThe KNHB intervention was positively evaluated, while more than 80% of the hockey coaches/trainers thought that the website and application for smartphone/table were of added value. Calculated effect size (d=0,23 between T0 and T1; d=0,34 between T0 and T2) showed a moderate effect on level of knowledge and skills of hockey coaches/trainers.ConclusionsThe KNHB intervention is feasible and leads to more knowledge and skills among hockey coaches/trainers. Its effect on injuries needs to be evaluated.