Implementation of concussion guidelines in community Australian Football and Rugby League– the experiences and challenges faced by coaches and sports trainers

Objectives

While guidelines outlining the appropriate management of sport-related concussion have been developed and adapted for use within community sport, it remains unknown how they are experienced by those responsible for implementing them.
Design

Longitudinal study.
Methods

111 coaches and sports trainers from community-level Australian Football and Rugby League teams completed pre- and post-season surveys assessing their attitudes towards using concussion guidelines. Participants also provided post-season feedback regarding their experiences in using the guidelines.
Results

71% of participants reported using the guidelines in the preceding season. Post-season attitude was related to pre-season attitude (p = 0.002), football code (p = 0.015), and team role (p = 0.045). An interaction between team role and guideline use (p = 0.012) was also found, with coaches who had used the guidelines, and sports trainers who had not, reporting more positive post-season attitudes towards using the concussion guidelines. Implementation challenges included disputing of decisions about return-to-play by players, parents, and coaches, and a perceived lack of time. Recommendations for improved guideline materials included using larger fonts and providing for witnessing of advice given to players.
Conclusions

This is the first study to examine the implementation of concussion guidelines in community sport. Training of coaches/sports trainers needs enhancement. In addition, new education should be developed for parents/players about the importance of the return-to-play advice given to them by those who follow these guidelines. Information provided by those who attempted to use the guidelines will assist the refinement of implementation and dissemination processes around concussion guidelines across sports.

Examining sports coaching philosophy: implications for policy, pedagogy and practice

This thesis showed that philosophy in coaching lacks the theoretical foundations of other helping professions, with a lack of guidance by formal coach education programs resulting in coaches adopting their own “sport philosophy”, which enabled coaches to operationalize it in ways that assisted their practice (observed through consistent coach behaviour).

Knowledge about sports-related concussion: is the message getting through to coaches and trainers?

Aim The need for accurate diagnosis and appropriate return-to-play decisions following a concussion in sports has prompted the dissemination of guidelines to assist managing this condition. This study aimed to assess whether key messages within these guidelines are reflected in the knowledge of coaches and sports trainers involved in community sport. Methods An online knowledge survey was widely promoted across Australia in May–August 2012 targeting community Australian Football (AF) and Rugby League (RL) coaches and sports trainers. 260 AF coaches, 161 AF sports trainers, 267 RL coaches and 228 RL sports trainers completed the survey. Knowledge scores were constructed from Likert scales and compared across football codes and respondent groups. Results General concussion knowledge did not differ across codes but sports trainers had higher levels than did coaches. There were no significant differences in either concussion symptoms or concussion management knowledge across codes or team roles. Over 90% of respondents correctly identified five of the eight key signs or symptoms of concussion. Fewer than 50% recognised the increased risk of another concussion following an initial concussion. Most incorrectly believed or were uncertain that scans typically show damage to the brain after a concussion occurs. Fewer than 25% recognised, and >40% were uncertain that younger players typically take longer to recover from concussion than adults. Conclusions The key messages from published concussion management guidelines have not reached community sports coaches and sports trainers. This needs to be redressed to maximise the safety of all of those involved in community sport.

The body, mind and soul of AFL footballers: tales of identity from the global sports entertainment industry

The paper discusses some of the findings of a research project funded by the Australian Football League (AFL) titled: Getting the Balance Right: Professionalism, Performance, Prudentialism and Playstations in the Life of AFL Footballers. The research explored the emergence and evolution of a professional identity for AFL footballers – an identity that has many facets including the ideas that a professional leads a balanced life, and has a prudent orientation to the future, to life after football. The AFL is a high profile, sports entertainment business in which brand relationships between the industry and its sponsors generate substantial income for the League, for Clubs, and for Coaches and players. In addition the AFL’s equalisation policies tightly regulate the ways in which Clubs can recruit, maintain and develop playing lists. In this context various tools of analysis are used to identify and characterise the particular Body, Mind and Soul elements of the young men who might be recruited to a Club; who might have significant time, money and effort invested in their development (as players, as persons); who might develop an identity as an AFL footballer. Drawing on Foucault’s work on the care of the self we argue that in this situation, narratives of identity necessarily involve a struggle for the Body, Mind and Soul of these young men.

The perceptions of expert coaches about effective leadership in sport

Research on effective leadership in sport has identified a number of characteristics and situations that impact on coaching effectiveness. These include coach effect on athlete satisfaction and performance, self-esteem and trait anxiety. This research has focused on athletes' perceptions of or preferences for specific leadership behaviors and actual coach behaviors identified by observing coaches. Few studies have recognized the views of the expert coach as a potentially valuable source of information regarding effective leadership and the coaching process. The present study investigated expert coaches' perception and interpretation of the leadership process. Twenty successful coaches working with Australian junior elite sport participants were purposefully sampled to cover a diversity of sports (team and individual) and provide a gender balance across sports. Through in-depth interviews, based on Grounded Theory, the study examined three aspects of coaching, which provided the basis of the interview guide. These were coaching history and influences, effective coaching behaviors, and coach training and accreditation. Eight major themes emerged: (a) influence of history on coaching behaviors, (b) knowledge of the sport, (c) pedagogy skills, (d) coaches' personal qualities, (e) coach-athlete relationships, (f) coaches' evaluation of the athlete, (g) coach and athlete outcomes, and (h) enjoyment of the coaching process. The results highlight the important role coaches play in future coach development, the impact of coach self-efficacy attributed to athlete self-efficacy, and how coach-related outcomes drive the coaching process. These results have noteworthy implications for coach education programs.

Player welfare and privacy in the sports entertainment industry

In an era when games at the elite level are sports entertainment businesses many of the elite performers in different industries have evolved into celebrities: they exist as images, icons and brands whose every thought, action, change of style or partner is commodified and consumed. This article reports on one aspect of a research project that was funded by the Australian Football League (AFL) to explore the emergence and evolution of a `professional identity' for AFL footballers. Drawing on Foucault's later work on the care of the Self we focus on the ways in which player identities are governed by coaches, club officials, and the AFL Commission/Executive; and the manner in which players conduct themselves in ways that can be characterized as professional — or not. The article explores the roles of Player Development Managers (PDMs) in emerging processes of risk and player management that can be seen as intrusive in players' lives. The research we report on produced evidence of tensions between the paternalistic, profiling and reporting elements of various risk management practices at the Club level — in an environment where what it means to be a professional footballer is taking on new forms.

Coaches’ perspectives on implementing an evidence-informed injury prevention programme in junior community netball

Objective For effective sports injury prevention, information is needed about the implementation context for interventions. This study describes coaches’ feedback on the implementation of an evidence-informed injury prevention programme in community junior netball using coaches’ perceptions and the RE–AIM framework.
Methods A lower-limb injury prevention programme (Down to Earth; D2E), for teaching safe-landing techniques, was delivered to 31 coaches from 31 junior community netball teams in a 1-h workshop. Coaches then delivered a 6-week programme at team training sessions starting in the week before the competition season commenced. 65% of coaches completed a feedback survey 17 weeks after they had delivered the programme.
Results Most (88%) coaches believed that D2E improved their players’ ability to perform correct landing techniques in games and that players had retained these improvements over the season. The majority (83%) indicated that an improvement in player athletic attributes was the greatest advantage of D2E, followed by a reduction in injury risk. Identified barriers to implementing
D2E were running out of time and very young players fi nding the drills too diffi cult. Coaches reported that they needed more ideas for training drills that could be incorporated into their programmes and believed that their own coaching training did not adequately prepare them to implement an injury prevention programme.
Conclusions Although coaches believed that D2E was effective in developing correct landing techniques, some modifications are needed to make it more suitable for younger players and coach education by accreditation courses could be improved to support the implementation of injury prevention programmes.

Translating guidelines for the diagnosis and management of sports-related concussion into practice

Sports injuries are a significant clinical and public
health concern. There is a growing call to improve the translation of available evidence-based and expert- informed sports injury prevention interventions into sustained use in practice by physicians and others (eg, athletic trainers, coaches, and parents) who care for injured athletes. This article provides a brief overview of the current sport injury prevention implementation literature before focusing specifically on the translation of guidelines (including consensus and position statements) developed to assist physicians and others diagnose and manage athletes with sport-related concussion and the associated return-to-play decisions. The outcomes of more than 20 published studies indicate that physician, athletic trainer, coach, parent,
and athlete knowledge, use of, and compliance with sport-related concussion guidelines are limited. More concerted, coordinated, and theory-informed efforts are required to facilitate the widespread dissemination, translation, and implementation of such guidelines. An example is provided of how implementation drivers could be used to inform the development of a comprehensive, multilevel implementation strategy targeting the individual, organizational, and system-level changes necessary to support the translation of available sport-related concussion guidelines in both the clinical and sports settings.

Balancing the risk of injury to gymnasts : how effective are the counter measures?

Background—To minimise injury risk and maximise gymnastics performance, coaches, parents, and health professionals working with young gymnasts need to understand and practise safe gymnastics.

Aims—To (a) identify the various injury counter measures specific to gymnastics, (b) critically review the literature describing each injury prevention measure, and (c) assess, using available risk factor and injury data, the weight of evidence to support each of these counter measures. Specific recommendations for further research and implementation strategies to prevent injury and improve safety are also given.

Methods—The relevant literature was identified through the use of Medline (1966 to May 1998) and SPORT Discus (1975 to May 1998) searches, hand searching of journals and reference lists, and discussions with key Australian gymnastics organisations.

Results—The key gymnastics injury counter measures identified in this review include coaching (physical preparation, education, spotting, and performance technique), equipment, and the health support system (medical screening, treatment, and rehabilitation). Categorisation of the type of evidence for the effectiveness of each of these counter measures in preventing injury showed that most of it is based on informal opinion/anecdotal evidence, uncontrolled data based studies, and several prospective epidemiological studies. There is no evidence from formally controlled trials or specific evaluation studies of counter measures for gymnastics.

Conclusions—Although gymnastics is a sport associated with young participants and frequent high volume, high impact training, there is a paucity of information on injury risk factors and the effectiveness of injury practices. Further controlled trials are needed to examine the extent to which injury prevention counter measures can prevent or reduce the occurrence of injury and re-injury. Particular attention should be devoted to improving training facilities, the design and testing of apparatus and personal equipment used by gymnasts, and coaching and the role of spotting in preventing injury.

Coaches' perceptions of golf swing kinematics

Using a computer-based videotape analysis system, a randomized series of golf swings was presented to 10 professional and 10 amateur golf coaches in an attempt to determine differences m their internal model of golf swing kinematics. A global measure was obtained by having coaches independently inspect the swings of eight golfers and estimate their golf handicaps. A micro level of analysis was undertaken by requiring participants to indicate what they considered to be 'ideal' swing characteristics using 17 predetermined limb, club, and body position angles for various phases of the swing Videotaped swings for a highly skilled and beginner level golfer were used for this task. Although the training requirements for professional coaches are much more demanding and their playing ability higher, evidence of internal model differences was not found in the handicap estimation task. It was also established that a golfer's swing may be perceived to have deficiencies but still produce sufficient accuracy to engender a low handicap On the second task, only one of the 17 estimated swing angles showed a significant difference between the coach groups. When, however, the two coach groups indicated their preferred angles for the highly skilled golfer and the beginner, 6 of the 17 angles were significantly different. The implications of these findings are that the two coach groups had similar ability to identify fundamental characteristics of the golf swing, but their model of the ideal swing was influenced by the observed golfer's skill level.

Quality of life improvements after sports injury

Over the past decade, there has been an increase in available data describing the incidence of sports injuries. However, the outcomes of such injuries remain relatively undocumented. Psychological aspects of sports injury rehabilitation have been documented in elite athletes but not in cohorts of general sports participants. The few studies that have described the financial costs of sports injuries have typically not assessed how these injuries affect quality of life. Despite recent estimates that lost quality of life accounts for 81% of total sports injury costs,1 this has received relatively little attention in the literature. The aim of this paper is to describe the quality of life outcomes associated with sports injuries and to present some preliminary observations about how these change over a six-week period.