Legal risk management and injury in the fitness industry: the outcomes of focus group research and a national survey of fitness professionals.

The Australian Fitness Industry Risk Management (AFIRM) Project was set up to explore the operation of rules and regulations for the delivery of safe fitness services. This article summarises the results of recent focus group research and a national survey of risk management practices by the AFIRM Project. Our focus group research in four States identified the following most important concerns: (1) the competency of fitness professionals; (2) the effectiveness of pre-exercise screening and the management of de-conditioned clients; (3) poor supervision of fitness service users and incorrect use of equipment; (4) fitness trainers failing to remain within their scope of practice; (5) equipment misuse (as distinct from incorrect use); and (6) poor fitness training environments. This information was then used to develop 45 specific items for a questionnaire that was disseminated throughout the fitness industry. The survey, which is the largest ever conducted in the Australian fitness industry (n = 1,178), identified similar concerns. Our research indicates that efforts to improve risk management in the fitness industry should focus, first and foremost, on the development and monitoring of safety policy, and improvements in the education and training of fitness instructors to ensure that they can incorporate risk management practices.

Cardiac emergency preparedness in health/fitness facilities in Australia.

BACKGROUND: Health/fitness facilities are popular venues for physical activity, where increasingly more individuals at risk of cardiovascular events exercise to achieve positive health outcomes. The aim of our study was to analyze cardiac emergency preparedness in health/fitness facilities in Queensland, Australia. DESIGN: Cross-sectional survey of health/fitness facilities in Queensland. METHODS: A risk management questionnaire was administered over 7 months, July 2009 to January 2010, using an online or paper-based version. The data are presented as the proportion of survey respondents giving specific responses to questionnaire items related to cardiac emergency preparedness, especially the provision of automated external defibrillators (AEDs). RESULTS: Fifty-two health/fitness facility managers responded to the survey. Most of the surveyed facilities conducted pre-activity screening (92%). Of those with a written emergency plan (79%), only 37% physically rehearsed their emergency response systems at regular intervals. Ninety-five percent of the facilities had fitness employees with a current first aid/cardiopulmonary resuscitation certificate and training. Of the 10 (19%) facilities with an on-site AED, only 6 had staff qualified to use the AED in an emergency, and only 6 had the AED as part of a public access defibrillator program. CONCLUSION: This is the first study to report that cardiac emergency preparedness is not optimal in the health/fitness facilities in Australia. Development of policies and procedures for training health/fitness professionals in emergency procedures is needed to minimize the risk when exercise-induced cardiac events occur at health/fitness facilities.

Incidence, bystander emergency response management and outcomes of out-of-hospital cardiac arrest at exercise and sport facilities in Australia.

OBJECTIVE: Despite growing emphasis on automated external defibrillators (AEDs) at sport venues in Australia, the risk of cardiac events at such locations is unknown. The aim of the present study was to investigate the incidence of out-of-hospital cardiac arrest (OHCA) at exercise and sport facilities (ESF) in Australia and the impact of effective bystander-initiated CPR and AED use on return of spontaneous circulation (ROSC) to hospital admission. METHODS: Data were obtained from the Queensland Ambulance Service for the 8-year period between January 2007 and January 2015. Data were analysed using descriptive statistics, non-parametric correlational tests and logistic regression. The OHCA incidence rate (IR) for ESF categories was standardised for 100 000 participant-years. RESULTS: Over the 8-year period, there were 250 OHCA events with a median age of 62 years (interquartile range 49-69) comprising mostly males (86.6%, n = 187). The risk of OHCA for 100 000 participants per year was highest at outdoor sports facilities (IR 5.1) followed by indoor sports or fitness facilities (IR 0.8). On arrival of paramedics, bystander-initiated CPR and AED was present at 12.4% (n = 31) of the cases achieving 33.3% (n = 9) ROSC to hospital admission. The odds of ROSC for effective CPR was 2.3 times the odds of ROSC for no CPR (P = 0.01). CONCLUSION: These findings have implications for policy development by government agencies and major sport and exercise organisations to improve bystander CPR and AED. This can help to ensure that ESF can properly respond to cardiac emergencies to save lives.

Effects of Swiss-ball core strength training on strength, endurance, flexibility, and balance in sedentary women.

The purpose of this study was to investigate the effects of Swiss-ball core strength training on trunk extensor (abdominal)/flexor (lower back) and lower limb extensor (quadriceps)/flexor (hamstring) muscular strength, abdominal, lower back and leg endurance, flexibility and dynamic balance in sedentary women (n = 21; age = 34 ± 8.09; height = 1.63 ± 6.91 cm; weight = 64 ± 8.69 kg) trained for 45 minutes, 3 d·wk-1 for 12 weeks. Results of multivariate analysis revealed significant difference (p ≤ 0.05) between pre and postmeasures of 60 and 90° s trunk flexion/extension, 60 and 240° s-1 lower limb flexion/extension (Biodex Isokinetic Dynamometer), abdominal endurance (curl-up test), lower back muscular endurance (modified Sorensen test), lower limb endurance (repetitive squat test), lower back flexibility (sit and reach test), and dynamic balance (functional reach test). The results support the fact that Swiss-ball core strength training exercises can be used to provide improvement in the aforementioned measures in sedentary women. In conclusion, this study provides practical implications for sedentary individuals, physiotherapists, strength and conditioning specialists who can benefit from core strength training with Swiss balls.

An epidemiological analysis of yoga-related injury presentations to emergency departments in Australia.

Objectives: Despite being considered a low-intensity exercise, concerns have been raised about the risk of injuries associated with yoga. This study aimed to analyze the characteristics and trend of yoga-related emergency department (ED) presentations from July 2009 to June 2016 in Victoria, Australia. Methods: The Victorian Emergency Minimum Dataset (VEMD) was used to collect the de-identified data. The data were first analyzed using descriptive statistics and Spearman's correlation. Further injury trend was analyzed by calculating the percentage change of the number of yoga-related injuries during the 7-year study period. Results: There were 118 yoga-related injury cases that significantly (p < .05) increased by 357% from July 2009 to June 2016. Most of the cases were female (n = 96; 81.4%) and between 20 and 39 years old (n = 68, 57.6%). Most common injuries comprised dislocations/sprains/strains (n = 60, 51.7%) followed by fractures (n = 17, 14.4%), and injury to muscle/tendon (n = 15, 12.7%). Conclusion: The findings warrant future nationwide research as well as an investigation into the risk management strategies of yoga service providers to minimize the risk of injury.