A systematic review of injuries in recreational field hockey: From injury problem to prevention.

The purpose of this study was to gather information from scientific literature related to all steps of Van Mechelen's "sequence of prevention" for injuries applied to youth and adult recreational field hockey players. A systematic review was conducted in Medline via Pubmed and in SPORTDiscus via EBSCOhost. Twenty-six original studies were included. Regarding injury incidence (step 1) results showed several overall injury incidence rates (youth: 1.47 per 1,000 Athlete Exposure (AE) time-loss (TL) injury up to 11.32 per 1,000 AE TL ánd non-time loss (NTL) injury, adults: 2.2 NTL injury per 1,000 AE, 15.2 injury per 1,000 hours of sports participation). Considering games and practices, most injuries were sustained in games (youth: 4.9, adults: 7.87 per 1,000 AE). Considering body parts, highest injury incidence rates were found in body parts in the lower extremities (youth: knee injuries in games (0.33 per 1,000 AE), adults: hamstring injuries in pre-season (0.75 per 1,000 AE)) and injuries in the head/face/eye (youth: 0.66 and adults: 0.94 head/face/eye, 0.71 head/face and 0.63 concussion per 1,000 AE). Regarding aetiology (step 2), no studies were found. Regarding the efficacy of available interventions (step 3 and 4), one study was found among youth players, describing a warm-up programme.

Mixed-methods process evaluation of the injury prevention Warming-up Hockey programme and its implementation.

Warming-up Hockey (WUP) is an effective injury prevention programme to reduce acute field hockey injuries among youth. This paper describes the process evaluation of the nationwide scaling-up. We conducted a mixed-methods process evaluation from September 2019 to December 2020 according to the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework, focusing on the intervention and its implementation. We collected data through questionnaires, interviews and web/app analytics. Participants were trainers/coaches, technical/board members of hockey clubs (TBMs) and employees of the Royal Dutch Hockey Federation (KNHB). In total, 226 trainers/coaches (61 via WUP and 165 via training courses) and 14 TBMs filled in questionnaires. Ten individuals (four trainers/coaches, four TBMs and two KNHB employees) participated in semistructured interviews. The study showed the following results according to the RE-AIM framework. Reach: According to web/app analytics, 1492 new accounts were registered. Effectiveness: Overall, users were satisfied with WUP and the implementation strategies, and believed WUP could reduce field hockey injuries. Adoption: 63% of the trainers/coaches (enrolled via WUP) indicated they used WUP. Implementation: Most trainers/coaches did not use WUP during every training session or match. Most TBMs promoted WUP in their club. Implementation barriers included lack of integration with other training programmes, 'know-it-all' trainers, lack of supervision on WUP use and delayed start of implementation. Facilitators included perceived added value, information need on injury prevention in small clubs and tailored communication. Maintenance: Users planned to use WUP occasionally. The KNHB intended to integrate WUP in their newly developed Knowledge Platform. To conclude, WUP was evaluated as a useful programme, but adherence to WUP was challenging. Timely preparation and creating an implementation plan based on stakeholder input, including communication at key moments during the sports season and tailored communication, were found to be important during implementation. Findings can be useful for others planning to implement evidence-based injury prevention programmes on a larger scale.

Child safety in cars: An observational study on the use of child restraint systems in The Netherlands.

OBJECTIVE: To minimize children's injuries due to car accidents, children must be transported in approved child restraint systems (CRS). The European Union optimized child protection by implementing R129 legislation for CRS in 2013. However, compliance with CRS recommendations after introduction of this newer standard has been scarcely evaluated. The main objectives of this study were to determine the prevalence of various types of CRS misuse and to investigate the use of ISOFIX and i-Size seats and parental knowledge regarding safe transportation of children in cars 5 years after the introduction of the newer R129 standard. METHODS: During a cross-sectional observational study in the summer of 2018, parking lots of sites in the Netherlands were visited by researchers. Arriving or departing Dutch drivers who transported children under 9 years old were interviewed by means of a questionnaire and the misuse of CRS was directly observed using a checklist. Misuse was defined as CRS inappropriate for the child (based on height and weight) and/or CRS wrongly installed in the car and/or child improperly restrained in CRS. RESULTS: In total, 392 drivers and 470 children were included in the study. Results showed that 83% of the children were transported with at least 1 misuse of their CRS: 7% of the CRS were inappropriate for the child, 49% of the CRS were wrongly installed in the car, and 59% of the children were improperly restrained in a CRS. Most CRS were installed using the seat belt (88%) compared to ISOFIX (12%). ISOFIX usage did not result in less CRS installation misuse (P = .338). The number of observed i-Size CRS was low (n = 13, 3%). Most drivers were familiar with ISOFIX (76%), but only 13% of the drivers had heard of i-Size. CONCLUSIONS: For 9 out of 10 children, CRS misuse was observed. Many children were transported in an appropriate CRS, but various mistakes were made when installing the CRS in the car and restraining children in the CRS. Moreover, ISOFIX usage did not result in statistically significant less CRS installation misuse compared to traditional seat belt usage, and i-Size CRS are still rather unknown 5 years after their introduction.