JOURNAL WATCH

A prospective physiotherapy intervention study during competition periods for three seasons was conducted on an America’s Cup yachting race crew of 30 professional sailors. In 2004, athletes did not receive any preventive physiotherapy. In 2005, preventive intervention (phase 1) consisted of stretching exercises before the yacht race and preventative taping. During most of the 2006 season, the physiotherapy programme was implemented, adding articular mobilisation before competition, ice baths after competition and kinesiotaping (phase 2). Late in 2006 and in 2007,

DIFFERENT STRATEGIES FOR SPORTS INJURY PREVENTION IN AN AMERICA’S CUP YACHTING CREW. Hadala M, Barrios C. Medicine and Science in Sports and Exercise 2009;41:1587–1596.

a recovery programme comprising core stability exercises, post-competition stretching exercises and 12h of compressive clothing was added (phase 3). Results: In the pre-intervention phase (2004), the rate of injured sailors/competition day was 1.66. This decreased to 0.60 sailors/ competition day in 2007 (phase 3). The number of athletes with more than one injury was significantly reduced from 53% (8 of 15) to 6.5% (2 of 12).

In the pre-intervention period, mastmen, grinders and bowmen showed a rate of 2.88 injuries per competition day. After phase 3, this group suffered only 0.35 injuries per competition day.

sportEX comment Congratulations to the America’s

Cup staff. The preventive programme clearly worked. Other sports take note.

CODING SPORTS INJURY SURVEILLANCE DATA: HAS VERSION 10 OF THE ORCHARD SPORTS INJURY CLASSIFICATION SYSTEM IMPROVED THE CLASSIFICATION OF SPORTS MEDICINE DIAGNOSES? Hammond LE, Lilley J, Ribbans WJ. British Journal of Sports Medicine 2009;43:498–502.

Injury surveillance data were gathered over a 2-year period in

professional football, cricketand rugby union to produce 335 diagnoses. They were coded with both Orchard Sports Injury Classification System (OSICS) 8 and OSICS-10. Code– diagnosis agreement was assessed for OSICS-8 in terms of whether a diagnosis was codeable or non-codeable, and for OSICS-10 by evaluating the highest available OSICS-10 tier of coding. Eight clinicians coded a list of 20 diagnoses, comprising a range of pathologies to all gross anatomical regions, which were compared to assess interrater reliability. Results: All diagnoses could be assigned an

appropriate code with OSICS-10, compared with 87% of diagnoses that could be assigned an OSICS-8 code. Contusions comprised almost half of OSICS-8 non-codeable diagnoses. OSICS-10 tier 2 codes accounted for 20% of diagnoses coded with the updated system. Of these 20%, almost half contained a more detailed diagnosis that did not have an available OSICS-10 tier 3 or 4 code. Interrater reliability increased with decreasing diagnostic detail, with an overall level shown to be moderate. OSICS-10 is a more encompassing system than OSICS-8 to use in classifying sports medicine diagnoses and has a moderate level of interrater reliability. Further minor revision may be required to address

A RANDOMIZED STUDY OF TWO PHYSIOTHERAPEUTIC APPROACHES AFTER KNEE LIGAMENT RECONSTRUCTION. Revenås A, Johansson A, Leppert J. Advances in Physiotherapy 2009;11:30.

After anterior cruciate ligament reconstruction

(ACLR), 24 patients were randomised to a knee-class therapy (KT) group and 27 to a guided therapy (GT) group, who received an individual programme with limited physiotherapy appointments. Function, activity level, muscle strength, knee-joint stability and knee-joint mobility were measured at 6 months and 12 months after surgery. Fourteen patients in the KT group and 24 patients in the GT group completed the physiotherapy appointments as prescribed. Results: At 6 months after surgery, the median Lysholm knee score was significantly higher in the KT group. At

6

the 12-month follow-up, the GT group’s improvement in the Lysholm knee score was significantly greater than the KT group’s. Noncompliance was high in the KT group. Subgroup analysis of the non-compliers in the KT group showed that their improvement in the Lysholm knee score between 0 months and 12 months was significantly greater than that of the KT group’s compliers.

sportEX comment The Lysholm score gives values in

categories that include, among others, limp, need for support, instability swelling and pain. The higher the score, the better. There are

lack of detail insome strain, effusion and contusion codes.

sportEX comment One for the researchers. The OSICS

was developed in 1992 for use in a study that examined the incidence of injury at the elite level of Australian Rules football, rugby league and rugby union. It allows classification of diagnoses for summary studies, permitting easy grouping into parent categories for tabulation and creates a database from which cases can be extracted for research. The bottom line is that version 10 is better then version 8.

a number of issues here, leading to many questions that can be addressed when improvement in the Lysholm knee score preparing your own rehab programmes. These questions include how much personal attention does a participant in a group class get? Is it more than the limited appointment

group? Are, therefore, the KT groups exercise movements corrected sooner, thus allowing for greater initial improvement? If the KT group is better after 6 months and worse after 12 months, then is the optimum course of treatment a mixture of both? The non- compliers in the KT group had good scores, so does this indicate that they didn’t comply because they didn’t feel they needed to attend the classes? And so is the point at which they drop out the time to start the individual sessions?

sportEX medicine 2009;42(Oct):4-6