Lauren Victoria Fortington

Introduction: Exercise is a key part of cancer care, yet its integration into routine practice remains limited. This study explored the experiences of people living with and beyond cancer, with an updated, opt-out referral model embedded within a supportive oncology setting, focusing on initial engagement with exercise physiology appointments. Through this model, patients were automatically scheduled for a consultation with an in-house exercise professional during their cancer treatment. Methods: A qualitative descriptive design comprised of two focus groups with 13 participants was employed to explore views across pre-defined elements of the model: referral to exercise, appointments, counselling, and tailoring. Results: Participants valued the automatic appointment structure as it normalised exercise as being part of their treatment and reduced the burden from decision-making and arrangement of appointments. Trust in their treating doctors and nurses, together with consistent messaging, reinforced exercise as a medically endorsed intervention. Counselling on exercise addressed misinformation, highlighted the physiological rationale, and helped foster a sense of control and agency. The inclusive gym environment and tailored plans further supported engagement with exercise, from which the importance of collaborative but individualised care was noted. While the opt-out process facilitated initial uptake, sustained access to exercise services beyond the clinical setting remains a challenge. Conclusions: Findings support the feasibility and acceptability of integrated referral pathways and underscore the need for system-level changes and community partnerships to ensure long-term, equitable access to exercise in cancer care.

Background The prevention and management of concussion is an ongoing challenge for sporting bodies worldwide. In community-level sport, there is a lack of robust data to support decision making around risk and recovery. This paper outlines a new Concussion Management Procedure (CMP) introduced to community rugby for managing concussion (specifically on-field management of suspected concussion), identifying the definitions, design, and inclusion parameters of the procedure. Approach In response to a community and sport need for direction on managing community players with concussion, Rugby Australia designed, trialled and introduced the new CMP. This CMP drew on the existing use of a yellow/red card from a referee when a player is sanctioned, by using a blue card as an indication of a player being removed from play for a suspected and confirmed concussion. Team administrators record all cards in the competition management software. Players with a blue card are unable to be selected for matches until medically cleared. The CMP encourages timely presentation to medical care and a cautious, medically supervised recovery before return to play. Conclusion This paper describes the Rugby Australia CMP. Through the CMP, data on the number of suspected and confirmed concussions can be obtained, together with key player (eg, age group) and game (eg, time in season) features and used for surveillance (quantifying concussion/ blue card occurrence) in community rugby.

Sport-related injuries are common presentations to primary care and hospital settings. Australian osteopaths practice mainly in private clinical settings in which the frequency of sport-related injury presentations, and how these injuries are managed, is unknown. The objective of the study was to describe the demographic, practice, and clinical management characteristics of Australian osteopaths who report often treating sport-related injuries. The study is a secondary analysis of data derived from the Australian osteopathy practice-based research network. Respondents indicated the frequency treating sports-related injuries in addition to other demographic, practice, and patient management characteristics. Backward logistic regression identified significant characteristics associated with often treating sport injuries. Over half (51%) of a nationally representative sample of Australian osteopaths reported treating sport-related injuries often. Those osteopaths who treat sports injuries often were likely to be male (p < 0.01) and utilise exercise prescription (OR2.34) and sports taping (OR5.99). Australian osteopaths who often treat sports-related injuries provide advice to patients and use exercise prescription more frequently than osteopaths who do not treat these injuries often. The data in the current work begin to explore how osteopaths manage sports-related injuries and highlights how they may be able to provide sports injury care for both recreational and elite sport populations.

Background: Mixed martial arts (MMA) and Muay Thai (MT) are widely practiced combat sports, yet research on the full spectrum of competition-related health problems (HPs) remains limited, particularly for MT. Existing studies in both sports primarily focus on retrospective analyses of severe injuries, often estimating time lost from training or competition. This study describes the incidence of all competition HPs reported seven days after MMA and MT contests, and determines the number of days impacted by tracking athletes’ self-identified worst HPs until resolution. Methods: Data on competition HPs were collected using an online questionnaire completed seven days after each MMA and MT event (n = 26). The questionnaire included the Oslo Sports Trauma Research Centre Questionnaire on Health Problems 2 (OSTRC-H2). The Combat Sports Commission of Western Australia provided competition exposure time data. Incidence rates of HPs were calculated per 100 min of exposure (HPIR_ME). Competitors reporting HPs were followed up weekly using the OSTRC-H2 questionnaire until their worst HPs resolved. Results: Of the 175 competitors (238 responses) who completed the questionnaire (76% male; age: 27 ± 6 years), 81 competitors (92 responses) reported a total of 411 HPs (315 injuries, 96 illnesses). Among the 92 worst HPs, 26 were substantial, and 24 prevented training. The HPIR_ME was 20.1 (95% CI: 16.5–24.4) for MMA and 25 (95% CI: 22.3–28) for MT. Follow-up captured 78 (85%) of the worst HPs, with 175 responses collected over 14–70 days post-competition. The median days impacted by the worst HPs were 20 for MMA and 16 for MT. Conclusions: Among respondents, 39% reported at least one HP. On average, the worst HPs resolved in less than three weeks. These findings provide valuable insights into the frequency and impact of competition HPs,offering important information for promoters, athletes, coaches, and regulatory bodies to better understand and address the health challenges faced by combat sports athletes.

This study investigates the rapid weight loss (RWL) and rapid weight gain (RWG) of contest winners and losers from Muay Thai (MT) and mixed martial arts (MMA) events. The relationship between rapid weight change variables of males and females, and competitive success is also examined. Data from a weight management questionnaire was collected one day post-competition from 185 participants across 24 fight events, resulting in 263 responses (MMA: n = 78, MT: n = 185). Official and secondary weigh-in data were provided by the Combat Sports Commission. The results show that in MT, contest winners compared to losers had significantly greater RWL–7 days (5.9 ± 2.6% vs. 4.6 ± 2.7%, p = 0.01), RWG (6.2 ± 2.9% vs. 4.7 ± 2.8%, p = 0.003), and RWG/RWL ratio (108% [86–132%] vs. 86% [60–119%], p = 0.038), while no significant differences were observed for MMA. Mixed logistic regression models that controlled for age showed that a 1% increase in female RWL–24 h ([OR = 1.57, R² = 0.105, p = 0.001]) was associated with a 1.6 times higher likelihood of winning compared to female athletes without this increase. We emphasise that associations do not imply causation, and it is possible that other factors which align with rapid weight change practices may impact the observed relationship. Nonetheless, MT contest winners show greater RWL, RWG, and RWG/RWL ratio than losers, and female rapid weight changes appear to be associated with competitive success in this cohort.

Concussions in contact sports are challenging for athletes, health professionals and sporting bodies to prevent, detect and manage. Design of interventions for primary prevention, early recognition of concussion and continuing to improve postconcussion management are essential for protecting athletes and promoting brain health. Over the last decade, there have been advancements in video technology for analysing head impact events and improvements in the clinical management of concussions. This study protocol describes how researchers, clinicians and staff from the Australasian National Rugby League (NRL) have brought these advancements together and developed a database of videos with head impact events and clinical outcomes. The intended outputs from this work will enhance the understanding of head impact events in NRL, from biomechanical and gameplay factors to concussion and return to play outcomes. Publishing this protocol increases the transparency of this large-scale effort to better identify head impacts and their relationship to concussions and player movement behaviour to contextualise these variables to generate new knowledge and support the reproducibility of these emerging findings. Between 2017 and 2023, over 5250 head contact cases were recorded in the database, from which >1700 head injury assessments were performed, and >600 concussions were diagnosed. Future studies using these data are planned to inform both primary and secondary injury prevention initiatives, such as risk analysis and prediction of game scenarios that result in concussion, as well as investigation of features and factors that help to inform the duration of recovery and return to play.

Musculoskeletal injury patterns are under-investigated in the Royal Australian Infantry Corps. Subsequently, more evidence is needed to support injury prevention processes in this population. One difficulty in collecting injury information to monitor injury patterns within combat populations accurately is known injury concealment behaviors in such populations. This study aims to examine musculoskeletal injury epidemiology within Australian infantry battalions using a tailored approach to mitigate reporting avoidance. A cross-sectional study using an anonymous online survey captured musculoskeletal injury information directly from personnel serving within 2 Australian infantry battalions. The survey requested information on participants’ injury frequency in the previous 12 months and the context of participants’ most severe injury. Injury context was restricted to the most severe during the period to limit recall bias. The applied injury case definition encompassed all injuries that affected an individual’s ability to perform in their role. A descriptive analysis of all data recorded across the 2 battalions was conducted. Subgroup statistical difference was assessed by examining the 95% CI overlap between groups. The Department of Defence and Veterans’ Affairs Human Research Ethics Committee granted ethical approval for this study. Overall, 166 individuals self-reported at least 1 injury in the past 12 months, representing a period prevalence of 55.5% (95% CI, 49.8-61.0%). No statistically significant prevalence differences existed between employment type, age, or sex. Approximately a quarter of injured participants were medically reclassified because of their injury, impacting their deployment fitness (n = 40, 24.4%). The following results relate to the most severe injury personnel experienced. Most injuries were service-related (n = 152, 91.6%). Field activities (n = 64, 39.3%) and physical training (n = 59, 36.2%) were the most common injury-related activities. Running was the most reported injury mechanism (n = 35, 21.7%), followed by pack marching (n = 29, 18.9%) and fall, slip, or trip (n = 18, 11.2%). Musculoskeletal injuries are common in the Australian infantry and significantly burden the workforce. Physical training and field exercises are most associated with injury and represent opportunities for injury risk-mitigation strategies to support the overall deployability of personnel and the combat effectiveness of their battalions. Future research should more formally explore the injury risk factors related to these activities using more robust study designs to collect injury and exposure information more accurately and reliably. One study strength includes using military-specific international injury surveillance guidelines to inform the survey design, to collect the recommended injury information for effective surveillance, and to enable future research comparison. A second study strength was tailoring the survey to promote participatory engagement, providing a high completion rate. A challenge in conducting this research was coordinating participant recruitment and data collection during domestic operations. Such challenges reflect the reality of conducting research in the military.