Cross-generational Physical Activity: Surveys of Children and Parents.

This study investigated the cross-generational physical activity of primary school-aged children and parents in Australia. Separate child and parent questionnaires were administered to establish a profile of the phenomenon. Cross-generational physical activity occurred across a wide variety of types of physical activity, including recreation, sport, and exercise. The study provides insight into the complexity of the physical activity partnership by showing that in a substantial proportion of partnerships, children initiate the physical activity. The importance of investigating both populations was shown as both common experiences in cross-generational physical activity, such as bonding and enjoyment were identified in addition to unique aspects. For example, child respondents disliked power, fitness, and skills mismatches whilst parent respondents disliked their children fighting and complaining. 59% of parents ranked holidays as a time they were more likely to engage in cross-generational physical activity. Findings from the surveys suggest that this physical activity partnership involves more than the provision of parental support for physical activity and modeling of a healthy behavior from parent to child.

Exploration of older people's perceptions of behavioural factors associated with falls.

Background: falls rates in older people continue to rise despite concerted efforts to manage falls risks. As more effective strategies to reduce falls in older people may arise from better understanding their perspectives on falls risk, this study aimed to explore perceptions and behavioural decisions that may affect risk of falling among older people living in regional Australia. Method: this qualitative research, informed by hermeneutics, explored older people's perspectives on decisions they made that could affect their falls risk. The study involved 26 participants (21 females) aged 65-84 years, residing in regional Australia. In total, 13 participated in semi-structured focus groups and 13 in semi-structured, in-depth interviews. Results: six key themes illuminated the challenges older people faced in relation to falls risk. These were: the role that independence played in decision making regarding risk; the influence of previous falls experience; older people's level of understanding of risks; ability and willingness to engage with support; the need or desire to cover up a fall history; and the influence of finances in managing risk. Older people's accounts demonstrated they experienced competing influences that impacted upon decisions they made with respect to falls risks. Most significantly, the complex interplay of these influences drove the decisions older people made, sometimes placing them at greater risk of falling. Conclusion: consideration of the multifaceted issues older people face when managing falls risk, and the influence these factors have on their behaviours, is vital to successfully reducing rates of fall related injuries in this population.

Acceptance of primary practitioner physiotherapists in an emergency department: A qualitative study of interprofessional collaboration within workforce reform.

Primary contact practitioner physiotherapists (PPs) are increasingly common in emergency departments (EDs) and provide targeted care to people with uncomplicated musculoskeletal conditions such as sprains, strains, and simple fractures. Workforce redesign can be challenging and success is influenced by staff attitude and opinion. The current study aimed to explore the experiences and perceptions of ED team members about a recently introduced PP service on existing staff and services in a large regional ED. Forty-two staff from eight professional groups participated in semi-structured interviews or focus groups which were audio recorded and field notes were taken. Data were transcribed verbatim and subsequently underwent thematic analysis. Acceptance emerged as one key theme. Acceptance of the PP service by ED staff was not automatic, unconditional, or implied and represented a continuum from PPs being tolerated as transient visitors to being subsumed as integrated members of the ED team. Acceptance of the service and its members was contingent upon the PPs demonstrating three interdependent qualities: being trustworthy, valuing learning, and complementing (not competing with) ED practices to achieve ED goals. Given that staff acceptance was crucial for the successful integration and performance of the service, understanding and manipulating the factors that influence acceptance might increase the likelihood of successfully implementing PP services in EDs. The results might also be applied to facilitate workforce reform in other settings.

Self-reported load carriage injuries of military soldiers.

The aim of this study was to investigate whether occupational load carriage constitutes a significant source of injury to military soldiers. An online survey was sent to soldiers serving in specific Australian Army Corps known to experience the greatest occupational exposure to load carriage. Of the 338 respondents, 34% sustained at least one load carriage injury. Fifty-two per cent of those injured during initial training reported sustaining an additional load carriage injury. The majority of injuries (61%) were to the lower limbs with bones and joints the most frequently injured body structures (39%). Endurance marching (continuous marching as part of a physical training session) was the activity accounting for most (38%) injuries. Occupational load carriage is associated with military soldier injuries and, once injured, soldiers are at a high risk of future load carriage injury. The bodily sites and nature of self-reported injuries in this study are akin to those of formally reported injuries and those of other militaries.

Reported load carriage injuries of the Australian army soldier.

INTRODUCTION: Many injuries experienced by soldiers can be attributed to the occupational loads they are required to carry. PURPOSE: The aim of this study was to determine whether contemporary military load carriage is a source of injuries to Australian Regular Army soldiers and to profile these injuries. METHODS: The Australian Defence Force 'Occupational Health, Safety and Compensation Analysis and Reporting' database was searched to identify all reported injuries sustained during load carriage events. Key search terms were employed and narrative description fields were interrogated to increase data accuracy. RESULTS: A total of 1,954 injury records were extracted from the database. Of these, 404 injuries were attributed to load carriage. The majority of these load carriage injuries involved either the lower limb or back, with bones and joints accounting for the most frequently reported body structures to be injured. Field activities were the leading activities being performed at the time that load carriage injuries occurred, and muscular stress was identified as the mechanism of injury for over half of reported load carriage injuries. CONCLUSION: This study suggests that load carriage is a substantial source of injury risk to Australian Army soldiers. Physical training may fail to adequately prepare soldiers for load carriage tasks during field training exercises.

Supervision, support and mentoring interventions for health practitioners in rural and remote contexts: an integrative review and thematic synthesis of the literature to identify mechanisms for successful outcomes.

OBJECTIVE: To identify mechanisms for the successful implementation of support strategies for health-care practitioners in rural and remote contexts. DESIGN: This is an integrative review and thematic synthesis of the empirical literature that examines support interventions for health-care practitioners in rural and remote contexts. RESULTS: This review includes 43 papers that evaluated support strategies for the rural and remote health workforce. Interventions were predominantly training and education programmes with limited evaluations of supervision and mentoring interventions. The mechanisms associated with successful outcomes included: access to appropriate and adequate training, skills and knowledge for the support intervention; accessible and adequate resources; active involvement of stakeholders in programme design, implementation and evaluation; a needs analysis prior to the intervention; external support, organisation, facilitation and/or coordination of the programme; marketing of the programme; organisational commitment; appropriate mode of delivery; leadership; and regular feedback and evaluation of the programme. CONCLUSION: Through a synthesis of the literature, this research has identified a number of mechanisms that are associated with successful support interventions for health-care practitioners in rural and remote contexts. This research utilised a methodology developed for studying complex interventions in response to the perceived limitations of traditional systematic reviews. This synthesis of the evidence will provide decision-makers at all levels with a collection of mechanisms that can assist the development and implementation of support strategies for staff in rural and remote contexts.

Soldier occupational load carriage: a narrative review of associated injuries.

This narrative review examines injuries sustained by soldiers undertaking occupational load carriage tasks. Military soldiers are required to carry increasingly heavier occupational loads. These loads have been found to increase the physiological cost to the soldier and alter their gait mechanics. Aggregated research findings suggest that the lower limbs are the most frequent anatomical site of injury associated with load carriage. While foot blisters are common, other prevalent lower limb injuries include stress fractures, knee and foot pain, and neuropathies, like digitalgia and meralgia. Shoulder neuropathies (brachial plexus palsy) and lower back injuries are not uncommon. Soldier occupational load carriage has the potential to cause injuries that impact on force generation and force sustainment. Through understanding the nature of these injuries targeted interventions, like improved physical conditioning and support to specialised organisations, can be employed.

Implementing the World Report on Disability in Malaysia: a student-led service to promote knowledge and innovation.

The lead article by Wylie, McAllister, Davidson, and Marshall (2013) puts forward pertinent issues facing the speech-language pathology profession raised by the World Report on Disability. This paper continues the discussion by reporting on a capacity building action research study on the development, implementation, and evaluation of a new approach to early intervention speech-language pathology through clinical education in Malaysia. This research evaluated a student-led service in community-based rehabilitation that supplemented existing and more typical institution-based services. A Malaysian community-based rehabilitation project was chosen due to its emphasis on increasing the equitability and accessibility of services for people with disabilities which was a catalyst for this research. Also, expanding awareness-building, education, and training activities about communication disability was important. The intention was to provide students with experience of working in such settings, and facilitate their development as advocates for broadening the scope of practice of speech-language pathology services in Malaysia. This article focuses on the findings pertaining to the collaborative process and the learning experiences of the adult participants. Through reflection on the positive achievements, as well as some failures, it aims to provide deeper understanding of the use of such a model.

Balance and agility training does not always decrease lower limb injury risks: a cluster-randomised controlled trial.

The objective of this study was to examine the effects on lower limb injury rates of adding structured balance and agility exercises to the 80-day basic training programme of army recruits. A blocked (stratified), cluster-randomised controlled trial was employed, with one intervention group (IG) and one control group (CG), in which 732 male and 47 female army recruits from the Australian Army Recruit Training Centre participated through to analysis. The IG performed specified balance and agility exercises in addition to normal physical training. The incidence of lower limb injury during basic training was used to measure effect. Analysis, which adhered to recommendations for this type of trial, used a weighted paired t-test based on the empirical logistic transform of the crude event rates. The intervention had no statistically significant effect on lower limb injury incidence (RR = 1.25, 95% CI 0.97-1.53, 90% CI 1.04-1.47), on knee and ankle injury incidence (RR = 1.08, 95% CI 0.83-1.38), and on knee and ankle ligament injury incidence (RR = 0.98, 95% CI 0.64-1.47). We conclude that the intervention, implemented in this fashion, is possibly harmful, with our best estimate of effect being a 25% increase in lower limb injury incidence rates. This type of structured balance and agility training added to normal military recruit physical training did not significantly reduce lower limb, knee and ankle, or knee and ankle ligament injury rates. Caution needs to be used when adding elements to training programmes with the aim of reducing injury, as fatigue associated with the addition may actually raise injury risk.

The effect of heel lifts on trunk muscle activation during gait: a study of young healthy females.

Heel lifts are a treatment option for low back pain (LBP), whilst high-heeled shoes have been linked to LBP development. This study evaluated the effects of in-shoe 20 mm high bilateral heel lifts on trunk muscle activity. Activity of the erector spinae (ErSp), internal oblique and external oblique muscles was evaluated using surface electromyography in 15 young (20.7+/-0.9 years) healthy female participants. Measures were taken during overground gait, both immediately and following two days habituation to the heel lifts. Immediately following the addition of the heel lifts, levels of ErSp muscle activity in the 5% epoch following heel strike increased by 19.2% (p<0.05). Following habituation, levels of ErSp muscle activity in the 5% epoch prior to heel strike increased by 24.1% (p<0.05), and a 14 ms (p<0.001) earlier onset of ErSp muscle activity prior to heel strike was observed. These results indicate the heel lifts altered muscle activity reactively around heel strike (i.e. greater activity after heel strike) immediately after application and proactively (i.e. earlier onsets and greater activity prior to heel strike) after short term habituation. When put in context of previous research on trunk muscle activity in LBP populations, these changes may be important considerations for the aetiology, treatment and prevention of LBP.