Integrating sport and exercise medicine clinics into the National Health Service: a qualitative study.

OBJECTIVES: To explore the services National Health Service (NHS)-based sport and exercise medicine (SEM) clinics can offer, and the barriers to creating and integrating SEM services into the NHS. METHODS: Semi-structured interviews were undertaken to collect data from identified 'stakeholders'. Stakeholders were identified as individuals who had experience and knowledge of the speciality of SEM and the NHS. An inductive thematic analysis approach was taken to analyse the data. RESULTS: N=15 stakeholder interviews. The management of musculoskeletal (MSK) injuries (both acute and chronic) and concussion were highlighted as the two key services that SEM clinics can offer that would most benefit the NHS. MSK ultrasound was also mentioned by all stakeholders as a critical service that SEM clinics should provide. While exercise medicine is an integral part of SEM, SEM clinics should perhaps not have a heavy exercise medicine focus. The key barriers to setting up SEM clinics were stated to be convincing NHS management, conflict with other specialities and a lack of awareness of the speciality. CONCLUSION: The management of acute MSK injuries and concussion should be the cornerstone of SEM services, ideally with the ability to provide MSK ultrasound. Education of others on the speciality of SEM, confirming consistent 'unique selling points' of SEM clinics and promoting how SEM can add value to the NHS is vital. If the successful integration of SEM into the NHS is not widely achieved, we risk the NHS not receiving all the benefits that SEM can provide to the healthcare system.

The relationships between rugby union and health: a scoping review protocol.

INTRODUCTION: Rugby union is played by over eight million people across the world and is considered a form of moderate-to-vigorous physical activity. Consequently, playing rugby may confer health benefits; however, to date, the principal focus of research has been on associated injuries and potential detrimental long-term health sequelae. This protocol outlines the methods behind studying any potential associations between rugby union and both physical and mental health. METHODS AND ANALYSIS: Best practice methodological frameworks (Arksey and O'Malley, Levac et al and the Joanna Briggs Institute) and previously published scoping review protocols in sport informs the methodology of this protocol. This protocol enables us to map the key concepts and evidence available, summarise and share existing research findings, and identify research gaps in the current literature. A three-step search strategy will identify reviews, original research, and published and grey literature. An initial search will identify suitable search terms, followed by a search using keyword and index terms. Two reviewers will independently screen identified studies for final inclusion. DISSEMINATION: When publishing the scoping review, we will map key concepts and evidence both numerically and thematically, as well as identify key research priorities for further studies. The review will subsequently be disseminated to stakeholder groups, practitioners and policymakers through a variety of peer-reviewed and non-peer-reviewed publications, conferences and via multimedia platforms.

Concussion knowledge and experience among Welsh amateur rugby union coaches and referees.

BACKGROUND: Rugby union is a collision sport where participants are at high risk of sustaining a concussion. In settings where there is little qualified medical supervision, certain stakeholders (eg, coaches and officials) should possess sufficient knowledge in regard to the recognition and management of concussion. AIM: The aim of this study was to assess the knowledge and experience of various aspects of concussion among coaches and referees involved in Welsh amateur rugby union. METHODS: A questionnaire was distributed to 1843 coaches and 420 referees. RESULTS: A total of 333 coaches and 283 referees completed the questionnaire (18% and 68% response rates, respectively). Participants exhibited greater knowledge of concussion symptom recognition relative to knowledge of both the consequences of concussion and associated return-to-play protocols, both of which could be considered poor. There were no differences in knowledge levels between coaches and referees or between participants with or without a history of concussion. Two-thirds of participants incorrectly believed that headgear could prevent concussion, and nearly 30% of coaches reported having witnessed other coaches allowing a potentially concussed player to continue playing. CONCLUSIONS: Identification of several misconceptions indicates that concussion management within Welsh amateur rugby union needs to be improved, warranting a multi-faceted educational intervention.

An observational study of spectators' step counts and reasons for attending a professional golf tournament in Scotland.

BACKGROUND: Spectators at several hundred golf tournaments on six continents worldwide may gain health-enhancing physical activity (HEPA) during their time at the event. This study aims to investigate spectators' reasons for attending and assess spectator physical activity (PA) (measured by step count). METHODS: Spectators at the Paul Lawrie Matchplay event in Scotland (August 2016) were invited to take part in this study. They were asked to complete a brief questionnaire with items to assess (1) demographics, (2) reasons for attendance and (3) baseline PA. In addition, participants were requested to wear a pedometer from time of entry to the venue until exit. RESULTS: A total of 339 spectators were recruited to the study and out of which 329 (97.2%) returned step-count data. Spectators took a mean of 11 589 steps (SD 4531). 'Fresh air' (rated median 9 out of 10) then 'watching star players', 'exercise/physical activity', 'time with friends and family' and 'atmosphere' (all median 8 out of 10) were rated the most important reasons for attending. CONCLUSION: This study is the first to assess spectator physical activity while watching golf (measured by step count). Obtaining exercise/PA is rated as an important reason for attending a tournament by many golf spectators. Spectating at a golf tournament can provide HEPA. 82.9% of spectators achieved the recommended daily step count while spectating. Further research directly assessing whether spectating may constitute a 'teachable moment', for increasing physical activity beyond the tournament itself, is merited.