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INJURY MITIGATION IN TEAM SPORTS. PART-3: IMPROVING RESEARCH QUALITY FEATURE / COLIN W. FULLER – COLIN FULLER CONSULTANCY
Colin W. Fuller Colin Fuller Consultancy Ltd Main Street, Sutton Bonington, LE12 5PE UK This paper is based on the author’s Keynote lecture presented at the 6th Football Medicine & Performance Association Conference on 17 May 2019.
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Introduction Part-1 of this series1 reviewed models used by researchers to develop injury mitigation programmes and Part-2 outlined2 the sportrelated risk management model. The aim of this paper is to present two techniques that can be used alongside the risk management model to improve the quality of current injury mitigation research. Injury Investigations A poorly researched area within injury mitigation is characterisation of the events leading to sports injuries: this information is of paramount importance for developing ways of preventing similar events occurring in the future. One management technique used to characterise injury threats, consequences and barriers is the bow-tie model3,4, which combines the benefits of event-tree and fault-tree analysis5. A simplified bow-tie diagram is presented in Figure 1 to illustrate the principles of the technique. The centre point of the figure shows a potential adverse event with a
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potential injury arising from the event. The left-hand side of the bow-tie diagram shows the immediate and root cause threats leading to the injury, while the right-hand side of the diagram shows the immediate and long-term, consequences resulting from the injury. Items on the left-hand side of the bow-tie impact mainly on the incidence of injury, whereas items on the right-hand side of the diagram impact on the severity of injury. Superimposed onto the left-hand side of the bow-tie diagram are potential barriers that could reduce the number of injuries and on the right-hand side potential barriers that could reduce the severity of injuries. These barriers equate to the preventive and therapeutic interventions included in the risk management model discussed previously in Part-2. The bow-tie summarises, in pictorial format, the threats, consequences and control barriers in place for a single event and a single injury linked with that event: a complete analysis of the risks associated with the event would clearly be more complex, as there would be other potential injuries to consider.
