Author Identifier

Caroline Finch

Document Type

Journal Article

Publication Title

British Journal of Sports Medicine

Medical Subject Headings

Adolescent; Adult; Athletic Injuries; Humans; Leg Injuries; Male; Middle Aged; Physical Conditioning, Human; Program Evaluation; Soccer; Victoria; Young Adult







First Page


Last Page


PubMed ID



BMJ Publishing Group Ltd


School of Medical and Health Sciences




This study was funded by a National Health and Medical Research Council (NHMRC) Partnership Project Grant (ID 565907) with additional support (both cash and in kind) from the project partner agencies: the Australian Football League (AFL); Victorian Health Promotion Foundation (VicHealth); NSW Sporting Injuries Committee (NSWSIC); JLT Sport, a division of Jardine Lloyd Thompson Australia Pty Ltd; the Department of Planning and Community Development; Sport and Recreation Victoria Division (SRV) and Sports Medicine Australia National and Victorian Branches (SMA). CFF was partially supported by an NHMRC Principal Research Fellowship (ID1058737). JLC was supported by a NHMRC practitioner fellowship (ID1058493). AD received full salary support from the NHMRC Partnership Project Grant. Aspects of this research are related to the work of the Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), which is one of the IOC centres of research excellence for the prevention of injuries and promotion of health in athletes.

Grant Number

NHMRC Number : 565907


Finch, C. F., Gray, S. E., Akram, M., Donaldson, A., Lloyd, D. G., & Cook, J. L. (2019). Controlled ecological evaluation of an implemented exercise-training programme to prevent lower limb injuries in sport: population-level trends in hospital-treated injuries. British Journal of Sports Medicine, 53(8), 487–492. Available here


OBJECTIVE: Exercise-training programmes have reduced lower limb injuries in trials, but their population-level effectiveness has not been reported in implementation trials. This study aimed to demonstrate that routinely collected hospital data can be used to evaluate population-level programme effectiveness.

METHOD: A controlled ecological design was used to evaluate the effect of FootyFirst, an exercise-training programme, on the number of hospital-treated lower limb injuries sustained by males aged 16-50 years while participating in community-level Australian Football. FootyFirst was implemented with 'support' (FootyFirst+S) or 'without support' (FootyFirst+NS) in different geographic regions of Victoria, Australia: 22 clubs in region 1: FootyFirst+S in 2012/2013; 25 clubs in region 2: FootyFirst+NS in 2012/2013; 31 clubs region 3: control in 2012, FootyFirst+S in 2013. Interrupted time-series analysis compared injury counts across regions and against trends in the rest of Victoria.

RESULTS: After 1 year of FootyFirst+S, there was a non-statistically significant decline in the number of lower limb injuries in region 1 (2012) and region 3 (2013); this was not maintained after 2 years in region 1. Compared with before FootyFirst in 2006-2011, injury count changes at the end of 2013 were: region 1: 20.0% reduction (after 2 years support); region 2: 21.5% increase (after 2 years without support); region 3: 21.8% increase (after first year no programme, second year programme with support); rest of Victoria: 12.6% increase.

CONCLUSION: Ecological analyses using routinely collected hospital data show promise as the basis of population-level programme evaluation. The implementation and sustainability of sports injury prevention programmes at the population-level remains challenging.



Creative Commons License

Creative Commons Attribution-Noncommercial 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License