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Objective: A diagnosis of Parkinson's often leads to uncertainty about the future and loss of perceived control. Peer support may offer a means to address these concerns and promote self-management. Design: A programme evaluation of the feasibility and potential effects of 'First Steps', utilising a pragmatic step wedge approach. Comparing First Steps (intervention) to (control) conditions. Setting: In the community at four sites in southern England. Participants: Newly diagnosed (≤ 12months) people with Parkinson's. Intervention: First Steps was a 2-day peer-conceived, developed and led intervention to support self-management. Main measures: At 0, 12 and 24 weeks anxiety and depression (Hospital, Anxiety and Depression Scale, HADS), daily functioning (World Health Organisation Disability Assessment Schedule, WHODAS), physical activity, quality of life (EQ5D), carer strain and service utilisation were assessed. Results: Between February 2018 and July 2019, 36 participants were enrolled into intervention and 21 to control conditions, all were included in statistical analysis. Lost to follow up was n = 1 (intervention) and n = 1 adverse event was reported (control, unrelated). Of the 36 allocated to the intervention n = 22 participants completed both days of First Steps during the study period. Completion of outcome measures was >95% at 24 weeks. Small effects favouring the intervention were found for HADS (odds ratio (OR) = 2.06, 95% confidence interval (CI) 0.24:17.84), Carer Strain Index (OR = 2.22, 95% CI 0.5:9.76) and vigorous (d = 0.42, 95% CI −0.12:0.97) and total physical activity (d = 0.41, 95% CI −0.13:0.95). EQ5D, WHOSDAS and service utilisation, was similar between groups. Conclusions: First Steps was feasible and safe and we found potential to benefit physical activity, mental health and carer strain. Further research with longer-term follow up is warranted. [ABSTRACT FROM AUTHOR]

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Background: Combat sports involve body contact through striking, kicking and/or throwing. They are anecdotally referred to as 'dangerous', yet long-term investigation into specific injury rates is yet to be explored.Objective: To describe incidence and prevalence of injury and illness within Olympic combat sports and to investigate risk of bias of prospective injury and illness research within these sports.Methods: We systematically searched literature published up until May 2016. We included prospective studies of injury/illness in elite combat athletes lasting more than 12 weeks. Risk of bias was assessed using a modified version of the Downs and Black checklist for methodological quality. Included studies were mapped to the Oxford Centre for Evidence-Based Medicine levels of evidence.Results: Nine studies were included, and most (n=6) had moderate risk of bias. Studies provided level 1/2b evidence that the most frequently injured areas were the head/face (45.8%), wrist (12.0%) and lower back (7.8%) in boxing; the lower back (10.9%), shoulder (10.2%) and knee (9.7%) in judo; the fingers (22.8%) and thigh (9.1%) in taekwondo; and the knee (24.8%), shoulder (17.8%) and head/face (16.6%) in wrestling. Heterogeneity of injury severity classifications and inconsistencies inexposure measures prevented any direct comparisons of injury severity/incidence across combat sports.Conclusions: There is currently a lack of consensus in the collection of injury/illness data, limiting the development of prevention programmes for combat sport as a whole. However, sport-specific data that identify body areas with high injury frequency can provide direction to clinicians, enabling them to focus their attention on developing pathologies in these areas. In doing so, clinicians can enhance the practical elements of their role within the integrated combat sport performance team and assist in the regular update of surveillance records. [ABSTRACT FROM AUTHOR]

Training camps are utilised in the selection process of Dragon Boat crews. Due to low funding in this sport, paddlers work full time and train around work hours, which may lead to rapid shifts in training load when attending camps. The objective was to detail the training loads of two elite dragon boat paddlers prior to and during a national training camp. An online system was used to collect training details and internal training loads. Data was extracted for the week leading into a camp, and the week of a camp, giving two, seven-day blocks. Weekly training loads for each paddler leading into the camp and during camp were 1680 units and 1600 units, respectively, and 5670 and 5050 units, respectively. This equated to more than a three-fold increase in training load from week-to-week. One paddler sustained an injury on the last day of this camp which negatively affected them for the rest of the season. Training load shifts can be managed by both the athlete and coach to minimise injury and illness risk. It is recommended that athletes utilise best practice guidelines, which recommend a 10% increase in load per week when preparing for intensive training blocks. Camp coaches and planners must consider the impact of shifts in load on the athletes and reduce the duration or number of sessions across a camp when an athlete has not completed sufficient training. This two-fold proactive approach to reducing rapid shifts in training load around national camps may reduce the risk of injury and illness while still maintaining the overall quality of the training camp. [ABSTRACT FROM AUTHOR]

Aim: The dual aim of this research was to consider the impact of providing the First Steps program on the stories of people with Parkinson's Disease (PD) and to investigate the psychosocial and emotional mechanisms which may explain this impact. Methods: A qualitative study using a subtle realist paradigm and hermeneutic phenomenological methodology was undertaken. A single semi-structured interview was used to consider the impact and experiences of people with PD who completed either the intervention (2-day peer-led behavior intervention using storytelling 6–8 weeks apart) or received telephone support calls as part of the active control group. Descriptive statistics and a narrative analysis were undertaken on the results. Results: Forty-two participants were invited to participate, forty of whom completed the interview. This included 18 from the intervention group and 22 from the active control group. The intervention group identified the value of the program as worth-while, demonstrating improved exercise behavior and coping mechanisms following the intervention. Three major stories (the affirmed, the validated and the transformed story) identified the impact of the intervention. Three internal mechanisms (perceived control, hope and action, and the individual's mind set) alongside three social mechanisms (social comparison, social control and the first opportunity to share with peers) appeared to explain this impact. Conclusion: This study provides exciting and novel evidence of the impact of a peer-led psycho-educational intervention for people newly diagnosed with PD. Further research is needed to consider the impact of stories-based approaches on participants and consider a critical evaluation of the mechanisms which may explain changes in stories and self-reported behaviour. [ABSTRACT FROM AUTHOR]