Are squash players protecting their eyes?

Visual Performance and Sports: A Scoping Review

Vision is central to success in nearly all sports, and there is an emerging body of research investigating the links between visual abilities and athletic performance. This preregistered scoping review seeks to clarify the topics of study, methodologies used, populations under investigation, researchers, and disciplines driving this field. Systematic searches of English-language articles were conducted in PubMed and Web of Science, with additional literature identified through bibliographic searches. Six hundred sixty-seven articles published between 1976 and 2023 were identified with 547 empirical studies, 58 review articles, 20 commentaries, and 4 meta-analyses, among others. Among the empirical papers, 411 reported on visual assessments and 98 on vision training interventions. The most represented sports included baseball, soccer, basketball, and cricket, with over 150 articles reporting on professional, elite, or Olympic athletes. This scoping review describes the breadth of this emerging field, identifies its strengths and weaknesses, and provides recommendations for future improvement.

Eye injuries in badminton - players' perspective toward the usage of personal protective equipment

OBJECTIVE

We conducted a survey between April to September 2021 to understand the perspective of badminton players on the usage of personal protective equipment to avoid eye injuries.

METHODS

The survey was conducted online. It was disseminated through various social media platforms and via e-mail. The survey was initially shared with university-level badminton players. Both recreational and professional players were included. They were further encouraged to circulate the survey questionnaire among their colleagues.

RESULTS

In total, the survey received 372 responses. After removing possible duplicates and incomplete responses (n = 28), 92.5% (n = 344) of the responses were included in the final analysis. Among the 344 included responses, recreational and professional players accounted for 77.6% (n = 267) and 22.4% (n = 77), respectively. The mean age ± SD of the recreational and professional players were 24.1 ± 6.3 years (range 14-60 years) and 25.7 ± 6.0 years (range 14-61 years), respectively. A significant difference was noted for self-reported eye injuries between recreational and professional players while playing badminton (χ2 value = 5.321, p = 0.02). Among the recreational and professional players, 93.6% (n = 250) and 88.3% (n = 68) did not use protective eyewear while playing badminton. Professional players were at higher risk of eye injuries than recreational players (OR = 2.9, 95% CI = 1.1-7.8).

CONCLUSION

The majority of badminton players in both groups agreed that PPE usage would lower the risk of sustaining eye injuries; however, they are ambiguous about the usage of protective eyewear. In contrast, players with self-reported eye injuries were aware of its impacts and encouraged the usage of PPEs associated with badminton. Further studies are warranted to understand and educate badminton players about the causes and impacts of eye injuries in badminton.

Epidemiological Patterns of Alternative Racquet-Sport Injuries in the United States, 1997-2016

Background

Racquet sports have increased in popularity over the past decade. Although research is available regarding the epidemiological characteristics of tennis injuries, little is known about the frequency and characteristics of injuries in other racquet sports.

Hypothesis

Given the increase in all racquet sport participation in the United States (US), it is hypothesized that injuries have accordingly become more frequent.

Study Design

Descriptive epidemiology study.

Methods

Using the National Electronic Injury Surveillance System database, we reviewed the numbers of badminton and squash/racquetball injuries presenting to a representative sample of US emergency departments (EDs). We used weighted estimates to extrapolate the data to the US population. Incidence estimates were compared with national participation data and stratified.

Results

A total of 4330 injuries were reported, representing an estimated 173,000 injuries presenting to US EDs from 1997 through 2016. Despite the increase in the number of players from 2006 through 2016, the annual injury rate for squash/racquetball declined significantly, including the rates for each body region assessed. No similar trend was found for badminton injuries. Within our extrapolated ED cohort, the lower extremities were the most common body region injured (37%). Strains/sprains were the most common injury type in the trunk (73%), lower extremities (65%), and upper extremities (32%), whereas lacerations were most common in the head/neck (49%). In badminton, the youngest players (age range, 5-18 years) sustained twice as many fractures (relative risk [RR], 1.96; 95% CI, 1.14-3.38) and almost 3 times as many lacerations as patients in any other age group. Similarly, the youngest squash/racquetball players were at highest risk for lacerations (RR, 1.45; 95% CI, 1.22-1.73) and head and neck injuries (RR, 1.52; 95% CI, 1.26-1.83).

Conclusion

Although declines in rates of squash/racquetball injuries were observed, the increasing popularity of badminton, squash, and racquetball necessitates further preventive measures to improve player safety, with an emphasis on the youngest players.

Use of Protective Eyewear in U.S. Children: Results From the National Health Interview Survey

PURPOSE

To study use of protective eyewear in children who participated in activities that can cause eye injury.

METHODS

National Health Interview Survey (NHIS) data from 2002 were used to analyze protective eyewear use by children who participated in activities that can cause eye injury. Weighted percentages and 95% confidence intervals (CI) of the sociodemographic characteristics of children who wore protective eyewear were analyzed. Odds ratios (OR) were estimated in logistic regression models.

RESULTS

In the 2002 NHIS, 3,901 children aged 6-17 years (51% of interviewed children) participated in activities that can cause eye injury, but while doing so, only 14.5% of children wore protective eyewear. After controlling for potentially confounding effects of study variables, females were less likely to wear protective eyewear than males (OR = 0.61; 95% CI: 0.48-0.76) and children aged 12-17 years were more likely to wear protective eyewear than children aged 6-8 years (12-14 year olds: OR = 1.72, 95% CI: 1.20-2.46; 15-17 year olds: OR = 1.60; 95% CI: 1.11-2.31). Race/ethnicity, parent's education, family structure, poverty status, and region of United States residence did not have significant influence on protective eyewear use.

CONCLUSIONS

To achieve the Healthy People 2010 objective of 20% of children using protective eyewear in recreational activities and hazardous situations around the home, intervention/education programs must continue to be improved and implemented.

The effectiveness of a squash eyewear promotion strategy

OBJECTIVE

To evaluate the protective eyewear promotion (PEP) project, which was a comprehensive educational strategy to increase the use of appropriate protective eyewear by squash players.

METHODS

An ecological study design was used. Four squash venues in one playing association were randomly chosen to receive PEP and four in another association maintained usual practice and hence formed a control group. The primary evaluation measurements were surveys of cross sectional samples of players carried out before and after the intervention. The surveys investigated players' knowledge, behaviours, and attitudes associated with the use of protective eyewear. The survey carried out after the intervention also determined players' exposure to PEP. Univariate and multivariate analyses were undertaken to describe differences at PEP venues from pre- to post-intervention and to compare these with the control venues.

RESULTS

The PEP players had 2.4 times the odds (95% confidence interval, 1.3 to 4.2) of wearing appropriate eyewear compared with control group players post-intervention, relative to the groups' pre-intervention baselines. Components of PEP, such as stickers and posters and the availability and prominent positioning of the project eyewear, were found to contribute to players adopting favourable eyewear behaviours.

CONCLUSIONS

Components of the PEP intervention were shown to be effective. The true success will be the sustainability and dissemination of the project, favourable eyewear behaviours, and evidence of the prevention of eye injuries long into the future.

Do squash players accurately report use of appropriate protective eyewear?

Self-report surveys are a common method of collecting data on protective equipment use in sport. The aim of this study was to assess the validity of self-reported use of appropriate protective eyewear by squash players. Surveys of squash players' appropriate protective eyewear behaviours were conducted over two consecutive years (2002 and 2003) at randomly-selected squash venues in Melbourne, Australia. Over the two years, 1219 adult players were surveyed (response rate of 92%). Trained observers also recorded the actual on-court appropriate protective eyewear behaviours of all players during the survey sessions. Eyewear use rates calculated from both data sources were compared. The self-reported appropriate protective eyewear use rate (9.4%; 95% CI 7.8, 11.0) was significantly higher (1.6 times more) than the observed rate (5.9%; 95%CI 4.6, 7.2). This suggests that players may over-report their use of appropriate protective equipment, though some may have incorrectly classified their eyewear as being appropriate or suitably protective. Studies that rely only on self-report data on protective equipment use need to take into account that this could lead to biased estimates.

Unprotected eyes in squash: not seeing the risk of injury

The use of appropriate eyewear in squash can protect the eyes against injury. However, few adult squash players adequately protect their eyes against potential severe injuries. We describe the characteristics of non-users of protective eyewear and examine predictors of appropriate eyewear use. Self-report surveys of adult players were conducted in metropolitan Melbourne, Australia. Information on players' knowledge, behaviours and attitudes associated with protective eyewear use was collected, in addition to player demographic data. Appropriate eyewear was defined as Standards-approved polycarbonate lens eyewear. The majority 92.2% of players did not adequately protect their eyes while playing squash. Significant predictors of reported eyewear use were: previous eye injury: playing squash on average more than 2 hr per wk: having played for more than 20 y; and having more favourable attitudes towards eye safety in squash. The significant predictors of appropriate eyewear use were: being female; previous eye injury; playing squash on average more than 2 hr per week; and having more favourable attitudes towards eye safety in squash. Understanding the characteristics of both users and non-users of appropriate eye protection in squash is essential for informing future prevention strategies.

Community football players' attitudes towards protective equipment--a pre-season measure

BACKGROUND

The Australian football injury prevention project (AFIPP) was a randomised controlled trial examining the effects of protective equipment on injury rates in Australian Football.

OBJECTIVE

To present the results of the AFIPP baseline survey of community football players' attitudes towards protective equipment.

METHODS

Teams of players were recruited from the largest community football league in Victoria, Australia, during the 2001 playing season; 301 players were enrolled in the study and all were surveyed before the season began about their attitudes towards protective headgear and mouthguards.

RESULTS

Almost three quarters of the players (73.6%) reported wearing mouthguards during the previous playing season (year 2000) compared with only 2.1% wearing headgear. The most common reasons for not wearing headgear and mouthguards (in non-users) were: "I don't like wearing it" (headgear: 44.8%; mouthguards: 30.6%), and "It is too uncomfortable" (headgear: 40.7%; mouthguards: 45.8%).

CONCLUSIONS

The higher mouthguard usage reflects the favourable attitudes towards mouthguards by Australian football players generally. Similarly, the low headgear usage reflects the low acceptance of this form of protection in this sport. Further research should be directed towards establishing the reasons why players seem to believe that headgear plays a role in injury prevention yet few wear it.

A pilot study of the attitudes of Australian Rules footballers towards protective headgear

Despite a relatively high risk of injury to participants of Australian Rules football, very few players report wearing protective equipment. The aim of this paper is to describe the results of a pilot survey of the attitudes of community-level Australian Rules football players towards protective headgear and the risk of head injury. Seventy players from four purposefully chosen clubs in metropolitan Melbourne completed a self-report questionnaire at the end of the 2000-playing season. Almost all players (91.4%) reported they did not wear protective headgear during the 2000 season. Non-headgear users said that headgear was too uncomfortable (47.4%) and they didn't like it (42.1%). However, 80.0% of non-users said they would wear it if it prevented injury. The major motivation for wearing headgear was to prevent injury. Players considered rugby, boxing and driving a car, to be associated with a higher-risk of head injury than Australian Rules football. As a group, the players perceived the risk of head injury in Australian Rules football to be low to moderate when compared to other sports and activities. This partially explains why so few players wore protective headgear. Repeat surveys on a larger sample should be conducted to further understand the attitudes towards protective headgear and perceptions of risk in community-level Australian football players.

Protective Eyewear Promotion

Eye injuries in squash have the potential to be severe. Although these injuries can be prevented through the use of protective eyewear, few players wear such eyewear. The aim of this paper is to outline the behavioural principles guiding the design of a squash eyewear promotion initiative, the Protective Eyewear Promotion (PEP). Ecological principles of behaviour change were used to provide a comprehensive perspective on intrapersonal factors, policies and physical environmental influences of protective eyewear use. Results of baseline player surveys and venue manager interviews were used to provide relevant and specific intervention content. At baseline, protective eyewear was not found to be readily available, and players' behaviours, knowledge and attitudes did not favour its use. The main components of PEP involved informing and educating both players and squash venue operators of the risk of eye injury and of appropriate protective eyewear, as well as assisting with the availability of the eyewear and offering incentives for players to use it. A structural strength of PEP was the strong collaborative links with the researchers of different disciplines, the squash governing body, eyewear manufacturers, squash venue personnel, as well as players. Attempts were made within the project structure to make provision for the future dissemination and sustainability of more widespread eye injury prevention measures in the sport of squash.