PubMed Health⌕ Search

Biomedical subjects

W M Garraway

Publications and source records attributed to W M Garraway.

At least 19 recordsLinked to original sources
PubMed2001

Influence of rugby injuries on players' subsequent health and lifestyle: beginning a long term follow up.

OBJECTIVES: To describe the current rugby playing status of a cohort of 1,169 men who had previously participated in an epidemiological survey of rugby injuries during the 1993-1994 season, and assess the consequences of rugby injuries sustained. METHODS: In May 1998, 911 (78%) men completed a questionnaire reporting their current involvement in rugby and the influence that the 324 (71%) injuries they had sustained four years earlier had since had on their health and wellbeing. RESULTS: The most common reasons given by the 390 (43%) ex-players for ceasing to play rugby were family (10%), employment (25%), and an injury sustained while playing rugby (26%), 80% of which were dislocations, strains, and sprains, mainly to the knee (35%), back (14%), and shoulder (9%). A significantly (chi2 test 21.7, df = 1, p<0.001) higher proportion of current players (90%) undertook (non-rugby) sporting activities compared with ex-players (78%). Few ex-players undertook coaching (12%) and refereeing (2%). Only 22 (9%) men reported significant negative effects to employment, family life, and health up to mid-1998 from injuries that occurred during the 1993-1994 season, although the impact on their lifestyle had been substantial in some cases. CONCLUSIONS: With the recent increase in the incidence of dislocation, strain, and sprain injuries in rugby football, the findings of this follow up could have a great impact on the game in the future. Although this survey has shown that, so far, only a small proportion of players suffer significant effects of rugby injuries, four years is not long enough to assess the long term effects. This cohort of rugby players need to be followed up for at least a further 20 years to determine whether there is a higher incidence of subsequent degenerative joint disease or other long term sequelae to injuries sustained while playing rugby.

Chi-Square Distribution↗
PubMed2001

Influence of preseason training, fitness, and existing injury on subsequent rugby injury.

OBJECTIVES: To examine the influence of preseason fitness, existing injury, and preseason rugby training on subsequent injury. METHODS: Players were eligible for the survey if they were a member of a Scottish Rugby Union (SRU) affiliated rugby club in the Border Reivers District of the SRU during the 1997-1998 season. A total of 803 (84%) players from 22 (88%) participating clubs provided details of rugby training, injuries sustained, and physical activity undertaken during the 16 week summer period (26 April to 16 August 1997) and their perceived fitness before the start of the season. Observers at participating clubs reported all injury episodes occurring to club players throughout the 1997-1998 season. RESULTS: One fifth of players did not attend any rugby training during the 16 week summer period; the remainder attended a median of 14 sessions. Throughout the 1997-1998 season, 675 injury episodes occurred to 423 (53%) players during training or in matches. After adjustment for whether players held a professional contract or were amateurs, Cox regression showed a 3.9% relative increase (95% confidence interval (CI) 1.9 to 5.9%) in the risk of injury over the season for each additional preseason training week attended, and a 61% relative increase (95% CI 32 to 97%) for those players who had been injured or were carrying an injury at the end of the previous season. CONCLUSIONS: Injury risk is more likely to be related to rugby training (type of activities undertaken in rugby training, or personalities and characteristics of players undertaking training more frequently) than to overall player fitness. Players who were injured at the end of the previous season were more likely to be injured in the following season. This may be because they do not allow previous injuries to heal sufficiently before returning to the game, or the intensity of their participation may increase their risk of injury.

Adolescent↗
PubMed2000

The influence of environmental factors on rugby football injuries.

The aim of this study was to establish the influence of weather and pitch conditions on the frequency and nature of rugby injuries. Observers at 26 senior rugby clubs in the Borders District of the Scottish Rugby Union reported all injuries to 1169 (96%) registered players at Saturday home and away matches during the 1993-94 season (August 1993 to April 1994). Weather and pitch conditions at 112 grounds were recorded on 605 occasions; 1268 Borders teams played at these grounds, with 344 injury episodes being sustained. Matches were played in dry weather for three-quarters of these occasions. There was a moderate association between weather and the state of the pitch (Spearman's rank correlation, r = -0.46, P < 0.001), with heavier pitches occurring in wetter weather. Logistic regression revealed that there were significant month-of-season (P = 0.003), wind strength (P = 0.008) and temperature (P = 0.011) effects on the risk of injury. On four of five occasions when matches were played in a downpour of rain, at least one injury episode occurred. Our results show that the month of the season and the weather may influence the occurrence of rugby injuries, but that the state of the pitch does not. Further studies are required to investigate these factors in more detail.

Adult↗
PubMed2000

Impact of professionalism on injuries in rugby union.

OBJECTIVES: To measure the frequency and nature of injuries occurring in competitive matches since professionalism was introduced in rugby union. METHODS: The cohort study previously conducted in players from senior rugby clubs in the Scottish Borders in 1993-1994 when rugby union was an entirely amateur sport was repeated in 1997-1998. The same injury definition, outcome criteria, and method of calculating playing hours were used. In total, 803 (84%) of 960 eligible players participated, including all 30 adult players who played professionally for the Scottish Rugby Union or Border Reivers District. The 576 injury episodes in 381 of these players in competitive matches were compared with the 373 injuries in 266 players out of 975 (94%) who were eligible and registered with the same senior rugby clubs in 1993-1994. Outcomes were the occurrence of injury episodes, days away from playing or training for rugby, and time lost to employment or attendance at school/college as a consequence of being injured. RESULTS: The proportion of players who were injured almost doubled from 1993-1994 to 1997-1998, despite an overall reduction of 7% of the playing strength of participating clubs. Period prevalence injury rates rose in all age specific groups, particularly in younger players. This translated into an injury episode every 3.4 matches in 1993-94, rising to one in every 2.0 matches in 1997-1998. An injury episode occurred in a professional team for every 59 minutes of competitive play. Professional players sustained a higher proportion of recurrent injuries, particularly in the early part of the season. Some 56% of all their days lost to the game were caused by injuries to the muscles, ligaments, and joints of the knee, hip, and thigh. CONCLUSIONS: The introduction of professionalism in rugby union has coincided with an increase in injuries to both professional and amateur players. To reduce this, attention should be focused on the tackle, where many injuries occur. The International Rugby Board should place a moratorium on the use of protective equipment in competitive matches until its contribution to player morbidity has been fully assessed.

Adolescent↗
PubMed1999

Factors influencing tackle injuries in rugby union football.

OBJECTIVES: To assess the influence of selected aspects of lifestyle, personality, and other player related factors on injuries in the tackle. To describe the detailed circumstances in which these tackles occurred. METHODS: A prospective case-control study was undertaken in which the tackling and tackled players ("the cases") involved in a tackle injury were each matched with "control" players who held the same respective playing positions in the opposing teams. A total of 964 rugby matches involving 71 senior clubs drawn from all districts of the Scottish Rugby Union (SRU) were observed by nominated linkmen who administered self report questionnaires to the players identified as cases and controls. Information on lifestyle habits, match preparation, training, and coaching experience was obtained. A validated battery of psychological tests assessed players' trait anger and responses to anger and hostility. The circumstances of the tackles in which injury occurred were recorded by experienced SRU coaching staff in interviews with involved players after the match. RESULTS: A total of 71 tackle injury episodes with correct matching of cases and controls were studied. The following player related factors did not contribute significantly to tackle injuries: alcohol consumption before the match, feeling "below par" through minor illness, the extent of match preparation, previous coaching, or practising tackling. Injured and non-injured players in the tackle did not differ in their disposition toward, or expression of, anger or hostility. Some 85% of tackling players who were injured were three quarters, and 52% of injuries occurred when the tackle came in behind the tackled player or within his peripheral vision. Either the tackling or tackled player was sprinting or running in all of these injury episodes. One third of injuries occurred in differential speed tackles--that is, when one player was travelling much faster than the other at impact. The player with the lower momentum was injured in 80% of these cases. Forceful or crunching tackles resulting in injury mostly occurred head on or within the tackled player's side vision. CONCLUSIONS: Attention should be focused on high speed tackles going in behind the tackled player's line of vision. Comparative information on the circumstances of the vast majority of tackles in which no injury occurs is required before any changes are considered to reduce injuries in the tackle.

Adolescent↗
PubMed1998

Pathophysiological relationships between lower urinary tract symptoms and the prostate do not strengthen over time.

BACKGROUND: The aim of this survey was to examine the relationships among baseline prostate gland volume and changes in urinary symptomatology 3 years later. METHODS: A Scottish community-based cohort of 193 men aged 40-79 years who had prostate volume measured by transrectal ultrasound (TRUS) were followed-up at 3 years. RESULTS: Only baseline nocturia correlated with prostate volume (r = 0.202, P = 0.0057), although some relationships existed for the antero-posterior dimension of the prostate gland. More statistically significant relationships were evident for adenoma volume rather than prostate volume, but they still had relatively low correlations (range, 0.19-0.31). CONCLUSIONS: This study demonstrates the lack of relationships between prostate gland variables and lower urinary tract symptoms (LUTS). Those relationships that are statistically significant (at the P < 0.01 level) are weak, and only explain at most 9% of the total variation of prostate or adenoma volume or their dimensions.

Adenoma↗
PubMed1998

Health-related quality of life associated with lower urinary tract symptoms in four countries.

OBJECTIVES: To describe health-related quality of life (HRQL) associated with lower urinary tract symptoms (LUTS) assessed by validated questionnaires in four countries. METHODS: More than 6000 men, recruited by using community- or population-based sampling in four countries, completed questionnaires soliciting information about urinary symptom frequency, bother, degree of interference with daily activities, and other measures of HRQL. RESULTS: In all countries, disease-specific HRQL worsened with increasing age. Adjusting for age, most disease-specific HRQL measures were significantly worse with increasing symptom severity. The correlation between symptoms and HRQL was strongest in countries with higher prevalence of symptoms, such as Japan or the United States, and less pronounced in countries with lower prevalence (France, Scotland), possibly reflecting the lower variability in scores. CONCLUSIONS: HRQL measures are worse in older men, and increased urinary symptom severity is associated with worse disease-specific HRQL in all countries, despite potential cross-cultural differences in disease prevalence, medication use, perceptions, or willingness to report symptoms or worse HRQL. This cross-cultural consistency suggests that an assessment of symptom bother or interference with daily activities may be useful in patient evaluation.

Adult↗
PubMed1998

The natural history of untreated lower urinary tract symptoms in middle-aged and elderly men over a period of five years.

OBJECTIVES: To describe changes in untreated lower urinary tract symptoms (LUTS), levels of bothersomeness and interference in selected living activities arising from LUTS in a cohort of men followed up for a period of 5 years. METHODS: 1,994 men aged 40-79 years registered in four health centres in Scotland completed a urinary symptom questionnaire in the community. 1,177 (71% of original eligible participants) were followed up at 5 years. RESULTS: The mean level of LUTS and the level of bothersomeness they caused increased universally between baseline and 5 years. The largest increases in mean symptom levels occurred for straining, hesitancy, incomplete emptying, weak stream and nocturia, and for mean levels of bothersomeness, i.e. dribbling, incomplete emptying, weak stream, frequency, nocturia and intermittency. The increase in mean interference level in selected living activities arising from LUTS was less marked. The progression of LUTS over time in individual men was very variable; however, the overall trend was one of continuing deterioration. CONCLUSION: If left untreated, overall levels of middle-aged and elderly mens' LUTS, bothersomeness and interference in selected activities caused by these symptoms will increase over time.

Adult↗
PubMed1997

Correlation between prostate size estimated by digital rectal examination and measured by transrectal ultrasound.

OBJECTIVES: To correlate prostate size estimates performed by single or multiple examiners through digital rectal examination (DRE) with volume measured by transrectal ultrasound (TRUS) and to propose measures for predicting prostate volume using DRE estimates in clinical settings. METHODS: Data from four sources were analyzed: (1) the Olmsted County community study of 397 patients examined by a single urology nurse, with TRUS measurements done by multiple examiners; (2) a community study in Stirling, Scotland, involving 480 patients with DRE and TRUS performed by one urologist; (3) baseline data from the Veterans Affairs Cooperative Study No. 359 in 1222 patients with DRE and TRUS measurements by multiple personnel at 31 centers; and (4) a clinical series of 100 men with DRE and TRUS by a single urologist. RESULTS: DRE estimates and TRUS volumes were significantly correlated (r = 0.4 to 0.9), but prostate size was underestimated by 25% to 55% for men with a prostate volume over 40 mL, depending on the study, with greater variability for studies involving multiple examiners. In one study that assessed prostate dimensions by DRE, posterior surface area (SA) correlated with overall TRUS volume (r = 0.4). According to receiver operating characteristic curves, SA showed a 70% and 76% chance of correctly identifying men with prostate volume greater than 30 or 40 mL, respectively; those with larger prostates were best distinguished by SA greater than 7 cm2 (sensitivity greater than 0.74, specificity greater than 0.50). CONCLUSIONS: DRE underestimates prostate size, particularly if TRUS volume is greater than 30 mL. However, DRE estimates may help identify prostates likely to be larger than certain cutpoints by TRUS. Posterior SA may be useful as a preliminary assessment when prostate size is an important predictor of therapeutic response.

Aged↗
PubMed1997

Influence of players' physique on rugby football injuries.

OBJECTIVES: To determine whether there is an association between a player's physique and injuries incurred while playing rugby football. METHODS: A cohort study was carried out involving all senior rugby clubs in the Scottish Borders during the 1993-1994 rugby season. Somatotype estimates were determined for 1152 (95%) of the 1216 eligible players. Body mass index (BMI), chest to waist ratio, and the ponderal index (PI) were used to classify players' physique as endomorphic (obese), mesomorphic (muscular), and ectomorphic (linear). RESULTS: A strong association was found between physique and age (chi 2 test: chi 2 = 317.2, df = 10, P < 0.0001). More younger players were ectomorphs. Older players were more often endomorphic. The physiques of forwards and backs were significantly different (chi 2 test: chi 2 = 58.6, df = 2, P < 0.0001), with forwards being of a heavier build than three-quarters, even after adjustment for age. Endomorphic players were more likely than ectomorphs to be injured in a match after adjustment for age (age-adjusted mean BMI for players who were injured in a match was 25.4 compared with 24.6 for players who were not injured in a match, P < 0.0001; adjusted chest to waist ratio means were 1.136 and 1.125 respectively, P = 0.0307; adjusted PI means were 0.414 and 0.417 respectively, P = 0.0056). Increased risk of injury may occur when players play out of position, since one fifth of all injuries occurred in this circumstance. CONCLUSIONS: Further research needs to be conducted using a more objective method of measuring somatotype on a further cohort of players so that the risk of injury for different body types can be examined more closely and related to other potential confounding factors. The level of increased risk for individuals playing out of their usual playing position needs to be established with a greater degree of certainty.

Adolescent↗
PubMed1996

Epidemiological comparison of injuries in school and senior club rugby.

OBJECTIVE: To determine the frequency, nature, circumstances, and outcome of schoolboy rugby injuries and to compare these injuries with those occurring in senior rugby clubs. METHODS: The study was a prospective cohort study, conducted on 1705 (98%) of 1736 eligible players from nine Edinburgh schools and 1169 (96%) of 1216 eligible players from all 26 senior Scottish Rugby Union clubs (South District) who provided personal details before the 1993-1994 rugby season. Adult linkpersons were appointed to notify the circumstances of all injury episodes occurring in matches or in rugby related training. RESULTS: 154 school players (9%) experienced 210 separate injuries in 186 injury episodes, 80% of which arose in matches. The prevalence rate of schoolboy match injuries was 86.8 (95% confidence interval 73.4 to 100.2) per 1000 player-seasons. Senior club match injury prevalence was much higher at 367.0 (339.4 to 394.6) per 1000 player-seasons. Club players had a higher rate of match injury than school-boys for all injury types. One third of schoolboy match injury episodes occurred in September and the majority of match injury episodes were associated with tackling (40%) or with being tackled (24%). Nine per cent of schoolboy match injury episodes were classified as severe, compared to 13% for clubs. Sixteen per cent (n = 23) of all schoolboy match injury episodes resulted in missed school attendance compared with 27% (n = 117) of all senior club match injury episodes which involved loss of employment or education. CONCLUSIONS: Schoolboy rugby is much safer than senior club rugby and the outcome of injuries that do occur is less disruptive. The relatively high rate of match injury in September migh be reduced by a more intensive period of preseason training.

Absenteeism↗
PubMed1996

Three-year follow-up of a community-based cohort of men with untreated benign prostatic hyperplasia.

OBJECTIVE: To describe changes over 3 years in urinary symptom severity and bothersomeness and in interference caused by symptoms in selected everyday activities in a cohort of men with untreated benign prostatic hyperplasia (BPH). METHODS: A prospective study of a community-based cohort of 217 men from Forth Valley, Scotland, which satisfied a working clinical definition of symptomatic BPH and had not received treatment, were followed up at 1 and 3 years. RESULTS: Significant increases occurred in both mean symptom and bothersome levels for nocturia, urgency, dribbling, intermittency and incomplete emptying. Considerable proportions of men recorded changes in symptom levels, with the most fluctuation occurring for dribbling, weak stream and frequency-changes in bothersome levels showed a similar pattern. An increased number of men experienced some degree of interference in two or more selected everyday activities, but mean interference levels showed little change. CONCLUSIONS: Increasing trends in symptom prevalence, bother-someness and in the proportions of men experiencing interference in everyday activities were established over the 3 years, despite considerable within-subject variation.

Adult↗
PubMed1996

Perceptions of urinary symptoms and health-care-seeking behaviour amongst men aged 40-79 years.

BACKGROUND: Little is known about why men fail to seek medical help for urological symptoms. AIM: This study was designed to document men's perceptions of urinary symptoms and to increase understanding of health-care-seeking behaviour. METHOD: A stratified random sample of men aged 40-79 years was drawn from the age-sex register of a health centre in Central Scotland. Two hundred men were interviewed using semi-structured qualitative techniques and asked to complete a symptom questionnaire. The response rate was 65%. RESULTS: Urinary symptoms reported to be most bothersome were dribbling, hesitancy and straining. All but the youngest age group (40-49 years) associated developing urinary symptoms with ageing. This was considered to be a reason not to consult a doctor. Most symptoms were not thought to be serious. Pain, haematuria and acute retention gave cause for concern, and were perceived as reasons for seeking medical help. Although urinary symptoms interfered with selected activities in daily life, this was not a worry to the men and was not seen to be a sufficient reason alone to consult their general practitioner. CONCLUSION: The insidious development of urinary problems over time reinforces the belief that it is part of getting older and accounts for the accommodation of symptoms within men's everyday living experiences. Bothersomeness associated with urinary symptoms was not synonymous with worry or problems. Doctors must be prepared to initiate discussion about urinary function in order to assess the impact of symptoms on an individual's daily life.

Adult↗
PubMed1995

Reproducibility and observer variability of transrectal ultrasound measurements of prostatic volume.

Transrectal ultrasound (TRUS) is an established investigation in benign and malignant prostatic disease though the level of reproducibility of TRUS volume measurements is not known. A group of observers in the UK and the USA who were participating in linked prospective studies of benign prostatic hyperplasia each carried out measurements during real-time scanning and on a series of static TRUS images. Results demonstrated good reproducibility for measurements of antero-posterior, transverse, and longitudinal dimensions of the prostate by an experienced UK urologist; only a minor degree of interobserver variation occurred in measurements made between experienced UK and USA observers. Using static images, USA observers obtained results that were in good agreement, whereas the UK observers, only two of whom used TRUS regularly, were in poor agreement with each other. This study demonstrates a high level of reproducibility for TRUS volume measurements performed by experienced observers.

Adult↗
PubMed1995

Regression to the mean occurs in measuring peak urinary flow.

OBJECTIVE: To investigate the anomalous rises in maximum urinary flow rates seen in a prostate-diagnostic clinic. SUBJECTS AND METHODS: The study comprised 1994 men aged 40-79 years registered at five health centres in Central Scotland, participating in a study of the natural history of benign prostatic hyperplasia (BPH), who completed a urodynamic assessment on up to three occasions: in the community, on referral to a prostate-diagnostic clinic and at a one-year follow-up. RESULTS: Subjects referred to the diagnostic clinic on the basis of maximum flow rate (Qmax < 15 mL/s) and/or urinary symptomatology showed a mean increase in Qmax (P < 0.001) when tested at the clinic and at the one-year follow-up. In health centres which referred men to the clinic with no pre-selection, there were no significant changes in Qmax. CONCLUSION: Regression to the mean occurs when patients are selected on the basis of a low Qmax. The use of isolated low values of Qmax in the process of diagnosing BPH should be avoided.

Adult↗
PubMed1994

Prostatism and the burden of benign prostatic hyperplasia on elderly men.

All men aged 40-79 years registered with two group general practices in Central Scotland were enumerated. Four hundred and ten men (249 in the working age group 40-64 years and 161 in retirement ages 65-79 years satisfied predetermined criteria for clinical benign prostatic hyperplasia (BPH) of prostatic weight > 20 g in the presence of urinary dysfunction and without evidence of malignancy. Despite a higher prevalence of BPH among the retirement group (428/1000) compared with men of working ages (202/1000), there were virtually no statistically significant differences between the two groups in terms of annoyance and interference in daily living activities caused by urinary dysfunction, frequency of urinary symptoms, or medical consultations for BPH. Although elderly men with BPH changed their lifestyle as a result of urinary dysfunction, only a low proportion of them disclosed their difficulties to a doctor. Increased education of the public and health care professionals about the nature and magnitude of the problem of BPH in elderly men is required.

Activities of Daily Living↗