The research of Professor Mark De Ste Croix has begun to question
well-established practice in injury prevention and has proposed a change
in focus that is directly related to fatigue resistance. The research has
led to new approaches to injury prevention for young athletes that are
specific to growth and that do not simply adopt adult models. The three
constituencies upon which the research has had impact are:
(i) Enriching and informing practice of national (The Football
Association), European (UEFA) and World (FIFA) governing bodies of sport;
(ii) Informing and changing the pre-habilitation practices of
physiotherapists, sports scientists, strength and conditioning
specialists, coaches, and medical professionals for youth footballers;
(iii) Reducing injury risk and incidence in youth footballers.
Research carried out by Cardiff University on the causes of maritime
fatigue was instrumental in increasing understanding of contributing
factors such as long working hours, and the inadequacy of current
reporting systems. Because 90% of goods are transported by sea, fatigue
influences at the individual and community level, as well as resulting in
significant financial penalties for companies when accidents occur.
Cardiff research has led to significant changes across industry and
government in (a) personal awareness/management, such as improved safety
training and (b) new international legislation and company policy aimed at
reducing fatigue and improving health and safety at sea.
Recent conflicts in Iraq and Afghanistan have exposed military personnel
to improvised explosive devices and anti-vehicle mines. These cause
complex lower limb injuries that frequently lead to long-term disability.
From 2008, the Centre for Blast Injury Studies and its forebear, the
Imperial Blast Research Group, both led by Bioengineering, have conducted
multidisciplinary studies into the effects of blast on physiological
systems. The research has led to changes in the posture and placement of
personnel in Army vehicles, with significant impact on casualties. It
informed the policy of Dstl concerning floor mat design and the policy of
a NATO Task Group concerning standards for accepting battlefield vehicles
in 2013. Mitigating effects of different boots have been characterised on
behalf of Army procurement. Research into treatment has, since 2012,
altered assessment criteria for, and timing of, amputations following heel
injury, with consequent reduction in pain and futile surgery. It has also
changed clinical practice for pelvic injuries in Afghanistan and major
trauma centres; the new procedures are taught on military trauma courses.
Finally, the research is currently being used in the US$80M commercial
development of military crash test dummies
Research at Portsmouth has had a major impact on risk reduction, improved
service life and reduced inspection/maintenance costs of safety critical
and expensive fan and compressor components in military and civil
aero-engines, as demonstrated particularly by the Liftfan Blisk
manufactured by Rolls-Royce.
The research outcomes have also impacted on the specification of design
stress levels by Rolls-Royce and MOD for aerofoils susceptible to FOD,
enabling damage size inspection limits to be established at higher and
more economic levels. The research has also provided increased confidence
in the application of weld-repair of FOD and of surface treatment using
Laser Shock Peening against FOD.
Flight safety has been a major focus in the past sixteen years at the
Civil Safety and Security Unit (CSSU), affiliated with the University of
Leicester's School of Management. The knowledge created has had three
impacts. First, the development of a tailored fatigue-risk management
system (FRMS) now in operation in a night-freight airline. FRMS provides
for the development and validation of rosters that optimise crews'
economic and safety performance, saving lives and money. Until this
research no UK-registered night-freight airline had operated a FRMS.
Second, the research underpins the evidence-base for the British Air Line
Pilots' Association (BALPA) in its lobbying of the European Aviation
Safety Agency (EASA). Third, the research is supporting the Society for
the Welfare of Indian Pilots (SWIP) in its campaign for safe flight-time
Quality of life for people with rheumatoid arthritis (RA) has improved,
responding to their stated major priority for help with fatigue. Their
self-management of fatigue has improved using our cognitive-behavioural
therapy intervention. Over 30,000 patients and healthcare professionals a
year request our resulting self-management booklet, distributed via
Arthritis Research UK.
This group's research spearheaded a new international
patient/professional consensus that fatigue must be measured in all
clinical trials. Along with the Bristol RA Fatigue scales, which we
developed (translated into 35 languages) this has helped to place fatigue
at the centre of drug development by changing the way the pharmaceutical
industry performs multi-national drug trials.
Nursing management has now improved demonstrably. Fatigue evaluation and
intervention have now been recommended in national guidelines.
Research at the University of Bath has had a significant impact on
reducing the burden of injury and illness in military training and sport.
We have engaged practitioner communities in evidence-based approaches to
injury and illness prevention. Our research has contributed directly to
reducing the burden of musculoskeletal injuries and heat illness by
informing military personnel selection, training and healthcare policies.
This affects approximately 20,000 military trainees per year and has
resulted in reduced morbidity and estimated training/medical costs of over
£60 million per annum. Our injury surveillance research has helped shape
the Rugby Football Union's (RFU) medical safety policy and, based on our
research, the International Rugby Board (governing 5 million players
worldwide) announced in May 2013 a global trial of new scrum laws designed
to reduce the incidence/severity of neck injuries.
This case study examines the long-term and ongoing relationship between
an industrial collaborator (Chas A Blatchford & Sons Ltd) and
researchers at the University of Roehampton. This systematic programme of
biomechanical research on how prostheses perform in activities other than
walking has had two significant outcomes. Firstly, this work has
significantly improved prosthetic design, with four new prosthetic designs
marketed worldwide. Secondly, it has increased awareness of — and
importantly increased engagement with - exercise therapy for amputees
among healthcare professionals (prosthetists and physiotherapists) and
amputees themselves. This research has reached a wider audience including
amputee charities and healthcare professionals, with whom we focus on
mobility and movement rather than the prostheses.