Andrea J Fradkin, Bloomsburg University James M Smoliga, Marywood University
ABSTRACT The purpose of this research was to investigate the short-term effects of changing warm-up behaviours using a brochure to promote the scientifically validated benefits. A total of 105 golfers from three different golf clubs in south east Melbourne, Australia participated in this study. The golfers completed three questionnaires over a five-week period. Golfers were given a brochure explaining the benefits of warming-up, as well as a description on how to warm-up for golf after completing the baseline questionnaire. One week later, golfers filled in another questionnaire to determine changes due to the brochure information. Finally, three weeks later, golfers completed the final questionnaire to compare the changes to both baseline and week one results. The number of golfers who warm-up prior to play and practice, as well as their warm-up knowledge improved significantly after they were given a brochure. This increase was most evident in the week following dissemination of the brochure. Before receiving warmup information, approximately one-third of the golfers stated they thought they warmed-up appropriately. However, when asked what activities they actually performed as part of their warm-up, not one golfer performed an appropriate warm-up. This study showed that there was a significant increase in golfers who performed a warm-up immediately after being given information on how to warmup and the benefits of doing so. There was a slight decrease in golfers warm-up behaviours and knowledge three weeks after being given the information, however, this decrease was still a significant improvement prior to the dissemination of information. This suggests that golfers may require a constant reminder on injury prevention measures “such as a sign in the tee-off area, rather than a brochure. Keywords: warm-up, behaviour change, injury prevention, golf
INTRODUCTION
Golf is a popular sport enjoyed by millions of people of all ages and abilities(Theriault & Lachance, 1998). However, golf participation can have the unfortunate consequence of injury that produces many costs, direct and indirect, economic and social. Further, fear of new injury, and of recurring injuries are barriers to participation (Finch & Owen, 2001). Thus injury prevention is integral in increasing the numbers of physically active people and in maintaining participation. Both the injury profile and the most frequently reported mechanisms of injuries in golf indicate that some of these injuries may be prevented by undertaking a warm-up (Fradkin et al., 2001; Fradkin et al., 2007). A warm-up is exercise undertaken to prepare the body and mind for the activity that will be participated in (Bourne, 1992). Previous studies conducted have shown that performing a golf specific warm-up program improves performance (Fradkin et al., 2004), and also reduces the risk of sustaining a golf injury (Fradkin, 2006). Previous studies have also documented amateur golfers’ knowledge, attitudes and behaviours relating to warming up (Fradkin et al., 2001; Fradkin et al., 2003; Fradkin et al., 2007). These studies found that amateur golfers have very little knowledge on what sort of warm-up to perform and the benefits of warmingup (Fradkin et al., 2001; Fradkin et al., 2007), and most golfers do not perform an appropriate warm-up –in fact less than 3% (Fradkin et al., 2001; Fradkin et al., 2003; Fradkin et al., 2007). When attempting to change behaviours the aim is to encourage individuals to adopt healthier behaviours (Caplan & Holland, 1990). Educational approaches aim to enable individuals to make informed choices, and do not seek to encourage or persuade people to follow a specified direction, but to become generally better informed and hence, make healthier choices (French, 1990). The key method of an educational approach involves the provision of information (French, 1990). It is important to remember that not all golfers will change their behaviours or attitudes, regardless of the information they receive. Nevertheless, their knowledge should have increased which is the first step in implementing a behaviour change (Naidoo & Wills, 1994). Brochures are a relatively easy and cost effective way to disseminate information to large groups of people, however, their effectiveness has not been studied in a sports injury prevention context. If golfers begin warming-up they are likely to reduce their injury risk as well as increasing their playing longevity keeping them physically active for longer, together increasing the health of golfers. The aim of this study was to investigate the short-term effects of changing golfers’ warm-up behaviours using a brochure to promote the scientifically validated benefits.
METHODS
Three golf clubs in Melbourne, Australia were invited to partake in this research study. Data were collected over a two-month period in November and December 2006 with each venue visited three times. Golfers provided contact details in the first week as well as their usual playing time so that they could be followed up more easily in the forthcoming weeks. During each five-hour session, after each golfer had completed their round, they were approached and given a quick overview of the research project and asked if they would like to participate in the study. One hundred and five golfers filled in three questionnaires over a period of five weeks. In the first session, golfers filled in a baseline questionnaire that documented their current knowledge, attitudes and behaviours (baseline). They were then given a brochure explaining the injury prevention and performance improvement benefits of warming-up, as well as a description on how to warm-up specifically for golf. One week later, the golfers filled in another questionnaire to determine whether their knowledge, attitudes, and behaviours had changed due to the brochure information (week one). Finally, three weeks later, the golfers filled in the final questionnaire to again determine their knowledge, attitudes, and behaviours and compare the changes to both baseline and week one results (week four). The questionnaires were modified from a previous instrument used to determine golfers’ knowledge, attitudes, and behaviours and took approximately 10 minutes to complete (Fradkin et al., 2001; Fradkin et al., 2007). A previous study used a four-week time frame to investigate the clinical impact of lifestyle change education on chronic disease risk factors (Aldana et al., 2005). Also, performance improvement benefits in golfers utilizing a warm-up have been shown to occur in less than five weeks (Fradkin et al., 2004), therefore this study utilised a five-week time frame. All data were analysed using Version 14 of SPSS with data entered on two occasions to ensure accuracy. Frequencies and descriptive statistics were generated for the relevant variables and 95% confidence intervals calculated. The McNemar test was used to test baseline vs. week one results, baseline vs. week four results, and week one vs. week four results.
RESULTS
A total of 105 golfers participated in the study with a response rate of 97.2%. The characteristics of the golfers in this study are shown in Table 1. Most golfers were male (69.5%). The mean age of the golfers was 37.6 years of age, ranging from 18 years to 79 years. This gender distribution reflects that for Australian golf participants, however, the age distribution in this study is considerably lower than Australian averages for golfers (Australian Bureau of Statistics, 2002).
Table 1. Characteristics of golfers in study.
Mean S.D.
Age (years) 37.6 18.5
Handicap 19.9 8.6
Average hours of play/week 5.4 3.2
Average hours of practice/week 1.1 1.2
Years golfing 14.0 14.1
Self-reported frequency of warm-up behaviours are shown in Table 2. Almost one-third of the sample reported to always warm-up and just over onequarter reported sometimes warming-up. On average, golfers who stated that they warmed-up did so for a mean of 9.8 minutes. Table 2. The self-reported frequency of warm-up activity by golfers (95% confidence intervals indicated).
Frequency of warm-up % 95% Confidence Intervals
Never 4.8 (-13.9, 23.3)
Seldom 14.3 (-3.6, 31.6)
Sometimes 25.7 (9.2, 42.2)
Often 22.9 (6.0, 39.6)
Always 32.4 (16.3, 47.7)
Knowledge of the types of warm-up that improved performance and reduced injury risk was very low. No golfer was able to identify the three components recommended for inclusion in a warm-up, however, 42.9% identified two of the three components. Although golfers were unable to determine which components should be incorporated in a warm-up routine, 71.4% believed that a warm-up reduced injury risk, and 63.8% believed a warm-up improved performance.
Over the five-week study period, the golfers frequency of play and practice did not vary considerably, however their knowledge of the components that should be incorporated in a warm-up routine altered over time (See Table 3).
Table 3. Changes in frequency of play and practice, warm-up length, and warm-up knowledge over study period.
Baseline Week 1 Week 4
Mean hours of play/week 5.4 5.8 5.4
Mean hours of practice/week 1.1 1.3 1.1
Mean length of warm-up 9.8 11.3 10.7
Correct knowledge of components in a warm-up 0.0% 46.7% 28.6%
The majority of golfers read the brochure they were given in the first week – 70.5% read it all, and 13.3% read parts of it, with 65.7% finding the entire brochure helpful and 17.1% finding parts of the brochure helpful. Interestingly, 61.9% altered their warm-up behaviours after reading the brochure, yet only 30.5% discussed what they had read with someone else. The percentage of golfers who warmed-up both prior to play and practice changed over the study period (See Figures 1 and 2), with the brochure intervention being introduced between baseline and week one.
Figure 2. Percentage of participants reporting warm-up behaviours prior to practice throughout study period.
DISCUSSION The number of golfers who warm-up prior to play and practice, as well as golfers warm-up knowledge improved significantly after they were given a brochure. This increase was most evident in the week following the dissemination of the information on the brochure. This is the first study to show that the number of golfers who warm-up prior to play or practice can be increased significantly if they are given information. Before being given any information on warming-up approximately one-third of the golfers in this study stated they thought that they warmed-up appropriately prior to play and practice. However, when asked what activities they actually performed as part of their warm-up, not one golfer performed an appropriate warm-up. This is consistent with low rates of observed warm-up behaviours (Fradkin et al., 2001), however, this limited warm-up activity is unlikely to be adequate to achieve either performance or injury prevention benefits (Fradkin et al., 2004). There was a significant increase in the number of golfers who warmedup immediately after being given the brochure. There was a slight decrease in golfers warm-up behaviours and knowledge three weeks after being given the information, however, this decrease was still a significant improvement from before the information was disseminated. This suggests some golfers may require a constant reminder on injury prevention measures €“such as a sign in the tee-off area, rather than something they only read once or twice. There was a large difference between the proportion of golfers who warm-up prior to play and practice. Golfers tend to think that they are less at risk of injury whilst practicing and as such, do not feel the need to warm-up prior to practice (Fradkin et al., 2003). This trend is also evident in this study with 41% of golfers claiming to warm-up prior to practice compared to 64% who warm-up prior to play. Even after the brochure intervention, the proportions of golfers who warm-up under each condition was still considerably uneven (86% prior to play compared to 63% prior to practice). Therefore, while the brochure increased the number of golfers who warm-up, it was not as successful in portraying that a warm-up is important prior to play and practice. There are a few limitations to this study that could affect the generalisability of these results. The survey was restricted to one specific area and was conducted over a limited time period. Furthermore, the self-report warm-up behaviour data need to be validated, though this studys findings agree with those of two previously published observational studies (Fradkin et al., 2001; Fradkin et al., 2003). Finally, the golfers in this study were only followed over a fiveweek period, and a longer follow-up period is necessary to determine whether the golfers increased knowledge and warm-up behaviours will continue over time. In conclusion, this study indicates that a brochure that details the knowledge concerning the benefits of performing an appropriate warm-up, and also highlighting the specific exercises that should be performed is effective in increasing golfers knowledge and changing their warm-up behaviours for the better. Further research is needed to examine the effects of a brochure on other populations and over a longer period of time.
APPLICATION This research has highlighted that providing golfers with information about an injury prevention measure is an effective way to increase knowledge and change behaviours, however, without a constant reminder, these changes tend to drop off over time. Other methods of promotion need to be investigated to determine the most effective way to disseminate information to golfers.
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