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Domhnall MacAuley on a great Norwegian success story

13 May, 10 | by Domhnall Macauley

Domhnall MacauleyA great Norwegian success story. Celebrated at Kleivstua in the pine forests of the national park as the sunshine and snow flurries competed for the Nordic Spring. This was the ten year anniversary meeting of the Oslo Sports Trauma Centre. And what a story…

When we invited Roald Bahr to write his clinical review on recent advances in sports medicine in 2001 (BMJ 2001;323(7308):328 (11 August), doi:10.1136/bmj.323.7308.328) it was clear that he was an emerging leader of the discipline. But, who could have imagined the scale of the achievements of this research group in the next decade. First publishing in the specialist literature, including many excellent papers in the British Journal of Sports Medicine, they gradually began to make an impact in the major peer reviewed literature.

For me, their 2005 paper, with an author list of stars, (BMJ 2005;330(7489):449 (26 February), doi:10.1136/bmj.38330.632801.8F) was pivotal in the evolution of sport and exercise medicine research worldwide. This randomised controlled clinical trial was of clinical importance in itself but, even more significant was that it showed that it was possible to test the principles of sport and exercise medicine using the highest quality research methodology. It will remain the benchmark against which every other intervention in sports medicine research will be measured for many years. They missed an opportunity of a celebrated double when their case control study of ski helmets was beaten to publication in the BMJ by Canadian colleagues (BMJ 2005;330(7486):281 (5 February), doi:10.1136/bmj.38314.480035.7C). But, they published it in JAMA the following year. A poor substitute for the BMJ- of course. While their 2005 paper dealt with Olympic handball, a minority sport, they moved centre stage in 2008 with their study of warm up in football (BMJ 2008;337:a2469 (9 December), doi: 10.1136/bmj.a2469). By now the publication train was running and, the evidence from this conference is that it will continue to do so for the foreseeable future.

Many research groups have a brief flourish when fate draws together a critical mass of bright and innovative people that fades as time erodes their original thinking. They don’t intend to let that happen and it is clear that, rather than rest on the laurels of 10 years of outstanding achievement, they intend to build for the future, nurturing new research leaders and chasing new horizons. One of their great strengths is their willingness to reach out to other researchers, through sabbaticals, work experience and drawing on visiting expertise. They create partnerships with centres of excellence around the world and continually search for new research ideas. You could see this in their invitation to Evert Verhagen to present a key note address on the health economic implications of his work on cost effectiveness analysis and sports injury prevention. And, exploring the importance of leadership and influence by strengthening links with the Centre for Hip Health in Vancouver which has had a major impact on Government Policy.  But the core of the conference was the current work presented by the Oslo research collaboration. It was a privilege to listen to their doctoral students present work ranging in maturity from explorations of early hypotheses to full dress rehearsals of a doctoral defence. Exciting, challenging, and difficult work. It would be unfair to reveal any details of the direction of their work but I can promise that they will continue to shift the sports medicine paradigm and bring the principles of sport and exercise medicine research into mainstream medical practice.

Domhnall MacAuley is primary care editor, BMJ

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  • Professor David Patterson

    Domhnall MacAuley on a great Norwegian success story

    We believe that Domhnall MacAuley was right to extol the excellence of the Oslo Sports Trauma Centre, its leadership, its research productivity and its contributions to the development of new knowledge in the domains of Sports and Exercise Medicine. The Institute of Sports and Exercise Medicine recognised this huge contribution by awarding Professor Roald Bahr the Prince Philip Medal in Sports and Exercise Medicine in 2008; the award was made by H.R.H. The Prince Philip, Duke of Edinburgh. This Norwegian model is certainly one that we in the UK can learn from in many ways.

    However, we take issue with the very pessimistic view expressed in subsequent correspondence, of the UK’s contribution to research in sport and exercise medicine which is described bleakly as a failed opportunity. The half empty bottle is all too easy to criticise but it can be very destructive particularly as a new discipline struggles to establish its research credentials at a difficult time – partly related to the changing nature and funding of research and partly related to the world financial situation. The very important issue to stress is the breadth of SEM research – when we were developing our vision statement (http://www.fsem.ac.uk) it was clear from the responses that we received that there are a number of groups in the UK that are undertaking SEM research but were working in university departments which would not be “badged” as SEM. They are also publishing in a variety of different prestigious journals which may not be recognised as SEM related.

    But there are positive signs that the UK is beginning to address some of the problems. There is now more funding for activity and health related research. The major funders of public health research in the UK have come together, under the auspices of the UK Clinical Research Collaboration (UKCRC) to develop a coordinated approach to improving public health research in the UK. The multidisciplinary Centre at Cambridge University brings together researchers with an established international track record in diet and physical activity research, epidemiology, biostatistics, health geography, health economics, behavioural science and intervention development and evaluation.

    This model needs to be replicated for sports science and for sports medicine. We additionally need to ensure that we bring the clinical, the educational and the research activities together so that we can benefit from the “virtuous” cycle of each informing the others. We in The ISEM are now working closely with Arthritis Research UK to develop a National Research Institute for Prevention of Long Term Musculoskeletal Disorders following Sport or Exercise Related Injuries. Given the paucity of research internationally it is also envisaged that such an Institute should act as a magnet for attracting the brightest and best internationally. In order to help develop the agenda for such an Institute we are organising an international conference in London in October.

    There is still a long way to go but we believe the “green shoots” are begining to appear. As yet they need nurturing and developing. Moreover we need to continue to believe that we can be amongst the best in the world in terms of sport and exercise medicine research.

    David Patterson Mark Batt
    Chairman of ISEM President, FSEM (UK)

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