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International Journal of Environmental... Feb 2017Due to the unpredictable, varied and often physical nature of law enforcement duties, police officers are at a high risk of work-related physical injury. The aim of this... (Review)
Review
Due to the unpredictable, varied and often physical nature of law enforcement duties, police officers are at a high risk of work-related physical injury. The aim of this critical narrative review was to identify and synthesize key findings of studies that have investigated musculoskeletal injuries sustained by law enforcement officers during occupational tasks. A systematic search of four databases using key search terms was conducted to identify potentially relevant studies, which were assessed against key inclusion and exclusion criteria to determine studies to be included in the review. Included studies were critically appraised and the level of evidence determined. Relevant data were extracted, tabulated and synthesized. The 16 identified studies ranged in percentage quality scores from 25.00% to 65.00%, with a mean score of 41.25% and high interrater agreement in scores reflected in a Cohen's Kappa coefficient, κ = 0.977. The most common body site of injury was the upper extremity, the most common injury types were soft-tissue sprains and strains and the most common cause of injury was a non-compliant offender, often involving assault. However, there was limited peer reviewed research in this area and the published research had a narrow focus and was of low to fair methodological quality.
Topics: Databases, Factual; Humans; Law Enforcement; Police; Wounds and Injuries
PubMed: 28165373
DOI: 10.3390/ijerph14020142 -
International Journal of Environmental... Mar 2022Various tests are available to assess athletes for factors associated with their susceptibility and risk of anterior cruciate ligament (ACL) injury or reinjury; however,... (Review)
Review
Various tests are available to assess athletes for factors associated with their susceptibility and risk of anterior cruciate ligament (ACL) injury or reinjury; however, it is unclear which tests are clinically meaningful and what should be considered when using them. Therefore, the aim of this scoping review was to screen and summarize testing and to derive evidence-based recommendations for clinicians, practitioners and future research. Five databases were searched to identify studies addressing musculoskeletal morphology or functional-performance-related screening tests with a clear conceptual link or an evidence-based relationship to ACL (re)injury. A quality rating was carried out using the National Institutes of Health (NIH) Study-Quality Assessment Tool. Six different categories of common screening tests were identified: balance and postural control, gait- and running-related tests, joint laxity, joint morphology and anthropometrics, jump tests and strength tests. Predicting future injury in a complex, dynamic system based on a single screening test is methodologically challenging, which is also reflected in the highly controversial findings in the literature regarding potential associations between specific screening tests and the occurrence of ACL injuries and reinjuries. Nonetheless, various screening tests can provide clinically relevant information on ACL-(re)injury-related factors and help to provide tailored preventive measures. A selection of corresponding evidence-based recommendations is derived and presented in this scoping review.
Topics: Anterior Cruciate Ligament Injuries; Anterior Cruciate Ligament Reconstruction; Athletes; Humans; Reinjuries; Return to Sport
PubMed: 35270563
DOI: 10.3390/ijerph19052864 -
Systematic Reviews May 2018Exertional lower body musculoskeletal injuries (ELBI) cost billions of dollars and compromise the readiness and job performance of military service and public safety... (Meta-Analysis)
Meta-Analysis Review
Prevention of exertional lower body musculoskeletal injury in tactical populations: protocol for a systematic review and planned meta-analysis of prospective studies from 1955 to 2018.
BACKGROUND
Exertional lower body musculoskeletal injuries (ELBI) cost billions of dollars and compromise the readiness and job performance of military service and public safety workers (i.e., tactical populations). The prevalence and burden of such injuries underscores the importance of prevention efforts during activities necessary to sustain core occupational competencies. Attempts to synthesize prevention techniques specific to tactical populations have provided limited insight on the comparative efficacy of interventions that do not modify physical training practices. There is also a need to assess the influence of sex, exposure, injury classification scheme, and study design. Thus, the primary purpose of the systematic review and planned meta-analysis detailed in this protocol is to evaluate the comparative efficacy of ELBI prevention strategies in tactical populations.
METHODS
A systematic search strategy will be implemented in MEDLINE, EMBASE, Cochrane, and CINAHL. A multi-tiered process will be used to capture randomized controlled trials and prospective cohort studies that directly assess the prevention of ELBI in tactical population(s). Extracted data will be used to compare prevention strategies and assess the influence of heterogeneity related to occupation, sex, exposure, injury characteristics, and study quality. In addition, individual risk of bias, meta-bias, and the quality of the body of evidence will be rigorously tested.
DISCUSSION
This systematic review and planned meta-analysis will comprehensively evaluate ELBI mitigation strategies in tactical populations, elucidate factors that influence responses to treatment, and assess the overall quality of the body of research. Results of this work will guide the prioritization of ELBI prevention strategies and direct future research efforts, with direct relevance to tactical, health and rehabilitation science, and human performance optimization stakeholders.
SYSTEMATIC REVIEW REGISTRATION
The systematic review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) on 3 Jan 2018 (registration number CRD42018081799 ).
Topics: Emergency Responders; Exercise; Humans; Lower Extremity; Military Personnel; Musculoskeletal System; Occupational Injuries; Prevalence; Wounds and Injuries
PubMed: 29729666
DOI: 10.1186/s13643-018-0730-9 -
International Journal of Environmental... Mar 2018The physical load ensuing from the repositioning and moving of patients puts health care workers at risk of musculoskeletal complaints. Technical equipment developed to... (Meta-Analysis)
Meta-Analysis Review
The physical load ensuing from the repositioning and moving of patients puts health care workers at risk of musculoskeletal complaints. Technical equipment developed to aid with patient handling should reduce physical strain and workload; however, the efficacy of these aids in preventing musculoskeletal disorders and complaints is still unclear. A systematic review of controlled intervention studies was conducted to examine if the risk of musculoskeletal complaints and disorders is reduced by technical patient handling equipment. MEDLINE/PubMed, EMBASE, Allied and Complementary Medicine Database (AMED), and Cumulative Index of Nursing and Allied Health Literature (CINAHL) were searched using terms for nursing, caregiving, technical aids, musculoskeletal injuries, and complaints. Randomized controlled trials and controlled before-after studies of interventions including technical patient handling equipment were included. The titles and abstracts of 9554 publications and 97 full-texts were screened by two reviewers. The qualitative synthesis included one randomized controlled trial (RCT) and ten controlled before-after studies. A meta-analysis of four studies resulted in a pooled risk ratio for musculoskeletal injury claims (post-intervention) of 0.78 (95% confidence interval 0.68-0.90). Overall, the methodological quality of the studies was poor and the results often based on administrative injury claim data, introducing potential selection bias. Interventions with technical patient handling aids appear to prevent musculoskeletal complaints, but the certainty of the evidence according to GRADE approach ranged from low to very low.
Topics: Health Personnel; Humans; Moving and Lifting Patients; Musculoskeletal Diseases; Musculoskeletal System; Occupational Diseases; Occupational Injuries
PubMed: 29522440
DOI: 10.3390/ijerph15030476 -
The Western Journal of Emergency... May 2021Firearm-related deaths and injuries are ongoing public health issues in the United States. We reviewed a series of gun violence- and firearm-related injuries treated at...
INTRODUCTION
Firearm-related deaths and injuries are ongoing public health issues in the United States. We reviewed a series of gun violence- and firearm-related injuries treated at a multi-campus community healthcare system in West Michigan to better understand the demographic and clinical characteristics of these injuries. We also studied hospital charges, and payers responsible, in an effort to identify stakeholders and opportunities for community- and hospital-based prevention.
METHODS
We performed a retrospective review of firearm injuries treated at Mercy Health Muskegon (MHM) between May 1, 2015 and June 30, 2019. Demographic data, injury type, Injury Severity Score (ISS), anatomic location and organ systems involved, length of stay (LOS), mortality, time of year, and ZIP code in which the injury occurred were reviewed, as were hospital charges and payers responsible.
RESULTS
Of those reviewed, 307 firearm-related injuries met inclusion criteria for the study. In 69.4% of cases the injury type was attempted murder or intent to do bodily harm. Accidental and self-inflicted injuries accounted for 25% of cases. There was a statistically significant difference in the mechanism of injury between Black and White patients with a higher proportion of Black men injured due to gun violence (P < 0.001). Median ISS was 8 and the most commonly injured organ system was musculoskeletal. Median LOS was one day. Self-inflicted firearm injuries had the highest rate of mortality (50%) followed by attempted murder (7%) and accidental discharge (3.1%; P < 0.001). Median hospital charge was $8,008. In 68% of cases, Medicaid was the payer. MHM received $4.98 million dollars in reimbursement from Medicaid; however, when direct and indirect costs were taken into account, a loss of $12,648 was observed.
CONCLUSION
Findings from this study reveal that young, Black men are the primary victims of gun violence-related injuries in our West Michigan service area. Hospital care of firearm-related injuries at MHM was predominantly paid for by Medicaid. Multiple stakeholders stand to benefit from funding and supporting community- and hospital-based prevention programs designed to reduce gun violence and firearm-related injuries in our service area.
Topics: Adolescent; Adult; Black or African American; Firearms; Gun Violence; Homicide; Hospital Charges; Humans; Injury Severity Score; Length of Stay; Male; Medicaid; Michigan; Middle Aged; Patient Discharge; Retrospective Studies; United States; White People; Wounds, Gunshot
PubMed: 34125018
DOI: 10.5811/westjem.2021.3.49255 -
Selected comorbidities of atopic dermatitis: Atopy, neuropsychiatric, and musculoskeletal disorders.Clinics in Dermatology 2017Atopic dermatitis (AD) is a chronic pruritic inflammatory skin disease with substantial morbidity and quality of life impairment. There are a number of comorbid health... (Review)
Review
Atopic dermatitis (AD) is a chronic pruritic inflammatory skin disease with substantial morbidity and quality of life impairment. There are a number of comorbid health problems that occur in patients with AD, aside from the cutaneous signs and symptoms. Chronic pruritus and inflammation can lead to sleep disturbances and mental health symptoms, which are not mutually exclusive. AD is associated with and may predispose to higher risk of other atopic disorders, including asthma and hay fever. Persons with AD appear to be at higher risk for multiple neuropsychiatric disorders, including depression, attention-deficit/hyperactivity disorder, speech disorders in childhood, headaches, and seizures. There is also a multifactorial association of AD with osteoporosis, injuries, and fractures. Elucidating the comorbidities of AD is important for disease management and improving overall clinical outcomes. This review summarizes recent developments in the atopic and neuropsychiatric comorbidities of AD.
Topics: Comorbidity; Dermatitis, Atopic; Humans; Mental Disorders; Musculoskeletal Diseases; Pruritus; Quality of Life; Sleep Wake Disorders; Wounds and Injuries
PubMed: 28709566
DOI: 10.1016/j.clindermatol.2017.03.008 -
International Journal of Sports Medicine Jun 2016This study aimed to describe injury/illness rates in ultratrail runners competing in a 65-km race to build a foundation for injury prevention and help race organizers to...
This study aimed to describe injury/illness rates in ultratrail runners competing in a 65-km race to build a foundation for injury prevention and help race organizers to plan medical provision for these events. Prospectively transcribed medical records were analysed for 77 athletes at the end of the race. Number of injuries/illnesses per 1 000 runners and per 1 000-h run, overall injury/illness rate and 90% confidence intervals and rates for major and minor illnesses, musculoskeletal injuries, and skin disorders were analysed. A total of 132 injuries/illnesses were encountered during the race. The overall injuries/illnesses were 1.9 per runner and 13.1 per 1 000-h run. Medical illnesses were the most prominent medical diagnoses encountered (50.3%), followed by musculoskeletal injuries (32.8%), and skin-related disorders (16.9%). Despite the ultra-long nature of the race, the majority of injuries/illnesses were minor in nature. Medical staff and runners should prepare to treat all types of injuries and illnesses, especially the fatigue arising throughout the course of an ultratrail run and injuries to the lower limbs. Future studies should attempt to systematically identify injury locations and mechanisms in order to better direct injury prevention strategies and plan more accurate medical care.
Topics: Adult; Athletes; Athletic Injuries; Female; Humans; Male; Middle Aged; Muscle, Skeletal; Running; Skin Diseases
PubMed: 27116340
DOI: 10.1055/s-0035-1569347 -
Sports Health 2023Risk for lower extremity musculoskeletal injury increases after sport-related concussion (SRC) and may result from unresolved motor control deficits. Muscle weakness is...
BACKGROUND
Risk for lower extremity musculoskeletal injury increases after sport-related concussion (SRC) and may result from unresolved motor control deficits. Muscle weakness is a deficit that could contribute to musculoskeletal injury risk.
HYPOTHESIS
Athletes with SRC will demonstrate quadriceps and hamstring muscle weakness at the time of return to sport and 30 days later compared with controls.
STUDY DESIGN
Prospective matched cohort.
LEVEL OF EVIDENCE
Level 3.
METHODS
A total of 31 athletes with SRC (CONCUSSION) were matched by sex, age, and activity level to controls (CONTROL). Testing was conducted at initial assessment and 30 days later; initial assessment in CONCUSSION occurred when cleared for return to play. Isokinetic testing assessed quadriceps and hamstring strength of the dominant and nondominant legs at 60 and 180 deg/s. Peak torque values were normalized to body mass (N-m/kg). Data were analyzed with repeated measures general linear models (group × time), and effect sizes were calculated.
RESULTS
Analysis at 60 deg/s included 26 matched pairs (15 male per group) and at 180 deg/s included 30 matched pairs (17 males per group). Time from concussion to initial assessment was 21.3 (7.8) mean (standard deviation) days. No significant interactions or main effects were detected ( > 0.05). Across muscle groups, legs, and testing speeds, effect sizes at initial assessment were small ( = 0.117 to 0.353), equating to a strength deficit in CONCUSSION of 0.04 to 0.18 N-m/kg, and effect sizes were further reduced at 30-day follow-up = -0.191 to 0.252).
CONCLUSION
In athletes with SRC, quadriceps and hamstring strength were decreased only minimally at return to play compared with controls and the difference lessened over 30 days.
CLINICAL RELEVANCE
Strength deficits may not be a major contributor to increased lower extremity musculoskeletal injury risk after SRC. Strength training could be implemented before return to play after SRC to mitigate any strength deficits.
Topics: Humans; Male; Athletic Injuries; Prospective Studies; Hamstring Muscles; Brain Concussion; Sports; Quadriceps Muscle; Leg Injuries; Muscle Strength
PubMed: 36517989
DOI: 10.1177/19417381221136140 -
Journal of Orthopaedic Research :... Mar 2020Rotator cuff tendinopathy (RCT), anterior cruciate ligament (ACL) ruptures, and carpal tunnel syndrome (CTS), are examples of chronic (RCT and CTS) and acute (ACL...
Rotator cuff tendinopathy (RCT), anterior cruciate ligament (ACL) ruptures, and carpal tunnel syndrome (CTS), are examples of chronic (RCT and CTS) and acute (ACL ruptures) musculoskeletal soft tissue injuries. These injuries are multifactorial in nature, with several identified intrinsic and extrinsic risk factors. Previous studies have implicated specific sequence variants within genes encoding structural and regulatory components of the extracellular matrix of tendons and/ligaments to predispose individuals to these injuries. An example, includes the association of sequence variants within the apoptotic regulatory gene, caspase-8 (CASP8) with other musculoskeletal injury phenotypes, such as Achilles tendinopathy. The primary aim of this study was, therefore, to investigate previously implicated DNA sequence variants within CASP8: rs3834129 (ins/del) and rs1045485 (G/C), and the rs13113 (T/A) identified using a whole exome sequencing approach, with risk of musculoskeletal injury phenotypes (RCT, ACL ruptures, and CTS) in three independent studies. In addition, the aim was to implicate a CASP8 genomic interval in the modulation of risk of RCT, ACL ruptures, or CTS. It was found that the AA genotype of CASP8 rs13113 (T/A) was independently associated with increased risk for CTS. In addition, it was found that the del-C haplotype (rs3834129-rs1045485) was significantly associated with non-contact ACL ruptures, which is in alignment with previous research findings. Collectively, the results of this study implicate the apoptosis pathway as biologically significant in the underlying pathogenesis of musculoskeletal injury phenotypes. These findings should be repeated in larger sample cohorts and across different populations. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:680-688, 2020.
Topics: Achilles Tendon; Adult; Alleles; Anterior Cruciate Ligament Injuries; Apoptosis; Carpal Tunnel Syndrome; Case-Control Studies; Caspase 8; Exome; Extracellular Matrix; Female; Gene Frequency; Genetic Predisposition to Disease; Genotype; Haplotypes; Humans; Male; Middle Aged; Musculoskeletal Diseases; Phenotype; Rotator Cuff Injuries; South Africa; Sweden; Tendinopathy; Whole Genome Sequencing; Young Adult
PubMed: 31692049
DOI: 10.1002/jor.24504 -
American Family Physician Nov 2019According to the U.S. Census Bureau, 18.2 million veterans were living in the United States in 2017, of whom 1.6 million were female. Less than one-half of all veterans...
According to the U.S. Census Bureau, 18.2 million veterans were living in the United States in 2017, of whom 1.6 million were female. Less than one-half of all veterans receive care at a Veterans Health Administration or military treatment facility, leaving most to receive services from primary care physicians. Injuries and illnesses common among this patient population include musculoskeletal injuries and chronic pain, mental health issues such as posttraumatic stress disorder (PTSD) and moral injury, traumatic brain injury, chemical and noise exposures, and infectious disease concerns. Family physicians should ask about military service and be well informed about the range of veterans' health concerns, particularly PTSD, depression, and suicidality. Physicians should screen veterans for depression using the Patient Health Questionnaire-9 and for PTSD using the PTSD Checklist for DSM-5. Veterans with traumatic brain injury should be screened specifically for comorbid PTSD and chronic pain because the diagnosis informs treatment. Exposures to loud noise, chemicals, and infectious diseases are prevalent and can cause disability. Family physicians can use available resources and clinical practice guidelines such as those from the U.S. Department of Veterans Affairs and Department of Defense to inform care and to assist veterans.
Topics: Adult; Chronic Pain; Communicable Diseases; Comorbidity; Curriculum; Education, Medical, Continuing; Female; Humans; Male; Mental Disorders; Middle Aged; Military Medicine; Practice Guidelines as Topic; United States; Veterans; Wounds and Injuries
PubMed: 31674738
DOI: No ID Found