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Journal of Science and Medicine in Sport Nov 2018Injuries cause more morbidity among soldiers in the U.S. Army than any other health condition. Over two-thirds of U.S. soldiers' injuries occur gradually from cumulative...
Injuries cause more morbidity among soldiers in the U.S. Army than any other health condition. Over two-thirds of U.S. soldiers' injuries occur gradually from cumulative micro-traumatic damage to the musculoskeletal system as a result of physical training activities. Paradoxically, the very physical training activities required to improve soldier performance also result in injury. Determining the amounts and types of physical training that maximize performance while minimizing injuries requires scientific evidence. This evidence must be incorporated into a framework that ensures scientific gaps are addressed and prevention efforts are evaluated. The five-step public health approach has proven to be an effective construct for Army public health to organize and build an injury prevention program. Steps include: 1) surveillance to define the magnitude of the problem, 2) research and field investigations to identify causes and risk factors, 3) intervention trials and systematic reviews to determine what works to address leading risk factors, 4) program and policy implementation to execute prevention, and 5) program evaluation to assess effectiveness. Dissemination is also needed to ensure availability of scientific lessons learned. Although the steps may not be conducted in order, the capability to perform each step is necessary to sustain a successful program and make progress toward injury control and prevention. As with many U.S. public health successes (e.g., seatbelts, smoking cessation), the full process can take decades. As described in this paper, the U.S. Army uses the public health approach to assure that, as the science evolves, it is translated into effective prevention.
Topics: Humans; Military Personnel; Musculoskeletal System; Occupational Injuries; Physical Conditioning, Human; United States; Wounds and Injuries
PubMed: 29602720
DOI: 10.1016/j.jsams.2018.02.011 -
Equine Veterinary Journal Mar 2023Certain stride characteristics have been shown to affect changes in biomechanical factors that are associated with injuries in human athletes. Determining the...
BACKGROUND
Certain stride characteristics have been shown to affect changes in biomechanical factors that are associated with injuries in human athletes. Determining the relationship between stride characteristics and musculoskeletal injury (MSI) may be key in limiting injury occurrence in the racehorse.
OBJECTIVES
This study aimed to determine whether changes in race day speed and stride characteristics over career race starts are associated with an increased risk of MSI in racehorses.
STUDY DESIGN
Case-control study.
METHODS
Speed, stride length, and stride frequency data were obtained from the final 200 m sectional of n = 5660 race starts by n = 584 horses (case n = 146, control n = 438). Multivariable joint models, combining longitudinal and survival (time to injury) analysis, were generated. Hazard ratios and their 95% confidence intervals (CI) are presented.
RESULTS
The risk of MSI increased by 1.18 (95% CI 1.09, 1.28; P < 0.001) for each 0.1 m/s decrease in speed and by 1.11 (95% CI 1.02, 1.21; P = 0.01) for each 10 cm decrease in stride length over time (career race starts). A more marked rate of decline in speed and stride length was observed approximately 6 races prior to injury. Risk of MSI was highest early in the horse's racing career.
MAIN LIMITATIONS
Only final sectional stride characteristics were assessed in the model. The model did not account for time between race starts.
CONCLUSIONS
Decreasing speed and stride length over multiple races is associated with MSI in racehorses. Monitoring stride characteristics over time may be beneficial for the early detection of MSI.
Topics: Animals; Case-Control Studies; Horses; Risk Factors; Running; Musculoskeletal System; Wounds and Injuries; Walking Speed
PubMed: 35477925
DOI: 10.1111/evj.13581 -
Science (New York, N.Y.) Jan 2019Barrier tissues are primary targets of environmental stressors and are home to the largest number of antigen-experienced lymphocytes in the body, including...
Barrier tissues are primary targets of environmental stressors and are home to the largest number of antigen-experienced lymphocytes in the body, including commensal-specific T cells. We found that skin-resident commensal-specific T cells harbor a paradoxical program characterized by a type 17 program associated with a poised type 2 state. Thus, in the context of injury and exposure to inflammatory mediators such as interleukin-18, these cells rapidly release type 2 cytokines, thereby acquiring contextual functions. Such acquisition of a type 2 effector program promotes tissue repair. Aberrant type 2 responses can also be unleashed in the context of local defects in immunoregulation. Thus, commensal-specific T cells co-opt tissue residency and cell-intrinsic flexibility as a means to promote both local immunity and tissue adaptation to injury.
Topics: Alarmins; Animals; CD8-Positive T-Lymphocytes; Candida albicans; Cell Plasticity; Female; GATA3 Transcription Factor; Interleukins; Male; Mice, Inbred C57BL; Mice, Transgenic; Microscopy, Confocal; Microscopy, Fluorescence; Nuclear Receptor Subfamily 1, Group F, Member 3; Sequence Analysis, RNA; Skin; Staphylococcus epidermidis; Symbiosis; Th17 Cells; Transcriptome; Wounds and Injuries
PubMed: 30523076
DOI: 10.1126/science.aat6280 -
Sports Health 2017
Topics: Athletes; Athletic Injuries; Brain Concussion; Humans; Musculoskeletal System; Return to Sport
PubMed: 28661829
DOI: 10.1177/1941738117714157 -
British Journal of Sports Medicine Dec 2009Traditional methods employed to study musculoskeletal injury mechanisms and joint biomechanics utilise in vivo or in vitro techniques. The advent of new technology and...
Traditional methods employed to study musculoskeletal injury mechanisms and joint biomechanics utilise in vivo or in vitro techniques. The advent of new technology and improved methods has also given rise to in silico (computer modelling) techniques. Under the current research paradigm, in vivo, in vitro and in silico methods independently provide information regarding the mechanisms and prevention of musculoskeletal injury. However, individually, each of these methods has multiple, inherent limitations and is likely to provide incomplete answers about multifactorial, complex injury conditions. The purpose of this treatise is to review current methods used to study, understand, and prevent musculoskeletal injury and to develop new conceptual-methodological frameworks that may help create a paradigm shift in musculoskeletal injury prevention research. We term the fusion of these three techniques in simulacra amalgama, or simply in sim, meaning a "union of models done on the likeness of phenomena." Anterior cruciate ligament (ACL) injury will be employed as a model example for the utility and applicability of the proposed, synthesised approach. Shifting the current experimental paradigm to incorporate a multifaceted, multidisciplinary, integration of in vivo, in vitro and in silico methods into the proposed in sim approaches may provide a platform for a more comprehensive understanding of the relationships between complex joint biomechanics and observed injury mechanisms.
Topics: Anterior Cruciate Ligament Injuries; Athletic Injuries; Humans; Philosophy, Medical; Research Design; Sports Medicine
PubMed: 19884108
DOI: 10.1136/bjsm.2009.065482 -
Clinical Journal of Sport Medicine :... Nov 2013High-quality sport-specific information about the nature, type, cause, and frequency of injuries is needed to set injury prevention priorities. This article describes... (Review)
Review
OBJECTIVE
High-quality sport-specific information about the nature, type, cause, and frequency of injuries is needed to set injury prevention priorities. This article describes the type, nature, and mechanism of injuries in community Australian Football (community AF) players, as collected through field-based monitoring of injury in teams of players.
DATA SOURCES
Compilation of published prospectively collected injury data from 3 studies in junior community AF (1202 injuries in 1950+ players) and 3 studies in adult community AF (1765 injuries in 2265 players). This was supplemented with previously unpublished data from the most recent adult community AF injury cohort study conducted in 2007 to 2008. Injuries were ranked according to most common body regions, nature of injury, and mechanism.
MAIN RESULTS
In all players, lower limb injuries were the most frequent injury in community AF and were generally muscle strains, joint sprains, and superficial injuries. These injuries most commonly resulted from incidental contact with other players, or from "overexertion." Upper limb injuries were less common but included fractures, strains, and sprains that were generally caused by incidental contact between players and the result of players falling to the ground.
CONCLUSIONS
Lower limb injuries are common in community AF and could have an adverse impact on sustained participation in the game. Based on what is known about their mechanisms, it is likely that a high proportion of lower limb injuries could be prevented and they should therefore be a priority for injury prevention in community AF.
Topics: Athletic Injuries; Australia; Cohort Studies; Football; Humans; Lower Extremity
PubMed: 24071665
DOI: 10.1097/JSM.0b013e31829aa3e8 -
Journal of Feline Medicine and Surgery Jun 2022The aim of the study was to describe traumatic stifle injury in cats and report complications and long-term outcome.
OBJECTIVES
The aim of the study was to describe traumatic stifle injury in cats and report complications and long-term outcome.
METHODS
The medical records from seven veterinary hospitals of cats treated for traumatic stifle injury were reviewed. Long-term follow-up data were collected from referring veterinarians and using the Feline Musculoskeletal Pain Index, collected from owners.
RESULTS
Seventy-two cats were included in the study. The most common combination of ligament injury involved both cruciate ligaments and the lateral collateral ligament (25.4%). Medial meniscal injury was more common (66.2%) than lateral meniscal injury (59.4%). A temporary transarticular pin was used intraoperatively to aid reduction in 23/73 (31.5%) surgeries. Postoperative immobilisation was applied in 41/72 (56.9%) cats with a mean duration of 4.8 weeks. Short-term complications occurred in 40/64 (62.5%) cats. Long-term complications occurred in seven (17.5%) cats. Overall outcome was excellent in 25/61 (41%) cats, good in 13/61 (21.3%) cats, fair in 11/61 (18%) cats and poor in 12/61 (19.7%) cats. Mean length of follow-up was 29.6 months (range 0.5-204). A significantly poorer outcome was observed in cats with medial meniscal injury and those undergoing revision surgery. Use of a transarticular pin when left in situ for postoperative immobilisation was associated with a poorer outcome (P = 0.043) and a higher risk of complications (P = 0.018). Postoperative immobilisation was not related to outcome.
CONCLUSIONS AND RELEVANCE
Traumatic stifle injury in cats can lead to rupture of multiple ligaments causing significant instability of the joint. Surgical treatment is associated with a high rate of short-term complications, although long-term outcome may still be good to excellent in the majority of cats (62.3%). In cats where follow-up was available, postoperative immobilisation had no positive effect on outcome and may not be required. Leaving a transarticular pin for postoperative immobilisation is not recommended as it was significantly associated with a poorer outcome and a higher complication rate.
Topics: Animals; Anterior Cruciate Ligament Injuries; Cat Diseases; Cats; Joint Dislocations; Retrospective Studies; Rupture; Stifle; Treatment Outcome
PubMed: 34254845
DOI: 10.1177/1098612X211028834 -
Canadian Association of Radiologists... May 2012Hip and groin pain is a common condition in professional athletes and may result from an acute injury or from chronic, repetitive trauma. It is responsible for... (Review)
Review
Hip and groin pain is a common condition in professional athletes and may result from an acute injury or from chronic, repetitive trauma. It is responsible for significant morbidity, which leads to time away from training and competition, and may result in a career-ending injury. The anatomic and biomechanical causes for hip and groin injuries are among the most complex and controversial in the musculoskeletal system. This makes clinical differentiation and subsequent management difficult because of the considerable overlap of symptoms and signs. This review article will evaluate several pathologic conditions of the hip and groin in athletes, divided into acute (secondary to single event) and chronic (secondary to altered biomechanical load or repetitive microtrauma) injuries, with an emphasis on imaging in the diagnosis of these injuries. Appropriate use of imaging along with clinical findings can allow accurate diagnosis and subsequent appropriate management of these patients to ultimately allow return to athletic activity.
Topics: Athletes; Athletic Injuries; Biomechanical Phenomena; Contrast Media; Cumulative Trauma Disorders; Diagnostic Imaging; Groin; Hip Injuries; Humans; Pain Measurement; Sports Medicine
PubMed: 21820270
DOI: 10.1016/j.carj.2010.11.001 -
Nature Communications Aug 2021Pain is a central feature of soft tissue trauma, which under certain contexts, results in aberrant osteochondral differentiation of tissue-specific stem cells. Here, the...
Pain is a central feature of soft tissue trauma, which under certain contexts, results in aberrant osteochondral differentiation of tissue-specific stem cells. Here, the role of sensory nerve fibers in this abnormal cell fate decision is investigated using a severe extremity injury model in mice. Soft tissue trauma results in NGF (Nerve growth factor) expression, particularly within perivascular cell types. Consequently, NGF-responsive axonal invasion occurs which precedes osteocartilaginous differentiation. Surgical denervation impedes axonal ingrowth, with significant delays in cartilage and bone formation. Likewise, either deletion of Ngf or two complementary methods to inhibit its receptor TrkA (Tropomyosin receptor kinase A) lead to similar delays in axonal invasion and osteochondral differentiation. Mechanistically, single-cell sequencing suggests a shift from TGFβ to FGF signaling activation among pre-chondrogenic cells after denervation. Finally, analysis of human pathologic specimens and databases confirms the relevance of NGF-TrkA signaling in human disease. In sum, NGF-mediated TrkA-expressing axonal ingrowth drives abnormal osteochondral differentiation after soft tissue trauma. NGF-TrkA signaling inhibition may have dual therapeutic use in soft tissue trauma, both as an analgesic and negative regulator of aberrant stem cell differentiation.
Topics: Animals; Axons; Cartilage; Cell Differentiation; Mice; Mice, Inbred C57BL; Nerve Growth Factor; Osteogenesis; Receptor, trkA; Signal Transduction; Stem Cells; Wounds and Injuries
PubMed: 34400627
DOI: 10.1038/s41467-021-25143-z -
Journal of Orthopaedic Research :... Apr 2020In this review, we highlight themes from a recent workshop focused on "Plasticity of Cell Fate in Musculoskeletal Tissues" held at the Orthopaedic Research Society's... (Review)
Review
In this review, we highlight themes from a recent workshop focused on "Plasticity of Cell Fate in Musculoskeletal Tissues" held at the Orthopaedic Research Society's 2019 annual meeting. Experts in the field provided examples of mesenchymal cell plasticity during normal musculoskeletal development, regeneration, and disease. A thorough understanding of the biology underpinning mesenchymal cell plasticity may offer a roadmap for promoting regeneration while attenuating pathologic differentiation. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:708-718, 2020.
Topics: Animals; Cell Differentiation; Cell Plasticity; Disease; Humans; Musculoskeletal Development; Myositis Ossificans; Ossification, Heterotopic; Regeneration; Wounds and Injuries
PubMed: 31721278
DOI: 10.1002/jor.24523