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Journal of Science and Medicine in Sport Feb 2023Identifying risk factors for musculoskeletal injury is critical to maintain the health and safety of athletes. While current tests consider isolated assessments of...
UNLABELLED
Identifying risk factors for musculoskeletal injury is critical to maintain the health and safety of athletes. While current tests consider isolated assessments of function or subjective ratings, objective tests of reactive postural responses, especially when in cognitively demanding scenarios, may better identify risk of musculoskeletal injury than traditional tests alone.
OBJECTIVES
Examine if objective assessments of reactive postural responses, quantified using wearable inertial measurement units, are associated with the risk for acute lower extremity musculoskeletal injuries in collegiate athletes.
DESIGN
Prospective survival analysis.
METHODS
191 Division I National Collegiate Athletic Association athletes completed an instrumented version of a modified Push and Release (I-mP&R) test at the beginning of their competitive season. The I-mP&R was performed with eyes closed under single- and dual-task (concurrent cognitive task) conditions. Inertial measurement units recorded acceleration and angular velocity data that was used to calculate time-to-stability. Acute lower extremity musculoskeletal injuries were tracked from first team activity for six months. Cox proportional hazard models were used to determine if longer times to stability were associated with faster time to injury.
RESULTS
Longer time-to-stability was associated with increased risk of injury; every 250 ms increase in dual-task median time-to-stability was associated with a 36% increased risk of acute, lower-extremity musculoskeletal injury.
CONCLUSIONS
Tests of reactive balance, particularly under dual-task conditions, may be able to identify athletes most at risk of acute lower extremity musculoskeletal injury. Clinically-feasible, instrumented tests of reactive should be considered in assessments for prediction and mitigation of musculoskeletal injury in collegiate athletes.
Topics: Humans; Athletic Injuries; Prospective Studies; Brain Concussion; Athletes; Leg Injuries; Postural Balance
PubMed: 36669902
DOI: 10.1016/j.jsams.2023.01.003 -
Clinical Orthopaedics and Related... Apr 2019
Topics: Humans; Military Medicine; Musculoskeletal Diseases; Orthopedic Procedures; Prognosis; Warfare; Wounds and Injuries
PubMed: 30839316
DOI: 10.1097/CORR.0000000000000695 -
Stem Cell Research & Therapy Oct 2011There are many similarities between health issues affecting military and civilian patient populations, with the exception of the relatively small but vital segment of... (Review)
Review
There are many similarities between health issues affecting military and civilian patient populations, with the exception of the relatively small but vital segment of active soldiers who experience high-energy blast injuries during combat. A rising incidence of major injuries from explosive devices in recent campaigns has further complicated treatment and recovery, highlighting the need for tissue regenerative options and intensifying interest in the possible role of stem cells for military medicine. In this review we outline the array of tissue-specific injuries typically seen in modern combat - as well as address a few complications unique to soldiers--and discuss the state of current stem cell research in addressing each area. Embryonic, induced-pluripotent and adult stem cell sources are defined, along with advantages and disadvantages unique to each cell type. More detailed stem cell sources are described in the context of each tissue of interest, including neural, cardiopulmonary, musculoskeletal and sensory tissues, with brief discussion of their potential role in regenerative medicine moving forward. Additional commentary is given to military stem cell applications aside from regenerative medicine, such as blood pharming, immunomodulation and drug screening, with an overview of stem cell banking and the unique opportunity provided by the military and civilian overlap of stem cell research.
Topics: Humans; Immunomodulation; Immunosuppression Therapy; Military Medicine; Regenerative Medicine; Stem Cell Transplantation; Stem Cells; Wounds and Injuries
PubMed: 22011454
DOI: 10.1186/scrt81 -
Journal of Vascular Surgery Aug 2019Sport-related vascular trauma is an important consequence of increased physical activity. Repetitive, high-intensity movements predispose athletes to vascular disease,... (Review)
Review
BACKGROUND/OBJECTIVE
Sport-related vascular trauma is an important consequence of increased physical activity. Repetitive, high-intensity movements predispose athletes to vascular disease, including arterial pathology, by exerting increased pressure on neurovascular structures. This is an important source of morbidity in an otherwise young and healthy population. Arterial pathology associated with repetitive trauma is often misdiagnosed as musculoskeletal injury. This article increases awareness of sport-related arterial disease by reviewing the symptomatology, investigation, and treatment modalities of this pathology. In addition, prognostic outcomes specific to the athlete are discussed.
RESULTS
Arterial thoracic outlet syndrome and vascular quadrilateral space syndrome are associated with athletes involved in overhead throwing exercises. Sport-related arterial pathology of the lower limb include external iliac artery endofibrosis (EIAE), popliteal artery entrapment syndrome (PAES), and adductor canal syndrome. Vascular stress and kinking secondary to vessel tethering are important contributors to pathology in EIAE. Chronic exertional compartment syndrome must also be considered, presenting with clinical features similar to PAES. In addition, athletes are predisposed to blunt mechanical trauma. Hypothenar hammer syndrome is one such example, contributing to a high burden of morbidity in this population.
CONCLUSIONS
In arterial thoracic outlet syndrome and vascular quadrilateral space syndrome, surgery is advocated in symptomatic individuals, with postoperative outcomes favorable for the athlete. Acute limb ischemia may occur as a result of secondary thrombosis or embolization, often without preceding claudication. PAES and adductor canal syndrome are associated with functional entrapment in the athlete, secondary to muscular hypertrophy. Surgical exploration may be indicated. Poorer outcomes are noted when this process is associated with vascular reconstruction. Surgical treatment of EIAE follows failure of conservative management, with limited data available on postoperative prognosis. Investigations for all these conditions should be targeted based on clinical suspicion. A delay in diagnosis can have severe consequences on return to competition in these high-functioning individuals.
Topics: Arteries; Athletes; Athletic Injuries; Humans; Recovery of Function; Return to Sport; Risk Factors; Treatment Outcome; Vascular System Injuries
PubMed: 31113722
DOI: 10.1016/j.jvs.2019.02.002 -
International Journal of Occupational... Jan 2020Police officers run a risk of injury that is higher than in most other occupations. This study aims to quantify injury prevalence and identify common musculoskeletal...
OBJECTIVES
Police officers run a risk of injury that is higher than in most other occupations. This study aims to quantify injury prevalence and identify common musculoskeletal injuries (MSIs) among police officers, using injury data from a municipal police service in Alberta, Canada.
MATERIAL AND METHODS
This is a descriptive study based on a secondary data analysis of the MSIs reported to the police service over a 41-month period; January 1, 2013 - June 2, 2016. Data from 1325 active police officers were examined, and injury prevalence was reported according to sex, injury diagnosis, the body part injured, and the work area.
RESULTS
The prevalence of strains and sprains was very high, at 89.2%. The back and shoulder were most frequently affected. Overall, injury proportions did not differ significantly across work areas. The injury risk was age-related but no significant differences in injuries between sexes were identified.
CONCLUSIONS
Minor injuries such as strains and sprains occur frequently in the police occupation. Future research should focus on specific risk factors for MSIs in police officers in order to aid prevention. Int J Occup Med Environ Health. 2020;33(1):59-66.
Topics: Adult; Age Factors; Alberta; Cross-Sectional Studies; Female; Humans; Male; Musculoskeletal System; Occupational Injuries; Police; Prevalence; Sprains and Strains; Workplace
PubMed: 31691680
DOI: 10.13075/ijomeh.1896.01454 -
International Journal of Molecular... Sep 2020Despite advances in treatment and care, burn trauma remains the fourth most common type of traumatic injury. Burn-induced cardiac failure is a key factor for patient... (Review)
Review
Despite advances in treatment and care, burn trauma remains the fourth most common type of traumatic injury. Burn-induced cardiac failure is a key factor for patient mortality, especially during the initial post-burn period (the first 24 to 48 h). Mitochondria, among the most important subcellular organelles in cardiomyocytes, are a central player in determining the severity of myocardial damage. Defects in mitochondrial function and structure are involved in pathogenesis of numerous myocardial injuries and cardiovascular diseases. In this article, we comprehensively review the current findings on cardiac mitochondrial pathological changes and summarize burn-impaired mitochondrial respiration capacity and energy supply, induced mitochondrial oxidative stress, and increased cell death. The molecular mechanisms underlying these alterations are discussed, along with the possible influence of other biological variables. We hope this review will provide useful information to explore potential therapeutic approaches that target mitochondria for cardiac protection following burn injury.
Topics: Animals; Burns; Humans; Mitochondria, Heart; Myocardium; Myocytes, Cardiac; Wounds and Injuries
PubMed: 32932869
DOI: 10.3390/ijms21186655 -
Frontiers in Immunology 2020Single trauma injuries or isolated fractures are often manageable and generally heal without complications. In contrast, high-energy trauma results in multi/poly-trauma... (Review)
Review
Single trauma injuries or isolated fractures are often manageable and generally heal without complications. In contrast, high-energy trauma results in multi/poly-trauma injury patterns presenting imbalanced pro- and anti- inflammatory responses often leading to immune dysfunction. These injuries often exhibit delayed healing, leading to fibrosis of injury sites and delayed healing of fractures depending on the intensity of the compounding traumas. Immune dysfunction is accompanied by a temporal shift in the innate and adaptive immune cells distribution, triggered by the overwhelming release of an arsenal of inflammatory mediators such as complements, cytokines and damage associated molecular patterns (DAMPs) from necrotic cells. Recent studies have implicated this dysregulated inflammation in the poor prognosis of polytraumatic injuries, however, interventions focusing on immunomodulating inflammatory cellular composition and activation, if administered incorrectly, can result in immune suppression and unintended outcomes. Immunomodulation therapy is promising but should be conducted with consideration for the spatial and temporal distribution of the immune cells during impaired healing. This review describes the current state of knowledge in the spatiotemporal distribution patterns of immune cells at various stages during musculoskeletal wound healing, with a focus on recent advances in the field of Osteoimmunology, a study of the interface between the immune and skeletal systems, in long bone fractures. The goals of this review are to (1) discuss wound and fracture healing processes of normal and delayed healing in skeletal muscles and long bones; (2) provide a balanced perspective on temporal distributions of immune cells and skeletal cells during healing; and (3) highlight recent therapeutic interventions used to improve fracture healing. This review is intended to promote an understanding of the importance of inflammation during normal and delayed wound and fracture healing. Knowledge gained will be instrumental in developing novel immunomodulatory approaches for impaired healing.
Topics: Animals; Bone Regeneration; Bony Callus; Fracture Healing; Hematoma; Humans; Immunomodulation; Inflammation; Multiple Trauma; Muscle, Skeletal; Musculoskeletal System; Regeneration; Time Factors; Wound Healing
PubMed: 32582170
DOI: 10.3389/fimmu.2020.01056 -
Clinical Orthopaedics and Related... Oct 2008Musculoskeletal injuries are a major public health problem globally, contributing a large burden of disability and suffering. This burden could be considerably lowered... (Review)
Review
Musculoskeletal injuries are a major public health problem globally, contributing a large burden of disability and suffering. This burden could be considerably lowered by implementation of affordable and sustainable strategies to strengthen orthopaedic trauma care, especially in low- and middle-income countries. This article summarizes the global burden of musculoskeletal injuries and provides several examples of successful programs that have improved care of injuries in health facilities in low- and middle-income countries. Finally, it discusses WHO efforts to build on the country experiences and to make progress in lowering the burden of musculoskeletal injuries globally.
Topics: Cost of Illness; Delivery of Health Care; Developing Countries; Emergency Medical Services; Global Health; Health Care Costs; Health Services Accessibility; Health Services Research; Healthcare Disparities; Humans; Musculoskeletal System; Orthopedic Procedures; Outcome and Process Assessment, Health Care; Practice Guidelines as Topic; Program Development; Program Evaluation; World Health Organization; Wounds and Injuries
PubMed: 18679760
DOI: 10.1007/s11999-008-0416-z -
The Journal of Orthopaedic and Sports... Oct 2004The purpose of this commentary is to present recent epidemiological findings regarding work-related musculoskeletal disorders (WMSDs) of the hand and wrist, and to... (Review)
Review
The purpose of this commentary is to present recent epidemiological findings regarding work-related musculoskeletal disorders (WMSDs) of the hand and wrist, and to summarize experimental evidence of underlying tissue pathophysiology and sensorimotor changes in WMSDs. Sixty-five percent of the 333 800 newly reported cases of occupational illness in 2001 were attributed to repeated trauma. WMSDs of the hand and wrist are associated with the longest absences from work and are, therefore, associated with greater lost productivity and wages than those of other anatomical regions. Selected epidemiological studies of hand/wrist WMSDs published since 1998 are reviewed and summarized. Results from selected animal studies concerning underlying tissue pathophysiology in response to repetitive movement or tissue loading are reviewed and summarized. To the extent possible, corroborating evidence in human studies for various tissue pathomechanisms suggested in animal models is presented. Repetitive, hand-intensive movements, alone or in combination with other physical, nonphysical, and nonoccupational risk factors, contribute to the development of hand/wrist WMSDs. Possible pathophysiological mechanisms of tissue injury include inflammation followed by repair and/or fibrotic scarring, peripheral nerve injury, and central nervous system reorganization. Clinicians should consider all of these pathomechanisms when examining and treating patients with hand/wrist WMSDs.
Topics: Cumulative Trauma Disorders; Epidemiologic Studies; Fibrosis; Hand Injuries; Humans; Incidence; Inflammation; Occupational Health; Risk Factors; Tendinopathy; Wrist Injuries
PubMed: 15552707
DOI: 10.2519/jospt.2004.34.10.610 -
International Archives of Occupational... Jul 2014This paper sought to assess organizational safety practices at three different levels of hierarchical workplace structure and to examine their association with injury...
OBJECTIVES
This paper sought to assess organizational safety practices at three different levels of hierarchical workplace structure and to examine their association with injury outcomes among construction apprentices.
METHODS
Using a cross-sectional sample of 1,775 construction apprentices, three measures of organizational safety practice were assessed: contractor-, steward-, and coworker-safety practice. Each safety practice measure was assessed using three similar questions (i.e., on-the-job safety commitment, following required or recommended safe work practices, and correcting unsafe work practices); the summed average of the responses ranged from 1 to 4, with a higher score indicating poorer safety practice. Outcome variables included the prevalence of four types of musculoskeletal pain (i.e., neck, shoulder, hand, and back pain) and injury-related absence.
RESULTS
In adjusted analyses, contractor-safety practice was associated with both hand pain (OR: 1.27, 95 % CI: 1.04, 1.54) and back pain (OR: 1.40, 95 % CI: 1.17, 1.68); coworker-safety practice was related to back pain (OR: 1.42, 95 % CI: 1.18, 1.71) and injury-related absence (OR: 1.36, 95 % CI: 1.11, 1.67). In an analysis that included all three safety practice measures simultaneously, the association between coworker-safety practice and injury-related absence remained significant (OR: 1.68, 95 % CI: 1.20, 2.37), whereas all other associations became non-significant.
CONCLUSIONS
This study suggests that organizational safety practice, particularly coworker-safety practice, is associated with injury outcomes among construction apprentices.
Topics: Absenteeism; Adolescent; Adult; Back Pain; Construction Industry; Cross-Sectional Studies; Female; Hand; Humans; Male; Middle Aged; Musculoskeletal Pain; Neck Pain; Occupational Diseases; Occupational Health; Prevalence; Safety Management; Shoulder Pain; Workplace; Wounds and Injuries; Young Adult
PubMed: 23748366
DOI: 10.1007/s00420-013-0889-2