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Clinics in Sports Medicine Oct 2014Musculoskeletal injuries during military and sport-related training are common, costly and potentially debilitating. Thus, there is a great need to develop and implement... (Review)
Review
Musculoskeletal injuries during military and sport-related training are common, costly and potentially debilitating. Thus, there is a great need to develop and implement evidence-based injury prevention strategies to reduce the burden of musculoskeletal injury. The lack of attention to implementation issues is a major factor limiting the ability to successfully reduce musculoskeletal injury rates using evidence-based injury prevention programs. We propose 7 steps that can be used to facilitate successful design and implementation of evidence-based injury prevention programs within the logical constraints of a real-world setting by identifying implementation barriers and associated solutions. Incorporating these 7 steps along with other models for behavioral health interventions may improve the overall efficacy of military and sport-related injury prevention programs.
Topics: Anterior Cruciate Ligament Injuries; Athletic Injuries; Humans; Knee Injuries; Military Personnel; Physical Education and Training; Program Development
PubMed: 25280612
DOI: 10.1016/j.csm.2014.06.012 -
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 -
Sports Health 2021Awareness of important injury risk factors associated with excessive pitching volume has been highlighted in the literature, but injury rates remain high. Shoulder pain... (Review)
Review
CONTEXT
Awareness of important injury risk factors associated with excessive pitching volume has been highlighted in the literature, but injury rates remain high. Shoulder pain in baseball players is associated with various changes in musculoskeletal movements, which presents as measurable impairments throughout the kinetic chain. Baseball coaches and rehabilitation professionals have utilized exercise programs targeting strength and flexibility of the throwing arm to prevent injuries. The purpose of this review is to summarize the current evidence regarding the effectiveness of arm care exercise programs in reducing upper extremity injury rates in adolescent baseball players.
EVIDENCE ACQUISITION
A search of electronic databases, including CINAHL with full text, MEDLINE, and SPORTDiscus was conducted to retrieve available articles in English from the years 2010 through 2020. The search terms , and were used.
STUDY DESIGN
Clinical review.
LEVEL OF EVIDENCE
Level 4.
RESULTS
Improving shoulder internal rotation range of motion by stretching the posterior shoulder muscles daily was associated with a 36% risk reduction of shoulder and elbow injuries. Group-based arm care exercise programs that target multiple musculoskeletal impairments demonstrated an approximately 50% reduced risk of elbow injury.
CONCLUSION
For adolescent baseball players, arm care injury prevention programs focusing on important musculoskeletal impairments are effective at reducing injury incidence rates. Multimodal injury prevention programs that improve multiple musculoskeletal impairments are more comprehensive and may result in better injury reduction than programs focusing on a singular impairment.
Topics: Adolescent; Arm; Arm Injuries; Baseball; Humans; Muscle Stretching Exercises; Range of Motion, Articular; Resistance Training; Risk Reduction Behavior; Rotation; Shoulder Injuries; Elbow Injuries
PubMed: 33514287
DOI: 10.1177/1941738120976384 -
Clinical Orthopaedics and Related... Oct 2008Approximately 2000 lives are lost in Uganda annually through road traffic accidents. In Kampala, they account for 39% of all injuries, primarily in males aged 16-44... (Review)
Review
Approximately 2000 lives are lost in Uganda annually through road traffic accidents. In Kampala, they account for 39% of all injuries, primarily in males aged 16-44 years. They are a result of rapid motorization and urbanization in a country with a poor economy. Uganda's population is an estimated 28 million with a growth rate of 3.4% per year. Motorcycles and omnibuses, the main taxi vehicles, are the primary contributors to the accidents. Poor roads and drivers compound the situation. Twenty-three orthopaedic surgeons (one for every 1,300,000 people) provide specialist services that are available only at three regional hospitals and the National Referral Hospital in Kampala. The majority of musculoskeletal injuries are managed nonoperatively by 200 orthopaedic officers distributed at the district, regional and national referral hospitals. Because of the poor economy, 9% of the national budget is allocated to the health sector. Patients with musculoskeletal injuries in Uganda frequently fail to receive immediate care due to inadequate resources and most are treated by traditional bonesetters. Neglected injuries typically result in poor outcomes. Possible solutions include a public health approach for prevention of road traffic injuries, training of adequate human resources, and infrastructure development.
Topics: Accidents, Traffic; Delivery of Health Care; Developing Countries; Education, Medical; Emergency Medical Services; Health Care Costs; Health Care Rationing; Health Services Accessibility; Health Services Research; Healthcare Disparities; Humans; Musculoskeletal System; National Health Programs; Orthopedic Procedures; Outcome and Process Assessment, Health Care; Program Development; Uganda; Wounds and Injuries
PubMed: 18629599
DOI: 10.1007/s11999-008-0369-2 -
The American Journal of Emergency... Jul 2016Fishing is a common pastime. In the developed world, it is commonly performed as a recreational activity. We aim to determine injury patterns and outcomes among patients...
INTRODUCTION
Fishing is a common pastime. In the developed world, it is commonly performed as a recreational activity. We aim to determine injury patterns and outcomes among patients injured while ice fishing.
METHODS
Data on initial emergency department visits from the National Electronic Injury Surveillance System-All Injury Program (NEISS-AIP) from 2009-2014 were analyzed. All patients with fishing related injuries were included. Primary endpoint was rate of admission or transfer. Secondary endpoints were defined a priori anatomical injury categories and patients were assigned into groups. Descriptive and power analysis was performed between patients with ice-fishing and traditional fishing related injuries.
RESULTS
We identified 8220 patients who sustained fishing related injuries, of which n=85 (1%) involved ice fishing. Ice fishing injuries occurred primarily in males (88%) with a mean age of 39.4years ±17.5 (std dev). The most common injuries related to ice fishing were: orthopedic/musculoskeletal (46%), minor trauma (37%), and major trauma (6%). Hot thermal injuries (burns) were the fourth most common type of ice-fishing injury (5%) but rarely occurred in warmer fishing months (<1%, P=.004). Cold thermal injuries (1%) and hypothermia (0%) were rare among ice-fishing injuries and immersion/drowning occurred in 5% of cases. The rate of admission/transfer was significantly greater in ice-fishing (11%) than the traditional fishing patients 3%, (P<.001), power was 90%.
CONCLUSION
Ice fishing is associated with more severe injury patterns and more thermal injuries and immersion injuries than traditional fishing. Providers and participants should be aware of the potential risks and benefits and counseled appropriately.
Topics: Adult; Emergency Service, Hospital; Female; Fisheries; Humans; Ice; Male; Middle Aged; Recreation; United States; Wounds and Injuries; Young Adult
PubMed: 27117462
DOI: 10.1016/j.ajem.2016.02.078 -
Journal of Athletic Training Apr 2020Tactical athletes commonly experience high levels of physical stress, which may increase their risk of musculoskeletal injury. It is critical to understand psychological...
CONTEXT
Tactical athletes commonly experience high levels of physical stress, which may increase their risk of musculoskeletal injury. It is critical to understand psychological predictors of functional movement (FM), which may help prevent musculoskeletal injury in this population.
OBJECTIVE
To determine the associations of combat and trauma exposure with FM characteristics of male tactical athletes. Secondary objectives were to explore confounding influences of age and physical injury history as well as the mediating role of bodily pain.
DESIGN
Cross-sectional study.
SETTING
Research laboratory.
PATIENTS OR OTHER PARTICIPANTS
Eighty-two healthy, male, active-duty US Navy Explosive Ordnance Disposal personnel (age = 34.0 ± 6.7 years).
MAIN OUTCOME MEASURE(S)
Participants completed measures of combat exposure, trauma exposure, physical injury history, and bodily pain. We assessed FM characteristics (ie, Functional Movement Screen [FMS], Y-Balance Test), from which we derived a composite functional status (CFS) measure. Hypotheses were tested using correlational and multiple regression (causal-steps) models.
RESULTS
In unadjusted models, trauma exposure was inversely associated with the FMS ( = .005) and CFS ( = .009) scores. In adjusted models, these relationships were robust to the confounding influences of age and physical injury history. Trauma exposure and bodily pain were substantive, independent predictors of FMS and CFS in causal-steps models (all values < .05), implying additive rather than mediated effects ( = 0.18-0.20). Combat exposure did not predict FM characteristics.
CONCLUSIONS
To our knowledge, this is the first evidence of the influence of trauma exposure on the FM characteristics of male tactical athletes, independent of age, physical injury, and bodily pain. This program of research may help to advance the prevention and treatment of musculoskeletal injuries in the tactical environment.
Topics: Adult; Athletes; Athletic Injuries; Cross-Sectional Studies; Humans; Male; Military Personnel; Musculoskeletal Pain; Occupational Exposure; Physical Examination; Physical Functional Performance; Psychological Trauma; Wounds and Injuries
PubMed: 32058798
DOI: 10.4085/1062-6050-111-19 -
Bulletin of the World Health... Jul 2016To estimate the burden of road traffic injuries and deaths for all road users and among different road user groups in Africa. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To estimate the burden of road traffic injuries and deaths for all road users and among different road user groups in Africa.
METHODS
We searched MEDLINE, EMBASE, Global Health, Google Scholar, websites of African road safety agencies and organizations for registry- and population-based studies and reports on road traffic injury and death estimates in Africa, published between 1980 and 2015. Available data for all road users and by road user group were extracted and analysed. We conducted a random-effects meta-analysis and estimated pooled rates of road traffic injuries and deaths.
FINDINGS
We identified 39 studies from 15 African countries. The estimated pooled rate for road traffic injury was 65.2 per 100 000 population (95% confidence interval, CI: 60.8-69.5) and the death rate was 16.6 per 100 000 population (95% CI: 15.2-18.0). Road traffic injury rates increased from 40.7 per 100 000 population in the 1990s to 92.9 per 100 000 population between 2010 and 2015, while death rates decreased from 19.9 per 100 000 population in the 1990s to 9.3 per 100 000 population between 2010 and 2015. The highest road traffic death rate was among motorized four-wheeler occupants at 5.9 per 100 000 population (95% CI: 4.4-7.4), closely followed by pedestrians at 3.4 per 100 000 population (95% CI: 2.5-4.2).
CONCLUSION
The burden of road traffic injury and death is high in Africa. Since registry-based reports underestimate the burden, a systematic collation of road traffic injury and death data is needed to determine the true burden.
Topics: Accidents, Traffic; Africa; Cost of Illness; Humans; Quality-Adjusted Life Years; Risk Factors; Wounds and Injuries
PubMed: 27429490
DOI: 10.2471/BLT.15.163121 -
Medicina (Kaunas, Lithuania) Mar 2023The incidence of injuries in rugby is extremely high, but studies have rarely examined the predictors of injury in amateur players. This study aimed to systematically...
The incidence of injuries in rugby is extremely high, but studies have rarely examined the predictors of injury in amateur players. This study aimed to systematically analyse sports and injury factors as potential predictors of musculoskeletal injuries in senior-level amateur rugby players. : The participants in this study were 101 senior-level rugby players from Croatia (average of 24.64 years old). At baseline, all participants were tested on sociodemographic and anthropometric parameters (age, body height and mass), consumption of dietary supplements, preseason injury status and training volume, and sport factors (position in game). Data on injury occurrence (dependent variable), prevalence of pain, training status, and characteristics of the played match were surveyed prospectively once a week during the three-month period (one half-season). : The logistic regression revealed a higher injury occurrence in forward players of the 1st row, 2nd row (OR = 5.07; 95% CI: 1.64-15.69), and center (OR = 4.72; 95% CI: 1.28-14.31), with reference to outside back players. When observed univariately, higher body mass, higher level of competition, more weekly training sessions, self-perceived pain, and playing with pain were significant injury risk factors. The multivariate logistic regression identified pre-season injury (OR = 1.30, 95% CI: 1.09-1.52), higher level of the game/match (OR = 1.44, 95% CI: 1.13-1.76), higher body mass (OR = 1.03, 95% CI: 1.01-1.05), and pain prevalence (OR = 5.71, 95% CI: 3.22-7.70) as multivariate predictors of injury occurrence over the season. : The results of this study showed that among sport factors, the playing position, level of competition, and training exposure represent major injury risk factors. Therefore, in order to reduce the number of injuries, special emphasis should be placed on the specific tackling technique of forward players, which could both increase their situational efficiency and protect them from injuries. Additionally, perceived pain, injury history, and playing with injury were noted among injury factors as the ones that can be predictors of future injuries. In that manner, it is important that coaching and medical staff monitor players with previous injuries and with pain symptoms in order to act preventively against injury occurrence.
Topics: Humans; Young Adult; Adult; Football; Rugby; Seasons; Athletic Injuries; Pain; Incidence
PubMed: 36984581
DOI: 10.3390/medicina59030579 -
American Family Physician Mar 2006Improper diagnosis and treatment of finger injuries can cause deformity and dysfunction over time. A basic understanding of the complex anatomy of the finger and of... (Review)
Review
Improper diagnosis and treatment of finger injuries can cause deformity and dysfunction over time. A basic understanding of the complex anatomy of the finger and of common tendon and ligament injury mechanisms can help physicians properly diagnose and treat finger injuries. Evaluation includes a general musculoskeletal examination as well as radiography (oblique, anteroposterior, and true lateral views). Splinting and taping are effective treatments for tendon and ligament injuries. Treatment should restrict the motion of injured structures while allowing uninjured joints to remain mobile. Although family physicians are usually the first to evaluate patients with finger injuries, it is important to recognize when a referral is needed to ensure optimal outcomes.
Topics: Clinical Trials as Topic; Finger Injuries; Humans; Ligaments, Articular; Splints; Tendon Injuries
PubMed: 16529088
DOI: No ID Found -
Journal of Athletic Training Apr 2020Rugby union is a field-based collision sport with high injury rates. Associations between injury characteristics and global positioning system-derived movement demands...
CONTEXT
Rugby union is a field-based collision sport with high injury rates. Associations between injury characteristics and global positioning system-derived movement demands in rugby union athletes are yet to be investigated.
OBJECTIVE
To investigate associations between match injuries and movement demands, anthropometrics, and physical performance in under-20-years university-level rugby union players.
DESIGN
Descriptive epidemiology study.
SETTING
Competition season.
PATIENTS OR OTHER PARTICIPANTS
Rugby union players (n = 34, age = 19.3 ± 0.6 years) from a university club were recruited.
MAIN OUTCOME MEASURE(S)
Acute medical attention non-time-loss (NTL), medical-attention time-loss (TL), and total medical-attention (MA) injuries sustained were recorded. Principal component (PC) analysis was performed on player-movement demand variables to identify independent-movement demand components. Pearson correlation and bivariate linear regression were used to test associations between match injuries and PCs. Anthropometric and physical performance measures were tested as predictors of match injuries using a forward stepwise multiple regression analysis.
RESULTS
Backs had lower anthropometric and performance measures than forwards ( < .05), whereas forwards performed fewer weekly movement demands than backs ( < .05). Increases in body mass and skinfold thickness were associated with more injuries ( < .05). Principal component analysis revealed 3 PCs representing overall performance, high-intensity running (HIR) performance, and impacts. Increases in HIR were associated with decreases in NTL upper limb and trunk ( = -0.32, = .03), NTL musculoskeletal ( = -0.36, = .05), NTL total ( = -0.46, < .01), TL musculoskeletal ( = -0.30, = .05), MA musculoskeletal ( = -0.41, < .01), and MA total ( = -0.48, < .01) injuries. Increases in impacts were associated with increased TL ( = 0.32, = .03) and MA ( = 0.33, = .03) head or neck injuries.
CONCLUSIONS
Backs experienced greater weekly movement demands than forwards. Increases in HIR demands were associated with decreased acute injuries in university rugby players. Increases in impacts were associated with more acute head or neck injuries. Positional differences in movement demands, anthropometrics, and physical performance highlight the need for position-specific training.
Topics: Anthropometry; Athletic Injuries; Athletic Performance; Australia; Football; Geographic Information Systems; Humans; Incidence; Male; Universities; Young Adult
PubMed: 32160057
DOI: 10.4085/1062-6050-575-18