History Of Injury Research Articles

Maximizing the performance of badminton athletes through core strength training: Unlocking their full potential using machine learning (ML) modeling

Core strength training plays an essential role in maximizing performance for badminton athletes. The core muscles in the abdominal, back, and hip regions provide stability, enable efficient power transfer between the upper and lower body, and allow for rapid changes in direction - all crucial components for success in badminton. However, optimizing core training requires an understanding of its impact on sport-specific skills. A variety of exercises targeting the abdominal, back, and hip muscles are discussed. Incorporating core strength training into regular regimens can improve athletes' overall strength, endurance, balance, control, and prevent injuries. This study investigates the effects of various core exercises on stability, agility, and power in badminton players. A comprehensive literature review was conducted to explore the biomechanical demands of badminton and how core musculature contributes to movements like serving, smashing, and lunging. Studies assessing the effects of core training programs in related racquet sports were also examined. The results indicate that targeted core exercises significantly improve athletes' stability, agility, and power output. Exercises targeting the abdominal, back, and hip muscles enhance performance capabilities while reducing injury risk. Machine learning (ML) techniques are then applied to further analyze the relationship between core training and athletic performance. An Artificial Neural Network (ANN) is developed using a dataset of athletes' training histories, metrics, and injury profiles. The model predicts enhancements to stability, agility, and strength from optimized core strengthening routines. Validation confirms the network accurately captures the complex interactions between training variables and physical attributes. This integrated approach provides evidence-based guidelines for tailoring individualized training regimens to unleash players' full abilities. ANNs hold promise for analyzing large datasets on athletes' performance metrics, training variables, and injury histories to design personalized training programs. Linear regression analysis confirmed the ANN's accurate predictions. The findings emphasize integrating data-driven core strength training tailored for badminton into comprehensive programs can help optimize physical abilities and elevate performance levels.

Prevalence and Awareness of Anterior Cruciate Ligament Injuries Among Full-Contact, Semi-contact, and Non-contact Sports Athletes in the Kingdom of Bahrain.

Background The anterior cruciate ligament (ACL) is a crucial connective tissue that links the femur to the tibia, playing a vital role in stabilizing the knee by resisting forward and rotational movements. ACL tears can occur due to both contact and non-contact sports injuries. Diagnosis and assessment typically involve the Lachman test and magnetic resonance imaging. Initial treatment focuses on reducing swelling, followed by physical therapy or surgery to restore long-term knee functionality. Objective This study aimed to assess the injury prevalence and awareness of ACL and the engagement of preventing training programs among Bahraini athletes across diverse sports. Methods A cross-sectional survey was utilized to evaluate injury prevalence and awareness of ACL and engagement in preventing training among 161 Bahraini athletes from different sports. Data were collected through a detailed questionnaire addressing demographics, sports involvement, ACL injury history, and preventive training. The analysis involved descriptive statistics, one-way ANOVA, and independent t-tests to compare knowledge across sports types. A chi-square test was performed to examine correlations between injury history and training. Results The results showed that athletes in full-contact sports exhibited significantly higher ACL injury awareness compared to those in semi-contact and non-contact sports. Furthermore, a higher percentage of athletes in semi-contact and non-contact sports reported a history of ACL injuries when compared to those in full-contact sports. However, there was no significant difference in the engagement of preventive exercise training across different sports categories. Conclusion A notable gap in ACL injury awareness exists among Bahraini athletes, varying significantly across sport types. The data highlight the need for customized educational programs catering to different sports.

Frontal Plane Body Posture as a Predictor of Musculoskeletal Injuries in Amateur Athletes: A Comprehensive Study of 89 Participants Over 12 Months.

BACKGROUND This study aimed to evaluate frontal plane body posture parameters as injury risk factors during physical activity in the previous 12 months. MATERIAL AND METHODS The study sample consisted of 41 males aged 21.3±1.1 years old and 48 females aged 20.8±0.6. To evaluate body posture, we assessed differences in the height of the acromion process (SSA) and differences in the height of the shoulder blades (LSAS), differences in the distance of the lower angles of the shoulder blades and spine (LSPD), differences in the height of the posterior superior iliac spine (PSIS), and the maximum deflection of spinous process line from the line C7-S1 (PTA). The Injury History Questionnaire was used for injury data collection from the previous 12 months. The parameters were assessed for their ability to distinguish between injured and non-injured individuals using the receiver operating characteristic (ROC) method. RESULTS The results suggest that LSPD is a significantly (P=0.028) better predictor of injury than other body posture parameters. The cut-off points for risk of injury based on the assessed body posture parameters demonstrated a diagnostic accuracy higher than chance, except for LSAS and PTA (AUC >0.5). In addition, there were no sex differences in the predictive potential of detecting injuries between males and females. CONCLUSIONS The LSPD has the greatest predictive value for musculoskeletal injuries. Our results suggest that body posture parameters, irrespective of sex, independently influence injury risk, emphasizing the need for preventive strategies targeting athletes' trunk and shoulder regions.

Risk Factors for Injury in Border Collies Competing in Agility Competitions.

Border Collies are the most common breed in agility and their reported injury rate is much higher than that of other breeds. We aimed to identify demographic, training, and competition variables associated with the injury risk for this breed. We hypothesized that higher jump heights and competition at national/international levels would increase the injury risk. Data were collected from an internet-based survey. A logistic regression model was built using backward selection. There were 934 Border Collies in the sample, with 488 reporting an injury. The jump height relative to the shoulder height was associated with injury, with dogs jumping noticeably above or below shoulder height more likely to report a history of injury. Other identified risk factors included the number of weekends spent competing/year, the number of competitions at the national level, the age when starting elbow height jumps and backside jumps, the acquisition of the dog from a breeder, and the age of the handler. Factors associated with prolonged injury (>3-month duration) were the age when starting elbow height jumps and having a veterinary assistant as a handler. Border Collies jumping above shoulder height had an increased risk of injury. However, those jumping below shoulder height were also at a higher risk, which could have been due to reverse causality. Similarly, the observed associations regarding differences based on the number of trial weekends/year may have been impacted by reverse causality as well. The increased risk of injury with elbow height jump training at <10 months of age may indicate that the repetitive impact of jump training prior to skeletal maturity negatively influences musculoskeletal development. These data provide valuable information for further prospective studies.

Development and validation of an electronic health record-based algorithm for identifying TBI in the VA: A VA Million Veteran Program study

ABSTRACT The purpose of this study was to develop and validate an algorithm for identifying Veterans with a history of traumatic brain injury (TBI) in the Veterans Affairs (VA) electronic health record using VA Million Veteran Program (MVP) data. Manual chart review (n = 200) was first used to establish ‘gold standard’ diagnosis labels for TBI (‘Yes TBI’ vs. ‘No TBI’). To develop our algorithm, we used PheCAP, a semi-supervised pipeline that relied on the chart review diagnosis labels to train and create a prediction model for TBI. Cross-validation was used to train and evaluate the proposed algorithm, ‘TBI-PheCAP.’ TBI-PheCAP performance was compared to existing TBI algorithms and phenotyping methods, and the final algorithm was run on all MVP participants (n = 702,740) to assign a predicted probability for TBI and a binary classification status choosing specificity = 90%. The TBI-PheCAP algorithm had an area under the receiver operating characteristic curve of 0.92, sensitivity of 84%, and positive predictive value (PPV) of 98% at specificity = 90%. TBI-PheCAP generally performed better than other classification methods, with equivalent or higher sensitivity and PPV than existing rules-based TBI algorithms and MVP TBI-related survey data. Given its strong classification metrics, the TBI-PheCAP algorithm is recommended for use in future population-based TBI research.

White Matter Hyperintensities and Mild TBI in Post-9/11 Veterans and Service Members.

The neurobehavioral significance of white matter hyperintensities (WMHs) seen on magnetic resonance imaging after traumatic brain injury (TBI) remains unclear, especially in Veterans and Service Members with a history of mild TBI (mTBI). In this study, we investigate the relation between WMH, mTBI, age, and cognitive performance in a large multisite cohort from the Long-term Impact of Military-relevant Brain Injury Consortium-Chronic Effects of Neurotrauma Consortium. The neuroimaging and neurobehavioral assessments for 1,011 combat-exposed, post-9/11 Veterans and Service Members (age range 22-69 years), including those with a history of at least 1 mTBI (n = 813; median postinjury interval of 8 years) or negative mTBI history (n = 198), were examined. White matter hyperintensities were present in both mTBI and comparison groups at similar rates (39% and 37%, respectively). There was an age-by-diagnostic group interaction, such that older Veterans and Service Members with a history of mTBI demonstrated a significant increase in the number of WMHs present compared to those without a history of mTBI. Additional associations between an increase in the number of WMHs and service-connected disability, insulin-like growth factor-1 levels, and worse performance on tests of episodic memory and executive functioning-processing speed were found. Subtle but important clinical relationships are identified when larger samples of mTBI participants are used to examine the relationship between history of head injury and radiological findings. Future studies should use follow-up magnetic resonance imaging and longitudinal neurobehavioral assessments to evaluate the long-term implications of WMHs following mTBI.

The Significance of Off-Season Tailor-Made Baseline Measurements in the Assessment of Post-Concussion in University Athletes.

This study aimed to investigate the significance of baseline measurements for amateur team athletes playing contact and collision team sports with a specific focus on the Sports Concussion Assessment Tool (SCAT) to improve concussion management. Symptoms of sports-related concussions (SRCs) can be diverse and long-lasting and include cognitive impairment, sleep disturbances, and vestibular dysfunction. Therefore, comprehensive baseline data are essential to preventing recurrent concussions and secondary injuries. This study was conducted during the 2023 off-season and evaluated the baseline condition of 65 male university rugby players using the SCAT5, which includes self-reported symptoms, and the modified Balance Error Scoring System (mBESS). The athletes were assessed for the presence or absence of SRC, and the mean values were compared using the Mann-Whitney U test. Among the participants, 35.38% (23/65) reported symptoms, with an average of 1.5 ± 2.8 symptoms per player and an average symptom score of 2.66 ± 5.93. In the mBESS, no errors were observed in the tandem stance test; however, 72.31% (47/65) made errors in the single-leg stance test on the non-dominant foot, with an average of 1.7 ± 1.5 errors. Many athletes self-reported symptoms and balance errors, even during asymptomatic periods before experiencing concussion, indicating unresolved issues. In the injury history survey, the baseline evaluations and injury histories of the participants classified into the SRC and non-SRC groups were compared. In the mBESS single-leg stance test (non-dominant foot), 84.21% (32/38) of the SRC group participants made errors, with an average score of 2.13 ± 1.52, whereas 55.55% (15/27) of the non-SRC group participants made errors, with an average score of 1.15 ± 1.35, showing a significant difference (p = 0.007). Additionally, significant differences were observed in the average number of ankle sprains (p = 0.027) and fractures (p = 0.048) between patients with and without a history of SRC. These findings indicate that athletes may have underlying issues even during normal periods before concussion. Moreover, the results highlighted the impact of previous concussions on motor control and injury risk. This underscores the importance of preseason baseline measurements using the SCAT to identify at-risk athletes and implement preventive measures. These findings align with the recommendations of the 6th International Conference on Concussion in Sport and suggest further refinement of concussion assessment tools.

The relationship between upper cross syndrome posture and shoulder disability

Background: Crossfit is a high-intensity sport that has the potential for injury risk. Upper cross syndrome posture increases muscle tension in the upper region, resulting in pressure on the neck and shoulders, pain, numbness, and decreased body function. This research aimed to determine the relationship between upper cross syndrome posture and shoulder functionality among cross fitter in Bali. Methods: The study was an analytical observational study with a cross-sectional design conducted from November 2023 to February 2024 with the main target population for this study being CrossFit practitioners at Crossfit Bali who experienced upper cross syndrome posture. The exclusion criterion is a history of a shoulder injury. The sample size was 50 people who had upper cross syndrome posture. This study used purposive sampling and the measurement of upper cross syndrome posture was used the REEDCO posture test Tragus to Wall test and Shoulder Pain and Disability Index. Results: It was found that 35 people had forward heads, 30 people had rounded shoulders, 33 people had uneven shoulders, and 8 people had tilted heads. Results of the decrease in functional shoulder using the SPADI test showed a mild decrease in 47 people (94%) and a moderate decrease in 3 people (6%). Results of the correlation test with the Spearman rho test, which is 0.647, it is stated the results are not related. Conclusion: There was no relationship between upper cross syndrome and functional shoulders in CrossFit in Bali.

Snooze it or Lose it: Understanding Sleep Disturbance and Injuries in Soccer and Basketball Student-Athletes.

To assess the sleep characteristics of collegiate soccer and basketball student-athletes and explore the associations between sleep and injury risk. Cohort study. NCAA D1 and NAIA Tier 1. One hundred eighty-one collegiate soccer and basketball student-athletes (42% female; mean age: 20.0 ± 1.7 years). Questionnaires were administered during the 2020/2021 and 2021/2022 preseason, collecting demographic, injury history, medical history, and sleep information, including sleep difficulty category scores of 0 to 4 (none), 5 to 7 (mild), and ≥8 (moderate/severe) and other sleep disturbance measures derived from the Athlete Sleep Screening Questionnaire (ASSQ), including insufficient sleep duration (<7 hours of sleep) and poor subjective sleep quality. All-complaint knee and ankle injuries. According to the ASSQ, 25.4% (95% confidence interval [CI], 17.9-34.3) of the student-athletes had mild sleep difficulty and 12.7% (95% CI, 7.3-20.1) had moderate/severe sleep difficulty. 36.1% (95% CI, 29.1-43.6) had insufficient sleep duration. 17.1% (95% CI, 11.7-23.7) were not satisfied with the quality of their sleep (poor sleep quality), and 13.8% (95% CI, 9.1-19.7) had an "eveningness" chronotype. Based on multivariable logistic regression models, student-athletes with poor sleep quality had significantly higher odds for injury (OR: 2.2, 95% CI, 1.04-4.79, P = 0.039). Clinically relevant dysfunctional sleep patterns are prevalent among collegiate soccer and basketball student-athletes. Poor sleep quality was significantly associated with injury risk among student-athletes. Findings suggest a substantial sleep problem in collegiate soccer and basketball student-athletes and warrant that student-athletes are regularly screened and timely interventions applied.

History of Multiple Allergies and Gradual Onset Running-Related Injuries in Distance Runners: SAFER XXXV.

To determine if any gradual onset running-related injury (GORRI) was associated with any allergies, multiple allergies (allergies to animals, plants, medication), and allergy medication use. Cross-sectional descriptive study. Two Oceans Marathons (56 km, 21.1 km), South Africa. A total of 76 654 race entrants (2012-2015). The prevalence (%) and prevalence ratios (PR; 95% confidence intervals) for history of (1) any allergies, (2) multiple allergies to broad categories of allergens (animal material, plant material, allergies to medication, and other allergies), and (3) allergy medication use. Using a compulsory online screening questionnaire, the outcome was a history of any GORRIs, and subcategories of GORRIs (muscle, tendon) in the past 12 months and history of GORRIs (and subtypes of GORRIs) were reported. In 68 258 records with injury and allergy data, the following were significantly associated with reporting any GORRIs: a history of any allergy (PR = 2.2; P < 0.0001), a history of allergies to broad categories of allergens (animal, plant, medication allergy, other) (P < 0.0001), and the use of allergy medication (P < 0.0001). A history of any allergies (PR = 2.4; P < 0.0001), all broad categories of allergies, and allergy medication use were significantly associated with muscle (P < 0.0001) and tendon injuries (P < 0.0001). The risk of reporting a GORRI increased as the number of reported categories of allergies increased (P < 0.0001). A novel finding was the cumulative risk effect with a history of multiple allergies. Further studies should aim to determine the underlying mechanism relating allergies and GORRIs.

Beaten to Blindness: Battered Baby Syndrome

Introduction: A battered child is one who sustains repetitive physical injuries due to non-accidental violence inflicted by a parent or guardian. Child abuse encompasses behaviors exposing the child to various forms of physical or sexual abuse, neglect, or emotional misconduct. Typically, battered child syndrome is diagnosed through a disparity between the history provided by the child's caregivers and the findings of clinical examination. Case details: An 18-month-old girl child was admitted to a tertiary care hospital, presenting with a four-day history of fever, vomiting for two days and a seizure episode. The child had a history of head injury one week ago, resulting in transient unconsciousness. Upon examination, multiple healed and fresh injuries were observed on the face, hands, and right thigh. CT brain revealed hypodensity areas with a mildly displaced fracture of the left frontal bone. Fundus examination identified bilateral multiple intraretinal hemorrhages and papilledema. X-ray showed a fracture of the right proximal tibia. The child required ventilator support during the hospital stay, and subsequently, developed retinal blindness. The child was managed accordingly. Discussion: The classical feature of Battered Baby Syndrome is the discrepancy between the nature of injuries and the history provided, and the delay between the injury and medical attention. The parental risk factors for child abuse are poverty, social isolation, drug addiction, violent environment, family history of abuse, communication skills deficit and the child related risk factors are children with special needs, children with behavior problems, bonding deficit. etc. Conclusion: The current case sheds light on the unfortunate prevalence of this condition within the Indian context, urging point-of-care health providers to stay vigilant and informed about child abuse patterns in the community. It serves as a crucial reminder of the responsibility we all share in safeguarding the well-being of children.

Sharps injuries among healthcare workers in Liberia and Ghana: a cross-sectional survey.

There are little data on sharps injuries among healthcare workers in West Africa despite the region's high rate of hepatitis B and human immunodeficiency virus. The purpose of this study is to investigate healthcare workers' history of sharps injuries in Liberia and Ghana. An electronic cross-sectional survey was conducted among healthcare workers in Liberia and Ghana from February to June 2022. A link to the survey was texted to participants through professional association membership lists, including nursing, midwifery, and physician assistant organizations in both Liberia and Ghana and a physician organization in Ghana only. Five hundred and nine participants reported an average of 1.8 injuries per year in Liberia and 1.1 in Ghana (P ≤ .01); 15.1% of healthcare workers reported three or more injuries in the past year. Liberia had a higher proportion of frequently injured workers (P = .01). Frequently injured workers were evenly distributed across worker types. Workers in this region are vulnerable to sharps injuries. A frequently injured subset of workers likely has distinctive risk factors and would benefit from further investigation and intervention.

Complexity in the diagnosis of endocrine ophthalmopathy with a carotid-cavernous fistula. A clinical case

Introduction. Clinical cases featuring a combination of endocrine ophthalmopathy with a carotid-cavernous fistula are scarce, with only four cases documented in the literature, thus posing a diagnostic challenge due to overlapping clinical symptoms. A carotid-cavernous fistula with high blood flow typically presents a clear clinical picture. However, low-flow variants are challenging to timely diagnose. A history of head trauma can be an essential diagnostic clue, as carotid-cavernous anastomosis develops in 75% of cases post-trauma and in 25% spontaneously. Bilateral carotid-cavernous fistulas are particularly rare.Purpose: to present the clinical features and outcomes of bilateral endocrine ophthalmopathy associated with a non-traumatic carotid-cavernous fistula, based on the prospective observation of a patient treated in various city healthcare hospitals during 2021–2022.Case description. The patient first visited the ophthalmologist in October 2021, presenting with bilateral exophthalmos, edema, and eye redness. A positive test for antibodies to thyroid-stimulating hormone and enlargement of the eye muscles, confirmed by orbital ultrasound, led to a diagnosis of “Endocrine Ophthalmopathy”. The patient’s condition was managed jointly by an endocrinologist and an ophthalmologist. Over two months, a worsening of ocular symptoms was observed, prompting a neurosurgical consultation. Cerebral angiography conducted in a hospital setting confirmed a carotid-cavernous fistula. An endovascular procedure was performed five months after the initial ocular symptoms appeared to separate the carotid-cavernous anastomosis on the right using a non-adhesive composition. Ocular symptoms resolved within 2–3 weeks post-surgery.Conclusions. Clinical manifestations of carotid-cavernous fistulas can resemble those of endocrine ophthalmopathy. The absence of a traumatic head injury history, complaints of unilateral head noise synchronous with the pulse, and the bilateral nature of the symptoms complicated the diagnosis of this neurosurgical pathology in a patient with endocrine ophthalmopathy. It is crucial to include both conditions in the differential diagnosis and to employ a multidisciplinary approach for effective management.

Head motion in the UK Biobank imaging subsample: longitudinal stability, associations with psychological and physical health, and risk of incomplete data.

Participant motion in brain magnetic resonance imaging is associated with processing problems including potentially non-useable/incomplete data. This has implications for representativeness in research. Few large studies have investigated predictors of increased motion in the first instance. We exploratively tested for association between multiple psychological and physical health traits with concurrent motion during T1 structural, diffusion, average resting-state and task functional magnetic resonance imaging in N = 52 951 UK Biobank imaging subsample participants. These traits included history of cardiometabolic, inflammatory, neurological and psychiatric conditions, as well as concurrent cognitive test scores and anthropometric traits. We tested for stability in motion in participants with longitudinal imaging data (n = 5305, average 2.64 years later). All functional and T1 structural motion variables were significantly intercorrelated (Pearson r range 0.3-0.8, all P < 0.001). Diffusion motion variables showed weaker correlations around r = 0.1. Most physical and psychological phenotypes showed significant association with at least one measure of increased motion including specifically in participants with complete useable data (highest β = 0.66 for diabetes versus resting-state functional magnetic resonance imaging motion). Poorer values in most health traits predicted lower odds of complete imaging data, with the largest association for history of traumatic brain injury (odds ratio = 0.720, 95% confidence interval = 0.562 to 0.923, P = 0.009). Worse psychological and physical health are consistent predictors of increased average functional and structural motion during brain imaging and associated with lower odds of complete data. Average motion levels were largely consistent across modalities and longitudinally in participants with repeat data. Together, these findings have implications for representativeness and bias in imaging studies of generally healthy population samples.

Montgomery Tracheal Tube - A Boon with a Challenge

Crico-tracheal resection and anastomosis are commonly used operative techniques in managing crico-tracheal stenosis grade III-IV. The Montgomery T-tube is used both as a tracheal stent and tracheostomy. Still, it poses various challenges to anaesthesiologists, like loss of anaesthetic gases through the open proximal end of the vertical limb and lack of standard anaesthesia circuit connectors. Here we present a case of 27 years old male with a history of gunshot injury to the neck three years ago with right vocal cord palsy with subglottic tracheal stenosis grade IV posted for microlaryngobronchoscopy (MLB) with crico-tracheal resection and anastomosis with Montgomery tracheal tube insertion. In this case, we used LMA proseal, which not only enabled us to stop the anaesthetic gas loss via the proximal vertical limb of the T-tube but also aided in checking airway patency and proper positioning of the T-tube via flexible bronchoscope through it.

Improving pressure injury risk assessment using real-world data from skilled nursing facilities: A cohort study.

This study aimed to improve the predictive accuracy of the Braden assessment for pressure injury risk in skilled nursing facilities (SNFs) by incorporating real-world data and training a survival model. A comprehensive analysis of 126 384 SNF stays and 62 253 in-house pressure injuries was conducted using a large calibrated wound database. This study employed a time-varying Cox Proportional Hazards model, focusing on variations in Braden scores, demographic data and the history of pressure injuries. Feature selection was executed through a forward-backward process to identify significant predictive factors. The study found that sensory and moisture Braden subscores were minimally contributive and were consequently discarded. The most significant predictors of increased pressure injury risk were identified as a recent (within 21 days) decrease in Braden score, low subscores in nutrition, friction and activity, and a history of pressure injuries. The model demonstrated a 10.4% increase in predictive accuracy compared with traditional Braden scores, indicating a significant improvement. The study suggests that disaggregating Braden scores and incorporating detailed wound histories and demographic data can substantially enhance the accuracy of pressure injury risk assessments in SNFs. This approach aligns with the evolving trend towards more personalized and detailed patient care. These findings propose a new direction in pressure injury risk assessment, potentially leading to more effective and individualized care strategies in SNFs. The study highlights the value of large-scale data in wound care, suggesting its potential to enhance quantitative approaches for pressure injury risk assessment and supporting more accurate, data-driven clinical decision-making.

Poster 373: Lower Extremity Injury Rates on Turf Versus Natural Grass Surfaces - An Analysis of Professional Football Athletes in the 2021 and 2022 Seasons

Objectives: As the emphasis on player safety in the national football league (NFL) has increased in recent years, numerous risk factors for injury have been closely scrutinized for their roles in placing players at increased risk. One such factor, the use of artificial turf football fields, has become a controversial topic, with many current and former players stating that turf fields place players at higher risk for injury while alternative sources have suggested there is no significant injury rate between artificial and natural grass surfaces. The purpose of this study was to quantify the rate of lower extremity injuries occurring in NFL players on artificial turf compared to natural grass surfaces and to characterize the degree of time missed with injury and the proportion of injuries requiring surgery. We hypothesized that major lower extremity injuries requiring surgical intervention occurred on artificial turf surfaces at a higher rate than on natural grass. Methods: Lower extremity Injury data for the 2021 and 2022 NFL seasons were obtained using publicly available records from the internet. All reported lower extremity injuries during the regular and playoff seasons were analyzed. Upper extremity, head, and back injuries were excluded. Preseason data was also excluded. Data collected included player position and age, playing surface of the field on which, the injury occurred, injury type, weeks missed with injury, and whether the patient underwent season-ending or minor surgery. Statistical analysis was performed using R Software (Rlabs). Descriptive statistics were used to summarize data, including percentages and counts for categorical and ordinal data and means with interquartile ranges for continuous data. Incidences of injury on both grass and turf fields were calculated for the 2021 and 2022 seasons by taking a ratio of the number of injuries that occurred and the number of games played on respective fields. Additionally, injuries were stratified by subsequent number of games missed: 0 games missed, 1-2 games missed, &gt;6 games missed. Multivariable logistic regression was performed to determine the influence of field type on the risk of major surgery. A p-value less than 0.05 was statistically significant. Results: In total there were 327 (44.12%) lower extremity injuries in 2021 and 391 (54.45%) lower extremity injuries in 2022, resulting in a total of 718 lower extremity injuries. A demographic summary of these injuries by position, age, field, and history of previous injury is displaced in Table 1. Combining the 2021/2022 seasons, the incidence rate of lower extremity injury on natural grass surfaces was 1.22 injuries/game while for turf surfaces, the incidence rate was 1.42 injuries/game (Table 2). Injury severity was stratified by weeks missed. Odds of a season-ending surgery were found to be significantly higher on turf surfaces compared to natural grass surfaces (OR 1.60, 95% CI 1.28-1.99, p&lt;0.05), while additional variables, including weather, age, position, and week of injury occurrence and history of prior injury were not found to influence the odds of season-ending surgery. In total, there were 50 players injured on the grass who required lower extremity surgery and 83 players injured on turf who required lower extremity surgeries. The most common surgeries after a lower extremity on grass were ACL repair (17), Achilles repair (9), and ankle or syndesmosis ORIF (7). The most common surgeries after a lower extremity on turf were ACL repair (30), Achilles repair (12), patella ORIF, or patellar tendon repair (8) (Table 3). Conclusions: The debate about playing on artificial turf versus natural grass has persisted for several years; however, there is a discrepancy in data reported on these overall injury rates. Our study showed that NFL athletes were more likely to get injured on artificial surfaces and that turf dramatically increased the likelihood of suffering a serious injury requiring surgery. These findings support earlier research, highlighting the necessity of putting player safety first and reducing dangers on pitches with artificial turf. For players, coaches, and teams to make wise decisions about playing surfaces, the study offers useful information regarding playing safety. Overall, it indicates that there is a higher risk of lower extremity injuries on artificial grass in the NFL, confirming the continuing discussion about field safety.

Perspectives on reasons why football and handball players sustain acute and severe knee injuries: a mixed-methods concept mapping study

BackgroundThe high incidence of knee injuries in football/handball challenges effective prevention. Identifying tangible and modifiable factors associated with a knee injury may innovate preventive actions. Engaging key stakeholders can reveal...

The Difference Between Throwing and Practice Volumes in Youth Softball Athletes With and Without Upper Extremity Pain.

Research indicates that mechanics differ between athletes with and without upper extremity pain; however, it is unclear which modifiable risk factors exist for throwing-related pain in softball athletes. To determine whether sport specialization, throwing, practice, and strength and conditioning training volumes vary between youth softball athletes with and without upper extremity pain. It was hypothesized that youth softball athletes with upper extremity pain would participate in softball year-round and have greater throwing, practice, and strength and conditioning volumes compared with those without pain. Cross-sectional study; Level of evidence, 3. A total of 232 youth softball athletes from travel ball, middle school, and high school leagues were invited to complete a survey to assess pain, sport specialization, throwing, practice, and strength and conditioning training volumes. Participants were classified into upper extremity pain and no pain groups based on their survey answers. The responses were compared between groups using Mann-Whitney U and chi-square tests. A total of 101 athletes-with a mean ± SD age of 13.3 ± 2.3 years, height of 161 ± 13.4 cm, and weight of 59.8 ± 14.8 kg-completed the survey and were included for analysis. The response rate was 43.53%, with 22 athletes in the upper extremity pain group and 79 athletes in the no pain group. A significant difference was observed between hours devoted per week to off-season softball practice (U, 626.6; Z =-2; P = .045), where those without upper extremity pain spent 4 fewer median hours (6 hours) practicing softball per week in the off-season compared with those with pain (10 hours). Also, a significant difference was found between the number of throws during an in-season game (U, 457; Z, -2.28; P = .022), where those without upper extremity pain reported 21 fewer median throws (70 throws) during an in-season game compared with those with pain (91 throws). Furthermore, 77% of those who reported upper extremity pain continued to play despite their pain. There were no other significant differences between demographic characteristics, specialization, injury history, and primary position, as well as throwing, practice, and strength and conditioning volumes. Our study demonstrates that youth softball athletes with upper extremity pain had more throws during in-season games and increased hours per week devoted to off-season practice than athletes without upper extremity pain. Our findings support the need for softball stakeholders (eg, coaches, clinicians, parents, and administrators) to engage in further research and recommendations regarding in-season pitch counts and off-season rest.

Poster 227: Prospective Clinical and Radiological Follow-Up Beyond 10 Years in Patients Undergoing Matrix-Induced Autologous Chondrocyte Implantation (MACI) in the Patellofemoral Joint

Objectives: Matrix-induced autologous chondrocyte implantation (MACI) has demonstrated encouraging outcomes in the treatment of knee cartilage defects, though limited research is available on its longer-term (≥10 years) sustainability in the patellofemoral joint. This prospective study sought to present and report the clinical and radiological outcome beyond 10 years in a prospectively recruited cohort of patients undergoing MACI in the patellofemoral knee joint. Methods: The current study included 82 patients (patella = 41, trochlea = 41) assessed at ≥10 years following patellofemoral MACI. Patients were assessed preoperatively and at 2, 5 and ≥10 years via the Knee Injury and Osteoarthritis Outcome score (KOOS), the 36-item Short Form Health Survey (SF-36), the frequency (VAS-F) and severity (VAS-S) of knee pain, patient satisfaction, active knee range of motion (ROM) and peak isokinetic knee extensor and flexor torque. High-resolution magnetic resonance imaging (MRI) assessed pertinent measures of graft outcome as per the magnetic resonance observation of cartilage repair tissue (MOCART) system, as well as an overall MRI composite score. Results were analyzed according to the graft location (patella or trochlea). Results: While no statistically significant differences (p&gt;0.05) were observed between those undergoing patella or trochlea MACI across the majority of demographic (age, weight, BMI), injury history (duration of symptoms) or surgery (defect size, prior procedures, requirement for concomitant patellofemoral re-alignment) variables, a significantly higher (p=0.013) proportion of males was seen in the trochlea MACI group. All patient-reported outcome measures significantly improved (p&lt;0.05), with no differences observed between those undergoing patella or trochlea MACI. No group differences (p&gt;0.05) were observed in active knee flexion or extension ROM between groups, though those undergoing patella (versus trochlea) MACI demonstrated significantly greater postoperative quadriceps (Figure 1) and hamstring strength limb symmetry indices. No statistically significant decline (p&gt;0.05) was seen from 2 years to final follow-up in any MRI-based measure, with no MRI-based differences observed between patella (Figure 2) and trochlea (Figure 3) grafts. In the cohort assessed at ≥10 years post-surgery, 4 patients (patella n=2, trochlea n=2) demonstrated graft failure on MRI, though a further 3 patients (all trochlea) were omitted from ≥10-year review that had already progressed toward total knee arthroplasty. Conclusions: Good clinical scores, high levels of patient satisfaction and adequate graft survivorship were observed at ≥10 years following MACI to the patella or trochlea.