Risk Of Injury Research Articles

Hepatotoxicity of antipsychotics: an exploratory pharmacoepidemiologic and pharmacodynamic study integrating FAERS data and in vitro receptor-binding affinities.

Antipsychotic psychopharmacotherapy is associated with the risk of drug-induced liver injury (DILI). However, understanding specific risk factors remains challenging due to limited data. This study investigates the relationship between receptor binding affinities and occupancies of antipsychotics and their associated hepatotoxic risks. A disproportionality analysis with calculation of the Reporting Odds Ratio (ROR) and the Information Component (IC) was conducted using data fromthe FDA Adverse Event Reporting System (FAERS) to identify signals related to the Standardised MedDRA Query "drug-related hepatic disorders", which served as a proxy for drug-induced hepatotoxicity. This was followed by a pharmacoepidemiologic-pharmacodynamic approach to investigate the relationship between the ROR and substance-related receptor binding affinities and occupancy, which was estimated based on in vitro receptor-binding profiles. Significant signals were identified for several antipsychotics, including chlorpromazine, loxapine, olanzapine, and quetiapine, with chlorpromazine and loxapine showing the highest RORs for DILI. Gender-specific analysis revealed a higher frequency of signals in female patients. Statistically significant negative correlations were identified between the ROR for drug-related hepatic disorders and the affinity for serotonin receptor 5-HT1A (r (17) = -0.68, p = 0.0012), while a positive correlation was observed for cholinergic receptors (r (17) = 0.46, p = 0.048). No significant correlations were found related to other receptors or drug properties. Our findings suggest that the serotonin and probably the cholinergic system may play a role in the development of DILI related to antipsychotic medications. The identification of antipsychotics with a higher association with DILI, such as chlorpromazine, underscores the need for careful monitoring in clinical practice. However, our findings need further longitudinal studies to confirm causality. A better understanding of the associations may inform clinical decision-making, particularly in patients with an increased susceptibility to liver damage.

Development and validation of a nomogram-based model to predict combined esophageal injury post-esophagoscopy for esophageal foreign bodies.

The aim of this study is to create and validate a nomogram model for predicting complications of esophageal injury post-esophagoscopy in patients with esophageal foreign bodies (EFB). We examined 303 patients who underwent esophagoscopy from January 2019 to December 2022 at a leading hospital in Anhui, known for its expertise in otorhinolaryngology-head and neck surgery. The patients were split into a modeling group and a validation group in a 7:3 ratio. Logistic regression analysis was employed to determine the risk factors for esophageal injury after undergoing esophagoscopy in patients with EFB. Based on these factors, a nomogram risk prediction model was developed and assessed using a goodness of fit test. Logistic regression analysis revealed that the type of foreign body, failure of gastroscopic retrieval, duration of lodgment, lodgment site, and presence of combined cardiovascular and cerebrovascular diseases were significant (p < 0.05) independent risk factors for esophageal injury following esophagoscopy for EFB. The area under the ROC curve for the training set was 0.850, and the Hosmer-Lemeshow goodness of fit test resulted in a p value of 0.908. For the validation set, the area under the ROC curve was 0.848, and the Hosmer-Lemeshow test gave a p value of 0.665. The calibration curve showed a close alignment between the predicted and observed values. The type of foreign body, duration of lodgment, lodgment site, previous failure of gastroscopic retrieval, and history of combined cardiovascular and cerebrovascular diseases are significant risk factors for esophageal injury following EFB esophagoscopy. This model accurately quantifies the risk of esophageal injury after EFB esophagoscopy.

Cybersecurity risks of automated (and autonomous) offshore oil and gas units—the IMO cybersecurity rules framework

Abstract Automated and/or autonomous offshore platforms or units are becoming more important in the energy sector, whether they are being used for oil and gas extraction or for carbon storage purposes. Automation means that harsh working conditions and risks of personal injury to crew could be cut to virtually zero. Automation also provides significant cost savings and helps make less attractive oil and gas fields more economically viable to exploit. However, automation does come with its own set of challenges—the notable one being the cybersecurity threat. Any regulation or international standard dealing with the cybersecurity risk which is relevant to automated offshore units is usually framed within those rules that apply to ships. This article examines to what extent that regulatory approach, especially that of the International Maritime Organisation’s (IMO) regime, could and should apply to automated or autonomous offshore platforms. It argues that whilst, for now, the IMO cybersecurity guidelines are relevant, a more targeted regulatory approach is needed.

Comparison of quadriceps and hamstring muscle strength ratios between dominant and non-dominant legs in Saudi under-17 and under-19 premier league football players: A cross-sectional study

Football’s global popularity is often overshadowed by frequent lower limb injuries, particularly hamstring strains, which are linked to imbalances in the strength ratio of hamstring-to-quadriceps (H/Q). Research on these factors among Saudi Premier League players, specifically in Madinah City, is limited. Our study is a cross-sectional study that assessed 42 male professional football players from Ohoud Football Club, divided into Underage 17 (UD- 17) and Under age 19 (UD-19) of age groups. The Strength of muscle for hamstrings and quadriceps, as well as the H/Q ratio, was measured using handheld dynamometers (HDD), and demographic data were analyzed using SPSSv26. Results showed that UD-19 players had significantly greater quadriceps strength on both dominants (dominant and non-dominant) sides compared to UD-17 players, with no significant differences in strength of hamstring. The ratio of hamstring to quadriceps was significantly higher in UD-17 players on the dominant side compared to UD-19 players, but statistically significant differences were not found on the non-dominant side. These results suggest that quadriceps strength develops with age and training, potentially reducing injury risk, while the strength of hamstring stabilizes earlier. Tailored training programs focusing on quadriceps strength and balanced hamstring development are recommended for improving injury prevention and performance. Future research involving larger and more diverse samples could further validate these findings and provide a deeper understanding of muscle dynamics in young football players.

Development, dissemination and survey evaluation of layered education for healthcare professionals to support implementation of firearm injury and mortality prevention strategies in emergency care settings, New York, USA

BackgroundThere is consensus on the need and ability to address firearm injury risk in healthcare settings; however, the lack of education for healthcare professionals hinders the implementation of evidence-based firearm...

The frequency of injuries of Iranian male professional soccer players: a cross-sectional study.

Soccer is known to be a sport that carries a high risk of injuries due to its physical nature, involving intense contact and rapid movements like acceleration, deceleration, jumping, and sudden changes in direction. Compared to other sports, soccer is considered a contact sport with a heightened injury risk. The primary objective of this study was to assess the prevalence of sports injuries among professional soccer players. In this cross-sectional study, 56 male professional footballers participated to assess their injuries. The Pre-Competition Medical Assessment (PCMA) was utilized as the standard protocol for evaluating the athletes. The study examined variables such as injury type, player position on the field, and body mass index (BMI) in accordance with the FIFA-recommended PCMA guidelines. Student t-test was used to compare demographic characteristics injured and healthy athlete. Chi square and fisher exact tests were used to assess the association between player position, injury type and BMI classification. In this study, the mean age of the soccer players was 19.38 ± 1.30 years, with a history of participating in 3 to 60 matches. The highest incidence of injuries was recorded in the knee (48.21%) and ankle (30.36%), respectively. A significant relationship was found between the players' positions on the field and knee pain, with strikers experiencing more knee pain compared to players in other positions (p less than 0.04). However, no significant association was observed between the players' BMI and the occurrence of sports injuries (p greater than 0.05). Given the widespread occurrence of knee injuries among footballers, particularly in attacking players, proper planning and appropriate training protocols would be useful to prevent knee injuries and reduce treatment costs.

Exploring the impact of sepak takraw ball heading on brain injury risk: An analytical and experimental investigation

Sepak takraw, a unique sport resembling volleyball but played with the legs, is popular in Asia. Players often use their foreheads to receive the ball, exposing them to potential brain injuries. This research evaluates the potential for brain injuries from heading in sepak takraw. Using both analytical and experimental approaches, we developed a mathematical model adapted from soccer-related studies to predict peak linear acceleration (PLA). We also conducted laboratory experiments to measure PLA and peak rotational acceleration (PRA) using a ball launcher and an Anthropomorphic Test Device (ATD). The mathematical model demonstrated a high level of accuracy in PLA prediction, confirming its reliability. Comparative analysis with soccer and water polo studies revealed that the measured PLA, PRA, and Head Injury Criteria (HIC) values for sepak takraw are below suggested concussion thresholds, indicating a lower risk of brain injury. However, this assessment does not account for the cumulative effects of repetitive head impacts, which increase the risk of brain injury over time. Despite sepak takraw’s distinct play style, the findings indicate that while the inherent risk of head injury from single impacts may be low, the potential long-term effects of repetitive impacts warrant further investigation. This study enhances the understanding of sports-related brain injuries and highlights the need for further research into subconcussive impacts and the development of protective measures. Our research paves the way for more comprehensive investigations, including field experiments, which are crucial for a nuanced understanding of sepak takraw’s impact dynamics.

The application of aquatic resistance exercises in different diseases

Aquatic exercise is an active exercise that make full use of the physical and hydrodynamic characteristics of water in a water environment to achieve a similar strength increase effect as land training, while avoiding the aggravation of joint stress and muscle microdamage caused by repetitive training. It has been widely studied in the field of sports rehabilitation and public fitness, while its form is basically presented in the form of aerobic exercise or interval training, the aquatic resistance exercises are often ignored by people. Due to the influence of the physical characteristics of water, the main form of muscle contraction of athletes performing resistance training in water is similar to isokinetic contraction, and the force used by practitioners is proportional to the resistance of water, which increases the centrifugal load of muscles and greatly reduces the risk of sports injury. In addition to the athletes, aquatic resistance exercises also have certain benefits for other clinical diseases. In this paper, the application of this training in swimming performance, rheumatoid arthritis, postmenopausal osteoporosis and knee osteoarthritis was reviewed in order to improve the clinical understanding and promote its rational application.

Runners injuries - main types of injuries of the musculoskeletal system of the lower limb and their treatment and prevention

Introduction and purposeRunning is currently one of the most popular physical activities practiced by people around the world, and the number of runners has been growing significantly for many years. The incidence of running-related lower limb injuries in runners ranges between 19.4% and 79.3% [1].The paper presents research results on the main types of injuries of the musculoskeletal system of the lower limb in runners, their risk factors, methods of treatment and prevention. The results indicate a significant relationship between regular training and the occurrence of injuries, and also emphasize the importance of prevention through rest, appropriate running technique and the selection of footwear. The work provides practical tips for runners and coaches that can help reduce the risk of injuries and improve the quality of training. Materials and methods The review was conducted by searching PubMed and other scientific databases focusing on currently available publications. The literature available in the PubMed database was reviewed using the following keywords: “running”, “running injuries”, “tendinopathy”, "running related injuries”, “running biomechanics”, “musculoskeletal injuries”. The analysis of 38 articles published between 2014-2024 was used to write the paper. Conclusions Running has many health benefits, but unfortunately it can also have a negative effect. The development of medical literature regarding appropriate prevention, knowledge of risk factors and treatment methods improves the prognosis of injuries in runners. Evolving diagnostic imaging, body monitoring, prevention, and adequate rest between activities are essential to long-term success in preventing running-related injuries.

Effectiveness of Osteopathic Treatment in Adults with Short Hamstring Syndrome: A Systematic Review.

Background/Objective: Short hamstring syndrome is common in the general population and can lead to impaired balance, function, and posture, and increased risk of injuries. Local treatments have obtained controversial results, so it is necessary to evaluate the effectiveness of other types of therapy such as osteopathic treatment. To evaluate the efficacy of osteopathic techniques in increasing the elasticity of the hamstring musculature in short hamstring syndrome. Methods: A systematic review of randomised controlled trials was conducted in PubMed, Medline, Cinhal, Scopus, WOS, SPORTDiscuss, and PEDro. The PEDro scale was used to evaluate the methodological quality and the RoB2 for the evaluation of biases. Results: A total of eight articles were selected. Most of the participants were assessed with the Active Knee Extension or Straight Leg Raise tests. The osteopathic techniques used were the muscle energy technique, suboccipital inhibition, and vertebral mobilisations. As for the control interventions, they mainly included passive stretching and placebo. Conclusions: The results suggest that osteopathic techniques are more effective than placebo or other interventions in increasing flexibility in adult patients with short hamstring syndrome. This effect can be explained by neurophysiological (Golgi apparatus, neuromuscular spindle activity, and Hoffmann reflex) and structural factors (dura mater, posture, and myofascial chains). Nevertheless, the evidence suggests that it would be beneficial to incorporate this type of treatment into flexibility improvement programmes.

Evaluation of Injury Risk in Indoor Climbing Athletes and Provision of Specialized Care in Greece: A Review and Study Protocol

Competitive climbing has witnessed significant growth in recent years, leading to an increased focus on both indoor and outdoor training. This rise in popularity has been accompanied by a higher frequency of climbing-related injuries, particularly in the upper limbs, with finger tendon injuries being the most prevalent. The rapid evolution of the sport, including the introduction of more complex climbing walls and movements, has further elevated the risk of injury among athletes. Despite the increasing number of injuries, there is a noticeable gap in specialized knowledge and treatment of these injuries, particularly in Greece, where healthcare providers may lack the expertise needed to effectively manage and rehabilitate climbing-related injuries. This study aims to address these gaps by conducting a detailed investigation into the epidemiology of climbing injuries. The research involves distributing comprehensive questionnaires to climbers, focusing on the types of injuries sustained, the level of climbing difficulty at the time of injury, and the specific types of climbing holds involved. Additionally, the study will document clinical symptoms and assess the level of specialized care provided by healthcare professionals. By correlating injury patterns with factors such as training intensity, climbing hold design, and the expertise of healthcare providers, this study seeks to develop targeted prevention and treatment strategies. The findings will not only contribute to safer climbing practices but also provide valuable insights into improving injury management and rehabilitation. This research is particularly relevant given the sport's inclusion in the Olympic Games, highlighting the need for a deeper understanding of the unique demands and risks associated with competitive climbing.

Waveform Analysis To Identify Biomechanical Relationships and Differences Between Softball Pitchers With and Without Pain.

Softball pitchers accrue high rates of injury. Research suggests certain mechanics at discrete pitch events are related with pain. Here, we examine relationships between peak throwing shoulder kinetics and trunk/pelvis kinematics and compare trunk/pelvis kinematics between pitchers who were healthy and those currently experiencing pain. (1) Peak shoulder kinetics would be positively related to greater trunk and pelvis flexion, lateral flexion, and rotation; and (2) pitchers in pain would exhibit greater trunk and pelvis flexion, lateral flexion, and rotation during the pitch than those who were pain-free. Cross-sectional study. A total of 42 high school pitchers (height, 1.71 ± 0.06 m; weight, 75.0 ± 15.9 kg; age, 16 ± 2 years) were separated into 2 groups based on presence or absence of pain. Peak kinetic data from 3 pitches per pitcher were averaged and used as dependent variables. Kinematic data were averaged across 3 trials, and time normalized to 101 datapoints between foot contact and follow-through of the pitch. Statistical parametric mapping regressions were used to assess the relationships between peak shoulder kinetics and waveform of trunk and pelvis kinematics. Pelvic lateral tilt significantly predicted peak throwing shoulder superior (P = 0.05) and lateral (P = 0.04) force. Pelvis rotation predicted peak superior force (P = 0.02). Waveform analyses revealed no waveform differences between healthy pitchers and those currently experiencing pain. Peak shoulder kinetic variables are related with pelvic positioning during the pitch; however, trunk and pelvis kinematics do not differ according to presence of pain. Pitchers in pain do not adopt specific trunk and pelvic alterations during the pitch, potentially concealing the effects of pain from visual identification. Coaches and clinicians need to discuss health status with pitchers versus relying on visual observations to understand pain and injury risk.

Anatomy of Inferior Temporal Arteries in Relation to Middle Cranial Fossa Structures: A Postmortem Computed Tomography Angiography Study

Abstract Objective The inferior temporal arteries (ITAs), branches of the posterior cerebral artery (PCA), are critical vascular structures encountered during subtemporal surgical approaches. Anatomical data based on multiphase postmortem computed tomography angiography (MPMCTA) are provided as a tool for preoperative surgical planning to lower the risk of ITA injury. Methods Adult (≥18 years) cases that underwent MPMCTA during 2015 to 2023 and whose cause of death did not involve the cerebral circulation were included in the study. Standardized measurements on four predefined coronal slices in relation to the posterior clinoid process (PCP) were established with references to projections in axial and sagittal planes. The main aim was to assess the presence, width, and course of anterior ITA (AITA), middle ITA (MITA), and posterior (PITA) particularly within the individual established quadrants of the middle cranial fossa. Results A total of 74 hemispheres were studied among 37 patients with the mean age of 52 ± 20.2 years. PITA was present in 98.7% of studied hemispheres, followed by MITA in 90.7% and AITA in 89.2%. The course of PITA was straight (65.8%) or oblique (34.3%), with significant difference in mean width (p = 0.050), branching angle (p &lt; 0.001), distance to tentorial hiatus (p &lt; 0.001), and superior petrosal sinus (p &lt; 0.001). A pattern of PITA loop was defined as a twisting of its course within the collateral sulcus. Significant relationship between the presence of AITA and MITA (p &lt; 0.001) along with the co-presence of AITA and PITA (p = 0.029) was found. Conclusion Knowledge of ITA characteristics and their relationship to surrounding anatomical structures is vital in subtemporal neurosurgical interventions. Preoperative inspection of the collateral sulcus and its relation to the surgical trajectory is critical to prevent PITA injury.

Clinical and subclinical acute brain injury caused by invasive cardiovascular procedures.

Over the past 50 years, the number and invasiveness of percutaneous cardiovascular procedures globally have increased substantially. However, cardiovascular interventions are inherently associated with a risk of acute brain injury, both periprocedurally and postprocedurally, which impairs medical outcomes and increases health-care costs. Current international clinical guidelines generally do not cover the area of acute brain injury related to cardiovascular invasive procedures. In this international Consensus Statement, we compile the available knowledge (including data on prevalence, pathophysiology, risk factors, clinical presentation and management) to formulate consensus recommendations on the prevention, diagnosis and treatment of acute brain injury caused by cardiovascular interventions. We also identify knowledge gaps and possible future directions in clinical research into acute brain injury related to cardiovascular interventions.

An Update on the Six Recommendations from the 2012 IADMS Standard Measures Initiative: Assessing and Reporting Dancer Capacities, Risk Factors, and Injuries.

In 2012, the Standard Measures Consensus Initiative (SMCI) of the International Association for Dance Medicine and Science (IADMS) presented 6 recommendations regarding dance injury surveillance, definitions of injury and exposure, dance-specific screening, risk reduction strategies, and collaborative data management. The aim was to standardize risk factor measurement and injury reporting by researchers in dance medicine and science. Since then, numerous reports on the recording and reporting of injury data in sport and performing arts have been published. IADMS commissioned SMCI to update the 2012 recommendations, a process that involved 3 stages: (1) current field experts were invited to join SMCI, (2) SMCI members reviewed recent and relevant sport and performing arts literature, then drafted, discussed, and revised section updates, (3) IADMS invited individuals representing diverse backgrounds in the IADMS community to critically review drafted updates. The final update serves as a bridge from the 6 recommendations in the 2012 report to the current state of evidence. We continue to encourage use of dance injury surveillance systems and support that surveillance protocols be fit-for-purpose, and that failure to use clear and consistent injury definitions perpetuates a lack of rigor in dance injury research. Based on new evidence, we recommend that some aspects of injury surveillance be self-reported, that the choice of dance exposure measures be dependent on the research question, contextual factors, and type of injury/health problem(s) of interest, and that studies using dance-specific screening articulate specific objectives, validity, and reliability of each protocol. Future studies should focus on the development, implementation, and evaluation of strategies to minimize injury risk to improve consistency and rigor in data collection and research reporting on the health and wellness of dancer populations, thus facilitating a future dance injury consensus statement similar to recent statements published for sports and circus arts.

Simulation of osteotomy in total knee arthroplasty with femoral extra-articular deformity assisted by artificial intelligence: a study based on three-dimensional models

BackgroundThe impact of extra-articular deformities (EADs) on lower limb alignment and collateral ligament integrity during total knee arthroplasty (TKA) poses significant challenges, increasing surgical complexity. Our study aims to evaluate the influence of EADs on mechanical axis alignment and the risk of collateral ligament injury during TKA using an AI-assisted surgical planning system, with the goal of minimizing ligament damage through precise and scientific planning.MethodsA healthy volunteer underwent CT and MRI scans of the lower limbs. The scan images were imported into Mimics 20.0 software, and the reconstructed models were spatially aligned using 3-maticResearch 11.0 software. Using Unigraphics NX9.0 software, 50 three-dimensional models of femoral lateral joint deformities with varying positions and angles were created. Finally, TKA was simulated using the AI JOINT preoperative planning system.ResultsThe larger the deformity angle and the closer it is to the knee joint, the more pronounced the deviation of the mechanical axis. During MA-aligned osteotomy, nine types of deformities can damage the collateral ligaments. After adjusting the varus/valgus of the prosthesis within a safe range of 3° and leaving a residual 3° varus/valgus in the lower limb alignment, only the 25° varus and 25° valgus deformities located at 90% of the femoral anatomical axis remain uncorrected.ConclusionFor patients with osteoarthritis and concurrent EAD undergoing TKA, using reconstructed 3D models of the collateral ligaments for preoperative planning helps visually assess collateral ligament damage, providing a practical solution. Minimizing intra-articular osteotomies within a safe range and allowing some residual alignment deviation can reduce the risk of collateral ligament injury.

Retrospective Observational Analysis of Computed Tomography Scans of Trauma Patients in Overseas Operations (SCANOPEX Study).

High-intensity conflicts are on Europe's doorstep. The French expertise in the medical management of frontline casualties in overseas operations is well established. However, in the management of severe trauma, we lack data on the injuries identified by body scanners in the field. Understanding the associations between injury mechanisms and radiological lesions would enable us to anticipate medical and surgical management. To study this possible link, we collected and interpreted scanogaphic data and analyzed them according to lesion mechanisms, following the algorithm MARCH used to implement the concept of Damage Control Resuscitation, which includes life-saving measures to ensure that the wounded reach medical-surgical facilities alive. This retrospective monocentric study collected data from body scanners performed in overseas operations between June 2011 and September 2023. Inclusion criteria were to be French military personnel and to have undergone a whole-body scanner in a theater of overseas operations. Exclusion criteria were to have died before the scan, to be foreign, non-military and a minor. Of 164 available files, 96 were eligible, 1 patient declared aged 70 years was excluded, and 95 files were retained. In our population, 18% of injured patients had a spinal fracture. Compared with road traffic accident casualties, improvised explosive device casualties were the most severely injured patients arriving alive at computed tomography, with a relative risk of Injury Severity Score > 8 of 2.29 [1.09-4.80] (P = .019). Improvised explosive device casualties had a relative risk of airway injuries of 2.57 [1.03-6.39] (P = .030), injuries leading to functional impairment of 3.21 [1.17-8.82] (P =.013), injuries leading to infection of 2.14 [1.21-3.76] (P = .0045), and injuries leading to shock of 3.21 [0.96-10.70] (P = .039). Deep metal splinters were only found in the improvised explosive device group. Preparing the medical corps to deal with war casualties is fundamental. Our study shows that it is essential to consider the mechanism of injury to understand the casualty better and predict potential injuries. In addition, the study of postmortem scans could greatly help analyze potentially avoidable deaths.

A mechanical comparison of the translational traction of female-specific and male soccer boots

ABSTRACT The studded outsole of a soccer boot provides additional traction to players to minimise the risk of slipping while performing high-speed manoeuvres. As excessive traction can lead to foot fixation and injury risk, there has been significant research surrounding the influence of stud configuration on the level of traction generated. This previous research, however, has predominately focused on the stud patterns, foot morphology and lower limb loading patterns of male players. As the popularity of women’s soccer increases, the aim of this investigation was to examine the differences in translational traction of female-specific soccer boots and male soccer boots currently available. A custom-built apparatus was used to determine the translational traction on both natural and artificial grass for four different movement directions. It was hypothesised that the female-specific boot in each pair would produce lower levels of translational traction as they are designed to be safer for female players who are more at risk of lower limb fixation injuries compared to males. An independent samples T-test showed that while there were some loading conditions where female boots produced lower translational traction compared to male boots, across all loading scenarios there was no significant difference between male and female boots (p = 0.818), thus the null hypothesis was rejected.

Effects of Fatigue on Ankle Flexor Activity and Ground Reaction Forces in Elite Table Tennis Players.

Fatigue specifically affects the force production capacity of the working muscle, leading to a decline in athletes' performance. This study investigated the impact of fatigue on ankle flexor muscle activity and ground reaction forces (GRFs) in elite table tennis players, with a focus on the implications for performance and injury risk. Twelve elite male table tennis athletes participated in this study, undergoing a fatigue protocol that simulated intense gameplay conditions. Muscle activity of the soleus (SOL) and gastrocnemius lateralis (GL) muscles, heel height, and GRFs were measured using a combination of wireless electromyography (EMG), motion capture, and force plate systems. Results showed a significant decrease in muscle activity in both legs post-fatigue, with a more pronounced decline in the right leg. This decrease in muscle activity negatively affected ankle joint flexibility, limiting heel lift-off. Interestingly, the maximal anteroposterior GRF generated by the left leg increased in the post-fatigue phase, suggesting the use of compensatory strategies to maintain balance and performance. These findings underscore the importance of managing fatigue, addressing muscle imbalances, and improving ankle flexibility and strength to optimize performance and reduce the risk of injuries.

Right knee ACL, PCL and MCL reconstruction with sports-related anxiety

Introduction: JM, a 20-year-old male professional ice hockey player, presented with a 2-week history of lack of range of motion, weakness, and pain in his right knee, after a 2-year post-medical collateral ligament repair of the right knee and 3 year-post anterior cruciate ligament, posterior cruciate ligament and medial collateral ligament reconstruction of the right knee. Case Description: In the course of history taken, it was revealed that 5 months prior to admission the patient had been informed by a psychiatrist that he had sport-related anxiety. With an unremarkable psychiatric history prior to age 18, the competitive nature of his sports career in addition to financial pressure may have contributed to his sports-related anxiety. His examination findings were consistent with a diagnosis of complete tears of the right anterior cruciate ligament and posterior cruciate ligament along with grade III medial collateral ligament injury. Discussion: The biopsychosocial model was used to explicate JM's case. JM's current injuries prompted reconstruction of the anterior cruciate, posterior cruciate, and medial collateral ligaments. Psychologically, JM's sports-related anxiety is not a rare phenomenon as recent studies have discovered an increased risk of sports-related anxiety amongst young professional athletes. Sports-related anxiety, along with competitive trait anxiety, may be factors that contribute to sports injury occurrence. Other psychological stressors can add to sports-related or competitive trait anxiety, further increasing the risk of sports injury reoccurrence. Summary: JM was admitted for a right knee open medial collateral ligament repair with internal bracing, anterior cruciate ligament reconstruction, posterior cruciate ligament reconstruction, and platelet rich plasma injection. As part of a holistic patient-centered treatment plan, a referral to psychiatry was made to address JM's sports-related anxiety with the goal of decreasing future risk of sports injury. Patient's Consent Obtained: Yes