Injury Prevention Research Research Articles

Addressing the void: firearm injury prevention in the USA

Addressing the void: firearm injury prevention in the USA

Developing a National Trauma Research Action Plan: Results from the injury prevention research gap Delphi survey.

In its 2016 report on trauma care, the National Academies of Sciences, Engineering, and Medicine called for the establishment of a National Trauma Research Action Plan to strengthen and guide future trauma research. To address this recommendation, the Department of Defense funded the Coalition for National Trauma Research to generate a comprehensive research agenda spanning the continuum of trauma and burn care. We describe the gap analysis and high priority research questions generated from the National Trauma Research Action Plan panel on injury prevention. Experts in injury prevention research were recruited to identify current gaps in injury prevention research, generate research questions and establish the priority of these questions using a consensus-driven Delphi survey approach from December 2019 through September 2020. Participants were identified using established Delphi recruitment guidelines to ensure heterogeneity and generalizability with both military and civilian representatives. Participants were encouraged, but not required, to use a Patient/Population, Intervention, Comparison, and Outcome format to generate research questions: Patient/Population; Intervention; Compare/Control; Outcome model. On subsequent surveys, participants were asked to rank the priority of each research question on a nine-point Likert scale, categorized to represent low-, medium-, and high-priority items. Consensus was defined as 60% or greater of panelists agreeing on the priority category. Twenty-eight subject matter experts generated 394 questions in 12 topic areas. By round 3 of the Delphi, 367 (93.1%) questions reached consensus, of which 169 (46.1%) were determined to be high priority, 196 (53.4%) medium priority, and 2 (0.5%) low priority. Among the 169 high priority questions, suicide (29.6%), firearm violence (20.1%), and violence prevention (18.3%) were the most prevalent topic areas. This Delphi gap analysis of injury prevention research identified 169 high priority research questions that will help guide investigators in future injury prevention research. Funding agencies and researchers should consider these gaps when they prioritize future research. Therepeutic/Care Management; Level IV.

Age differences in upper extremity joint moments and strength during a laboratory-based tether-release forward fall arrest in older women

Age-related declines in upper extremity muscle strength may affect an older adult’s ability to land and control a simulated forward fall impact. The role of individual upper extremity joints during a forward fall impact has not been examined. The purpose was to evaluate the age differences in upper extremity joint moment contributions during a simulated forward fall and upper extremity muscle strength in older women. A convenience sample of 68 older women (70 (8) yrs) performed three trials of a simulated forward fall. Percentage joint moments of the upper extremity were recorded. Upper extremity muscle strength was collected via handgrip, hand-held dynamometry of the shoulder and elbow and a custom multi-joint concentric and eccentric strength isokinetic dynamometer protocol. Percentage joint moment contributions differed between women in their sixties and seventies with significantly greater relative shoulder joint involvement (P =.008), coupled with lower elbow joint contributions (P =.004) in comparison to 80 year olds. An increase in each year of age was associated with a 4% increase in elbow contribution (Beta = -0.421, r2 = 17.9, P = 0.0001) and a 3.7% decrease in shoulder contribution (Beta = 0.373, r2 = 14.6, P = 0.002). Older women exhibit different landing strategies as they age. Fall injury prevention research should consider interventions focused on these differences taking into account the contributions of upper extremity strength.

Sex Differences in Pre-Season Anthropometric, Balance and Range-of-Motion Characteristics in Elite Youth Soccer Players.

In soccer, injury epidemiology differs between males and females. It is clinically useful to know whether there are between-sex differences in selected characteristics relevant to primary injury risk and injury prevention practices. The purpose of this study was to explore between-sex differences in anthropometric, balance, and range-of-motion characteristics in Spanish elite male and female youth soccer players. This was a pre-season cross-sectional study. Sixty-nine males (age 16.8 ± 0.9 yr; height 175.9 ± 6.8 cm; mass 67.9 ± 6.3 kg) and thirty-seven females (age 17.2 ± 1.7 yr; height 164.0 ± 6.3 cm; mass 59.0 ± 5.8 kg) participated. Anthropometrics (standing/sitting height, bodymass, right/left leg length) and right/left anterior reach test (ART), hip internal/external active range of motion, active knee extension (AKE), and weightbearing lunge test (WBLT) were measured. Between-sex differences were assessed with Bonferroni-corrected Mann–Whitney U tests and Cliff’s delta (d). Between-sex significant differences (p < 0.003, d ≥ 0.50) were observed for anthropometric data and for hip internal rotation. No between-sex significant differences were observed for ART/AKE/WBLT measures. Between-sex significant differences with large effect sizes were identified for anthropometric data and right/left hip internal rotation. The present study adds new data to the literature for young Spanish male and female soccer players. The present findings will help inform clinical reasoning processes and future injury prevention research for elite male and female youth soccer players.

Firearm Injury and Mortality Prevention in Pediatric Health-care Settings.

Firearm Injury and Mortality Prevention in Pediatric Health-care Settings.

Injury and Injury Prevention in United States Para Swimming: A Mixed-Methods Approach.

BackgroundPara swimming has experienced increased participation in recent years. Injury and injury prevention research on Para swimmers is lacking compared to swimmers without impairment.PurposeThis study aimed to gather data in Para swimmers on typical injuries, injury prevention programs, and attitudes toward injury and injury prevention in this population.Study DesignCross-sectional, mixed-methods design evaluating injuries, injury management, and injury prevention in elite Para swimmers in United States (U.S.).MethodsPara swimmers on the U.S. Paralympics Swimming National teams at multiple competition levels were invited to complete an online survey. Qualitative interviews with six U.S. Paralympics National team Para swimmers were conducted to provide detail on athlete experiences with injury and prevention.ResultsTwenty-one of 56 surveys were returned: 11 of 21 participants (52.4%) reported experiencing an injury that altered their weekly training. All (21/21) reported participating in strength training and 19 of 21 (90.5%) reported incorporating stretching into their training regimen, although strengthening/stretching regimens included routines that may not have been specifically targeted toward injury prevention. Six of 21 (28.6%) reported participation in an injury prevention program. Qualitative interview themes included the impact of swimmers’ compensated body mechanics on injury risk, the value of individualized injury prevention programs, and the importance of knowledgeable coaching and rehabilitation staff.ConclusionsInjury prevention programs are important components in Para swimming training although they are underutilized based on responses in this study. These programs should be individualized to address swimming biomechanics and athlete-specific impairments. Increasing coaching knowledge and access to individualized programs may reduce injury prevalence among this at-risk population.Level of Evidence3

11+ Dance: A Neuromuscular Injury Prevention Exercise Program for Dancers

ABSTRACT Epidemiological studies over the past decade indicate high injury prevalence in preprofessional ballet (76%) and professional contemporary and ballet dancers (60–69%). Injuries can have detrimental effects both for the dancers and the dance company. Most injuries are in the lower limb and reported as the gradual onset of overuse. Professional dance companies have reduced injury incidence and severity through the implementation of comprehensive injury audit programs and proactive exercise prescription. Injury prevention research in dance is scarce, and there has been no intervention targeting dance injuries. This article describes the development of 11+ Dance, an injury prevention training program designed for dancers, based on current evidence and best practice on injury prevention in sports. It is a 25–30-minute neuromuscular-based training program focused on strength, balance, and jumping/landing technique, with special attention to ankle, knee, and hip alignment. The high prevalence of injuries reported in the different styles of dance suggests that implementation of an injury prevention program is both the plausible and ethical action to take for all levels of performance.

Abstracts from the Canadian Athletic Therapists association October 13, 2021

[...]this study aims to explore the satisfaction and sense of safety of HCPs with regard to sanitary measures to prevent the spread of COVID-19 in outpatient clinics during the pandemic. Sport Injury Prevention Research Centre, University of Calgary, Calgary, Alberta;BC Injury Prevention Research and Prevention Unit, BC Children's Hospital, Vancouver, British Columbia;Carleton Sport Medicine Clinic, Carleton University, Ottawa, Ontario Introduction: Approximately 20,000 varsity student-athletes participate at U SPORTS institutions. [...]this study aimed to (1) describe the context, course topic requests, and tool suggestions from university representatives and athletes at U SPORTS institutions, and (2) describe the development of an online education program specifically for Canadian varsity athletes. Phases included a needs assessment survey with clinicians and program directors, a needs assessment survey with athletes, content selection, mapping behavioral goals to evidenced-based behavior-change techniques, script/storyboard development, engagement interviews with varsity athletes, and final tool development.

Adolescent Running Biomechanics - Implications for Injury Prevention and Rehabilitation.

Global participation in running continues to increase, especially amongst adolescents. Consequently, the number of running-related injuries (RRI) in adolescents is rising. Emerging evidence now suggests that overuse type injuries involving growing bone (e.g., bone stress injuries) and soft tissues (e.g., tendinopathies) predominate in adolescents that participate in running-related sports. Associations between running biomechanics and overuse injuries have been widely studied in adults, however, relatively little research has comparatively targeted running biomechanics in adolescents. Moreover, available literature on injury prevention and rehabilitation for adolescent runners is limited, and there is a tendency to generalize adult literature to adolescent populations despite pertinent considerations regarding growth-related changes unique to these athletes. This perspective article provides commentary and expert opinion surrounding the state of knowledge and future directions for research in adolescent running biomechanics, injury prevention and supplemental training.

Coaches’ attitudes to injury and injury prevention: a qualitative study of Irish field hockey coaches

Translating injury prevention research into practice has been challenging, which may be due to a poor understanding of the contextual factors influencing the occurrence of injury. Coaches are key figure...

PHYSICAL THERAPISTS’ PERCEPTIONS OF ADOLESCENT IDIOPATHIC SCOLIOSIS TREATMENT

Background:Few studies have demonstrated the benefit of physical therapy in the treatment of adolescent idiopathic scoliosis (AIS), alone or in conjunction with bracing or surgery. To our knowledge, there is no consensus in pediatric physical therapists who treat AIS patients.Purpose:To identify the optimal physical therapy practices for AIS including; weekly frequency, session length, treatment duration, clinical interventions, therapeutic goal-setting, and outcome measures from pediatric physical therapists’ perspectives.Methods:A 40-question validated survey, The Analysis of the Schroth Method in Adjunct to Physical Therapy Services for Treatment of AIS, was distributed to pediatric physical therapists across the country via the Academy of Pediatric Physical Therapy electronic newsletter and via dissemination by the Injury Prevention Research Interest Group from Pediatric Research in Sport Medicine. REDCap was used to collect and organize responses. The responses were analyzed by a descriptive statistics using percentages (%).Results:Sixty-five responses were obtained. The majority of physical therapists, 78.5%, were Doctors of Physical Therapy (DPT), treating 1-5 AIS patients a week (69.2%), and 18.8% had Schroth certification. Preferred treatment frequency was twice a week (41.5%) for a duration of 60 minutes (53.8%), over the course of 3-5 months (44.6%). The top three common clinical interventions were; core and trunk stability enhancement (90.8%), abdominal strengthening (83.1%) and postural correction (80.0%). The three most common therapeutic goal-setting parameters were activity based (78.5%), quality of life measure based (56.9%), and therapy participation based (50.8%). Additionally, for outcome measures, patient reported outcome was the most common objective measurement (78.5%), followed by pain (63.1%), manual muscle testing (46.2%), range of motion (44.6%), cobb angle (27.7%), scoliometer readings (26.2%) and Adam’s forward bend test (10.8%). Therapists often monitored progress with completed surveys by patients. However, patients’ ability to return to activity was the most common marker of improvement (72.3%). Patient’s scoliosis was often being treated in another manner aside from PT (46.2%), and many patients had medical conditions in addition to scoliosis (52.3%).Conclusion:According to our data, pediatric physical therapists believe that patients with AIS can benefit from physical therapy treatments addressing core and trunk stability, abdominal strengthening, and postural correction. Ideal treatment sessions would occur twice a week for 60 minutes over a period of 3-5 months. Objective measurements can be monitored to ensure improvements in quality of life, pain, strength, range of motion and curvature of the patient’s spine.AcknowledgementsThe Injury Prevention Research Interest Group from Pediatric Research in Sports Medicine and Suzanne M. McCahan, PhD

Effectiveness of exercise interventions to prevent shoulder injuries in athletes: a systematic review protocol.

This review will evaluate the effectiveness of exercise intervention versus no intervention or alternate intervention to prevent shoulder injuries in athletes. Injury-prevention research has proven the effectiveness of exercise in preventing sports injuries in general and in the lower limb specifically. However, the results have been extrapolated to sport-related shoulder injuries from limited evidence. Similar reviews have been faced with insufficient high-quality evidence and limited studies due to restrictive target populations, resulting in reduced generalizability. Peer-reviewed randomized controlled trials, with adequate control arms, investigating shoulder-injury events after exercise intervention in athletes, both training or competing in sports, will be included. Studies with substitute end points for injury events and non-self-propelled athletes, or vehicle-assisted athletes, will be excluded. A comprehensive search of multiple databases will be used to find relevant studies. The databases will be searched from inception to April 2021, with no language restrictions imposed. Keywords and derivatives of "sport," "exercise intervention," "prevention," "shoulder injury," and "randomized controlled trials" will be used.Sources will include Academic Search Ultimate (EBSCO), CINAHL Plus (EBSCO), Cochrane Central Register of Controlled Trials (Wiley), MasterFILE Premier (EBSCO), MEDLINE (PubMed), Physiotherapy Evidence Database (PEDro), ProQuest Health and Medical Complete and Nursing and Allied Health Source (ProQuest Complete), ScienceDirect (Elsevier), Scopus (Elsevier), SPORTDiscus (EBSCO), and Web of Science (Clarivate Analytics). Data appraisal, extraction, and synthesis will follow JBI guidance for systematic reviews of effectiveness. PROSPERO CRD42020204141.

Comparison of childhood household injuries and risk factors between urban and rural communities in Ghana: A cluster-randomized, population-based, survey to inform injury prevention research and programming

BackgroundChildhood household injuries incur a major proportion of the global disease burden, particularly in low- and middle-income countries (LMICs). However, household injury hazards are differentially distributed across developed environments. Therefore, we aimed to compare incidence of childhood household injuries and prevalence of risk factors between communities in urban and rural Ghana to inform prevention initiatives. MethodsData from urban and a rural cluster-randomized, population-based surveys of caregivers of children <5 years in Ghana were combined. In both studies, caregivers were interviewed about childhood injuries that occurred within the past 6 months and 200 meters of the home that resulted in missed school/work, hospitalization, and/or death. Sampling weights were applied, injuries and incidence rate ratios (IRRs) were described, and multi-level regression was used to identify and compare risk factors. ResultsWe sampled 200 urban and 357 rural households that represented 20,575 children in Asawase and 14,032 children in Amakom, Ghana, respectively. There were 143 and 351 injuries in our urban and rural samples, which equated to 594 and 542 injuries per 1,000 child-years, respectively (IRR 1.09, 95%CI 1.05-1.14). Toddler-aged children had the highest odds of injury both urban and rural communities (OR 3.77 vs 3.17, 95%CI 1.34-10.55 vs 1.86-5.42 compared to infants, respectively). Urban children were more commonly injured by falling (IRR 1.50, 95%CI 1.41-1.60), but less commonly injured by flame/hot substances (IRR 0.51, 95%CI 0.44-0.59), violence (IRR 0.41, 95%CI 0.36-0.48), or motor vehicle (IRR 0.50, 95%CI 0.39-0.63). Rural households that cooked outside of the home (OR 0.36, 95%CI 0.22-0.60) and that also supervised older children (OR 0.33, 95%CI 0.17-0.62) had lower odds of childhood injuries than those that did not. ConclusionsChildhood injuries were similarly common in both urban and rural Ghana, but with different patterns of mechanisms and risk factors that must be taken into account when planning prevention strategies. However, the data suggest that several interventions could be effective, including: community-based, multi-strategy initiatives (e.g., home hazard reduction, provision of safety equipment, establishing community creches); traffic calming interventions in rural community clusters; and passive injury surveillance systems that collect data to inform violence and broader prevention strategies.

Development of the integrated New Jersey Safety and Health Outcomes (NJ-SHO) data warehouse: catalysing advancements in injury prevention research

ObjectiveOur objective was to describe the development of the New Jersey Safety and Health Outcomes (NJ-SHO) data warehouse—a unique and comprehensive data source that integrates state-wide administrative databases in NJ...

Tackle injury epidemiology and performance in rugby league - narrative synthesis.

In rugby league (RL), the ability to repeatedly engage in the tackle, whether as a ball carrier or tackler, is essential for team success and player performance. It is also the leading cause of injury, with over 90% of total injuries occurring during the tackle in professional and amateur cohorts. To effectively reduce the risk of injury and optimise performance, establishing the extent of the 'problem', through injury surveillance or descriptive performance studies is required. The purpose of this narrative synthesis was to systematically search and synthesise tackle injury epidemiology and tackle performance frequency in RL. To achieve this objective, a systematic review was conducted. The search was limited to English-only articles published between January 1995 and October 2018. Based on the search criteria, a total of 53 studies were found: 32 focused on tackle injury epidemiology (nine cases studies) and 21 focused on tackle frequency. In general, over 600 tackles may occur during an RL match. Tackle injury frequencies (both overall and time-loss injuries) ranged between 47%-94% at the professional level, and between 38%-96% for the lower levels of play. A greater proportion of injuries occurring in professional RL are severe time-loss injuries when compared to lower levels of play. Most time-loss and overall injuries occur to players who are tackled, i.e., ball carriers, across all levels of play. This narrative synthesis will facilitate tackle injury prevention and performance research in RL, and act as a reference document for coaches and practitioners.

Integrating complex systems science into road safety research and practice, Part 2: applying systems tools to the problem of increasing pedestrian death rates

ObjectivesTo provide a specific example of how systems dynamics tools can increase understanding of stakeholder ‘mental models’ and generate robust systems-based hypotheses about the escalating problem of rising pedestrian death...

Prevention of sports injuries in Sri Lanka: what do we know about injuries in our athletes?

In terms of safeguarding the health and well-being of athletes in Sri Lanka, a primary focus has always been toward the treatment of injuries after they have occurred and promoting rehabilitation back into sport. There has been little attention towards the primary prevention of injuries in Sri Lankan sports. As a developing sporting nation, the benefits of injury prevention are immense: from a public health and financial perspective, through to individual benefits for athletes’ physical, psychological and social health. Understanding the reasons behind the lack of motive towards sports injury prevention in the country, and challenges in developing and implementing injury prevention measures in the field is useful so that these reasons can be addressed and overcome. Based on recent experience in conducting injury prevention research among Sri Lankan junior cricketers, this article discusses injury prevention principles in sport and provides directions for future sport injury prevention research in Sri Lanka.

Sex-based differences in landing mechanics vary between the drop vertical jump and stop jump

The purpose of the present study was to compare landing mechanics between the stop jump (SJ) and drop vertical jump (DVJ) and to compare sex-based differences in landing mechanics between tasks. 50 healthy recreational athletes were recruited and each participant completed seven SJs and seven DVJs. Peak knee flexion and abduction angle, knee flexion and ab/adduction range of motion (ROM), peak vertical and posterior ground reaction force (GRF), peak internal knee extension and knee adduction moment were computed for the dominant limb during the first landing of both tasks. A two-way ANOVA was used to determine the effects of and interactions between sex (men vs women) and task (SJ vs DVJ) for each outcome. There was an interaction for peak vertical GRF (p = 0.024), knee flexion ROM (p = 0.027), knee ab/adduction ROM (p = 0.047), and peak knee flexion (p = 0.034) and adduction (p = 0.012) moment. The SJ resulted in smaller vertical GRFs, larger posterior GRFs, and larger peak internal knee adduction moments relative to the DVJ (all p < 0.002). Women landed with larger peak knee abduction angles, larger internal knee adduction moments, and smaller knee extension moments relative to men (p = 0.001–0.026). Overall, as the SJ resulted in larger posterior GRFs and internal knee adduction moments, this task produced movements which resemble most anterior cruciate ligament (ACL) injuries and are risk factors for ACL injuries. As the SJ produced more sex-based differences, it may be better suited than the DVJ for ACL injury risk screening. This study therefore stressed the importance of selecting an appropriate landing task for ACL injury prevention research and clinical return to sport assessment.

Using Workers' Compensation Claims Data to Describe Nonfatal Injuries among Workers in Alaska.

BackgroundTo gain a better understanding of nonfatal injuries in Alaska, underutilized data sources such as workers’ compensation claims must be analyzed. The purpose of the current study was to utilize workers’ compensation claims data to estimate the risk of nonfatal, work-related injuries among occupations in Alaska, characterize injury patterns, and prioritize future research.MethodsA dataset with information on all submitted claims during 2014–2015 was provided for analysis. Claims were manually reviewed and coded. For inclusion in this study, claims had to represent incidents that resulted in a nonfatal acute traumatic injury, occurred in Alaska during 2014–2015, and were approved for compensation.ResultsConstruction workers had the highest number of injuries (2,220), but a rate lower than the overall rate (34 per 1,000 construction workers, compared to 40 per 1,000 workers overall). Fire fighters had the highest rate of injuries on the job, with 162 injuries per 1,000 workers, followed by law enforcement officers with 121 injuries per 1,000 workers. The most common types of injuries across all occupations were sprains/strains/tears, contusions, and lacerations.ConclusionThe successful use of Alaska workers’ compensation data demonstrates that the information provided in the claims dataset is meaningful for epidemiologic research. The predominance of sprains, strains, and tears among all occupations in Alaska indicates that ergonomic interventions to prevent overexertion are needed. These findings will be used to promote and guide future injury prevention research and interventions.

Sports Injury Prevention is Complex: We Need to Invest in Better Processes, Not Singular Solutions.

In recent years, an understanding has developed that sports injuries are the emergent outcomes of complex, dynamic systems. Thus, the influence of local contextual factors on injury outcomes is increasingly being acknowledged. These realisations place injury prevention research at a crossroads. Currently, injury prevention researchers develop universally applicable injury prevention solutions, but the adoption of these solutions in practice is low. This occurs because implementation contexts are both unique and dynamic in nature, and as a result singular, static solutions are often incompatible. In contrast, practitioners address injury prevention through iterative cycles of trial and error, aiming to optimise the injury prevention process within their own unique contexts. The purpose of this critical review is to draw attention to the misalignment between research and practice-based approaches to injury prevention. In light of this, we propose alternative research approaches that acknowledge the process-driven nature of injury prevention in practice. We propose that a core focus of sport injury prevention research should be to provide practitioners with useful and relevant information to support their decision making around their localised injury prevention practice. Through this approach, injury prevention research ceases to be about what works, and begins to engage with understanding what works in what contexts and why?