Prevention Of Musculoskeletal Injuries Research Articles

Prevention of Musculoskeletal Injuries in Gastrointestinal Endoscopists

Gastroenterologists are exposed daily to musculoskeletal (MSK) stress during upper and lower gastrointestinal endoscopy, both during routine endoscopies and during long, demanding therapeutic procedures. There is evidence that endoscopy-related MSK injuries are becoming more common, particularly in the back, neck, shoulders, elbows, and hands. The aims of this study were to identify the most stressed muscle groups during endoscopy; to measure their activity using surface electromyographical (EMG) sensors; to detect areas of muscle overload; and to identify the number of microbreaks taken in specific muscles. Furthermore, we measured differences in the loading of these muscle groups with and without the use of special support systems such as a belt-like holder. Measurements were performed on 15 subjects (7 experienced endoscopists and 8 non-endoscopists). Due to this small sample size, inside each group, we achieved inconclusive results regarding statistically significant differences in different muscle groups. We increased the sample size by comparing all participants with and without the belt support system, disregarding their endoscopic background. There was a statistically significant difference (p < 0.05) in muscle tension and in levels of microbreaks in the muscles of the left forearm, biceps, and trapezius muscles. No statistically significant difference was observed in the muscle tension and level of microbreaks in the left deltoid muscle (p > 0.05). We hypothesize that the increased level of muscle loading and decreased level of microbreaks in the deltoid muscle are due to different muscle activity and different shoulder movements. Additionally, the deltoid muscle is not connected to the kinetic chain of body posture and stabilization. It is our belief that MSK injuries in gastrointestinal (GI) endoscopy can be prevented with the use of a belt-like support system.

Systematic Review and Meta-analysis of Exercise for the Prevention of Musculoskeletal Injuries in Soldiers

Systematic Review and Meta-analysis of Exercise for the Prevention of Musculoskeletal Injuries in Soldiers

Barriers and facilitators to implementation of musculoskeletal injury mitigation programmes for military service members around the world: a scoping review

IntroductionMusculoskeletal injury (MSK-I) mitigation and prevention programmes (MSK-IMPPs) have been developed and implemented across militaries worldwide. Although programme efficacy is often reported, development and implementation details are often overlooked, limiting...

The Effect of Varying Eccentric Velocity on Muscle Hypertrophy

Resistance training is essential to muscle hypertrophy as it fatigues fibres through time-under-tension (TUT). As myocyte energy depletes, metabolites accrete, leading to inflammation to increase cell size, so it is adapted for future stimuli. TUT can be measured by varying eccentric velocities: i.e., the rate at which a muscle lengthens under load. A longer period of lengthening will lead to greater metabolite accretion and inflammation. However, it is unknown whether TUT is a threshold or if it can gradually increase and lead to more muscle growth. Through a literature review and experiment, this project investigates the effect of varying eccentric velocity on muscle hypertrophy. Previous research in the field of muscle physiology and metabolism were explored, with an emphasis on eccentric training. The supplementary experiment measured shoulder growth in response to the medial deltoid exercise called lateral raises, where different eccentric velocities were assigned to groups. Individualistic daily calorie and protein intake were controlled to ensure that sufficient nutrients were available for recovery and performance. Surprisingly, post-experimental research suggested that high-velocity eccentric training was best for hypertrophy due to greater levels of force production. This was consistent with the experiment, which found that the group with a fast-velocity eccentric, a lower TUT, experienced greater growth. They also exhibited greater strength gain due to neuromuscular junction adaptation. These findings related to TUT are significant for designing exercise regimens that are optimal for the prevention and rehabilitation of musculoskeletal injuries and disorders. The review’s findings suggest that fast-velocity eccentric contractions are ideal for increasing muscle size and strength.

Prevalence of Flexibility Among Health Care Professional Students

Flexibility is a physiological characteristic that allows an individual to execute voluntary movements of maximum joint angular amplitude within morphological limits, free of pain and restrictions. The prevention of musculoskeletal injuries and improvement in muscle movement and performance depend on body flexibility. The purpose of this study was to analyse the prevalence of flexibility among health care professional students. A total of 700 students, in which 68 students were excluded and 632 students were included, Subjects were assessed for joint flexibility by using the measurements of joint range of motion developed by Norkin and White. The inclusion and exclusion criteria were female students aged between 17 and 25 years with recent fractures and sprains, a history of neurological problems, and recent surgeries. The major muscles tested for flexibility are trapezius, pectoralis major, hip flexors, rectus femoris, hamstrings, and calf muscles, as these muscles commonly cause the restriction identified with stretching pain for each muscle. Statistical analyses were conducted according to gender, age, body mass index value[normal-overweight-obese], and the results of the muscle flexibility test. In the overall sample, 9.17% of students had pectoral muscle tightness; 22% of students had upper trapezius muscle tightness; 38% of students had hamstring muscle tightness; 18.2% of students had calf muscle tightness; 3.32% of students had adductor muscle tightness; and 9.33 % of students had rectus femoris muscle tightness. This study confirms that the flexibility of the major muscles is poor because of their daily activities, BMI, and ageing process. Poor flexibility may lead to poor posture and some musculoskeletal problems. These studies help them learn how important it is to do regular physical activities every day.

Concurrent measurement of serum and radiomic biomarkers in the clinical investigation of equine musculoskeletal injuries: A prospective pilot study.

The prevention of musculoskeletal injuries and their relatedwelfare and economic impacts represent an immediate priority for the horse racing industry. This prospective pilot study aimed to evaluate a method to quantitatively analyze scintigraphic features of specific anatomical regions of the horse's appendicular skeleton in combination with secondary measures of musculoskeletal metabolism in blood. Twelve horses referred for scintigraphic assessment of lameness were enrolled. Blood samples were collected immediately prior to the administration of radiotracer. Serum concentrations associated with bone turnover were determined for the following biomarkers: C-terminal telopeptides of type I collagen, proteoglycans and sulfated glycosaminoglycans, collagen type II, osteocalcin, and procollagen II C-terminal propeptide. Scintigraphic images underwent radiomic analysis of discrete regions of the distal limbs and these data were correlated to bone turnover markers. Three lame horses demonstrated asymmetrical radiomic abnormalities. The concentration of osteocalcin in the lame horses was significantly higher when compared to the control group, while no significant changes were observed for the other screened serum biomarkers. Findings from the current study provided evidence that radiomic analysis of equine scintigraphy is feasible. This method has the potential to interrogate which serum markers are associated with musculoskeletal injuries.

Prevention of Lower Extremity Musculoskeletal Injuries in Tactical and First Responder Populations: A Systematic Review and Meta-Analysis of Randomized Trials From 1955 to 2020.

Sinnott, AM, Krajewski, KT, LaGoy, AD, Beckner, ME, Proessl, F, Canino, MC, Nindl, BC, Turner, RL, Lovalekar, MT, Connaboy, C, and Flanagan, SD. Prevention of lower extremity musculoskeletal injuries in tactical and first responder populations: A systematic review and meta-analysis of randomized trials from 1955 to 2020. J Strength Cond Res 37(1): 239-252, 2023-Lower extremity musculoskeletal injuries (LEMSIs) impose a significant burden on tactical and first responder populations. To determine the effectiveness of LEMSI prevention strategies, we performed a systematic review and meta-analysis of randomized controlled trials published in English from 1955 to 2020 (PROSPERO: CRD42018081799). MEDLINE, EMBASE, Cochrane, CINAHL, ProQuest, and DTIC databases were searched for trials that assigned military service members, police, firefighters, or paramedics to LEMSI prevention interventions with a minimum surveillance period of 12 weeks. Evidence was synthesized as odds ratios (OR) for LEMSI occurrence between individuals assigned to interventions and those assigned to standard activities. Risk of bias was assessed with the Cochrane Risk of Bias tool 2.0. Random-effects meta-analyses were conducted for (a) physical training and (b) footwear modifications to reduce LEMSI and (c) footwear modifications to reduce stress fractures specifically. Certainty in the body of evidence was determined with the GRADE approach. Of 28,499 records, 18 trials comprised of more than 11,000 subjects were synthesized. Interventions included physical training (8, N = 6,838), footwear modifications (8, N = 3,792), nutritional supplementation (1, N = 324), and training modifications (1, N = 350). Overall risk of bias was generally moderate ( N = 7 of 18) or high ( N = 9 of 18). Physical training (OR = 0.87, 95% CI [0.71, 1.08], p = 0.22, I 2 = 58.4%) and footwear modification (OR = 1.13, 95% CI [0.85, 1.49], p = 0.42, I 2 = 0.0%) did not reduce LEMSI or stress fractures (OR = 0.76, 95% CI [0.45, 1.28], p = 0.30, I 2 = 70.7%). Our results indicate that there is weak evidence to support current LEMSI prevention strategies. Future efforts will benefit from longer surveillance periods, assessment of women and nonmilitary populations, improved methodological rigor, and a greater breadth of approaches.

Effects of prevention programmes on injury risk in military personnel: a systematic review with meta-analysis

IntroductionExercise programmes have been used to prevent injuries in military personnel, as they can reduce modifiable risk factors for injuries. Our aim was to review the literature to evaluate the...

Early Changes of Hamstrings Morphology and Contractile Properties during 10 d of Complete Inactivity.

The hamstrings (HS) muscle group plays a fundamental role in maintaining knee stability, thus contributing to the prevention and rehabilitation of lower limb musculoskeletal injuries. However, little is known about HS structural and functional adaptations after periods of prolonged inactivity. Our purpose was to investigate the HS morphological and contractile properties changes during 10 d of bed rest (BR). Ten young healthy males underwent a 10-d BR. HS cross-sectional area (CSA) (at 30%, 50%, and 70% of femur length) and biceps femoris long head (BFlh) architecture were assessed by ultrasound imaging after 0 d (BR0), 2 d (BR2), 4 d (BR4), 6 d (BR6), and 10 d (BR10) of BR, whereas BFlh contractile properties (radial twitch displacement [Dm] and contraction time [Tc]) were evaluated at the same time points by tensiomyography. HS muscle volume was assessed by magnetic resonance imaging at BR0 and BR10. A reduction in muscle volume was observed in BFlh ( P = 0.002; Δ = -3.53%), biceps femoris short head ( P = 0.002; Δ = -3.54%), semitendinosus ( P = 0.002; Δ = -2.63%), semimembranosus ( P = 0.002; Δ = -2.01%), and HS pooled together ( P < 0.001; Δ = -2.78%). Early changes in CSA were detected at 30% femur length already at BR6 for BFlh ( P = 0.009; Δ = -2.66%) and biceps femoris short head ( P = 0.049; Δ = -1.96%). We also found a reduction in fascicle length at BR6 ( P = 0.035; Δ = -2.44%) and BR10 ( P < 0.001; Δ = -2.84%). Dm and Tc increased at BR2 ( P = 0.010; Δ = 30.0%) and B10 ( P = 0.019; Δ = 19.7%), respectively. Despite being a nonpostural muscle group, HS exhibited a moderate reduction in muscle dimensions in response to a short unloading period. Small changes in BFlh fascicle length were also observed, accompanied by alterations in BFLh contractile properties. These HS modifications should not be ignored from a clinical perspective.

Lower limb risk prevention in athletes: evaluation and strategies

Risk prevention of sports-related lower limb musculoskeletal injuries in adult and youth athletes is an important topic encompassing health and economic factors. For example, muscle injuries in professional football players could expose these athletes to recurrence, creating a significant economic problem for the football club. Such observations have led to the development of prevention programs, predominantly exercise-based injury prevention strategies, which may be multi-component or single-component. These programs focus on intrinsic risk factors, such as strength deficits, lack of flexibility, poor balance, coordination, endurance, previous injury, body size, anatomical alignment issues, foot shape, age, and sex. The FIFA 11+ program is an important example of an exercise-based program. It was developed under the leadership of the Fédération Internationale de Football Association with the aim of evaluating and, where necessary, implementing preventive training routines for soccer players. Despite the program being designed for soccer players, it has shown efficacy in other sports too. Many studies also emphasize the importance of identifying and avoiding extrinsic risk factors related to type and level of activity, shoe type, bracing equipment, etc. Understanding of the incidence, the severity, and the etiology of a specific injury is required in order to provide adequate prevention measures and to reduce the need for surgery. The present study focuses explicitly on identifying and evaluating possible interventions for lower limb injuries.

Multibody Computer Model of the Entire Equine Forelimb Simulates Forces Causing Catastrophic Fractures of the Carpus during a Traditional Race.

Simple SummaryPalios are traditional horseraces held in the main square of few Italian cities. Due to peculiar features of such circuits, adapted to the square architecture and thus characterized by tight curves and unconventional footing surface, horses involved are at particular risk of accidents. Prevention of catastrophic musculoskeletal injuries is a significant issue and matter of debate during these events. In particular, the negotiation of the curves in the city circuits is a significative concern. An experiment was set up to build a model of entire forelimb at the point of failure in the context of a turn comparable to that in a Palio circuit. The model was informed by live data and the output compared to post-mortem findings obtained from a horse that sustained a catastrophic fracture of the carpus during this competition. The objective of this study is to determine the magnitude and distribution of internal forces generated across the carpus under which the catastrophic injury has occurred and describe related post-mortem findings.A catastrophic fracture of the radial carpal bone experienced by a racehorse during a Palio race was analyzed. Computational modelling of the carpal joint at the point of failure informed by live data was generated using a multibody code for dynamics simulation. The circuit design in a turn, the speed of the animal and the surface characteristics were considered in the model. A macroscopic examination of the cartilage, micro-CT and histology were performed on the radio-carpal joint of the limb that sustained the fracture. The model predicted the points of contact forces generated at the level of the radio-carpal joint where the fracture occurred. Articular surfaces of the distal radius, together with the proximal articular surface of small carpal bones, exhibited diffuse wear lines, erosions of the articular cartilage and subchondral bone exposure. Even though the data in this study originated from a single fracture and further work will be required to validate this approach, this study highlights the potential correlation between elevated impact forces generated at the level of contact surfaces of the carpal joint during a turn and cartilage breakdown in the absence of pre-existing pathology. Computer modelling resulted in a useful tool to inversely calculate internal forces generated during specific conditions that cannot be reproduced in-vivo because of ethical concerns.

Correlation of eccentric strength of the knee extensors and knee proprioception with dynamic postural control.

It is important for clinicians and researchers to perform dynamic postural control evaluation for predicting musculoskeletal conditions, injury prevention, and rehabilitation. The purpose of this study was to investigate the relationship (1) between the eccentric strength of the knee extensors and star excursion balance test (SEBT), and (2) between the knee proprioception and SEBT. Forty healthy young adults participated in this study. The eccentric peak torque (EPT) of the knee extensors, joint position sense, and force sense were measured. The participants also performed SEBT. Pearson's product-moment correlation and multiple linear regression analysis were used to determine the relationship between the variables and SEBT. The posteromedial direction of the SEBT was positively and strongly correlated with EPT (r= 0.74, P< 0.01). The anterior and posterolateral directions were positively and moderately correlated with EPT (r= 0.46, P< 0.01, and r= 0.69, P< 0.01, respectively.). However, knee proprioception was not correlated with all the directions of SEBT (P> 0.05). According to the results of multiple linear regression analysis, EPT of the knee extensors significantly predicted SEBT reach distances. The eccentric strength of the knee extensors seems to be an essential factor in dynamic postural control. However, the knee proprioception did not show a significant correlation with SEBT.

Sensor-Based Evaluation of Physical Therapy Exercises.

Physical therapy is important for the treatment and prevention of musculoskeletal injuries, as well as recovery from surgery. In this paper, we explore techniques for automatically determining whether an exercise was performed correctly or not, based on camera images and wearable sensors. Classifiers were tested on data collected from 30 patients during normally-scheduled physical therapy appointments. We considered two lower limb exercises, and asked how well classifiers could generalize to the assessment of individuals for whom no prior data were available. We found that our classifiers performed well relative to several metrics (mean accuracy: 0.76, specificity: 0.90), but often returned low sensitivity (mean: 0.34). For one of the two exercises considered, these classifiers compared favorably with human performance.

Musculoskeletal practices for the preparticipation physical examination

BackgroundLittle is known about the musculoskeletal (MSK) exam providers use during the Preparticipation Physical Examination (PPE). The primary aims of this study were to determine current practice with regards to the MSK screening exam, if goals are being met, and if there may be opportunities for improvement.MethodsThis cross-sectional survey-based study utilized a REDCap instrument that was distributed to members of the American Academy of Family Physicians (AAFP) and the American Medical Society for Sports Medicine (AMSSM). Questions focused on participant demographics and MSK exam practices for the PPE. Descriptive statistics were used.ResultsThe study had a total of 616 participants with a response rate of 9 %. The majority of respondents (82 %) were familiar with the 4th Edition PPE Monograph and 80 % either moderately or strongly agreed that they use this as a guideline for their MSK screening exam. The 90 s MSK screening test was implemented by 52 % of the participants. The majority of participants use an orthopedic exam as part of their PPE (82 %). Ninety-two percent of participants felt satisfied that their MSK exam would screen for current injury, while only 42 % were satisfied that it effectively screened for future injury. 86 % of participants agree that the MSK exam should be performed, while 26 % said that they don’t perform a physical exam at all.DiscussionThere is a lack of understanding of the PPE Monograph as there is wide variability in MSK screening techniques providers use despite the majority of participants being familiar with the guidelines described in the monograph. Additionally, providers don’t believe that the MSK exam screens for future injury.ConclusionsThe goals of the MSK portion of the 4th Edition PPE monograph are not adequately being met and there is a need for further research to validate screening exams for the prevention of MSK injury.

A musician-centered approach to management of performance-related upper musculoskeletal injuries

Study DesignInvited Clinical Commentary BackgroundPerformance related musculoskeletal disorders (PRMD) are common in instrumental musicians and often affect the upper extremities. These overuse injuries typically result from inadequate attention to the musculoskeletal demands required for the high-level performance of musician-students and experienced instrumentalists.1 PRMDs often interfere with career trajectory, and in extreme cases, can be career ending. Many clinicians and healthcare practitioners treating upper extremity injuries are not familiar with the specific demands faced by instrumental musicians and how to tailor treatment and prevention strategies to the specific risks and occupational needs of each instrumental group. Purpose of the studyThis paper describes an evidenced-based framework for the assessment, prevention, and treatment of musculoskeletal musician injuries to provide clinicians with an instrument-specific, and musician-centered guide for practice. We synthesized available literature on instrumental ergonomics, biomechanical demands, and upper extremity injuries to highlight the risks and common upper-extremity pathologies, focusing on the specific demands of instrumental groups: piano, high strings (violin and viola), low strings (cello and bass), percussion, woodwinds, and brass. Targeted assessment, prevention, and treatment strategies are reviewed in this context to provide healthcare providers with an evidence-based framework to approach the treatment of PRMD to mitigate incidence of injury during practice and performance. MethodsA comprehensive search of electronic databases was conducted including all study designs. ResultsThis review describes risk factors for PRMD in instrumental musicians, strategies to prevent misuse and performance injury, and musician-centered interventions to allow playing while reducing risk of misuse. ConclusionThe suggested assessment and treatment framework can assist clinicians with a customized patient-centered approach to prevention and treatment by addressing the gap in clinical knowledge with the goal of ultimately reducing the incidence and severity of PRMD in musicians.

Balance, reframe, overcome. attitudes, priorities and perceptions toward physical activity and exercise-therapy in youth 12-24 months after a sport-related anterior cruciate ligament injury

Purpose: Anterior cruciate ligament (ACL) tears are common injuries in active youth and are associated with an 8-fold increased risk of osteoarthritis (OA). There is consistent evidence that exercise-based activities (i.e., exercise-therapy, physical activity, and sport) are essential for musculoskeletal health, injury and OA prevention, and OA management. Unfortunately, there are deleterious psychological, social, and contextual factors associated with ACL injuries that negatively impact one’s ability to participate and fully benefit from exercise-based activities.

Sex and Age Comparisons in Neuromuscular And Biomechanical Characteristics of the Knee in Young Athletes.

BackgroundThe identification of risk factors for injury is a key step for musculoskeletal injury prevention in youth sports. Not identifying and correcting for injury risk factors may result in lost opportunity for athletic development. Physical maturation and sex affect these characteristics, which may indicate the need for both age and sex-based injury prevention programs.Hypothesis/PurposeThis study examined age and sex differences in knee strength, static balance, jump height, and lower extremity landing biomechanics in school- and high school-age athletes.Study DesignCross-sectionalMethodsForty healthy school aged (10.8±0.8 yrs) and forty high school (16.8±0.8 yrs) athletes completed isokinetic knee flexion and extension strength tests, single-leg static balance and single-leg vertical stop jump tasks.ResultsHigh school athletes were significantly stronger (~67% and 35% stronger for males and females, respectively) and jumped higher (regardless of sex) compared to school age athletes. High school males had worse balance (~28%) compared to their younger counterparts. High school females had lower strength (~23%) compared to males but had better balance (~46%). Conclusion: Maturation had different effects on the variables analyzed and sex differences were mainly observed after maturation. These differences may be minimized through appropriate age and sex specific training programs.Levels of Evidence3aClinical RelevanceNeuromuscular and biomechanical differences between sex and age groups should be accounted for in injury prevention and rehabilitation. Inadequate training may be a primary factor contributing to injuries in a young athletic population. When designing training programs for long term athlete development, programs should be dependent on decrements seen at specific time points throughout maturation.What is known about the subject: Generally, both males and females get stronger and jump higher as they get older but the results comparing balance and biomechanics between genders or across age groups have been mixed.What this study adds to existing knowledge: The current study looks at multiple neuromuscular and biomechanical variables in male and female participants at different maturation statuses. The current data supports the significant changes observed in strength and jump height, as both genders age, but the data also demonstrates significant differences in balance between age groups in males and between genders in balance and knee flexion angles.

Osteopathic model of the development and prevention of occupational musculoskeletal disorders.

The direct and indirect costs of work-related musculoskeletal disorders are significant. Prevention is the most effective way to control these costs. To do that, we must understand how these disorders develop. To use the five models of osteopathic care to illustrate how cellular processes and neural reflexes interact to create work-related musculoskeletal pathology and to provide evidence-informed musculoskeletal injury and disability prevention recommendations. A literature review of electronic databases (Google Scholar, PubMed, OVID, Cochrane Central Register of Controlled Trials, PEDro, and OSTMED.DR) from inception to October 16, 2019 and hand-search of publication references was performed for systematic reviews, cohort studies, case-control studies, and randomizedcontrolled trials. The search terms reflected topics related to occupational injury and injury prevention, and included supplementary laboratory studies and narrative reviews related to the biological aspects of musculoskeletal injury. The eligible studies contained the following criteria: (1) the population of working age; (2) exposures to known risk factors, musculoskeletal disorders, and psychosocial factors; (3) written in English; (4) full text papers published in peer-reviewed journals; and (5) systematic review, cohort study, case-control study, and randomized controlled trial methodology. Studies were excluded if they included outcomes of productivity andcosts only or outcomes that were assessed through qualitative methods only. The literature search resulted in 1,074 citations; 26 clinical studies and 14 systematic reviews were used in this review. A comprehensive workplace musculoskeletal disorder prevention program should match demands to capacity, correct dysfunctional movement patterns, and limit tissue vulnerability (biomechanical-structural model); restore alpha-gamma balance, tonic-phasic synergistic function, and autonomic balance (neurological model); maximize physiologic reserve (metabolic-energy model) component of a prevention program; optimize respiration and circulation (respiratory-circulatory model); and address cognitive distortions (behavioral-biopsychosocial model). The presented osteopathic model of the development and prevention of work-related musculoskeletal disorders suggests that a combination of preventive interventions will be more effective than any single preventive intervention.

The Feasibility of Dynamic Musculoskeletal Function Analysis of the Vastus Lateralis in Endurance Runners Using Continuous, Hands-Free Ultrasound

Dynamic imaging of the skeletal muscles used to be strenuous and often impossible to perform manually. Accordingly, long-term dynamic musculoskeletal imaging has not been performed. The feasibility of long-term dynamic musculoskeletal functional analysis using hands-free ultrasound will be demonstrated in ten healthy endurance runners. After every kilometer, the vastus lateralis muscle was imaged whilst running using a fixated probe connected to a smart phone. The image quality was quantified by estimation of the probe-skin contact preservation and the field-of-view stability. Moreover, the pennation angles and muscle thicknesses were computed automatically. Long-term dynamic acquisition was successful in nine out of ten runners. Probe-skin contact loss ranged between 0 and 57% of the gait cycle. The biggest change in field-of-view occurred during the first kilometer with an average decline in complex-wavelet structural similarity index of 0.21, followed by an onward total decrease of 0.09, on average. The mean pennation angle and thickness were approximately constant, with the average fluctuation being 0.94 degrees and 0.11 cm, respectively. The feasibility of long-term musculoskeletal function analysis has been demonstrated, with probe-skin contact loss the main limiting factor. Dynamic, hands-free ultrasound might enable research for a more profound insight in the prevention and rehabilitation of musculoskeletal injuries.

High Prevalence of Hip and Knee Arthroplasty in Former Professional American Style Football Players: A Call to Action.

High Prevalence of Hip and Knee Arthroplasty in Former Professional American Style Football Players: A Call to Action.