Risk Of Musculoskeletal Injury Research Articles

The association between Thoroughbred racehorse training practices and musculoskeletal injuries in Victoria, Australia.

Catastrophic musculoskeletal injuries (CMI) in horses are associated with both too little and too much high-speed exercise. In order to advise trainers on training and management strategies that minimize the risk of musculoskeletal injury (MSI), a better understanding of how training practices affect MSI in racehorses is needed. Data from prospective studies relating training data and MSI are complicated by the gradual development of pathology and the effect of this on the ability of horses to train consistently prior to the identification of an injury. To circumvent this, 66 Australian Thoroughbred trainers were surveyed on their intended training practices, including rest, pre-training, and race-fit practices. Associations between intended training practices and catastrophic and non-catastrophic race day MSI outcomes in two-year-old and mature (≥three-year-old) horses were assessed using multivariable negative binomial regression models. The incidence of two-year-old race day MSI was lower for trainers who preferred shorter times (weeks) to trial, less time in fast work pre-trial (p = 0.003), shorter, more frequent rest periods (p < 0.01) and higher amounts of fast work at 15.5-16.7 m/s once race-fit (p = 0.001). The incidence of mature horse race day MSI was lower for trainers who preferred longer rest periods (p = 0.026) and a high-volume pre-trial training strategy comprising a high volume of slower speed gallop training and longer times to trial compared to fast and light training programs (p = 0.004) for their mature horses, in addition to higher amounts of fast work at 15.5-16.7 m/s for their race-fit two-year-olds (p = 0.012). Race day CMI incidence was lower for trainers who preferred lower volumes of fast gallop work for their race-fit mature horses (p < 0.05). These results suggest that two-year-old training practices could affect MSI risk later in a horse's career, and that age and stage in training (pre-trial, race-fit) are important considerations when developing training practices to minimize the risk of MSI.

Effects of COVID-19 on Rate of Injury and Position-Specific Injury During the 2020 National Football League Season.

Costello II, JP, Wagner, JD, Dahl, VA, Cohen, JL, Reuter, AM, and Kaplan, LD. Effects of COVID-19 on rate of injury and position-specific injury during the 2020 National Football League season. J Strength Cond Res XX(X): 000-000, 2023-Because of the COVID-19 pandemic, the National Football League (NFL) made changes to its operations for the 2020 season. We hypothesize an increase in the rate of injuries during the 2020 season. Publicly available data were reviewed to identify NFL injuries from the 2015-2020 seasons. Player position, description of injury, date of injury, and injury setting were recorded. p ≤ 0.05 was considered statistically significant. For the 2020 season, compared with the 2015-2019 seasons, there was an increased risk of injury during the regular season overall relative risk (RR) = 1.308 (p < 0.05), week (W)1 RR = 7.33 (p < 0.05), W1-6 RR = 1.964 (p < 0.05), W7-12 RR = 1.8909 (p < 0.05), and during the postseason overall RR = 1.1444 (p < 0.05), calculated using analysis of variance. There was an overall increased risk of abdominal or core injuries RR = 1.248 (p < 0.05), groin or hip injuries RR = 2.534 (p < 0.05), and hamstring injuries RR = 3.644 (p < 0.05). There was an increased risk of hamstring injuries in cornerbacks RR = 3.219 (p < 0.05) and running backs RR = 1.1394 (p < 0.05), hip or groin injuries in guards RR = 1.105 (p < 0.05), Achilles tendon injuries in safeties RR = 1.6976 (p < 0.05), quadriceps injuries in running backs RR = 1.6191 (p < 0.05), and arm injuries in defensive tackles RR = 1.221 (p < 0.05). There was an increase in the overall rate of injuries in the 2020 NFL season, both in the regular season and postseason, compared with the 2015-2019 seasons. The overall rate of abdominal or core, groin or hip, and hamstring injuries increased. Specific player positions saw unique increases in rates of injuries. These findings may be due to numerous operational changes implemented, such as reduced in-person training and the elimination of the preseason, leading to suboptimal, sports-specific conditioning and increased risk of musculoskeletal injury.

Reliability and Measurement Error of the Qualitative Analysis of Single Leg Loading (QASLS) Tool For Unilateral Tasks.

Movement quality assessment is popular within clinical and sporting practice, due to the contribution diminished or suboptimal movement quality is believed to have on musculoskeletal (MSK) injury risk. Various movement quality assessments exist, many are limited to bilateral or jumping movements evaluation. Qualitative analysis of single leg loading (QASLS) is a new clinical assessment tool for unilateral tasks that utilizes a dichotomous scoring system of ten questions relating to the segmental body regions of the trunk, lower and upper limb. To determine the intra and inter-rater, within- and between-session reliability of the QASLS tool during two unilateral movement tasks, and provide insight to measurement error and smallest detectable difference (SDD). Reliability Study. Fifteen healthy females (mean age 19 years SD2; height 167 cm, +/- 6; weight 56 kg, +/- 6) completed two unilateral tasks, single leg squat (SLS) and single leg landing (SLL), within session data collection occurred on the same day, with between session data collection occurring seven days later. Tasks were scored with the QASLS tool via video playback. Intra-Class correlation coefficients (ICCk,3) were used to measure within and between session reliability, and Kappa coefficients and percentage of exact agreement (PEA%) were used to determine intra and inter-rater reliability. Standard error of measurement (SEM) and the SDD for the compound score of each limb was calculated. Within session reliability of QASLS scores was good (ICC = 0.82-0.86) for SLS and moderate (ICC = 0.67-0.87) for SLL. Between session reliability was moderate (ICC = 0.69-0.87) for SLS and excellent (ICC = 0.92-0.93) for SLL. SEM was less than 1 point, and SDD for compound score ranging from 1.0-2.5 points. Intra-rater agreement of compound QASLS score was near perfect (k = 0.85-100; PEA% 90-100%) and agreement of individual components was substantial- near perfect (k = 0.13-0.74; PEA% 78-100%). Inter-rater agreement for compound QASLS scores ranged from non-substantial (k = 0.13-0.74; PEA% 43.3-90%) for SLS and non-slight (k =0.03-0.17; PEA% 43.3-60%) for SLL. The QASLS movement analysis tool can be used to analyze movement quality during two unilateral loading tasks with moderate to excellent within and between session reliability. PEA% was acceptable for inter-rater agreement, however rater education training is recommended to develop more acceptable levels of reliability. 3.

Throwing Shoulder Adaptations Are Not Related to Shoulder Injury or Pain: A Preliminary Report.

Overhead throwing in baseball and softball athletes induces shoulder adaptations theorized to increase risk of shoulder musculoskeletal injury (MSI) and/or pain due to range of motion (ROM) deficits. Shoulder ROM adaptations are associated with a higher risk for developing shoulder MSI and pain. Prospective cohort study. Level 3. A total of 60 National Collegiate Athletic Association Division I athletes cleared for full athletic participation and free from upper extremity MSI in the last 4 weeks (age, 19.0 ± 1.2 years; weight, 82.1 ± 13.7 kg; height, 178.6 ± 11.2 cm; softball, n = 23; baseball, n = 37). Passive glenohumeral internal rotation (IR), external rotation (ER), and horizontal adduction (HA) ROM were measured with the scapula stabilized and used to categorize participants with/without external rotation gain (ERG), external rotation insufficiency (ERI), glenohumeral internal rotation deficit (GIRD), pathological GIRD, and posterior shoulder tightness (PST) before the competitive season. Groups were then compared to assess the incidence of shoulder MSI prospectively and prevalence of shoulder pain at the initial evaluation. Baseball and softball athletes demonstrated significantly less IR ROM in the dominant shoulder (50.6° ± 9.4°) compared with the nondominant shoulder (59.1° ± 8.6°; P < 0.01) and significantly more ER ROM (dominant, 104.6° ± 12.1°; nondominant, 97.7° ± 12.0°; P < 0.01). Incidence of shoulder MSI was 15% but was not significantly related to any shoulder adaptations. No significant relationship was found between prevalence of pain and any shoulder adaptations in the 27% of athletes with pain. Increased ER and decreased IR ROM adaptations in intercollegiate overhead throwing athletes do not appear to be correlated to risk of shoulder MSI or pain. The findings of this level 3 prospective study provide clinicians working with overhead athletes information regarding shoulder MSI risk and pain. It is recommended that clinicians should not use ROM adaptations exclusively to determine increased risk of shoulder MSI.

Musculoskeletal Injuries in the Endoscopy Practitioner Risk Factors, Ergonomic Challenges and Prevention—Narrative Review and Perspectives

GI endoscopy forms an important part in the daily practice of a gastroenterologist. Musculoskeletal injuries related to GI endoscopy are on the rise. Observational studies and surveys depict the importance of a proper ergonomic environment when performing GI endoscopy. Our aim is to describe the pathophysiology, risk factors and possible preventive measures to reduce the risk of musculoskeletal injuries during gastrointestinal (GI) endoscopy. We review the most relevant studies that outline the gravity of the problem. A detailed analysis of proposed ergonomic recommendations is performed, outlining crucial steps in injury prevention. Proper ergonomic education is a key step in preventing occupational injury. Robotics and other mechanical solutions offer a variety of approaches to tackling the ergonomic challenge. Implementing proper ergonomic education and mechanical solutions lowers the possibility of occupational injury. The strategies and appliances presented are beneficial to all GI endoscopy practitioners.

Errors in Augmented Reality Interactions Affected Muscular Loads in the Neck and Shoulders

The use of augmented reality (AR) head-mounted displays is becoming increasingly prevalent due to their ability to provide interactive experiences with high degrees of freedom. However, AR interactions have been shown to be associated with increased biomechanical loads in the neck and shoulders. This repeated-measures study evaluated the effects of interaction errors on neck and shoulder biomechanical loads during AR tasks. Twenty participants performed two standardized AR tasks (omni-directional pointing and cube placing) with and without AR interaction errors. During the tasks, neck and shoulder angles and muscle activity were collected. The results showed that the presence of errors led to increased neck extension and shoulder flexion angles. Peak muscle activity in the shoulders (anterior and medial deltoids) also increased with errors. These findings highlight the importance of reducing interaction errors in AR interfaces to minimize risks of musculoskeletal discomfort and injuries in the neck and shoulders

NIOSH research efforts to prevent work-related Musculoskeletal Disorders

NIOSH researchers are pioneering the study of musculoskeletal health as professional ergonomists. We examine physical and social components of work environments to mitigate musculoskeletal injury risks. Part of our mission is to reduce the burden of work-related musculoskeletal disorders (MSDs) through a focused program of research and prevention that protects workers from MSDs, helps management mitigate related risks and liabilities, and helps practitioners improve the efficacy of workplace interventions. The purpose of this discussion panel is to disseminate research findings and recommendations (1) to practitioners to interpret and apply the results of research to real-world problems, and (2) to inspire researchers to continue their efforts to protect the millions of workers at risk.

Postpartum Women’s Perceptions of Risk of Musculoskeletal Injuries in the Canadian Armed Forces: A Qualitative Research Study

Musculoskeletal injuries (MSKi) are a major concern within military forces, significantly reducing productivity and military readiness. Within the Canadian Armed Forces (CAF), MSKi are the most common cause of delayed deployment of members. There is a lack of research specifically focused on the experiences of postpartum CAF members and their perceived risk of MSKi. Drawing on Giles et al.’s equity-centered 4 E’s injury prevention framework (education, engineering, enforcement, and equity), we highlight that individuals who experience pregnancy may perceive themselves to be at heightened risk of injury due to sex and gender-based inequities in their workplace. This qualitative research draws on data from focus groups with 32 individuals who experienced pregnancy while serving in the CAF. Using reflexive thematic analysis, we identified the following findings related to perceived increased risk of MSKi: (a) nature of relevant physiological and anatomical changes in pregnancy, (b) unreasonable pressures to return to work at peak physical readiness, and (c) perceived challenges associated with accessing resources and services to support physical recovery. There are opportunities to improve access to injury prevention resources and support for pregnant and postpartum CAF members to reduce rates of MSKi. Findings from this study may be additionally relevant to armed forces more broadly or other professions that require return to physical readiness.

Anomalous Incidence of Fatal Musculoskeletal Injury in North American 2-Year-Old Thoroughbred Racehorses in the Year 2020.

Racehorse training and racing schedules in many parts of the United States and Canada were interrupted or otherwise reduced during the first three to six months of 2020. This was an indirect consequence of mitigations to prevent the spread of the pandemic virus COVID-19. Data from the Equine Injury Database, a census-level survey of all race starts made in the USA and Canada, were used to analyse the incidence of fatalities in 2009-2022 among three age cohorts of racehorses within each year. There was a statistically significant increase in the incidence of musculoskeletal fatalities among 2-year-old Thoroughbreds in 2020, compared to the period 2009-2019. In 2021 and 2022, the training schedules of 2-year-old horses returned to pre-2020 levels, as did the incidence of fatalities. The delayed start to training for 2-year-old horses was associated with an increase in risk of fatal musculoskeletal injury for those horses during 2020, but the risk for the same horses in 2021-when they were 3 years old-was not significantly different to the risk for 3-year-olds in any other year. The increased risk of fatal musculoskeletal injury in 2020 was only found among horses that were 2 years old in 2020-horses aged 3 years or more in 2020 were not at increased risk.

Timing Differences in Stride Cycle Phases in Retired Racehorses Ridden in Rising and Two-Point Seat Positions at Trot on Turf, Artificial and Tarmac Surfaces.

Injuries to racehorses and their jockeys are not limited to the racetrack and high-speed work. To optimise racehorse-jockey dyads' health, well-being, and safety, it is important to understand their kinematics under the various exercise conditions they are exposed to. This includes trot work on roads, turf and artificial surfaces when accessing gallop tracks and warming up. This study quantified the forelimb hoof kinematics of racehorses trotting over tarmac, turf and artificial surfaces as their jockey adopted rising and two-point seat positions. A convenience sample of six horses was recruited from the British Racing School, Newmarket, and the horses were all ridden by the same jockey. Inertial measurement units (HoofBeat) were secured to the forelimb hooves of the horses and enabled landing, mid-stance, breakover, swing and stride durations, plus stride length, to be quantified via an in-built algorithm. Data were collected at a frequency of 1140 Hz. Linear Mixed Models were used to test for significant differences in the timing of these stride phases and stride length amongst the different surface and jockey positions. Speed was included as a covariate. Significance was set at p < 0.05. Hoof landing and mid-stance durations were negatively correlated, with approximately a 0.5 ms decrease in mid-stance duration for every 1 ms increase in landing duration (r2 = 0.5, p < 0.001). Hoof landing duration was significantly affected by surface (p < 0.001) and an interaction between jockey position and surface (p = 0.035). Landing duration was approximately 4.4 times shorter on tarmac compared to grass and artificial surfaces. Mid-stance duration was significantly affected by jockey position (p < 0.001) and surface (p = 0.001), speed (p < 0.001) and jockey position*speed (p < 0.001). Mean values for mid-stance increased by 13 ms with the jockey in the two-point seat position, and mid-stance was 19 ms longer on the tarmac than on the artificial surface. There was no significant difference in the breakover duration amongst surfaces or jockey positions (p ≥ 0.076) for the ridden dataset. However, the mean breakover duration on tarmac in the presence of a rider decreased by 21 ms compared to the in-hand dataset. Swing was significantly affected by surface (p = 0.039) and speed (p = 0.001), with a mean swing phase 20 ms longer on turf than on the artificial surface. Total stride duration was affected by surface only (p = 0.011). Tarmac was associated with a mean stride time that was significantly reduced, by 49 ms, compared to the turf, and this effect may be related to the shorter landing times on turf. Mean stride length was 14 cm shorter on tarmac than on grass, and stride length showed a strong positive correlation with speed, with a 71 cm increase in stride length for every 1 m s-1 increase in speed (r2 = 0.8, p < 0.001). In summary, this study demonstrated that the durations of the different stride cycle phases and stride length can be sensitive to surface type and jockey riding position. Further work is required to establish links between altered stride time variables and the risk of musculoskeletal injury.

Effects of error rates and target sizes on neck and shoulder biomechanical loads during augmented reality interactions

Augmented reality (AR) interactions have been associated with increased biomechanical loads on the neck and shoulders. To provide a better understanding of the factors that may impact such biomechanical loads, this repeated-measures laboratory study evaluated the effects of error rates and target sizes on neck and shoulder biomechanical loads during two standardized AR tasks (omni-directional pointing and cube placing). Twenty participants performed the two AR tasks with different error rates and target sizes. During the tasks, angles, moments, and muscle activity in the neck and shoulders were measured. The results showed that the target sizes and error rates significantly affected angles, moments, and muscle activity in the neck and shoulder regions. Specifically, the presence of errors increased neck extension, shoulder flexion angles and associated moments. Muscle activity in the neck (splenius capitis) and shoulder (anterior and medial deltoids) also increased when the errors were introduced. Moreover, interacting with larger targets resulted in greater neck extension moments and shoulder abduction angles along with higher muscle activity in the splenius capitis and upper trapezius muscles. These findings indicate the importance of reducing errors and incorporating appropriate target sizes in the AR interfaces to minimize risks of musculoskeletal discomfort and injuries in the neck and shoulders.

Analisis Postur Kerja Karyawan Produksi Sepatu Olahraga Menggunakan Metode Novel Ergonomic Postural Assessment pada Karyawan Ruang Produksi UD. XYZ Gresik

This research is discussed about the analysis of work posture in small-medium industries that produce sports shoes. UD XYZ Gresik is one of the companies in the athletic shoe industry that receives requests for shoes every day. Working hours for 9 hours with a break time of 1 hour. Production targets are sometimes not achieved, causing employees to work overtime. Along with the targets that must be achieved every day, employees in the shoe production room have to sit for a long time during working hours. Long working hours have an impact on musculoskeletal disorders, especially back pain. Working posture (sitting position) and length of work are factors that affect physical ability which continues to decline. Thus resulting in absenteeism and economic losses caused by a decrease in work capacity and a decrease in employee productivity. Novel Ergonomic Postural Assessment as an ergonomics method used as a tool to analyze the risk of ergonomics and working posture in the upper body to reduce the risk of musculoskeletal injuries in the production process. The results showed that the value of the first working posture was 6 (work posture needs further research and action is needed in the near future). For the second working posture, the final NERPA score was 7 (work posture needs to be checked further and action taken as soon as possible). Both of these scores require improvement due to the risk of severe musculoskeletal disorders.

Increased Barefoot Stride Variability Might Be Predictor Rather than Risk Factor for Overuse Injury in the Military.

Footwear usage could be a promising focus in reducing musculoskeletal injury risk in lower extremities commonly observed among the military. The goal of this research was to find potential gait-related risk factors for lower leg overuse injuries. Cases (n = 32) were active-duty infantry soldiers who had suffered an overuse injury in the previous six months of service before enrolling in the study. The control group (n = 32) included infantry soldiers of the same age and gender who did not have a history of lower leg overuse injury. In the gait laboratory, individuals were asked to walk on a 5-m walkway. Rearfoot eversion, ankle plantar/dorsiflexion and stride parameters were evaluated for barefoot and shod conditions. Barefoot walking was associated with higher stride time variability among cases. According to the conditional regression analysis, stride time variability greater than 1.95% (AUC = 0.77, 95% CI (0.648 to 0.883), p < 0.001) during barefoot gait could predict lower leg overuse injury. Increased barefoot gait variability should be considered as a possible predictive factor for lower leg overuse injury in the military, and gait with military boots masked stride-related differences between soldiers with and without lower leg overuse injury.

Prevalence of Shoulder and Neck Pain Among Healthcare Workers in the Central Region of Saudi Arabia.

Introduction Musculoskeletal disorders (MSDs) have a tremendous impact on working people and are becoming a serious problem in the modern society. The healthcare system is regarded as having one of the most physically demanding jobs, and the risk of musculoskeletal injuries is high. Irrespective of their age, healthcare workers (HCWs) worldwide frequently experience shoulder and neck pain. In our study, we sought to understand what initiates shoulder and neck pain, such as stress or environmental factors, and what causes shoulder and neck discomfort among Saudi Arabian healthcare professionals. Methods A descriptive, cross-sectional study was conducted from 2022 to 2023, assessing shoulder and neck pain among healthcare workers in the central region of Saudi Arabia. An online survey was used, with 409 participants aged 20 or older. The questionnaire included socio-demographic data, Shoulder Pain and Disability Index (SPADI) questionnaire to measure shoulder pain and disability, neck Bournemouth questionnaire (NBQ) to assess neck pain, and quadruple visual analogue scale (QVAS) to measure the intensity of pain. Results Of the 409 HCWs, 56% were males, and 56.5% belonged to the age group of 20-30 years. The prevalence of high-intensity pain based on QVAS criteria was 29.3%. The mean percentage of neck pain (32.3%) was slightly higher than shoulder pain (31.8%). There was a significant association between the level of pain intensity in terms of the total score of NBQ, SPADI score, and its dimensions. It is interesting to know that HCWs with associated chronic diseases had higher scores in all three questionnaires (NBQ, SPADI, and QVAS). Conclusion High-intensity musculoskeletal pain was relatively high among HCWs. It was found that neck pain affected HCWs more than shoulder pain. Furthermore, an increased pain intensity in the shoulder and neck was more frequently seen in HCWs with chronic diseases. More studies are needed to determine the causes and risk factors for neck and shoulder pain to help improve the healthcare system and patient care.

Deep learning-based estimation of whole-body kinematics from multi-view images

It is necessary to analyze the whole-body kinematics (including joint locations and joint angles) to assess risks of fatal and musculoskeletal injuries in occupational tasks. Human pose estimation has gotten more attention in recent years as a method to minimize the errors in determining joint locations. However, the joint angles are not often estimated, nor is the quality of joint angle estimation assessed. In this paper, we presented an end-to-end approach on direct joint angle estimation from multi-view images. Our method leveraged the volumetric pose representation and mapped the rotation representation to a continuous space where each rotation was uniquely represented. We also presented a new kinematic dataset in the domain of residential roofing with a data processing pipeline to generate necessary annotations for the supervised training procedure on direct joint angle estimation. We achieved a mean angle error of 7.19° on the new Roofing dataset and 8.41° on the Human3.6M dataset, paving the way for employment of on-site kinematic analysis using multi-view images.

Poster 383: Incidence of Sports Related Tendon Ruptures in the United States

Objectives: Physical activity is known to have multiple beneficial health effects, including a reduced risk of cardiovascular disease, improved insulin sensitivity and cognitive function [1,2]. Sports participation inherently increases the risk of musculoskeletal injury, including tendon rupture [3]. Tendon ruptures can be debilitating injuries and often require multidisciplinary treatment and long recovery periods and potentially lead to significant reductions in quality of life, lost productivity, and considerable healthcare costs [4]. Previous studies have been focused primarily on specific types of tendon injuries and/or specific patient populations such as high-level athletes and military trainees, which is not generalizable to the US population [5-8]. There currently exist no updated, population-based studies describing the incidence and demographics of all athletic/sports-related tendon ruptures in the general US population. The purpose of this study was to describe the contemporary epidemiology of athletic tendon ruptures in the US in the most recent two decades using a nationally representative sample. Methods: The NEISS database, a nationally representative sample of US hospital emergency departments was used to ascertain the incidence rates of various types of tendon ruptures in the Unites States. All cases from 2001-2020 were reviewed for case narratives to select only those cases with a clear diagnosis of an acute primary tendon rupture. After exclusions, a total of n=5,765 unweighted cases were identified, representing a national estimate of N=235,189 tendon ruptures (95% CI=186,833- 283,546). Finally, each case narrative was manually reviewed and cross-referenced with the case’s product codes to assign a primary injury mechanism to each patient record, and only those cases involving exercise-/sports-related injury mechanisms were included in the final analyses. Statistical analysis was performed using the survey data commands in Stata/IC, version 17.0 (StataCorp, College Station, TX, US), accounting for sample weights and the complex survey designs. The incidence rate (IR) of tendon ruptures and mechanism were calculated and chi-square tests were used to compare estimated IRs between groups. Student t-test/analysis of variance and design-adjusted Rao-Scott chi- square analysis was used for direct comparisons of means for continuous variables and proportions for categorical variables, respectively [9,10]. Temporal trends and annual percentage changes were assessed via regression analysis. Results: An estimated total of 141,382 individuals (95% CI=107,478-175,286) presented to US EDs with a sports-related tendon rupture over the study period for an overall incidence of 22.9 Person-Years at-risk (PYR) (95% CI=17.4-28.3). Mean age was 37.7 years (95% CI=37.0-38.5). Peak incidence of tendon ruptures occurred in the fourth decade and persons aged 20-40 years accounted for a majority of cases (78.2%). Achilles tendon rupture was the most common injury, representing over half of all cases (55.9%). Basketball was the most common sports-related injury mechanism, accounting for more than one-third of all injuries (36.6%) and a common mechanism for all tendon ruptures of the lower extremity. For sports-related injuries involving upper extremity tendons, weight lifting was the most common mechanism for most, including biceps, rotator cuff, and triceps/pectoralis tendon ruptures. Nearly half of all injuries occurred in contact sports (46.8%). The annual incidence of all sports-related tendon ruptures in the US increased significantly from 2001 to 2020 (AAPC=1.9, 95% CI=1.0-2.8; P&lt;0.01). For comparison, the annual incidence of all non-sports-related tendon ruptures also increased significantly over the same time period (AAPC=4.9, 95% CI=3.7-6.1; P&lt;0.01), and in fact increased at a significantly higher rate than that of all sports-related ruptures (P&lt;0.01). Complete national injury estimate data for each specific type of sport or recreational activity, overall and for each type of tendon rupture, is reported in the Supplement Tables (Supplement 5,6). Conclusions: Tendon ruptures can be debilitating injuries for all patients and can especially affect personal and team performance of competitive athletes to differing degrees depending on the athlete’s particular sport [11]. There is a paucity of population-based studies describing the incidence and demographics of all athletic/exercise-related tendon ruptures in the general US population. This study highlights an increasing annual incidence of athletic tendon ruptures over the last two decades in the US, primarily affecting males of many different age groups. The incidence of nearly all types of tendon ruptures was significantly higher in males when compared with females, which is generally consistent with previous studies involving other large patient populations [12-16]. Previous population-based studies demonstrating an increased incidence of tendon ruptures in recent years have attributed these trends in part to increased athletic participation among adults of various ages [16–18]. Our results show the same trends and are likely attributed to increased participation in athletics, as well as the growing popularity of unconventional sports. [Table: see text][Table: see text][Table: see text][Table: see text]

Sex differences in musculoskeletal injury epidemiology and subsequent loss of tactical readiness during Marine Corps Officer Candidates School

IntroductionThe US Marine Corps (USMC) Officer Candidates School (OCS) is a 10-week training course for Marine Officer Candidates (MOCs). OCS training is rigorous and demanding, which results in a high...

Automated Classification of the Phases Relevant to Work-Related Musculoskeletal Injury Risks in Residential Roof Shingle Installation Operations Using Machine Learning

Awkward kneeling in sloped shingle installation operations exposes roofers to knee musculoskeletal disorder (MSD) risks. To address the varying levels of risk associated with different phases of shingle installation, this research investigated utilizing machine learning to automatically classify seven distinct phases in a typical shingle installation task. The classification process relied on analyzing knee kinematics data and roof slope information. Nine participants were recruited and performed simulated shingle installation tasks while kneeling on a sloped wooden platform. The knee kinematics data were collected using an optical motion capture system. Three supervised machine learning classification methods (i.e., k-nearest neighbors (KNNs), decision tree (DT), and random forest (RF)) were selected for evaluation. The KNN classifier provided the best performance for overall accuracy. The results substantiated the feasibility of applying machine learning in classifying shingle installation phases from workers’ knee joint rotation and roof slope angles, which may help facilitate method and tool development for automated knee MSD risk surveillance and assessment among roofers.

An estimation of the endoscopist's musculoskeletal injury risk for right and left lateral decubitus positions during colonoscopy: a field-based ergonomic study

BackgroundColonoscopy exposes endoscopists to awkward postures and prolonged forces, which increases their risk of musculoskeletal injury. Patient positioning has a significant impact on the ergonomics of colonoscopy. Recent trials have found the right lateral decubitus position is associated with quicker insertion, higher adenoma detection rates, and greater patient comfort compared to the left lateral decubitus position. However, this patient position is perceived as more strenuous by endoscopists.MethodsNineteen endoscopists were observed performing colonoscopies during a series of four-hour endoscopy clinics. Durations of each patient position (right lateral decubitus, left lateral decubitus, prone, and supine) were recorded for all observed procedures (n = 64). Endoscopist injury risk was estimated by a trained researcher for the first and last colonoscopies of the shifts (n = 34) using Rapid Upper Limb Assessment (RULA), an observational ergonomic tool that estimates risk of musculoskeletal injury by scoring postures of the upper body and factors such as muscle use, force, and load. The total RULA scores were compared with a Wilcoxon Signed-Rank test for patient position (right and left lateral decubitus) and time (first and last procedures) with significance taken at p < 0.05. Endoscopist preferences were also surveyed.ResultsThe right lateral decubitus position was associated with significantly higher RULA scores than the left lateral decubitus position (median 5 vs. 3, p < 0.001). RULA scores were not significantly different between the first and last procedures of the shifts (median 5 vs. 5, p = 0.816). 89% of endoscopists preferred the left lateral decubitus position, primarily due to superior ergonomics and comfort.ConclusionRULA scores indicate an increased risk of musculoskeletal injury in both patient positions, with greater risk in the right lateral decubitus position.

Musculoskeletal Injury Risk Stratification: A Traffic Light System for Military Service Members.

Risk factor identification is a critical first step in informing musculoskeletal injury (MSKI) risk mitigation strategies. This investigation aimed to determine if a self-reported MSKI risk assessment can accurately identify military service members at greater MSKI risk and determine whether a traffic light model can differentiate service members' MSKI risks. A retrospective cohort study was conducted using existing self-reported MSKI risk assessment data and MSKI data from the Military Health System. A total of 2520 military service members (2219 males: age 23.49 ± 5.17 y, BMI 25.11 ± 2.94 kg/m2; and 301 females: age 24.23 ± 5.85 y, BMI 25.59 ± 3.20 kg/m2, respectively) completed the MSKI risk assessment during in-processing. The risk assessment consisted of 16 self-report items regarding demographics, general health, physical fitness, and pain experienced during movement screens. These 16 data points were converted to 11 variables of interest. For each variable, service members were dichotomized as at risk or not at risk. Nine of the 11 variables were associated with a greater MSKI risk and were thus considered as risk factors for the traffic light model. Each traffic light model included three color codes (i.e., green, amber, and red) to designate risk (i.e., low, moderate, and high). Four traffic light models were generated to examine the risk and overall precision of different cut-off values for the amber and red categories. In all four models, service members categorized as amber [hazard ratio (HR) = 1.38-1.70] or red (HR = 2.67-5.82) were at a greater MSKI risk. The traffic light model may help prioritize service members who require individualized orthopedic care and MSKI risk mitigation plans.