Potential Risk Factors For Injury Research Articles

BABY SAFETY SHOWER: A UNIQUE FORMAT FOR PROVIDING PEDIATRIC INJURY PREVENTION EDUCATION.

Objective The purpose of this project is to provide injury prevention education to first-time parents of infants less than 6 months of age in a baby safety shower format and to evaluate the effectiveness of this format in knowledge retention. Methods Participants included first-time parents either in pregnancy or with a child less than 6 months of age. Participants completed an information form that included questions about potential risk factors for injuries. Each participant was given a pretest to determine the basic knowledge of childhood safety information and received a bath thermometer, toilet lock, outlet covers, cabinet locks, door knob covers, and a car seat. Medical health care professionals presented brief lectures on cardiopulmonary resuscitation, crib safety and sudden infant death syndrome, toy safety, choking hazards, water safety, smoke detectors, poisonings, stress management and shaken baby syndrome, firearm safety, and car seats. A follow-up (post-test) telephone call was made 1 month after the shower. Analysis of the most frequent questions missed on the pretest was compared with the percent correct increase of the same questions on the post-test, using the z-test of proportions. Results A total of 24 caregivers participated in two separate baby safety showers. Of the 24 pretests, the most common question missed was the temperature that a water heater should be set to prevent scalding. Only 50% answered this question correctly. However, 83% correctly responded on the post-test (z = 1.50, p = .12). The second most incorrectly answered question was about the safe positioning of infants during sleep. Seventy-one percent answered this question correctly on the pretest. This same question on the post-test was answered 100% correctly (z = 1.63, p = .10). Seventy-one percent of participants believed that it is safe for an infant to sleep in the bed with an adult on the pretest compared with the post-test, in which all of the participants answered this statement to be false. All of the participants believed that smoking around infants is harmful on the pretest and post-test. There was a 50% response rate for the post-test. Conclusion Caregivers can learn important safety information about childhood injury prevention in a baby safety shower format. Individual questions demonstrated 33% and 29% improvements in the knowledge of safety water temperature and sleeping positions, respectively (although attrition during post-testing reduced statistical power below our planned detection limits). We believe that the baby shower format is an effective educational intervention.

Determining the intra- and inter-observer reliability of screening tools used in sports injury research

Sports injury etiological studies explore the relationships between potential injury risk factors and injury outcomes. The ability of such studies to clearly identify intrinsic risk factors for sports injury depends on the accuracy of their measurement. Measurements need to be reproducible over time and repeatable by different observers, as well as within a given individual. The importance of the reliability of pre-participation screening protocols and other clinical assessment tools has been identified in a number of published studies. However, a review of these studies indicates that a variety of statistical techniques have been used to calculate intra- and inter-observer reliability. While the intra-class correlation coefficient (ICC) is the most often cited measure, a range of statistical approaches to estimating ICCs have been used. It is therefore difficult to determine which statistical method is most appropriate in the context of measuring intrinsic risk factors in sports injury research. This paper summarises a statistical method for the concurrent assessment of intra- and inter-observer reliability and presents an argument for why this approach should be adopted by sports injury researchers using screening protocols that collect continuous data.

Recomendaciones para el entrenamiento y prevención de lesiones en gimnastas de rítmica de elite

Objective To identify risk factors for injury in rhythmic sportive gymnastics and to provide recommendations for reducing the risk of injury. Methods A one-year retrospective survey of injuries in twenty national-level rhythmic gymnasts (ages 14.8 to 18.8 years; mean age 17.1 years). Hours of rhythmic gymnastics (RG) training per week, minutes of stretching per day, and hours of conditioning per week, were analyzed as potential risk factors for injury. Main outcome measures were injuries that required time off, major injuries (at least 7 days off), injuries to muscle-tendon units, and fractures. Results Thirteen (65%) of 20 gymnasts sustained timeloss injuries, and 4 gymnasts (20%) reported major injuries. Seventeen (85%) gymnasts reported muscle-tendon unit injuries and 5 (25%) suffered fractures. Sixteen (80%) of the gymnasts reported back pain or stress fractures of the back, 8 of whom required time off training. One gymnast (5%) incurred a concussion. Logistic regression indicated that rhythmic gymnastics training and stretching were associated with muscle-tendon unit injury. On multivariate analysis, stretching was found to be the only independent predictor of muscle-tendon unit injuries with each additional minute lowering the risk by approximately 10% (p ≤ 0.01). Conditioning and stretching were both independent predictors of fractures. The risk of fracture was estimated to increase by over 60% for each additional hour of weekly conditioning (odds ratio = 1.62, p = 0.03) and decrease by almost 20% for each additional minute of daily stretching (odds ratio = 0.81, p = 0.04). None of the variables studied were predictive of back pain or injury. Conclusions: Injuries in rhythmic gymnastics may be reduced by increasing the amount of time spent stretching per day (at least 40 minutes), and limiting conditioning to a maximum of 6 hours per week.

Musculoskeletal Modeling and Dynamic Simulation of the Thoroughbred Equine Forelimb During Stance Phase of the Gallop

Because thoroughbred racehorses have a high incidence of forelimb musculoskeletal injuries, a model was desired to screen potential risk factors for injuries. This paper describes the development of a musculoskeletal model of the thoroughbred forelimb and a dynamic simulation of the motion of the distal segments during the stance phase of high-speed (18 m/s) gallop. The musculoskeletal model is comprised of segment, joint, muscle-tendon, and ligament information. The dynamic simulation incorporates a proximal forward-driving force, a distal ground reaction force model, muscle activations, and initial positions and velocities. A simulation of the gallop after transection of an accessory ligament demonstrated increased soft tissue strains in the remaining support structures of the distal forelimb. These data were consistent with those previously reported from in vitro experimental data and supported usefulness of the model for the study of distal forelimb soft tissue mechanics during the stance phase of the gallop.

Risk factors for agricultural injury: a case-control analysis of Iowa farmers in the Agricultural Health Study.

The purpose of this case-control study nested in the Agricultural Health Study was to assess risk factors for agricultural injury among a large group of Iowa farmers. A questionnaire sent to 6,999 farmers identified 431 cases who had a farm work-related injury requiring medical advice/treatment in the previous year and 473 controls who had no injury in the previous year. We assessed several potential risk factors for injury. A multiple logistic regression analysis showed significant associations between farm work-related injury and weekly farming work hours (> or = 50 hours/week) (OR = 1.65; 95% CI = 1.23-2.21), the presence of large livestock (OR = 1.77; 95% CI = 1.24-2.51), education beyond high school (OR = 1.61; 95% CI = 1.21-2.12), regular medication use (OR = 1.44; 95% CI = 1.04-1.96), wearing a hearing aid (OR = 2.36; 95% CI = 1.07-5.20), and younger age. These results confirm the importance of risk factors identified in previous analytic studies and suggest directions for future research in preventive intervention strategies to reduce farm work-related injuries.

MULTIVARIATE ANALYSIS OF INTRINSIC INJURY RISK FACTORS IN A COHORT OF US ARMY BASIC TRAINEES

Previous studies of injuries in basic combat training (BCT) have predominately examined only individuals completing the training. In this study we used survival analysis to adjust for time at risk of injury so the entire BCT population could be examined regardless of whether or not the individual completed training. Potential intrinsic injury risk factors were examined among 675 men participating in the newly lengthened 9-week BCT cycle during the summer of the year 2000. Injury data were obtained from a review of the subjects' medical records at the conclusion of training. Potential injury risk factors were obtained prospectively from records in the basic training units. Data were analyzed using Cox regression, with time to the first time-loss injury as the dependent variable. Continuous risk factor variables were converted into quartiles (Q). Only 12 percent of the cohort experienced time-loss injury. Univariate Cox regressions showed that push-up performance on entry to BCT, 2-mile run performance on entry to BCT, exercise history prior to BCT, and cigarette smoking history were related to time to injury (p < 0.01); age, stature, body mass, body mass index, and sit-up performance were not (p>0.10). Stepwise multivariate Cox regression showed that slower 2-mile run performance and cigarette smoking history were independently related to time to injury. Adjusted risk ratios and 95 percent confidence intervals (in parentheses) from the multivariate analysis were as follows: 2-mile run performance - Q1 = 1.0, Q2 = 1.5(0.6–3.6), Q3 = 3.6(1.6–7.9)*, Q4(slow) = 3.4(1.6–7.6)*; cigarette smoking in year before BCT - None = 1.0, Quit = 2.1(1.0–4.1)*, < 10 cig/day = 1.6(0.8–3.3), > 10 cig/day = 2.1(1.2–3.7)* [where * indicates p < 0.05 compared to level with risk ratio of 1.0]. These data indicate that aerobic endurance and cigarette smoking history are independent risk factors for time loss injury among men participating in a 9-week US Army BCT cycle.

Biomechanical risk factors for exercise-related lower limb injuries.

There is a significant risk of injury when undertaking physical activities. Abnormal biomechanics of the lower limb has been implicated as a causative factor for injury. Although there have been a large number of studies in this field, many lack consistency of definitions and methodology. A large number of these studies have been retrospective, and it is often impossible to identify the baseline population. The evidence suggests that limitation of range of ankle dorsiflexion, limitation of range of hip eversion, excessive joint laxity, leg length discrepancy, an excessively supinated or pronated foot, excessively high or low arches of the foot and a large Q-angle are risk factors for injury. On the other hand, there is little convincing evidence that an abnormal range of ankle plantar flexion, genu varum or valgum or undue muscle tightness may be potential risk factors. All of these biomechanical abnormalities need further evaluation as potential risk factors for injury. Any trials undertaken must endeavour to define and describe their methods fully, and ensure that their results are reproducible.

Risk Factors Associated with Stress Reactions in Female Marines

Women have a higher stress fracture rate than men in military studies, although the exact cause of this is not clear. Hyperpronation has been implicated as a potential risk factor for injury. In this prospective observational study, we measured subtalar joint range of motion in 101 women (ages 20-27 years) enrolled in Marine Corps Officer Candidate School in June 1994. The purpose of this study was to identify risk factors for injury in female Marine Corps officer candidates. The primary area of interest was the association between the amount of subtalar joint range of motion and stress reactions. Questionnaires were administered that explored previous physical activities, sports participation, and menstrual history. Anthropometric measurements were performed, including subtalar joint range of motion. During the 10 weeks of physical training, 11.5% of the women (N = 12) had stress reactions compared with 7% of the men (N = 10). There was no statistically significant difference in the means of subtalar joint range of motion in the stress reaction group compared with the non-stress reaction group. Differences in stress reaction rate across quartiles of subtalar joint range of motion were not significant. Those women who ran fewer miles (< or = 2.8 miles per session) before training had a higher rate of stress reactions (p < 0.04). Younger individuals (< 23 years) had a higher rate of stress reactions (p < 0.01). Women with fewer menstrual periods (< 10 per year) had a higher rate of stress reactions (p < 0.02). A narrow pelvis (< or = 26 cm) was associated with a higher rate of stress reactions (p < 0.09). We conclude that an increased subtalar joint range of motion is not a risk factor for stress reactions in women. However, further studies with a larger study population should be performed to confirm these findings.

Injuries Associated With Three-Wheeled, All-Terrain Vehicles, Alaska, 1983 and 1984

From January 1983 through December 1984, twenty deaths and at least 534 injuries in Alaska were associated with three-wheeled, all-terrain vehicles. Age at death ranged from 12 to 53 years; 15 deaths (75%) were in the 15- to 34-year age group. Of the 20 fatalities, 12 (60%) might have been prevented had the riders been wearing a helmet. Alcohol use was detected or highly suspected as the major contributing cause of the fatal crash for 12 of 15 drivers and three of five female passengers. Potential risk factors for injuries associated with all-terrain vehicles include alcohol use, failure to use helmets, rider inexperience and inattention, and excessive speed.