Risk Factors For Musculoskeletal Injuries Research Articles

Physical and Performance Characteristics Related to Unintentional Musculoskeletal Injury in Special Forces Operators: A Prospective Analysis.

Seventy-seven percent of musculoskeletal injuries sustained by United States Army Special Forces Operators are preventable. Identification of predictive characteristics will promote the development of screening methods to augment injury-prevention programs. To determine physical and performance characteristics that predict musculoskeletal injuries. Clinical laboratory. A total of 95 Operators (age = 32.7 ± 5.1 years, height = 179.8 ± 6.9 cm, mass = 89.9 ± 12.7 kg). Laboratory testing consisted of body composition, aerobic and anaerobic capacity, upper and lower body strength and flexibility, balance, and biomechanical evaluation. Injury data were captured for 12 months after laboratory testing. Injury frequencies, cross-tabulations, and relative risks (RRs) were calculated to evaluate the relationships between physical characteristics and injury proportions. Between-groups differences (injured versus uninjured) were assessed using appropriate t tests or Mann-Whitney U tests. Less shoulder-retraction strength (RR = 1.741 [95% confidence interval = 1.003, 3.021]), knee-extension strength (RR = 2.029 [95% confidence interval = 1.011, 4.075]), and a smaller trunk extension : flexion ratio (RR = 0.533 [95% confidence interval = 0.341, 0.831]) were significant risk factors for injury. Group comparisons showed less trunk strength (extension: P = .036, flexion: P = .048) and smaller right vertical ground reaction forces during landing ( P = .025) in injured Operators. Knee strength, aerobic capacity, and body mass index were less in the subgroup of spine-injured versus uninjured Operators ( P values = .013-.036). Knee-extension and shoulder-retraction strength were risk factors for musculoskeletal injury in Operators. Less trunk-flexion and -extension strength, higher body mass index, lower aerobic capacity, and increased ground reaction forces during landing were characteristics that may also contribute to musculoskeletal injury. Having 2 or more risk factors resulted in a greater injury proportion (χ2 = 13.512, P = .015); however, more research is needed. Athletic trainers working in the military or similar high-demand settings can use these data to augment screening and injury-prevention protocols.

THE EFFECT of ONE-ON-ONE INTERVENTION in ATHLETES with MULTIPLE RISK FACTORS for INJURY.

Lower extremity injuries in soccer players are extremely common. Implementation of group injury prevention programs has gained popularity due to time and cost-effectiveness. Unfortunately, players with greater number of risk factors are most likely to sustain an injury, yet less likely to benefit from a group injury prevention program. The purpose of this study was to determine if targeting these high risk players with one-on-one treatment would result in a reduction in the number of risk factors they possess. The authors hypothesized that fifty percent or more of subjects receiving one-on-one intervention would have a reduction of ≥1 risk factor(s). Quasi-experimental pretest-posttest design. Division I men's and women's soccer players were screened for modifiable risk factors using a battery of tests which assessed mobility, fundamental movement pattern performance, motor control, and pain. Players with ≥ 3 risk factors ("high risk") received one-on-one treatment from a physical therapist via an algorithm twice per week for four weeks. Players with < 3 risk factors ("low risk") did not receive one-on-one intervention. The proportion of treatment successes in the intervention group was 0.923 (95% CI 0.640-0.998). A significant proportion of high risk subjects (0.846) became low risk at posttest (p = 0.003). A significant between group difference was noted in risk factor change from pretest to posttest (p = 0.002), with the median risk factor change in the intervention group being -3. Utilizing one-on-one interventions designed to target evidence-based risk factors is an effective strategy to eliminate LE musculoskeletal injury risk factors in high risk individuals. 2b.

Triathlon Injuries: Transitioning from Prevalence to Prediction and Prevention.

The Ironman triathlon began in Hawaii in 1978 with 50 participants. Since then, the race has continued to grow in popularity. Injuries are very common among triathletes. Studies have looked at the relationship between injuries and many different factors. Sex, age, and morphological characteristics, such as height, weight, and body mass index, have not been shown to correlate with injury. The association between training volume and injury has shown inconsistent results. This could be due to multiple factors in study design including definitions and evaluation of training volume. Recent literature highlights the complex relationship between risk factors and injury occurrence. This article reviews the epidemiology and risk factors for musculoskeletal injuries in Ironman distance triathletes as well as general research and theories on training volume assessment and injury risk to provide recommendations for future studies and strategies for injury prevention.

The effects of load configuration, mass, and movement speed on biomechanical risk factors for musculoskeletal injuries

The effects of load configuration, mass, and movement speed on biomechanical risk factors for musculoskeletal injuries

Effect of track surface firmness on the development of musculoskeletal injuries in French Trotters during four months of harness race training

OBJECTIVE To evaluate the effect of track surface firmness on the development of musculoskeletal injuries in French Trotters during 4 months of race training. ANIMALS 12 healthy 3-year-old French Trotters. PROCEDURES Horses were paired on the basis of sex and body mass. Horses within each pair were randomly assigned to either a hard-track or soft-track group. The counterclockwise training protocol was the same for both groups. Surface firmness of each track was monitored throughout the training period. Radiography, ultrasonography, MRI, and scintigraphy were performed on all 4 limbs of each horse before and after 2 and 4 months of training. Lesions were described, and lesion severity was classified with a 5-point system, where 0 = no lesions and 4 = severe lesion. RESULTS 86 lesions were identified, of which 46 (53.5%) were classified as potentially clinically relevant (grade, ≥ 2). Of the 18 moderate and severe lesions, 15 were identified in horses of the hard-track group, and 10 of those were in forelimbs. Moderate to severe tendinopathy of the superficial digital flexor tendon of the forelimb developed in 3 of the 6 horses of the hard-track group but none of the horses of the soft-track group. Metatarsal condyle injuries were more frequent in horses of the hard-track group than horses of the soft-track group. Severe lesions were identified only in left limbs. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that track surface firmness is a risk factor for musculoskeletal injuries in horses trained for harness racing.

Meta-analysis of Cigarette Smoking and Musculoskeletal Injuries in Military Training.

Tobacco use is common among military personnel, as is musculoskeletal injury during training. In a review of the literature on musculoskeletal injuries, there was mixed evidence on the role of smoking as a risk factor. The purpose of this study is to review and analyze the literature on the impact of cigarette smoking on lower-extremity overuse injuries in military training. We performed a literature search on articles published through October 2016. Search terms focused on lower-extremity overuse musculoskeletal injuries and cigarette smoking in military populations. We conducted a meta-analysis overall and by sex, including smoking intensity. We identified 129 potential studies and selected 18 based on quality. The overall rate ratio for smoking was 1.31, 1.31 for men, and 1.23 for women. Overall and for each sex, rate ratios were significantly greater than 1.0 for each intensity level of smoking. Smoking is a moderate risk factor for musculoskeletal injury and may account for a meaningful proportion of injuries among men and women due to the high prevalence of smoking and injury in this population. Although enlistees are not allowed to smoke during basic training, their risk of injury remains high, indicating that smokers may remain at increased risk for medium- to long-term duration.

Epidemiology of Musculoskeletal Injury during Racing on New Zealand Racetracks 2005-2011.

Simple SummaryThere is currently limited information on the types, or risk, of injuries occurring for horses racing in flat races in New Zealand. Race reports and records from six racing seasons were used to determine the reasons why horses failed to finish a race. In total, 544 horses failed to complete a race, of which 177 were due to veterinary events. Most of the veterinary events that occurred during a race were classed as musculoskeletal injuries (136/177; 77%). The rate of musculoskeletal injuries during a race, 0.72 per 1000 starts, was lower than the rates reported for other racing jurisdictions. The condition of the track and the distance of the race were associated with the rate of musculoskeletal injury during a race. There may be differences in the training programmes and racing schedules for horses in the southern hemisphere, which may have contributed to the low rates reported in this study.The objective of the study was to determine the incidence of veterinary events that resulted in a horse failing to finish a race and identify risk factors for musculoskeletal injury (MSI) during a race. Data were obtained on Thoroughbred flat race starts in New Zealand between 1 August 2005 and 31 July 2011 (six racing seasons). Stipendiary Steward’s reports were key-word searched to identify veterinary events that prevented a horse from finishing a race. Race data were used calculate the incidence of veterinary events per 1000 horse starts and Poisson regression was used to investigate risk factors for MSI. There were 188,616 race starts and 177 reported veterinary events. The incidence of MSI on race day was 0.72 per 1000 starts, whilst the incidence of respiratory events was 0.21 per 1000 starts. The rate of MSI was significantly lower on ‘dead’ and ‘slow’ tracks compared with ‘good’ tracks and significantly greater in longer races (≥1671 m) compared with races of ≤1200 m. The rate of MSI during flat races in New Zealand appears lower than that reported worldwide, which may be due to the management and training of horses in New Zealand or differences in case definitions used in comparable studies.

Knee joint kinematics and kinetics during the hop and cut after soft tissue artifact suppression: Time to reconsider ACL injury mechanisms?

The recent development of a soft tissue artifact (STA) suppression method allows us to re-evaluate the tibiofemoral kinematics currently linked to non-contact knee injuries. The purpose of this study was therefore to evaluate knee joint kinematics and kinetics in six degrees of freedom (DoF) during the loading phases of a jump lunge and side cut using this in silico method. Thirty-five healthy adults completed these movements and their surface marker trajectories were then scaled and processed with OpenSim's inverse kinematics (IK) and inverse dynamics tools. Knee flexion angle-dependent kinematic constraints defined based on previous bone pin (BP) marker trajectories were then applied to the OpenSim model during IK and these constrained results were then processed with the standard inverse dynamics tool. Significant differences for all hip, knee, and ankle DoF were observed after STA suppression for both the jump lunge and side cut. Using clinically relevant effect size estimates, we conclude that STA contamination had led to misclassifications in hip transverse plane angles, knee frontal and transverse plane angles, medial/lateral and distractive/compressive knee translations, and knee frontal plane moments between the NoBP and the BP IK solutions. Our results have substantial clinical implications since past research has used joint kinematics and kinetics contaminated by STA to identify risk factors for musculoskeletal injuries.

Trait Anxiety as a Risk Factor for Musculoskeletal Injury in Athletes: A Critically Appraised Topic

Trait Anxiety as a Risk Factor for Musculoskeletal Injury in Athletes: A Critically Appraised Topic

Assisting Frail Seniors With Toileting in a Home Bathroom: Approaches Used by Home Care Providers

Home care providers experience high occupational injury rates. Improving safety is becoming increasingly urgent as this sector expands to support the aging population. Caregivers identify assisting with toileting as a particularly frequent and difficult activity. This mixed-methods observational study identified and analyzed the toileting subactivities that place care providers at the greatest risk of musculoskeletal injury. Eight personal support workers (home care aides) assisted a frail older adult (actor) in a simulated home bathroom. Overall technique and body postures were analyzed. Exposure to musculoskeletal injury risk factors (low back loads and time in extreme trunk postures) was greatest when removing/replacing clothing and providing posterior perineal care; high loads were also possible during transfers. Exposures can be reduced by lowering the pants only to knee level or squatting to raise them. A bidet seat or attachment can perform perineal cleaning, which accounted for 32% of time in severe trunk flexion.

FIRST STEPS TOWARDS PREVENTION OF MUSCULOSKELETAL INJURIES IN SPEED SKATING

BackgroundMusculoskeletal injuries are commonly seen by medical staff of speed skating teams, but lack of injury registration underreports the incidence and prevalence of these injuries. Systematic injury prevention research in...

RISK FACTORS FOR INJURIES IN ELITE YOUTH TENNIS PLAYERS

BackgroundThe number of elite junior tennis players is growing. However, very little is known about the risk factors for injuries in this specific population.ObjectiveTo identify risk factors for musculoskeletal injuries...

Musculoskeletal Problems Among Greek Perioperative Nurses in Regional Hospitals in Southern Peloponnese : Musculoskeletal Problems in Perioperative Nurses.

The surgery unit is a particularly labor-intensive environment in the hospital. Studies reflect the correlation of labor risk factors for musculoskeletal injuries among nurses but few have investigated the relationship to perioperative nurses. The purpose of this study is the identification and definition of ergonomic risk factors in the operating room and their connection with musculoskeletal disorders in perioperative nurses in regional hospitals in Greece. Forty four Greek perioperative nurses working in regional hospitals in southern Peloponnese participated. Anonymous self-administered questionnaire was used to collect the data, which consisted of three parts (investigating musculoskeletal symptoms, description of work, psychometric evaluation). The analysis was done with the statistical program SPSS.19. Symptoms of musculoskeletal problems emerged. Specifically, 54.4% in the lumbar, 47.7% in the neck, 45.5% in the shoulder, followed by smaller percentages of the hip, knee, elbow and ankle. 6.8% of participants indicated no musculoskeletal symptoms in the last year while 74.9% of those who had symptoms presented them in two or more areas. Activities rated as a major problem among others were the manual handling, tools with weight and vibration etc. 100% of respondents agreed that the work in the surgery unit is demanding and has anxiety. The lack of support from the government (81.8%), combined with the low perioperative nurses (6.8%) having the opportunity to participate in administrative decisions concerning them were related to problems in the organization and management of work. Apart from engineers target factors, a main aim should be the organization of work within the framework of a national policy based on European directives on the protection and promotion of the health and safety of workers.

Heavy Loads and Lifting are Risk Factors for Musculoskeletal Injuries in Deployed Female Soldiers.

The purpose of this prospective cohort study was to investigate physical, occupational, and psychosocial risk factors for musculoskeletal injuries (MSI) in deployed female soldiers. Before deployment, participants completed performance testing and surveys and after deployment an additional survey detailing occupational demands and MSI. Data analyzed found 57/160 (36%) suffered 78 MSI. In unadjusted analyses, these factors increased the relative risk (RR, 95% confidence interval) of injury: wearing an average load >10% body weight (BW) (RR = 2.00, 1.31-4.57), wearing an average load >1 hour (RR = 2.44, 1.30-4.57), heaviest load worn >15% BW (RR = 5.83, 1.51-22.50), wearing a backpack (RR = 1.82, 1.23-2.80), wearing body armor >1 hour (RR = 1.62, 1.002-2.62), lifting objects weighing above 22.68 kg (RR = 1.96, 1.08-3.57), lifting objects one to two times (RR = 1.73, 1.002-2.97), carrying objects >7.62 m (RR = 2.01, 1.19-3.42), and Y Balance composite score <95.23 (RR = 1.71, 1.13-2.60). The best logistic regression model predicting MSI was average load as % BW (odds ratio [OR] = 1.04, 1.01-1.07), heaviest load as % BW (OR = 1.03, 1.01-1.05), average repetitions lifting objects (OR = 1.07, 1.01-1.14), and sit-ups (OR = 0.93, 0.93-0.99). Results indicate that risk of MSI in deployed female soldiers increased with heavier equipment worn and more repetitious lifting, although more performing more sit-ups on the fitness test before deployment reduced the risk.

Hamstring and Gluteal Muscle Activation During the Assessment of Dynamic Movements

Recently, sports medicine professionals have shown interest in using dynamic movement assessments to help identify biomechanical risk factors for musculoskeletal injury. Thus the purpose of this study was to propose two movements (single leg step down and single leg lateral hop) that could predict injury and determine if these proposed movements elicited muscle activation of the hamstrings and gluteals. Surface electromyography was employed and muscle activations of the hamstrings and gluteus medius muscles were classified as strong during both the single leg step down (SLSD) and single leg lateral hop (SLLH). Both the hamstrings and gluteus medius muscles are associated with musculoskeletal injury. The SLSD and SLLH cause significantly high muscle activation of both these muscle groups and should be considered for use in dynamic movement assessments.

Does Ligamentous Laxity Protect Against Chondral Injury in Patients with Patellofemoral Instability?

Objectives:Hypermobility may be a risk factor for musculoskeletal injuries during sports participation. However, we have seen a low incidence of chondral injuries requiring treatment in patients undergoing medial patellofemoral ligament (MPFL) reconstruction for patellofemoral instability. It is unknown if patients with ligamentous laxity, who are at an increased risk for patellofemoral instability, are somewhat protected from chondral injury. We hypothesize in patients undergoing MPFL reconstruction for patellofemoral instability, patients with ligamentous laxity will be less likely to have chondral defects requiring surgical intervention.Methods:171 patients (32 male, 139 female) average age 22 years (range 11-57) with patellofemoral instability were rated with the Beighton-Horan (BH) scale for constitutional ligamentous laxity (0-9). Preoperative MRIs were evaluated (chondral injury present/absent, size of chondral injury, Outerbridge grade) and intra-operative arthroscopic findings noted (chondral injury present/absent, size of chondral injury, Outerbridge grade, surgical intervention yes/no, type of surgical intervention) of 79 non-lax (BH<6) and 92 ligamentously lax patients (BH≥6) (LAX) undergoing MPFL reconstruction. Anatomic measurements were documented for each patient including: tibial tubercle-trochlear groove (TT-TG) distance, Caton-Deschamps (C/D) ratio for patellar height, and the Dejour classification of trochlear dysplasia. Surgical interventions included chondroplasty, microfracture, particulated juvenile cartilage implantation (DeNovo, Zimmer, Warsaw, IN), osteochondral fracture fixation or osteochondral allograft transplantation (OATS).Results:58/171 (33.9%) required a surgical intervention for a chondral defect: chondroplasty 29/58 (50%), microfracture 16/58 (27.6%), particulated juvenile cartilage implantation 18/58 (31%), osteochondral fracture fixation 2/58 (3.5%), and OATS 2/58 (3.5%). There was no difference in the proportion of additional procedures in LAX vs. non-lax (p=0.475). There was no difference in the proportion of patellar chondral injuries sustained (LAX 29.3% vs. non-lax 45.7%) (p=0.538) but LAX patients had a lower proportion of patellar grade IV chondral injury compared to non-lax (p=0.026). There was no difference in the proportion of femoral chondral injuries sustained (LAX 13.1% vs. non-lax 26.4%) (p=0.073) but LAX patients had a lower proportion of femoral grade IV chondral injury compared to non-lax (p=0.023). There was no association of chondral injury with trochlear morphology (p=0.843), patellar height (p=0.303), TT-TG (p=0.874), number of instability events (p=0.878), age at time of surgery (p=0.482), and contact vs. non-contact mechanism of injury (p=0.772).Conclusion:LAX patients had a lower proportion of severe patellar and femoral cartilage injuries. There was no significant difference in the proportions of injuries, however there were 2x the proportion of femoral chondral injuries and 1.5x the proportion of patellar chondral injuries in non-lax vs. LAX, which is clinically significant.

Examining the Factor Structure and Reliability of the Safe Patient Handling Perception Scale: An Initial Validation Study.

Perceiving imminent safe patient handling and movement (SPH&M) dangers may reduce musculoskeletal (MSK) injuries for nurses in the workplace. The purpose of this study is to develop and validate the 17-item Safe Patient Handling Perception Scale (SPHPS) as an evaluation instrument assessing perceptual risk of MSK injury based on SPH&M knowledge, practice, and resource accessibility in the workplace. Data were collected from a convenience sample (N = 117) of nursing employees at a Veteran Affairs Medical Center. Factor analysis identified three factors: knowledge, practice, and accessibility. The SPHPS demonstrated high levels of reliability, supported by acceptable alpha scores (SPHM knowledge [α = .866], SPHM practices [α = .901], and access to SPHM resources [α = .855]), in addition to the relatively low standard error of measurement scores (SEM). The study outcomes suggest that the SPHPS is a valid and reliable tool that can measure participants' perceived risk factors for MSK injuries.

Biomechanical Evaluation of a Bed Feature to Assist in Turning and Laterally Repositioning Patients

This study investigated the effects of hospital bed features on the biomechanical stresses experienced by nurses when turning and laterally repositioning patients. Turn Assist, a common feature in ICU beds that helps to rotate patients, and side rail orientation were evaluated. Manual patient handling is a risk factor for musculoskeletal injury, and turning patients is one of the most common patient handling activities. No known studies have evaluated bed attributes such as the Turn Assist feature and side rail orientation that may affect the stresses experienced by the nurse. Nine female nurses laterally repositioned and turned a 63-kg and 123-kg subject on an ICU bed while motion capture, ground reaction forces, and hand force data were recorded. Loading of the spine and shoulder was modeled using 3D Static Strength Prediction Program (3DSSPP). Spine compression and shear forces did not exceed recommended limits when turning or laterally repositioning. However, the mean pull forces required to manually laterally reposition even the 63-kg subject was 340 Newtons, more than 50% greater than limits established in psychophysical testing. Turn Assist considerably reduced spine loading and pull forces for both turning and laterally repositioning. Lowering side rails reduced spinal compression by 11% when turning patients. Laterally repositioning patients as part of turning may pose an injury risk to caregivers. Turn Assist reduces physical loading on nurses when turning and repositioning patients. Caregivers should consider using Turn Assist and other aids such as mechanical lifts or sliding sheets especially when turning patients requires lateral repositioning.

Risk factors for musculoskeletal injury in preprofessional dancers: a systematic review

BackgroundPreprofessional dancers partake in rigorous training and have high injury prevalence. Attempts to identify risk factors for dance injuries have focused on a diversity of intrinsic and extrinsic factors.ObjectiveTo identify...

Prevalence of Musculoskeletal Injury Among Collegiate Marching Band and Color Guard Members.

To investigate the prevalence of musculoskeletal injury (MSI) in collegiate marching band and color guard members and the associated factors. An electronic survey was developed and delivered via the Qualtrics survey platform to collegiate marching band and color guard members in the United States. Information collected included demographics; years of experience; training and performance characteristics; footwear worn; instrument played/equipment used; participation in stretching/strengthening programs; injury prevalence and type; treatment sought for injury; and participation time lost due to injury. There were 1,379 (792 female, 587 male) members of 21 collegiate marching bands who completed the survey. Respondents had an average age of 19.8 yrs, height 171.9 cm, weight 72.3 kg, and BMI 24.4 kg/m2. Twenty-five percent of respondents reported sustaining a MSI as a result of participating in marching band or color guard. Females were 20% more likely to sustain a MSI and 87.7% of MSI involved the lower extremity. A significant difference in BMI was found between those who did and did not sustain a MSI (p=0.014). Members of collegiate marching band and color guard may be at risk of sustaining a MSI due to the repetitive nature of the activities performed during practice and performance. The lower extremity is more prone to injury, and a higher BMI may be a risk factor for MSI in this population.