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Sample records for physical activity-related injury

  1. Physical activity-related injuries in older adults: a scoping review.

    PubMed

    Stathokostas, Liza; Theou, Olga; Little, Robert M D; Vandervoort, A A; Raina, Parminder

    2013-10-01

    The purpose of this project is to conduct a comprehensive and systematic scoping review to identify and document the breadth of literature related to physical activity-related injuries in older adults. The population of interest was adults (both males and females) over the age of 65 years, participating in exercise, leisure-time, or sport-type physical activities. The initial search yielded 16,828 articles, with 43 articles ultimately included. The final 43 articles utilized the following study designs: three experimental (two randomized control and one non-randomized control), 14 prospective studies, and 26 retrospective. The results of this scoping review would suggest that it may be premature to provide definitive incidence rates, causes, and correlates of physical activity-related injuries in older adults. However, the current literature does not suggest that older adults are at an increased risk of injury from participation in physical activities. Future research should utilize a consistent definition of 'injury' and consistent and comprehensive descriptors of injuries--including intensity level of engagement of activity and burden/severity of injury. In addition, injury rates in specific populations are needed, particularly for the oldest-old, for those in assisted-living situations, and for subgroups with clinical conditions. Finally, greater surveillance and documentation of older adult initiatives and interventions are needed in order to identify programs successful in reducing the injury rates of their target populations.

  2. Physical Activity-Related Injury Profile in Children and Adolescents According to Their Age, Maturation, and Level of Sports Participation.

    PubMed

    Costa E Silva, Lara; Fragoso, Maria Isabel; Teles, Júlia

    Physical activity (PA) is beneficial, enhancing healthy development. However, one-third of school-age children practicing sports regularly suffer from an injury. These injuries are associated with sex, chronological age, and PA level. To identify the importance of age, PA level, and maturity as predictors of injury in Portuguese youth. Descriptive epidemiological study. Level 3. Information about injury and PA level was assessed via 2 questionnaires (LESADO RAPIL II) from 647 subjects aged 10 to 17 years. Maturity offset according to Mirwald (time before or after peak height velocity) and Tanner-Whitehouse III bone age estimates were used to evaluate maturation. Binary logistic regression and gamma regression were used to determine significant predictors of injury and injury rate. Injury occurrence was higher for both sexes in recreational, school, and federated athletes (athletes engaged in sports that are regulated by their respective federations, with formal competition). These injuries also increased with age in boys and in the higher maturity offset group in girls. Injury rate was higher for both sexes in the no sports participation group. Early-maturing girls, with higher bone age and lower maturity offset, showed higher injury rate. Injuries in Portuguese youth were related to PA level, age, and biological maturation. Recreational, school, and federated athletes had more injury ocurrences while subjects with no sports participation had higher injury risk. Older subjects had more injuries. Early-maturing girls that had just passed peak height velocity may be particularly vulnerable to risk of sports injury because of the growing process. Increased knowledge about injury with specific PA exposure data is important to an overall risk management strategy. This study has deepened the association between injury and biological maturation variables.

  3. A Social Cognitive Perspective of Physical-Activity-Related Behavior in Physical Education

    ERIC Educational Resources Information Center

    Martin, Jeffrey J.; Kulinna, Pamela Hodges

    2005-01-01

    The purpose of the current study was to examine student and teacher physical-activity-related behavior using the theory of planned behavior and self-efficacy theory. Although teachers reported an overwhelmingly positive attitude toward teaching physical activity lessons to promote fitness development, they only devoted 4% of their class time to…

  4. Parental Social Support and the Physical Activity-Related Behaviors of Youth: A Review

    ERIC Educational Resources Information Center

    Beets, Michael W.; Cardinal, Bradley J.; Alderman, Brandon L.

    2010-01-01

    Social support from parents serves as one of the primary influences of youth physical activity-related behaviors. A systematic review was conducted on the relationship of parental social support to the physical activity-related behaviors of youth. Four categories of social support were identified, falling under two distinct mechanisms--tangible…

  5. Sports activities related to injuries? A survey among 9-19 year olds in Switzerland.

    PubMed

    Michaud, P A; Renaud, A; Narring, F

    2001-03-01

    Most data on sports injuries are gathered in clinical settings so that their epidemiology in the general population is not well known. To explore the link between sports injuries with the type and the amount of sports activity and biological factors. In 1996, 3,609 in-school adolescents 10-19 years (1,847 girls and 1,762 boys) participated in a regional survey. This included anthropometric measurements and a self administered questionnaire. Altogether 28.2% of girls and 35.9% of boys reported one or more sports injuries during the previous year and 2.1% of girls and 6.5% of boys reported at least one hospitalization due to a sports injury. Using the mean rate of injuries as reference level, some sports are highly related to injury occurrence: body building (relative risk (RR) 1.7, 95% confidence interval (CI) 1.5 to 1.9), skateboarding and rollerskating (RR 1.6, 1.4 to 1.8), athletics (RR 1.5, 1.3 to 1.7), snowboarding (RR 1.5, 1.4 to 1.6), basketball (RR 1.3, 1.2 to 1.4), soccer (RR 1.3, 1.2 to 1.4), and ice hockey (RR 1.2, 1.1 to 1.3). Using a logistic regression, several variables associated with a higher risk of injury were identified: the amount of physical activity, high risk sports, and Tanner pubertal stages. The risk of sports injury increases not so much with age but with exposure to specific sports and with pubertal development.

  6. Sports activities related to injuries? A survey among 9–19 year olds in Switzerland

    PubMed Central

    Michaud, P; Renaud, A; Narring, F

    2001-01-01

    Background—Most data on sports injuries are gathered in clinical settings so that their epidemiology in the general population is not well known. Objective—To explore the link between sports injuries with the type and the amount of sports activity and biological factors. Methods—In 1996, 3609 in-school adolescents 10–19 years (1847 girls and 1762 boys) participated in a regional survey. This included anthropometric measurements and a self administered questionnaire. Results—Altogether 28.2% of girls and 35.9% of boys reported one or more sports injuries during the previous year and 2.1% of girls and 6.5% of boys reported at least one hospitalization due to a sports injury. Using the mean rate of injuries as reference level, some sports are highly related to injury occurrence: body building (relative risk (RR) 1.7, 95% confidence interval (CI) 1.5 to 1.9), skateboarding and rollerskating (RR 1.6, 1.4 to 1.8), athletics (RR 1.5, 1.3 to 1.7), snowboarding (RR 1.5, 1.4 to 1.6), basketball (RR 1.3, 1.2 to 1.4), soccer (RR 1.3, 1.2 to 1.4), and ice hockey (RR 1.2, 1.1 to 1.3). Using a logistic regression, several variables associated with a higher risk of injury were identified: the amount of physical activity, high risk sports, and Tanner pubertal stages. Conclusion—The risk of sports injury increases not so much with age but with exposure to specific sports and with pubertal development. PMID:11289534

  7. Analysis on sports and recreation activity-related eye injuries presenting to the Emergency Department

    PubMed Central

    Moon, Sungbae; Ryoo, Hyun Wook; Ahn, Jae Yun; Park, Jung Bae; Seo, Kang Suk; Shin, Sang Do; Song, Kyoung Jun; Lee, Kang Hyun; Yoo, In Sool; Cho, Jin Seong; Ryu, Hyun Ho; Jeong, Tae Oh; Yeom, Seok Ran; Kim, Young Taek; Hong, Sung Ok

    2016-01-01

    AIM To investigate the incidence and general characteristics of sports-related eye injuries in patients visiting the Emergency Department. METHODS A cross-sectional, multi-center, observational study. Patients with an injured eye who visited the Emergency Department at one of nine hospitals in Korea were enrolled. All data were prospectively collected between March and September 2010 using a questionnaire. Eye injuries that occurred during risky sports were examined by gender and age. Additionally, the rate of open globe injuries that occurred with and without protective eyewear was examined for each activity. Continuous variables were compared using Student's t-test and categorical variables were compared using Chi-square test. RESULTS A total of 446 patients had sports-related eye injuries. Teenagers (10-19 years old) and young adults (20-29 years old) had the most eye injuries. Eye injuries accounted for 0.2% of Emergency Department patients. Baseball was the most common cause of sports-related eye injuries, followed by soccer and hiking. Protective gear was worn by 9.4% of all patients. Patients that were 30-39 years of age had the highest rate of protective gear use, followed by patients that were 40-49 years of age. The proportion of sports-related eye injuries that were open-globe injuries was highest for soccer and hiking. CONCLUSION Although injuries were most common in patients below the age of 10 years, these patients had the lowest rate of protective eyewear use. Injuries in adults over 40 years of age most commonly occurred during hiking, but the rate of protective eyewear use was low. Young athletes should be educated on and provided with protective eyewear and policies protective gear use should be established. For older adults, eye protection should be encouraged, especially during hiking. PMID:27803871

  8. Do Motives to Undertake Physical Activity Relate to Physical Activity in Adolescent Boys and Girls?

    PubMed

    Kopcakova, Jaroslava; Veselska, Zuzana Dankulincova; Geckova, Andrea Madarasova; Kalman, Michal; van Dijk, Jitse P; Reijneveld, Sijmen A

    2015-07-08

    Low levels of physical activity (PA) during adolescence contribute to obesity and poor health outcomes in adolescence, and these associations endure into adulthood. The aim of this study was to assess the associations between motives for PA and the level of PA among adolescent boys and girls. We obtained data regarding motives for PA and frequency of PA in 2010 via the Health Behavior in School-aged Children cross-sectional study in the Czech and Slovak Republics (n = 9018, mean age = 13.6, 49% boys). Respondents answered questions about their motives for PA and the frequency of their PA. Motives for PA were assessed using 13 items, which were structured in four groups. We explored the association between the motives for PA and sufficient PA using univariate and multivariate logistic regression models adjusted for age, and separately for boys and girls. "Good child" motives and Achievement motives were significantly associated with sufficient PA among both boys and girls. Health motives were associated with sufficient PA only among boys, and Social motives were associated with sufficient PA only among girls. Motives for PA were associated with the level of PA, and this association was partially gender dependent. These gender differences should be considered in interventions focusing on enhancement of PA.

  9. Do Motives to Undertake Physical Activity Relate to Physical Activity in Adolescent Boys and Girls?

    PubMed Central

    Kopcakova, Jaroslava; Dankulincova Veselska, Zuzana; Madarasova Geckova, Andrea; Kalman, Michal; van Dijk, Jitse P.; Reijneveld, Sijmen A.

    2015-01-01

    Low levels of physical activity (PA) during adolescence contribute to obesity and poor health outcomes in adolescence, and these associations endure into adulthood. The aim of this study was to assess the associations between motives for PA and the level of PA among adolescent boys and girls. We obtained data regarding motives for PA and frequency of PA in 2010 via the Health Behavior in School-aged Children cross-sectional study in the Czech and Slovak Republics (n = 9018, mean age = 13.6, 49% boys). Respondents answered questions about their motives for PA and the frequency of their PA. Motives for PA were assessed using 13 items, which were structured in four groups. We explored the association between the motives for PA and sufficient PA using univariate and multivariate logistic regression models adjusted for age, and separately for boys and girls. “Good child” motives and Achievement motives were significantly associated with sufficient PA among both boys and girls. Health motives were associated with sufficient PA only among boys, and Social motives were associated with sufficient PA only among girls. Motives for PA were associated with the level of PA, and this association was partially gender dependent. These gender differences should be considered in interventions focusing on enhancement of PA. PMID:26184246

  10. The relationship between isometric trunk muscle endurance and physical activity related energy expenditure in healthy young adults.

    PubMed

    Bayraktar, Deniz; Özyürek, Seher; Genç, Arzu

    2015-01-01

    Despite the popularity of core stabilization, there is limited evidence as to the relationship between performance on tests of isometric trunk muscle endurance and physical activity levels in adults. To investigate the relationship between isometric trunk muscle endurance and physical activity related energy expenditure in healthy young adults. A total of 51 participants (24 female) participated in the study. Median age and body mass index were; 22 years (Min-max: 18-26 years) and 21.8 kg/m2 (Min-Max: 18.59-28.98 kg/m2), respectively. Participants completed the International Physical Activity Questionnaire. Isometric trunk muscle endurance was assessed with holding times of isometric trunk flexor, extensor, and lateral side bridge tests. Collected data were summarized based on median and interquartile ranges. The Spearman's correlation test was used to ascertain the relationship between isometric trunk muscle endurance and physical activity related energy expenditure. There were no gender differences in holding times of the trunk flexor and trunk extensor endurance tests (p> 0.05). Males showed higher endurance scores for side bridge test than females (p< 0.001). No difference was found in physical activity related energy expenditure between males and females. No correlation was observed between isometric trunk muscle endurance and physical activity related energy expenditure for either females or males (p> 0.05). According to our findings, trunk muscle endurance is not related to physical activity related energy expenditure in healthy young adults.

  11. Factors in Daily Physical Activity Related to Calcaneal Mineral Density in Men

    NASA Technical Reports Server (NTRS)

    Hutchinson, Teresa M.; Whalen, Robert T.; Cleek, Tammy M.; Vogel, John M.; Arnaud, Sara B.

    1995-01-01

    To determine the factors in daily physical activity that influence the mineral density of the calcaneus, we recorded walking steps and the type and duration of exercise in 43 healthy 26-to 51-yr-old men. Areal (g/sq cm) calcaneal bone mineral density (CBMD) was measured by single energy x-ray densitometry. Subjects walked a mean (+/- SD) of 7902(+/-2534) steps per day or approximately 3.9(+/-1.2) miles daily. Eight subjects reported no exercise activities. The remaining 35 subjects spent 143(2-772) (median and range) min/wk exercising. Twenty-eight men engaged in exercise activities that generate single leg peak vertical ground reaction forces (GRF(sub z)) of 2 or more body weights (high loaders, HL), and 15 reported exercise or daily activities that typically generate GRF(sub z) less than 1.5 body weights (low loaders, LL). CBMD was 12% higher in HL than LL (0.668 +/- 0.074 g/sq cm vs 0.597 +/- 0.062 g/sq cm, P less than 0.004). In the HL group, CBMD correlated to reported minutes of high load exercise (r = 0.41, P less than 0.03). CBMD was not related to the number of daily walking steps (N = 43, r = 0.03, NS). The results of this study support the concept that the dominant factor in daily physical activity relating to bone mineral density is the participation in site specific high loading activities, i.e., for the calcaneus, high calcaneal loads.

  12. Suprathreshold Heat Pain Response Predicts Activity-Related Pain, but Not Rest-Related Pain, in an Exercise-Induced Injury Model

    PubMed Central

    Coronado, Rogelio A.; Simon, Corey B.; Valencia, Carolina; Parr, Jeffrey J.; Borsa, Paul A.; George, Steven Z.

    2014-01-01

    Exercise-induced injury models are advantageous for studying pain since the onset of pain is controlled and both pre-injury and post-injury factors can be utilized as explanatory variables or predictors. In these studies, rest-related pain is often considered the primary dependent variable or outcome, as opposed to a measure of activity-related pain. Additionally, few studies include pain sensitivity measures as predictors. In this study, we examined the influence of pre-injury and post-injury factors, including pain sensitivity, for induced rest and activity-related pain following exercise induced muscle injury. The overall goal of this investigation was to determine if there were convergent or divergent predictors of rest and activity-related pain. One hundred forty-three participants provided demographic, psychological, and pain sensitivity information and underwent a standard fatigue trial of resistance exercise to induce injury of the dominant shoulder. Pain at rest and during active and resisted shoulder motion were measured at 48- and 96-hours post-injury. Separate hierarchical models were generated for assessing the influence of pre-injury and post-injury factors on 48- and 96-hour rest-related and activity-related pain. Overall, we did not find a universal predictor of pain across all models. However, pre-injury and post-injury suprathreshold heat pain response (SHPR), a pain sensitivity measure, was a consistent predictor of activity-related pain, even after controlling for known psychological factors. These results suggest there is differential prediction of pain. A measure of pain sensitivity such as SHPR appears more influential for activity-related pain, but not rest-related pain, and may reflect different underlying processes involved during pain appraisal. PMID:25265560

  13. Suprathreshold heat pain response predicts activity-related pain, but not rest-related pain, in an exercise-induced injury model.

    PubMed

    Coronado, Rogelio A; Simon, Corey B; Valencia, Carolina; Parr, Jeffrey J; Borsa, Paul A; George, Steven Z

    2014-01-01

    Exercise-induced injury models are advantageous for studying pain since the onset of pain is controlled and both pre-injury and post-injury factors can be utilized as explanatory variables or predictors. In these studies, rest-related pain is often considered the primary dependent variable or outcome, as opposed to a measure of activity-related pain. Additionally, few studies include pain sensitivity measures as predictors. In this study, we examined the influence of pre-injury and post-injury factors, including pain sensitivity, for induced rest and activity-related pain following exercise induced muscle injury. The overall goal of this investigation was to determine if there were convergent or divergent predictors of rest and activity-related pain. One hundred forty-three participants provided demographic, psychological, and pain sensitivity information and underwent a standard fatigue trial of resistance exercise to induce injury of the dominant shoulder. Pain at rest and during active and resisted shoulder motion were measured at 48- and 96-hours post-injury. Separate hierarchical models were generated for assessing the influence of pre-injury and post-injury factors on 48- and 96-hour rest-related and activity-related pain. Overall, we did not find a universal predictor of pain across all models. However, pre-injury and post-injury suprathreshold heat pain response (SHPR), a pain sensitivity measure, was a consistent predictor of activity-related pain, even after controlling for known psychological factors. These results suggest there is differential prediction of pain. A measure of pain sensitivity such as SHPR appears more influential for activity-related pain, but not rest-related pain, and may reflect different underlying processes involved during pain appraisal.

  14. Preseason Perceived Physical Capability and Previous Injury.

    PubMed

    Sciascia, Aaron; Haegele, Lauren E; Lucas, Jean; Uhl, Timothy L

    2015-09-01

    Patient opinion about the ability to perform athletic maneuvers is important after injury; however, prospective assessment of self-perceived physical capability for athletes before the beginning of a season is lacking. To perform a descriptive analysis of knee, shoulder, and elbow self-perceived measures of physical capability specific to athletics and to compare the measures between athletes with and without a history of injury. Cross-sectional study. Preparticipation physical examinations. A total of 738 collegiate athletes (486 men, 251 women; age = 19 ± 1 years) were administered questionnaires after receiving medical clearance to participate in their sports. Of those athletes, 350 reported a history of injury. Athletes self-reported a history of knee, shoulder, or elbow injury. Perceived physical capability of the 3 joints was evaluated using the Knee Injury and Osteoarthritis Outcome Score Sport and Recreation Function and Knee-Related Quality of Life subscales and the Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow Score. We conducted nonparametric analysis to determine if scores differed between athletes with and without a history of injury. Median values for the Knee Injury and Osteoarthritis Outcome Score Sports and Recreation Function and Knee-Related Quality of Life subscales and the Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow Score for all athletes were 100. Median values for perceived physical capability of athletes with a history of injury were 3 to 12 points lower for each questionnaire before the start of the season (P < .001). Our study provided descriptive values for individual perceived knee, shoulder, and elbow physical capability of collegiate athletes participating in 19 sports. Athletes who did not report previous injuries perceived their physical capabilities to be nearly perfect, which could set the goal for these athletes to return to participation after injury. Athletes reporting previous injuries perceived less physical

  15. Injury risk during different physical activity behaviours in children: a systematic review with bias assessment.

    PubMed

    Nauta, Joske; Martin-Diener, Eva; Martin, Brian W; van Mechelen, Willem; Verhagen, Evert

    2015-03-01

    The current focus on a physically active lifestyle in children puts children at increased physical activity-related injury risk. To summarise, in a systematic review, the evidence for the injury risk of several physical activity behaviours in 6- to 12-year-old children. An electronic search was performed in three databases (Embase, PubMed and SPORTDiscus). Inclusion criteria were: age 6-12 years; report on injuries related to overall physical activity, active commuting, unorganised leisure time physical activity, physical education and/or organised sports; incidence rates expressed as injuries per hours of physical activity; and published after January 1st 2000. Risk of bias was assessed for all studies included. Eight studies were included. The risk of bias assessment resulted in two studies with a score that was higher than 75 %; risk bias of those two studies was considered low. The medically treated, injury incidence rate was reported to be between 0.15 and 0.27 injuries per 1,000 h of physical activity. The absolute number of injuries related to unorganised leisure time physical activity was higher than the absolute number of injuries reported in organised sports. The respective injury incidence rate expressed per 1,000 h exposure was, however, generally lower during unorganised leisure time than during organised sports. Reported injury incidence rates related to active commuting were comparable to those for unorganised leisure time physical activity. Conflicting injury incidence rates were reported for physical education. Subgroup analysis suggested that girls and children with low habitual levels of physical activity are at increased injury risk. A limitation of the review is that no standard bias assessment was available for this specific context. Children are at an inherent injury risk while participating in physical activities. Most injury prevention efforts have focussed on the sports setting, but our results suggest that many children sustain an injury

  16. Active relatives and health-related physical fitness in European adolescents: the HELENA Study.

    PubMed

    Martín-Matillas, Miguel; Ortega, Francisco B; Ruiz, Jonatan R; Martínez-Gómez, David; Vicente-Rodríguez, Germán; Marcos, Ascensión; Béghin, Laurent; Kafatos, Anthony; González-Gross, Marcela; Zaccaria, Maria; Molnár, Dénes; De Henauw, Stefaan; Sjöström, Michael; Moreno, Luis A; Castillo, Manuel J

    2012-01-01

    High physical fitness in childhood and adolescence is positively associated with favourable health-related outcomes. Our aim was to examine the relationship between relatives' (father, mother, brother, sister, and best friend) physical activity engagement and encouragement on adolescents' physical fitness. Adolescents were part of the HELENA study, a multi-centre study conducted in 10 cities from nine European countries in 2006-2008. Participants were 3288 adolescents (48% boys, 52% girls) aged 12.5-17.5 years with valid data on at least one of the three fitness variables studied: muscular strength (standing long jump), speed/agility (4×10 m shuttle run), and cardiorespiratory fitness (20 m shuttle run). The adolescents reported their relatives' physical activity engagement and encouragement. Analysis of covariance showed that relatives' physical activity engagement (father, mother, brother, and best friend) was positively related to cardiorespiratory fitness (P < 0.05); and mother's and sisters' physical activity engagement were positively associated with higher muscular strength in adolescents (P < 0.05). Furthermore, father's physical activity encouragement was positively linked to physical fitness (all fitness components) in adolescents (P < 0.05). Interventions aimed at improving physical fitness in young people might be more successful when family members, particularly mothers and fathers, are encouraged to engage in physical activity and support adolescents' physical activity.

  17. Macrotheories: child physical punishment, injury and abuse.

    PubMed

    Cousins, Judy

    2005-08-01

    This is the first paper in a series of two that focus on causational factors that contribute to child physical punishment and the continuum between physical punishment, injury and child physical abuse. The papers will explore macro and microtheoretical perspectives, examine their influence on child discipline and child physical abuse and propose a framework to guide and inform professional practice in the field of child physical maltreatment Paper one introduces the reader to the political context of child physical discipline and analyses current definitions. The extent of punishment and injuries sustained is explored and the relationship between macrotheoretical perspectives examined. The paper concludes by highlighting the continuum between child physical punishment and child physical abuse.

  18. Preseason Perceived Physical Capability and Previous Injury

    PubMed Central

    Sciascia, Aaron; Haegele, Lauren E.; Lucas, Jean; Uhl, Timothy L.

    2015-01-01

    Context  Patient opinion about the ability to perform athletic maneuvers is important after injury; however, prospective assessment of self-perceived physical capability for athletes before the beginning of a season is lacking. Objective  To perform a descriptive analysis of knee, shoulder, and elbow self-perceived measures of physical capability specific to athletics and to compare the measures between athletes with and without a history of injury. Design  Cross-sectional study. Setting  Preparticipation physical examinations. Patients or Other Participants  A total of 738 collegiate athletes (486 men, 251 women; age = 19 ± 1 years) were administered questionnaires after receiving medical clearance to participate in their sports. Of those athletes, 350 reported a history of injury. Main Outcome Measure(s)  Athletes self-reported a history of knee, shoulder, or elbow injury. Perceived physical capability of the 3 joints was evaluated using the Knee Injury and Osteoarthritis Outcome Score Sport and Recreation Function and Knee-Related Quality of Life subscales and the Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow Score. We conducted nonparametric analysis to determine if scores differed between athletes with and without a history of injury. Results  Median values for the Knee Injury and Osteoarthritis Outcome Score Sports and Recreation Function and Knee-Related Quality of Life subscales and the Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow Score for all athletes were 100. Median values for perceived physical capability of athletes with a history of injury were 3 to 12 points lower for each questionnaire before the start of the season (P < .001). Conclusions  Our study provided descriptive values for individual perceived knee, shoulder, and elbow physical capability of collegiate athletes participating in 19 sports. Athletes who did not report previous injuries perceived their physical capabilities to be nearly perfect, which could set the

  19. Accelerometer-measured daily physical activity related to aerobic fitness in children and adolescents.

    PubMed

    Dencker, Magnus; Andersen, Lars B

    2011-06-01

    Maximum oxygen uptake (VO(2PEAK)) is generally considered to be the best single marker for aerobic fitness. While a positive relationship between daily physical activity and aerobic fitness has been established in adults, the relationship appears less clear in children and adolescents. The purpose of this paper is to summarise recently published data on the relationship between daily physical activity, as measured by accelerometers, and VO(2PEAK) in children and adolescents. A PubMed search was performed on 29 October 2010 to identify relevant articles. Studies were considered relevant if they included measurement of daily physical activity by accelerometry and related to a VO(2PEAK) either measured directly at a maximal exercise test or estimated from maximal power output. A total of nine studies were identified, with a total number of 6116 children and adolescents investigated. Most studies reported a low-to-moderate relationship (r = 0.10-0.45) between objectively measured daily physical activity and VO(2PEAK). No conclusive evidence exists that physical activity of higher intensities are more closely related to VO(2PEAK), than lower intensities.

  20. Mothers' intentions to support children's physical activity related to attention and implicit agreement with advertisements.

    PubMed

    Berry, Tanya R; Craig, Cora L; Faulkner, Guy; Latimer, Amy; Rhodes, Ryan; Spence, John C; Tremblay, Mark S

    2014-02-01

    ParticipACTION's Think Again campaign targeted mothers who think their children are sufficiently active, yet whose children do not achieve recommended amounts of physical activity. This research examined the relationship of mothers' intentions to support children's physical activity with explicit believability and implicit agreement with the Think Again campaign message, attention paid to the advertisement, involvement with the issue, concern regarding children's inactivity, and attitudes. Participants were mothers from Edmonton, Canada (N = 102) who viewed one Think Again advertisement then completed a measure of implicit agreement with the campaign message and questionnaires. The mothers who paid attention to the message and were concerned for their own children were more likely to intend to act on campaign messages. The majority of participants implicitly agreed that children's physical inactivity was a problem, but there was less agreement that physical inactivity was a problem for their own children. Participants automatically tended to agree with campaign messages when the focus was on children in general, but there was greater disagreement when asked about participant's own children. Why most mothers were not in agreement with the reality of how much physical activity their children needs remains to be determined.

  1. Physical Activity Related to Depression and Predicted Mortality Risk: Results from the Americans' Changing Lives Study

    ERIC Educational Resources Information Center

    Lee, Pai-Lin; Lan, William; Lee, Charles C.-L.

    2012-01-01

    This study examined the association between three types of physical activities (PA) and depression, and the relationship between PA and later mortality. Previous studies rarely assessed these associations in one single study in randomly selected population samples. Few studies have assessed these relations by adjusting the covariate of…

  2. Physical Activity Related to Depression and Predicted Mortality Risk: Results from the Americans' Changing Lives Study

    ERIC Educational Resources Information Center

    Lee, Pai-Lin; Lan, William; Lee, Charles C.-L.

    2012-01-01

    This study examined the association between three types of physical activities (PA) and depression, and the relationship between PA and later mortality. Previous studies rarely assessed these associations in one single study in randomly selected population samples. Few studies have assessed these relations by adjusting the covariate of…

  3. Brief Physical Activity-Related Psychosocial Measures: Reliability and Construct Validity

    PubMed Central

    Carlson, Jordan A.; Sallis, James F.; Wagner, Nicole; Calfas, Karen J.; Patrick, Kevin; Groesz, Lisa M.; Norman, Gregory J.

    2015-01-01

    Background Psychosocial factors have been related to physical activity (PA) and are used to evaluate mediation in PA interventions. Methods Brief theory-based psychosocial scales were compiled from existing measures and evaluated. Study 1 assessed factor structure and construct validity with self-reported PA and accelerometry in overweight/obese men (N = 441) and women (N = 401). Study 2 assessed 2-week reliability and internal consistency in 49 college students. Results Confirmatory factor analysis indicated good fit in men and women (CFI = .90; RMSEA = .05). Construct validity was supported for change strategies (r = .29–.46), self-efficacy (r = .19–.22) and enjoyment (r = .21–.33) in men and women, and for cons in women (r = –.19 to –.20). PA pros (r = −.02 to .11) and social support (r = −.01 to .12) were not supported for construct validity. Test-retest reliability ICCs ranged from .49–.81. Internal consistency alphas ranged from .55–.90. Reliability was supported for most scales with further testing needed for cons (alphas = .55–.63) and enjoyment (ICC = .49). Conclusions Many of the brief scales demonstrated adequate reliability and validity, while some need further development. The use of these scales could advance research and practice in the promotion of PA. PMID:22207589

  4. Parent health literacy and "obesogenic" feeding and physical activity-related infant care behaviors.

    PubMed

    Yin, H Shonna; Sanders, Lee M; Rothman, Russell L; Shustak, Rachel; Eden, Svetlana K; Shintani, Ayumi; Cerra, Maria E; Cruzatte, Evelyn F; Perrin, Eliana M

    2014-03-01

    To examine the relationship between parent health literacy and "obesogenic" infant care behaviors. Cross-sectional analysis of baseline data from a cluster randomized controlled trial of a primary care-based early childhood obesity prevention program (Greenlight). English- and Spanish-speaking parents of 2-month-old children were enrolled (n = 844). The primary predictor variable was parent health literacy (Short Test of Functional Health Literacy in Adults; adequate ≥ 23; low <23). Primary outcome variables involving self-reported obesogenic behaviors were: (1) feeding content (more formula than breast milk, sweet drinks, early solid food introduction), and feeding style-related behaviors (pressuring to finish, laissez-faire bottle propping/television [TV] watching while feeding, nonresponsiveness in letting child decide amount to eat); and (2) physical activity (tummy time, TV). Multivariate logistic regression analyses (binary, proportional odds models) performed adjusting for child sex, out-of-home care, Women, Infants, and Children program status, parent age, race/ethnicity, language, number of adults/children in home, income, and site. Eleven percent of parents were categorized as having low health literacy. Low health literacy significantly increased the odds of a parent reporting that they feed more formula than breast milk, (aOR = 2.0 [95% CI: 1.2-3.5]), immediately feed when their child cries (aOR = 1.8 [1.1-2.8]), bottle prop (aOR = 1.8 [1.002-3.1]), any infant TV watching (aOR = 1.8 [1.1-3.0]), and inadequate tummy time (<30 min/d), (aOR = 3.0 [1.5-5.8]). Low parent health literacy is associated with certain obesogenic infant care behaviors. These behaviors may be modifiable targets for low health literacy-focused interventions to help reduce childhood obesity. Copyright © 2014 Mosby, Inc. All rights reserved.

  5. Parent Health Literacy and “Obesogenic” Feeding and Physical Activity-related Infant Care Behaviors

    PubMed Central

    Yin, H. Shonna; Sanders, Lee M.; Rothman, Russell L.; Shustak, Rachel; Eden, Svetlana K.; Shintani, Ayumi; Cerra, Maria E.; Cruzatte, Evelyn F.; Perrin, Eliana M.

    2014-01-01

    Objective To examine the relationship between parent health literacy and “obesogenic” infant care behaviors. Study design Cross-sectional analysis of baseline data from a cluster randomized controlled trial of a primary care-based, early childhood obesity prevention program (Greenlight). English and Spanish-speaking parents of 2 month old children enrolled (n=844). The primary predictor variable was a parent health literacy (Short Test of Functional Health Literacy in Adults (STOFHLA); adequate>=23; low<23). Primary outcome variables involving self-reported obesogenic behaviors: (1) feeding content (more formula than breastmilk, sweet drinks, early solid food introduction) and feeding style-related behaviors (pressuring to finish, laissez-faire bottle propping/television [TV] watching while feeding, non-responsiveness in letting child decide amount to eat); and (2) physical activity (tummy time, TV). Multivariate logistic regression analyses (binary, proportional odds models) performed adjusting for child sex, out of home care, WIC status, parent age, race/ethnicity, language, number of adults/children in home, income, and site. Results 11.0% of parents were categorized as having low health literacy. Low health literacy significantly increased the odds of a parent reporting that they feed more formula than breast milk (AOR=2.0 [95%CI:1.2–3.5]), immediately feed when their child cries (AOR=1.8[1.1–2.8]), bottle prop (AOR=1.8 [1.002–3.1]), any infant TV watching (AOR=1.8 [1.1–3.0]), and inadequate tummy time (<30 minutes/day) (AOR=3.0[1.5–5.8]). Conclusions Low parent health literacy is associated with certain obesogenic infant care behaviors. These behaviors may be modifiable targets for low health literacy-focused interventions to help reduce childhood obesity. PMID:24370343

  6. Physical fitness and volume of leisure time physical activity relate with low stress and high mental resources in young men.

    PubMed

    Kettunen, O; Kyröläinen, H; Santtila, M; Vasankari, T

    2014-08-01

    There is limited evidence available regarding the relationship between physical fitness, especially muscular fitness, and the mental well-being among young healthy men. Therefore, the aim of the present study was to investigate the impact of measured cardiovascular and muscle fitness and self reported leisure time physical activity (LTPA) on outcomes of stress and mental resources in Finnish young men. In a cross-sectional study, 831 men (mean age 25 y) underwent cardiovascular and muscle fitness test and completed LTPA and Occupational Stress Questionnaires (OSQ). For analysis, the subjects were divided to LTPA, CVF and MFI tertiles. The group with low LTPA reported 6% and 13% more stress (ANCOVA using age, body mass index, smoking and alcohol use as covariates, P<0.05 in both) and 6% and 12% (P<0.05 in both) less mental resources than the moderate and high LTPA groups, respectively. The group having low cardiovascular fitness experienced 8% and 9% (P<0.001 in both) more stress and 7% and 7% (P<0.05 in both) less mental resources than moderate and high cardiovascular fitness groups. The low muscle fitness index (MFI) group reported 7% (P<0.01) less mental resources than those with moderate MFI and 8% (P<0.001) more stress and 8% (P<0.001) less mental resources than those with high MFI. Both good aerobic and muscular fitness together with high LTPA are associated with low stress and high mental resources.

  7. Epidemiology of Musculoskeletal Injuries among Sedentary and Physically Active Adults.

    ERIC Educational Resources Information Center

    Hootman, Jennifer M.; Macera, Carol A.; Ainsworth, Barbara E.; Addy, Cheryl L.; Martin, Malissa; Blair, Steven N.

    2002-01-01

    Examined types and frequencies of musculoskeletal injuries among adults with above average activity levels enrolled in the Dallas Aerobics Center Longitudinal Study. Participant surveys and examinations indicated that one-quarter of all respondents reported musculoskeletal injuries (most of which were activity- related). Sport participants had the…

  8. Measuring physical activity-related environmental factors: reliability and predictive validity of the European environmental questionnaire ALPHA

    PubMed Central

    2010-01-01

    Background A questionnaire to assess physical activity related environmental factors in the European population (a 49-item and an 11-item version) was created as part of the framework of the EU-funded project "Instruments for Assessing Levels of PHysical Activity and fitness (ALPHA)". This paper reports on the development and assessment of the questionnaire's test-retest stability, predictive validity, and applicability to European adults. Methods The first pilot test was conducted in Belgium, France and the UK. In total 190 adults completed both forms of the ALPHA questionnaire twice with a one-week interval. Physical activity was concurrently measured (i) by administration of the long version of the International Physical Activity Questionnaire (IPAQ) by interview and (ii) by accelerometry (Actigraph™ device). After adaptations, the second field test took place in Belgium, the UK and Austria; 166 adults completed the adapted questionnaire at two time points, with minimum one-week interval. In both field studies intraclass correlation coefficients (ICC) and proportion of agreement were computed to assess the stability of the two test scores. Predictive validity was examined in the first field test by correlating the results of the questionnaires with physical activity data from accelerometry and long IPAQ-last 7 days. Results The reliability scores of the ALPHA questionnaire were moderate-to good in the first field testing (ICC range 0.66 - 0.86) and good in the second field testing (ICC range 0.71 - 0.87). The proportion of agreement for the ALPHA short increased significantly from the first (range 50 - 83%) to the second field testing (range 85 - 95%). Environmental scales from both versions of the ALPHA questionnaire were significantly associated with self-reported minutes of transport-related walking, and objectively measured low intensity physical activity levels, particularly in women. Both versions were easily administered with an average completion time

  9. [Evaluation of perceptions of physical activity related built environment among urban adults with different characteristics in Hangzhou].

    PubMed

    Ren, Yanjun; Liu, Qingmin; Cao, Chengjian; Su, Meng; Lyu, Jun; Li, Liming

    2015-10-01

    To understand the perceptions of physical activity-related built environment among urban adults in Hangzhou. A face-to-face interview was conducted among the urban residents aged 25-59 years selected through multistage stratified random sampling in Hangzhou in 2012. The Neighborhood Environment Walkability Scale-Abbreviated (NEWS-A) was used to assess the perception of built environment among residents, including residential building density, the diversities of stores, facilities and others, the accessibility to public service, the street connectivity, walking/cycling facilities, aesthetics, traffic safety, and public security. The multilevel logistic regression model was used to assess the demographic characteristics, BMI and other factors' influence on people's perceptions. Among 1 362 local residents surveyed, no sex, martial status and occupation specific significant differences in the perception of built environment were found. After adjusting other factors, the age group 45-59 years was positively related to the score of street connectivity (OR=2.02, 95% CI: 1.30-3.15). The educational level of college or higher was positively associated with the score of residential building density (OR=1.97, 95% CI: 1.29-3.00) but negatively associated with the score of facility variety (OR=0.65, 95% CI: 0.43-0.97). Overweight or obesity was negatively related to the scores of walking/cycling ways (OR=0.67, 95%CI: 0.48-0.95) and public security (OR=0.75, 95% CI: 0.57-0.99). Compared with the class I residential area, the people in class III residential area had lower perception scores on facility diversity (OR=0.11, 95% CI: 0.04-0.30), accessibility to public service (OR=0.33, 95% CI: 0.11-0.95), street connectivity (OR=0.30, 95% CI: 0.11-0.86) and traffic safety (OR=0.39, 95% CI: 0.17-0.91). The perceptions of physical activity-related built environment was associated with age, educational level, BMI and residential area. The personal characteristics should be considered

  10. Physical activity, and physical activity related to sports, leisure and occupational activity as risk factors for ALS: A systematic review.

    PubMed

    Lacorte, Eleonora; Ferrigno, Luigina; Leoncini, Emanuele; Corbo, Massimo; Boccia, Stefania; Vanacore, Nicola

    2016-07-01

    Amyotrophic lateral sclerosis (ALS) is considered a multifactorial, multisystem neurodegenerative disease due to an interaction between environmental and genetic factors. This systematic review aims at gathering all available evidence on the association between physical activity (PA) and the risk of ALS. Relevant literature published up to January 2015 was gathered through structured searches on Medline, The Cochrane Library, and the ISI Web of Science databases. Studies considering any type of PA as the main exposure and a diagnosis of ALS or motor neuron disease were selected. Data were extracted in standardized forms, and the quality of included studies was assessed using the Newcastle-Ottawa Scale (NOS). Bibliographic searches yielded 3168 records. Nineteen case control studies and 7 cohort studies met the inclusion criteria, and were included in the analysis. Evidence on cumulative measures of PA as a risk factor for ALS remain inconclusive. However, cohort studies report a significantly higher number of cases of ALS in professional soccer and American football players, and a slightly increased risk of ALS in varsity athletes. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Physical Activity Assessment: Biomarkers and Self-Report of Activity-Related Energy Expenditure in the WHI

    PubMed Central

    Neuhouser, Marian L.; Di, Chongzhi; Tinker, Lesley F.; Thomson, Cynthia; Sternfeld, Barbara; Mossavar-Rahmani, Yasmin; Stefanick, Marcia L.; Sims, Stacy; Curb, J. David; Lamonte, Michael; Seguin, Rebecca; Johnson, Karen C.; Prentice, Ross L

    2013-01-01

    We used a biomarker of activity-related energy expenditure (AREE) to assess measurement properties of self-reported physical activity and to determine the usefulness of AREE regression calibration equations in the Women's Health Initiative. Biomarker AREE, calculated as the total energy expenditure from doubly labeled water minus the resting energy expenditure from indirect calorimetry, was assessed in 450 Women's Health Initiative participants (2007–2009). Self-reported AREE was obtained from the Arizona Activity Frequency Questionnaire (AAFQ), the 7-Day Physical Activity Recall (PAR), and the Women's Health Initiative Personal Habits Questionnaire (PHQ). Eighty-eight participants repeated the protocol 6 months later. Reporting error, measured as log(self-report AREE) minus log(biomarker AREE), was regressed on participant characteristics for each instrument. Body mass index was associated with underreporting on the AAFQ and PHQ but overreporting on PAR. Blacks and Hispanics underreported physical activity levels on the AAFQ and PAR, respectively. Underreporting decreased with age for the PAR and PHQ. Regressing logbiomarker AREE on logself-reported AREE revealed that self-report alone explained minimal biomarker variance (R2 = 7.6, 4.8, and 3.4 for AAFQ, PAR, and PHQ, respectively). R2 increased to 25.2, 21.5, and 21.8, respectively, when participant characteristics were included. Six-month repeatability data adjusted for temporal biomarker variation, improving R2 to 79.4, 67.8, and 68.7 for AAFQ, PAR, and PHQ, respectively. Calibration equations “recover” substantial variation in average AREE and valuably enhance AREE self-assessment. PMID:23436896

  12. Injury Prevention in Physical Education: Scenarios and Solutions

    ERIC Educational Resources Information Center

    Merrie, Michael D.; Shewmake, Cole; Calleja, Paul

    2016-01-01

    The purpose of this article is to provide physical educators with practical strategies that can assist in preventing injuries in the classroom. The dynamic nature of physical education and the numerous tasks physical educators must complete daily can be challenging. Embedded in these challenges is the constant risk of student injury. Fortunately,…

  13. Injury Prevention in Physical Education: Scenarios and Solutions

    ERIC Educational Resources Information Center

    Merrie, Michael D.; Shewmake, Cole; Calleja, Paul

    2016-01-01

    The purpose of this article is to provide physical educators with practical strategies that can assist in preventing injuries in the classroom. The dynamic nature of physical education and the numerous tasks physical educators must complete daily can be challenging. Embedded in these challenges is the constant risk of student injury. Fortunately,…

  14. 77 FR 3106 - Damages Received on Account of Personal Physical Injuries or Physical Sickness

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-23

    ... 9573] RIN 1545-BF81 Damages Received on Account of Personal Physical Injuries or Physical Sickness... damages on account of personal physical injuries or physical sickness and taxpayers paying these damages..., damages received from a legal suit, action, or settlement agreement must be based upon ``tort or tort type...

  15. Mental health following traumatic physical injury: an integrative literature review.

    PubMed

    Wiseman, Taneal; Foster, Kim; Curtis, Kate

    2013-11-01

    To investigate the state of knowledge on the relationship between physical trauma and mental health in patients admitted to hospital with traumatic physical injury. Adults who sustain traumatic physical injury can experience a range of mental health problems related to the injury and subsequent changes in physical health and function. However early screening and identification of mental health problems after traumatic physical injury is inconsistent and not routine during the hospital admission process for the physically injured patient. Integrative review methods were used. Data were sourced for the period 1995-2010 from EMBASE, CINAHL, MEDLINE and PsycINFO and hand searching of key references. Abstracts were screened by 3 researchers against inclusion/exclusion criteria. Forty-one papers met the inclusion criteria. Data were retrieved, appraised for quality, analysed, and synthesised into 5 main categories. Forty-one primary research papers on the relationship between mental health and traumatic physical injury were reviewed. Studies showed that post-traumatic stress disorder, depression and anxiety were frequent sequelae associated with traumatic physical injury. However, these conditions were poorly identified and treated in the acute hospital phase despite their effect on physical health. There is limited understanding of the experience of traumatic physical injury, particularly in relation to mental health. Greater translation of research findings to practice is needed in order to promote routine screening, early identification and referral to treatment for mental health problems in this patient group. Copyright © 2012 Elsevier Ltd. All rights reserved.

  16. Sports injuries in physical education teacher education students.

    PubMed

    Goossens, L; Verrelst, R; Cardon, G; De Clercq, D

    2014-08-01

    Sports injuries could be highly detrimental to the career of a physical education teacher education (PETE) student. To enable the development of future sports injury prevention programs, sports injuries in 128 first-year academic bachelor PETE students were registered prospectively during one academic year. Common risk factors for sports injuries, taken from the literature, were also evaluated by means of logistic regression analysis. We found an incidence rate of 1.91 and an injury risk of 0.85, which is higher than generally found in a sports-active population. Most injuries involved the lower extremities, were acute, newly occurring injuries, and took place in non-contact situations. More than half of all injuries lead to an inactivity period of 1 week or more and over 80% of all injuries required medical attention. A major part of these injuries happened during the intracurricular sports classes. Few differences were seen between women and men. A history of injury was a significant risk factor (P = 0.018) for the occurrence of injuries, and performance of cooling-down exercises was significantly related to a lower occurrence of ankle injuries (P = 0.031). These data can inform future programs for the prevention of sports injuries in PETE students. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Physical Training Injuries and Interventions for Military Recruits

    DTIC Science & Technology

    2012-05-01

    FITNESS AND TRAINING-RELATED INJURY RISK Researchers have identified multiple risk factors for training- related injury ( Table I). Physical fitness...composition or body fatness can be directly esti- mated by hydrostatic weighing, dual-energy X-ray absorp- tiometry, bioelectrical impedance, skinfold ... thickness , and circumferential measures. The Army uses specified anatomic circumferential measurements to estimate body fat percent- age. Body mass

  18. Physical training risk factors for musculoskeletal injury in female soldiers.

    PubMed

    Roy, Tanja C; Songer, Thomas; Ye, Feifei; LaPorte, Ronald; Grier, Tyson; Anderson, Morgan; Chervak, Michelle

    2014-12-01

    Musculoskeletal injuries (MSIs) result in the most medical encounters, lost duty days, and permanent disability. Women are at greater risk of injury than men and physical training is the leading cause of injury. The purpose of this study was to investigate the demographic, body composition, fitness, and physical training risk factors for injuries in female Soldiers serving in garrison Army units over the past 12 months. Self-report survey was collected from 625 women. The ankle was the most frequently injured body region, 13%. Running was the activity most often associated with injury, 34%. In univariate analysis lower rank, older age, history of deployment, no unit runs, weekly frequency of personal resistance training, and history of injury were all associated with injury. In multivariate analysis rank, history of injury, weekly frequency of unit runs, and weekly frequency of personal resistance training were the best combination of predictors of injury. Running once or twice a week with the unit protected against MSIs, whereas participating in personal resistance training sessions once or twice a week increased the risk of MSIs. With more emphasis on running and resistance training, the U.S. Army could reduce injuries and save billions of dollars in training and health care costs.

  19. Anthropometrics, Physical Performance, and Injury Characteristics of Youth American Football

    PubMed Central

    Caswell, Shane V.; Ausborn, Ashley; Diao, Guoqing; Johnson, David C.; Johnson, Timothy S.; Atkins, Rickie; Ambegaonkar, Jatin P.; Cortes, Nelson

    2016-01-01

    Background: Prior research has described the anthropometric and physical performance characteristics of professional, collegiate, and high school American football players. Yet, little research has described these factors in American youth football and their potential relationship with injury. Purpose: To characterize anthropometric and physical performance measures, describe the epidemiology of injury, and examine the association of physical performance measures with injury among children participating within age-based divisions of a large metropolitan American youth football league. Study Design: Case-control study; Level of evidence, 3. Methods: Demographic, anthropometric, and physical performance characteristics and injuries of 819 male children were collected over a 2-year period (2011-2012). Injury data were collected by the league athletic trainer (AT) and coaches. Descriptive analysis of demographic, anthropometric, and physical performance measures (40-yard sprint, pro-agility, push-ups, and vertical jump) were conducted. Incidence rates were computed for all reported injuries; rates were calculated as the number of injuries per 1000 athlete-exposures (AEs). Multinomial logistic regression was used to identify whether the categories of no injury, no-time-loss (NTL) injury, and time-loss (TL) injury were associated with physical performance measures. Results: Of the 819 original participants, 760 (92.8%) completed preseason anthropometric measures (mean ± SD: age, 11.8 ± 1.2 years; height, 157.4 ± 10.7 cm; weight, 48.7 ± 13.3 kg; experience, 2.0 ± 1.8 years); 640 (78.1%) players completed physical performance measures. The mean (±SD) 40-yard sprint and pro-agility measures of the players were 6.5 ± 0.6 and 5.7 ± 0.5 seconds, respectively; the number of push-ups and maximal vertical jump height were 16.5 ± 9.3 repetitions and 42.3 ± 8.4 cm, respectively. Players assigned to different teams within age divisions demonstrated no differences in

  20. Design of the iPlay study: systematic development of a physical activity injury prevention programme for primary school children.

    PubMed

    Collard, Dorine C M; Chinapaw, Mai J M; van Mechelen, Willem; Verhagen, Evert A L M

    2009-01-01

    Health benefits of physical activity in children are well known. However, a drawback is the risk of physical activity-related injuries. Children are at particular risk for these injuries, because of a high level of exposure. Because of the high prevalence of physical activity injuries and the negative short- and long-term consequences, prevention of these injuries in children is important. This article describes how we systematically developed a school-based physical activity injury prevention programme using the intervention mapping (IM) protocol. IM describes a process for developing theory- and evidence-based health promotion programmes. The development can be described in six steps: (i) perform a needs assessment; (ii) identify programme and performance objectives; (iii) select methods and strategies; (iv) develop programme; (v) adopt and implement; and (vi) evaluate. First, the results of the needs assessment showed the injury problem in children and the different risk factors for physical activity injuries. Based on the results of the needs assessment the main focus of the injury prevention programme was described. Second, the overall programme objective of the injury prevention programme was defined as reducing the incidence of lower extremity physical activity injuries. Third, theoretical methods and practical strategies were selected to accomplish a decrease in injury incidence. The theoretical methods used were active learning, providing cues and scenario-based risk information, and active processing of information. The practical strategy of the injury prevention programme was an 8-month course about injury prevention to be used in physical education classes in primary schools. Fourth, programme materials that were used in the injury prevention programme were developed, including newsletters for children and parents, posters, exercises to improve motor fitness, and an information website. Fifth, an implementation plan was designed in order to ensure that

  1. Dietary-related and physical activity-related predictors of obesity in children: a 2-year prospective study.

    PubMed

    Carlson, Jordan A; Crespo, Noe C; Sallis, James F; Patterson, Ruth E; Elder, John P

    2012-04-01

    This observational study examined cross-sectional and 24-month longitudinal associations of physical activity and dietary behaviors with change in BMI and percent body fat among children aged 6–9 years old. Data were from the control group (n = 271; 48% Latino) of a community-based childhood obesity prevention program. Assessments were conducted at baseline and at 24 months and included height and weight, bioelectrical impedance–derived percent body fat, and 10 physical activity and dietary behaviors measured via parent report of their child. Cross-sectional analysis of variances (ANOVA) (normal weight, overweight, obese) and longitudinal mixed-effects linear regression models were used to investigate the relation of each physical activity and dietary behavior with BMI and percent body fat. At baseline, obese children engaged in less physical activity and more sedentary behavior than normal-weight children (p < 0.05). Increased physical activity (p < 0.01) and number of breakfasts eaten with family (p < 0.05) were associated with decreased BMI z-score and percent body fat. Decreased sedentary behavior and sugar-sweetened beverage consumption were associated with decreased percent body fat (p < 0.05) but not BMI. In this cohort of 271 children, increased physical activity and eating breakfast with family and reduced screen-based sedentary behaviors and sugar-sweetened beverage consumption were associated with more favorable trends in adiposity. Therefore, attention to these behaviors may be of particular importance. Results also suggest that future studies should include percent body fat as an outcome for a more precise assessment of the association of behavior with adiposity.

  2. Physical fitness and injury reporting among active duty and National Guard/Reserve women: associations with risk and lifestyle factors.

    PubMed

    Kazman, Josh B; de la Motte, Sarah; Bramhall, Elizabeth M S; Purvis, Dianna L; Deuster, Patricia A

    2015-01-01

    As more women enter the military, it is important to understand how different risks and lifestyle factors influence physical fitness and injury among women in both active duty (AD) and National Guard/Reserve (NG/R). Women in military service are less fit and more likely to suffer musculoskeletal injuries during physical training than men. They also use more medical care during deployment than men. Using data from the Comprehensive Soldier and Family Fitness Global Assessment Tool 2.0 (GAT 2.0), self-reported health and lifestyle and behavioral risk factors were analyzed in nondeployed Army personnel, with the goals of examining (1) service-component differences across traditional risk and lifestyle factors, and (2) correlates of physical performance and physical activity-related injury. Self-report GAT 2.0 data included health risk factors (overall perceived health, sleep, diet, tobacco and alcohol use), self-reported health metrics (height, weight, Army Physical Fitness Test (APFT) scores), and history of physical activity-related injury. The GAT 2.0 was completed by 1,322 AD and 1,033 NG/R women, and APFT data were available for a subsample of 605 AD and 582 NG/R women. Initial analyses of GAT 2.0 data indicated that AD had higher rates of fair/poor perceived health, poor sleep, and unhealthy diet compared to NG/R women. However, AD women had a lower APFT fail rate (8%) than NG (27%) and R (28%). Active duty women were more likely to experience a physical injury in the past 6 months (38%) than NG (19%) and R (22%) women, and more likely to seek medical care than NG/R women. Across all service components, predictive factors for APFT failure included high body mass index (BMI), fair/poor health, and unhealthy diet. Predictive factors for physical injury included high BMI, fair/poor health, and binge drinking. Our analyses suggest that AD women Soldiers are more physically fit than NG/R women Soldiers, which is accompanied by a greater prevalence of physical

  3. Physical injuries and fatalities resulting from the Oklahoma City bombing.

    PubMed

    Mallonee, S; Shariat, S; Stennies, G; Waxweiler, R; Hogan, D; Jordan, F

    1996-08-07

    To provide an epidemiologic description of physical injuries and fatalities resulting from the April 19, 1995, bombing of the Alfred P. Murrah Federal Building in Oklahoma City. Descriptive epidemiologic study of all persons injured by the bombing and of all at-risk occupants of the federal building and 4 adjacent buildings. Data were gathered from hospital emergency and medical records departments, medical examiner records, and surveys of area physicians, building occupants, and survivors. All persons known to have been exposed to the blast. Characteristics of fatalities and injuries, injury maps, and injury rates by building location. A total of 759 persons sustained injuries, 167 persons died, 83 survivors were hospitalized, and 509 persons were treated as outpatients. Of the 361 persons who were in the federal building, 319 (88%) were injured, of whom 163 (45%) died, including 19 children. Persons in the collapsed part of the federal building were significantly more likely to die (153/175, 87%) than those in other parts of the building (10/186, 5%) (risk ratio [RR], 16.3; 95% confidence interval [CI], 8.9-29.8). In 4 adjacent buildings, injury rates varied from 38% to 100%; 3 persons in these buildings and 1 person in an outdoor location died. The most frequent cause of death was multiple injuries. Among survivors, soft tissue injuries, fractures, sprains, strains, and head injuries were most common; these injuries were most often caused by flying glass and other debris and collapsed ceilings. The Oklahoma City bombing resulted in the largest number of fatalities of any terrorist act in the United States, and there were 4 times as many nonfatal injuries as fatalities. Disaster management plans should include the possibility of terrorist bombing, and medical preparedness should anticipate that most injuries will be nonfatal. The role of building collapse in fatal injuries should be considered in the design of buildings at high risk of being bombed so as to

  4. Measuring the Ability to Tolerate Activity-Related Discomfort: Initial Validation of the Physical Activity Acceptance Questionnaire (PAAQ)

    PubMed Central

    Butryn, Meghan L.; Arigo, Danielle R.; Raggio, Greer A.; Kaufman, Alison I.; Kerrigan, Stephanie G.; Forman, Evan M.

    2015-01-01

    Background Physical activity (PA) is essential for health, but many adults find PA adherence challenging. Acceptance of discomfort related to PA may influence an individual's ability to begin and sustain a program of exercise. The aim of this study was to evaluate the psychometric properties of the Physical Activity Acceptance Questionnaire (PAAQ). Method The PAAQ was administered to three distinct samples (N = 418). Each sample completed additional self-report measures; one sample also wore accelerometers for seven days (at baseline and six months later). Results The PAAQ demonstrated high internal validity for its total score (α = 0.89) and two subscales (Cognitive Acceptance α = 0.86, Behavioral Commitment α = 0.85). The PAAQ also showed convergent validity with measures of mindfulness, self-reported physical activity levels, and accelerometer-verified levels of moderate-to-vigorous PA (MVPA; ps < 0.05). The Cognitive Acceptance subscale showed predictive validity for objectively-verified PA levels among individuals attempting to increase PA over six months (p = 0.05). Test-retest reliability for a subset of participants (n = 46) demonstrated high consistency over one week (p < 0.0001). Conclusions The PAAQ demonstrates sound psychometric properties, and shows promise for improving the current understanding of PA facilitators and barriers among adults. PMID:25106049

  5. The Effects of Physical Restraint on Self-Injurious Behaviour.

    ERIC Educational Resources Information Center

    Singh, N. N.; And Others

    1981-01-01

    Brief (one minute) response contingent physical restraint was shown in two experiments with a 16-year-old profoundly retarded institutionalized girl to be more effective in controlling self-injurious behavior (SIB) than three minute physical restraint, which in the first study produced an increase in SIB. (CL)

  6. Physical Disability After Injury-Related Inpatient Rehabilitation in Children

    PubMed Central

    Durbin, Dennis R.; Winston, Flaura K.; Zhao, Huaqing; Stineman, Margaret G.

    2013-01-01

    OBJECTIVE: To determine the residual physical disability after inpatient rehabilitation for children 7 to 18 years old with traumatic injuries. METHODS: This was a retrospective cohort study of patients aged 7 to 18 years who underwent inpatient rehabilitation for traumatic injuries from 2002 to 2011. Patients were identified from the Uniform Data System for Medical Rehabilitation. Injuries were captured by using standardized Medicare Inpatient Rehabilitation Facility Patient Assessment Instrument codes. Functional outcome was measured with the Functional Independence Measure (FIM) instrument. A validated, categorical grading system of the FIM motor items was used, consisting of clinically relevant levels of physical achievement from grade 1 (need for total assistance) to grade 7 (completely independent for self-care and mobility). RESULTS: A total of 13 798 injured children underwent inpatient rehabilitation across 523 facilities during the 10-year period. After a mean 3-week length of stay, functional limitations were reduced, but children still tended to have residual physical disabilities (median admission grade: 1; median discharge grade: 4). Children with spinal cord injuries, either alone or in combination with other injuries, had lower functional grade at discharge, longer lengths of stay, and more comorbidities at discharge than those with traumatic brain injuries, burns, and multiple injuries (P < .0001 for all comparisons). CONCLUSIONS: Children had very severe physical disability on admission to inpatient rehabilitation for traumatic injuries, and those with spinal cord injuries had persistent disability at discharge. These traumatic events during critical stages of development may result in a substantial care burden over the child’s lifespan. PMID:23248228

  7. A multifactorial injury prevention intervention reduces injury incidence in Physical Education Teacher Education students.

    PubMed

    Goossens, L; Cardon, G; Witvrouw, E; Steyaert, A; De Clercq, D

    2016-01-01

    Physical Education Teacher Education (PETE) students are at considerable risk for non-contact sports injuries of the lower extremities. Multifactorial injury prevention interventions including exercises have been successful in sports populations, but no such study has ever been performed in PETE students. This study investigated the efficacy of a multifactorial injury prevention intervention on injury incidence reduction in PETE students. PETE students in the intervention group (n = 154) and in the control group (n = 189) registered sports injuries prospectively. The intervention lasted one academic year and consisted of an injury awareness programme and preventive strategies, implemented by the PETE sports lecturers. Differences in injury incidence between the intervention and control group were tested by Poisson regression Wald tests. There was a trend towards significantly lower incidence rate (2.18 vs. 2.73; p = 0.061) in the intervention group compared with the control group. Students in the intervention group had significantly less acute, first-time and extracurricular injuries. The largest reduction was observed for injuries during unsupervised practice sessions. A multifactorial injury prevention intervention embedded into a regular PETE programme is a promising and feasible strategy to prevent injuries in PETE students. Further research is needed to investigate whether the results may be generalised to other PETE programmes.

  8. Therapeutic physical exercise in neural injury: friend or foe?

    PubMed Central

    Park, Kanghui; Lee, Seunghoon; Hong, Yunkyung; Park, Sookyoung; Choi, Jeonghyun; Chang, Kyu-Tae; Kim, Joo-Heon; Hong, Yonggeun

    2015-01-01

    [Purpose] The intensity of therapeutic physical exercise is complex and sometimes controversial in patients with neural injuries. This review assessed whether therapeutic physical exercise is beneficial according to the intensity of the physical exercise. [Methods] The authors identified clinically or scientifically relevant articles from PubMed that met the inclusion criteria. [Results] Exercise training can improve body strength and lead to the physiological adaptation of skeletal muscles and the nervous system after neural injuries. Furthermore, neurophysiological and neuropathological studies show differences in the beneficial effects of forced therapeutic exercise in patients with severe or mild neural injuries. Forced exercise alters the distribution of muscle fiber types in patients with neural injuries. Based on several animal studies, forced exercise may promote functional recovery following cerebral ischemia via signaling molecules in ischemic brain regions. [Conclusions] This review describes several types of therapeutic forced exercise and the controversy regarding the therapeutic effects in experimental animals versus humans with neural injuries. This review also provides a therapeutic strategy for physical therapists that grades the intensity of forced exercise according to the level of neural injury. PMID:26834383

  9. Blood markers of fatty acids and vitamin D, cardiovascular measures, body mass index, and physical activity relate to longitudinal cortical thinning in normal aging.

    PubMed

    Walhovd, Kristine B; Storsve, Andreas B; Westlye, Lars T; Drevon, Christian A; Fjell, Anders M

    2014-05-01

    We hypothesized that higher levels of omega-3 fatty acids, vitamin D, and physical activity relate to cortical sparing, whereas higher levels of cholesterol, systolic blood pressure, and body mass index (BMI) relate to increased atrophy in the adult lifespan. Longitudinal measures of cortical thickness were derived from magnetic resonance imaging scans acquired (mean interval 3.6 years) from 203 healthy persons aged 23-87 years. At follow-up, measures of BMI, blood pressure, and physical activity were obtained. Blood levels of docosahexaenoic acid, eicosapentaenoic acid, vitamin D, and cholesterol were measured in a subsample (n = 92). Effects were tested in cortical surface-based analyses, with sex, age, follow-up interval, and the interactions between each included as covariates. Higher levels of docosahexaenoic acid, vitamin D, and physical activity related to cortical sparing. Higher cholesterol and BMI related to increased cortical thinning. Effects were independent, did not interact with age, and the cholesterol effect was restricted to males. Eicosapentaenoic acid and blood pressure showed no effects. The observed effects show promise for potential factors to reduce cortical atrophy in normal aging.

  10. Musculoskeletal injuries in physical education versus non-physical education teachers: a prospective study.

    PubMed

    Goossens, Lennert; Vercruysse, Sien; Cardon, Greet; Haerens, Leen; Witvrouw, Erik; De Clercq, Dirk

    2016-01-01

    Physical education (PE) teachers have a physically demanding job, putting them at a considerable risk for musculoskeletal injuries. To structurally develop tailored injury prevention programmes for PE teachers, a clear understanding of the extent, characteristics and underlying factors of their musculoskeletal injuries compared to referents is necessary. Therefore, the current study prospectively followed 103 PE teachers and 58 non-PE teachers, who registered musculoskeletal injuries and time of exposure to sports participation during one school year. Pearson χ(2)-tests and independent samples t-tests determined significant differences between PE and non-PE teachers regarding demographics and variables possibly related to injury occurrence. PE teachers had 1.23 and non-PE teachers 0.78 injuries/teacher/school year. This difference was significantly different after adjustment for hours spent weekly on intracurricular teaching during the career and for injury history during the preceding six months (P = 0.009; OR = 0.511; 95% CI = 0.308-0.846). PE teachers' most affected body parts were the knee and the back. PE teachers had a more extensive injury history (P < 0.001), a higher work- (P < 0.001) and sport index (P < 0.001), practiced more sports (P < 0.002) and taught more extracurricular sports (P = 0.001). Future injury prevention programmes should take account for the great injury history and heavy physical load in PE teachers.

  11. The physical basis of explosion and blast injury processes.

    PubMed

    Proud, W G

    2013-03-01

    Energetic materials are widely used in civilian and military applications, such as quarrying and mining, flares, and in munitions. Recent conflicts have involved the widespread use of improvised explosive devices to attack military, civilians and infrastructure. This article gives a basic overview of explosive technology and the underlying physical processes that produce the injuries encountered. In particular aspects relevant to primary and secondary injuries are discussed.

  12. Development of Physical Activity-Related Parenting Practices Scales for Urban Chinese Parents of Preschoolers: Confirmatory Factor Analysis and Reliability.

    PubMed

    Suen, Yi-Nam; Cerin, Ester; Barnett, Anthony; Huang, Wendy Y J; Mellecker, Robin R

    2017-09-01

    Valid instruments of parenting practices related to children's physical activity (PA) are essential to understand how parents affect preschoolers' PA. This study developed and validated a questionnaire of PA-related parenting practices for Chinese-speaking parents of preschoolers in Hong Kong. Parents (n = 394) completed a questionnaire developed using findings from formative qualitative research and literature searches. Test-retest reliability was determined on a subsample (n = 61). Factorial validity was assessed using confirmatory factor analysis. Subscale internal consistency was determined. The scale of parenting practices encouraging PA comprised 2 latent factors: Modeling, structure and participatory engagement in PA (23 items), and Provision of appropriate places for child's PA (4 items). The scale of parenting practices discouraging PA scale encompassed 4 latent factors: Safety concern/overprotection (6 items), Psychological/behavioral control (5 items), Promoting inactivity (4 items), and Promoting screen time (2 items). Test-retest reliabilities were moderate to excellent (0.58 to 0.82), and internal subscale reliabilities were acceptable (0.63 to 0.89). We developed a theory-based questionnaire for assessing PA-related parenting practices among Chinese-speaking parents of Hong Kong preschoolers. While some items were context and culture specific, many were similar to those previously found in other populations, indicating a degree of construct generalizability across cultures.

  13. Physical Activity and Musculoskeletal Injuries in Women: The Women's Injury Study

    PubMed Central

    DeFina, Laura F.; Leonard, David; Custodio, Michelle A.; Morrow, James R.

    2013-01-01

    Abstract Background Increased injury rates have been associated with physical activity (PA). The differences in musculoskeletal injury (MSI) characteristics resulting from PA, versus those unrelated to PA, are unknown. We describe the pattern of PA and non-PA MSI incurred by community-dwelling women. Methods Data were extracted from the Women's Injury Study, a web-based observational study that tracked weekly PA behaviors and self-reported MSI of 909 community-dwelling women ages 20–83 years. The primary outcome was self-reported MSI that interrupted daily activities ≥2 days and/or required treatment from a health care provider. Follow-up telephone reporting of MSIs allowed further description of injuries. Mixed effects logistic regression was used to identify injury sites associated with PA, controlling for age, body mass index, previous injury, and use of alcohol. Results Incidence of PA and non-PA MSIs were comparable; some differences in injury characteristics were evident across 83,241 person-weeks of reporting. Non-PA MSIs were more likely to come on “suddenly” (54% vs. 8%) and commonly involved head/jaw/neck injuries. Reported PA-related MSIs were less likely to require health care provider treatment (60% vs. 80%) and resulted in less missed days of work/school (11%) versus non-PA MSIs (17%). Compared to non-PA related injuries, PA-related injuries were more likely to involve the lower (odds ratio [OR]=3.10, p=0.002) or upper limbs (OR=2.54, p=0.01) and less likely to involve the head/jaw/neck (OR=0.21, p=0.002). Conclusion There are some differences in mechanisms of injury, the distribution of injuries by anatomical location, and the treatment of injuries depending on aerobic activity participation, although absolute rates of MSI were comparable. PMID:24117001

  14. Physical Training, Fitness, and Injuries: Lessons Learned From Military Studies.

    PubMed

    Jones, Bruce H; Hauschild, Veronique D

    2015-11-01

    Injuries are the leading cause of medical encounters across the U.S. military services resulting in more than 2.0 million clinic visits per year. Almost 50% of military service members experience an injury each year and half of those injuries are caused by physical training (PT), exercise, or sports. To prevent a problem as large and complex as injuries in the military requires a systematic approach. Several key questions must be answered to effectively address a problem such as injuries: (1) how big is the problem? (2) what are the causes and risk factors for the problem? (3) do modifiable risk factors for the problem exist? and (4) what works to prevent the problem? The article discusses leading causes of injuries for U.S. Army populations. It then explores key risk factors for exercise and training-related injuries: (1) the amounts of training, (2) types of training activities, (3) participants level of fitness, and (4) personal health risk behaviors. The article concludes with a review of prevention strategies illustrating interventions that have been shown to be effective, and others that are not effective. The data presented suggest that PT and exercise cause injuries and that modifications of training are most likely to prevent the problem.

  15. The Importance of Physical Fitness for Injury Prevention: Part 2.

    PubMed

    Knapik, Joseph J

    2015-01-01

    This report examines associations between injuries and flexibility, stretching, warm-up, and body composition. Military studies show that either too much or too little flexibility increases injury risk. Static stretching prior to exercise does not appear to reduce the overall injury incidence, although further research is needed on some types of injuries. Static stretching also appears to reduce strength and power (explosive strength). Warm-up (low intensity activity prior to exercise or sports) appears to reduce injury risk. Body mass index (BMI; weight in kg/ height in m²) is a surrogate measure of body fat because it is highly related to laboratory measures of body fat. However, Soldiers can also have a high BMI because of higher muscle mass. If high BMI reflects a larger percentage of body fat relative to height, injury risk might be increased because the additional fat would increase the intensity of physical activity, leading to more rapid fatigue and repetitive stress on the musculoskeletal system. Low BMI could reflect a paucity of fat or muscle/ bone, or both. Low BMI may make Soldiers more susceptible to injury if they lack the muscle mass or strength in the supportive structures (ligaments, bones) required to perform certain physical tasks, and if they overexert or overuse the available muscle mass or supportive structures. Studies in basic combat training show that both high and low BMI increases injury risk. However, studies among active duty Soldiers only show that injury risk increases as BMI increases, possibly because very few active duty Soldiers have very low BMI (i.e., less than 18 kg/m²). 2015.

  16. Physical and psychological determinants of injury in Ontario forest firefighters.

    PubMed

    Gordon, H; Larivière, M

    2014-12-01

    Forest firefighters are faced with multiple physical and psychological challenges as a result of their duties. Little is known about the determinants of injury among these workers. The Ontario Ministry of Natural Resources (OMNR) Aviation, Forest Fire and Emergency Services (AFFES) records detailed information on two mutually exclusive types of workplace injury: First aid (self-reported) and Workplace Safety Insurance Board (WSIB, i.e. received medical attention). To identify the contributions of physical and psychological factors on the likelihood of injury among forest firefighters. Participants were male and female forest firefighters aged between 18 and 65. Data were collected using two self-administered instruments: The NEO Personality Inventory and the Job Stress Survey. Secondary data were collected from the OMNR AFFES and data were analysed by way of multivariate statistical procedures. There were 252 participants. Those who were older, had a history of injury, had high scores for the personality construct of Neuroticism or low scores for the Openness construct were significantly more likely to incur a first aid injury, while those with high experience levels were significantly less likely to incur injury (P < 0.05). High job stress was the only significant predictor of WSIB injury (P < 0.05). First aid and WSIB injuries in the OMNR AFFES were quite distinct phenomena and different factors need consideration in their prediction. It is recommended that managers and decision-makers in this field consider factors such as job stress, personality and the prior occurrence of injuries in their assessment of risk. © The Author 2014. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  17. Longitudinal influence of musculo-skeletal injuries and extra physical education on physical fitness in schoolchildren.

    PubMed

    Rexen, C T; Ersbøll, A K; Wedderkopp, N; Andersen, L B

    2016-12-01

    The aims of this study were to investigate if (A) injuries and (B) increased physical education (PE) influenced the development of physical fitness in schoolchildren. Simultaneously, to investigate if a possible PE effect was modified by sport participation outside school hours. This was a longitudinal controlled school-based study. Six schools with 270 min of PE (extra PE) and four schools with 90 min of PE were followed up for 2.5 years. In total, 1054 children were included for analysis (normal PE = 443, extra PE = 611). Development in fitness was analyzed using composite z-scores from six fitness tests measured four times. Information of injury and sport was derived from weekly automated mobile phone text messages surveying the presence of musculo-skeletal pain and organized sport participation. Injury and extra PE both influenced the development of physical fitness. Injury decreased development of physical fitness with -1.01 composite z-score units (95% CI: -1.57; -0.45). Extra PE increased physical fitness development with 0.80 (95% CI: 0.49; 1.10) composite z-score units. The influence of injury was not dependent on extra PE. No modifying effect was found by mean weekly sport participation outside school hours. In conclusion, extra PE had a positive effect, whereas injuries had a negative effect on physical fitness development in schoolchildren. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. Physical demands, injuries, and conditioning practices of stock car drivers.

    PubMed

    Ebben, William P; Suchomel, Timothy J

    2012-05-01

    The purpose of this study was to assess the physical demands, injuries, and conditioning practices of stock car drivers. Forty stock car drivers from 27 states in the United States participated in the interviews for 43.9 ± 13.9 minutes. The interviews examined background information, the physical demands of racing, injuries associated with racing, and the athletic and fitness background and practices of the subjects. Numerical data were analyzed using Pearson's correlation coefficients. Responses to open-ended questions were analyzed using inductive content analysis. Results revealed significant correlation between track points standings and the length of the resistance training sessions (R = -0.71, p = 0.002) and subject self-assessment of their fitness (R = -0.53, p = 0.045). Results also revealed that "upper-body strength" was identified as the most important physical demand. Extreme fatigue was the most common feeling after a demanding race. Subjects reported that shoulder fatigue was the most common form of muscle soreness experienced after a race. Back and torso injuries were the most common injury, although head injuries most frequently required medical attention. The subjects' biggest fear was fire, followed closely by head and neck injury. The bench press and running were the most commonly performed resistance training and cardiovascular exercises, respectively. Subjects reported that their highest motivation for training was to improve their racing performance. Many subjects had athletic backgrounds with football identified as the sport they had most commonly participated in. This study provides additional detailed information. Results of this study can assist strength and conditioning professionals in the development of strength and conditioning programs for performance enhancement and injury prevention that are specific to the needs of this population of athletes.

  19. Injuries from explosions: physics, biophysics, pathology, and required research focus.

    PubMed

    Champion, Howard R; Holcomb, John B; Young, Lee Ann

    2009-05-01

    Explosions cause more complex and multiple forms of damage than any other wounding agent, are the leading cause of death on the battlefield, and are often used by terrorists. Because explosion-related injuries are infrequently seen in civilian practice, a broader base of knowledge is needed in the medical community to address acute needs of patients with explosion-related injuries and to broaden mitigation-focused research efforts. The objective of this review is to provide insight into the complexities of explosion-related injury to help more precisely target research efforts to the most pressing areas of need in primary prevention, mitigation, and consequence management. An understanding of the physics and biological consequences of explosions together with data on the nature or severity of contemporary combat injuries provide an empiric basis for a comprehensive and balanced portfolio of explosion-related research. Cited works were identified using MeSH terms as directed by subtopic. Uncited information was drawn from the authors' surgical experience in Iraq, analysis of current combat trauma databases, and explosion-related research. Data from Iraq and Afghanistan confirm that survivable injuries from explosions are dominated by penetrating fragment wounds, substantiating longstanding and well-known blast physics mechanisms. Keeping this factual basis in mind will allow for appropriate vectoring of funds to increase understanding of this military and public health problem; address specific research and training needs; and improve mitigation strategies, tactics, and techniques for vehicles and personal protective equipment. A comprehensive approach to injury from explosions should include not only primary prevention, but also injury mitigation and consequence management. Recalibration of medical research focus will improve management of injuries from explosions, with profound implications in both civilian and military healthcare systems.

  20. The Effects of Physical Restraint on Self-Injurious Behaviour.

    ERIC Educational Resources Information Center

    Singh, N. N.; And Others

    1981-01-01

    Two experiments investigated the effects of two durations (1 and 3 minutes) of physical restraint on the rate of self injurious behavior (SIB) of a profoundly retarded adolescent girl. In both experiments one minute restraint was found to be more effective than three minute restraint in reducing the rate of SIB. (Author/SB)

  1. Injuries in children with extra physical education in primary schools.

    PubMed

    Rexen, Christina Trifonov; Andersen, Lars Bo; Ersbøll, Annette Kjær; Jespersen, Eva; Franz, Claudia; Wedderkopp, Niels

    2014-04-01

    (1) Examine the influence of extra physical education (EPE) on the number of musculoskeletal injuries in public schools accounting for organized sports participation (OSP) outside school. (2) Examine the major injury subgroup: growth-related overuse (GRO) through the overuse-related injury group. A longitudinal controlled school-based study among Danish public schools. At baseline, 1216 children participated age 6.2-12.4 yr. Six schools (701 children) with EPE and four control schools (515 children) were followed up with weekly automated mobile phone text messages for information on musculoskeletal problems and OSP. Health care personnel diagnosed the children according to the World Health Organization's International Classification of Diseases, Tenth Revision. Data were analyzed using a two-part zero-inflated negative binomial (ZINB) regression model. School type had no influence on the odds of sustaining an injury but increased the probability of sustaining a higher injury count for children with injuries, with total injuries by a factor of 1.29 (95% confidence interval [CI] = 1.07-1.56), overuse by a factor of 1.29 (95% CI = 1.06-1.55), and GRO by a factor of 1.38 (95% CI = 1.02-1.80). Weekly mean OSP decreased the odds of belonging to the group of children with no injuries, by a factor of 0.29 (95% CI = 0.14-0.58), 0.26 (95% CI = 0.14-0.48), and 0.17 (95% CI = 0.06-0.52) for total, overuse, and GRO, respectively. OSP also increased the probability of sustaining a higher injury count for children with injuries by a factor of 1.11 (95% CI = 1.02-1.22), 1.10 (95% CI = 1.00-1.22), and 1.14 (95% CI = 1.00-1.30), respectively. Children enrolled in EPE schools with high OSP have the highest odds of injury and a high probability of sustaining a higher injury count compared to their peers at schools with normal PE. Special attention should be assigned to these children during compulsory PE.

  2. 75 FR 1301 - Damages Received on Account of Personal Physical Injuries or Physical Sickness; Hearing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-11

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF THE TREASURY Internal Revenue Service 26 CFR Part 1 RIN 1545-BF81 Damages Received on Account of Personal Physical Injuries or Physical Sickness; Hearing AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of...

  3. The importance of physical fitness for injury prevention: part 1.

    PubMed

    Knapik, Joseph J

    2015-01-01

    Physical fitness can be defined as a set of attributes that allows the ability to perform physical activity. The attributes or components of fitness were identified by testing large numbers of individuals on physical performance tests (e.g., sit-ups, push-ups, runs, pull-ups, rope climbs, vertical jump, long jumps), and using statistical techniques to find tests that seem to share common performance requirements. These studies identified strength, muscular endurance, cardiorespiratory endurance, coordination, balance, flexibility, and body composition as important fitness components. Military studies have clearly shown that individuals with lower levels of cardiorespiratory endurance or muscular endurance are more likely to be injured and that improving fitness lowers injury risk. Those who are more fit perform activity at a lower percentage of their maximal capability and so can perform the task for a longer period of time, fatigue less rapidly, recover faster, and have greater reserve capacity for subsequent tasks. Fatigue alters movement patterns, putting stress on parts of the body unaccustomed to it, possibly increasing the likelihood of injury. Soldiers should develop and maintain high levels of physical fitness, not only for optimal performance of occupational tasks but also to reduce injury risk. 2015.

  4. Injury and Fitness Outcomes during Implementation of Physical Readiness Training

    DTIC Science & Technology

    2003-01-01

    recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness in healthy adults. Medicine and...J. J. Knapik’ K. G. Hauret’ S. Arnold’ M. Canham-Chervak’ A. J. Mansfield’ E. l. Hoedebecke’ D. McMillian2 Injury and Fitness Outcomes During... fitness outcomes in Ba- sic Combat Training (BCT) during implementation of Physical Readiness Training (PRT). PRT is the U.S. Army’s emerging physi- cal

  5. Injury biomechanics, neuropathology, and simplified physics of explosive blast and impact mild traumatic brain injury.

    PubMed

    Bandak, F A; Ling, G; Bandak, A; De Lanerolle, N C

    2015-01-01

    Explosive blast shock waves and blunt impact to the head are two types of loading shown to result in mild traumatic brain injury (mTBI). While mTBI from these two causes shares some common features behaviorally, there are distinct differences in the pathophysiology of the underlying injury mechanisms. Various elucidations have been offered in the literature to explain the organic damage associated with mTBI resulting from both types of loading. The current state of understanding in this field is somewhat limited by the degree of appreciation of the physics and biomechanics governing the effects of explosive blast shock waves and blunt impact on the head, which has resulted in the various approaches to the investigation of the operative brain injury "wounding mechanisms". In this chapter we provide a simplified description of terminology associated with forces on the head from explosive blast shock waves and blunt impact, to assist readers in the field in evaluating interpretations of brain injury "wounding" processes. Remarkably, mTBI from either loading is shown generally to result in only a small loss of neurons, with hippocampal neurons appearing to be particularly vulnerable to explosive blast shock waves. Explosive blast studies in large animal models show a unique pattern of periventricular injury, which is different from the classic diffuse axonal injury. Both astrocyte and microglial activation are also seen in explosive blast as well as impact trauma, but this may be a general secondary brain injury response, nonspecific to explosive blast or blunt trauma. Additionally, while moderate to severe impact closed head injuries sometimes result in petechial hemorrhages or hematomas, they do not appear to be associated with explosive blast mTBI even with repeated exposure to blasts.

  6. Physical therapy treatment time during inpatient spinal cord injury rehabilitation

    PubMed Central

    Taylor-Schroeder, Sally; LaBarbera, Jacqueline; McDowell, Shari; Zanca, Jeanne M.; Natale, Audrey; Mumma, Sherry; Gassaway, Julie; Backus, Deborah

    2011-01-01

    Background/objective To describe the nature and distribution of activities during physical therapy (PT) delivered in inpatient spinal cord injury (SCI) rehabilitation and discuss predictors (patient and injury characteristics) of the amount of time spent in PT for specific treatment activities. Methods Six hundred patients from six inpatient SCI centers were enrolled in the SCIRehab study. Physical therapists documented details, including time spent, of treatment provided during 37 306 PT sessions that occurred during inpatient SCI rehabilitation. Ordinary least squares regression models associated patient and injury characteristics with time spent in specific PT activities. Results SCIRehab patients received a mean total of 55.3 hours of PT over the course of their rehabilitation stay. Significant differences among four neurologic groups were seen in the amount of time spent on most activities, including the most common PT activities of strengthening exercises, stretching, transfer training, wheelchair mobility training, and gait training. Most PT work (77%) was provided in individual therapy sessions; the remaining 23% was done in group settings. Patient and injury characteristics explained only some of the variations seen in time spent on wheelchair mobility, transfer and bed mobility training, and range of motion/stretching. Conclusion Analysis yielded both expected and unexpected trends in SCI rehabilitation. Significant variation was seen in time spent on PT activities within and among injury groups. Providing therapeutic strengthening treatments consumed the greatest proportion of PT time. About one-quarter of all PT services were provided in group settings. Details about services provided, including time spent, will serve as a starting point in detailing the optimal treatment delivery for maximal outcomes. PMID:21675354

  7. How Do Stages of Change for Physical Activity Relate to Employee Sign-Up for and Completion of a Worksite Physical Activity Competition?

    PubMed

    Walker, Timothy J; Tullar, Jessica M; Taylor, Wendell C; Román, Rolando; Amick, Benjamin C

    2016-07-25

    Introduction This study evaluated whether stages of change for physical activity (PA) predict sign-up, participation, and completion in a PA competition. Method Deidentified data were provided to evaluate a PA competition between 16 different institutions from a public university system. Employees who completed a health assessment (HA) prior to the start of the PA competition (n = 6,333) were included in the study. Participants completed a self-report HA and logged their PA throughout the competition. Multivariable logistic regression models tested whether stages of change predicted PA competition sign-up and completion. An ordinal logistic regression model tested whether stages of change predicted number of weeks of PA competition participation. Results Stages of change predicted PA competition sign-up and completion, but not weeks of participation. The odds for PA competition sign-up were 1.64 and 1.98 times higher for employees in preparation and action/maintenance (respectively) compared with employees in precontemplation/contemplation. The odds for PA competition completion were 4.17 times higher for employees in action/maintenance compared with employees in precontemplation/contemplation/preparation. Conclusion The PA competition was more likely to reach employees in preparation, action, or maintenance stages than precontemplation/contemplation. Most of the completers were likely participating in regular PA prior to the competition.

  8. Effects of an osteoporosis prevention training program on physical activity-related stages of change and self-efficacy among university students, Shiraz, Iran: a Randomized Clinical Trial

    PubMed Central

    KAVEH, MOHAMMAD HOSSIEN; GOLIJ, MONIRE; NAZARI, MAHIN; MAZLOOM, ZOHREH; REZAEIAN ZADEH, ABBAS

    2014-01-01

    Introduction: Osteoporosis is a major problem in today's world, being characterized by decreased bone mass and bone change. Due to deficiency of theory-based studies in young population, especially in students, there are significant knowledge gaps of effective planning. Thepresent study was performed in response to this need. The present study investigated the effect of an empowerment program on physical activity related stages of change and self-efficacyin preventing osteoporosis among university students. Methods:In this randomized controlled trial (IRCT: IRCT201212016261N2), 152 female students of Shiraz University of Medical Sciences were selected through multi-stages cluster sampling and were randomly assigned to an experimental (n=76) and a control (n=76) group.The pre-and post-intervention data were collected using the Stages of Exercise Change Questionnaire (SECQ) of Marcos with Cronbach's alpha reliability of 0.89 and also the self-efficacy scale with a Cronbach's alpha reliability of 0.88 and Test-Retest Correlation Coefficient of 0.80. The educational intervention for the experimental group took place through problem-based learning method, small group discussion, and training manuals. In addition, training CDs and brochures were given to the subjects and short SMSs were sent to them. The data were analyzed throughSPSS, version 14, usingMann-Whitney test, Chi-square test, Wilcoxon and regression tests. Results:Pre-intervention findings showed that participants had behavioral constructs below the expected levels. The results showed that the experimental group received significant statisticalincrease after the intervention in stage of change. Before the intervention, the mean scores of stages of changes in the experimental groups was 2.28±0.86 but this rose to 3±0.84 in the first post-test and 3.22±0.84 in the second post-test. The control group showed a significant increase in stage of change without intervention (pre-test 2.04±0.82, first post

  9. Effects of an osteoporosis prevention training program on physical activity-related stages of change and self-efficacy among university students, Shiraz, Iran: a Randomized Clinical Trial.

    PubMed

    Kaveh, Mohammad Hossien; Golij, Monire; Nazari, Mahin; Mazloom, Zohreh; Rezaeian Zadeh, Abbas

    2014-10-01

    Osteoporosis is a major problem in today's world, being characterized by decreased bone mass and bone change. Due to deficiency of theory-based studies in young population, especially in students, there are significant knowledge gaps of effective planning. Thepresent study was performed in response to this need. The present study investigated the effect of an empowerment program on physical activity related stages of change and self-efficacyin preventing osteoporosis among university students. In this randomized controlled trial (IRCT: IRCT201212016261N2), 152 female students of Shiraz University of Medical Sciences were selected through multi-stages cluster sampling and were randomly assigned to an experimental (n=76) and a control (n=76) group.The pre-and post-intervention data were collected using the Stages of Exercise Change Questionnaire (SECQ) of Marcos with Cronbach's alpha reliability of 0.89 and also the self-efficacy scale with a Cronbach's alpha reliability of 0.88 and Test-Retest Correlation Coefficient of 0.80. The educational intervention for the experimental group took place through problem-based learning method, small group discussion, and training manuals. In addition, training CDs and brochures were given to the subjects and short SMSs were sent to them. The data were analyzed throughSPSS, version 14, usingMann-Whitney test, Chi-square test, Wilcoxon and regression tests. Pre-intervention findings showed that participants had behavioral constructs below the expected levels. The results showed that the experimental group received significant statisticalincrease after the intervention in stage of change. Before the intervention, the mean scores of stages of changes in the experimental groups was 2.28±0.86 but this rose to 3±0.84 in the first post-test and 3.22±0.84 in the second post-test. The control group showed a significant increase in stage of change without intervention (pre-test 2.04±0.82, first post-test 2.18±0.87 and second post

  10. Physical examination tests for hip dysfunction and injury.

    PubMed

    Reiman, Michael P; Mather, Richard C; Cook, Chad E

    2015-03-01

    Physical examination tests for hip dysfunction and injury of the strongest diagnostic accuracy were identified in a recent systematic review with meta-analysis in BJSM. These tests are described in this article. A detailed description of the various different tests is given, with photographs for each test procedure. Diagnostic interpretation of each test requires careful consideration, with special attention to specific variables such as test performance and patient population. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  11. The Use of Physical Restraint in the Treatment of Self-Injury and as Positive Reinforcement.

    ERIC Educational Resources Information Center

    Favell, Judith E.; And Others

    1978-01-01

    Three experiments investigated the effects of a treatment package on the self-injurious behavior of three profoundly retarded persons (ages 8-27 years) who appeared to enjoy the physical restraints used to prevent their self-injury. (Author)

  12. Physical environment of the home and adolescent injury risk.

    PubMed

    Schwebel, David C; Janice Gilliland, M; Moore, Jeffrey G

    2009-01-01

    The home environment is one of the most significant contextual factors that contributes to young children's unintentional injury risk, but there are very limited data concerning risks present in the homes of adolescents. This study was designed to offer descriptive data on aspects of the home physical environment that might contribute to adolescent injury risk in the United States. A diverse sample of 42 adolescents ages 14-16 participated. Researchers completed an inspection of the adolescents' home, searching for various safety-related hazards. Homes tended to be safe in some domains (e.g., presence of smoke detectors), but had substantial risk in other domains. For example, over 90% of homes were without functioning carbon monoxide detectors; 29% had unlocked firearms present; 21% had exposed electrical cords; and 31% had alcohol present and unlocked. Although residential environment risks are viewed to be most concerning for very young children, over 30% of fatal adolescent injuries occur in the home. Results suggest there are substantial risks to adolescent safety in the home environment.

  13. History and physical examination of hip injuries in elderly adults.

    PubMed

    Hamedan Al Maqbali, Mohammed Abdullah

    2014-01-01

    Hip fracture is the most common injury occurring to elderly people and is associated with restrictions of the activities of the patients themselves. The discovery of a hip fracture can be the beginning of a complex journey of care, from initial diagnosis, through operational procedures to rehabilitation. The patient's history and physical examination form the basis of the diagnosis and monitoring of elderly patients with hip problems and dictate the appropriate treatment strategy to be implemented. The aim of this study is to discuss the different diagnoses of hip pain in a case study of an elderly woman who initially complained of pain in her right knee following a fall at home. It shows that musculoskeletal physical examination determined the management of the hip fracture that was found to be present. In addition, the aim of this article is to review diagnostic tests such as radiographs and recommend appropriate management and treatment of hip fractures in elderly patients.

  14. Association of Physical Inactivity, Weight, Smoking, and Prior Injury on Physical Performance in a Military Setting.

    PubMed

    Teyhen, Deydre S; Rhon, Daniel I; Butler, Robert J; Shaffer, Scott W; Goffar, Stephen L; McMillian, Danny J; Boyles, Robert E; Kiesel, Kyle B; Plisky, Phillip J

    2016-11-01

     Although inactivity, being overweight, smoking, and a history of injury are identified as risk factors for poor health and injury, few authors have examined their association on physical performance. Young adults may be more likely to adopt healthier lifestyles if they understand the effect of health behaviors on performance.  To determine the association of being overweight, smoking, inactivity, and a history of injury with physical performance.  Cross-sectional study.  Military population.  Active-duty service members (N = 1466; 1380 men, 86 women; age = 24.7 ± 5.0 years; body mass index = 26.7 ± 3.4 kg/m(2)).  Participants performed 8 measures (the triple-crossover hop for distance, the 6-m timed-hop test, the Functional Movement Screen, the Lower Quarter Y-Balance Test, the Upper Quarter Y-Balance Test, and the 3-event Army Physical Fitness Test) for evaluation of endurance, strength, muscular endurance, power, agility, balance, and motor control. Participants were categorized based on the number of health risk factors present. Using an analysis of covariance, we assessed the relationship between risk factors and physical performance with age and sex as covariates.  Compared with those who had no risk factors (27.9% of men, 34.9% of women), physical performance was worse in those who had 1, 2, or 3 to 4 risk factors present by 4.3%, 6.7%, and 10.3%, respectively. Decrements in performance for those with 3 to 4 risk factors ranged from 3.3% to 14.4%.  An unhealthy lifestyle habit or a history of injury was negatively associated with physical performance. Physical performance decrements were associated with the number of risk factors present. Understanding how risk factors contribute to decreased physical performance may enable clinicians to improve compliance with injury-prevention programs in occupational settings in which a young and relatively healthy workforce may be more concerned about performance than health.

  15. Effects of Physical Training and Fitness on Running Injuries in Physically Active Young Men.

    PubMed

    Grier, Tyson L; Canham-Chervak, Michelle; Anderson, Morgan K; Bushman, Timothy T; Jones, Bruce H

    2017-01-01

    Grier, TL, Canham-Chervak, M, Anderson, MK, Bushman, TT, and Jones, BH. Effects of physical training and fitness on running injuries in physically active young men. J Strength Cond Res 31(1): 207-216, 2017-The purpose of this investigation was to determine the effects of physical training (PT) and fitness on risks for running-related injuries (RRIs) in physically active young men. Personal characteristics, PT, Army Physical Fitness Test scores, and injury data were obtained by survey. Army Physical Fitness Test variables (push-ups, sit-ups, and 2-mile run) were converted into quartiles (Q), where Q1 = lowest performance and Q4 = highest performance. Odds ratios (OR) and 95% confidence intervals (95% CI) were calculated using multivariate logistic regression. Over 4,000 (n = 4,236) soldiers were surveyed. Running injury incidence was 14%. A greater risk of an RRI was associated with older age (OR31+/<22 years = 1.62, 95% CI, 1.21-2.18), higher BMI ((Equation is included in full-text article.)), and total distance ran per week during unit PT (OR16.1+/1-5 miles = 1.66, 95% CI, 1.15-2.41). A lower risk of an RRI was associated with total distance run per week during personal PT (OR5.1-10/1-5 miles = 0.70, 95% CI, 0.53-0.91, OR10.1-16 +/1-5 miles = 0.58, 95% CI, 0.35-0.97, OR16.1+/1-5 miles = 0.54, 95% CI, 0.30-0.98), higher aerobic endurance as measured by 2-mile run performance (ORQ4/Q1 = 0.50, 95% CI, 0.35-0.72), and unit resistance training ≥3 times a week (OR≥3 times per week/none = 0.46, 95% CI, 0.29-0.73). Greater personal PT running mileage decreased injuries in this population suggesting that the increased protective effect of higher aerobic fitness outweighed the injurious effect of running more miles during personal PT. Countermeasures to prevent RRIs could entail enhancing aerobic endurance, providing opportunities for personal aerobic training, monitoring for excessive unit PT running mileage and encouraging unit resistance training ≥3 times per week.

  16. Depressive Symptoms and Impaired Physical Function after Acute Lung Injury

    PubMed Central

    Colantuoni, Elizabeth; Mendez-Tellez, Pedro A.; Dinglas, Victor D.; Shanholtz, Carl; Husain, Nadia; Dennison, Cheryl R.; Herridge, Margaret S.; Pronovost, Peter J.; Needham, Dale M.

    2012-01-01

    Rationale: Survivors of acute lung injury (ALI) frequently have substantial depressive symptoms and physical impairment, but the longitudinal epidemiology of these conditions remains unclear. Objectives: To evaluate the 2-year incidence and duration of depressive symptoms and physical impairment after ALI, as well as risk factors for these conditions. Methods: This prospective, longitudinal cohort study recruited patients from 13 intensive care units (ICUs) in four hospitals, with follow-up 3, 6, 12, and 24 months after ALI. The outcomes were Hospital Anxiety and Depression Scale depression score greater than or equal to 8 (“depressive symptoms”) in patients without a history of depression before ALI, and two or more dependencies in instrumental activities of daily living (“impaired physical function”) in patients without baseline impairment. Measurements and Main Results: During 2-year follow-up of 186 ALI survivors, the cumulative incidences of depressive symptoms and impaired physical function were 40 and 66%, respectively, with greatest incidence by 3-month follow-up; modal durations were greater than 21 months for each outcome. Risk factors for incident depressive symptoms were education 12 years or less, baseline disability or unemployment, higher baseline medical comorbidity, and lower blood glucose in the ICU. Risk factors for incident impaired physical function were longer ICU stay and prior depressive symptoms. Conclusions: Incident depressive symptoms and impaired physical function are common and long-lasting during the first 2 years after ALI. Interventions targeting potentially modifiable risk factors (e.g., substantial depressive symptoms in early recovery) should be evaluated to improve ALI survivors’ long-term outcomes. PMID:22161158

  17. Resistance Training in Youth: Laying the Foundation for Injury Prevention and Physical Literacy.

    PubMed

    Zwolski, Christin; Quatman-Yates, Catherine; Paterno, Mark V

    The rising incidence of physical activity- and sports-related injuries has prompted the present-day investigation of resistance training as a potential means of injury prevention and physical literacy development among youth. Relevant studies on the topics of athlete development, physical literacy, resistance training, and injury prevention in children and adolescents were reviewed (PubMed and Sports Discus, 1982-2016). Recommendations from consensus guidelines and position statements applicable to resistance training and injury prevention in youth, in addition to young athlete development, were reviewed. Additionally, hand searches, expert requests, article reference lists, and gray literature were utilized and reviewed for pertinent content. Clinical review. Level 4. Youth throughout the physical activity spectrum are at risk for physical activity- and sports-related injury. Of highest priority are early specializers, physically inactive youth, and young girls, owing to increased injury rates. Resistance training among these at-risk populations has been shown to reduce injury risk by up to 68% and improve sports performance and health measures, in addition to accelerating the development of physical literacy. Recent recommendations, position statements, and national initiatives advocate for the incorporation of resistance training with qualified instruction among these groups. Resistance training in addition to free play and other structured physical activity training can serve as a protective means against injury and a positive catalyst for the development of physical literacy to offset the impact of diminishing physical activity and early sport specialization in today's youth.

  18. The use of physical agents in rehabilitation of athletic injuries.

    PubMed

    Hillman, S K; Delforge, G

    1985-07-01

    The competitive athlete's motivation to return to activity following injury presents a challenge to the sports medicine specialist to utilize the most effective rehabilitation procedures available. Safe return to competition necessitates maximal restoration of those components of physical fitness affected by injury (such as muscular strength, power, endurance). Various forms of superficial heat and cold application, deep heat modalities, and electrical currents have been used to supplement therapeutic exercise in this process. In recent years, the therapeutic benefits of cold for the control of exercise-induced edema and as a prelude to performance of prescribed exercise have been widely recognized. Although short wave and microwave diathermy appear to have lost much of their appeal as deep tissue heating modalities, the thermal and mechanical effects of ultrasound continue to make it a widely used modality in sports medicine. Adaptation of alternating electrical currents for use in transcutaneous nerve stimulation has given the sports medicine clinician a useful modality for pain management. The more recently developed "Russian" electrical stimulator provides a promising modality for muscle re-education and restoration of muscular strength.

  19. Physical and rehabilitation medicine (PRM) care pathways: "spinal cord injury".

    PubMed

    Albert, T; Beuret Blanquart, F; Le Chapelain, L; Fattal, C; Goossens, D; Rome, J; Yelnik, A P; Perrouin Verbe, B

    2012-09-01

    This document is part of a series of documents designed by the French Physical and Rehabilitation Medicine Society (SOFMER) and the French Federation of PRM (FEDMER). These documents describe the needs for or a specific type of patients; PRM care objectives, human and material resources to be implemented, chronology as well as expected outcomes. "Care pathways in PRM" is a short document designed to enable the reader (physicians, decision-maker, administrator, lawyer or finance manager) to quickly apprehend the needs of these patients and the available therapeutic care structures for proper organization and pricing of these activities. The patients after spinal cord injury are divided into five categories according to the severity of the impairments, each one being treated according to the same six parameters according to the International Classification of Functioning, Disability and Health (WHO), while taking into account personal and environmental factors that could influence the needs of these patients.

  20. Physical abilities after head injury. A retrospective study.

    PubMed

    Talmage, E W; Collins, G A

    1983-12-01

    A two-year retrospective study of head-injured patients was done to determine physical abilities of these patients at the time of discharge from an inpatient rehabilitation service. The relationship of nine specific activities of daily living to cognitive level, discharge placement status, medical or trauma complications, and other injuries was studied. The modal patient is described. At time of discharge, most patients were able to move in bed, achieve and maintain sitting balance, transfer, achieve and maintain standing, and walk on level surfaces. Additionally, fewer than half of the patients studied were independent in stair climbing. Wheelchair management was considered a new activity for a majority of patients; only 56 percent of the patients achieved independence in this activity.

  1. Initial evaluation of posterior cruciate ligament injuries: history, physical examination, imaging studies, surgical and nonsurgical indications.

    PubMed

    Lopez-Vidriero, Emilio; Simon, David A; Johnson, Donald H

    2010-12-01

    Compared with anterior cruciate ligament injuries, posterior cruciate ligament injuries are a rare event. The mechanisms are predictable and a thorough physical examination is mandatory to rule out or define combined injury patterns. Stress radiography and magnetic resonance imaging studies are very helpful adjuncts. Acute and chronic injuries require slightly different approaches. As our understanding of normal and pathologic knee joint kinematics develops, nonoperative rehabilitation goals and operative techniques continue to evolve.

  2. Development and Optimization of an Injury Prevention Intervention for Physical Education Teachers

    ERIC Educational Resources Information Center

    Vercruysse, Sien; De Clercq, Dirk; Goossens, Lennert; Aelterman, Nathalie; Haerens, Leen

    2017-01-01

    Background: Injury prevention is highly needed in physically active populations, such as pre-service and in-service physical education teachers (PETs). As a lack of adherence to preventive strategies is problematic in injury, it seems crucial to develop and optimize interventions that correspond to the specific needs and wishes of PETs. Aim: The…

  3. Development and Optimization of an Injury Prevention Intervention for Physical Education Teachers

    ERIC Educational Resources Information Center

    Vercruysse, Sien; De Clercq, Dirk; Goossens, Lennert; Aelterman, Nathalie; Haerens, Leen

    2017-01-01

    Background: Injury prevention is highly needed in physically active populations, such as pre-service and in-service physical education teachers (PETs). As a lack of adherence to preventive strategies is problematic in injury, it seems crucial to develop and optimize interventions that correspond to the specific needs and wishes of PETs. Aim: The…

  4. Sports injury, occupational physical activity, joint laxity, and meniscal damage.

    PubMed

    Baker, Paul; Coggon, David; Reading, Isabel; Barrett, David; McLaren, Magnus; Cooper, Cyrus

    2002-03-01

    To investigate the risk factors for meniscal damage, an important determinant of knee osteoarthritis. We studied 243 men and women aged 20-59 years in whom the diagnosis of a meniscal tear was confirmed for the first time at arthroscopy, over a 25 month period, in 2 British hospitals. Each case was compared with one or 2 community controls, matched by age and sex, who were registered with the same general practitioner. Information on exposure to risk factors was obtained by a structured questionnaire and physical examination. Meniscal tear was strongly associated with participation in sports during the 12 months preceding the onset of symptoms; the risk was particularly high for soccer (OR 3.7; 95% CI 2.1-6.6). Higher body mass index and occupational kneeling (OR 3.8; 95% CI 1.3-11.0) and squatting (OR 2.9; 95% CI 1.0-8.0) were associated with an increased risk of degenerative meniscal lesions, after adjustment for social class, joint laxity, and sports participation. Joint laxity was associated with degenerative meniscal lesions independently of occupational physical activity, sports, and obesity. Our results confirm the importance of sporting activities entailing knee torsion in acute meniscal tear. They also point to a role for occupational activity, adiposity, and joint laxity in the pathogenesis of degenerative meniscal lesions. Modifying these mechanical risk factors may serve to reduce the risk of meniscal injury and may also help to prevent later knee osteoarthritis.

  5. Risk Factors for Physical Injury Among Help-Seeking Battered Women

    PubMed Central

    Mechanic, Mindy B.; Weaver, Terri L.; Resick, Patricia A.

    2010-01-01

    Physical injuries among battered women represent risks for both acute and long-term physical health functioning. The current study assessed the nature and extent of minor and severe injuries among a help-seeking sample of battered women. Hierarchical regression analyses were conducted to assess the unique roles of physical violence, sexual coercion, psychological abuse, and stalking to the prediction of minor and severe injuries in battered women. Not unexpectedly, length of relationship abuse and severity of physical aggression were the most robust predictors of minor and severe physical injuries. Consistent with other research findings, psychological abuse and stalking, as a block, contributed uniquely to the prediction of severe injuries. Results are discussed in terms of implications for future research and intervention with battered women. PMID:18757347

  6. Injuries to Athletes with Physical Disabilities: Prevention Implications.

    ERIC Educational Resources Information Center

    Bloomquist, Lorraine E.

    1986-01-01

    While athletes with disabilities may not be injured any more often than other athletes, the types of injuries they sustain are specific to their disabilities and chosen sports. Characteristic injuries are described, and preventive measures are suggested. (Author/MT)

  7. The impact of injuries study. multicentre study assessing physical, psychological, social and occupational functioning post injury--a protocol.

    PubMed

    Kendrick, Denise; O'Brien, Claire; Christie, Nicola; Coupland, Carol; Quinn, Casey; Avis, Mark; Barker, Marcus; Barnes, Jo; Coffey, Frank; Joseph, Stephen; Morris, Andrew; Morriss, Richard; Rowley, Emma; Sleney, Jude; Towner, Elizabeth

    2011-12-31

    Large numbers of people are killed or severely injured following injuries each year and these injuries place a large burden on health care resources. The majority of the severely injured are not fully recovered 12-18 months later. Psychological disorders are common post injury and are associated with poorer functional and occupational outcomes. Much of this evidence comes from countries other than the UK, with differing health care and compensation systems. Early interventions can be effective in treating psychological morbidity, hence the scale and nature of the problem and its impact of functioning in the UK must be known before services can be designed to identify and manage psychological morbidity post injury. A longitudinal multi-centre study of 680 injured patients admitted to hospital in four areas across the UK: Nottingham, Leicester/Loughborough, Bristol and Surrey. A stratified sample of injuries will ensure a range of common and less common injuries will be included. Participants will complete a baseline questionnaire about their injury and pre-injury quality of life, and follow-up questionnaires 1, 2, 4, and 12 months post injury. Measures will include health and social care utilisation, perceptions of recovery, physical, psychological, social and occupational functioning and health-related quality of life. A nested qualitative study will explore the experiences of a sample of participants, their carers and service providers to inform service design. This study will quantify physical, psychological, social and occupational functioning and health and social care utilisation following a range of different types of injury and will assess the impact of psychological disorders on function and health service use. The findings will be used to guide the development of interventions to maximise recovery post injury.

  8. The impact of injuries study. multicentre study assessing physical, psychological, social and occupational functioning post injury - a protocol

    PubMed Central

    2011-01-01

    Background Large numbers of people are killed or severely injured following injuries each year and these injuries place a large burden on health care resources. The majority of the severely injured are not fully recovered 12-18 months later. Psychological disorders are common post injury and are associated with poorer functional and occupational outcomes. Much of this evidence comes from countries other than the UK, with differing health care and compensation systems. Early interventions can be effective in treating psychological morbidity, hence the scale and nature of the problem and its impact of functioning in the UK must be known before services can be designed to identify and manage psychological morbidity post injury. Methods/Design A longitudinal multi-centre study of 680 injured patients admitted to hospital in four areas across the UK: Nottingham, Leicester/Loughborough, Bristol and Surrey. A stratified sample of injuries will ensure a range of common and less common injuries will be included. Participants will complete a baseline questionnaire about their injury and pre-injury quality of life, and follow-up questionnaires 1, 2, 4, and 12 months post injury. Measures will include health and social care utilisation, perceptions of recovery, physical, psychological, social and occupational functioning and health-related quality of life. A nested qualitative study will explore the experiences of a sample of participants, their carers and service providers to inform service design. Discussion This study will quantify physical, psychological, social and occupational functioning and health and social care utilisation following a range of different types of injury and will assess the impact of psychological disorders on function and health service use. The findings will be used to guide the development of interventions to maximise recovery post injury. PMID:22208707

  9. Football injuries and physical symptoms. A review of the literature.

    PubMed

    Dvorak, J; Junge, A

    2000-01-01

    Football is one of the most popular sports worldwide. The frequency of football injuries is estimated to be approximately 10 to 35 per 1000 playing hours. The majority of injuries occur in the lower extremities, mainly in the knees and ankles; the number of head injuries is probably underestimated. The average cost for medical treatment per football injury is estimated to be $150 (U.S. dollars). Considering the number of active football players worldwide, the socioeconomic and financial consequences of injury are of such a proportion that a prevention program to reduce the incidence of injuries is urgently required. For this reason, an analysis of intrinsic (person-related) and extrinsic (environment-related) risk factors was undertaken based on a review of the current literature. It was concluded that the epidemiologic information regarding the sports medicine aspects of football injuries is inconsistent and far from complete because of the employment of heterogeneous methods, various definitions of injury, and different characteristics of the assessed teams. The aim of this study was to analyze the literature on the incidence of injuries and symptoms in football players, as well as to identify risk factors for injury and to demonstrate possibilities for injury prevention.

  10. Effectiveness of a school-based physical activity injury prevention program: a cluster randomized controlled trial.

    PubMed

    Collard, Dorine C M; Verhagen, Evert A L M; Chinapaw, Mai J M; Knol, Dirk L; van Mechelen, Willem

    2010-02-01

    To study the effects of a school-based injury prevention program on physical activity injury incidence and severity. Cluster randomized controlled trial performed from January 1, 2006, through July 31, 2007. Forty Dutch primary schools. A total of 2210 children (aged 10-12 years). Schools were randomized to receive either the regular curriculum or an intervention program that targeted physical activity injuries. Incidence and severity of physical activity injuries per 1000 hours of physical activity participation. A total of 100 injuries in the intervention group and 104 injuries in the control group were registered. Nonresponse at baseline or follow-up was minimal (8.7%). The Cox regression analyses adjusted for clustering showed a small nonsignificant intervention effect on total (HR, 0.81; 95% confidence interval [CI], 0.41-1.59), sports club (0.69; 0.28-1.68), and leisure time injuries (0.75; 0.36-1.55). However, physical activity appeared to be an effect modifier. In those who were less physically active, the intervention had a larger effect. The intervention reduced the total and leisure time injury incidence (HR, 0.47; 95% CI, 0.21-1.06; and 0.43; 0.16-1.14; respectively). Sports club injury incidence was significantly reduced (HR, 0.23; 95% CI, 0.07-0.75). We found a substantial and relevant reduction in physical activity injuries, especially in children in the low active group, because of the intervention. This school-based injury prevention program is promising, but future large-scale research is needed.

  11. Retrospective examination of injuries and physical fitness during Federal Bureau of Investigation new agent training

    PubMed Central

    2011-01-01

    Background A retrospective examination was conducted of injuries, physical fitness, and their association among Federal Bureau of Investigation (FBI) new agent trainees. Methods Injuries and activities associated with injuries were obtained from a review of medical records in the medical clinic that served the new agents. A physical fitness test (PFT) was administered at Weeks 1, 7 and 14 of the 17-week new agent training course. The PFT consisted of push-ups, sit-ups, pull-ups, a 300-meter sprint, and a 1.5-mile run. Injury data were available from 2000 to 2008 and fitness data were available from 2004 to early 2009. Results During the survey period, 37% of men and 44% of women experienced one or more injuries during the new agent training course (risk ratio (women/men) = 1.18, 95% confidence interval = 1.07-1.31). The most common injury diagnoses were musculoskeletal pain (not otherwise specified) (27%), strains (11%), sprains (10%), contusions (9%), and abrasions/lacerations (9%). Activities associated with injury included defensive tactics training (48%), physical fitness training (26%), physical fitness testing (6%), and firearms training (6%). Over a 6-year period, there was little difference in performance of push-ups, sit-ups, pull-ups, or the 300-meter sprint; 1.5-mile run performance was higher in recent years. Among both men and women, higher injury incidence was associated with lower performance on any of the physical fitness measures. Conclusion This investigation documented injury diagnoses, activities associated with injury, and changes in physical fitness, and demonstrated that higher levels of physical fitness were associated with lower injury risk. PMID:21981817

  12. Retrospective examination of injuries and physical fitness during Federal Bureau of Investigation new agent training.

    PubMed

    Knapik, Joseph J; Spiess, Anita; Swedler, David; Grier, Tyson; Hauret, Keith; Yoder, James; Jones, Bruce H

    2011-10-09

    A retrospective examination was conducted of injuries, physical fitness, and their association among Federal Bureau of Investigation (FBI) new agent trainees. Injuries and activities associated with injuries were obtained from a review of medical records in the medical clinic that served the new agents. A physical fitness test (PFT) was administered at Weeks 1, 7 and 14 of the 17-week new agent training course. The PFT consisted of push-ups, sit-ups, pull-ups, a 300-meter sprint, and a 1.5-mile run. Injury data were available from 2000 to 2008 and fitness data were available from 2004 to early 2009. During the survey period, 37% of men and 44% of women experienced one or more injuries during the new agent training course (risk ratio (women/men) = 1.18, 95% confidence interval = 1.07-1.31). The most common injury diagnoses were musculoskeletal pain (not otherwise specified) (27%), strains (11%), sprains (10%), contusions (9%), and abrasions/lacerations (9%). Activities associated with injury included defensive tactics training (48%), physical fitness training (26%), physical fitness testing (6%), and firearms training (6%). Over a 6-year period, there was little difference in performance of push-ups, sit-ups, pull-ups, or the 300-meter sprint; 1.5-mile run performance was higher in recent years. Among both men and women, higher injury incidence was associated with lower performance on any of the physical fitness measures. This investigation documented injury diagnoses, activities associated with injury, and changes in physical fitness, and demonstrated that higher levels of physical fitness were associated with lower injury risk.

  13. Epidemiology of Injuries Associated With Physical Training Among Young Men in the Army

    DTIC Science & Technology

    1993-01-01

    the benefits of physical activity and exercise has led army. ked. Sci. Sports i.verc., Vol. 25, No. 2, pp. 197-203, 1993. It is widely acknowledged that...musculoskeletal injuries occur as a result public health officials in the United States to promote of vigorous physical activity and exercise , but... EXERCISE , PHYSICAL the foundation for Army training injury prevention ACTIVITY , INCIDENCE, MULTIVARIATE ANALYSIS strategies. The primary purposes of

  14. Adapted marching distances and physical training decrease recruits' injuries and attrition.

    PubMed

    Roos, Lilian; Boesch, Maria; Sefidan, Sandra; Frey, Franz; Mäder, Urs; Annen, Hubert; Wyss, Thomas

    2015-03-01

    There is evidence that progressive loading of physical demands at the beginning of basic military service and specific physical training can reduce injury incidences. Therefore, aim of this study was to measure the effects of a progressive increase in marching distances and an adapted physical training program on injury incidence and attrition rate in a Swiss Army infantry training school. One company reduced the distances covered on foot during the first 4 weeks of basic military training. A second company performed an adapted physical training program for 10 weeks. A third company participated in both interventions combined, and a fourth company served as a control group without any intervention. The injury incidences and attrition rates of 651 male recruits were registered during 21 weeks of military service. Several predictor variables for injury and attrition, such as physical fitness, previous injuries, level of previous physical activity, smoking, motivation, and socioeconomic factors, were assessed as well. The data were analyzed using binary logistic backward regressions. Each intervention separately had a favorable effect on injury prevention. However, combining the 2 interventions resulted in the greatest reduction in injury incidence rate (-33%). Furthermore, the adapted physical training successfully reduced the military service attrition rates (-53%). Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

  15. Volume of Physical Activity and Injury Occurrence in Young Basketball Players

    PubMed Central

    Gianoudis, Jenny; Webster, Kate E.; Cook, Jill

    2008-01-01

    Participation in organised, competitive physical activity by young athletes is increasing rapidly. This is concurrent with an increase in sporting injuries in the young population. This pilot study aimed to compare the weekly volume and types of physical activity in young basketball players injured and not injured during the season. Detailed physical activity and injury data were prospectively collected in 46 school-level basketball players aged 14 to 18 years. Participants completed physical activity logs which documented the type of physical activity undertaken, what the activity consisted of (i.e. training, competition) and the level at which it was played on a daily basis. Allied health staff completed a weekly injury form. Results showed that injured and uninjured athletes participated in a similar volume of total weekly physical activity over the season. However, injured athletes (p = 0.04) and athletes who specifically sustained overuse injuries (p = 0.01) participated in a greater amount of basketball refereeing than uninjured athletes. Based on these findings it was concluded that greater participation in running-type physical activity such as refereeing, as an addition to training and competition, may predispose the young basketball player to increased injury risk. Future research using larger sample sizes are required to further investigate the role of participation volume and type on injury occurrence in adolescent athletes. Key points Basketball players participating in larger amounts of running-type physical activity, in addition to regular training and competition, may be predisposed to overuse injury Future studies using larger sample sizes are required to investigate the precise volumes of physical activity that increase injury risk This would assist in the development of participation guidelines to decrease the current injury rates observed in the young athletic population. PMID:24150146

  16. If Exercise is Medicine, Where is Exercise in Medicine? Review of U.S. Medical Education Curricula for Physical Activity-Related Content.

    PubMed

    Cardinal, Bradley J; Park, Eugene A; Kim, MooSong; Cardinal, Marita K

    2015-09-01

    This study provides an update on the amount and type of physical activity education occurring in medical education in the United States in 2013. It is the first study to do so since 2002. Applying content analysis methodology, we reviewed all accessible accredited doctor of medicine and doctor of osteopathic medicine institutions' websites for physical activity education related coursework (N = 118 fully accessible; 69.41%). The majority of institutions did not offer any physical activity education-related courses. When offered, they were rarely required. Courses addressing sports medicine and exercise physiology were offered more than courses in other content domains. Most courses were taught using a clinical approach. No differences were observed between MD and DO institutions, or between private and public institutions. More than one-half of the physicians trained in the United States in 2013 received no formal education in physical activity and may, therefore, be ill-prepared to assist their patients in a manner consistent with Healthy People 2020, the National Physical Activity Plan, or the Exercise is Medicine initiative. The Bipartisan Policy Center, American College of Sports Medicine, and the Alliance for a Healthier Generation called for a reversal of this situation on June 23, 2014.

  17. Asteroseismic stellar activity relations

    NASA Astrophysics Data System (ADS)

    Bonanno, A.; Corsaro, E.; Karoff, C.

    2014-11-01

    Context. In asteroseismology an important diagnostic of the evolutionary status of a star is the small frequency separation which is sensitive to the gradient of the mean molecular weight in the stellar interior. It is thus interesting to discuss the classical age-activity relations in terms of this quantity. Moreover, as the photospheric magnetic field tends to suppress the amplitudes of acoustic oscillations, it is important to quantify the importance of this effect by considering various activity indicators. Aims: We propose a new class of age-activity relations that connects the Mt. Wilson S index and the average scatter in the light curve with the small frequency separation and the amplitude of the p-mode oscillations. Methods: We used a Bayesian inference to compute the posterior probability of various empirical laws for a sample of 19 solar-like active stars observed by the Kepler telescope. Results: We demonstrate the presence of a clear correlation between the Mt. Wilson S index and the relative age of the stars as indicated by the small frequency separation, as well as an anti-correlation between the S index and the oscillation amplitudes. We argue that the average activity level of the stars shows a stronger correlation with the small frequency separation than with the absolute age that is often considered in the literature. Conclusions: The phenomenological laws discovered in this paper have the potential to become new important diagnostics to link stellar evolution theory with the dynamics of global magnetic fields. In particular we argue that the relation between the Mt. Wilson S index and the oscillation amplitudes is in good agreement with the findings of direct numerical simulations of magneto-convection.

  18. Distraction Injury of the Thoracic Spine With Spinal Cord Transection and Vascular Injury in a 5-Week-Old Infant Boy: A Case of Child Physical Abuse.

    PubMed

    Brink, Farah W; Gold, Delia L; Adler, Brent; Letson, Megan McGraw

    2017-03-01

    Distraction injury of the spine with spinal cord transection and adjacent vascular injury is rarely described in the setting of child physical abuse. We report a 5-week-old infant boy who sustained these injuries after an abusive event. The clinical presentation, imaging findings, and recommended evaluation modalities are discussed. An overview of pediatric spinal column and vascular injuries secondary to physical abuse is given.

  19. Does physical fitness affect injury occurrence and time loss due to injury in elite vocational ballet students?

    PubMed

    Twitchett, Emily; Brodrick, Anna; Nevill, Alan M; Koutedakis, Yiannis; Angioi, Manuela; Wyon, Matthew

    2010-01-01

    Most ballet dancers will suffer at least one injury a year. There are numerous causes of injury in dance, and while many investigators have documented risk factors such as anatomical characteristics, past medical history, menstrual history, dance experience, length of dance training, fatigue, and stress, risk factors related to body characteristics and nutrient intake, levels of conditioning, or physical fitness parameters have only recently received the same amount of attention. The aim of the present study was, therefore, to investigate correlations between ballet injury and body fat percentage, active and passive flexibility, lower limb power, upper body and core endurance, and aerobic capacity. Low levels of aerobic fitness were significantly associated with many of the injuries sustained over a 15-week period (r=.590, p=0.034), and body fat percentage was significantly associated with the length of time a dancer was forced to modify activity due to injury (r=-.614, p=0.026). This information may be of benefit to dancers, teachers, physical therapists and physicians in dance schools and companies when formulating strategies to prevent injury.

  20. Trauma and seronegative spondyloarthropathy: report of two more cases of peripheral arthritis precipitated by physical injury.

    PubMed Central

    Olivieri, I; Gemignani, G; Christou, C; Pasero, G

    1989-01-01

    Two more cases of B27 associated peripheral arthritis triggered by physical injury are reported. One patient developed arthritis after a minor insult and in the other Reiter's syndrome occurred after the injury. Possibly, trauma causes release of self antigens from the injured joints. PMID:2787143

  1. Domestic violence against children and adolescents: prevalence of physical injuries in a southern Brazilian metropolis.

    PubMed

    Valente, Leidielly Aline; Dalledone, Mariana; Pizzatto, Eduardo; Zaiter, Wellington; de Souza, Juliana Feltrin; Losso, Estela Maris

    2015-01-01

    Violence against children and adolescents is a public health issue worldwide that threatens physical and mental wellbeing and causes irreparable harm. Reports on this violence are an essential way to prevent it and to protect the children and adolescents. Thus, the objective of the present study was to evaluate the prevalence of physical injuries that occur in domestic environments and reported to the Child and Adolescent Protection Network. This retrospective study was conducted at the Epidemiology Center of the Municipality of Curitiba. A total of 10,483 reports for the years 2010 (5,112) and 2011 (5,371) were analyzed and from them were selected reports of physical injuries that occurred in the family environment. The children and adolescents were 0-17 years old, comprising 322 cases of physical abuse within the family in 2010. Out of these, 57.1% were male and 42.9% were female, and 58% (187) presented head and neck injuries. There were 342 reports in 2011, 49% were male and 51% were female; head and neck injuries corresponded to 65% (222) of the reported cases. The prevalence of injuries increased by 6% and head and neck injury increased by 19% between 2010 and 2011. It may be concluded that physical abuse is associated with a high prevalence of head and neck injury, which is easily observed by the health and education professionals. Notification organs should be created in Brazilian hospitals and health centers, which is essential to conduct epidemiological surveillance and appropriate policies.

  2. Physical collisions and injury in professional rugby league match-play.

    PubMed

    Gabbett, Tim J; Jenkins, David G; Abernethy, Bruce

    2011-05-01

    To document the frequency of physical collisions and incidence of contact injury in professional rugby league match-play. Prospective cohort study. Video recordings of 77 National Rugby League (NRL) matches were coded for the number and type of physical collisions in which players were involved. Each match was analysed and coded for defensive (i.e. tackles, missed tackles, and ineffective tackles) and attacking collisions (i.e. tackled in possession, broken tackles, offloads, support runs, and decoy runs). Injuries that occurred as a result of a physical collision were also recorded. The total number of physical collisions performed per game was greatest in the wide running forwards (47 [95% CI, 42-52]), and was significantly greater (P<0.05) than the hit-up forwards (36 [95% CI, 32-40]), adjustables (29 [95% CI, 26-32]), and outside backs (24 [95% CI, 22-27]) positional groups. A total of 48 collision injuries were sustained, resulting in an overall injury incidence of 10.6 (95% CI, 7.6-13.6) per 10,000 collisions. Injuries resulting from attacking collisions were consistently higher than injuries sustained in defensive collisions. Wide running forwards had the lowest incidence of injury, and the adjustables and outside backs had the highest incidence of injury. These results highlight the physical demands associated with collisions and tackles in professional rugby league. Furthermore, the results of this study suggest that playing position and the type of collision sustained have a greater influence over contact injury risk in rugby league than the number of physical collisions performed. Copyright © 2011 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  3. Group physical therapy during inpatient rehabilitation for acute spinal cord injury: findings from the SCIRehab Study.

    PubMed

    Zanca, Jeanne M; Natale, Audrey; Labarbera, Jacqueline; Schroeder, Sally Taylor; Gassaway, Julie; Backus, Deborah

    2011-12-01

    Inpatient rehabilitation for spinal cord injury (SCI) includes the use of both individual and group physical therapy sessions. A greater understanding of group physical therapy use will help in the evaluation of the appropriateness of its use and contribute to the development of standards of practice. This report describes the extent to which group physical therapy is being used in inpatient rehabilitation for SCI, identifies group physical therapy interventions being delivered, and examines patterns in the types of activities being used for people with different levels and completeness of injury (ie, injury groups). The SCIRehab Study is a 5-year, multicenter investigation that uses practice-based evidence research methodology. Data on characteristics of participants and treatments provided were collected through detailed chart review and customized research documentation completed by clinicians at the point of care. The analyses described here included data from 600 participants enrolled during the first year of the project. Most of the participants (549/600) spent time in group physical therapy, and 23% of all documented physical therapy time was spent in group sessions. The most common group physical therapy activities were strengthening, manual wheelchair mobility, gait training, endurance activities, and range of motion/stretching. Time spent in group physical therapy and the nature of activities performed varied among the injury groups. Physical therapy use patterns observed in the 6 participating centers may not represent all facilities providing inpatient rehabilitation for SCI. Research documentation did not include all factors that may affect group physical therapy use, and some sessions were not documented. The majority of physical therapy was provided in individual sessions, but group physical therapy contributed significantly to total physical therapy time. Group physical therapy time and activities differed among the injury groups in patterns

  4. Reach of Supplemental Nutrition Assistance Program-Education (SNAP-Ed) interventions and nutrition and physical activity-related outcomes, California, 2011-2012.

    PubMed

    Molitor, Fred; Sugerman, Sharon; Yu, Hongjian; Biehl, Michael; Aydin, May; Levy, Melanie; Ponce, Ninez A

    2015-03-12

    This study combined information on the interventions of the US Department of Agriculture's Supplemental Nutrition Assistance Program-Education with 5,927 interview responses from the California Health Interview Survey to investigate associations between levels of intervention reach in low-income census tracts in California and self-reported physical activity and consumption of fruits and vegetables, fast food, and sugar-sweetened beverages. We determined 4 levels of intervention reach (low reach, moderate reach, high reach, and no intervention) across 1,273 program-eligible census tracts from data on actual and eligible number of intervention participants. The locations of California Health Interview Survey respondents were geocoded and linked with program data. Regression analyses included measures for sex, age, race/ethnicity, and education. Adults and children from high-reach census tracts reported eating more fruits and vegetables than adults and children from no-intervention census tracts. Adults from census tracts with low, moderate, or high levels of reach reported eating fast food less often than adults from no-intervention census tracts. Teenagers from low-reach census tracts reported more physical activity than teenagers in no-intervention census tracts. The greatest concentration of Supplemental Nutrition Assistance Program-Education interventions was associated with adults and children eating more fruits and vegetables and adults eating fast food less frequently. These findings demonstrate the potential impact of such interventions as implemented by numerous organizations with diverse populations; these interventions can play an important role in addressing the obesity epidemic in the United States. Limitations of this study include the absence of measures of exposure to the intervention at the individual level and low statistical power for the teenager sample.

  5. Quantification of Physical Activity During Basic Combat Training and Associated Injuries

    DTIC Science & Technology

    2014-03-31

    evaluating the role of dietary supplements for physically active people. AM J Clin Nutr 2000, 72:S541-S550. 30. Rodriguez DA, Brown AL, Troped PJ...epidemiology as physical damage to the body as a result of an energy exchange < 39>. Cumulative injury incidence(%) for each of the 5 injury indices were...31.1% vs. 24.5%, p=0.028) reported they had sustained a lower body injury at some point prior to arriving at BCT. There were no significant gender or

  6. Physical injury and workplace assault in UK mental health trusts: An analysis of formal reports.

    PubMed

    Renwick, Laoise; Lavelle, Mary; Brennan, Geoffrey; Stewart, Duncan; James, Karen; Richardson, Michelle; Williams, Hilary; Price, Owen; Bowers, Len

    2016-08-01

    Workplace violence is a significant problem for health service personnel, with National Health Service (NHS) workers subject to 68 683 physical assaults between 2013 and 2014. Almost 70% of assaults occur in the mental health sector, and although serious, non-fatal injury is rare, the individual and economic impact can be substantial. In the present study, we analysed mandatory incident reports from a national database to examine whether there were identifiable precursors to incidents leading to staff injury, and whether staff characteristics were associated with injury. In line with previous descriptions, we found injury occurred either as a direct result of patient assault or during physical interventions employed by staff to contain aggression. Importantly, we found little evidence from staff reports that patients' symptoms were driving aggression, and we found less evidence of patient perspectives among reports. We make several recommendations regarding the reporting of these events that could inform policy and interventions aimed at minimizing the likelihood of injury.

  7. The state of head injury biomechanics: past, present, and future part 2: physical experimentation.

    PubMed

    Goldsmith, Werner; Monson, Kenneth L

    2005-01-01

    This presentation is the continuation of the article published in Critical Reviews of Biomedical Engineering, 29(5-6), 2001. That issue contained topics dealing with components and geometry of the human head, classification of head injuries, some early experimental studies, and tolerance considerations. It then dealt with head motion and load characterization, investigations during the period from 1939 to 1966, injury causation and early modeling efforts, the 1966 Head Injury Conference and its sequels, mechanical properties of solid tissues, fluid characterization, and early investigation of the mechanical properties of cranial materials. It continued with a description of the systematic investigations of solid cranial components and structural properties since 1966, fetal cranial properties, analytical head modeling, and numerical solutions of head injury. The paper concluded with experimental dynamic loading of human living and cadaver heads, dynamic loading of surrogate heads, and head injury mechanics. This portion of the paper describes physical head injury experimentation involving animals, primarily primates, human cadavers, volunteers, and inanimate physical models. In order to address the entire domain of head injury biomechanics in the two-part survey, it was intended that this information be supplemented by discussions of head injury tolerance and criteria, automotive and sports safety considerations, and the design of protective equipment, but Professor Goldsmith passed away before these sections could be completed. It is nevertheless anticipated that this attenuated installment will provide, in conjunction with the first part of the survey, a valuable resource for students and practitioners of head injury biomechanics.

  8. The Nature of Bias Crime Injuries: A Comparative Analysis of Physical and Psychological Victimization Effects.

    PubMed

    Fetzer, Matthew D; Pezzella, Frank S

    2016-10-13

    The core justification of bias crime statutes concerns whether bias-motivated crimes are qualitatively different from otherwise motivated crimes. We test the hypothesis that bias crimes are more detrimental than non-bias crimes by testing for multi-dimensional injuries to victims of bias and non-bias-motivated criminal conduct. Using National Crime Victimization Survey (NCVS) Extract 2013 Collection Year Incident-level Extract File, we analyzed physical injuries and psychological trauma to NCVS victims during 2013. We found a range of covariates consistent with the likelihood of physical injury and psychological trauma. These included whether the incident was bias motivated, whether weapons (firearms, knives, other or unknown type of weapons) were involved, whether the incident involved multiple offenders or strangers, or whether drugs or alcohol were involved. Our findings reinforce previous studies that detected empirical evidence of multi-dimensional physical and psychological injuries to bias crime victims.

  9. Effective components of exercise and physical activity-related behaviour-change interventions for chronic non-communicable diseases in Africa: protocol for a systematic mixed studies review with meta-analysis

    PubMed Central

    Igwesi-Chidobe, Chinonso N; Godfrey, Emma L; Kengne, Andre P

    2015-01-01

    Introduction Chronic non-communicable diseases (NCDs) account for a high burden of mortality and morbidity in Africa. Evidence-based clinical guidelines recommend exercise training and promotion of physical activity behaviour changes to control NCDs. Developing such interventions in Africa requires an understanding of the essential components that make them effective in this context. This is a protocol for a systematic mixed studies review that aims to determine the effective components of exercise and physical activity-related behaviour-change interventions for chronic diseases in Africa, by combining quantitative and qualitative research evidence from studies published until July 2015. Methods and analysis We will conduct a detailed search to identify all published and unpublished studies that assessed the effects of exercise and physical activity-related interventions or the experiences/perspectives of patients to these interventions for NCDs from bibliographic databases and the grey literature. Bibliographic databases include MEDLINE, EMBASE, CENTRAL (Cochrane Central Register of Controlled Trials), PsycINFO, CINAHL and Web of Science. We will include the following African regional databases: African Index Medicus (AIM) and AFROLIB, which is the WHO's regional office database for Africa. The databases will be searched from inception until 18 July 2015. Appraisal of study quality will be performed after results synthesis. Data synthesis will be performed independently for quantitative and qualitative data using a mixed methods sequential explanatory synthesis for systematic mixed studies reviews. Meta-analysis will be conducted for the quantitative studies, and thematic synthesis for qualitative studies and qualitative results from the non-controlled observational studies. The primary outcome will include exercise adherence and physical activity behaviour changes. This review protocol is reported according to Preferred Reporting Items for Systematic reviews and

  10. Effective components of exercise and physical activity-related behaviour-change interventions for chronic non-communicable diseases in Africa: protocol for a systematic mixed studies review with meta-analysis.

    PubMed

    Igwesi-Chidobe, Chinonso N; Godfrey, Emma L; Kengne, Andre P

    2015-08-12

    Chronic non-communicable diseases (NCDs) account for a high burden of mortality and morbidity in Africa. Evidence-based clinical guidelines recommend exercise training and promotion of physical activity behaviour changes to control NCDs. Developing such interventions in Africa requires an understanding of the essential components that make them effective in this context. This is a protocol for a systematic mixed studies review that aims to determine the effective components of exercise and physical activity-related behaviour-change interventions for chronic diseases in Africa, by combining quantitative and qualitative research evidence from studies published until July 2015. We will conduct a detailed search to identify all published and unpublished studies that assessed the effects of exercise and physical activity-related interventions or the experiences/perspectives of patients to these interventions for NCDs from bibliographic databases and the grey literature. Bibliographic databases include MEDLINE, EMBASE, CENTRAL (Cochrane Central Register of Controlled Trials), PsycINFO, CINAHL and Web of Science. We will include the following African regional databases: African Index Medicus (AIM) and AFROLIB, which is the WHO's regional office database for Africa. The databases will be searched from inception until 18 July 2015. Appraisal of study quality will be performed after results synthesis. Data synthesis will be performed independently for quantitative and qualitative data using a mixed methods sequential explanatory synthesis for systematic mixed studies reviews. Meta-analysis will be conducted for the quantitative studies, and thematic synthesis for qualitative studies and qualitative results from the non-controlled observational studies. The primary outcome will include exercise adherence and physical activity behaviour changes. This review protocol is reported according to Preferred Reporting Items for Systematic reviews and Meta-Analysis protocols (PRISMA

  11. The evaluation of physical exam findings in patients assessed for suspected burn inhalation injury.

    PubMed

    Ching, Jessica A; Shah, Jehan L; Doran, Cody J; Chen, Henian; Payne, Wyatt G; Smith, David J

    2015-01-01

    The purpose of this investigation was to evaluate the utility of singed nasal hair (SN), carbonaceous sputum (CS), and facial burns (FB) as indicators of burn inhalation injury, when compared to the accepted standard of bronchoscopic diagnosis of inhalation injury. An institutional review board approved, retrospective review was conducted. All patients were suspected to have burn inhalation injury and subsequently underwent bronchoscopic evaluation. Data collected included: percent burn TBSA, burn injury mechanism, admission physical exam findings (SN, CS, FB), and bronchoscopy findings. Thirty-five males and twelve females met inclusion criteria (n = 47). Bronchoscopy was normal in 31 patients (66%). Data were analyzed as all patients and in subgroups according to burn TBSA and an enclosed space mechanism of injury. Physical exam findings (SN, CS, FB) were evaluated individually and in combination. Overall, the sensitivities, specificities, positive predictive values, and negative predictive values calculated were poor and inconsistent, and they did not improve within subgroup analysis or when physical findings were combined. Further statistical analysis suggested the physical findings, whether in isolation or in combination, have poor discrimination between patients that have and do not have inhalation injury (AUC < 0.7, P > .05) and poor agreement with the diagnosis made by bronchoscopy (κ < 0.4, P > .05). This remained true in the subgroup analysis as well. Our data demonstrated the findings of SN, CS, and FB are unreliable evidence for inhalation injury, even in the context of an enclosed space mechanism of injury. Thus, these physical findings are not absolute indicators for intubation and should be interpreted as one component of the history and physical.

  12. Injuries to Athletes with Physical Disabilities: Prevention Implications.

    PubMed

    Bloomquist, L E

    1986-09-01

    In brief: While athletes with disabilities may not be injured any more often than the able-bodied, the types of injuries they sustain are specific to their disabilities and sports. Wheelchair athletes, for example, are especially susceptible to hypothermia and hyperthermia due to their inactive leg muscles, vasomotor paralysis, and reduced evaporative heat loss and cooling. This review of current literature reveals that high-risk sports are track and field, basketball, and road racing, with soft-tissue injuries the most common among wheelchair athletes. Carpal tunnel syndrome is also a characteristic injury. Many preventive measures are suggested, including prescription of sport chairs tailored to an athlete's body type, disability, and sport.

  13. Development and reliability of a scale of physical-activity related informal social control for parents of Chinese pre-schoolers

    PubMed Central

    2014-01-01

    Background Parents’ perceived informal social control, defined as the informal ways residents intervene to create a safe and orderly neighbourhood environment, may influence young children’s physical activity (PA) in the neighbourhood. This study aimed to develop and test the reliability of a scale of PA-related informal social control relevant to Chinese parents/caregivers of pre-schoolers (children aged 3 to 5 years) living in Hong Kong. Methods Nominal Group Technique (NGT), a structured, multi-step brainstorming technique, was conducted with two groups of caregivers (mainly parents; n = 11) of Hong Kong pre-schoolers in June 2011. Items collected in the NGT sessions and those generated by a panel of experts were used to compile a list of items (n = 22) for a preliminary version of a questionnaire of informal social control. The newly-developed scale was tested with 20 Chinese-speaking parents/caregivers using cognitive interviews (August 2011). The modified scale, including all 22 original items of which a few were slightly reworded, was subsequently administered on two occasions, a week apart, to 61 Chinese parents/caregivers of Hong Kong pre-schoolers in early 2012. The test-retest reliability and internal consistency of the items and scale were examined using intraclass correlation coefficients (ICC), paired t-tests, relative percentages of shifts in responses to items, and Cronbach’s α coefficient. Results Thirteen items generated by parents/caregivers and nine items generated by the panel of experts (total 22 items) were included in a first working version of the scale and classified into three subscales: “Personal involvement and general informal supervision”, “Civic engagement for the creation of a better neighbourhood environment” and “Educating and assisting neighbourhood children”. Twenty out of 22 items showed moderate to excellent test-test reliability (ICC range: 0.40-0.81). All three subscales of informal social control

  14. Prediction of blunt traumatic injuries and hospital admission based on history and physical exam.

    PubMed

    Beal, Alan L; Ahrendt, Mark N; Irwin, Eric D; Lyng, John W; Turner, Steven V; Beal, Christopher A; Byrnes, Matthew T; Beilman, Greg A

    2016-01-01

    We evaluated the ability of experienced trauma surgeons to accurately predict specific blunt injuries, as well as patient disposition from the emergency department (ED), based only on the initial clinical evaluation and prior to any imaging studies. It would be hypothesized that experienced trauma surgeons' initial clinical evaluation is accurate for excluding life-threatening blunt injuries and for appropriate admission triage decisions. Using only their history and physical exam, and prior to any imaging studies, three (3) experienced trauma surgeons, with a combined Level 1 trauma experience of over 50 years, predicted injuries in patients with an initial GCS (Glasgow Coma Score) of 14-15. Additionally, ED disposition (ICU, floor, discharge to home) was also predicted. These predictions were compared to actual patient dispositions and to blunt injuries documented at discharge. A total of 101 patients with 92 blunt injuries were studied. 43/92 (46.7 %) injuries would have been missed by only performing an initial history and physical exam ("Missed injury"). A change in treatment, though often minor, was required in 19/43 (44.2 %) of the missed injuries. Only 1/43 (2.3 %) of these "missed injuries" (blunt aortic injury) required surgery. Sensitivity, specificity, and accuracy for injury prediction were 53.2, 95.9, and 92.3 % respectively. Positive and negative predictive values were 53.8 and 95.8 % respectively. Prediction of disposition from the ED was 77.8 % accurate. In 7/34 (20.6 %) patients, missed injuries led to changes in disposition. "Undertriage" occurred in 9/99 (9.1 %) patients (Predicted for floor but admitted to ICU). Additionally, 8/84 (9.5 %) patients predicted for floor admission were sent home from the ED; and 5/13 (38.5 %) patients predicted for ICU admission were actually sent to the floor after complete evaluations, giving an "overtriage" rate of 13/99 (13.1 %) patients. In a neurologically-intact group of trauma patients

  15. Development of a Conceptual Model to Predict Physical Activity Participation in Adults with Brain Injuries

    ERIC Educational Resources Information Center

    Driver, Simon

    2008-01-01

    The purpose was to examine psychosocial factors that influence the physical activity behaviors of adults with brain injuries. Two differing models, based on Harter's model of self-worth, were proposed to examine the relationship between perceived competence, social support, physical self-worth, affect, and motivation. Adults numbering 384 with…

  16. Development of a Conceptual Model to Predict Physical Activity Participation in Adults with Brain Injuries

    ERIC Educational Resources Information Center

    Driver, Simon

    2008-01-01

    The purpose was to examine psychosocial factors that influence the physical activity behaviors of adults with brain injuries. Two differing models, based on Harter's model of self-worth, were proposed to examine the relationship between perceived competence, social support, physical self-worth, affect, and motivation. Adults numbering 384 with…

  17. Strategies for optimizing military physical readiness and preventing musculoskeletal injuries in the 21st century.

    PubMed

    Nindl, Bradley C; Williams, Thomas J; Deuster, Patricia A; Butler, Nikki L; Jones, Bruce H

    2013-01-01

    With downsizing of the military services and significant budget cuts, it will be more important than ever to optimize the health and performance of individual service members. Musculoskeletal injuries (MSIs) represent a major threat to the health and fitness of Soldiers and other service members that degrade our nation's ability to project military power. This affects both financial (such as the economic burden from medical, healthcare, and disability costs) and human manpower resources (Soldiers medically unable to optimally perform their duties and to deploy). For example, in 2012, MSIs represented the leading cause of medical care visits across the military services resulting in almost 2,200,000 medical encounters. They also result in more disability discharges than any other health condition. Nonbattle injuries (NBIs) have caused more medical evacuations (34%) from recent theaters of operation than any other cause including combat injuries. Physical training and sports are the main cause of these NBIs. The majority (56%) of these injuries are the direct result of physical training. Higher levels of physical fitness protect against such injuries; however, more physical training to improve fitness also causes higher injury rates. Thus, military physical training programs must balance the need for fitness with the risks of injuries. The Army has launched several initiatives that may potentially improve military physical readiness and reduce injuries. These include the US Army Training and Doctrine Command's Baseline Soldier Physical Readiness Requirements and Gender Neutral Physical Performance Standards studies, as well as the reimplementation of the Master Fitness Trainer program and the Army Medical Command's Soldier Medical Readiness and Performance Triad Campaigns. It is imperative for military leaders to understand that military physical readiness can be enhanced at the same time that MSIs are prevented. A strategic paradigm shift in the military's approach

  18. Evidence based prevention of acute injuries during physical exercise in a WHO safe community

    PubMed Central

    Timpka, T; Lindqvist, K

    2001-01-01

    Objective—To evaluate a community based programme for evidence based prevention of injuries during physical exercise. Design—Quasi-experimental evaluation using an intervention population and a non-random control population. Participants—Study municipality (population 41 000) and control municipality (population 26 000) in Sweden. Main outcome measures—Morbidity rate for sports related injuries treated in the health care system; severity classification according to the abbreviated injury scale (AIS). Results—The total morbidity rate for sports related injuries in the study area decreased by 14% from 21 to 18 injuries per 1000 population years (odds ratio 0.87; 95% confidence interval (CI) 0.79 to 0.96). No tendency towards a decrease was observed in people over 40. The rate of moderately severe injury (AIS 2) decreased to almost half (odds ratio 0.58; 95% CI 0.50 to 0.68), whereas the rate of minor injuries (AIS 1) increased (odds ratio 1.22; 95% CI 1.06 to 1.40). The risk of severe injuries (AIS 3–6) remained constant. The rate of total sports injury in the control area did not change (odds ratio 0.93; 95% CI 0.81 to 1.07), and the trends in the study and control areas were not statistically significantly different. Conclusion—An evidence based prevention programme based on local safety rules and educational programmes can reduce the burden of injuries related to physical exercise in a community. Future studies need to look at adjusting the programme to benefit all age groups. Key Words: injuries; prevention; evaluation; community; intervention; safety promotion PMID:11157457

  19. The use of physical restraint in the treatment of self-injury and as positive reinforcement.

    PubMed Central

    Favell, J E; McGimsey, J F; Jones, M L

    1978-01-01

    Two experiments investigated the effects of a treatment package on the self-injurious behavior of three profoundly retarded persons who appeared to enjoy the physical restraints used to prevent their self-injury. The treatment package included physically restraining subjects contingent on increasing periods of time during which no self-injury occurred, and providing them with toys and attention during intervals between restraints. A reversal and multiple-baseline analysis documented that the rapid and complete reduction in self-injury by all subjects was due to this treatment package. Because these results suggested that physical restraint might function as a positive reinforcer, in a third experiment physical restraint was applied contingent on a marble placement response with one subject. A reversal design demonstrated that toy play systematically increased when each response resulted in restraint. The experiments have implications for the nonaversive remediation of self-injury in individuals who are restrained, as well as for the development and maintenance of self-injury in natural settings. PMID:670112

  20. Sports injuries and illnesses in first-year physical education teacher education students.

    PubMed

    van Beijsterveldt, Anne-Marie; Richardson, Angelo; Clarsen, Benjamin; Stubbe, Janine

    2017-01-01

    We aimed to investigate the magnitude and characteristics of injuries and illnesses in Dutch physical education teacher education (PETE) students. During the first 21 weeks of the academic year, 245 first-year students registered their health problems online using the Oslo Sports Trauma Research Centre (OSTRC) Questionnaire on Health Problems. A total of 276 injuries, 140 illnesses and 69 unclassified health problems were reported. We found an injury incidence rate of 11.7 injuries per 1000 hours (95% CI 10.4 to 13.2). Injury characteristics were: 42% overuse injuries, 62% causing absence from sports (median injury time loss=2 days) and 64% reinjuries. Most injuries were located at the knee, lower leg (anterior) and ankle. The duration of the illnesses was short (<1 week). We implemented a new registration method in the PETE academic programme. The results show that the risk for health problems is high for PETE students. Prevention is necessary, and to decrease injuries prevention programmes should focus on the lower extremities.

  1. Perceptions of physical activity and walking in an early stage after stroke or acquired brain injury.

    PubMed

    Törnbom, Karin; Sunnerhagen, Katharina S; Danielsson, Anna

    2017-01-01

    Physical activity has been established as being highly beneficial for health after stroke. There are considerable global efforts to find rehabilitation programs that encourage increased physical activity for persons with stroke. However, many persons with stroke or acquired brain injury do not reach recommended levels of physical activity and increased knowledge about why is needed. We aimed to explore views and experiences of physical activity and walking among persons with stroke or acquired brain injury. A qualitative study was conducted, among persons with stroke (n = 8) or acquired brain injury (n = 2) from a rehabilitation unit at Sahlgrenska University Hospital in Sweden. Semi-structured in-depth interviews were held about perceptions and experiences of walking and physical activity in general. Data were analyzed using qualitative content analysis, with categories that were determined inductively. Physical activity in general and walking ability more specifically were considered very important by the participants. However, physical activity was, regardless of exercising habits pre-injury, associated with different kinds of negative feelings and experiences. Commonly reported internal barriers in the current study were; fatigue, fear of falling or getting hurt in traffic, lack of motivation and depression. Reported external barriers were mostly related to walking, for example; bad weather, uneven ground, lack of company or noisy or too busy surroundings. Persons with stroke or acquired brain injury found it difficult to engage in and sustain an eligible level of physical activity. Understanding individual concerns about motivators and barriers surrounding physical activity may facilitate the work of forming tailor-made rehabilitation for these groups, so that the levels of physical activity and walking can increase.

  2. Perceptions of physical activity and walking in an early stage after stroke or acquired brain injury

    PubMed Central

    2017-01-01

    Background Physical activity has been established as being highly beneficial for health after stroke. There are considerable global efforts to find rehabilitation programs that encourage increased physical activity for persons with stroke. However, many persons with stroke or acquired brain injury do not reach recommended levels of physical activity and increased knowledge about why is needed. We aimed to explore views and experiences of physical activity and walking among persons with stroke or acquired brain injury. Method A qualitative study was conducted, among persons with stroke (n = 8) or acquired brain injury (n = 2) from a rehabilitation unit at Sahlgrenska University Hospital in Sweden. Semi-structured in-depth interviews were held about perceptions and experiences of walking and physical activity in general. Data were analyzed using qualitative content analysis, with categories that were determined inductively. Results Physical activity in general and walking ability more specifically were considered very important by the participants. However, physical activity was, regardless of exercising habits pre-injury, associated with different kinds of negative feelings and experiences. Commonly reported internal barriers in the current study were; fatigue, fear of falling or getting hurt in traffic, lack of motivation and depression. Reported external barriers were mostly related to walking, for example; bad weather, uneven ground, lack of company or noisy or too busy surroundings. Conclusion Persons with stroke or acquired brain injury found it difficult to engage in and sustain an eligible level of physical activity. Understanding individual concerns about motivators and barriers surrounding physical activity may facilitate the work of forming tailor-made rehabilitation for these groups, so that the levels of physical activity and walking can increase. PMID:28273158

  3. Impact of physical injury on mental health after the 2004 Southeast Asia tsunami.

    PubMed

    Dyster-Aas, Johan; Arnberg, Filip K; Lindam, Anna; Johannesson, Kerstin Bergh; Lundin, Tom; Michel, Per-Olof

    2012-06-01

    The risk of developing enduring post-traumatic stress reactions and mental health problems in the aftermath of disasters is substantial. However, there are inconsistencies regarding the contribution of physical injury as an independent risk factor for developing psychiatric morbidity after disasters. The aim was to assess whether physical injury was associated with post-traumatic stress reactions and general mental health after adjusting for perceived life-threat in the aftermath of the 2004 tsunami. A sample of 1501 highly exposed survivors from the 2004 Southeast Asia tsunami was selected from a cohort of Swedish survivors surveyed 14 and 36 months after the event. The impact of physical injury on post-traumatic stress and general mental health was assessed by regression models accounting for subjective life-threat. Physical injury was associated with higher levels of post-traumatic stress reactions and poorer general mental health. These associations were observed at both 14 and 36 months after the disaster. Physical injury has a specific contribution to the association between traumatic experience and both post-traumatic stress reactions and general mental health in victims of the 2004 tsunami. The effect is stable over several years.

  4. Can Vascular Injury be Appropriately Assessed With Physical Examination After Knee Dislocation?

    PubMed

    Weinberg, Douglas S; Scarcella, Nicholas R; Napora, Joshua K; Vallier, Heather A

    2016-06-01

    Knee dislocations are rare injuries with potentially devastating vascular complications. An expeditious and accurate diagnosis is necessary, as failing to diagnose vascular injury can result in amputation; however, the best diagnostic approach remains controversial. We asked: (1) What patient factors are predictors of vascular injury after knee dislocation? (2) What are the diagnostic utilities of palpable dorsalis pedis or posterior tibial pulses, and the presence of an ankle-brachial index (ABI) of 0.9 or greater? A database at a Level I trauma center was queried for patients with evidence of knee dislocation, demographic information (age at the time of injury, sex, Injury Severity Score, BMI, mechanism of injury), and the presence of open injury were recorded. One-hundred forty-one patients underwent screening at initial presentation, of whom 26 (24%) underwent early vascular exploration based on an abnormal physical examination. One-hundred five (91%) of the remaining 115 patients were available at a minimum followup of 6 months (mean, 19 ± 10 months). In total, 31 unique patients were excluded, including 10 patients (7%) who were lost to followup before 6 months. Among the 110 patients who met inclusion criteria, the mean age and SD was 37 ± 13 years, and the Injury Severity Score was 15 ± 9. There were 71 males (65%). Logistic regression was used to determine independent correlates of vascular injury. The vascular examination was reviewed for the presence of a palpable pulse in the dorsalis pedis artery, the presence of a palpable pulse in the posterior tibial artery, and whether the ABI in the dorsalis pedis was 0.9 or greater. Contingency tables were generated to assess the sensitivity, specificity, and accuracy of physical examination maneuvers. The physical examination was collectively regarded as "normal" when both pulses were palpable and the ABI was 0.9 or greater. The initial physical examination as just described was considered the diagnostic test

  5. PHYSICAL EXAMINATIONS FOR DIAGNOSING MENISCAL INJURIES: CORRELATION WITH SURGICAL FINDINGS

    PubMed Central

    Gobbo, Ricardo da Rocha; Rangel, Victor de Oliveira; Karam, Francisco Consoli; Pires, Luiz Antônio Simões

    2015-01-01

    Objective: A set of five maneuvers for meniscal injuries (McMurray, Apley, Childress and Steinmann 1 and 2) was evaluated and their sensitivity, specificity, accuracy and likelihood were calculated. The same methods were applied to each test individually. Methods: One hundred and fifty-two patients of both sexes who were going to undergo videoarthroscopy on the knee were examined blindly by one of five residents at this hospital, without knowledge of the clinical data and why the patient was going to undergo an operation. This examination was conducted immediately before the videoarthroscopy and its results were recorded in an electronic spreadsheet. The set of maneuvers was considered positive when one was positive. In the individual analysis, it was enough for the test to be positive. Results: The analysis showed that the set of five meniscal tests presented sensitivity of 89%, specificity of 42%, accuracy of 75%, positive likelihood of 1.53 and negative likelihood of 0.26. Individually, the tests presented accuracy of between 48% and 53%. Conclusion: The set of maneuvers for meniscal injuries presented a good accuracy and significant value, especially for ruling out injury. Individually, the tests had less diagnostic value, although the Apley test had better specificity. PMID:27047833

  6. Cohort study of physical activity and injury among Latino farm workers

    PubMed Central

    Xiao, Hong; Stoecklin-Marois, Maria; Li, Chin-Shang; McCurdy, Stephen A.; Schenker, Marc

    2016-01-01

    Introduction This study characterized physical activity and its association with injury among Latino farm workers. Methods An interviewer-administered questionnaire was used to collect baseline and follow-up data on 843 and 640 Latino farm workers, respectively. Participants were 18–55 years old, engaged in farm work and residing in Mendota, CA at baseline interview. The questionnaire assessed self-reported physical activity and risk of injury. Results The 12 month prevalence of injury decreased from 9.0% at baseline to 6.9% at follow up interview. In GEE models adjusted for age, follow-up time, gender, smoking, income and years working in agriculture, poor/fair self-assessed health status (OR=1.82, 95% CI: 1.18, 2.82) and 2–3 hours per day of sitting/watching TV/using a computer (OR=0.50, 95% CI: 0.30–0.83) were significantly associated with injury. Conclusions Physical activity was not associated with injury in this population. Efforts to reduce injuries should focus on known risk factors such as poor health status. PMID:25943698

  7. Physically demanding jobs and occupational injury and disability in the U.S. Army.

    PubMed

    Hollander, Ilyssa E; Bell, Nicole S

    2010-10-01

    Effective job assignments should take into account physical capabilities to perform required tasks. Failure to do so is likely to result in increased injuries and musculoskeletal disability. To evaluate the association between job demands and health outcomes among U.S. Army soldiers. Multivariate Cox proportional hazards analysis is used to describe associations between job demands, hospitalizations, and disability among 261,096 enlisted Army soldiers in heavily, moderately, and lightly physically demanding occupations (2000-2005) who were followed for up to 5 years. Controlling for gender, race, and age, soldiers in heavily demanding jobs were at increased risk for any-cause injury, on-duty injuries, any-cause hospitalizations, and any-cause disability, but not for musculoskeletal disability. Army job assignments should more accurately match physical capabilities to job demands and/or jobs should be redesigned to reduce injuries. Though musculoskeletal disorders are often the result of acute injury, the demographic and occupational risk patterns differ from acute injury.

  8. Piloting a physical activity centred education programme for adults with a brain injury.

    PubMed

    Driver, Simon; Irwin, Kelley; Woolsey, Anne; Warren, Ann Marie

    2013-01-01

    To pilot test a physical activity centred education (PACE) programme for adults with a brain injury. Purposive sampling was utilized from a convenience sample of nine adults with a brain injury (five female; four male). The sample completed an 8-week health promotion programme focused on improving physical activity behaviours. Participants completed measures of self-efficacy, stage of change and rehabilitation outcomes pre- and post-programme. Descriptive analysis, effect sizes (ES) and percentage change in variables were assessed. Results indicated improved rehabilitation outcomes as participants decreased from moderate to mild limitation (ES = 1.67). Furthermore, participants reported increased self-efficacy (ES = 0.41) and intention to be active. Specialists are challenged to find modes of rehabilitation that improve the health of individuals with a brain injury. Pilot results from the PACE programme indicate that education about physical activity may play an important role in the rehabilitation process and lead to improved health outcomes.

  9. Orthopedic Surgeons and Physical Therapists Differ in Assessment of Need for Physical Therapy After Traumatic Lower-Extremity Injury

    PubMed Central

    MacKenzie, Ellen J.; Castillo, Renan C.; Bosse, Michael J.

    2009-01-01

    Background Lower-extremity injuries constitute the leading cause of trauma hospitalizations among people under the age of 65 years. Rehabilitation has the potential to favorably influence the outcomes associated with traumatic lower-extremity injuries. Objectives The objectives of this study were to explore variability in surgeon and physical therapist assessments of the need for physical therapy in patients with traumatic lower-extremity injuries and to determine the factors associated with assessments of need. Design This study was a retrospective cohort investigation. Methods Participants were 395 patients treated by reconstruction in the Lower-Extremity Assessment Project. They were evaluated at 8 level I trauma centers at 3, 6, and 12 months after hospitalization by an orthopedic surgeon and a physical therapist to determine the need for physical therapy. Analyses included multilevel logistic regression. Results Chi-square analyses showed that surgeon and therapist assessments of need differed statistically across trauma centers. Surgeons were more likely to assess a need for therapy at 3 months when participants had low work self-efficacy, impaired knee flexion range of motion (ROM), and weight-bearing limitations and at 6 and 12 months when participants had impaired knee flexion ROM and weight-bearing and balance limitations. Therapists were more likely to assess a need for therapy at 3 months when participants had moderate to severe pain and at 6 and 12 months when participants had low work self-efficacy, pain, impaired knee flexion ROM, and balance limitations. Conclusions The results revealed variability in assessments of the need for physical therapy at the provider and trauma center levels. Differences in provider assessments highlight the need for communication and further investigation into the outcomes and timing of physical therapy for the treatment of traumatic lower-extremity injuries. PMID:19875460

  10. Orthopedic surgeons and physical therapists differ in assessment of need for physical therapy after traumatic lower-extremity injury.

    PubMed

    Archer, Kristin R; Mackenzie, Ellen J; Castillo, Renan C; Bosse, Michael J

    2009-12-01

    Lower-extremity injuries constitute the leading cause of trauma hospitalizations among people under the age of 65 years. Rehabilitation has the potential to favorably influence the outcomes associated with traumatic lower-extremity injuries. The objectives of this study were to explore variability in surgeon and physical therapist assessments of the need for physical therapy in patients with traumatic lower-extremity injuries and to determine the factors associated with assessments of need. This study was a retrospective cohort investigation. Participants were 395 patients treated by reconstruction in the Lower-Extremity Assessment Project. They were evaluated at 8 level I trauma centers at 3, 6, and 12 months after hospitalization by an orthopedic surgeon and a physical therapist to determine the need for physical therapy. Analyses included multilevel logistic regression. Chi-square analyses showed that surgeon and therapist assessments of need differed statistically across trauma centers. Surgeons were more likely to assess a need for therapy at 3 months when participants had low work self-efficacy, impaired knee flexion range of motion (ROM), and weight-bearing limitations and at 6 and 12 months when participants had impaired knee flexion ROM and weight-bearing and balance limitations. Therapists were more likely to assess a need for therapy at 3 months when participants had moderate to severe pain and at 6 and 12 months when participants had low work self-efficacy, pain, impaired knee flexion ROM, and balance limitations. The results revealed variability in assessments of the need for physical therapy at the provider and trauma center levels. Differences in provider assessments highlight the need for communication and further investigation into the outcomes and timing of physical therapy for the treatment of traumatic lower-extremity injuries.

  11. Physical exercise improves arterial stiffness after spinal cord injury

    PubMed Central

    Hubli, Michèle; Currie, Katharine D.; West, Christopher R.; Gee, Cameron M.; Krassioukov, Andrei V.

    2014-01-01

    Objective/background Aortic pulse wave velocity (PWV), the gold-standard assessment of central arterial stiffness, has prognostic value for cardiovascular disease risk in able-bodied individuals. The aim of this study was to compare aortic PWV in athletes and non-athletes with spinal cord injury (SCI). Design Cross-sectional comparison. Methods Aortic PWV was assessed in 20 individuals with motor-complete, chronic SCI (C2–T5; 18 ± 8 years post-injury) using applanation tonometry at the carotid and femoral arterial sites. Ten elite hand-cyclists were matched for sex to 10 non-athletes; age and time since injury were comparable between the groups. Heart rate and discrete brachial blood pressure measurements were collected throughout testing. Outcome measures Aortic PWV, blood pressure, heart rate. Results Aortic PWV was significantly lower in athletes vs. non-athletes (6.9 ± 1.0 vs. 8.7 ± 2.5 m/second, P = 0.044). There were no significant between-group differences in resting supine mean arterial blood pressure (91 ± 19 vs. 81 ± 10 mmHg) and heart rate (60 ± 10 vs. 58 ± 6 b.p.m.). Conclusion Athletes with SCI exhibited improved central arterial stiffness compared to non-athletes, which is in agreement with the previous able-bodied literature. This finding implies that chronic exercise training may improve arterial health and potentially lower cardiovascular disease risk in the SCI population. PMID:24976366

  12. Correlations between injury, training intensity, and physical and mental exhaustion among college athletes.

    PubMed

    Vetter, Rheba E; Symonds, Matthew L

    2010-03-01

    The primary purpose of this research was to obtain information concerning injury incidence and perceptions of training intensities and fatigue levels among college athletes via a survey study. A second purpose was to illuminate correlations between the collected data. This study employed an investigator-designed survey instrument administered to 411 NCAA Division II male and female athletes, with 149 completed responses. The survey included 3 themes: injury incidence, training intensity, and physical and mental exhaustion. Men and women spent 4.5 days per week training using moderate- and high-intensity levels. Fifty percent of the total number of athletes reported chronic injury. During the competition season, physical exhaustion occurred "frequently" 30.86 and 23.53% of the time with men and women, respectively. In the noncompetition season, physical exhaustion was "frequently" experienced 19.75 and 17.65% of the time among men and women, respectively. Statistically significant correlations (p < 0.05) were found with acute injury for men and chronic injury for women. Also, training intensity levels and physical and mental exhaustion for men and women were statistically significant. The current investigators found the training involved 2-3 hours of moderate to high intensity 4.5 days per week both during competition and noncompetition; women and men spent 2-3 hours of light intensity 1.31 and 1.45 days per week, respectively. Women and men in addition to training, engaged in 3.78 and 4.43 hours of leisure physical activity per week. The investigators recommend tapering, periodization, and rest to help avoid overuse syndrome, overreaching, and overtraining that leads to excessive physical and mental exhaustion and injury.

  13. Blast mines: physics, injury mechanisms and vehicle protection.

    PubMed

    Ramasamy, A; Hill, A M; Hepper, A E; Bull, A M J; Clasper, J C

    2009-12-01

    Since World War II, more vehicles have been lost to land mines than all other threats combined. Anti-vehicular (AV) mines are capable of disabling a heavy vehicle, or completely destroying a lighter vehicle. The most common form of AV mine is the blast mine, which uses a large amount of explosive to directly damage the target. In a conventional military setting, landmines are used as a defensive force-multiplier and to restrict the movements of the opposing force. They are relatively cheap to purchase and easy to acquire, hence landmines are also potent weapons in the insurgents' armamentarium. The stand-offnature of its design has allowed insurgents to cause significant injuries to security forces in current conflicts with little personal risk. As a result, AV mines and improvised explosive devices (IEDs) have become the most common cause of death and injury to Coalition and local security forces operating in Iraq and Afghanistan. Detonation of an AV mine causes an explosive, exothermic reaction which results in the formation of a shockwave followed by a rapid expansion of gases. The shockwave is mainly reflected by the soillair interface and fractures the soil cap overthe mine. The detonation products then vent through the voids in the soil, resulting in a hollow inverse cone which consists of the detonation gases surrounded by the soil ejecta. It is the combination of the detonation products and soil ejecta that interact with the target vehicle and cause injury to the vehicle occupants. A number of different strategies are required to mitigate the blast effects of an explosion. Primary blast effects can be reduced by increasing the standoff distance between the seat of the explosion and the crew compartment. Enhancement of armour on the base of the vehicle, as well as improvements in personal protection can prevent penetration of fragments. Mitigating tertiary effects can be achieved by altering the vehicle geometry and structure, increasing vehicle mass, as

  14. Physical Exam Risk Factors for Lower Extremity Injury in High School Athletes: A Systematic Review

    PubMed Central

    Onate, James A.; Everhart, Joshua S.; Clifton, Daniel R.; Best, Thomas M.; Borchers, James R.; Chaudhari, Ajit M.W.

    2016-01-01

    Objective A stated goal of the preparticipation physical evaluation (PPE) is to reduce musculoskeletal injury, yet the musculoskeletal portion of the PPE is reportedly of questionable use in assessing lower extremity injury risk in high school-aged athletes. The objectives of this study are: (1) identify clinical assessment tools demonstrated to effectively determine lower extremity injury risk in a prospective setting, and (2) critically assess the methodological quality of prospective lower extremity risk assessment studies that use these tools. Data Sources A systematic search was performed in PubMed, CINAHL, UptoDate, Google Scholar, Cochrane Reviews, and SportDiscus. Inclusion criteria were prospective injury risk assessment studies involving athletes primarily ages 13 to 19 that used screening methods that did not require highly specialized equipment. Methodological quality was evaluated with a modified physiotherapy evidence database (PEDro) scale. Main Results Nine studies were included. The mean modified PEDro score was 6.0/10 (SD, 1.5). Multidirectional balance (odds ratio [OR], 3.0; CI, 1.5–6.1; P < 0.05) and physical maturation status (P < 0.05) were predictive of overall injury risk, knee hyperextension was predictive of anterior cruciate ligament injury (OR, 5.0; CI, 1.2–18.4; P < 0.05), hip external: internal rotator strength ratio of patellofemoral pain syndrome (P = 0.02), and foot posture index of ankle sprain (r = −0.339, P = 0.008). Conclusions Minimal prospective evidence supports or refutes the use of the functional musculoskeletal exam portion of the current PPE to assess lower extremity injury risk in high school athletes. Limited evidence does support inclusion of multidirectional balance assessment and physical maturation status in a musculoskeletal exam as both are generalizable risk factors for lower extremity injury. PMID:26978166

  15. Physical Exam Risk Factors for Lower Extremity Injury in High School Athletes: A Systematic Review.

    PubMed

    Onate, James A; Everhart, Joshua S; Clifton, Daniel R; Best, Thomas M; Borchers, James R; Chaudhari, Ajit M W

    2016-11-01

    A stated goal of the preparticipation physical evaluation (PPE) is to reduce musculoskeletal injury, yet the musculoskeletal portion of the PPE is reportedly of questionable use in assessing lower extremity injury risk in high school-aged athletes. The objectives of this study are: (1) identify clinical assessment tools demonstrated to effectively determine lower extremity injury risk in a prospective setting, and (2) critically assess the methodological quality of prospective lower extremity risk assessment studies that use these tools. A systematic search was performed in PubMed, CINAHL, UptoDate, Google Scholar, Cochrane Reviews, and SportDiscus. Inclusion criteria were prospective injury risk assessment studies involving athletes primarily ages 13 to 19 that used screening methods that did not require highly specialized equipment. Methodological quality was evaluated with a modified physiotherapy evidence database (PEDro) scale. Nine studies were included. The mean modified PEDro score was 6.0/10 (SD, 1.5). Multidirectional balance (odds ratio [OR], 3.0; CI, 1.5-6.1; P < 0.05) and physical maturation status (P < 0.05) were predictive of overall injury risk, knee hyperextension was predictive of anterior cruciate ligament injury (OR, 5.0; CI, 1.2-18.4; P < 0.05), hip external:internal rotator strength ratio of patellofemoral pain syndrome (P = 0.02), and foot posture index of ankle sprain (r = -0.339, P = 0.008). Minimal prospective evidence supports or refutes the use of the functional musculoskeletal exam portion of the current PPE to assess lower extremity injury risk in high school athletes. Limited evidence does support inclusion of multidirectional balance assessment and physical maturation status in a musculoskeletal exam as both are generalizable risk factors for lower extremity injury.

  16. Effect of Physical and Academic Stress on Illness and Injury in Division 1 College Football Players.

    PubMed

    Mann, J Bryan; Bryant, Kirk R; Johnstone, Brick; Ivey, Patrick A; Sayers, Stephen P

    2016-01-01

    Stress-injury models of health suggest that athletes experience more physical injuries during times of high stress. The purpose of this study was to evaluate the effect of increased physical and academic stress on injury restrictions for athletes (n = 101) on a division I college football team. Weeks of the season were categorized into 3 levels: high physical stress (HPS) (i.e., preseason), high academic stress (HAS) (i.e., weeks with regularly scheduled examinations such as midterms, finals, and week before Thanksgiving break), and low academic stress (LAS) (i.e., regular season without regularly scheduled academic examinations). During each week, we recorded whether a player had an injury restriction, thereby creating a longitudinal binary outcome. The data were analyzed using a hierarchical logistic regression model to properly account for the dependency induced by the repeated observations over time within each subject. Significance for regression models was accepted at p ≤ 0.05. We found that the odds of an injury restriction during training camp (HPS) were the greatest compared with weeks of HAS (odds ratio [OR] = 2.05, p = 0.0003) and LAS (OR = 3.65, p < 0.001). However, the odds of an injury restriction during weeks of HAS were nearly twice as high as during weeks of LAS (OR = 1.78, p = 0.0088). Moreover, the difference in injury rates reported in all athletes during weeks of HPS and weeks of HAS disappeared when considering only athletes that regularly played in games (OR = 1.13, p = 0.75) suggesting that HAS may affect athletes that play to an even greater extent than HPS. Coaches should be aware of both types of stressors and consider carefully the types of training methods imposed during times of HAS when injuries are most likely.

  17. Effects of a multifactorial injury prevention intervention in physical education teachers: A randomized controlled trial.

    PubMed

    Vercruysse, Sien; Haerens, Leen; Verhagen, Evert; Goossens, Lennert; De Clercq, Dirk

    2016-10-01

    Physical education (PE) teachers are at a high risk of musculoskeletal sports or work-related injuries because of the physical activity as inherent part of their profession. Such injuries have a negative impact on work and leisure time activities, and effective injury prevention interventions are needed. The present study aimed at testing the effectiveness of an injury prevention intervention that was developed and optimized according to PE teachers' wishes and values. Fifty-five PE teachers were randomly assigned to intervention or control group. Intervention group teachers engaged in two days of training during which they familiarized with eight injury prevention strategies (seven intrinsic and one extrinsic). A special feature of the intervention was that the way of delivery was based on the self-determination theory in order to stimulate participants' motivation to adhere to the proposed strategies. Prospective registrations during one school year were conducted concerning injuries and preventive behaviours. Results showed that the intervention group teachers had a lower number of injuries per 1000 h time of exposure (TOE) than the controls (INT: 0.49, CON: 1.14 injuries/1000 h TOE, OR: 2.32, 95% CI: 1.06-5.07), and applied a broader variety of strategies including dynamic and static stretching, core stability, balance and strength training, when compared to the controls who mainly engaged in warming-up. In conclusion, with the same amount of time, an injury reduction was found in PE teachers through a more balanced use of provided preventive strategies.

  18. Reliability and validity of daily physical activity measures during inpatient spinal cord injury rehabilitation

    PubMed Central

    Zbogar, Dominik; Eng, Janice J; Miller, William C; Krassioukov, Andrei V; Verrier, Mary C

    2016-01-01

    Objectives: To assess the test–retest reliability and convergent validity of daily physical activity measures during inpatient spinal cord injury rehabilitation. Design: Observational study. Setting: Two inpatient spinal cord injury rehabilitation centres. Subjects: Participants (n = 106) were recruited from consecutive admissions to rehabilitation. Methods: Physical activity during inpatient spinal cord injury rehabilitation stay was recorded on two days via (1) wrist accelerometer, (2) hip accelerometer if ambulatory, and (3) self-report (Physical Activity Recall Assessment for People with Spinal Cord Injury questionnaire). Spearman’s correlations and Bland–Altman plots were utilized for test–retest reliability. Correlations between physical activity measures and clinical measures (functional independence, hand function, and ambulation) were performed. Results: Correlations for physical activity measures between Day 1 and Day 2 were moderate to high (ρ = 0.53–0.89). Bland–Altman plots showed minimal bias and more within-subject differences in more active individuals and wide limits of agreement. None of these three physical activity measures correlated with one another. A moderate correlation was found between wrist accelerometry counts and grip strength (ρ = 0.58) and between step counts and measures of ambulation (ρ = 0.62). Functional independence was related to wrist accelerometry (ρ = 0.70) and step counts (ρ = 0.56), but not with self-report. Conclusion: The test–retest reliability and convergent validity of the instrumented measures suggest that wrist and hip accelerometers are appropriate tools for use in research studies of daily physical activity in the spinal cord injury rehabilitation setting but are too variable for individual use. PMID:27635252

  19. Prevalence of abusive injuries in siblings and household contacts of physically abused children.

    PubMed

    Lindberg, Daniel M; Shapiro, Robert A; Laskey, Antoinette L; Pallin, Daniel J; Blood, Emily A; Berger, Rachel P

    2012-08-01

    Siblings and other children who share a home with a physically abused child are thought to be at high risk for abuse, but rates of injury in these contact children are unknown and screening of contacts is highly variable. Our objective was to determine the prevalence of abusive injuries identified by a common screening protocol among contacts of physically abused children. This is an observational, multicenter cross-sectional study of children evaluated for physical abuse, and their contacts, by 20 US child abuse teams who used a common screening protocol for the contacts of physically abused children with serious injuries. Contacts underwent physical examination if they were <5 years old, physical examination and skeletal survey (SS) if they were <24 months old, and physical examination, SS, and neuroimaging if they were <6 months old. Protocol-indicated SS identified at least 1 abusive fracture in 16 of 134 contacts (11.9%, 95% confidence interval [CI] 7.5-18.5) <24 months of age. None of these fractures had associated findings on physical examination. No injuries were identified by neuroimaging in 19 of 25 eligible contacts (0.0%, 95% CI 0.0-13.7). Twins were at substantially increased risk of fracture relative to nontwin contacts (odds ratio 20.1, 95% CI 5.8-69.9). SS should be obtained in the contacts of injured, abused children for contacts who are <24 months old, regardless of physical examination findings. Twins are at higher risk of abusive fractures relative to nontwin contacts.

  20. Physical and environmental factors contributing to music related injuries among children.

    PubMed

    McKechnie, Natalie C; Jacobs, Karen

    2011-01-01

    This study asserts that a combination of environmental and physical factors influence the child pianist's risk for developing a music related injury. 26 participants (10 piano students, 10 parents, and 6 piano teachers) were included in this study. Piano students were ages 5 to 11 and currently enrolled in piano lessons. Three questionnaires addressed the factors affecting the participant groups (children, parents, and piano teachers). Participants completed one questionnaire about the factors contributing to the development of music related injuries in child pianists. Descriptive statistics were used to analyze the results. None of the student participants had pain, discomfort, or a history of music related injuries. The majority of parents and teachers reported that the lighting was the most important environmental factor affecting students' playing in the piano lesson. 70% of parents reported that the presence of family members most greatly affected students' practicing at home. 100% of the teachers and parents reported that the most important physical factors contributing to students' injury-free playing were playing with proper technique and learning effective practice strategies. All parents and students who were taking piano lessons in their homes reported the most satisfaction with their piano lesson environment. The results of this study do not support a relationship between environmental or physical factors and the presence of pain, discomfort, or music related injuries in students.

  1. Management of ionizing radiation injuries and illnesses, part 1: physics, radiation protection, and radiation instrumentation.

    PubMed

    Christensen, Doran M; Jenkins, Mark S; Sugarman, Stephen L; Glassman, Erik S

    2014-03-01

    Ionizing radiation injuries and illnesses are exceedingly rare; therefore, most physicians have never managed such conditions. When confronted with a possible radiation injury or illness, most physicians must seek specialty consultation. Protection of responders, health care workers, and patients is an absolute priority for the delivery of medical care. Management of ionizing radiation injuries and illnesses, as well as radiation protection, requires a basic understanding of physics. Also, to provide a greater measure of safety when working with radioactive materials, instrumentation for detection and identification of radiation is needed. Because any health care professional could face a radiation emergency, it is imperative that all institutions have emergency response plans in place before an incident occurs. The present article is an introduction to basic physics, ionizing radiation, radiation protection, and radiation instrumentation, and it provides a basis for management of the consequences of a radiologic or nuclear incident.

  2. Nonsuicidal Self-Injury: What Physical and Sport Educators Should Know

    ERIC Educational Resources Information Center

    Trujillo, Natasha P.

    2015-01-01

    The increasing prevalence of nonsuicidal self-injury (NSSI) among children and youth suggests that increased awareness, attention, and training must be disseminated to frontline personnel. Physical and sport educators have an increased chance of identifying students who are currently engaging in NSSI because of the nature of their work. This…

  3. OUTCOME OF PHYSICAL THERAPY AND SPLINTING IN HAND BURNS INJURY. OUR LAST FOUR YEARS' EXPERIENCE.

    PubMed

    Rrecaj, Shkurta; Hysenaj, Hajrie; Martinaj, Merita; Murtezani, Ardiana; Ibrahimi-Kacuri, Dafina; Haxhiu, Bekim; Buja, Zene

    2015-12-01

    Burn injuries in hands are much more complex and the appearance of contractures is a common complication. Hand burn injuries often result in limited functionality, flexion and extension of fingers and present a major hindrance in rehabilitation. The aim of physical therapy and splinting after hand burn injury is to maintain mobility, prevent the development of the contracture and to promote the functionality of hand and good cosmetic results. The purpose of this study is to presents our experience of 38 children with hand burn injuries, admitted and treated at the Department of Plastic Surgery, UCCK-Pristina, Kosovo, during the years 2012-2015. Physical therapy is focused on active/passive range of motion in affected joints, management of cicatrix, strengthening exercise, coordination and use of splints for correction contractures. Patients were evaluated in three, six months and the definitive evaluation is done after 9 months of physical therapy and splinting. We have improvement in range of motion (ROM), functionality, coordination, muscle force, decrease of keloids scars. This study shows the importance of physical therapy and splinting, achieving good results in preventing contracture, improving range of motion, muscle force and good cosmetic results.

  4. Nonsuicidal Self-Injury: What Physical and Sport Educators Should Know

    ERIC Educational Resources Information Center

    Trujillo, Natasha P.

    2015-01-01

    The increasing prevalence of nonsuicidal self-injury (NSSI) among children and youth suggests that increased awareness, attention, and training must be disseminated to frontline personnel. Physical and sport educators have an increased chance of identifying students who are currently engaging in NSSI because of the nature of their work. This…

  5. Longitudinal Study of Emotional, Social, and Physical Changes after Traumatic Brain Injury.

    ERIC Educational Resources Information Center

    Lezak, Muriel D.; O'Brien, Kevin P.

    1988-01-01

    The article discusses research on the chronic emotional, social, and physical changes associated with traumatic brain injury (TBI) as it relates to the planning and effective management of TBI patients' behavioral and social problems. At five years post-trauma most of 39 patients followed were still socially dysfunctional in one or more ways.…

  6. A Multivariate Model for Predicting Rape and Physical Injury Outcomes during Sexual Assaults.

    ERIC Educational Resources Information Center

    Ullman, Sarah E.; Knight, Raymond A.

    1991-01-01

    Analyzed relation of situational factors, offender aggression, and victim resistance to women's sexual abuse and physical injury during sexual assaults using police reports/court testimonies of 274 women who avoided rape or were raped. After situational variables were partialed out, women's screaming was related to less severe sexual abuse;…

  7. Health and economic benefits of physical activity for patients with spinal cord injury

    PubMed Central

    Miller, Larry E; Herbert, William G

    2016-01-01

    Spinal cord injury (SCI) is a traumatic, life-disrupting event with an annual incidence of 17,000 cases in the US. SCI is characterized by progressive physical deconditioning due to limited mobility and lack of modalities to allow safe physical activity that may partially offset these deleterious physical changes. Approximately, 50% of patients with SCI report no leisure-time physical activity and 15% report leisure-time physical activity below the threshold where meaningful health benefits could be realized. Collectively, about 363,000 patients with SCI, or 65% of the entire spinal cord injured population in the US, engages in insufficient physical activity and represents a target population that could derive considerable health benefits from even modest physical activity levels. Currently, the annual direct costs related to SCI exceed US$45 billion in the US. Rehabilitation protocols and technologies aimed to improve functional mobility have potential to significantly reduce the risk of medical complications and cost associated with SCI. Patients who commence routine physical activity in the first post-injury year and experience typical motor function improvements would realize US$290,000 to US$435,000 in lifetime cost savings, primarily due to fewer hospitalizations and less reliance on assistive care. New assistive technologies that allow patients with SCI to safely engage in routine physical activity are desperately needed. PMID:27757043

  8. Health and economic benefits of physical activity for patients with spinal cord injury.

    PubMed

    Miller, Larry E; Herbert, William G

    2016-01-01

    Spinal cord injury (SCI) is a traumatic, life-disrupting event with an annual incidence of 17,000 cases in the US. SCI is characterized by progressive physical deconditioning due to limited mobility and lack of modalities to allow safe physical activity that may partially offset these deleterious physical changes. Approximately, 50% of patients with SCI report no leisure-time physical activity and 15% report leisure-time physical activity below the threshold where meaningful health benefits could be realized. Collectively, about 363,000 patients with SCI, or 65% of the entire spinal cord injured population in the US, engages in insufficient physical activity and represents a target population that could derive considerable health benefits from even modest physical activity levels. Currently, the annual direct costs related to SCI exceed US$45 billion in the US. Rehabilitation protocols and technologies aimed to improve functional mobility have potential to significantly reduce the risk of medical complications and cost associated with SCI. Patients who commence routine physical activity in the first post-injury year and experience typical motor function improvements would realize US$290,000 to US$435,000 in lifetime cost savings, primarily due to fewer hospitalizations and less reliance on assistive care. New assistive technologies that allow patients with SCI to safely engage in routine physical activity are desperately needed.

  9. MANAGEMENT OF ACUTE SPORTS INJURIES AND MEDICAL CONDITIONS BY PHYSICAL THERAPISTS: ASSESSMENT VIA CASE SCENARIOS

    PubMed Central

    Karges, Joy Renae; Salsbery, Mitchell A.; Smith, Danna; Stanley, Erica J.

    2011-01-01

    Purpose/Background: Some physical therapists (PTs) provide services at sporting events, but there are limited studies investigating whether PTs are properly prepared to provide such services. The purpose of this study was to assess acute sports injury and medical condition management decision-making skills of PTs. Methods: A Web-based survey presented 17 case scenarios related to acute medical conditions and sport injuries. PTs from the Sports Physical Therapy Section of The American Physical Therapy Association were e-mailed a cover letter/Web link to the survey and invited to participate over a 30-day period. Data were analyzed using SPSS 18.0. Results: A total of 411 of 5158 PTs who were members of the Sports Physical Therapy Association in 2009 and had valid e-mail addresses completed the survey, of which 389 (7.5%) were appropriate for analysis. Over 75.0% of respondents felt “prepared” or “somewhat prepared” to provide immediate care for 13 out of 16 medical conditions, with seizures, spinal cord injuries, and internal organ injuries having the lowest percentages. Over 75.0% of the respondents made “appropriate” or “overly cautious” decisions for 11 of the 17 acute injury or medical condition cases. Conclusions: Results of the current study indicate that PTs felt more “prepared” and tended to make “appropriate” return to play decisions on the acute sports injury and medical condition case studies more often than coaches who participated in a similar study, regardless of level of importance of the game or whether the athlete was a starter vs. non-starter. However, for PTs who plan on assisting at sporting events, additional preparation/education may be recommended, such as what is taught in an emergency responder course. PMID:21904695

  10. Risk factors for physical injury among help-seeking battered women: an exploration of multiple abuse dimensions.

    PubMed

    Mechanic, Mindy B; Weaver, Terri L; Resick, Patricia A

    2008-10-01

    Physical injuries among battered women represent risks for both acute and long-term physical health functioning. The current study assessed the nature and extent of minor and severe injuries among a help-seeking sample of battered women. Hierarchical regression analyses were conducted to assess the unique roles of physical violence, sexual coercion, psychological abuse, and stalking to the prediction of minor and severe injuries in battered women. Not unexpectedly, length of relationship abuse and severity of physical aggression were the most robust predictors of minor and severe physical injuries. Consistent with other research findings, psychological abuse and stalking, as a block, contributed uniquely to the prediction of severe injuries. Results are discussed in terms of implications for future research and intervention with battered women.

  11. Vascular injuries in knee dislocations: the role of physical examination in determining the need for arteriography.

    PubMed

    Stannard, James P; Sheils, Todd M; Lopez-Ben, Robert R; McGwin, Gerald; Robinson, James T; Volgas, David A

    2004-05-01

    Popliteal artery injury is frequently associated with knee dislocation following blunt trauma, an injury that is being seen with increasing frequency. The primary purpose of the present study was to evaluate the use of physical examination to determine the need for arteriography in a large series of patients with knee dislocation. The secondary purpose was to evaluate the correlation between physical examination findings and clinically important vascular injury in the subgroup of patients who underwent arteriography. One hundred and thirty consecutive patients (138 knees) who had sustained an acute multiligamentous knee injury were evaluated at our level-1 trauma center between August 1996 and May 2002 and were included in a prospective outcome study. Four patients (four knees) were lost to follow-up, leaving 126 patients (134 knees) available for inclusion in the study. The results of the physical examination of the vascular status of the extremities were used to determine the need for arteriography. The mean duration of follow-up was nineteen months (range, eight to forty-eight months). Physical examination findings, magnetic resonance imaging findings, and surgical findings were combined to determine the extent of ligamentous damage. Nine patients had flow-limiting popliteal artery damage, for an overall prevalence of 7%. Ten patients had abnormal findings on physical examination, with one patient having a false-positive result and nine having a true-positive result. The knee dislocations in the nine patients with popliteal artery damage were classified, according to the Wascher modification of the Schenck system, as KD-III (one knee), KD-IV (seven knees), and KD-V (one knee). Selective arteriography based on serial physical examinations is a safe and prudent policy following knee dislocation. There is a strong correlation between the results of physical examination and the need for arteriography. Increased vigilance may be justified in the case of a patient

  12. Transient disablement in the physically active with musculoskeletal injuries, part I: a descriptive model.

    PubMed

    Vela, Luzita I; Denegar, Craig

    2010-01-01

    Disablement theory has been characterized as the sequence of events that occurs after an injury, but little research has been conducted to establish how disablement is experienced and described by physically active persons. To describe the disablement process in physically active persons with musculoskeletal injuries. Concurrent, embedded mixed-methods study. For the qualitative portion, interviews were conducted to create descriptive disablement themes. For the quantitative portion, frequencies analysis was used to identify common terminology. National Collegiate Athletic Association Division I collegiate and club sports, collegiate intramural program, large high school athletics program, and outpatient orthopaedic center. Thirty-one physically active volunteers (15 males, 16 females; mean age  =  21.2 years; range, 14-53 years) with a current injury (18 lower extremity injuries, 13 upper extremity injuries) participated in individual interviews. Six physically active volunteers (3 males, 3 females; mean age  =  22.2 years; range, 16-28 years) participated in the group interview to assess trustworthiness. We analyzed interviews through a constant-comparison method, and data were collected until saturation occurred. Common limitations were transformed into descriptive themes and were confirmed during the group interview. Disablement descriptors were identified with frequencies and fit to the themes. A total of 15 overall descriptive themes emerged within the 4 disablement components, and descriptive terms were identified for each theme. Impairments were marked by 4 complaints: pain, decreased motion, decreased muscle function, and instability. Functional limitations were denoted by problems with skill performance, daily actions, maintaining positions, fitness, and changing directions. Disability consisted of problems with participation in desired activities. Lastly, problems in quality of life encompassed uncertainty and fear, stress and pressure, mood and

  13. Return to Sports and Physical Activities After Primary Partial Arthrodesis for Lisfranc Injuries in Young Patients.

    PubMed

    MacMahon, Aoife; Kim, Paul; Levine, David S; Burket, Jayme; Roberts, Matthew M; Drakos, Mark C; Deland, Jonathan T; Elliott, Andrew J; Ellis, Scott J

    2016-04-01

    Research regarding outcomes in sports and physical activities after primary partial arthrodesis for Lisfranc injuries has been sparse. The purposes of this study were to assess various sports and physical activities in young patients following primary partial arthrodesis for Lisfranc injuries and to compare these with clinical outcomes. Patients who underwent primary partial arthrodesis for a Lisfranc injury were identified by a retrospective registry review. Thirty-eight of 46 eligible patients (83%) responded for follow-up at a mean of 5.2 (range, 1.0 to 9.3) years with a mean age at surgery of 31.8 (range, 16.8 to 50.3) years. Physical activity participation was assessed with a new sports-specific, patient-administered questionnaire. Clinical outcomes were assessed with the Foot and Ankle Outcome Score (FAOS). Patients participated in 29 different and 155 total physical activities preoperatively, and 27 different and 145 total physical activities postoperatively. Preoperatively, 47.1% were high impact, and postoperatively, 44.8% were high impact. The most common activities were walking, bicycling, running, and weightlifting. Compared to preoperatively, difficulty was the same in 66% and increased in 34% of physical activities. Participation levels were improved in 11%, the same in 64%, and impaired in 25% of physical activities. Patients spent on average 4.2 (range, 0.0 to 19.8) hours per week exercising postoperatively. In regard to return to physical activity, 97% of respondents were satisfied with their operative outcome. Mean postoperative FAOS subscores were significantly worse for patients who had increased physical activity difficulty. Most patients were able to return to their previous physical activities following primary partial arthrodesis for a Lisfranc injury, many of which were high-impact. However, the decreased participation or increase in difficulty of some activities suggests that some patients experienced postoperative limitations in exercise

  14. Work-related activities associated with injury in occupational and physical therapists.

    PubMed

    Darragh, Amy R; Campo, Marc; King, Phyllis

    2012-01-01

    The purpose of this study was to examine work activities associated with work-related injury (WRI) in occupational and physical therapy. 1,158 occupational and physical therapists in Wisconsin responded to a mailed survey, from a total of 3,297 OTs and PTs randomly selected from the State licensure list. The study used a cross-sectional, survey design. Participants reported information about WRI they sustained between 2004 and 2006, including the activities they were performing when injured. Investigators analyzed 248 injury incidents using qualitative and quantitative analysis. Data were examined across OT and PT practice in general, and also by practice area. Manual therapy and transfers/lifts were associated with 54% of all injuries. Other activities associated with injury were distinct to practice area, for example: floor work in pediatrics; functional activities in acute care; patient falls in skilled nursing facilities; and motor vehicle activities in home care. Injury prevention activities must address transfers and manual therapy, but also must examine setting-specific activities influenced by environment and patient population.

  15. Lower extremity functional electrical stimulation cycling promotes physical and functional recovery in chronic spinal cord injury.

    PubMed

    Sadowsky, Cristina L; Hammond, Edward R; Strohl, Adam B; Commean, Paul K; Eby, Sarah A; Damiano, Diane L; Wingert, Jason R; Bae, Kyongtae T; McDonald, John W

    2013-11-01

    To examine the effect of long-term lower extremity functional electrical stimulation (FES) cycling on the physical integrity and functional recovery in people with chronic spinal cord injury (SCI). Retrospective cohort, mean follow-up 29.1 months, and cross-sectional evaluation. Washington University Spinal Cord Injury Neurorehabilitation Center, referral center. Twenty-five people with chronic SCI who received FES during cycling were matched by age, gender, injury level, and severity, and duration of injury to 20 people with SCI who received range of motion and stretching. Lower extremity FES during cycling as part of an activity-based restorative treatment regimen. Change in neurological function: motor, sensory, and combined motor-sensory scores (CMSS) assessed by the American Spinal Injury Association Impairment scale. Response was defined as ≥ 1 point improvement. FES was associated with an 80% CMSS responder rate compared to 40% in controls. An average 9.6 CMSS point loss among controls was offset by an average 20-point gain among FES subjects. Quadriceps muscle mass was on average 36% higher and intra/inter-muscular fat 44% lower, in the FES group. Hamstring and quadriceps muscle strength was 30 and 35% greater, respectively, in the FES group. Quality of life and daily function measures were significantly higher in FES group. FES during cycling in chronic SCI may provide substantial physical integrity benefits, including enhanced neurological and functional performance, increased muscle size and force-generation potential, reduced spasticity, and improved quality of life.

  16. Work-Related Activities Associated with Injury in Occupational and Physical Therapists

    PubMed Central

    Campo, Marc; King, Phyllis

    2013-01-01

    Objective The purpose of this study was to examine work activities associated with work-related injury (WRI) in occupational and physical therapy. Participants 1,158 occupational and physical therapists in Wisconsin responded to a mailed survey, from a total of 3,297 OTs and PTs randomly selected from the State licensure list. Methods The study used a cross-sectional, survey design. Participants reported information about WRI they sustained between 2004 and 2006, including the activities they were performing when injured. Investigators analyzed 248 injury incidents using qualitative and quantitative analysis. Results Data were examined across OT and PT practice in general, and also by practice area. Manual therapy and transfers/lifts were associated with 54% of all injuries. Other activities associated with injury were distinct to practice area, for example: floor work in pediatrics; functional activities in acute care; patient falls in skilled nursing facilities; and motor vehicle activities in home care. Conclusions Injury prevention activities must address transfers and manual therapy, but also must examine setting-specific activities influenced by environment and patient population. PMID:22523031

  17. The Relation between Hamstring Strain Injury and Physical Characteristics of Japanese Collegiate Sepak Takraw Players.

    PubMed

    Kubo, Y; Nakazato, K; Koyama, K; Tahara, Y; Funaki, A; Hiranuma, K

    2016-11-01

    The aim of this study was to investigate the injuries in Japanese collegiate sepak takraw players. We primarily focused on hamstring strain injury (HSI), and investigated the associated physical characteristics. The study included 77 Japanese collegiate sepak takraw players who were interviewed; data were collected regarding injuries sustained by them during the game within the past year. The hip range of motion (ROM) was measured. The total number of injuries was 48 in a year. The rate of HSI was the highest (31.3%) among all the injuries. All HSIs occurred in the dominant leg because of the sunback spike. Using the Mann-Whitney U test, significant differences in age and sport-related experience were observed between the injured group and uninjured group. Upon using logistic regression analysis, the presence of a HSI was found to be associated with the sport-related experience (adjusted odds ratio [OR], 0.30; 95% confidence interval [CI], 0.12-0.77) and the hip extension ROM (adjusted OR, 0.81; 95% CI, 0.66-0.99) after adjusting for sex, sport-related experience, and the hip ROM. HSI is the most common injury in Japanese collegiate sepak takraw players. Short sport-related experience and small hip extension ROM are related with the occurrence of HSI. © Georg Thieme Verlag KG Stuttgart · New York.

  18. Blast induced mild traumatic brain injury/concussion: A physical analysis

    NASA Astrophysics Data System (ADS)

    Kucherov, Yan; Hubler, Graham K.; DePalma, Ralph G.

    2012-11-01

    Currently, a consensus exists that low intensity non-impact blast wave exposure leads to mild traumatic brain injury (mTBI). Considerable interest in this "invisible injury" has developed in the past few years but a disconnect remains between the biomedical outcomes and possible physical mechanisms causing mTBI. Here, we show that a shock wave travelling through the brain excites a phonon continuum that decays into specific acoustic waves with intensity exceeding brain tissue strength. Damage may occur within the period of the phonon wave, measured in tens to hundreds of nanometers, which makes the damage difficult to detect using conventional modalities.

  19. Anterior cruciate ligament injury after more than 20 years: I. Physical activity level and knee function.

    PubMed

    Tengman, E; Brax Olofsson, L; Nilsson, K G; Tegner, Y; Lundgren, L; Häger, C K

    2014-12-01

    Little is known about physical activity level and knee function including jump capacity and fear of movement/reinjury more than 20 years after injury of the anterior cruciate ligament (ACL). Seventy persons with unilateral ACL injury participated (23 ± 2 years post-injury): 33 treated with physiotherapy in combination with surgical reconstruction (ACLR ), and 37 treated with physiotherapy alone (ACLPT ). These were compared with 33 age- and gender-matched controls. Assessment included knee-specific and general physical activity level [Tegner activity scale, International Physical Activity Questionnaire (IPAQ)], knee function [Lysholm score, Knee injury and Osteoarthritis Outcome Score (KOOS)], jump capacity (one-leg hop, vertical jump, side hops), and fear of movement/reinjury [Tampa Scale for Kinesiophobia (TSK)]. Outcomes were related to degree of osteoarthritis (OA). ACL-injured had lower Lysholm, KOOS, and Tegner scores than controls (P < 0.001), while IPAQ score was similar. ACL-injured demonstrated inferior jump capacity in injured compared with noninjured leg (6-25%, P < 0.001-P = 0.010 in the different jumps), while noninjured leg had equal jump capacity as controls. ACL groups scored 33 ± 7 and 32 ± 7 of 68 on TSK. Lower scores on Lysholm and KOOS symptom were seen for persons with moderate-to-high OA than for no-or-low OA, while there were no differences for physical activity and jump capacity. Regardless of treatment, there are still negative knee-related effects of ACL injury more than 20 years later.

  20. Penetrating zone II neck injury: does dynamic computed tomographic scan contribute to the diagnostic sensitivity of physical examination for surgically significant injury? A prospective blinded study.

    PubMed

    Gonzalez, Richard P; Falimirski, Mark; Holevar, Michele R; Turk, Bartel

    2003-01-01

    The purpose of this study was to prospectively evaluate the utility of dynamic computed tomographic (CT) scanning as a diagnostic tool and adjunct to physical examination in the identification of surgically significant penetrating zone II neck injuries. All patients older than 14 years of age who suffered penetrating zone II neck injuries were eligible for entry into the study protocol at an urban Level I trauma center. All patients that presented with signs of surgically significant injury on physical examination underwent immediate neck exploration. Patients that did not show signs of surgically significant injury were entered into the study protocol and underwent soft tissue dynamic CT scan (1/2-cm cuts, 250-mL oral contrast) of the neck after initial resuscitation. After CT scan, all patients entered into the study protocol underwent esophagography. After completion of radiologic assessment, all study protocol patients underwent surgical exploration of the neck. The patient's surgical team was blinded to results of the CT scan and esophagography before and during surgical exploration of the neck. During a 42-month period from May 1997 to March 2001, 42 patients were entered into the study protocol. Thirty-six (86%) of the injuries were secondary to stab wounds and the rest were caused by gunshot wounds. Surgical exploration revealed four esophageal injuries, of which two (50%) were missed by CT scan. Esophagography missed the identical esophageal injuries, as did CT scan. Both of the missed esophageal injuries were secondary to stab wounds. Seven internal jugular vein injuries were diagnosed intraoperatively, of which four (57%) were diagnosed by CT scan. During the study period, all patients with carotid artery and tracheal injuries were diagnosed by physical examination and thus underwent immediate surgical exploration without study entry. Dynamic CT scan contributes minimally to the sensitivity of physical examination in the diagnosis of surgically

  1. Predictors of cognitive and physical fatigue in post-acute mild-moderate traumatic brain injury.

    PubMed

    Schiehser, Dawn M; Delano-Wood, Lisa; Jak, Amy J; Hanson, Karen L; Sorg, Scott F; Orff, Henry; Clark, Alexandra L

    2017-10-01

    Post-traumatic fatigue (PTF) is a common, disabling, and often chronic symptom following traumatic brain injury (TBI). Yet, the impact of chronic cognitive and physical fatigue and their associations with psychiatric, sleep, cognitive, and psychosocial sequelae in mild-moderate TBI remain poorly understood. Sixty Veterans with a history of mild-moderate TBI and 40 Veteran controls (VC) were administered the Modified Fatigue Impact Scale, a validated measure of TBI-related cognitive and physical fatigue as well as measures of neuropsychiatric, psychosocial, sleep, and objective cognitive functioning. Compared to VC, TBI Veterans endorsed significantly greater levels of cognitive and physical fatigue. In TBI, psychiatric symptoms, sleep disturbance, and post-traumatic amnesia (PTA) were associated with both cognitive and physical fatigue, while loss of consciousness (LOC) and poor attention/processing speed were related to elevations in cognitive fatigue only. In regression analyses, anxiety, sleep disturbance, and LOC significantly predicted cognitive fatigue, while only post-traumatic stress symptoms and PTA contributed to physical fatigue. Cognitive and physical fatigue are problematic symptoms following mild-moderate TBI that are differentially associated with specific injury and psychiatric sequelae. Findings provide potential symptom targets for interventions aimed at ameliorating fatigue, and further underscore the importance of assessing and treating fatigue as a multi-dimensional symptom following TBI.

  2. Effects of aquatic exercise on physical function and fitness among people with spinal cord injury

    PubMed Central

    Li, Chunxiao; Khoo, Selina; Adnan, Athirah

    2017-01-01

    Abstract Objective: The aim of this review is to synthesize the evidence on the effects of aquatic exercise interventions on physical function and fitness among people with spinal cord injury. Data source: Six major databases were searched from inception till June 2015: MEDLINE, CINAHL, EMBASE, PsychInfo, SPORTDiscus, and Cochrane Center Register of Controlled Trials. Study appraisal and synthesis methods: Two reviewers independently rated methodological quality using the modified Downs and Black Scale and extracted and synthesized key findings (i.e., participant characteristics, study design, physical function and fitness outcomes, and adverse events). Results: Eight of 276 studies met the inclusion criteria, of which none showed high research quality. Four studies assessed physical function outcomes and 4 studies evaluated aerobic fitness as outcome measures. Significant improvements on these 2 outcomes were generally found. Other physical or fitness outcomes including body composition, muscular strength, and balance were rarely reported. Conclusions and implications of key findings: There is weak evidence supporting aquatic exercise training to improve physical function and aerobic fitness among adults with spinal cord injury. Suggestions for future research include reporting details of exercise interventions, evaluating other physical or fitness outcomes, and improving methodological quality. PMID:28296754

  3. Long-term physical, psychological and social consequences of severe injuries.

    PubMed

    van der Sluis, C K; Eisma, W H; Groothoff, J W; ten Duis, H J

    1998-05-01

    This 6 year follow-up study was designed to evaluate the long-term physical, psychological and social outcomes of severely injured patients (Injury Severity Score of greater than or equal to 16). Patients were treated at the University Hospital Groningen, the Netherlands, between January 1989 and December 1989. Outcomes were assessed using a postal questionnaire. After injury, the 55 respondents had predominantly complaints of the extremities, the spine and the head. Psychological complaints were present in 84 per cent of patients and mainly concerned fatigue, slowness and memory impairments. Despite these physical and psychological complaints, 74 per cent of patients were able to return to work and the memory succeeded in complying with job requirements. Injuries of the extremities and the spine were risk factors for failing to return to work. Social consequences were also reflected in broken marriages (6/22) and changes of leisure activities (45 per cent). On the basis of the impairments and disabilities revealed, we conclude that further improvement of the long-term outcomes of severely injured patients may be achieved by advancements in the treatment of injuries to the head, spine or extremities, comprehensive psychological support and vocational rehabilitation.

  4. Psychosocial interventions for the prevention of disability following traumatic physical injury

    PubMed Central

    De Silva, Mary; MacLachlan, Malcolm; Devane, Declan; Desmond, Deirdre; Gallagher, Pamela; Schnyder, Ulrich; Brennan, Muireann; Patel, Vikram

    2012-01-01

    Background Traumatic physical injury can result in many disabling sequelae including physical and mental health problems and impaired social functioning. Objectives To assess the effectiveness of psychosocial interventions in the prevention of physical, mental and social disability following traumatic physical injury. Search methods The search was not restricted by date, language or publication status. We searched the following electronic databases; Cochrane Injuries Group Specialised Register, CENTRAL (The Cochrane Library 2009, Issue 1), MEDLINE (Ovid SP), EMBASE (Ovid SP), PsycINFO (Ovid SP), Controlled Trials metaRegister (www.controlled-trials.com), AMED (Allied & Complementary Medicine), ISI Web of Science: Social Sciences Citation Index (SSCI), PubMed. We also screened the reference lists of all selected papers and contacted authors of relevant studies. The latest search for trials was in February 2008. Selection criteria Randomised controlled trials that consider one or more defined psychosocial interventions for the prevention of physical disability, mental health problems or reduced social functioning as a result of traumatic physical injury. We excluded studies that included patients with traumatic brain injury (TBI). Data collection and analysis Two authors independently screened the titles and abstracts of search results, reviewed the full text of potentially relevant studies, independently assessed the risk of bias and extracted data. Main results We included five studies, involving 756 participants. Three studies assessed the effect of brief psychological therapies, one assessed the impact of a self-help booklet, and one the effect of collaborative care. The disparate nature of the trials covering different patient populations, interventions and outcomes meant that it was not possible to pool data meaningfully across studies. There was no evidence of a protective effect of brief psychological therapy or educational booklets on preventing disability

  5. Psychological sequelae of the station nightclub fire: Comparing survivors with and without physical injuries using a mixed-methods analysis.

    PubMed

    Trinh, Nhi-Ha T; Nadler, Deborah L; Shie, Vivian; Fregni, Felipe; Gilman, Stephen E; Ryan, Colleen M; Schneider, Jeffrey C

    2014-01-01

    Surveying survivors from a large fire provides an opportunity to explore the impact of emotional trauma on psychological outcomes. This is a cross-sectional survey of survivors of The Station Fire. Primary outcomes were post-traumatic stress (Impact of Event Scale - Revised) and depressive (Beck Depression Inventory) symptoms. Linear regression was used to examine differences in symptom profiles between those with and without physical injuries. The free-response section of the survey was analyzed qualitatively to compare psychological sequelae of survivors with and without physical injuries. 104 participants completed the study survey; 47% experienced a burn injury. There was a 42% to 72% response rate range. The mean age of respondents was 32 years, 62% were male, and 47% experienced a physical injury. No significant relationships were found between physical injury and depressive or post-traumatic stress symptom profiles. In the qualitative analysis, the emotional trauma that survivors experienced was a major, common theme regardless of physical injury. Survivors without physical injuries were more likely to experience survivor guilt, helplessness, self-blame, and bitterness. Despite the post-fire challenges described, most survivors wrote about themes of recovery and renewal. All survivors of this large fire experienced significant psychological sequelae. These findings reinforce the importance of mental health care for all survivors and suggest a need to understand factors influencing positive outcomes.

  6. Psychological Sequelae of the Station Nightclub Fire: Comparing Survivors with and without Physical Injuries Using a Mixed-Methods Analysis

    PubMed Central

    Trinh, Nhi-Ha T.; Nadler, Deborah L.; Shie, Vivian; Fregni, Felipe; Gilman, Stephen E.; Ryan, Colleen M.; Schneider, Jeffrey C.

    2014-01-01

    Background Surveying survivors from a large fire provides an opportunity to explore the impact of emotional trauma on psychological outcomes. Methods This is a cross-sectional survey of survivors of The Station Fire. Primary outcomes were post-traumatic stress (Impact of Event Scale – Revised) and depressive (Beck Depression Inventory) symptoms. Linear regression was used to examine differences in symptom profiles between those with and without physical injuries. The free-response section of the survey was analyzed qualitatively to compare psychological sequelae of survivors with and without physical injuries. Results 104 participants completed the study survey; 47% experienced a burn injury. There was a 42% to 72% response rate range. The mean age of respondents was 32 years, 62% were male, and 47% experienced a physical injury. No significant relationships were found between physical injury and depressive or post-traumatic stress symptom profiles. In the qualitative analysis, the emotional trauma that survivors experienced was a major, common theme regardless of physical injury. Survivors without physical injuries were more likely to experience survivor guilt, helplessness, self-blame, and bitterness. Despite the post-fire challenges described, most survivors wrote about themes of recovery and renewal. Conclusions All survivors of this large fire experienced significant psychological sequelae. These findings reinforce the importance of mental health care for all survivors and suggest a need to understand factors influencing positive outcomes. PMID:25536085

  7. Physical therapy recommendations for service members with mild traumatic brain injury.

    PubMed

    Weightman, Margaret M; Bolgla, Robyn; McCulloch, Karen L; Peterson, Michelle D

    2010-01-01

    Mild traumatic brain injuries (MTBIs) are of increasing concern in both the military and civilian populations as the potential long-term effects and costs of such injuries are being further recognized. Injuries from conflicts in Afghanistan and Iraq have increased public awareness and concern for TBI. The Proponency Office for Rehabilitation and Reintegration, Office of the Surgeon General, US Army tasked a team of physical and occupational therapists to assemble evidence-informed guidelines for assessment and intervention specific to MTBI. Given the paucity of specific guidelines for physical therapy related to MTBI, we focused on literature that dealt with the specific problem area or complaint of the Service member following MTBI. Recommendations, characterized as practice standards or practice options based on strength of evidence, are provided relative to patient/client education, activity intolerance, vestibular dysfunction, high-level balance dysfunction, posttraumatic headache, temporomandibular disorder, attention and dual-task performance deficits, and participation in exercise. While highlighting the need for additional research, this work can be considered a starting point and impetus for the development of evidence-based practice in physical therapy for our deserving Service members.

  8. Influence of physical exercise on traumatic brain injury deficits: scaffolding effect.

    PubMed

    Archer, Trevor

    2012-05-01

    Traumatic brain injury (TBI) may be due to a bump, blow, or jolt to the head or a penetrating head injury that disrupts normal brain function; it presents an ever-growing, serious public health problem that causes a considerable number of fatalities and cases of permanent disability annually. Physical exercise restores the healthy homeostatic regulation of stress, affect and the regulation of hypothalamic-pituitary-adrenal axis. Physical activity attenuates or reverses the performance deficits observed in neurocognitive tasks. It induces anti-apoptotic effects and buttresses blood-brain barrier intactness. Exercise offers a unique non-pharmacologic, non-invasive intervention that incorporates different regimes, whether dynamic or static, endurance, or resistance. Exercise intervention protects against vascular risk factors that include hypertension, diabetes, cellular inflammation, and aortic rigidity. It induces direct changes in cerebrovasculature that produce beneficial changes in cerebral blood flow, angiogenesis and vascular disease improvement. The improvements induced by physical exercise regimes in brain plasticity and neurocognitive performance are evident both in healthy individuals and in those afflicted by TBI. The overlap and inter-relations between TBI effects on brain and cognition as related to physical exercise and cognition may provide lasting therapeutic benefits for recovery from TBI. It seems likely that some modification of the notion of scaffolding would postulate that physical exercise reinforces the adaptive processes of the brain that has undergone TBI thereby facilitating the development of existing networks, albeit possibly less efficient, that compensate for those lost through damage.

  9. Measurement of Physical Performance and Objective Fatigability in People with Mild-to-Moderate Traumatic Brain Injury

    ERIC Educational Resources Information Center

    Merritta, Catherine; Cherian, Binu; Macaden, Ashish S.; John, Judy Ann

    2010-01-01

    The aims of this study were to objectively measure the physical performance and physical endurance of patients with traumatic brain injury with minimization of cognitive and psychological fatigue, and to compare the physical performance of brain injured patients with that of healthy controls. This was a nonrandomized partially blinded controlled…

  10. Measurement of Physical Performance and Objective Fatigability in People with Mild-to-Moderate Traumatic Brain Injury

    ERIC Educational Resources Information Center

    Merritta, Catherine; Cherian, Binu; Macaden, Ashish S.; John, Judy Ann

    2010-01-01

    The aims of this study were to objectively measure the physical performance and physical endurance of patients with traumatic brain injury with minimization of cognitive and psychological fatigue, and to compare the physical performance of brain injured patients with that of healthy controls. This was a nonrandomized partially blinded controlled…

  11. Lower extremity functional electrical stimulation cycling promotes physical and functional recovery in chronic spinal cord injury

    PubMed Central

    Sadowsky, Cristina L.; Hammond, Edward R.; Strohl, Adam B.; Commean, Paul K.; Eby, Sarah A.; Damiano, Diane L.; Wingert, Jason R.; Bae, Kyongtae T.; McDonald, John W.

    2013-01-01

    Objective To examine the effect of long-term lower extremity functional electrical stimulation (FES) cycling on the physical integrity and functional recovery in people with chronic spinal cord injury (SCI). Design Retrospective cohort, mean follow-up 29.1 months, and cross-sectional evaluation. Setting Washington University Spinal Cord Injury Neurorehabilitation Center, referral center. Participants Twenty-five people with chronic SCI who received FES during cycling were matched by age, gender, injury level, and severity, and duration of injury to 20 people with SCI who received range of motion and stretching. Intervention Lower extremity FES during cycling as part of an activity-based restorative treatment regimen. Main outcome measure Change in neurological function: motor, sensory, and combined motor–sensory scores (CMSS) assessed by the American Spinal Injury Association Impairment scale. Response was defined as ≥1 point improvement. Results FES was associated with an 80% CMSS responder rate compared to 40% in controls. An average 9.6 CMSS point loss among controls was offset by an average 20-point gain among FES subjects. Quadriceps muscle mass was on average 36% higher and intra/inter-muscular fat 44% lower, in the FES group. Hamstring and quadriceps muscle strength was 30 and 35% greater, respectively, in the FES group. Quality of life and daily function measures were significantly higher in FES group. Conclusion FES during cycling in chronic SCI may provide substantial physical integrity benefits, including enhanced neurological and functional performance, increased muscle size and force-generation potential, reduced spasticity, and improved quality of life. PMID:24094120

  12. Assessment of physical examination and magnetic resonance imaging findings of hamstring injury as predictors for recurrent injury.

    PubMed

    Verrall, Geoffrey M; Slavotinek, John P; Barnes, Peter G; Fon, Gerald T; Esterman, Adrian

    2006-04-01

    Prospective cohort study. To examine clinical and magnetic resonance imaging (MRI) features of hamstring muscle injury to determine if any are predictive for recurrent injury. Hamstring muscle strain injury and subsequent recurrent injury are common. Little information exists on factors that may increase the risk for recurrent injury. The subjects were athletes from 3 professional Australian Rules football teams (n = 162). Anthropometric measurements, clinical signs, convalescent interval, and MRI assessment and measurement were undertaken and recorded in athletes with hamstring muscle strain injury. Athletes were followed for the presence, or absence, of recurrent injury to the same-side posterior thigh over the same and subsequent playing seasons. Thirty athletes met criteria for hamstring injury. Twelve (40%) of 30 athletes had recurrent injury within the same season, with an additional 7 athletes having recurrent injury in the subsequent season. None of the features examined were associated with increased recurrent injury risk within the same playing season. Statistical analysis demonstrated that when combining the same with the subsequent playing season a larger size of initial hamstring injury, as measured by MRI, was associated with an increased risk for recurrent injury (P<.01). A measured transverse size of injury greater than 55% of the muscle, or calculated volume of injury greater than 21.8 cm3, resulted in an increased risk for hamstring recurrence of 2.2 (95% CI, 0.88-5.32) and 2.3 (95% CI, 0.94-5.81) times, respectively, when compared to athletes with hamstring injuries below these measurements. A larger size of hamstring injury was indicative of higher risk for recurrent injury but only after the subsequent playing season was considered along with the same playing season. None of the other parameters tested, including a shorter convalescent interval and clinical features, were associated with an increased risk for recurrent injury. However, due to

  13. Type, intensity and duration of daily physical activities performed by adults with spinal cord injury.

    PubMed

    Perrier, M-J; Stork, M J; Martin Ginis, K A

    2017-01-01

    Secondary analysis of cross-sectional data. To describe and compare (1) self-reported intensities and durations of specific types of daily physical activities and (2) minutes per day spent on daily physical activities across key demographic groups. Community (Ontario, Canada). Participants were 695 adults with spinal cord injury (SCI; 76% male, Mage=46.81±13.41 years, Myears post injury=15.19±11.10 years). Daily activities were assessed over the telephone using the Physical Activity Recall Assessment for People with SCI. Multivariate analyses of variance (MANOVA) were computed to test for differences in intensities and durations of different daily activities (objective 1) and between-group differences in minutes per day of daily activities (objective 2). Overall, participants reported 127.92±142.79 min per day of daily physical activities with significantly more time spent in mild intensity (78.93±104.62 min per day) than moderate- (40.23±68.71 min per day) or heavy-intensity activities (8.75±24.53 min per day). Four patterns emerged with respect to type, duration and intensity, with some activities being typically performed at lighter or heavier intensities than others. There were significant differences in minutes per day of activity intensity and duration between groups based on education, injury severity and mode of mobility (P<0.05). Given that some groups were more likely to engage in moderate-heavy-intensity activities, and some activities were more likely to be performed at moderate-heavy intensities, interventions that target key groups to increase certain daily activities may be one strategy to enhance overall physical activity participation among people with SCI.

  14. Transient Disablement in the Physically Active With Musculoskeletal Injuries, Part I: A Descriptive Model

    PubMed Central

    Vela, Luzita I.; Denegar, Craig

    2010-01-01

    Abstract Context: Disablement theory has been characterized as the sequence of events that occurs after an injury, but little research has been conducted to establish how disablement is experienced and described by physically active persons. Objective: To describe the disablement process in physically active persons with musculoskeletal injuries. Design: Concurrent, embedded mixed-methods study. For the qualitative portion, interviews were conducted to create descriptive disablement themes. For the quantitative portion, frequencies analysis was used to identify common terminology. Setting: National Collegiate Athletic Association Division I collegiate and club sports, collegiate intramural program, large high school athletics program, and outpatient orthopaedic center. Patients or Other Participants: Thirty-one physically active volunteers (15 males, 16 females; mean age  =  21.2 years; range, 14–53 years) with a current injury (18 lower extremity injuries, 13 upper extremity injuries) participated in individual interviews. Six physically active volunteers (3 males, 3 females; mean age  =  22.2 years; range, 16–28 years) participated in the group interview to assess trustworthiness. Data Collection and Analysis: We analyzed interviews through a constant-comparison method, and data were collected until saturation occurred. Common limitations were transformed into descriptive themes and were confirmed during the group interview. Disablement descriptors were identified with frequencies and fit to the themes. Results: A total of 15 overall descriptive themes emerged within the 4 disablement components, and descriptive terms were identified for each theme. Impairments were marked by 4 complaints: pain, decreased motion, decreased muscle function, and instability. Functional limitations were denoted by problems with skill performance, daily actions, maintaining positions, fitness, and changing directions. Disability consisted of problems with

  15. The Effectiveness of Physical Agents for Lower-Limb Soft Tissue Injuries: A Systematic Review.

    PubMed

    Yu, Hainan; Randhawa, Kristi; Côté, Pierre; Optima Collaboration

    2016-07-01

    Study Design Systematic review. Background Soft tissue injuries to the lower limb bring a substantial health and economic burden to society. Physical agents are commonly used to treat these injuries. However, the effectiveness of many such physical agents is not clearly established in the literature. Objective To evaluate the effectiveness and safety of physical agents for soft tissue injuries of the lower limb. Methods We searched 5 databases from 1990 to 2015 for randomized controlled trials (RCTs), cohort studies, and case-control studies. Paired reviewers independently screened the retrieved literature and appraised relevant studies using the Scottish Intercollegiate Guidelines Network criteria. Studies with a high risk of bias were excluded. We synthesized low-risk-of-bias studies according to principles of best-evidence synthesis. Results We screened 10261 articles. Of 43 RCTs identified, 20 had a high risk of bias and were excluded from the analysis, and 23 RCTs had a low risk of bias and were included in the analysis. The available higher-quality evidence suggests that patients with persistent plantar fasciitis may benefit from ultrasound or foot orthoses, while those with persistent midportion Achilles tendinopathy may benefit from shockwave therapy. However, the current evidence does not support the use of shockwave therapy for recent plantar fasciitis, low-Dye taping for persistent plantar fasciitis, low-level laser therapy for recent ankle sprains, or splints for persistent midportion Achilles tendinopathy. Finally, evidence on the effectiveness of the following interventions is not established in the current literature: (1) shockwave therapy for persistent plantar fasciitis, (2) cryotherapy or assistive devices for recent ankle sprains, (3) braces for persistent midportion Achilles tendinopathy, and (4) taping or electric muscle stimulation for patellofemoral pain syndrome. Conclusion Almost half the identified RCTs that evaluated the effectiveness of

  16. Childhood adversities and adult use of potentially injurious physical discipline in Japan

    PubMed Central

    Umeda, Maki; Kawakami, Norito; Kessler, Ronald C.; Miller, Elizabeth

    2015-01-01

    Using data derived from the World Mental Health Japan Survey (n = 1,186), this study examined the intergenerational continuity of potentially injurious physical discipline of children in a community sample from Japan with a special focus on the confounding effects of 11 other types of childhood adversities (CAs) and the intervening effects of mental disorders and socioeconomic status. Bivariate analyses revealed that having experienced physical discipline as children and five other CAs was significantly associated with the use of physical discipline as parents in the Japanese community examined. However, childhood physical discipline was the only CA that remained significant after adjusting for the other CAs. The association of childhood physical discipline with adult perpetration was independent of the respondents’ mental disorders and household income. No significant gender differences were found in the associations between childhood physical discipline and adult perpetration. The current study on Japan provided empirical support consistent with results found in other countries regarding the intergenerational transmission of child physical abuse. PMID:26478655

  17. Childhood adversities and adult use of potentially injurious physical discipline in Japan.

    PubMed

    Umeda, Maki; Kawakami, Norito; Kessler, Ronald C; Miller, Elizabeth

    2015-05-01

    Using data derived from the World Mental Health Japan Survey (n = 1,186), this study examined the intergenerational continuity of potentially injurious physical discipline of children in a community sample from Japan with a special focus on the confounding effects of 11 other types of childhood adversities (CAs) and the intervening effects of mental disorders and socioeconomic status. Bivariate analyses revealed that having experienced physical discipline as children and five other CAs was significantly associated with the use of physical discipline as parents in the Japanese community examined. However, childhood physical discipline was the only CA that remained significant after adjusting for the other CAs. The association of childhood physical discipline with adult perpetration was independent of the respondents' mental disorders and household income. No significant gender differences were found in the associations between childhood physical discipline and adult perpetration. The current study on Japan provided empirical support consistent with results found in other countries regarding the intergenerational transmission of child physical abuse.

  18. Response of ependymal progenitors to spinal cord injury or enhanced physical activity in adult rat.

    PubMed

    Cizkova, Dasa; Nagyova, Miriam; Slovinska, Lucia; Novotna, Ivana; Radonak, Jozef; Cizek, Milan; Mechirova, Eva; Tomori, Zoltan; Hlucilova, Jana; Motlik, Jan; Sulla, Igor; Vanicky, Ivo

    2009-09-01

    Ependymal cells (EC) in the spinal cord central canal (CC) are believed to be responsible for the postnatal neurogenesis following pathological or stimulatory conditions. In this study, we have analyzed the proliferation of the CC ependymal progenitors in adult rats processed to compression SCI or enhanced physical activity. To label dividing cells, a single daily injection of Bromo-deoxyuridine (BrdU) was administered over a 14-day-survival period. Systematic quantification of BrdU-positive ependymal progenitors was performed by using stereological principles of systematic, random sampling, and optical Dissector software. The number of proliferating BrdU-labeled EC increased gradually with the time of survival after both paradigms, spinal cord injury, or increased physical activity. In the spinal cord injury group, we have found 4.9-fold (4 days), 7.1-fold (7 days), 4.9-fold (10 days), and 5.6-fold (14 days) increase of proliferating EC in the rostro-caudal regions, 4 mm away from the epicenter. In the second group subjected to enhanced physical activity by running wheel, we have observed 2.1-2.6 fold increase of dividing EC in the thoracic spinal cord segments at 4 and 7 days, but no significant progression at 10-14 days. Nestin was rapidly induced in the ependymal cells of the CC by 2-4 days and expression decreased by 7-14 days post-injury. Double immunohistochemistry showed that dividing cells adjacent to CC expressed astrocytic (GFAP, S100beta) or nestin markers at 14 days. These data demonstrate that SCI or enhanced physical activity in adult rats induces an endogenous ependymal cell response leading to increased proliferation and differentiation primarily into macroglia or cells with nestin phenotype.

  19. Barriers to Leisure-Time Physical Activities in Individuals with Spinal Cord Injury.

    PubMed

    Hwang, Eric J; Groves, Mary D; Sanchez, Jacqueline N; Hudson, Cassandra E; Jao, Rachel G; Kroll, Meghan E

    2016-07-01

    This study investigated the personal, environmental, and activity barriers to leisure-time physical activities (LTPAs) among individuals with spinal cord injury (SCI). A survey instrument was administered to 85 participants with SCI. Personal barriers to LTPAs included issues involving motivation, pain, scheduling, and financial resources. Environmental barriers marked the issues regarding availability and accessibility to specialized programs, activities, and professional services. Activity barriers included limitations in equipment, training, and personal skills required by the selected activities. Significant negative correlations were found between these barriers and the levels of physical activity and satisfaction with physical activity. While working with clients with SCI, occupational therapists should identify those LTPA barriers and possible solutions in order to establish individualized action plans for enhancing participation in LTPAs.

  20. Children with special physical health care needs: restraint use and injury risk in motor vehicle crashes.

    PubMed

    Huang, Patty; Kallan, Michael J; O'Neil, Joseph; Bull, Marilyn J; Blum, Nathan J; Durbin, Dennis R

    2011-10-01

    Physical disabilities may affect a child passenger's fit within a conventional motor vehicle restraint. The aim of this study is to describe and compare injury risk in motor vehicle crashes (MVC) among children with and without special physical health care needs (SPHCN). This analysis, conducted in 2007-2008, utilizes data collected between December 1998 and November 2002 in a cross-sectional study of children ≤15 years old involved in crashes of State-Farm insured vehicles in 15 states and the District of Columbia. Parent reports via telephone survey were used to define pre-crash SPHCN, restraint status, and occurrence of significant injuries using a validated survey. Complete data were collected for 18,852 children aged 0-15 years; 159 children were reported to have a SPHCN (0.8% and 0.7% of children aged 0-8 and 9-15 years, respectively). A greater proportion of children with SPHCN aged 0-8 years were appropriately restrained (P < 0.001), but there was no significant difference in restraint use among children with and without SPHCN aged 9-15 years. There was no significant association between the presence of a SPHCN and injury risk in either age group, after adjustment for child/driver characteristics (children aged 0-8 years: OR 1.27, 95% CI: 0.48-3.33; children aged 9-15 years: OR 1.51, 95% CI: 0.38-6.11). Children with and without SPHCN have similar injury risk in MVC, despite increased age-appropriate restraint usage among children aged 0-8 years. When counseling families about vehicle safety, practitioners should consider the fit of a child with SPHCN in a restraint system.

  1. Validity of Accelerometry to Measure Physical Activity Intensity in Children With an Acquired Brain Injury.

    PubMed

    Baque, Emmah; Sakzewski, Leanne; Trost, Stewart G; Boyd, Roslyn N; Barber, Lee

    2017-10-01

    To evaluate the validity of the ActiGraph accelerometer (AG) to differentiate between standardized, physical activity tasks using oxygen consumption ((Equation is included in full-text article.)O2) as the criterion measure in children and adolescents with an acquired brain injury; to determine vector magnitude activity intensity cut-points; to compare performance of cut-points to previously published cut-points. Twenty-seven children performed standardized walking and stepping activities wearing a portable indirect calorimeter, AG, and heart rate monitor. Differences in (Equation is included in full-text article.)O2 and AG vector magnitude activity counts were measured during activities. Receiver operating characteristic curves were determined for intensity cut-points. (Equation is included in full-text article.)O2 and AG activity counts significantly increased as walking speed increased. Discrimination of the newly derived cut-points was excellent and demonstrated greater agreement compared with the previously published cut-points. Output from accelerometers can differentiate physical activity intensity in children with an acquired brain injury. Future studies can apply these cut-points to evaluate physical activity performance.

  2. Effects of personal and occupational stress on injuries in a young, physically active population: a survey of military personnel.

    PubMed

    Bedno, Sheryl; Hauret, Keith; Loringer, Kelly; Kao, Tzu-Cheg; Mallon, Timothy; Jones, Bruce

    2014-11-01

    The aim of this study was to document risk factors for any injury and sports- and exercise-related injuries, including personal and occupational stress among active duty service members (SMs) in the Air Force, Army, Marine Corps, and Navy. A total of 10,692 SMs completed the April 2008 Status of Forces Survey of Active Duty Members. The survey asked about demographics, personal stress and occupational stress, injuries from any cause, and participation in sports- and exercise- related activities in the past year. The survey used a complex sampling procedure to create a representative sample of SMs. Logistic regression was used to examine the associations of injury outcomes with potential risk factors. 49% of SMs sought medical care for an injury in the past year and 25% sustained a sports- and exercise-related activities injury. Odds of injury were higher for the Army and Marine Corps than for the Air Force or Navy. This survey showed that higher personal and occupational stress was associated with higher risks of injury. SMs who experienced higher levels of personal or occupational stress reported higher risks of injuries. The effects of stress reduction programs on injury risks should be evaluated in military and other young physically active populations.

  3. Risk factors for physical impairment after acute lung injury in a national, multicenter study.

    PubMed

    Needham, Dale M; Wozniak, Amy W; Hough, Catherine L; Morris, Peter E; Dinglas, Victor D; Jackson, James C; Mendez-Tellez, Pedro A; Shanholtz, Carl; Ely, E Wesley; Colantuoni, Elizabeth; Hopkins, Ramona O

    2014-05-15

    Existing studies of risk factors for physical impairments in acute lung injury (ALI) survivors were potentially limited by single-center design or relatively small sample size. To evaluate risk factors for three measures of physical impairments commonly experienced by survivors of ALI in the first year after hospitalization. A prospective, longitudinal study of 6- and 12-month physical outcomes (muscle strength, 6-minute-walk distance, and Short Form [SF]-36 Physical Function score) for 203 survivors of ALI enrolled from 12 hospitals participating in the ARDS Network randomized trials. Multivariable regression analyses evaluated the independent association of critical illness-related variables and intensive care interventions with impairments in each physical outcome measure, after adjusting for patient demographics, comorbidities, and baseline functional status. At 6 and 12 months, respectively, mean (± SD) values for strength (presented as proportion of maximum strength score evaluated using manual muscle testing) was 92% (± 8%) and 93% (± 9%), 6-minute-walk distance (as percent-predicted) was 64% (± 22%) and 67% (± 26%), and SF-36 Physical Function score (as percent-predicted) was 61% (± 36%) and 67% (± 37%). After accounting for patient baseline status, there was significant association and statistical interaction of mean daily dose of corticosteroids and intensive care unit length of stay with impairments in physical outcomes. Patients had substantial impairments, from predicted values, for 6-minute-walk distance and SF-36 Physical Function outcome measures. Minimizing corticosteroid dose and implementing existing evidence-based methods to reduce duration of intensive care unit stay and associated patient immobilization may be important interventions for improving ALI survivors' physical outcomes.

  4. Risk Factors for Physical Impairment after Acute Lung Injury in a National, Multicenter Study

    PubMed Central

    Wozniak, Amy W.; Hough, Catherine L.; Morris, Peter E.; Dinglas, Victor D.; Jackson, James C.; Mendez-Tellez, Pedro A.; Shanholtz, Carl; Ely, E. Wesley; Colantuoni, Elizabeth

    2014-01-01

    Rationale: Existing studies of risk factors for physical impairments in acute lung injury (ALI) survivors were potentially limited by single-center design or relatively small sample size. Objectives: To evaluate risk factors for three measures of physical impairments commonly experienced by survivors of ALI in the first year after hospitalization. Methods: A prospective, longitudinal study of 6- and 12-month physical outcomes (muscle strength, 6-minute-walk distance, and Short Form [SF]-36 Physical Function score) for 203 survivors of ALI enrolled from 12 hospitals participating in the ARDS Network randomized trials. Multivariable regression analyses evaluated the independent association of critical illness–related variables and intensive care interventions with impairments in each physical outcome measure, after adjusting for patient demographics, comorbidities, and baseline functional status. Measurements and Main Results: At 6 and 12 months, respectively, mean (± SD) values for strength (presented as proportion of maximum strength score evaluated using manual muscle testing) was 92% (± 8%) and 93% (± 9%), 6-minute-walk distance (as percent-predicted) was 64% (± 22%) and 67% (± 26%), and SF-36 Physical Function score (as percent-predicted) was 61% (± 36%) and 67% (± 37%). After accounting for patient baseline status, there was significant association and statistical interaction of mean daily dose of corticosteroids and intensive care unit length of stay with impairments in physical outcomes. Conclusions: Patients had substantial impairments, from predicted values, for 6-minute-walk distance and SF-36 Physical Function outcome measures. Minimizing corticosteroid dose and implementing existing evidence-based methods to reduce duration of intensive care unit stay and associated patient immobilization may be important interventions for improving ALI survivors’ physical outcomes. PMID:24716641

  5. Dental injuries: "first aid" knowledge of Southampton teachers of physical education.

    PubMed

    Newman, L J; Crawford, P J

    1991-12-01

    A total of 66 teachers of physical education within the Southampton telephone area responded to a postal questionnaire related to their knowledge of the first aid treatment of dental injuries. In a case study investigating tooth fracture, 64% gave an appropriate answer. In a second case study relating to avulsion (loss) of a permanent tooth, 43% gave an appropriate answer. There was an unclear relationship between the point in their careers at which teachers had received first aid training and the accuracy of their responses. There is a need for further information in this area.

  6. Gender Differences in the Relative Impact of Physical and Relational Bullying on Adolescent Injury and Weapon Carrying

    ERIC Educational Resources Information Center

    Dukes, Richard L.; Stein, Judith A.; Zane, Jazmin I.

    2010-01-01

    Using structural equation modeling, concurrent associations were assessed among physical bullying, relational bullying, physical victimization, relational victimization, injury and weapon carrying using data from the population of 1300 adolescent girls and 1362 adolescent boys in grades 7-12 in a Colorado school district. For both genders, being a…

  7. Gender Differences in the Relative Impact of Physical and Relational Bullying on Adolescent Injury and Weapon Carrying

    ERIC Educational Resources Information Center

    Dukes, Richard L.; Stein, Judith A.; Zane, Jazmin I.

    2010-01-01

    Using structural equation modeling, concurrent associations were assessed among physical bullying, relational bullying, physical victimization, relational victimization, injury and weapon carrying using data from the population of 1300 adolescent girls and 1362 adolescent boys in grades 7-12 in a Colorado school district. For both genders, being a…

  8. Identifying physical activity type in manual wheelchair users with spinal cord injury by means of accelerometers.

    PubMed

    García-Massó, X; Serra-Añó, P; Gonzalez, L M; Ye-Lin, Y; Prats-Boluda, G; Garcia-Casado, J

    2015-10-01

    This was a cross-sectional study. The main objective of this study was to develop and test classification algorithms based on machine learning using accelerometers to identify the activity type performed by manual wheelchair users with spinal cord injury (SCI). The study was conducted in the Physical Therapy department and the Physical Education and Sports department of the University of Valencia. A total of 20 volunteers were asked to perform 10 physical activities, lying down, body transfers, moving items, mopping, working on a computer, watching TV, arm-ergometer exercises, passive propulsion, slow propulsion and fast propulsion, while fitted with four accelerometers placed on both wrists, chest and waist. The activities were grouped into five categories: sedentary, locomotion, housework, body transfers and moderate physical activity. Different machine learning algorithms were used to develop individual and group activity classifiers from the acceleration data for different combinations of number and position of the accelerometers. We found that although the accuracy of the classifiers for individual activities was moderate (55-72%), with higher values for a greater number of accelerometers, grouped activities were correctly classified in a high percentage of cases (83.2-93.6%). With only two accelerometers and the quadratic discriminant analysis algorithm we achieved a reasonably accurate group activity recognition system (>90%). Such a system with the minimum of intervention would be a valuable tool for studying physical activity in individuals with SCI.

  9. Ability of Preseason Body Composition and Physical Fitness to Predict the Risk of Injury in Male Collegiate Hockey Players

    PubMed Central

    Grant, John A.; Bedi, Asheesh; Kurz, Jennifer; Bancroft, Richard; Gagnier, Joel J.; Miller, Bruce S.

    2015-01-01

    Background: Injuries in collegiate ice hockey can result in significant time lost from play. The identification of modifiable risk factors relating to a player’s physical fitness allows the development of focused training and injury prevention programs targeted at reducing these risks. Purpose: To determine the ability of preseason fitness outcomes to predict in-season on-ice injury in male collegiate ice hockey players. Study Design: Prognostic cohort study. Level of Evidence: Level 3. Methods: Athlete demographics, percentage body fat, aerobic capacity (300-m shuttle run; 1-, 1.5-, 5-mile run), and strength assessment (sit-ups, push-ups, grip strength, bench press, Olympic cleans, squats) data were collected at the beginning of 8 successive seasons for 1 male collegiate ice hockey team. Hockey-related injury data and player-level practice/game athlete exposure (AE) data were also prospectively collected. Seventy-nine players participated (203 player-years). Injury was defined as any event that resulted in the athlete being unable to participate in 1 or more practices or games following the event. Multivariable logistic regression was performed to determine the ability of the independent variables to predict the occurrence of on-ice injury. Results: There were 132 injuries (mean, 16.5 per year) in 55 athletes. The overall injury rate was 4.4 injuries per 1000 AEs. Forwards suffered 68% of the injuries. Seventy percent of injuries occurred during games with equal distribution between the 3 periods. The mean number of days lost due to injury was 7.8 ± 13.8 (range, 1-127 days). The most common mechanism of injury was contact with another player (54%). The odds of injury in a forward was 1.9 times (95% CI, 1.1-3.4) that of a defenseman and 3 times (95% CI, 1.2-7.7) that of a goalie. The odds of injury if the player’s body mass index (BMI) was ≥25 kg/m2 was 2.1 times (95% CI, 1.1-3.8) that of a player with a BMI <25 kg/m2. The odds ratios for bench press

  10. Longitudinal changes in physical capacity over 20 years in athletes with spinal cord injury.

    PubMed

    Shiba, Sumiko; Okawa, Hiroyuki; Uenishi, Hiroyasu; Koike, Yumi; Yamauchi, Katuya; Asayama, Ko; Nakamura, Taro; Tajima, Fumihiro

    2010-08-01

    To investigate the longitudinal changes in physical capacity over 20 years in athletes with spinal cord injury (SCI). Longitudinal study (20-y follow-up). Laboratory setting. Persons with SCI (N=7). Not applicable. Maximum oxygen consumption Vo(2)max) measured in 1986-1988 and in 2006. Subjects with SCI maintained stable Vo(2)max in 2006. Six of the 7 continued various wheelchair sports activities, while 1 person quit sports activities 1 year after the baseline study. The latter person showed reduced Vo(2)max by 53%, while 2 persons who continued strenuous wheelchair sports activities showed increased Vo(2)max by 43% and 45% after 20 years. The results indicated that physical capacity reflected the level of sports activity in subjects with SCI who maintained sports activities.

  11. Risk factors and injury prevention in elite athletes: a descriptive study of the opinions of physical therapists, doctors and trainers.

    PubMed

    Saragiotto, Bruno T; Di Pierro, Carla; Lopes, Alexandre D

    2014-01-01

    Musculoskeletal injuries occur frequently in elite athletes. Understanding what professionals who work with patients with sports injuries think about prevention has been suggested as an important aspect to improve the effectiveness of programs to prevent sports injuries. To describe and characterize the opinions of physical therapists, physicians and trainers on 'risk factors' and 'prevention of injury' in elite athletes. This is a qualitative study with semi-structured interviews with members of the medical and technical department of the Brazilian delegation who participated in the Pan American Games of Guadalajara 2011. The interview was conducted using two questions: 1) "What do you think can cause injuries in athletes participating in your sport?" 2) "What do you do to prevent injuries in your sport?" The interviews were analyzed in two stages, the identification of thematic units, followed by the categorization and grouping of thematic units. We interviewed a total of 30 professionals. Regarding question 1, the main factors attributed as responsible for injury were over-training and incorrect sports techniques. Regarding question 2, the main reported strategies used to prevent injuries were muscle strengthening, nutritional counseling and guidance. The main factors affecting the appearance of lesions were over-training, incorrect sports technique, inadequate nutrition and factors related to the athlete's behavior. The main injury prevention strategies were muscle strengthening, nutritional counseling and guidance.

  12. Risk factors and injury prevention in elite athletes: a descriptive study of the opinions of physical therapists, doctors and trainers

    PubMed Central

    Saragiotto, Bruno T.; Di Pierro, Carla; Lopes, Alexandre D.

    2014-01-01

    Background Musculoskeletal injuries occur frequently in elite athletes. Understanding what professionals who work with patients with sports injuries think about prevention has been suggested as an important aspect to improve the effectiveness of programs to prevent sports injuries. Objectives To describe and characterize the opinions of physical therapists, physicians and trainers on 'risk factors' and 'prevention of injury' in elite athletes. Method This is a qualitative study with semi-structured interviews with members of the medical and technical department of the Brazilian delegation who participated in the Pan American Games of Guadalajara 2011. The interview was conducted using two questions: 1) "What do you think can cause injuries in athletes participating in your sport?" 2) "What do you do to prevent injuries in your sport?" The interviews were analyzed in two stages, the identification of thematic units, followed by the categorization and grouping of thematic units. Results We interviewed a total of 30 professionals. Regarding question 1, the main factors attributed as responsible for injury were over-training and incorrect sports techniques. Regarding question 2, the main reported strategies used to prevent injuries were muscle strengthening, nutritional counseling and guidance. Conclusions The main factors affecting the appearance of lesions were over-training, incorrect sports technique, inadequate nutrition and factors related to the athlete's behavior. The main injury prevention strategies were muscle strengthening, nutritional counseling and guidance. PMID:24845023

  13. Prevention of physical training-related injuries recommendations for the military and other active populations based on expedited systematic reviews.

    PubMed

    Bullock, Steven H; Jones, Bruce H; Gilchrist, Julie; Marshall, Stephen W

    2010-01-01

    The Military Training Task Force of the Defense Safety Oversight Council chartered a Joint Services Physical Training Injury Prevention Working Group to: (1) establish the evidence base for making recommendations to prevent injuries; (2) prioritize the recommendations for prevention programs and policies; and (3) substantiate the need for further research and evaluation on interventions and programs likely to reduce physical training-related injuries. A work group was formed to identify, evaluate, and assess the level of scientific evidence for various physical training-related injury prevention strategies through an expedited systematic review process. Of 40 physical training-related injury prevention strategies identified, education, leader support, and surveillance were determined to be essential elements of a successful injury prevention program and not independent interventions. As a result of the expedited systematic reviews, one more essential element (research) was added for a total of four. Six strategies were not reviewed. The remaining 31 interventions were categorized into three levels representing the strength of recommendation: (1) recommended; (2) not recommended; and (3) insufficient evidence to recommend or not recommend. Education, leadership support, injury surveillance, and research were determined to be critical components of any successful injury prevention program. Six interventions (i.e., prevent overtraining, agility-like training, mouthguards, semirigid ankle braces, nutrient replacement, and synthetic socks) had strong enough evidence to become working group recommendations for implementation in the military services. Two interventions (i.e., back braces and pre-exercise administration of anti-inflammatory medication) were not recommended due to evidence of ineffectiveness or harm, 23 lacked sufficient scientific evidence to support recommendations for all military services at this time, and six were not evaluated. Six interventions

  14. The effectiveness of physical interventions for people with spinal cord injuries: a systematic review.

    PubMed

    Harvey, L A; Lin, C-Wc; Glinsky, J V; De Wolf, A

    2009-03-01

    Systematic review. To provide a quantitative analysis of all randomized controlled trials designed to determine the effectiveness of physical interventions for people with spinal cord injury (SCI). Sydney, Australia. A search was conducted for randomized controlled trials involving physical interventions for people with SCI. Two reviewers independently rated methodological quality using the PEDro scale and extracted key findings from the trials. Four thousand five hundred and forty three abstracts were identified of which 31 trials met the inclusion criteria. Trials examined the effectiveness of fitness and strength training (n=7), gait training (n=5), hand therapy (n=3), stretch (n=4), acupuncture (n=3), hand splinting (n=2) and other related therapies (n=7). Six trials reported a between-group mean difference with a clearly important treatment effect on at least one outcome measure. These trials supported the use of fitness, strength and gait training as well as acupuncture. There is initial evidence supporting the effectiveness of some physical interventions for people with SCI. However, there is a pressing need for high-quality trials to determine the effectiveness of all physical interventions commonly administered in clinical practice.

  15. Physical Activity and Kidney Injury in Pediatric and Young Adult Kidney Transplant Recipients.

    PubMed

    Wolf, Mattie F; George, Roshan P; Warshaw, Barry; Wang, Elizabeth; Greenbaum, Larry A

    2016-12-01

    To quantify physical activity and grip strength in pediatric kidney transplant recipients and describe attitudes about exercise and exercise counseling given concerns about allograft injury. This was a cross-sectional analysis of 101 kidney transplant recipients (7-21 years old) >6 months post-transplant. Patients completed the Physical Activity Questionnaire (PAQ). Grip strength was measured with a dynamometer. We asked about activity limitations and provider counseling. Univariate analysis and multiple linear regression were used to determine independent predictors of PAQ score and grip strength z score. We enrolled 101 of 122 eligible patients. Median PAQ score was 2.2 (range 0-5) and was lower compared with controls (P < .001). The average grip strength z score was -1.1 and -0.7 in the right and left hand, respectively. Predictors of lower grip strength were younger age (P = .036), non-African American race (P = .029), lower height z score (P = .010), and longer percentage of lifetime with kidney disease (P = .029). Although 49% and 67% limited exercise before and after transplant, respectively, 67% reported increased activity after transplant. By parent report, provider counseling included limiting certain activities (71%) and encouraging regular exercise (45%). Physical activity and grip strength are low after kidney transplant. Patients perceive an emphasis on exercise limitations rather than the benefits of regular exercise. Interventions that encourage physical activity may be beneficial. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. What is the efficacy of physical therapeutics for treating neuropathic pain in spinal cord injury patients?

    PubMed

    Fattal, C; Kong-A-Siou, D; Gilbert, C; Ventura, M; Albert, T

    2009-03-01

    Evaluate the place and level of proof of physical therapeutics for treating neuropathic pain in spinal cord injury (SCI) patients. Literature review from three databases: PubMed, Embase, Pascal. The following keywords were selected: chronic neuropathic pain/non-pharmacological treatment; transcutaneous electrical nerve stimulation, physiotherapy, acupuncture, physical therapy, transcranial magnetic stimulation, heat therapy, ice therapy, cold therapy, massage, ultrasound, alternative treatment, complementary treatment, occupational therapy. The articles were analyzed using the double-reading mode. Three techniques emerge from the literature: magnetic or electrical transcranial stimulation, transcutaneous electrical nerve stimulation and acupuncture. Even though the first method is not easily accessible on a daily basis it is the one that yields the most promising results validated by Grade B studies. Healthcare professionals remain faithful to pain-relieving transcutaneous neurostimulation for both segmental neuropathic pain and below-level central neuropathic pain. Acupuncture is advocated by Canadian teams and could offer some interesting options; however, to this day, it does not have the methodological support and framework required to validate its efficacy. All other physical therapies are used in a random way. Only below-level massages are advocated by the patients themselves. To this day, no study can validate the integration of physical therapy as part of the array of therapeutics used for treating neuropathic pain in SCI patients. In the future, it will require controlled and randomized therapeutic studies on homogenous groups of SCI patients, to control the various confusion factors.

  17. Experimental study of blast-induced traumatic brain injury using a physical head model.

    PubMed

    Zhang, Jiangyue; Pintar, Frank A; Yoganandan, Narayan; Gennarelli, Thomas A; Son, Steven F

    2009-11-01

    This study was conducted to quantify intracranial biomechanical responses and external blast overpressures using physical head model to understand the biomechanics of blast traumatic brain injury and to provide experimental data for computer simulation of blast-induced brain trauma. Ellipsoidal-shaped physical head models, made from 3-mm polycarbonate shell filled with Sylgard 527 silicon gel, were used. Six blast tests were conducted in frontal, side, and 45 degrees oblique orientations. External blast overpressures and internal pressures were quantified with ballistic pressure sensors. Blast overpressures, ranging from 129.5 kPa to 769.3 kPa, were generated using a rigid cannon and 1.3 to 3.0 grams of pentaerythritol tetranitrate (PETN) plastic sheet explosive (explosive yield of 13.24 kJ and TNT equivalent mass of 2.87 grams for 3 grams of material). The PETN plastic sheet explosive consisted of 63% PETN powder, 29% plasticizer, and 8% nitrocellulose with a density of 1.48 g/cm3 and detonation velocity of 6.8 km/s. Propagation and reflection of the shockwave was captured using a shadowgraph technique. Shockwave speeds ranging from 423.3 m/s to 680.3 m/s were recorded. The model demonstrated a two-stage response: a pressure dominant (overpressure) stage followed by kinematic dominant (blast wind) stage. Positive pressures in the brain simulant ranged from 75.1 kPa to 1095 kPa, and negative pressures ranged from -43.6 kPa to -646.0 kPa. High- and normal-speed videos did not reveal observable deformations in the brain simulant from the neutral density markers embedded in the midsagittal plane of the head model. Amplitudes of the internal positive and negative pressures were found to linearly correlate with external overpressure. Results from the current study suggested a pressure-dominant brain injury mechanism instead of strain injury mechanism under the blast severity of the current study. These quantitative results also served as the validation and calibration

  18. Body composition modifications in people with chronic spinal cord injury after supervised physical activity

    PubMed Central

    Neto, Frederico Ribeiro; Lopes, Guilherme Henrique

    2011-01-01

    Background Quantification of body composition variables is important for planning of better activities in relation to individuals with spinal cord injury (SCI). Objectives (1) To evaluate changes in body composition in patients with SCI after a supervised physical activity process; (2) To correlate total body fat with time since injury. Design Pre-post intervention. Setting Sarah Rehabilitation Hospital Network, Brazil. Participants Fifty-three men with SCI aged 18–52 years with duration of injury >3 years. Interventions The subjects were divided into three groups: tetraplegia (TT) (C5–C8), high paraplegia (HP) (T1–T6), and low paraplegia (LP) (T7–L2). Body composition was estimated in the first and last weeks of hospitalization. Outcome measures Body weight (kg), skinfolds sum (mm), absolute (kg), and relative (%) fat and lean body mass. Results Body weight increased in TT and decreased in HP (0.8 kg, 95%CI 0.1–1.5; and −1.0 kg, 95%CI −2.0 to 0.0, respectively; P < 0.05). Skinfolds sum decreased only in HP (−13.1 mm, 95%CI −20.7 to −5.5; P < 0.05). Absolute and relative body fat decreased significantly in the paraplegia groups. Lean body mass (LBM) percentage increased significantly in the paraplegia groups. Absolute LBM increased in TT and LP (0.8 kg, 95%CI 0.3–1.3; and 1.3 kg, 95%CI 0.8 to 1.8, respectively; P < 0.05). There was no correlation between time since injury and skinfolds sum for the three groups (P < 0.05). Conclusion TT, HP, and LP demonstrated favorable changes in body composition after 29 days of supervised physical activity. However, these changes were different in direction and magnitude. PMID:22330114

  19. Warming-up and stretching for improved physical performance and prevention of sports-related injuries.

    PubMed

    Shellock, F G; Prentice, W E

    1985-01-01

    Competitive and recreational athletes typically perform warm-up and stretching activities to prepare for more strenuous exercise. These preliminary activities are used to enhance physical performance and to prevent sports-related injuries. Warm-up techniques are primarily used to increase body temperature and are classified in 3 major categories: (a) passive warm-up - increases temperature by some external means; (b) general warm-up - increases temperature by nonspecific body movements; and (c) specific warm-up - increases temperature using similar body parts that will be used in the subsequent, more strenuous activity. The best of these appears to be specific warm-up because this method provides a rehearsal of the activity or event. The intensity and duration of warm-up must be individualised according to the athlete's physical capabilities and in consideration of environmental factors which may alter the temperature response. The majority of the benefits of warm-up are related to temperature-dependent physiological processes. An elevation in body temperature produces an increase in the dissociation of oxygen from haemoglobin and myoglobin, a lowering of the activation energy rates of metabolic chemical reactions, an increase in muscle blood flow, a reduction in muscle viscosity, an increase in the sensitivity of nerve receptors, and an increase in the speed of nervous impulses. Warm-up also appears to reduce the incidence and likelihood of sports-related musculoskeletal injuries. Improving flexibility through stretching is another important preparatory activity that has been advocated to improve physical performance. Maintaining good flexibility also aids in the prevention of injuries to the musculoskeletal system. Flexibility is defined as the range of motion possible around a specific joint or a series of articulations and is usually classified as either static or dynamic. Static flexibility refers to the degree to which a joint can be passively moved to the

  20. Association of physical examination with pulmonary artery catheter parameters in acute lung injury*

    PubMed Central

    Grissom, Colin K.; Morris, Alan H.; Lanken, Paul N.; Ancukiewicz, Marek; Orme, James F.; Schoenfeld, David A.; Thompson, B. Taylor

    2016-01-01

    Objective To correlate physical examination findings, central venous pressure, fluid output, and central venous oxygen saturation with pulmonary artery catheter parameters. Design Retrospective study. Setting Data from the multicenter Fluid and Catheter Treatment Trial of the National Institutes of Health Acute Respiratory Distress Syndrome Network. Patients Five hundred thirteen patients with acute lung injury randomized to treatment with a pulmonary artery catheter. Interventions Correlation of physical examination findings (capillary refill time >2 secs, knee mottling, or cool extremities), central venous pressure, fluid output, and central venous oxygen saturation with parameters from a pulmonary artery catheter. Measurements We determined association of baseline physical examination findings and on-study parameters of central venous pressure and central venous oxygen saturation with cardiac index <2.5 L/min/m2 and mixed venous oxygen saturation <60%. We determined correlation of baseline central venous oxygen saturation and mixed venous oxygen saturation and predictive value of a low central venous oxygen saturation for a low mixed venous oxygen saturation. Measurements and Main Results Prevalence of cardiac index <2.5 and mixed venous oxygen saturation <60% was 8.1% and 15.5%, respectively. Baseline presence of all three physical examination findings had low sensitivity (12% and 8%), high specificity (98% and 99%), low positive predictive value (40% and 56%), but high negative predictive value (93% and 86%) for cardiac index <2.5 and mixed venous oxygen saturation <60%, respectively. Central venous oxygen saturation <70% predicted a mixed venous oxygen saturation <60% with a sensitivity 84%, specificity 70%, positive predictive value 31%, and negative predictive value of 96%. Low cardiac index correlated with cool extremities, high central venous pressure, and low 24-hr fluid output; and low mixed venous oxygen saturation correlated with knee mottling and

  1. Association of physical examination with pulmonary artery catheter parameters in acute lung injury.

    PubMed

    Grissom, Colin K; Morris, Alan H; Lanken, Paul N; Ancukiewicz, Marek; Orme, James F; Schoenfeld, David A; Thompson, B Taylor

    2009-10-01

    To correlate physical examination findings, central venous pressure, fluid output, and central venous oxygen saturation with pulmonary artery catheter parameters. Retrospective study. Data from the multicenter Fluid and Catheter Treatment Trial of the National Institutes of Health Acute Respiratory Distress Syndrome Network. Five hundred thirteen patients with acute lung injury randomized to treatment with a pulmonary artery catheter. Correlation of physical examination findings (capillary refill time >2 secs, knee mottling, or cool extremities), central venous pressure, fluid output, and central venous oxygen saturation with parameters from a pulmonary artery catheter. We determined association of baseline physical examination findings and on-study parameters of central venous pressure and central venous oxygen saturation with cardiac index <2.5 L/min/m2 and mixed venous oxygen saturation <60%. We determined correlation of baseline central venous oxygen saturation and mixed venous oxygen saturation and predictive value of a low central venous oxygen saturation for a low mixed venous oxygen saturation. Prevalence of cardiac index <2.5 and mixed venous oxygen saturation <60% was 8.1% and 15.5%, respectively. Baseline presence of all three physical examination findings had low sensitivity (12% and 8%), high specificity (98% and 99%), low positive predictive value (40% and 56%), but high negative predictive value (93% and 86%) for cardiac index <2.5 and mixed venous oxygen saturation <60%, respectively. Central venous oxygen saturation <70% predicted a mixed venous oxygen saturation <60% with a sensitivity 84%,specificity 70%, positive predictive value 31%, and negative predictive value of 96%. Low cardiac index correlated with cool extremities, high central venous pressure, and low 24-hr fluid output; and low mixed venous oxygen saturation correlated with knee mottling and high central venous pressure, but these correlations were not found to be clinically useful. In

  2. Simulation of blast-induced early-time intracranial wave physics leading to traumatic brain injury.

    PubMed

    Taylor, Paul A; Ford, Corey C

    2009-06-01

    The objective of this modeling and simulation study was to establish the role of stress wave interactions in the genesis of traumatic brain injury (TBI) from exposure to explosive blast. A high resolution (1 mm3 voxels) five material model of the human head was created by segmentation of color cryosections from the Visible Human Female data set. Tissue material properties were assigned from literature values. The model was inserted into the shock physics wave code, CTH, and subjected to a simulated blast wave of 1.3 MPa (13 bars) peak pressure from anterior, posterior, and lateral directions. Three-dimensional plots of maximum pressure, volumetric tension, and deviatoric (shear) stress demonstrated significant differences related to the incident blast geometry. In particular, the calculations revealed focal brain regions of elevated pressure and deviatoric stress within the first 2 ms of blast exposure. Calculated maximum levels of 15 KPa deviatoric, 3.3 MPa pressure, and 0.8 MPa volumetric tension were observed before the onset of significant head accelerations. Over a 2 ms time course, the head model moved only 1 mm in response to the blast loading. Doubling the blast strength changed the resulting intracranial stress magnitudes but not their distribution. We conclude that stress localization, due to early-time wave interactions, may contribute to the development of multifocal axonal injury underlying TBI. We propose that a contribution to traumatic brain injury from blast exposure, and most likely blunt impact, can occur on a time scale shorter than previous model predictions and before the onset of linear or rotational accelerations traditionally associated with the development of TBI.

  3. Direct referral and physical activity counselling upon discharge from spinal cord injury rehabilitation.

    PubMed

    Pelletier, C A; Latimer-Cheung, A E; Warburton, D E; Hicks, A L

    2014-05-01

    Sixteen-week follow-up study. To evaluate the efficacy of referral from a health-care provider to regular exercise combined with 16 weeks of counselling support following discharge from inpatient or outpatient spinal cord injury (SCI) rehabilitation. Two rehabilitation centres in Canada. Seventeen participants (age 42.1±10.6 years, C3-T12, ASIA impairment score A-C) were recruited at discharge from inpatient (n=9; 5.2±1.3 months post-injury) or outpatient (n=8; 14.2±3.8 months post-injury) rehabilitation and were given a referral for regular exercise. Telephone counselling support was provided and adherence to the prescribed program was monitored for 16 weeks. There was a nonsignificant difference in exercise adherence rates (percentage of available sessions attended) between participants discharged from inpatient (71.4±44.9%) and those from outpatient (39.5±27.2%) rehabilitation programs. The most common barriers to participation were physical health problems (50%) and transportation (36%). An exercise beliefs questionnaire revealed that participants value exercise at discharge from rehabilitation, despite the common report of a relative lack of confidence in their ability to perform or adapt aerobic and resistance exercises to their specific capabilities. A system of direct referral and ongoing counselling support following discharge from either inpatient or outpatient SCI rehabilitation appears to encourage sustained participation, although future health promotion strategies should continue to provide specific information about how to adapt and complete aerobic and resistance exercises. Rick Hansen Institute and Ontario Neurotrauma Foundation.

  4. Physical activity and transcutaneous oxygen pressure in men with spinal cord injury.

    PubMed

    Crespo-Ruiz, Beatriz; del-Ama, Antonio J; Jiménez-Díaz, Fernando J; Morgan, Jennifer; de la Peña-González, Ana; Gil-Agudo, Ángel M

    2012-01-01

    This pilot study proposed a method for assessing the status of vascular flow measured by transcutaneous oxygen pressure (TcPO2) in the area of the ischium in people with spinal cord injury (SCI). In a sample of 38 men (two groups: 12 physically active and 26 sedentary) with thoracic SCI, the distribution of the physiological response of the tissues under load during sitting was assessed through analysis of ischium TcPO2 values obtained by an oximeter. TcPO2 baseline, recovery time of TcPO2 after sitting (Trec), the percentage of TcPO2 (%TcPO2) of maximum pressure TcPO2, and mechanic maximal pressure (Pmax) were evaluated. Trec in the physically active group was significantly lower (p < 0.05) than in the sedentary group. Likewise, significant differences in %TcPO2 between groups (p < 0.05) were also found. We concluded that the physiological response of the tissues under an individual with SCI's own weight resulting from prolonged sitting is better in those who are physically active.

  5. Occupational, Physical, and Speech Therapy Treatment Activities During Inpatient Rehabilitation for Traumatic Brain Injury.

    PubMed

    Beaulieu, Cynthia L; Dijkers, Marcel P; Barrett, Ryan S; Horn, Susan D; Giuffrida, Clare G; Timpson, Misti L; Carroll, Deborah M; Smout, Randy J; Hammond, Flora M

    2015-08-01

    To describe the use of occupational therapy (OT), physical therapy (PT), and speech therapy (ST) treatment activities throughout the acute rehabilitation stay of patients with traumatic brain injury. Multisite prospective observational cohort study. Inpatient rehabilitation settings. Patients (N=2130) admitted for initial acute rehabilitation after traumatic brain injury. Patients were categorized on the basis of admission FIM cognitive scores, resulting in 5 fairly homogeneous cognitive groups. Not applicable. Percentage of patients engaged in specific activities and mean time patients engaged in these activities for each 10-hour block of time for OT, PT, and ST combined. Therapy activities in OT, PT, and ST across all 5 cognitive groups had a primary focus on basic activities. Although advanced activities occurred in each discipline and within each cognitive group, these advanced activities occurred with fewer patients and usually only toward the end of the rehabilitation stay. The pattern of activities engaged in was both similar to and different from patterns seen in previous practice-based evidence studies with different rehabilitation diagnostic groups. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  6. Autologous bone marrow-derived cell therapy combined with physical therapy induces functional improvement in chronic spinal cord injury patients.

    PubMed

    El-Kheir, Wael Abo; Gabr, Hala; Awad, Mohamed Reda; Ghannam, Osama; Barakat, Yousef; Farghali, Haithem A M A; El Maadawi, Zeinab M; Ewes, Ibrahim; Sabaawy, Hatem E

    2014-04-01

    Spinal cord injuries (SCI) cause sensory loss and motor paralysis. They are normally treated with physical therapy, but most patients fail to recover due to limited neural regeneration. Here we describe a strategy in which treatment with autologous adherent bone marrow cells is combined with physical therapy to improve motor and sensory functions in early stage chronic SCI patients. In a phase I/II controlled single-blind clinical trial (clinicaltrials.gov identifier: NCT00816803), 70 chronic cervical and thoracic SCI patients with injury durations of at least 12 months were treated with either intrathecal injection(s) of autologous adherent bone marrow cells combined with physical therapy or with physical therapy alone. Patients were evaluated with clinical and neurological examinations using the American Spinal Injury Association (ASIA) Impairment Scale (AIS), electrophysiological somatosensory-evoked potential, magnetic resonance imaging (MRI), and functional independence measurements. Chronic cervical and thoracic SCI patients (15 AIS A and 35 AIS B) treated with autologous adherent bone marrow cells combined with physical therapy showed functional improvements over patients in the control group (10 AIS A and 10 AIS B) treated with physical therapy alone, and there were no long-term cell therapy-related side effects. At 18 months posttreatment, 23 of the 50 cell therapy-treated cases (46%) showed sustained functional improvement. Compared to those patients with cervical injuries, a higher rate of functional improvement was achieved in thoracic SCI patients with shorter durations of injury and smaller cord lesions. Therefore, when combined with physical therapy, autologous adherent bone marrow cell therapy appears to be a safe and promising therapy for patients with chronic SCI of traumatic origin. Randomized controlled multicenter trials are warranted.

  7. Gender differences in the relative impact of physical and relational bullying on adolescent injury and weapon carrying.

    PubMed

    Dukes, Richard L; Stein, Judith A; Zane, Jazmin I

    2010-12-01

    Using structural equation modeling, concurrent associations were assessed among physical bullying, relational bullying, physical victimization, relational victimization, injury and weapon carrying using data from the population of 1300 adolescent girls and 1362 adolescent boys in grades 7-12 in a Colorado school district. For both genders, being a relational bully was a significantly stronger predictor of weapon carrying than being a physical bully, and both bullying types were significant predictors of more weapon carrying. For both genders, being a victim of physical bullying, a victim of relational bullying, or being a relational bully significantly predicted more injury. In latent means comparisons, adolescent girls reported more relational victimization and adolescent boys reported more physical bullying and victimization, more weapon carrying, and more injury. The relative strength of relational bullying on weapon carrying, and the health-related consequences of bullying on interpersonal violence and injury support concerted efforts in schools to mitigate these behaviors. Attention to differences related to age and gender also is indicated in the design of bullying mitigation programs. Copyright © 2010 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

  8. Injuries to primary school pupils and secondary school students during physical education classes and in their leisure time.

    PubMed

    Videmsek, Mateja; Karpljuk, Damir; Mlinar, Suzana; Mesko, Maja; Stihec, Joze

    2010-09-01

    The study aimed to establish the frequency of injuries in primary and secondary schools during leisure time and physical education classes in school as well as in group and individual sports. The sample included 2842 pupils from nine primary schools and 1235 students from five secondary schools in Slovenia. The data were processed with the SPSS statistical software package and the frequencies and Crosstabs were calculated. The results showed that substantially more pupils and students were injured in their leisure time than during physical education classes. Girls were more frequently injured in group and individual sports practiced during physical education classes and in individual sports practiced in their leisure time, whereas boys suffered more injuries in group sports practiced in their leisure time. As regards group sports, pupils and students were most frequently injured while playing football in their leisure time whereas, during physical education classes, they suffered most injuries in volleyball, followed closely by basketball and football; as regards individual sports, pupils and students were most frequently injured while cycling and rollerblading in their leisure time, whereas during physical education classes they suffered most injuries in athletics.

  9. Leisure time physical activity in a population-based sample of people with spinal cord injury part I: demographic and injury-related correlates.

    PubMed

    Ginis, Kathleen A Martin; Latimer, Amy E; Arbour-Nicitopoulos, Kelly P; Buchholz, Andrea C; Bray, Steven R; Craven, B Catharine; Hayes, Keith C; Hicks, Audrey L; McColl, Mary Ann; Potter, Patrick J; Smith, Karen; Wolfe, Dalton L

    2010-05-01

    To estimate the number of minutes a day of leisure time physical activity (LTPA) performed by people with chronic spinal cord injury (SCI) and to identify the demographic and injury-related characteristics associated with LTPA in a population-based sample of people with chronic SCI. Cross-sectional telephone survey. General community. Men and women with SCI (N=695). Not applicable. The number of minutes/day of LTPA performed at a mild intensity or greater. Respondents reported mean minutes +/- SD of 27.14+/-49.36 of LTPA/d; however, 50% reported no LTPA whatsoever. In a multiple regression analysis, sex, age, years postinjury, injury severity, and primary mode of mobility each emerged as a unique predictor of LTPA. Multiple correspondence analysis indicated that being a man over the age of 34 years and greater than 11 years postinjury was associated with inactivity, while being a manual wheelchair user and having motor complete paraplegia were associated with the highest level of daily LTPA. Daily LTPA levels are generally low in people with SCI. Women, older adults, people with less recent injuries, people with more severe injuries, and users of power wheelchairs and gait aids are general subgroups that may require special attention and resources to overcome unique barriers to LTPA. Specific subgroups may also require targeted interventions.

  10. Knowledge, attitude and practice in emergency management of dental injury among physical education teachers: a survey in Bangalore urban schools.

    PubMed

    Mohandas, U; Chandan, G D

    2009-01-01

    The purpose of this study was to assess, by means of a self administered structured questionnaire, the level of Knowledge, Attitude and Practice of physical education teachers in Bangalore city with regards to emergency management of dental injuries. The questionnaire surveyed the physical education teacher's background, knowledge of management of tooth fracture, avulsion, luxation injuries, it also investigated physical education teacher's attitude and the way they handle the injuries. The sample consisted 580 teachers from 700 selected schools in Bangalore city. Chi-square test was applied to test the significance between trained and untrained teachers. Among the population 70% were males physical education teachers 30% were females. 95% of the teachers had physical education training and 5% did not have the training. 95% of the population had first aid component and 5% did not have. Only 25% of trained physical education teachers had correct knowledge about tooth identification and 17% among untrained teachers. 81% of trained teachers answered correctly regarding management of fractured anterior teeth against 27.5% of untrained teachers (P< 0.0002). The present report indicates that there is lack of knowledge and practice among physical education teachers in Bangalore city regarding emergency management of dental trauma. Educational programs to improve the knowledge and awareness among the teachers have to be implemented.

  11. Partner aggression among men and women in substance use disorder treatment: correlates of psychological and physical aggression and injury.

    PubMed

    Chermack, Stephen T; Murray, Regan L; Walton, Maureen A; Booth, Brenda A; Wryobeck, John; Blow, Frederic C

    2008-11-01

    This study examined intimate partner aggression in a sample of 489 participants enrolled in substance use disorder treatment, and expands on prior research by including measures of various forms of aggression, a mixed gender sample (76% men, 24% women), and measurement of several potential risk domains. Aggression measures included both participant-partner and partner-to-participant psychological aggression, physical aggression and injury. Analyses focused on the role of distal and proximal risk factors, including demographics, history of childhood physical and sexual abuse, and family history of problems with alcohol, drugs and depression, as well as recent substance use and symptoms of depression. Overall rates of participant-partner psychological aggression (77%), physical aggression (54%) and injuring partners (33%) were high, as were rates of partner-to-participant psychological aggression (73%), physical aggression (51%), and injury (33%). Several distal (family history variables, physical abuse) and proximal factors (binge drinking, several different drugs, depressive symptoms) were bivariately related to most of the aggression measures. However, according to multivariate analyses predicting aggression and injury measures, binge drinking and cocaine use were the drugs significantly associated with most measures, depression symptoms also were related to most aggression and injury measures, and a history of reported childhood physical abuse was related to all frequency of aggression and injury measures among those reporting such behaviors. Overall, the high rates of aggression among both men and women observed in this study further illustrate the need for interventions targeting substance use and aggression, and for further research regarding the inter-relationships among substance, aggression and depressive symptoms.

  12. Partner Aggression among Men and Women in Substance Use Disorder Treatment: Correlates of Psychological and Physical Aggression and Injury

    PubMed Central

    Chermack, Stephen T.; Murray, Regan L; Walton, Maureen A; Booth, Brenda A; Wryobeck, John; Blow, Frederic C.

    2013-01-01

    This study examined intimate partner aggression in a sample of 489 participants enrolled in substance use disorder treatment, and expands on prior research by including measures of various forms of aggression, a mixed gender sample (76% men, 24% women), and measurement of several potential risk domains. Aggression measures included both participant-to-partner and partner-to-participant psychological aggression, physical aggression and injury. Analyses focused on the role of distal and proximal risk factors, including demographics, history of childhood physical and sexual abuse, and family history of problems with alcohol, drugs and depression, as well as recent substance use and symptoms of depression. Overall rates of participant-to-partner psychological aggression (77%), physical aggression (54%) and injuring partners (33%) were high, as were rates of partner-to-participant psychological aggression (73%), physical aggression (51%), and injury (33%). Several distal (family history variables, physical abuse) and proximal factors (binge drinking, several different drugs, depressive symptoms) were bivariately related to most of the aggression measures. However, according to multivariate analyses predicting aggression and injury measures, binge drinking and cocaine use were the drugs significantly associated with most measures, depression symptoms also were related to most aggression and injury measures, and a history of reported childhood physical abuse was related to all frequency of aggression and injury measures among those reporting such behaviors. Overall, the high rates of aggression among both men and women observed in this study further illustrate the need for interventions targeting substance use and aggression, and for further research regarding the inter-relationships among substance, aggression and depressive symptoms. PMID:18554825

  13. Physical examination is a poor screening test for abdominal-pelvic injury in adult blunt trauma patients.

    PubMed

    Michetti, Christopher P; Sakran, Joseph V; Grabowski, Jurek G; Thompson, Earl V; Bennett, Kristen; Fakhry, Samir M

    2010-03-01

    To determine if physical examination can reliably detect or exclude abdominal or pelvic injury in adult trauma activation patients. Trauma registry and medical record data were retrospectively reviewed for all adult blunt trauma patients with Glasgow coma scale score>8, from 6/30/05 to 12/31/06. Attending surgeons' dictated admission history and physical examination reports were individually reviewed. Patients' subjective reports of abdominal pain were recorded as present or absent. Exam findings of the lower ribs, abdomen, and pelvis were each separately recorded as positive or negative, and were compared with findings on a subsequent objective evaluation of the abdomen (OEA). "Clinically significant" injuries were defined as those that would change patient management. One thousand six hundred sixty-three patients were studied. Of patients with a negative abdominal exam, 10% had a positive OEA. When abdominal pain was absent, and exam of the lower ribs, abdomen, and pelvis was normal, OEA was positive in 7.6%, and 5.7% had a clinically significant injury. While a positive abdominal exam was predictive of a positive OEA (P<0.01), a negative exam, even when broadened (pain, lower ribs, abdomen, pelvis) did not exclude significant injuries. Ten percent of trauma activation patients with a negative abdominal exam have occult abdominal/pelvic injuries. Even when exam of the lower ribs, abdomen, and pelvis are all negative and abdominal pain is absent, 5.7% have occult injuries that would change management. OEA should be used liberally for adult blunt trauma activation patients regardless of physical exam findings, to avoid missing clinically significant injuries. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  14. The Epidemiology of Physical Training Injuries in U.S. Army Infantry Trainees: Methodology, Population, and Risk Factors

    DTIC Science & Technology

    1988-11-01

    Livingston. 1965. 18. Hoppenfeld S. Chapter 6 Physical examination of the hip and pelvis; Chapter 7 Physical examination of the knee; and, Chapter 8... Hip 4 (1.3) 4 3-12 2 (50.0) Thigh 14 (4.6) 3.5 2-100 4 (28.6) Knee 46 (15.2) ii 0-90 30 (65.2) Calf 7 (2.3) 6 3-30 4 (57.1) Foot 25 (8.6) 1.5 0-9 21...Sites and Types of Injuries Experienced During Basic Training Injury Site Frequency Ankle 33 Calf 26 Foot 33 Hip 1 Knee 31 Lower Back 18 Thigh 5 Injury

  15. Intraindividual variability in physical and emotional functioning: comparison of adults with traumatic brain injuries and healthy adults.

    PubMed

    Burton, Catherine L; Hultsch, David F; Strauss, Esther; Hunter, Michael A

    2002-08-01

    Recent research has shown that individuals with certain neurological conditions demonstrate greater intraindividual variability on cognitive tasks compared to healthy controls. The present study investigated intraindividual variability in the domains of physical functioning and affect/stress in three groups: adults with mild head injuries, adults with moderate/severe head injuries, and healthy adults. Participants were assessed on 10 occasions and results indicated that (a) individuals with head injuries demonstrated greater variability in dominant finger dexterity and right grip strength than the healthy controls; (b) increased variability tended to be associated with poorer performance/report both within and across tasks; and (c) increased variability on one task was associated with increased variability on other tasks. The findings suggest that increased variability in physical function, as well as cognitive function, represents an indicator of neurological compromise.

  16. Relationship of physical therapy inpatient rehabilitation interventions and patient characteristics to outcomes following spinal cord injury: The SCIRehab project

    PubMed Central

    Teeter, Laura; Gassaway, Julie; Taylor, Sally; LaBarbera, Jacqueline; McDowell, Shari; Backus, Deborah; Zanca, Jeanne M.; Natale, Audrey; Cabrera, Jordan; Smout, Randall J.; Kreider, Scott E. D.; Whiteneck, Gale

    2012-01-01

    Background/objective Examine associations of type and quantity of physical therapy (PT) interventions delivered during inpatient spinal cord injury (SCI) rehabilitation and patient characteristics with outcomes at the time of discharge and at 1 year post-injury. Methods Physical therapists delivering routine care documented details of PT interventions provided. Regression modeling was used to predict outcomes at discharge and 1 year post-injury for a 75% subset; models were validated with the remaining 25%. Injury subgroups also were examined: motor complete low tetraplegia, motor complete paraplegia, and American Spinal Injury Association (ASIA) Impairment Scale (AIS) D motor incomplete tetra-/paraplegia. Results PT treatment variables explain more variation in three functionally homogeneous subgroups than in the total sample. Among patients with motor complete low tetraplegia, higher scores for the transfer component of the discharge motor Functional Independence Measure () are strongly associated with more time spent working on manual wheelchair skills. Being male is the most predictive variable for the motor FIM score at discharge for patients with motor complete paraplegia. Admission ASIA lower extremity motor score (LEMS) and change in LEMS were the factors most predictive for having the primary locomotion mode of “walk” or “both (walk and wheelchair)” on the discharge motor FIM for patients with AIS D injuries. Conclusion Injury classification influences type and quantity of PT interventions during inpatient SCI rehabilitation and is a strong predictor of outcomes at discharge and 1 year post-injury. The impact of PT treatment increases when patient groupings become more homogeneous and outcomes become specific to the groupings. Note This is the second of nine articles in the SCIRehab series. PMID:23318034

  17. Comparative study of the detection of joint injury in early-stage rheumatoid arthritis by magnetic resonance imaging of the wrist and finger joints and physical examination.

    PubMed

    Tamai, Mami; Kawakami, Atsushi; Iwamoto, Naoki; Kawashiri, Shin-Ya; Fujikawa, Keita; Aramaki, Toshiyuki; Kita, Junko; Okada, Akitomo; Koga, Tomohiro; Arima, Kazuhiko; Kamachi, Makoto; Yamasaki, Satoshi; Nakamura, Hideki; Ida, Hiroaki; Origuchi, Tomoki; Takao, Shoichiro; Aoyagi, Kiyoshi; Uetani, Masataka; Eguchi, Katsumi

    2011-03-01

    To verify whether magnetic resonance imaging (MRI)-proven joint injury is sensitive as compared with joint injury determined by physical examination. MRI of the wrist and finger joints of both hands was examined in 51 early-stage rheumatoid arthritis (RA) patients by both plain and gadolinium diethylenetriaminepentaacetic acid-enhanced MRI. Synovitis, bone edema, and bone erosion (the latter two included as bone lesions at the wrist joints); metacarpophalangeal joints; and proximal interphalangeal joints were considered as MRI-proven joint injury. Japan College of Rheumatology-certified rheumatologists had given a physical examination just before the MRI study. The presence of tender and/or swollen joints in the same fields as MRI was considered as joint injury on physical examination. The association of MRI-proven joint injury with physical examination-proven joint injury was examined. A total of 1,110 sites were available to be examined. MRI-proven joint injury was found in 521 sites, whereas the other 589 sites were normal. Physical examination-proven joint injury was found in 305 sites, which was significantly low as compared with MRI-proven joint injury (P = 1.1 × 10(-12) versus MRI). Joint injury on physical examination was not found in 81.5% of the sites where MRI findings were normal. Furthermore, an association of the severity of MRI-proven joint injury with that of joint injury on physical examination was clearly demonstrated (P = 1.6 × 10(-15), r(s) = 0.469). Our present data suggest that MRI is not only sensitive but accurately reflects the joint injury in patients with early-stage RA. Copyright © 2011 by the American College of Rheumatology.

  18. Systematic Review of Theory-Based Interventions Aimed at Increasing Physical Activity in Individuals with Spinal Cord Injury

    ERIC Educational Resources Information Center

    Wilroy, Jereme; Knowlden, Adam

    2016-01-01

    Background: Approximately 200,000 individuals have a spinal cord injury (SCI) and more than 12,000 new cases are diagnosed each year in the United States. Lowered physical functioning caused by SCI often leads to a sedentary lifestyle, increasing risk for chronic diseases, secondary medical conditions, and lower quality of life. Purpose: The aim…

  19. A multidimensional physical therapy program for individuals with cerebellar ataxia secondary to traumatic brain injury: a case series.

    PubMed

    Sartor-Glittenberg, Cecelia; Brickner, Lori

    2014-02-01

    The purpose of this case series is to describe changes in impairments and activity limitations in three individuals with severe cerebellar ataxia from traumatic brain injury (TBI) who participated in a long-term, multidimensional physical therapy program. A secondary purpose is to document use of a climbing wall for these persons. Each of the individuals had a TBI, severe ataxia and was admitted to a transitional neuro-rehabilitation day treatment program. The first person, a 22-year-old, was 6 years post injury and had 127 individual physical therapy sessions over 12 months. The second person, a 16-year-old, was 5½ months post injury and had 187 individual therapy sessions over 19 months. The third person, a 20-year-old, was 6 months post injury and had 89 individual therapy sessions over 23 months. An integrative treatment approach was used, and the individuals participated in activities to minimize ataxia and improve mobility. Each of them made gains in coordination, balance, balance confidence, endurance and mobility. The three individuals with cerebellar ataxia participated in a long-term, individualized, multidimensional physical therapy treatment program, and made improvements in all areas of impairment and activity limitations. This study reinforces the need for long-term, multidimensional physical therapy for individuals with ataxia.

  20. Systematic Review of Theory-Based Interventions Aimed at Increasing Physical Activity in Individuals with Spinal Cord Injury

    ERIC Educational Resources Information Center

    Wilroy, Jereme; Knowlden, Adam

    2016-01-01

    Background: Approximately 200,000 individuals have a spinal cord injury (SCI) and more than 12,000 new cases are diagnosed each year in the United States. Lowered physical functioning caused by SCI often leads to a sedentary lifestyle, increasing risk for chronic diseases, secondary medical conditions, and lower quality of life. Purpose: The aim…

  1. The physical activity recall assessment for people with spinal cord injury: validity.

    PubMed

    Latimer, Amy E; Ginis, Kathleen A Martin; Craven, B Catharine; Hicks, Audrey L

    2006-02-01

    This study examined the construct validity of the physical activity recall assessment for people with spinal cord injury (PARA-SCI). First, to assess convergent validity, relationships between PARA-SCI scores and measures of aerobic fitness and muscular strength were examined among 73 men and women with SCI. Second, extreme groups analyses were conducted. PARA-SCI scores from 158 people with SCI were compared between groups differing on demographic, disability, and behavioral characteristics. Scores from the leisure time physical activity (LTPA) and cumulative activity PARA-SCI categories correlated positively with parameters of aerobic fitness and muscular strength. Scores from the lifestyle activity PARA-SCI category were not consistently associated with fitness parameters. LTPA category scores could differentiate between groups differing by age, sex, gym or sports team membership, and frequency of participation in LTPA. Lifestyle and cumulative activity scores were unable to distinguish between most groups. The convergent validity study provided evidence of validity for the PARA-SCI LTPA and cumulative activity categories. The extreme groups analyses provided further evidence of the validity of the LTPA category by demonstrating differences in extreme groups. Together, these findings contribute to the accumulating evidence of the construct validity of the PARA-SCI LTPA category and its utility for assessing LTPA among individuals with SCI. These results also highlight measurement constraints of the lifestyle activity and cumulative activity categories.

  2. Physical therapy after spinal cord injury: a systematic review of treatments focused on participation.

    PubMed

    Gómara-Toldrà, Natàlia; Sliwinski, Martha; Dijkers, Marcel P

    2014-07-01

    Context Over the last four decades, the focus of spinal cord injury (SCI) rehabilitation has shifted from medical management to issues that affect quality of life and community participation. Physical therapists (PTs) need to design and implement interventions that result in maximal participation to provide an individual with SCI an effective rehabilitation program. Objective The aim of this review is to assess the extent, content, and outcomes of physical therapy (PT) interventions focused on improving the participation of individuals with SCI. Methods A search was conducted in Medline, Embase, CENTRAL, CINAHL, PEDro, and PsycINFO. We included studies, of all designs, focused on improving the participation of individuals with SCI using PT interventions.The primary author and a reviewer independently selected articles for inclusion, assessed articles quality, and extracted the data. Results Five studies met the inclusion criteria. The interventions applied were 9- and 12-month body weight-supported treadmill training in two studies, a supervised 9-month exercise program, a 12-week home exercise program, and a 10-week multidisciplinary cognitive behavioral program for coping with chronic neuropathic pain. Four of five PT interventions positively impacted the individual's perceived participation and satisfaction with participation. Conclusion The body of research by PTs on interventions to improve participation is limited. PTs must document the effects of interventions with a valid outcome tool to enable more research that examines participation. Expanding participation research will allow PTs to meet the needs of individuals with SCI and identify what interventions best facilitate integration into the community.

  3. Spinal cord injury influences psychogenic as well as physical components of female sexual ability.

    PubMed

    Anderson, K D; Borisoff, J F; Johnson, R D; Stiens, S A; Elliott, S L

    2007-05-01

    Secure, web-based survey. Elicit specific information about sexual function from women with spinal cord injuries (SCI). World-wide web. Individuals 18 years or older living with SCI obtained a pass code to enter a secure website and then answered survey questions. Bladder and/or bowel incontinence during sexual activity and/or sexual intercourse were significant concerns and prevented some women from seeking sexual activity. Autonomic dysreflexia (AD) during sexual activity was interpreted negatively by many and was found to interfere with sexual activity. Most subjects reported difficulty becoming psychologically aroused as well as physically aroused, which were both correlated with feeling that their SCI had altered their sexual sense of self. An inverse relationship existed between developing new areas of arousal above the level of lesion and not having sensation or movement below the lesion. The most commonly reported sexual stimulation leading to the best arousal involved stimulation of the head/neck and torso areas. The majority of subjects reported having experienced intercourse postinjury. Most participants reported difficulty with positioning during foreplay and intercourse, vaginal lubrication, and spasticity during intercourse. Almost half reported experiencing orgasm postinjury and this was positively associated with the presence of genital sensation. SCI significantly impairs psychological and physical aspects of female sexual arousal. In addition, bladder and bowel incontinence as well as AD negatively impact sexual activity and intercourse.

  4. The identification by physiotherapists of the physical problems resulting from a mild traumatic brain injury.

    PubMed

    Quinn, B; Sullivan, S J

    2000-12-01

    In New Zealand, over 9000 people are diagnosed with a traumatic brain injury (TBI) each year, with at least 80% being classified as mild. The cognitive deficits resulting from mild traumatic brain injury (MTBI) have been well documented, but this is not the case for the physical problems. As a result, the physical problems are not well understood and few people with a MTBI are referred for physiotherapy. The aim of this research was to use a modified Delphi Technique to gain consensus amongst physiotherapists working with TBI clients with regard to: (1) The common motor performance problems associated with MTBI; (2) The importance of assessing these motor performance problem; and (3) Whether these motor performance problems should be used in a formal assessment (FA) or included as a screening measure (SM). Following a pilot study to establish face validity and clarity of instructions, a national sample of 52 physiotherapists with a minimum of 1 year's experience working with TBI clients was recruited. In Round 1, 42 physiotherapists listed 424 physical problems which, in their clinical experience, may occur in people with a recent MTBI. A planning committee developed these listed problems into 33 items. In Round 2, these items were then rated by the physiotherapists as to their importance of being included in an assessment. Using 75% consensus criteria, 31 items were deemed as being at least 'important' for inclusion. In Round 3, the physiotherapists were asked whether these items should be used in a FA or used as a SM. Of the 31 items which were retained, seven reached consensus for FA (balance with unstable, reduced or changing base of support; dynamic standing balance; high level balance activities; quality of movement; ballistic activities; gait; proprioception). Five items reached consensus for being used as a SM (attention; behaviour; sport and leisure activities; vocational activities; quality of movement). Consensus of classification was not reached for the

  5. Physical training in boots and running shoes: a historical comparison of injury incidence in basic combat training.

    PubMed

    Knapik, Joseph J; Jones, Bruce H; Steelman, Ryan A

    2015-03-01

    For many years, U.S. Army soldiers performed physical training (PT) in a modified duty uniform and combat boots. The belief that PT in combat boots was associated with injuries lead to the introduction of running shoes for PT in 1982. A historical comparison was conducted examining injuries before and after the change to running shoes in Basic Combat Training (BCT). Searches in literature databases and other sources identified 16 studies with quantitative data on injury incidence during 8-week BCT cycles. Employing studies with similar injury definitions (n = 12), injury incidence was compared in the boot and running shoe periods using meta-analyses, χ(2) statistics, and risk ratios (RRs) with 95% confidence intervals (95% CIs). The boot and shoe periods demonstrated little difference in overall injury incidence (men: RR[boot/shoes] = 1.04, 95% CI = 0.91-1.18, p = 0.50; women: RR = 0.94, 95% CI = 0.85-1.05, p = 0.27) or in lower extremity injury incidence (men: RR[boot/shoes] = 0.91, 95% CI = 0.64-1.30, p = 0.66; women: RR = 1.06, 95% CI = 0.89-1.27, p = 0.51). These analyses provided little support for a reduction in injury risk after the switch from boots to running shoes for PT in BCT. A large randomized, prospective cohort study should be conducted to determine if injury rates are different when PT is conducted in running shoes versus boots. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

  6. Nutritional status and physical activity level as risk factor for traumatic dental injuries occurrence: a systematic review

    PubMed Central

    Goettems, Marília Leão; Schuch, Helena Silveira; Hallal, Pedro Curi; Torriani, Dione Dias; Demarco, Flávio Fernando

    2014-01-01

    Aim To systematically review epidemiological articles assessing traumatic dental injuries (TDI) rates according to the physical activity habits and nutritional status. Methods A search was conducted using PubMed, ISI, Scopus, SciELO, LILACS, and gray literature in Brazilian Theses Databank. We searched for dental trauma, traumatic dental injuries, tooth injuries, tooth fractures, physical activity, motor activity, exercise, sedentary lifestyle, sports, obesity, body mass index (BMI), overweight, and fatness. Databases were searched in duplicate from their earliest records until 2012. Additional studies were identified by searching bibliographies of the articles. Two reviewers performed data extraction and analyzed study procedural quality using the Newcastle–Ottawa scale. PRISMA guidelines for reporting systematic reviews were followed. Results We found 1159 articles, of whom 14 reports involving 13 studies were selected. One article was a birth cohort, one had a case–control design, and the others were cross-sectional. The quality of evidence varied across the studies and was high (9) in 3. Eleven of the studies included assessed influence of nutritional status: five show a positive association between dental trauma and overweight and six do not show any association. Regarding physical activity level, five studies assessed its effect on trauma occurrence: two detected that physical activity acts as a protective factor and two that physical active increases the risk of dental injuries, and one showed no differences in TDI occurrence. Physical activity estimated from questionnaires and BMI were the most frequently used measures, but methodological differences prevent the comparison of results. Conclusion The results suggest that no truly causal relationship exists between dental trauma and physical activity and nutritional status. Due to the relatively low level of evidence currently present, studies with more robust design, for example, prospective cohort

  7. Nutritional status and physical activity level as risk factor for traumatic dental injuries occurrence: a systematic review.

    PubMed

    Goettems, Marília Leão; Schuch, Helena Silveira; Hallal, Pedro Curi; Torriani, Dione Dias; Demarco, Flávio Fernando

    2014-08-01

    To systematically review epidemiological articles assessing traumatic dental injuries (TDI) rates according to the physical activity habits and nutritional status. A search was conducted using PubMed, ISI, Scopus, SciELO, LILACS, and gray literature in Brazilian Theses Databank. We searched for dental trauma, traumatic dental injuries, tooth injuries, tooth fractures, physical activity, motor activity, exercise, sedentary lifestyle, sports, obesity, body mass index (BMI), overweight, and fatness. Databases were searched in duplicate from their earliest records until 2012. Additional studies were identified by searching bibliographies of the articles. Two reviewers performed data extraction and analyzed study procedural quality using the Newcastle-Ottawa scale. PRISMA guidelines for reporting systematic reviews were followed. We found 1159 articles, of whom 14 reports involving 13 studies were selected. One article was a birth cohort, one had a case-control design, and the others were cross-sectional. The quality of evidence varied across the studies and was high (9) in 3. Eleven of the studies included assessed influence of nutritional status: five show a positive association between dental trauma and overweight and six do not show any association. Regarding physical activity level, five studies assessed its effect on trauma occurrence: two detected that physical activity acts as a protective factor and two that physical active increases the risk of dental injuries, and one showed no differences in TDI occurrence. Physical activity estimated from questionnaires and BMI were the most frequently used measures, but methodological differences prevent the comparison of results. The results suggest that no truly causal relationship exists between dental trauma and physical activity and nutritional status. Due to the relatively low level of evidence currently present, studies with more robust design, for example, prospective cohort should address this question, especially

  8. Epidemiology of Exercise- and Sports-Related Injuries in a Population of Young, Physically Active Adults: A Survey of Military Servicemembers.

    PubMed

    Hauret, Keith G; Bedno, Sheryl; Loringer, Kelly; Kao, Tzu-Cheg; Mallon, Timothy; Jones, Bruce H

    2015-11-01

    Numerous studies document the health benefits of a physically active lifestyle, but relatively few document the hazards of physical activity. Because of the requirement for physical fitness to complete their mission, the United States military services have a vested interest in understanding the benefits and risks of physical activity including exercise and sports. One of these risks is injury. Rates and proportion of injuries caused by exercise- and sports-related (ESR) activities have not been reported previously across the services. The purposes of this population survey were to (1) document the rates and proportion of all injuries caused by ESR activities among military personnel, (2) compare rates across the military services, and (3) describe the causes and types of ESR injuries as well as associated days of limited activity. Descriptive epidemiology study. The Defense Manpower Data Center administered the web-based 2008 Status of Forces Survey of Active Duty Service Members to a random sample of active-duty personnel. In all, 10,692 servicemembers completed the survey, which included questions about injuries from any cause and from exercise and sports during the previous year. Responses were weighted to produce population estimates for injury rates (any injury and ESR injury). Percentage distributions were used to describe activities, injury types, days of limited activity, and contributing factors for ESR injuries. There were 49% of servicemembers who sustained an injury from any cause in the previous year; 25% had an ESR injury. Thus, 52% of all injuries were ESR injuries. ESR injury rates ranged from 20% for the Navy to 33% for the Marine Corps. Running accounted for 45% of ESR injuries. Forty percent of ESR injuries were sprains and strains. As an indicator of injury severity, 35% of ESR injuries required more than 2 weeks of limited activity. This study quantified the overall incidence of injuries and the large proportion that are caused by exercise and

  9. Crown-of-thorns starfish predation and physical injuries promote brown band disease on corals

    NASA Astrophysics Data System (ADS)

    Katz, Sefano M.; Pollock, F. Joseph; Bourne, David G.; Willis, Bette L.

    2014-09-01

    Brown band (BrB) disease manifests on corals as a ciliate-dominated lesion that typically progresses rapidly causing extensive mortality, but it is unclear whether the dominant ciliate Porpostoma guamense is a primary or an opportunistic pathogen, the latter taking advantage of compromised coral tissue or depressed host resistance. In this study, manipulative aquarium-based experiments were used to investigate the role of P. guamense as a pathogen when inoculated onto fragments of the coral Acropora hyacinthus that were either healthy, preyed on by Acanthaster planci (crown-of-thorns starfish; COTS), or experimentally injured. Following ciliate inoculation, BrB lesions developed on all of COTS-predated fragments ( n = 9 fragments) and progressed up to 4.6 ± 0.3 cm d-1, resulting in ~70 % of coral tissue loss after 4 d. Similarly, BrB lesions developed rapidly on experimentally injured corals and ~38 % of coral tissue area was lost 60 h after inoculation. In contrast, no BrB lesions were observed on healthy corals following experimental inoculations. A choice experiment demonstrated that ciliates are strongly attracted to physically injured corals, with over 55 % of inoculated ciliates migrating to injured corals and forming distinct lesions, whereas ciliates did not migrate to healthy corals. Our results indicate that ciliates characteristic of BrB disease are opportunistic pathogens that rapidly migrate to and colonise compromised coral tissue, leading to rapid coral mortality, particularly following predation or injury. Predicted increases in tropical storms, cyclones, and COTS outbreaks are likely to increase the incidence of coral injury in the near future, promoting BrB disease and further contributing to declines in coral cover.

  10. Are joint injury, sport activity, physical activity, obesity, or occupational activities predictors for osteoarthritis? A systematic review.

    PubMed

    Richmond, Sarah A; Fukuchi, Reginaldo K; Ezzat, Allison; Schneider, Kathryn; Schneider, Geoff; Emery, Carolyn A

    2013-08-01

    Systematic review with meta-analysis. To identify risk factors for osteoarthritis (OA) of the knee, hip, and ankle, including joint injury, sport, physical activity, overweight/obesity, and occupational activity, in all age groups. OA is a significant health problem worldwide, affecting up to 10% of men and 18% of women over 60 years of age. There has not been a comprehensive review examining modifiable physical risk factors associated with the onset of OA. This evidence is important to inform the physiotherapy management of individuals following onset of OA. Twelve electronic databases were systematically reviewed. The studies selected met the following criteria: (1) original data; (2) joint injury, sport activity, physical activity, overweight/obesity, and/or occupational activity investigated as risk factors; (3) outcomes included OA (hip, knee, and/or ankle); and (4) analytic component of study design. The data extracted included study design, years of follow-up, study population, OA definition, risk factors, and results (effect estimates reported or calculated where available). The quality of evidence was assessed based on a modified version of the Downs and Black checklist. Joint injury, obesity, and occupational activity were associated with an increased risk of OA of the knee and hip. Sport and physical activity produced inconsistent findings. Joint injury was identified as a significant risk factor for knee OA (combined odds ratio = 3.8; 95% confidence interval: 2.0, 7.2) and hip OA (combined odds ratio = 5.0; 95% confidence interval: 1.4, 18.2), as was previous meniscectomy with or without anterior cruciate ligament injury for knee OA (combined odds ratio = 7.4; 95% confidence interval: 4.0, 13.7). There is a paucity of research examining risk factors associated with ankle OA; this review identified only 2 studies with this outcome. Joint injury, obesity, and occupational activity are associated with an increased risk of knee and hip OA. Some findings

  11. The association of sports and physical recreation with life satisfaction in a community sample of people with spinal cord injuries.

    PubMed

    Tasiemski, Tomasz; Kennedy, Paul; Gardner, Brian Patrick; Taylor, Nicola

    2005-01-01

    The purpose of this study is to assess satisfaction with life domains in people with spinal cord injuries (SCI) and investigate whether participation in sports and physical recreation is associated with life satisfaction in SCI. 1,748 randomly selected participants with SCI who fulfilled the criteria: SCI at level C5 or below, wheelchair dependent; aged 18-50 at the time of injury; at least 1 year post-injury, were approached to take part in this study. Completed replies were received from 985 individuals with SCI (198 women, 798 men). The measures used included the Sports Participation Questionnaire, the Life Satisfaction Questionnaire and the Hospital Anxiety and Depression Scale. The numbers of hours participating in sports decreased significantly after injury. There was a greater decrease in numbers participating in team sports in comparison to the decrease seen in numbers participating in individual sports. The highest level of satisfaction existed within social domains such as: family life and contacts with friends. The lowest level of satisfaction was found in regard to the participant's sexual life and vocational situation. Higher satisfaction with life in general was demonstrated in respondents with SCI involved in sports or physical recreation compared to those not participating in physical activities.

  12. Continued experience with physical examination alone for evaluation and management of penetrating zone 2 neck injuries: results of 145 cases.

    PubMed

    Sekharan, J; Dennis, J W; Veldenz, H C; Miranda, F; Frykberg, E R

    2000-09-01

    Our preliminary experience with physical examination alone in the evaluation of penetrating zone 2 neck injuries for vascular trauma was previously reported in 28 patients over a 2-year period (1991-1993). The purpose of the current study was to examine the results of this approach in a much larger group of patients over an 8-year period. The medical records for all patients admitted to our level I trauma center (all of them entered into our prospective protocol) between December 1991 and April 1999 with penetrating zone 2 neck trauma were reviewed for their initial presentation and any documented vascular injury. A total of 145 patients made up the study group; in 30 of these patients, the penetrating trajectory also traversed zone 1 or 3. Thirty-one patients (21%) had hard signs of vascular injury (active bleeding, expanding hematoma, bruit/thrill, pulse deficit, central neurologic deficit) and were taken immediately to the operating room; 28 (90%) of these 30 patients had either major arterial or venous injuries requiring operative repair (the false-positive rate for physical examination thus being 10%). Of the 114 patients with no hard signs, 23 underwent arteriography because of proximity of the injury to the vertebral arteries or because the trajectory included another zone. Of these 23 arteriograms, three showed abnormalities, but only one required operative repair. This case had no complications relating to the initial delay. The remaining 91 patients with no hard signs were observed without imaging or surgery for a minimum of 23 hours, and none had any evidence of vascular injury during hospitalization or during the initial 2-week follow-up period (1/114; false-negative rate for physical examination, 0.9%). This series confirms the earlier report indicating that patients with zone 2 penetrating neck wounds can be safely and accurately evaluated by physical examination alone to confirm or exclude vascular injury. The missed-injury rate is 0.7% (1/145) with

  13. Role of physical activity in the occurrence of falls and fall-related injuries in community-dwelling adults over 50 years old.

    PubMed

    Pereira, Catarina L N; Baptista, Fátima; Infante, Paulo

    2014-01-01

    This study examined the effect of the type, level and amount of physical activity in falls and fall-related injuries. Participants were 506 community-dwelling adults aged >50 years (390 women: 67.7 ± 6.8 years and 116 men: 69.6 ± 6.6 years). Falls, fall-related injuries (slight and severe), and physical activity (type, level and energy expenditure) were evaluated by questionnaires. Confounders included co-morbidities, fear of falling, environmental hazards and physical fitness. After adjustment for confounders, logistic analysis revealed that the likelihood of falling decreased by 2% for each 100 metabolic expenditure (MET-min/week) of total physical activity and increased by 5% for each 100 MET-min/week of vigorous-intensity physical activity; total physical activity >1125 MET-min/week and vigorous physical activity <500 MET-min/week were identified as cut-off values discriminating non-fallers from fallers. Compared to the low physical activity level, increased physical activity levels diminished the likelihood of the occurrence of severe fall-related injuries by 76% (moderate) and 58% (high; p < 0.05) in fallers. Being active, especially sufficiently active, reduces fall-related injuries by decreasing falls and by safeguarding against severe injuries when falls occur. At least 1125 MET-min/week of total physical activity including >500 MET-min/week of vigorous intensity seems to prevent falls and, therefore, fall-related injuries.

  14. Laparoscopic cholecystectomy poses physical injury risk to surgeons: analysis of hand technique and standing position.

    PubMed

    Youssef, Yassar; Lee, Gyusung; Godinez, Carlos; Sutton, Erica; Klein, Rosemary V; George, Ivan M; Seagull, F Jacob; Park, Adrian

    2011-07-01

    This study compares surgical techniques and surgeon's standing position during laparoscopic cholecystectomy (LC), investigating each with respect to surgeons' learning, performance, and ergonomics. Little homogeneity exists in LC performance and training. Variations in standing position (side-standing technique vs. between-standing technique) and hand technique (one-handed vs. two-handed) exist. Thirty-two LC procedures performed on a virtual reality simulator were video-recorded and analyzed. Each subject performed four different procedures: one-handed/side-standing, one-handed/between-standing, two-handed/side-standing, and two-handed/between-standing. Physical ergonomics were evaluated using Rapid Upper Limb Assessment (RULA). Mental workload assessment was acquired with the National Aeronautics and Space Administration-Task Load Index (NASA-TLX). Virtual reality (VR) simulator-generated performance evaluation and a subjective survey were analyzed. RULA scores were consistently lower (indicating better ergonomics) for the between-standing technique and higher (indicating worse ergonomics) for the side-standing technique, regardless of whether one- or two-handed. Anatomical scores overall showed side-standing to have a detrimental effect on the upper arms and trunk. The NASA-TLX showed significant association between the side-standing position and high physical demand, effort, and frustration (p<0.05). The two-handed technique in the side-standing position required more effort than the one-handed (p<0.05). No difference in operative time or complication rate was demonstrated among the four procedures. The two-handed/between-standing method was chosen as the best procedure to teach and standardize. Laparoscopic cholecystectomy poses a risk of physical injury to the surgeon. As LC is currently commonly performed in the United States, the left side-standing position may lead to increased physical demand and effort, resulting in ergonomically unsound conditions for

  15. Operational Physical Performance and Fitness in Military Women: Physiological, Musculoskeletal Injury, and Optimized Physical Training Considerations for Successfully Integrating Women Into Combat-Centric Military Occupations.

    PubMed

    Nindl, Bradley C; Jones, Bruce H; Van Arsdale, Stephanie J; Kelly, Karen; Kraemer, William J

    2016-01-01

    This article summarizes presentations from a 2014 United States Department of Defense (DoD) Health Affairs Women in Combat symposium addressing physiological, musculoskeletal injury, and optimized physical training considerations from the operational physical performance section. The symposium was held to provide a state-of-the-science meeting on the U.S. DoD's rescinding of the ground combat exclusion policy opening up combat-centric occupations to women. Physiological, metabolic, body composition, bone density, cardiorespiratory fitness, and thermoregulation differences between men and women were briefly reviewed. Injury epidemiological data are presented within military training and operational environments demonstrating women to be at a higher risk for musculoskeletal injuries than men. Physical training considerations for improved muscle strength and power, occupational task performance, load carriage were also reviewed. Particular focus of this article was given to translating physiological and epidemiological findings from the literature on these topics toward actionable guidance and policy recommendations for military leaders responsible for military physical training doctrine: (1) inclusion of resistance training with special emphasis on strength and power development (i.e., activation of high-threshold motor units and recruitment of type II high-force muscle fibers), upper-body strength development, and heavy load carriage, (2) moving away from "field expediency" as the major criteria for determining military physical training policy and training implementation, (3) improvement of load carriage ability with emphasis placed on specific load carriage task performance, combined with both resistance and endurance training, and (4) providing greater equipment resources, coaching assets, and increased training time dedicated to physical readiness training. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

  16. Incidence of Self-Reported Interpersonal Violence Related Physical Injury in Iran

    PubMed Central

    Salamati, Payman; Rahimi-Movaghar, Afarin; Motevalian, Seyed Abbas; Amin-Esmaeili, Masoumeh; Sharifi, Vandad; Hajebi, Ahmad; Rad Goodarzi, Reza; Hefazi, Mitra; Naji, Zohrehsadat; Saadat, Soheil; Rahimi-Movaghar, Vafa

    2015-01-01

    Background: Violence is the cause of death for 1.5 million people in a year. Objectives: Our study aimed to estimate the incidence rate of self-reported interpersonal violence related physical injury (VRPI) and its associated factors in Iran. Patients and Methods: The sample included people ranged from 15 to 64 years old who were residing in Iran. A total of 1525 clusters were selected from the whole country. Six families were selected from each cluster via a systematic random sampling method. Then, the residential units were identified and the interviewers contacted the inhabitants. In the next step, one of the family members was selected by using Kish grid method. The instrument was a researcher-made questionnaire and consisted of two sections; demographics and project related data. Face validity and content validity of our questionnaire were investigated based on expert opinions and the reliability was confirmed by a pilot study, as well. The inclusion criteria were considered for choosing the interviewers. An interviewer was assigned for each 42 participants (7 clusters). An educational seminar was held for the administrative managers (54 persons) and interviewers (230 persons) for a week. The field work was distributed among all 46 Medical Sciences universities in Iran. In each university, administrative issues were related to an executive director. Mann-Whitney U test and odds ratio were used to analyze the data with 95% confidence interval. α value was considered less than 5%. Results: The frequency of VRPI among 7886 participants was 24 during the last three months. The incidence rate of interpersonal VRPI was estimated at 3.04 per 1000 population (95% CI: 2.66-3.42) during a three-month interval in Iran. The incidence was 4.72 per 1000 population (95% CI: 4.01-5.43) for males and 1.78 per 1000 population (95% CI: 1.39-2.17) for females during a three-month interval. The mean (SD) of age of the participants with and without a history of VRPI were 26.5 (7

  17. Incidence of self-reported interpersonal violence related physical injury in iran.

    PubMed

    Salamati, Payman; Rahimi-Movaghar, Afarin; Motevalian, Seyed Abbas; Amin-Esmaeili, Masoumeh; Sharifi, Vandad; Hajebi, Ahmad; Rad Goodarzi, Reza; Hefazi, Mitra; Naji, Zohrehsadat; Saadat, Soheil; Rahimi-Movaghar, Vafa

    2015-03-01

    Violence is the cause of death for 1.5 million people in a year. Our study aimed to estimate the incidence rate of self-reported interpersonal violence related physical injury (VRPI) and its associated factors in Iran. The sample included people ranged from 15 to 64 years old who were residing in Iran. A total of 1525 clusters were selected from the whole country. Six families were selected from each cluster via a systematic random sampling method. Then, the residential units were identified and the interviewers contacted the inhabitants. In the next step, one of the family members was selected by using Kish grid method. The instrument was a researcher-made questionnaire and consisted of two sections; demographics and project related data. Face validity and content validity of our questionnaire were investigated based on expert opinions and the reliability was confirmed by a pilot study, as well. The inclusion criteria were considered for choosing the interviewers. An interviewer was assigned for each 42 participants (7 clusters). An educational seminar was held for the administrative managers (54 persons) and interviewers (230 persons) for a week. The field work was distributed among all 46 Medical Sciences universities in Iran. In each university, administrative issues were related to an executive director. Mann-Whitney U test and odds ratio were used to analyze the data with 95% confidence interval. α value was considered less than 5%. The frequency of VRPI among 7886 participants was 24 during the last three months. The incidence rate of interpersonal VRPI was estimated at 3.04 per 1000 population (95% CI: 2.66-3.42) during a three-month interval in Iran. The incidence was 4.72 per 1000 population (95% CI: 4.01-5.43) for males and 1.78 per 1000 population (95% CI: 1.39-2.17) for females during a three-month interval. The mean (SD) of age of the participants with and without a history of VRPI were 26.5 (7.21) and 33.05 (12.05) years, respectively (P = 0

  18. Physical therapy after spinal cord injury: A systematic review of treatments focused on participation

    PubMed Central

    Gómara-Toldrà, Natàlia; Sliwinski, Martha; Dijkers, Marcel P.

    2014-01-01

    Context Over the last four decades, the focus of spinal cord injury (SCI) rehabilitation has shifted from medical management to issues that affect quality of life and community participation. Physical therapists (PTs) need to design and implement interventions that result in maximal participation to provide an individual with SCI an effective rehabilitation program. Objective The aim of this review is to assess the extent, content, and outcomes of physical therapy (PT) interventions focused on improving the participation of individuals with SCI. Methods A search was conducted in Medline, Embase, CENTRAL, CINAHL, PEDro, and PsycINFO. We included studies, of all designs, focused on improving the participation of individuals with SCI using PT interventions.The primary author and a reviewer independently selected articles for inclusion, assessed articles quality, and extracted the data. Results Five studies met the inclusion criteria. The interventions applied were 9- and 12-month body weight-supported treadmill training in two studies, a supervised 9-month exercise program, a 12-week home exercise program, and a 10-week multidisciplinary cognitive behavioral program for coping with chronic neuropathic pain. Four of five PT interventions positively impacted the individual's perceived participation and satisfaction with participation. Conclusion The body of research by PTs on interventions to improve participation is limited. PTs must document the effects of interventions with a valid outcome tool to enable more research that examines participation. Expanding participation research will allow PTs to meet the needs of individuals with SCI and identify what interventions best facilitate integration into the community. PMID:24621042

  19. Regulation of jasmonic acid biosynthesis by silicon application during physical injury to Oryza sativa L.

    PubMed

    Kim, Yoon-Ha; Khan, Abdul Latif; Waqas, Muhammad; Jeong, Hee-Jeong; Kim, Duk-Hwan; Shin, Jeong Sheop; Kim, Jong-Guk; Yeon, Myung-Hun; Lee, In-Jung

    2014-07-01

    We investigated the effects of silicon (Si) application on rice plants (Oryza sativa L.) and its responses in the regulation of jasmonic acid (JA) during wounding stress. Endogenous JA was significantly higher in wounded rice plants than in non-wounded. In contrast, Si treatment significantly reduced JA synthesis as compared to non-Si applications under wounding stress. mRNA expression of O. sativa genes showed down-regulation of lipoxygenase, allene oxide synthase 1, allene oxide synthase 2, 12-oxophytodienoate reductase 3, and allene oxide cyclase upon Si application and wounding stress as compared to non-Si-treated wounded rice plants. The physical injury-induced-oxidative stress was modulated by Si treatments, which resulted in higher catalase, peroxidase, and polyphenol oxidase activities as compared with non-Si-treated plants under wounding stress. The higher Si accumulation in rice plants also reduced the level of lipid peroxidation, which helped the rice plants to protect it from wounding stress. In conclusion, Si accumulation in rice plants mitigated the adverse effects of wounding through regulation of antioxidants and JA.

  20. Physical and rehabilitation medicine (PRM) care pathways: adults with severe traumatic brain injury.

    PubMed

    Pradat-Diehl, P; Joseph, P-A; Beuret-Blanquart, F; Luauté, J; Tasseau, F; Remy-Neris, O; Azouvi, P; Sengler, J; Bayen, É; Yelnik, A; Mazaux, J-M

    2012-11-01

    This document is part of a series of guidelines documents designed by the French Physical and Rehabilitation Medicine Society (SOFMER) and the French Federation of PRM (FEDMER). These reference documents focus on a particular pathology (here patients with severe TBI). They describe for each given pathology patients' clinical and social needs, PRM care objectives and necessary human and material resources of the pathology-dedicated pathway. 'Care pathways in PRM' is therefore a short document designed to enable readers (physician, decision-maker, administrator, lawyer, finance manager) to have a global understanding of available therapeutic care structures, organization and economic needs for patients' optimal care and follow-up. After a severe traumatic brain injury, patients might be divided into three categories according to impairment's severity, to early outcomes in the intensive care unit and to functional prognosis. Each category is considered in line with six identical parameters used in the International Classification of Functioning, Disability and Health (World Health Organization), focusing thereafter on personal and environmental factors liable to affect the patients' needs.

  1. Movement Repetitions in Physical and Occupational Therapy during Spinal Cord Injury Rehabilitation

    PubMed Central

    Zbogar, Dominik; Eng, Janice J; Miller, William C; Krassioukov, Andrei V; Verrier, Molly C

    2016-01-01

    Study Design Longitudinal observational study. Objective To quantify the amount of upper and lower extremity movement repetitions (i.e., voluntary movements as part of a functional task or specific motion) occurring during inpatient spinal cord injury (SCI) physical (PT) and occupational therapy (OT), and examine changes over the inpatient rehabilitation stay. Setting Two stand-alone inpatient SCI rehabilitation centres. Methods Participants 103 patients were recruited through consecutive admissions to SCI rehabilitation. Interventions Trained assistants observed therapy sessions and obtained clinical outcome measures in the second week following admission and in the second to last week prior to discharge. Main Outcome Measures PT and OT time, upper and lower extremity repetitions, and changes in these outcomes over the rehabilitation stay. Results We observed 561 PT and 347 OT sessions. Therapeutic time comprised two-thirds of total therapy time. Summed over PT and OT, median upper extremity repetitions in patients with paraplegia were 7 repetitions and in patients with tetraplegia, 42 repetitions. Lower extremity repetitions and steps primarily occurred in ambulatory patients and amounted to 218 and 115, respectively (summed over PT and OT sessions at discharge). Wilcoxon signed rank tests revealed that most repetition variables did not change significantly over the inpatient rehabilitation stay. In contrast, clinical outcomes for the arm and leg improved over this time period. Conclusions Repetitions of upper and lower extremity movement are markedly low during PT and OT sessions. Despite improvements in clinical outcomes, there was no significant increase in movement repetitions over the inpatient rehabilitation stay. PMID:27752057

  2. Nasal epithelial repair and remodeling in physical injury, infection, and inflammatory diseases.

    PubMed

    Yan, Yan; Gordon, William M; Wang, De-Yun

    2013-06-01

    To summarize the current knowledge of cellular and molecular mechanisms of nasal epithelial repair and remodeling during physical and pathophysiological conditions. Nasal epithelial repair and remodeling is a highly organized and well coordinated process, involving inflammation, proliferation, differentiation, matrix deposition, and remodeling, and is regulated by a wide variety of growth factors and cytokines. From the in-vivo and in-vitro studies conducted in both human and animal models, undifferentiated basal cells (progenitors) are able to migrate from adjacent epithelium, spread over the denuded basement membrane, and proliferate in injured regions (self-renewal) in necessary (homeostasis) or excessive (hyperplasia) degree. Progenitor cells reorient to an apical-basal polarity, and progressively differentiate into ciliated and nonciliated columnar cells and goblet cells, reconstituting a functional respiratory epithelium after several weeks. This recovery process can be observed during various types and severity of injury, and also in common nasal diseases, including acute viral, allergic, and nonallergic rhinitis, as well as chronic rhinosinusitis with and without nasal polyps. Although nearly 10 000 articles about nasal epithelium have been published in the last decade, the mechanisms underlying the nasal epithelial repair are still understood at only a superficial descriptive level. In order to advance rhinology to the next level of a comprehensive knowledge of the orchestrated genetic and molecular processes acting during epithelial repair, combined clinical and experimental studies using sophisticated investigational plans to elucidate the functions of both the protein-coding and regulatory portions of the human genome are required.

  3. Occupational, Physical, and Speech Therapy Treatment Activities during Inpatient Rehabilitation for Traumatic Brain Injury

    PubMed Central

    Beaulieu, Cynthia L.; Dijkers, Marcel P.; Barrett, Ryan S.; Horn, Susan D.; Giuffrida, Clare G.; Timpson, Misti L.; Carroll, Deborah M.; Smout, Randy J.; Hammond, Flora M.

    2015-01-01

    Objective To describe use of Occupational Therapy (OT), Physical Therapy (PT) and Speech Therapy (ST) treatment activities throughout the acute rehabilitation stay of patients with traumatic brain injuries (TBI). Design Multi-site prospective observational cohort study. Setting 9 U.S. and 1 Canadian inpatient rehabilitation settings. Participants 2130 patients admitted for initial acute rehabilitation following TBI. Patients were categorized based on admission FIM cognitive scores, resulting in 5 fairly homogenous groups. Interventions Not applicable. Main Outcome Measures Percentage of patients engaged in specific activities and mean time patients engaged in the activities, per 10-hour block of time for OT, PT, and ST combined. Results Therapy activities in OT, PT, and ST across all 5 cognitive groups had a primary focus on basic activities. While advanced activities occurred in each discipline and within each cognitive group, these advanced activities occurred with fewer patients and usually only toward the end of the rehabilitation stay. Conclusions The pattern of activities engaged in was both similar to and different from patterns seen in previous PBE studies with different rehabilitation diagnostic groups. PMID:26212399

  4. Movement repetitions in physical and occupational therapy during spinal cord injury rehabilitation.

    PubMed

    Zbogar, D; Eng, J J; Miller, W C; Krassioukov, A V; Verrier, M C

    2017-02-01

    Longitudinal observational study. To quantify the amount of upper- and lower-extremity movement repetitions (that is, voluntary movements as part of a functional task or specific motion) occurring during inpatient spinal cord injury (SCI), physical (PT) and occupational therapy (OT), and examine changes over the inpatient rehabilitation stay. Two stand-alone inpatient SCI rehabilitation centers. Participants: A total of 103 patients were recruited through consecutive admissions to SCI rehabilitation. Trained assistants observed therapy sessions and obtained clinical outcome measures in the second week following admission and in the second to last week before discharge. PT and OT time, upper- and lower-extremity repetitions and changes in these outcomes over the course of rehabilitation stay. We observed 561 PT and 347 OT sessions. Therapeutic time comprised two-thirds of total therapy time. Summed over PT and OT, the median upper-extremity repetitions in patients with paraplegia were 7 repetitions and in patients with tetraplegia, 42 repetitions. Lower-extremity repetitions and steps primarily occurred in ambulatory patients and amounted to 218 and 115, respectively (summed over PT and OT sessions at discharge). Wilcoxon-signed rank tests revealed that most repetition variables did not change significantly over the inpatient rehabilitation stay. In contrast, clinical outcomes for the arm and leg improved over this time period. Repetitions of upper- and lower-extremity movements are markedly low during PT and OT sessions. Despite improvements in clinical outcomes, there was no significant increase in movement repetitions over the course of inpatient rehabilitation stay.

  5. Psychological Aggression, Physical Aggression, and Injury in Nonpartner Relationships Among Men and Women in Treatment for Substance-Use Disorders*

    PubMed Central

    Murray, Regan L.; Chermack, Stephen T.; Walton, Maureen A.; Winters, Jamie; Booth, Brenda M.; Blow, Frederic C.

    2008-01-01

    Objective: This study focused on the prevalence and predictors of psychological aggression, physical aggression, and injury rates in nonintimate partner relationships in a substance-use disorder treatment sample. Method: The sample included 489 (76% men, 24% women) participants who completed screening measures for inclusion in a randomized control trial for an aggression-prevention treatment. Primary outcome measures included rates of past-year psychological aggression, physical aggression, and injury (both from the participant to nonpartners and from nonpartners to the participant). Potential predictors included individual factors (e.g., age, gender), developmental factors (e.g., family history of drug use, childhood physical abuse), and recent factors (e.g., depression, cocaine use). Results: Rates of participant-tononpartner psychological aggression (83%), physical aggression (61%), and injury (47%) were high, as were rates of nonpartner-to-participant aggression. Bivariate analyses revealed significant relationships between the aggression outcomes and most of the individual, developmental, and recent factors. However, multivariate analyses (zero-inflated Poisson regression) revealed that age, treatment status, current symptoms of depression, heavy periods of drinking, and cocaine use were related most frequently to the occurrence of aggression to and from nonpartners. Conclusions: Nonpartner aggression may be as common within a substance-use disorder sample as partner aggression, and it is associated with heavy drinking episodes, cocaine use, and depressive symptoms. The findings highlight the need for the development of effective violence interventions addressing violence in nonpartner relationship types. PMID:18925348

  6. Staying physically active after spinal cord injury: a qualitative exploration of barriers and facilitators to exercise participation.

    PubMed

    Kehn, Matthew; Kroll, Thilo

    2009-06-01

    While enhancing physical activity has been an essential goal of public health officials, people with physical impairments such as spinal cord injury (SCI) are more likely to live a sedentary lifestyle. Exercise has been shown to decrease the risk for many of the secondary conditions associated with SCI, including osteoporosis, cardiovascular disease, pressure ulcers, urinary tract infections, diabetes and arthritis, yet this population is rarely a target for health promotion efforts. This paper examines the self-reported exercise experiences of people with SCI using a qualitative-exploratory design. We enrolled 26 individuals with SCI (15 self-described 'exercisers' and 11 'non-exercisers') from a non-random pool of survey responders. Semi-structured phone interviews were conducted to record participants' experiences with exercise pre/post injury, barriers and facilitators to being active and perceived health impact. Regardless of exercise status, all participants reported physical activity prior to injury and expressed interest in becoming active or maintaining an active lifestyle. Participants identified a range of both motivational and socio-environmental factors that were either facilitating or constraining of such a lifestyle. Non-exercisers identified barriers to exercise, including a perceived low return on physical investment, lack of accessible facilities, unaffordable equipment, no personal assistance and fear of injury. Exercisers identified facilitators, including personal motivation, independence, availability of accessible facilities and personal assistants, fear of health complications, and weight management. Exercisers associated a greater range of specific health benefits with being active than non-exercisers. Despite motivation and interest in being exercise active, people with SCI face many obstacles. Removal of barriers coupled with promotion of facilitating factors, is vital for enhancing opportunities for physical activity and reducing the

  7. Physical Risk Factors for a Medial Elbow Injury in Junior Baseball Players: A Prospective Cohort Study of 353 Players.

    PubMed

    Sakata, Jun; Nakamura, Emi; Suzukawa, Makoto; Akaike, Atsushi; Shimizu, Kuniaki

    2017-01-01

    The physical risk factors for a medial elbow injury in junior baseball players are unknown. To identify the risk factors for an initial medial elbow injury in junior baseball players. Case-control study; Level of evidence, 3. Junior baseball players (aged 6-12 years) without a history of elbow pain underwent a clinical assessment, ultrasonography, and physical function measurements before the baseball season started. Bilateral passive range of motion (ROM) of elbow extension and flexion, external rotation (ER) and internal rotation (IR) of the shoulder, and ER and IR of the hip were measured. IR and ER strength of the shoulder and scapular muscles were measured on both sides. The thoracic kyphosis angle was measured with participants in a relaxed standing position. Before these examinations, every participant completed a questionnaire regarding his or her age, sex, total years of baseball played, position in baseball, number of balls thrown, and episodes of pain during throwing. After the initial test session, each participant was followed up for 12 months to assess for the occurrence of a new injury. Multiple regression analysis was used to identify the risk factors for a medial elbow injury. Seventy-eight players (22.1%) sustained a medial elbow injury. Age ≥9 years (odds ratio [OR], 2.708; 95% CI, 1.224-5.990), pitcher position (OR, 2.620; 95% CI, 1.389-4.941), >100 throws per day (OR, 1.936; 95% CI, 1.072-3.497), thoracic kyphosis angle ≥30° (OR, 2.501; 95% CI, 1.381-4.531), and elbow extension deficit ≥5° (OR, 1.973; 95% CI, 1.022-3.809) were significantly associated with a medial elbow injury. The incidence of an initial medial elbow injury was 22.1%. Age, number of throws per day, thoracic kyphosis angle, and elbow extension deficit are newly discovered risk factors related to physical function. Improvement of the posture and early detection of a silent elbow extension deficit may prevent a medial elbow injury.

  8. Recommendations for Prevention of Physical Training (PT)-Related Injuries: Results of a Systematic Evidence-Based Review by the Joint Services Physical Training Injury Prevention Work Group (JSPTIPWG)

    DTIC Science & Technology

    2003-10-01

    non-specific low back pain . BMC Musculoskelet Disord 2004;5(1):40-56. Heymans MW, de Vet HC, Bongers PM, Koes BW, van Mechelen W. Back schools...23(6):694-701. Baker P, Reading I, Cooper C, Coggon D. Knee disorders in the general population and their relation to occupation. Occupational...USACHPPM REPORT NO. 21-KK-08QR-08 Recommendations for Prevention of Physical Training (PT)- Related Injuries: Results of a Systematic Evidence

  9. Diagnosis of knee injuries: comparison of the physical examination and magnetic resonance imaging with the findings from arthroscopy☆

    PubMed Central

    Orlando Júnior, Nilton; de Souza Leão, Marcos George; de Oliveira, Nelson Henrique Carvalho

    2015-01-01

    Objectives To ascertain the sensitivity, specificity, accuracy and concordance of the physical examination (PE) and magnetic resonance imaging (MRI) in comparison with arthroscopy, in diagnosing knee injuries. Methods Prospective study on 72 patients, with evaluation and comparison of PE, MRI and arthroscopic findings, to determine the concordance, accuracy, sensitivity and specificity. Results PE showed sensitivity of 75.00%, specificity of 62.50% and accuracy of 69.44% for medial meniscal (MM) lesions, while it showed sensitivity of 47.82%, specificity of 93.87% and accuracy of 79.16% for lateral meniscal (LM) lesions. For anterior cruciate ligament (ACL) injuries, PE showed sensitivity of 88.67%, specificity of 94.73% and accuracy of 90.27%. For MM lesions, MRI showed sensitivity of 92.50%, specificity of 62.50% and accuracy of 69.44%, while for LM injuries, it showed sensitivity of 65.00%, specificity of 88.46% and accuracy of 81.94%. For ACL injuries, MRI showed sensitivity of 86.79%, specificity of 73.68% and accuracy of 83.33%. For ACL injuries, the best concordance was with PE, while for MM and LM lesions, it was with MRI (p < 0.001). Conclusions Meniscal and ligament injuries can be diagnosed through careful physical examination, while requests for MRI are reserved for complex or doubtful cases. PE and MRI used together have high sensitivity for ACL and MM lesions, while for LM lesions the specificity is higher. Level of evidence II – Development of diagnostic criteria on consecutive patients (with universally applied reference “gold” standard). PMID:27218085

  10. Diagnosis of knee injuries: comparison of the physical examination and magnetic resonance imaging with the findings from arthroscopy.

    PubMed

    Orlando Júnior, Nilton; de Souza Leão, Marcos George; de Oliveira, Nelson Henrique Carvalho

    2015-01-01

    To ascertain the sensitivity, specificity, accuracy and concordance of the physical examination (PE) and magnetic resonance imaging (MRI) in comparison with arthroscopy, in diagnosing knee injuries. Prospective study on 72 patients, with evaluation and comparison of PE, MRI and arthroscopic findings, to determine the concordance, accuracy, sensitivity and specificity. PE showed sensitivity of 75.00%, specificity of 62.50% and accuracy of 69.44% for medial meniscal (MM) lesions, while it showed sensitivity of 47.82%, specificity of 93.87% and accuracy of 79.16% for lateral meniscal (LM) lesions. For anterior cruciate ligament (ACL) injuries, PE showed sensitivity of 88.67%, specificity of 94.73% and accuracy of 90.27%. For MM lesions, MRI showed sensitivity of 92.50%, specificity of 62.50% and accuracy of 69.44%, while for LM injuries, it showed sensitivity of 65.00%, specificity of 88.46% and accuracy of 81.94%. For ACL injuries, MRI showed sensitivity of 86.79%, specificity of 73.68% and accuracy of 83.33%. For ACL injuries, the best concordance was with PE, while for MM and LM lesions, it was with MRI (p < 0.001). Meniscal and ligament injuries can be diagnosed through careful physical examination, while requests for MRI are reserved for complex or doubtful cases. PE and MRI used together have high sensitivity for ACL and MM lesions, while for LM lesions the specificity is higher. Level of evidence II - Development of diagnostic criteria on consecutive patients (with universally applied reference "gold" standard).

  11. Reference system of competence and engagement in adapted physical activities of people with recent spinal cord injury.

    PubMed

    Gernigon, Christophe; Pereira Dias, Catarina; Riou, François; Briki, Walid; Ninot, Grégory

    2015-01-01

    This study tested whether persons with Recent Spinal Cord Injury (RSCI) who practice adapted physical activities (APA) and those who do not differ with regard to achievement goals, physical self-perceptions, and global self-esteem. Adults with RSCI in rehabilitation centers voluntarily completed questionnaires of achievement goals and self-esteem. Then, based on whether they engaged or not in APA programs, they were considered participants or non-participants in APA. Compared to participants in APA, non-participants were more oriented toward mastery-avoidance goals and had lower scores of physical self-worth and global self-esteem. No differences were found for other achievement goals and for low-level dimensions of physical self. These findings suggest that mastery-avoidance goals are associated with a maladaptive motivational pattern when intrapersonal comparison conveys a threat for the self. Practical implications for rehabilitation programs for persons with RSCI are offered. Adapted Physical Activities (APA) programs are supervised physical activity programs in which the choice of the activity as well as the frequency, the duration, and the intensity of practice are adapted to the inpatients' capabilities. Attempts to master physical activities can be seen as threatening experiences to be avoided by persons with Recent Spinal Cord Injury (RSCI) in rehabilitation centers. Comparing one's capabilities in physical activities with those of other persons with RSCI is not motivationally detrimental with respect to the practice of these activities. Upon persons with RSCI' arrival in rehabilitation centers, physical educators should promote a friendly competitive climate in the practice of APA to help inpatients recover healthy levels of physical self-perceptions and global self-esteem as well as motivation to exercise.

  12. Effects of aquatic exercise on physical function and fitness among people with spinal cord injury: A systematic review.

    PubMed

    Li, Chunxiao; Khoo, Selina; Adnan, Athirah

    2017-03-01

    The aim of this review is to synthesize the evidence on the effects of aquatic exercise interventions on physical function and fitness among people with spinal cord injury. Six major databases were searched from inception till June 2015: MEDLINE, CINAHL, EMBASE, PsychInfo, SPORTDiscus, and Cochrane Center Register of Controlled Trials. Two reviewers independently rated methodological quality using the modified Downs and Black Scale and extracted and synthesized key findings (i.e., participant characteristics, study design, physical function and fitness outcomes, and adverse events). Eight of 276 studies met the inclusion criteria, of which none showed high research quality. Four studies assessed physical function outcomes and 4 studies evaluated aerobic fitness as outcome measures. Significant improvements on these 2 outcomes were generally found. Other physical or fitness outcomes including body composition, muscular strength, and balance were rarely reported. There is weak evidence supporting aquatic exercise training to improve physical function and aerobic fitness among adults with spinal cord injury. Suggestions for future research include reporting details of exercise interventions, evaluating other physical or fitness outcomes, and improving methodological quality.

  13. The trajectory of physical and mental health from injury to 5 years after multiple trauma: a prospective, longitudinal cohort study.

    PubMed

    Soberg, Helene L; Finset, Arnstein; Roise, Olav; Bautz-Holter, Erik

    2012-05-01

    To describe the trajectory of physical and mental health from injury to 5 years postinjury for patients with multiple trauma, and to examine predictors of recovery of physical and mental health. A prospective, longitudinal cohort study with data from injury (baseline), the return home (t1), and 1 (t2), 2 (t3), and 5 (t4) years. Hospital and community setting. Patients (N=105; mean age ± SD, 35.3±14.0y; age range, 18-67y; 83% men) with multiple trauma and a New Injury Severity Score (NISS) ≥16 treated at a regional trauma referral center. Mean NISS ± SD was 34.6±12.6, and mean Glasgow Coma Scale (GCS) score ± SD was 12.2±3.9. Not applicable. Medical Outcomes Study 36-Item Short-Form Health Survey physical component summary (PCS) and mental component summary (MCS), injury severity parameters, and World Health Organization Disability Assessment Schedule II (WHODAS II) for activities and participation. The proportion with poor physical health (<40 points on the PCS) stabilized at 56% at t4 from 81% at t1. The proportion with poor mental health (<40 points on the MCS) stabilized at 31% at t4 from 43% at t1. Generalized estimating equations showed that predictors of PCS were time points of measurement (Wald, 85.50; P<.001), GCS (B=-.48, P=.004), time in hospital/rehabilitation (B=-.22, P=.001), and the rank-transformed WHODAS II subscales Getting around (B=.16, P<.001) and Participation in society (B=.06, P=.015). Predictors of MCS were time points of measurement (Wald 13.46, P=.004), sex (men/women) (B=-4.24, P=.003), education (low/high) (B=3.43, P=.019), and WHODAS II cognitive function (B=.18, P<.001) and Participation in society (B=.18, P≤.001). Physical and mental health over the 5 years improved with time, but was still significantly below population means. The physical and mental health status stabilized, but the recovery trajectories differed for physical and mental health. Predictors of health were personal and injury-related factors and function in a

  14. Simulation of blast-induced, early-time intracranial wave physics leading to traumatic brain injury.

    SciTech Connect

    Taylor, Paul Allen; Ford, Corey C.

    2008-04-01

    U.S. soldiers are surviving blast and impacts due to effective body armor, trauma evacuation and care. Blast injuries are the leading cause of traumatic brain injury (TBI) in military personnel returning from combat. Understanding of Primary Blast Injury may be needed to develop better means of blast mitigation strategies. The objective of this paper is to investigate the effects of blast direction and strength on the resulting mechanical stress and wave energy distributions generated in the brain.

  15. Altered left ventricular performance in aging physically active mice with an ankle sprain injury.

    PubMed

    Turner, Michael J; Guderian, Sophie; Wikstrom, Erik A; Huot, Joshua R; Peck, Bailey D; Arthur, Susan T; Marino, Joseph S; Hubbard-Turner, Tricia

    2016-02-01

    We assessed the impact of differing physical activity levels throughout the lifespan, using a musculoskeletal injury model, on the age-related changes in left ventricular (LV) parameters in active mice. Forty male mice (CBA/J) were randomly placed into one of three running wheel groups (transected CFL group, transected ATFL/CFL group, SHAM group) or a SHAM Sedentary group (SHAMSED). Before surgery and every 6 weeks after surgery, LV parameters were measured under 2.5 % isoflurane inhalation. Group effects for daily distance run was significantly greater for the SHAM and lesser for the ATLF/CFL mice (p = 0.013) with distance run decreasing with age for all mice (p < 0.0001). Beginning at 6 months of age, interaction (group × age) was noted with LV posterior wall thickness-to-radius ratios (h/r) where h/r increased with age in the ATFL/CFL and SHAMSED mice while the SHAM and CFL mice exhibited decreased h/r with age (p = 0.0002). Passive filling velocity (E wave) was significantly greater in the SHAM mice and lowest for the ATFL/CFL and SHAMSED mice (p < 0.0001) beginning at 9 months of age. Active filling velocity (A wave) was not different between groups (p = 0.10). Passive-to-active filling velocity ratio (E/A ratio) was different between groups (p < 0.0001), with higher ratios for the SHAM mice and lower ratios for the ATFL/CFL and SHAMSED mice in response to physical activity beginning at 9 months of age. Passive-to-active filling velocity ratio decreased with age (p < 0.0001). Regular physical activity throughout the lifespan improved LV structure, passive filling velocity, and E/A ratio by 6 to 9 months of age and attenuated any negative alterations throughout the second half of life. The diastolic filling differences were found to be significantly related to the amount of activity performed by 9 months and at the end of the lifespan.

  16. When Physics Meets Biology: Low and High-Velocity Penetration, Blunt Impact, and Blast Injuries to the Brain

    PubMed Central

    Young, Leanne; Rule, Gregory T.; Bocchieri, Robert T.; Walilko, Timothy J.; Burns, Jennie M.; Ling, Geoffrey

    2015-01-01

    The incidence of traumatic brain injuries (TBI) in the US has reached epidemic proportions with well over 2 million new cases reported each year. TBI can occur in both civilians and warfighters, with head injuries occurring in both combat and non-combat situations from a variety of threats, including ballistic penetration, acceleration, blunt impact, and blast. Most generally, TBI is a condition in which physical loads exceed the capacity of brain tissues to absorb without injury. More specifically, TBI results when sufficient external force is applied to the head and is subsequently converted into stresses that must be absorbed or redirected by protective equipment. If the stresses are not sufficiently absorbed or redirected, they will lead to damage of extracranial soft tissue and the skull. Complex interactions and kinematics of the head, neck and jaw cause strains within the brain tissue, resulting in structural, anatomical damage that is characteristic of the inciting insult. This mechanical trauma then initiates a neuro-chemical cascade that leads to the functional consequences of TBI, such as cognitive impairment. To fully understand the mechanisms by which TBI occurs, it is critically important to understand the effects of the loading environments created by these threats. In the following, a review is made of the pertinent complex loading conditions and how these loads cause injury. Also discussed are injury thresholds and gaps in knowledge, both of which are needed to design improved protective systems. PMID:25999910

  17. When physics meets biology: low and high-velocity penetration, blunt impact, and blast injuries to the brain.

    PubMed

    Young, Leanne; Rule, Gregory T; Bocchieri, Robert T; Walilko, Timothy J; Burns, Jennie M; Ling, Geoffrey

    2015-01-01

    The incidence of traumatic brain injuries (TBI) in the US has reached epidemic proportions with well over 2 million new cases reported each year. TBI can occur in both civilians and warfighters, with head injuries occurring in both combat and non-combat situations from a variety of threats, including ballistic penetration, acceleration, blunt impact, and blast. Most generally, TBI is a condition in which physical loads exceed the capacity of brain tissues to absorb without injury. More specifically, TBI results when sufficient external force is applied to the head and is subsequently converted into stresses that must be absorbed or redirected by protective equipment. If the stresses are not sufficiently absorbed or redirected, they will lead to damage of extracranial soft tissue and the skull. Complex interactions and kinematics of the head, neck and jaw cause strains within the brain tissue, resulting in structural, anatomical damage that is characteristic of the inciting insult. This mechanical trauma then initiates a neuro-chemical cascade that leads to the functional consequences of TBI, such as cognitive impairment. To fully understand the mechanisms by which TBI occurs, it is critically important to understand the effects of the loading environments created by these threats. In the following, a review is made of the pertinent complex loading conditions and how these loads cause injury. Also discussed are injury thresholds and gaps in knowledge, both of which are needed to design improved protective systems.

  18. Pre-employment physical capacity testing as a predictor for musculoskeletal injury in paramedics: A review of the literature.

    PubMed

    Jenkins, Natasha; Smith, Gavin; Stewart, Scott; Kamphuis, Catherine

    2016-11-22

    Workplace injuries place a significant physical, social and financial burden on organisations globally. Paramedics provide emergency management of workplace injuries, and are subjected to heightened injury risk as a direct consequence of providing such care. This review aims to identify the current evidence reporting workplace musculoskeletal injury generally, and to relate this to pre-employment physical capacity testing within the paramedic industry specifically. A search of the electronic databases (Ovid Medline, Cochrane Database of Systematic Reviews, NIOSHTIC-2, RILOSH, CISDOC and HSELINE) was completed using the keywords musculoskeletal, workplace, injury, industrial, accident, pre-employment physical capacity testing, paramedic, emergency service employee, firefighter, and police. Articles were excluded if they did not describe pre-employment physical capacity testing, musculoskeletal injuries, or were not available in English. The electronic literature search identified 765 articles, following application of exclusion criteria: based on title/abstract of article (669); no relevance (62) or unavailable in English (4), 30 articles were included in this review.The review identified that physical fitness, gender, age, equipment and demographic variables were key factors in the current high rate of paramedic workplace injury. However, there is little evidence available to quantify the relationship between pre-employment physical capacity testing and subsequent injury amongst the paramedic cohort. Despite evidence suggesting that pre-employment physical capacity testing scores may be predictive of subsequent musculoskeletal injury in paramedics, there are currently no studies in this area. Quantifying the potential association between factors affecting the conduct of paramedic work and the type of injuries that result requires examination through future research.

  19. Attitudes toward People with Disabilities Caused by Illness or Injury: Beyond Physical Impairment

    ERIC Educational Resources Information Center

    Shiloh, Shoshana; Heruti, Irit; Berkovitz, Tamar

    2011-01-01

    This study examined differences in attitudes toward and reactions to individuals with comparable disabilities caused by injury or illness. Participants were students and healthcare professionals randomly assigned to read one of eight vignettes constructed in a between-subjects, full-factorial design: 2 (illness/injury)x2 (male/female)x2…

  20. Relationships between Personality Disorders, Social Disturbances, and Physical Disability Following Traumatic Brain Injury.

    ERIC Educational Resources Information Center

    Lezak, Muriel D.

    1987-01-01

    The post-injury psychosocial problems of 42 adult male head injury patients over a 3-year period were evaluated using the Portland Adaptability Inventory. In all time periods, the areas most impaired were social contact, work/school, and leisure as well as elevated frequencies of problems with anxiety, depression, and significant relationships.…

  1. Descriptive Epidemiology of Musculoskeletal Injuries in Naval Special Warfare Sea, Air, and Land Operators.

    PubMed

    Lovalekar, Mita; Abt, John P; Sell, Timothy C; Wood, Dallas E; Lephart, Scott M

    2016-01-01

    The purpose of this analysis was to describe medical chart reviewed musculoskeletal injuries among Naval Special Warfare Sea, Air, and Land Operators. 210 Operators volunteered (age: 28.1 ± 6.0 years, height: 1.8 ± 0.1 m, weight: 85.4 ± 9.3 kg). Musculoskeletal injury data were extracted from subjects' medical charts, and injuries that occurred during 1 year were described. Anatomic location of injury, cause of injury, activity when injury occurred, and injury type were described. The frequency of injuries was 0.025 per Operator per month. Most injuries involved the upper extremity (38.1% of injuries). Frequent anatomic sublocations for injuries were the shoulder (23.8%) and lumbopelvic region of the spine (12.7%). Lifting was the cause of 7.9% of injuries. Subjects were participating in training when 38.1% of injuries occurred and recreational activity/sports when 12.7% of injuries occurred. Frequent injury types were strain (20.6%), pain/spasm/ache (19.0%), fracture (11.1%), and sprain (11.1%). The results of this analysis underscore the need to investigate the risk factors, especially of upper extremity and physical activity related injuries, in this population of Operators. There is a scope for development of a focused, customized injury prevention program, targeting the unique injury profile of this population.

  2. Children at risk of residual physical problems after public road traffic injuries--a 1-year follow-up study.

    PubMed

    Olofsson, Eva; Bunketorp, Olle; Andersson, Anna-Lena

    2012-01-01

    To describe the residual physical problems 1 year after traffic injuries in children with respect to age, gender, extraction (Swedish or foreign), type of care, type of accident and use of protective equipment, type of injury, and the impact on daily living activities. Hospital data were analysed for children, aged 15 or under, after road traffic accidents in the Gothenburg region in 2000. Age, gender, type of road user, counterpart, use of protective equipment, type and severity of each injury, and type of care were related to follow-up data obtained by a self-completed questionnaire answered 1 year after the accident. The AIS90 was used for injury classification. Residual physical problems were specified, graded, and mapped on anatomical pictures of the body by the respondents. Logistic regression was used to explore independent factors for residual problems. A total of 341 children (81%) fulfilled the study. Cyclists dominated, 60%, followed by moped users, car occupants and pedestrians. The mean age was 11 years, 61% were boys, 16% were of foreign extraction, 26% were treated as inpatients, and 11% had at least one serious (AIS3+) injury. Residual problems were reported for 16% of the study group (n=53), and of these 31% were located to the lower extremities (mostly knee problems), upper extremities in 20%, face in 14%, neck in 14%, upper trunk in 8%, lower trunk in 8%, and skull/brain in 3%. Significant permanent impairment was reported in one case. Cyclists reported problems significantly less frequently than others. Children reporting problems tended to be older and were most often injured as moped users. Problems to the neck and the upper trunk were reported to a higher rate than the injury rate in these regions. Children with residual problems reported limitations in daily living activities after the accident more often than those without residual physical problems. Residual physical problems were reported in about one sixth of the study group, few with

  3. Evidence-based risk assessment and recommendations for physical activity clearance: stroke and spinal cord injury.

    PubMed

    Zehr, E Paul

    2011-07-01

    Physical activity (PA) has potential benefits after stroke or spinal cord injury (SCI), especially in improving efficiency and functional capacity in activities of daily living. Currently, many who could benefit from PA may be routinely excluded from participation because of myths related to functional capacity and the concern for harm. The purpose of this review was to evaluate the literature for reports of adverse events during exercise after stroke or SCI, and to provide recommendations regarding exercise participation in supervised and unsupervised environments. Studies were evaluated for quality, and the summary level and quality of evidence were evaluated using the AGREE rubric, modified to address the main outcome measure of adverse events. Levels of exercise stress were evaluated for aerobic activities, using an established rubric. Included in the current analysis were 32 studies for stroke and 4 for SCI. In aggregate, this yielded a total of 730 experimental participants with stroke and 143 with SCI. It should be noted that almost all studies were not designed to examine naturally occurring adverse events from PA. Significant contraindications to unsupervised exercise include manifestation of autonomic dysreflexia in SCI and cardiovascular comorbidity after stroke. There are clear benefits of exercise training on physiological outcomes in stroke and SCI, but the relation between outcomes and safety remains unclear. However, taken on balance, the risk-to-benefit ratio favors the recommendation of exercise. This recommendation is based on studies in which participants were almost universally screened for participation in supervised environments. Thus, the grading of evidence for finding adverse events to support this conclusion is inadequate.

  4. Disability, Home Physical Environment and Non-Fatal Injuries among Young Children in China

    PubMed Central

    Xiang, Hui-yun; Yu, Chuan-hua; Du, Yu-kai

    2012-01-01

    Objectives We compared the patterns of medically attended injuries between children with and without disabilities and explored the residential environment risks in five counties of Hubei Province in the People's Republic of China by a 1∶1 matched case-control study based on the biopsychosocial model of the International Classification of Functioning, Disability and Health – ICF. Methods 1201 children aged 1–14 with disabilities and 1201 their healthy counterparts matched as having the same gender, same age, and lived in the same neighborhood were recruited in our study. Characteristics of injuries in the past 12 months were compared between children with and without disabilities. The associations among disability status, home environment factors and injuries were examined in logistic regression analysis taking into account sociodemographic factors. Results Children with disabilities had a significantly higher prevalence of injury than children without disabilities (10.2% vs. 4.4%; P<.001). The two groups differed significantly in terms of number of injury episodes, injury place and activity at time of injury. Falls were the leading mechanism of injury regardless of disability status. Most of the injury events happened inside the home and leisure activities were the most reported activity when injured for both groups. The univariate OR for injury was 4.46 (2.57–7.74) for the disabled children compared with the non-disabled children. Disabled children whose family raised cat/dog(s) were 76% more likely to be injured during the last 12 months (OR = 1.76; 95% CI = 1.02, 3.02),comparing with those whose family did not have any cat/dog. And for children without disabilities, those whose family had cat/dog(s) were over 3 times more likely to having injuries comparing with those whose family did not have any cat/dog. Conclusions Children with disabilities had a significantly increased risk for injury. Interventions to prevent residential injury are an

  5. Rugby injuries.

    PubMed

    McIntosh, Andrew S

    2005-01-01

    The purpose of this chapter is to review critically the existing studies on the epidemiology of pediatric rugby injuries and discuss suggestions for injury prevention and further research. Data were sourced from the sports medicine and science literature mainly since 1990, and from a prospective injury surveillance project in rugby undertaken by the University of New South Wales (UNSW) in Sydney during 2002. Literature searches were performed using Medline and SportsDiscus. Reported injury rates were between 7 and 18 injuries per 1,000 hours played, with the rate of injuries resulting in loss of playing or training time measured at 6.5-10.6 per 1,000 hours played. Injury rates increased with age and level of qualification. Head injury and concussion accounted for 10-40% of all injuries. In the UNSW study, concussion accounted for 25% of injuries resulting in loss of playing or training time in the under 13 year age group. Upper and lower extremity injuries were equally apportioned, with musculoskeletal injuries being the main type of injury. Fractures were observed in the upper extremity and ankle, and joint/ligament injuries affected the shoulder, knee and ankle. The tackle was associated with around 50% of all injuries. The scrum produced fewer injuries, but is historically associated with spinal cord injury. Rugby is a contact sport with injury risks related to physical contact, primarily in the tackle. Most injuries affect the musculoskeletal system, with the exception of concussion. Spinal cord injury is rare, but catastrophic. Research is required to understand better injury risks and to reduce the incidence of shoulder, knee and ankle joint injuries, concussion and spinal injury.

  6. Correlates of self-reported physical function in individuals with spinal cord injuries and disorders: does self-efficacy matter?

    PubMed

    Hill, J N; Etingen, B; Miskevics, S; LaVela, S L

    2017-06-06

    Data were collected via a cross-sectional mailed survey with Veterans with spinal cord injury and disorders (SCI/D). To examine self-efficacy in Veterans with SCI/D reporting high versus low perceptions of physical function. Department of Veterans Affairs (VA) Spinal Cord Injury System of Care-nation-wide, 24 Spinal Cord Injury (SCI) Centers. The survey provided patient-reported data on demographic and injury characteristics, basic mobility and fine motor function, and perceived self-efficacy. Bivariate comparisons were conducted to compare perceptions of self-efficacy between Veterans with SCI/D reporting perceptions of 'high' versus 'low' basic mobility and fine motor function. A multivariate logistic regression was conducted to identify factors independently associated with high physical function when controlling for covariates. Response rate (896/1452=61.7%). Multivariate analysis showed that age (odds ratio (OR)=0.98, 95% confidence interval (CI): 0.96-1.00, P=0.03), tetraplegia (OR=0.20, 95% CI: 0.13-0.32, P⩽0.0001), diabetes (OR=0.53, 95% CI: 0.31-0.91, P=0.02), depression (OR=0.62, 95% CI: 0.39-0.98, P=0.04) and pressure ulcers (OR=0.42, 95% CI: 0.25-0.72, P=0.001) were all independently associated with lower odds of high physical function. When controlling for covariates, persons with high self-efficacy were nearly two times more likely to have high physical function (OR=1.98, 95% CI: 1.22-3.22, P=0.01). Lower perceptions of basic mobility and fine motor function among individuals with SCI/D were correlated with lower self-efficacy, even when controlling for other covariates. The relationship between physical function and self-efficacy suggests that interventions focused on improving self-efficacy or physical function may also see improvements in the other. Further, studies exploring the impact of interventions on the relationship between self-efficacy and physical function are needed to understand the relationship between the two.Spinal Cord advance

  7. Effect of structured physical activity on prevention of serious fall injuries in adults aged 70-89: randomized clinical trial (LIFE Study)

    USDA-ARS?s Scientific Manuscript database

    OBJECTIVE: To test whether a long term, structured physical activity program compared with a health education program reduces the risk of serious fall injuries among sedentary older people with functional limitations. DESIGN: Multicenter, single blinded randomized trial (Lifestyle Interventions and ...

  8. The fitness training unit in U.S. Army basic combat training: physical fitness, training outcomes, and injuries.

    PubMed

    Knapik, J J; Canham-Chervak, M; Hoedebecke, E; Hewitson, W C; Hauret, K; Held, C; Sharp, M A

    2001-04-01

    This study involved a retrospective examination of physical fitness, training outcomes, and injury rates among personnel in the Fitness Training Unit (FTU). Personnel were assigned to the FTU based on low performance on push-ups, sit-ups, and/or a 1-mile run (N = 44 men, 95 women) and received an augmented physical fitness program before basic combat training (BCT). They were compared with 712 men and 379 women who took the same test but were not assigned to the FTU and went directly to BCT. FTU and non-FTU personnel trained in the same battalions. Army Physical Fitness Test scores and BCT outcomes (discharged or completed BCT in 8 weeks) were obtained from unit training records. Injuries during BCT were documented from a review of the medical records. On entry to BCT, FTU women had similar 2-mile run times compared with non-FTU women (21.6 vs. 21.5 minutes, respectively; p = 0.86); FTU men were considerably slower on the 2-mile run than non-FTU men (20.3 vs. 17.3 minutes; p < 0.01). FTU women and non-FTU women had similar graduation success (60% vs. 68%, respectively; p = 0.14) and time-loss injury rates (1.3 vs. 1.4 people injured/100 person-days, respectively; p = 0.90). FTU men were less likely to graduate than non-FTU men (55% vs. 82%; p < 0.01) and more likely to suffer a time-loss injury (1.2 vs. 0.7 people injured/100 person-days; p < 0.01). Efforts should be directed toward providing a sufficient training stimulus to improve the aerobic fitness level of men (as well as women) in the FTU.

  9. Feasibility and results of a case study of yoga to improve physical functioning in people with chronic traumatic brain injury.

    PubMed

    Schmid, Arlene A; Miller, Kristine K; Van Puymbroeck, Marieke; Schalk, Nancy

    2016-01-01

    The purpose of this mixed-methods case study was to investigate whether an 8-week 1:1 yoga program was feasible and beneficial to people with traumatic brain injury (TBI). This was a mixed-methods case study of one-to-one yoga for people with TBI included three people. We completed assessments before and after the 8-week yoga intervention and included measures of balance, balance confidence, pain, range of motion, strength and mobility. Qualitative interviews were included at the post-assessment. We include a percent change calculation and salient quotes that represent the perceived impact of the yoga intervention. All participants completed the yoga intervention and all demonstrated improvements in physical outcome measures. For the group, balance increased by 36%, balance confidence by 39%, lower extremity strength by 100% and endurance by 105%. Qualitative data support the use of yoga to improve multiple aspects of physical functioning, one participant stated: "I mean it's rocked my world. It's changed my life. I mean all the different aspects. I mean physically, emotionally, mentally, it's given me you know my life back…". Yoga, delivered in a one-to-one setting, appears to be feasible and beneficial to people with chronic TBI. Chronic traumatic brain injury (TBI) leads to many aspects of physical functioning impairment. Yoga delivered in a one-to-one setting may be feasible and beneficial for people with chronic TBI.

  10. Exercise self-efficacy and the relation with physical behavior and physical capacity in wheelchair-dependent persons with subacute spinal cord injury.

    PubMed

    Nooijen, Carla F J; Post, Marcel W M; Spooren, Annemie L; Valent, Linda J; Broeksteeg, Rogier; Sluis, Tebbe A; Stam, Henk J; van den Berg-Emons, Rita J G

    2015-11-19

    Since physical activity and exercise levels are known to be generally low in persons with spinal cord injury (SCI), there seems to be a need for intervention. Exercise self-efficacy (ESE), the confidence persons have in their ability to be physically active and exercise, is an important and modifiable predictor of physical behavior. The goal of this study was to 1) describe ESE in persons with subacute SCI, 2) to assess ESE in subgroups based on demographic and lesion characteristics, and 3) to explore the relation between ESE and physical behavior and physical capacity. Thirthy-seven persons with subacute SCI who are wheelchair dependent participated. Participants completed the Exercise Self-Efficacy Scale. We recorded age and lesion characteristics, measured physical behavior (physical activity, motility and sedentary day time, n = 35) with an accelerometer-based activity monitor and measured physical capacity (peak power output, n = 28 and peak oxygen uptake, n = 24) during a maximal hand-cycling test. Measurements were performed 2 months prior to discharge from inpatient rehabilitation. Mann-Whitney tests were used to test for differences between subgroups based on age and lesion characteristics and spearman correlations were used to assess the relation between ESE and physical activity and physical capacity. Persons with tetraplegia had lower ESE compared to persons with paraplegia (Z = -1.93, p = 0.05). No differences in ESE were found between subgroups based on age and motor completeness of the lesion. In persons with paraplegia, ESE was positively related to peak power output (ρ = 0.58, p = 0.02). The relation of ESE with wheeled physical activity was ρ = 0.36, p = 0.09. In persons with SCI who are dependent on a manual wheelchair, lesion level when categorized as paraplegic and tetraplegic affected ESE whereas age categories and completeness categories did not. Persons with tetraplegia were found to have lower confidence

  11. The role of parents and temperament on children's estimation of physical ability: links to unintentional injury prevention.

    PubMed

    Schwebel, David C; Bounds, Marjorie L

    2003-01-01

    Unintentional injuries, the leading cause of pediatric mortality, are caused by a complex set of intrapersonal and environmental factors. The role of three critical variables--parental supervision, children's temperament, and estimation of children's physical abilities--was examined. Sixty-four 6- and 8-year-old children completed a laboratory experiment with a parent. Both children and parents judged the child's ability to complete reaching, stepping, and crouching tasks. Parents also completed a parent-report measure of children's temperament. Both children and parents overestimated children's ability, although children did so more than parents. Parents of temperamentally impulsive and undercontrolled children judged that their children could complete tasks that were actually beyond the child's ability. Temperament also affected children's judgments while parents were known to be present or absent: Temperamentally impulsive and undercontrolled children were more accurate in their judgments when parents were standing next to them than when parents were hidden from view behind a one-way mirror. The mechanism by which parental supervision might protect children from injury appears to be at least twofold: (a) Parents overestimate children's ability less frequently than children themselves, suggesting supervising parents could intervene to prevent children from attempting dangerous activities; and (b) children judge their physical abilities more cautiously when parents are present. Implications for temperament theory and for injury prevention are discussed.

  12. Attitudes toward people with disabilities caused by illness or injury: beyond physical impairment.

    PubMed

    Shiloh, Shoshana; Heruti, Irit; Berkovitz, Tamar

    2011-12-01

    This study examined differences in attitudes toward and reactions to individuals with comparable disabilities caused by injury or illness. Participants were students and healthcare professionals randomly assigned to read one of eight vignettes constructed in a between-subjects, full-factorial design: 2 (illness/injury)× 2 (male/female)× 2 (visible/not visible). Participants completed questionnaires measuring reactions to the target person and attitudes toward people with disabilities. We found that both students and healthcare professionals expressed more positive attitudes toward persons with injury-related compared with illness-related disabilities, but that these differences were typically not expressed in reported social encounters with individual disabled persons. The effects of the illness-injury distinction were moderated by sex only among students, with the highest distancing reported from a female with an illness-related disability. Visibility of the disability triggered more social distancing among students, regardless of the injury-illness distinction. We concluded that the illness-injury distinction is a socially and psychologically significant factor.

  13. Wheelchair-specific fitness of persons with a long-term spinal cord injury: cross-sectional study on effects of time since injury and physical activity level.

    PubMed

    de Groot, Sonja; van der Scheer, Jan W; Bakkum, Arjan J T; Adriaansen, Jacinthe J E; Smit, Christof A; Dijkstra, Catja; Post, Marcel W M; van der Woude, Lucas H V

    2016-01-01

    To study the impact of time since injury (TSI) and physical activity (PA) on fitness of persons with spinal cord injury (SCI). Cross-sectional study. Persons with SCI (N = 158) in three TSI strata: 10-19, 20-29 and ≥30 years after SCI and divided in an active and inactive group. Fitness [peak power output (POpeak) and peak oxygen uptake (VO2peak)] was assessed. In persons with tetraplegia, no significant relationship was found between TSI and fitness after controlling for confounders, while a higher activity level was related to a higher POpeak in this group. Active people with tetraplegia also showed less decline in POpeak with an increase in TSI compared to inactive people. In persons with paraplegia, after controlling for confounders, it was shown that TSI had a negative effect on POpeak, while PA was not significantly associated with fitness in people with paraplegia. In people with paraplegia, fitness was significantly lower in those with a longer TSI. Persons with a long TSI might need more attention to remain fit and PA might be an important element in that respect as shown by the results of the group with a tetraplegia. Wheelchair-specific fitness seems to diminish over time after paraplegia. An active lifestyle is related to wheelchair-specific fitness in persons with tetraplegia. Prevention of long-term deconditioning is very important.

  14. The relationship between ACL injuries and physical fitness in young competitive ski racers: a 10-year longitudinal study.

    PubMed

    Raschner, Christian; Platzer, Hans-Peter; Patterson, Carson; Werner, Inge; Huber, Reinhard; Hildebrandt, Carolin

    2012-12-01

    Epidemiological studies have shown a high incidence of anterior cruciate ligament (ACL) injuries among competitive alpine skiers. Little is known regarding modifiable risk factors in young skiers. There are still uncertainties in gender-related risk factors. The purpose of this study was to determine the relationship between ACL injuries and internal risk factors. Retrospective data analyses were performed based on a group of 175 female and 195 male alpine ski racers between the ages of 14 and 19 years. The athletes underwent physical testing annually from 1996 to 2006. Z score transformations normalised the age groups. Multivariate binary logistic regressions were calculated for men and women separately to detect significant predictors of ACL ruptures. t Tests were computed to reveal the differences in test scores between injured and non-injured athletes. A total of 57 (15%) ACL injuries occurred. The female-male risk ratio (RR) was higher in females (2.3, 95% CI 1.3 to 4.2). Z scores for relative leg force, ratio of absolute core flexion to extension force, relative core strength and reactive strength index were predictive variables for men. Z scores of all of these predictive variables except relative leg force were higher in the non-injured group. The ratios of absolute flexion to extension force and absolute core strength were predictive covariates for women. Z scores for absolute core strength were higher in the non-injured group. The risk of ACL injury was greater in female athletes. The findings suggest that core strength is a predominant critical factor for ACL injuries in young ski racers.

  15. Psychological distress after physical injury: a one-year follow-up study of conscious hospitalised patients.

    PubMed

    Skogstad, Laila; Tøien, Kirsti; Hem, Erlend; Ranhoff, Anette Hylen; Sandvik, Leiv; Ekeberg, Øivind

    2014-01-01

    Acute physical injury may lead to psychological distress. The relationship between peritraumatic responses, injury severity, the personality trait of optimism/pessimism and psychological distress is not fully understood. In addition, the development of post-traumatic stress symptoms may differ in subgroups. One hundred and eighty-one patients (18-65 years) completed questionnaires 1 (baseline), 3 and 12 months after first admission for acute physical injury. All patients were conscious on arrival. Scores on the Casualty Chain Inventory (CCI) for peritraumatic responses, the Impact of Event Scale (IES), the Hospital Anxiety and Depression Scale (HADS), the Life Orientation Test-Revised (LOT-R), trauma-related variables (ISS, Abbreviated Injury Scale [AIS], Glasgow Coma Scale [GCS]), and background variables were assessed. Mean IES scores were 21.5 (95% CI: 19.0-24.0) at baseline and 15.8 (13.5-18.1) at 12 months (p<0.001). One subgroup (delayed onset, 12.2%) had an increase of at least 10 points in the IES score and another subgroup (chronic, 13.3%) had high and persistent post-traumatic stress symptoms during the follow-up period. At baseline, 45.3% had an IES score ≥ 20, indicating possible clinical case levels, compared with 33.1% at 12 months. Accordingly, 14% had anxiety symptoms and 10.8% had depression symptoms at a case level (HADS ≥ 8) at one-year follow-up. Mutually independent predictors of post-traumatic stress symptoms at 12 months were dissociation (OR 1.3, 95% CI: 1.1-1.6) and perception (OR 1.1, 95% CI: 1.0-1.3) measured by the CCI. Being in work before injury (OR 0.1, 95% CI: 0.02-0.4) and higher educational level (OR 0.3, 95% CI: 0.1-0.7) were associated with fewer IES symptoms. Dissociation and having a pessimistic trait predicted anxiety and depression at 12 months. Previous psychiatric problems predicted anxiety symptoms, and high educational level predicted less depression symptoms. One-third of conscious physical injured patients had post

  16. Stat 6-dependent induction of myeloid derived suppressor cells after physical injury regulates nitric oxide response to endotoxin.

    PubMed

    Munera, Veronica; Popovic, Petar J; Bryk, Jodie; Pribis, John; Caba, David; Matta, Benjamin M; Zenati, Mazen; Ochoa, Juan B

    2010-01-01

    To delineate the role of T-helper 2 (Th2) cytokines in the induction of trauma induced myeloid suppressor cells (TIMSC) and the regulation of nitric oxide production. Trauma induces myeloid cells that express CD11b+/Gr1+ and arginase 1 and exhibit an immune suppressing activity. This article explores the mechanisms that induce TIMSC and the effects on nitric oxide production in response to endotoxin. TIMSC were studied in response to Th2 cytokines and a subsequent challenge to endotoxin. The role of Th2 cytokines was studied in STAT6-/- mice. Accumulation of TIMSC in spleens was studied using flow cytometry and immunhistochemistry. Plasma was recovered to measure accumulation of nitric oxide metabolites. TIMSC accumulated in the spleen of injured mice and were particularly sensitive to IL-4 and IL-13 with large inductions of arginase activity. Significant blunting in both the accumulation of TIMSC in the spleen and induction of arginase 1 was observed in STAT6-/- mice after physical injury. Accumulation of nitric oxide metabolites to endotoxin was observed in STAT6-/- mice. This study shows that induction of CD11b+/Gr1+ cells after physical injury play an essential role in the regulation of nitric oxide production after a septic challenge. The accumulation and induction of arginase 1 in TIMSC is Th2 cytokine dependent. To our knowledge, the role of TIMSC in the regulation of nitric oxide is a novel finding. This observation adds to the possibility that TIMSC could play an important role in immunosuppression observed after physical injury.

  17. Physical demands and injuries to the upper extremity associated with the space program.

    PubMed

    Viegas, Steven F; Williams, David; Jones, Jeffrey; Strauss, Samuel; Clark, Jonathan

    2004-05-01

    Hand and upper-extremity overuse and repetitive injuries in astronauts have been and continue to be a common problem in the space program. The demands on upper-extremity use in the astronaut training program, the zero-gravity environment, the extreme temperature conditions of space, the effects of space travel on human physiology/anatomy, and the constraints and pressures of space suits and gloves all can negatively impact upper-extremity function in ways that can result in overuse/repetitive injuries. Future plans for space exploration include endeavors that will continue and even increase the demands on the hand and upper extremity.

  18. Linking blast physics to biological outcomes in mild traumatic brain injury: Narrative review and preliminary report of an open-field blast model.

    PubMed

    Song, Hailong; Cui, Jiankun; Simonyi, Agnes; Johnson, Catherine E; Hubler, Graham K; DePalma, Ralph G; Gu, Zezong

    2016-08-21

    Blast exposures are associated with traumatic brain injury (TBI) and blast-induced TBIs are common injuries affecting military personnel. Department of Defense and Veterans Administration (DoD/VA) reports for TBI indicated that the vast majority (82.3%) has been mild TBI (mTBI)/concussion. mTBI and associated posttraumatic stress disorders (PTSD) have been called "the invisible injury" of the current conflicts in Iraq and Afghanistan. These injuries induce varying degrees of neuropathological alterations and, in some cases, chronic cognitive, behavioral and neurological disorders. Appropriate animal models of blast-induced TBI will not only assist the understanding of physical characteristics of the blast, but also help to address the potential mechanisms. This report provides a brief overview of physical principles of blast, injury mechanisms related to blast exposure, current blast animal models, and the neurological behavioral and neuropathological findings related to blast injury in experimental settings. We describe relationships between blast peak pressures and the observed injuries. We also report preliminary use of a highly reproducible and intensity-graded blast murine model carried out in open-field with explosives, and describe physical and pathological findings in this experimental model. Our results indicate close relationships between blast intensities and neuropathology and behavioral deficits, particularly at low level blast intensities relevant to mTBI.

  19. Physical Therapy Activities in Stroke, Knee Arthroplasty, and Traumatic Brain Injury Rehabilitation: Their Variation, Similarities, and Association With Functional Outcomes

    PubMed Central

    Hsieh, Ching-Hui; Putman, Koen; Smout, Randall J.; Horn, Susan D.; Tian, Wenqiang

    2011-01-01

    Background The mix of physical therapy services is thought to be different with different impairment groups. However, it is not clear how much variation there is across impairment groups. Furthermore, the extent to which the same physical therapy activities are associated with functional outcomes across different types of patients is unknown. Objective The purposes of this study were: (1) to examine similarities and differences in the mix of physical therapy activities used in rehabilitation among patients from different impairment groups and (2) to examine whether the same physical therapy activities are associated with functional improvement across impairment groups. Design This was a prospective observational cohort study. Methods The study was conducted in inpatient rehabilitation facilities. The participants were 433 patients with stroke, 429 patients with total knee arthroplasty (TKA), and 207 patients with traumatic brain injury (TBI). Measures used in this study included: (1) the Comprehensive Severity Index to measure the severity of each patient's medical condition, (2) the Functional Independence Measure (FIM) to measure function, and (3) point-of-care instruments to measure time spent in specific physical therapy activities. Results All 3 groups had similar admission motor FIM scores but varying cognitive FIM scores. Patients with TKA spent more time on exercise than the other 2 groups (average=31.7 versus 6.2 minutes per day). Patients with TKA received the most physical therapy (average=65.3 minutes per day), whereas the TBI group received the least physical therapy (average=38.3 minutes per day). Multivariate analysis showed that only 2 physical therapy activities (gait training and community mobility) were both positively associated with discharge motor FIM outcomes across all 3 groups. Three physical therapy activities (assessment time, bed mobility, and transfers) were negatively associated with discharge motor FIM outcome. Limitations The study

  20. Sports Safety. Accident Prevention and Injury Control in Physical Education, Athletics, and Recreation.

    ERIC Educational Resources Information Center

    Yost, Charles Peter, Ed.

    This anthology of articles concerned with injury in sports and safety procedures is divided into three parts. Part One is devoted to general discussions of safety and a guiding philosophy for accident prevention. Part Two develops articles on administration and supervision, including discussions of health examination, legal liability, facilities,…

  1. The Effects of Creatine Supplementation and Physical Exercise on Traumatic Brain Injury.

    PubMed

    Freire Royes, Luiz Fernando; Cassol, Gustavo

    2016-01-01

    Traumatic brain injury (TBI) is a devastating disease frequently followed by significant behavioral disabilities and long-term medical complications that include a wide range of behavioral and emotional problems. TBI is characterized by a combination of immediate mechanical dysfunction of brain tissue and secondary damage developed over a longer period of time following the injury. The early inflammatory response after tissue injury can be triggered by several factors such as extravasated blood products and reactive oxygen species (ROS). It is important to note that energy generation and mitochondrial function are closely related to and interconnected with delayed secondary manifestations of brain injury, including early neuromotor dysfunction, cognitive impairment and post-traumatic epilepsy (PTE). Given the extent of post-traumatic changes in neuronal function and the possibility of amplifying secondary cascades, different therapies designed to minimize damage and retain/restore cellular function after TBI are currently being studied. In this context, the present review covers the preclinical and clinical literature investigating the role of inflammation and free radicals in secondary damage generated by several models of TBI. Furthermore, the present review aims to discuss the role of creatine, a guanidine compound popularly used as a performance-enhancing supplement for high-intensity athletic performance, in secondary damage induced by TBI. In this narrative review, we also discuss the beneficial effect of exercise performed in animal models of TBI and how the results from animal studies can be applied to clinical settings.

  2. Preventing ACL Injuries in Females: What Physical Educators Need to Know

    ERIC Educational Resources Information Center

    Toscano, Lisa; Carroll, Brianne

    2015-01-01

    Anterior cruciate ligament (ACL) injuries happen at a frequent rate, especially in girls and women. While there are many factors that contribute to ACL tears, teaching proper landing techniques and strengthening certain muscles can decrease the incidence of ACL tears, especially in women. This article reviews some of the high-risk factors that…

  3. Preventing ACL Injuries in Females: What Physical Educators Need to Know

    ERIC Educational Resources Information Center

    Toscano, Lisa; Carroll, Brianne

    2015-01-01

    Anterior cruciate ligament (ACL) injuries happen at a frequent rate, especially in girls and women. While there are many factors that contribute to ACL tears, teaching proper landing techniques and strengthening certain muscles can decrease the incidence of ACL tears, especially in women. This article reviews some of the high-risk factors that…

  4. Physical and biochemical characteristics of biological fluids in rats with modeled thermal injury.

    PubMed

    Vorobyov, A V; Martusevich, A K; Solovyova, A G; Razmakhov, A M; Luzan, A S; Dmitriev, A D

    2009-04-01

    Lactate dehydrogenase activity, crystallogenic and initiator characteristics of biological substrates were evaluated by enzymological and crystalloscopic analysis of rat serum and urine. Changes in these characteristics of biological media in combined thermal injury were shown. This approach is effective for evaluation of the metabolic status in rats with experimental burn disease.

  5. Relationships of physical job tasks and living conditions with occupational injuries in coal miners.

    PubMed

    Bhattacherjee, Ashis; Bertrand, Jean-Pierre; Meyer, Jean-Pierre; Benamghar, Lahoucine; Otero Sierra, Carmen; Michaely, Jean-Pierre; Ghosh, Apurna Kumar; d'Houtaud, Alphonse; Mur, Jean-Marie; Chau, Nearkasen

    2007-04-01

    This study assessed the relationships of job tasks and living conditions with occupational injuries among coal miners. The sample included randomly selected 516 underground workers. They completed a standardized self-administred questionnaire. The data were analyzed via logistic regression method. The rate of injuries in the past two years was 29.8%. The job tasks with significant crude relative risks were: power hammer, vibrating hand tools, pneumatic tools, bent trunk, awkward work posture, heat, standing about and walking, job tasks for trunk and upper/lower limbs, pain caused by work, and muscular tiredness. Logistic model shows a strong relationship between the number of job tasks (JT) and injuries (adjusted ORs vs. JT 0-1: 2.21, 95%CI 1.27-3.86 for JT 2-6 and 3.82, 2.14-6.82 for JT>or=7), and significant ORs>or=1.71 for face work, not-good-health-status, and psychotropic drug use. Musculoskeletal disorders and certain personality traits were also significant in univariate analysis. Therefore job tasks and living conditions strongly increase the injuries, and occupational physicians could help workers to find remedial measures.

  6. Physical Injury and Somatic Complaints: The Mediating Role of Posttraumatic Stress Symptoms in Young Survivors of a Terror Attack.

    PubMed

    Bugge, Ingrid; Dyb, Grete; Stensland, Synne Øien; Ekeberg, Øivind; Wentzel-Larsen, Tore; Diseth, Trond H

    2017-06-01

    Physically injured trauma survivors have particularly high risk for later somatic complaints and posttraumatic stress symptoms (PTSS). However, the potential mediating role of PTSS linking injury to later somatic complaints has been poorly investigated. In this study, survivors (N = 255) were interviewed longitudinally at 2 timepoints after the terror attack on Utøya Island, Norway, in 2011. Assessments included injury sustained during the attack, PTSS (after 4-5 months), somatic complaints (after 14-15 months), and background factors. Causal mediation analysis was conducted to evaluate the potential mediating role of PTSS in linking injury to somatic complaints comparing 2 groups of injured survivors with noninjured survivors. For the nonhospitalized injured versus the noninjured survivors, the mediated pathway was significant (average causal mediation effect; ACME = 0.09, p = .028, proportion = 55.8%). For the hospitalized versus the noninjured survivors, the mediated pathway was not significant (ACME = 0.04, p = .453, proportion = 11.6%). PTSS may play a significant mediating role in the development of somatic complaints among nonhospitalized injured trauma survivors. Intervening health professionals should be aware of this possible pathway to somatic complaints. Copyright © 2017 International Society for Traumatic Stress Studies.

  7. Comparison between dopaminergic agents and physical exercise as treatment for periodic limb movements in patients with spinal cord injury.

    PubMed

    De Mello, M T; Esteves, A M; Tufik, S

    2004-04-01

    Randomized controlled trial of physical exercise and dopaminergic agonist in persons with spinal cord injury and periodic leg movement (PLM). The objective of the present study was to compare the effectiveness of physical exercise and of a dopaminergic agonist in reducing the frequency of PLM. Centro de Estudos em Psicobiologia e Exercício. Universidade Federal de São Paulo, Brazil. A total of 13 volunteers (mean age: 31.6+/-8.3 years) received L-DOPA (200 mg) and benserazide (50 mg) 1 h before sleeping time for 30 days and were then submitted to a physical exercise program on a manual bicycle ergometer for 45 days (3 times a week). Both L-DOPA administration (35.11-19.87 PLM/h, P<0.03) and physical exercise (35.11-18.53 PLM/h, P<0.012) significantly reduced PLM; however, no significant difference was observed between the two types of treatment. The two types of treatment were found to be effective in the reduction of PLM; however, physical exercise is indicated as the first treatment approach, while dopaminergic agonists or other drugs should only be recommended for patients who do not respond to this type of treatment.

  8. Testing the feasibility of training peers with a spinal cord injury to learn and implement brief action planning to promote physical activity to people with spinal cord injury

    PubMed Central

    Gainforth, Heather L.; Latimer-Cheung, Amy E.; Davis, Connie; Casemore, Sheila; Martin Ginis, Kathleen A.

    2015-01-01

    Objective The present study tested the feasibility of training peers with spinal cord injury (SCI) to learn brief action planning (BAP), an application of motivational interviewing principles, to promote physical activity to mentees with SCI. Method Thirteen peers with SCI attended a half-day BAP workshop. Using a one-arm, pre-, post-test design, feasibility to learn BAP was assessed in terms of peers' (1) BAP and motivational interviewing spirit competence; (2) training satisfaction; and (3) motivations to use BAP as assessed by measures of the theory of planned behavior constructs. Measures were taken at baseline, immediately post-training, and 1 month follow up. Results Following the training, participants' BAP and motivational interviewing competence significantly increased (P's < 0.05, d's > 2.27). Training satisfaction was very positive with all means falling above the scale midpoint. Participants' perceived behavioral control to use BAP increased from baseline to post (P < 0.05, d = 0.91) but was not maintained at follow up (P > 0.05). Conclusion Training peers with a SCI to learn to use BAP is feasible. Practical implications BAP is a tool that can be feasibly learned by peers to promote physical activity to their mentees. PMID:25429692

  9. Testing the feasibility of training peers with a spinal cord injury to learn and implement brief action planning to promote physical activity to people with spinal cord injury.

    PubMed

    Gainforth, Heather L; Latimer-Cheung, Amy E; Davis, Connie; Casemore, Sheila; Martin Ginis, Kathleen A

    2015-07-01

    The present study tested the feasibility of training peers with spinal cord injury (SCI) to learn brief action planning (BAP), an application of motivational interviewing principles, to promote physical activity to mentees with SCI. Thirteen peers with SCI attended a half-day BAP workshop. Using a one-arm, pre-, post-test design, feasibility to learn BAP was assessed in terms of peers' (1) BAP and motivational interviewing spirit competence; (2) training satisfaction; and (3) motivations to use BAP as assessed by measures of the theory of planned behavior constructs. Measures were taken at baseline, immediately post-training, and 1 month follow up. Following the training, participants' BAP and motivational interviewing competence significantly increased (P's < 0.05, d's > 2.27). Training satisfaction was very positive with all means falling above the scale midpoint. Participants' perceived behavioral control to use BAP increased from baseline to post (P < 0.05, d = 0.91) but was not maintained at follow up (P > 0.05). Training peers with a SCI to learn to use BAP is feasible. BAP is a tool that can be feasibly learned by peers to promote physical activity to their mentees.

  10. Snowboard injuries.

    PubMed

    Pino, E C; Colville, M R

    1989-01-01

    A retrospective survey of 267 snowboarders was undertaken to determine the population at risk and types and mechanisms of injuries sustained in this sport. Snowboarders are young (average age, 21 years), male (greater than 90%), view themselves in average or above average physical condition (96%), and have varied sports interests. One hundred ten injuries that resulted in a physician visit were reported. Ligament sprains, fractures, and contusions were the most frequent types of injury. Fifty percent of all injuries occurred in the lower extremities, with ankle injuries being the most common. Snowboard riders using equipment with increased ankle support seem to be more protected from lower extremity injuries. The lower extremity injuries were concentrated in the forward limb of the snowboarder, where the rider's weight is disproportionately distributed. Differences in the mechanism and spectrum of injury between snowboarding and skiing injuries were noted, including: impact rather than torsion as the major mechanism of injury, a significant lack of thumb injuries, comparative increase in ankle injuries, a decrease in knee injuries, and a higher percentage of upper extremity injuries.

  11. Effect of Physical and Social Components of Enriched Environment on Astrocytes Proliferation in Rats After Cerebral Ischemia/Reperfusion Injury.

    PubMed

    Chen, Xiuping; Zhang, Xin; Liao, Weijing; Wan, Qi

    2017-01-12

    Treatment of enriched environment (EE) exerts neuroprotective effect in cerebral ischemia/reperfusion (I/R) injury. However, how the component of EE contributes to the functional recovery after brain ischemia remains unclear. Here we examined the effect of physical and social components of EE on poststroke astrocytes proliferation using an animal model of middle cerebral artery occlusion (MCAO) followed by reperfusion. Rats were divided into five groups: physical enrichment group (PE), social enrichment group (SE), physical and social enrichment group (PSE), ischemia + standard group (IS) and sham-operated + standard group (SS). In a set of behavioral tests, we demonstrated that animals in the enriched groups exhibited improved functional outcomes compared with those in standard group. Reduced infarct volume was only observed in PSE and PE groups. Double immunofluorescent labeling and western blot analysis revealed that rats in PSE and PE groups showed significantly more proliferated astrocytes and higher expression levels of brain-derived neurotrophic factor (BDNF) in the periinfarct cortex, compared with those in SE group. Astrocytes proliferation and BDNF expression were significantly correlated with functional outcomes. Collectively, this study suggests that physical activity is a more important component of EE regarding the effect on astrocytes proliferation and BDNF expression, which may contribute to the improved neurological function of stroke animals.

  12. Efficacy of Acute Intermittent Hypoxia on Physical Function and Health Status in Humans with Spinal Cord Injury: A Brief Review

    PubMed Central

    Astorino, Todd A.; Harness, Eric T.; White, Ailish C.

    2015-01-01

    Spinal cord injury (SCI) results in a loss of motor and sensory function and is consequent with reductions in locomotion, leading to a relatively sedentary lifestyle which predisposes individuals to premature morbidity and mortality. Many exercise modalities have been employed to improve physical function and health status in SCI, yet they are typically expensive, require many trained clinicians to implement, and are thus relegated to specialized rehabilitation centers. These characteristics of traditional exercise-based rehabilitation in SCI make their application relatively impractical considering the time-intensive nature of these regimens and patients' poor access to exercise. A promising approach to improve physical function in persons with SCI is exposure to acute intermittent hypoxia (IH) in the form of a small amount of sessions of brief, repeated exposures to low oxygen gas mixtures interspersed with normoxic breathing. This review summarizes the clinical application of IH in humans with SCI, describes recommended dosing and potential side effects of IH, and reviews existing data concerning the efficacy of relatively brief exposures of IH to modify health and physical function. Potential mechanisms explaining the effects of IH are also discussed. Collectively, IH appears to be a safe, time-efficient, and robust approach to enhance physical function in chronic, incomplete SCI. PMID:26167303

  13. Sensitivity of physical examination versus arthroscopy in diagnosing subscapularis tendon injury.

    PubMed

    Faruqui, Sami; Wijdicks, Coen; Foad, Abdullah

    2014-01-01

    The purpose of this study was to examine the accuracy of physical examination in the detection of subscapularis tendon tears and compare it with the gold standard of arthroscopy to determine whether clinical examination can reliably predict the presence of subscapularis tendon tears. This was a retrospective analysis of 52 patients (52 shoulders) who underwent arthroscopic subscapularis tendon repairs between September 2008 and April 2012. Positive findings on any combination of the belly press, lift-off, and bear hug tests constituted a positive physical examination result. There was a positive finding on physical examination in 42 of 52 patients. The sensitivity of the physical examination as a whole was 81%. The literature has shown that the belly press, bear hug, and lift-off tests are specific to the subscapularis tendon. To the authors’ knowledge, this is the first study to evaluate the sensitivity of these 3 separate clinical tests as a composite. Knowledge regarding the sensitivity of the subscapularis-specific physical examination as a composite can lead practitioners to implement all 3 components, even when 1 test has a negative finding, thus promoting a more thorough physical examination. Because unrepaired subscapularis tendon tears can result in poor outcomes in the repair of other rotator cuff tendons, a complete physical examination would be beneficial to patients with shoulder pathology. The authors conclude that physical examination, when performed consistently by an experienced practitioner, can reliably predict the presence of subscapularis tendon tears.

  14. Long-Term Athletic Development in Youth Alpine Ski Racing: The Effect of Physical Fitness, Ski Racing Technique, Anthropometrics and Biological Maturity Status on Injuries

    PubMed Central

    Müller, Lisa; Hildebrandt, Carolin; Müller, Erich; Fink, Christian; Raschner, Christian

    2017-01-01

    Alpine ski racing is known to be a sport with a high risk of injuries. Because most studies have focused mainly on top-level athletes and on traumatic injuries, limited research exists about injury risk factors among youth ski racers. The aim of this study was to determine the intrinsic risk factors (anthropometrics, biological maturity, physical fitness, racing technique) for injury among youth alpine ski racers. Study participants were 81 youth ski racers attending a ski boarding school (50 males, 31 females; 9–14 years). A prospective longitudinal cohort design was used to monitor sports-related risk factors over two seasons and traumatic (TI) and overuse injuries (OI). At the beginning of the study, anthropometric characteristics (body height, body weight, sitting height, body mass index); biological maturity [status age at peak height velocity (APHV)]; physical performance parameters related to jump coordination, maximal leg and core strength, explosive and reactive strength, balance and endurance; and ski racing technique were assessed. Z score transformations normalized the age groups. Multivariate binary logistic regression (dependent variable: injury yes/no) and multivariate linear regression analyses (dependent variable: injury severity in total days of absence from training) were calculated. T-tests and multivariate analyses of variance were used to reveal differences between injured and non-injured athletes and between injury severity groups. The level of significance was set to p < 0.05. Relatively low rates of injuries were reported for both traumatic (0.63 TI/athlete) and overuse injuries (0.21 OI/athlete). Athletes with higher body weight, body height, and sitting height; lower APHV values; better core flexion strength; smaller core flexion:extension strength ratio; shorter drop jump contact time; and higher drop jump reactive strength index were at a lower injury risk or more vulnerable for fewer days of absence from training. However

  15. Long-Term Athletic Development in Youth Alpine Ski Racing: The Effect of Physical Fitness, Ski Racing Technique, Anthropometrics and Biological Maturity Status on Injuries.

    PubMed

    Müller, Lisa; Hildebrandt, Carolin; Müller, Erich; Fink, Christian; Raschner, Christian

    2017-01-01

    Alpine ski racing is known to be a sport with a high risk of injuries. Because most studies have focused mainly on top-level athletes and on traumatic injuries, limited research exists about injury risk factors among youth ski racers. The aim of this study was to determine the intrinsic risk factors (anthropometrics, biological maturity, physical fitness, racing technique) for injury among youth alpine ski racers. Study participants were 81 youth ski racers attending a ski boarding school (50 males, 31 females; 9-14 years). A prospective longitudinal cohort design was used to monitor sports-related risk factors over two seasons and traumatic (TI) and overuse injuries (OI). At the beginning of the study, anthropometric characteristics (body height, body weight, sitting height, body mass index); biological maturity [status age at peak height velocity (APHV)]; physical performance parameters related to jump coordination, maximal leg and core strength, explosive and reactive strength, balance and endurance; and ski racing technique were assessed. Z score transformations normalized the age groups. Multivariate binary logistic regression (dependent variable: injury yes/no) and multivariate linear regression analyses (dependent variable: injury severity in total days of absence from training) were calculated. T-tests and multivariate analyses of variance were used to reveal differences between injured and non-injured athletes and between injury severity groups. The level of significance was set to p < 0.05. Relatively low rates of injuries were reported for both traumatic (0.63 TI/athlete) and overuse injuries (0.21 OI/athlete). Athletes with higher body weight, body height, and sitting height; lower APHV values; better core flexion strength; smaller core flexion:extension strength ratio; shorter drop jump contact time; and higher drop jump reactive strength index were at a lower injury risk or more vulnerable for fewer days of absence from training. However, significant

  16. Mental and Physical Health Outcomes in Parents of Children with Burn Injuries as Compared with Matched Controls.

    PubMed

    Enns, Jessica; Gawaziuk, Justin P; Khan, Sazzadul; Chateau, Dan; Bolton, James M; Sareen, Jitender; Stone, James; Doupe, Malcolm; Logsetty, Sarvesh

    2016-01-01

    Pediatric burn injuries are common, and the stress of caring for them can affect caregivers' health. This study's objective was to examine the rates of common mental and physical disorders of parents of burn-injured children (cases) compared with matched controls (controls). This is a population-based study linking the Regional Pediatric burn registry with administrative health information. Pediatric burn cases were matched 1:5 with control children from the general population based on age, sex, and geographical location then parents identified. One thousand and twenty-six parental cases and 4858 controls were identified. International Classification of Disease codes were used to identify diagnoses of common mental and physical disorders. Using rates of disease 2 years before and 2 years after the date of burn, the changes in the relative rates of health outcomes were compared between the cases and the controls. The cases had higher rates of postinjury mental and physical illness compared with the matches. However, it was found that controls also had increased rates postindex date and additionally cases had increased rates of preinjury illnesses. There was no difference in the relative rates of illnesses between the groups from pre- to post-index date. The higher rate of illness in cases postinjury could be explained by preinjury illness, and similar rate increases in the control cohort. Evaluation of the effect of a child's burn injury on parents should take into context the preexisting health of the parent. Socioeconomic factors associated with increased risk of burns may also be associated with adverse health outcomes.

  17. The effect of physical characteristics and field position on the shoulder and elbow injuries of 490 baseball players: confirmation of diagnosis by magnetic resonance imaging.

    PubMed

    Han, Kyung-Jin; Kim, Yong-Kweon; Lim, Seung-Kil; Park, Jin-Young; Oh, Kyung-Soo

    2009-07-01

    To evaluate the distribution of shoulder and elbow injuries confirmed by magnetic resonance imaging in throwing athletes. Descriptive epidemiological study. Tertiary institution. Five hundred fifty-four baseball players referred to our institute for shoulder and elbow rehabilitation. All injured players except those with fractures underwent magnetic resonance imagings, which were read by a radiologist, and players were diagnosed by orthopedic surgeons based on the clinical and imaging findings. Analysis of baseball-related injuries was performed according to the physical characteristics of each athlete and his positions on the team. Junior high school players sustained a higher proportion of osteochondritis dissecans compared with high school and collegiate players. High school and collegiate players were more likely to have ulnar collateral ligament (UCL) injuries or superior labrum anterior-posterior (SLAP) lesions than junior high school players. Pitchers and outfielders were more likely to have UCL injuries than the infielders. In the junior high school group, the players with UCL injuries were taller and heavier than the players in the control group. In the high school group with UCL injuries or SLAP lesions, the players were both taller and heavier than the players in the control group. These data support the conclusion that there is a significant difference in the distribution of injuries according to the player's age and position. For the age-matched comparison, taller and heavier players are more likely to be affected by UCL injury or SLAP lesion.

  18. Mouthguards in sport activities : history, physical properties and injury prevention effectiveness.

    PubMed

    Knapik, Joseph J; Marshall, Stephen W; Lee, Robyn B; Darakjy, Salima S; Jones, Sarah B; Mitchener, Timothy A; delaCruz, Georgia G; Jones, Bruce H

    2007-01-01

    Three systematic reviews were conducted on: (i) the history of mouthguard use in sports; (ii) mouthguard material and construction; and (iii) the effectiveness of mouthguards in preventing orofacial injuries and concussions. Retrieval databases and bibliographies were explored to find studies using specific key words for each topic. The first recorded use of mouthguards was by boxers, and in the 1920s professional boxing became the first sport to require mouthguards. Advocacy by the American Dental Association led to the mandating of mouthguards for US high school football in the 1962 season. Currently, the US National Collegiate Athletic Association requires mouthguards for four sports (ice hockey, lacrosse, field hockey and football). However, the American Dental Association recommends the use of mouthguards in 29 sports/exercise activities. Mouthguard properties measured in various studies included shock-absorbing capability, hardness, stiffness (indicative of protective capability), tensile strength, tear strength (indicative of durability) and water absorption. Materials used for mouthguards included: (i) polyvinylacetate-polyethylene or ethylene vinyl acetate (EVA) copolymer; (ii) polyvinylchloride; (iii) latex rubber; (iv) acrylic resin; and (v) polyurethane. Latex rubber was a popular material used in early mouthguards but it has lower shock absorbency, lower hardness and less tear and tensile strength than EVA or polyurethane. Among the more modern materials, none seems to stand out as superior to another since the characteristics of all the modern materials can be manipulated to provide a range of favourable characteristics. Impact studies have shown that compared with no mouthguard, mouthguards composed of many types of materials reduce the number of fractured teeth and head acceleration. In mouthguard design, consideration must be given to the nature of the collision (hard or soft objects) and characteristics of the mouth (e.g. brittle incisors, more

  19. Age of Drinking Onset and Injuries, Motor Vehicle Crashes, and Physical Fights After Drinking and When Not Drinking

    PubMed Central

    Hingson, Ralph W.; Edwards, Erika M.; Heeren, Timothy; Rosenbloom, David

    2010-01-01

    Background Earlier age of drinking onset has been associated with greater odds of involvement in motor vehicle crashes, unintentional injuries, and physical fights after drinking. This study explores whether early drinkers take more risks even when sober by comparing potential associations between age of drinking onset and these outcomes after drinking relative to when respondents have not been drinking. Method From a national sample, 4,021 ever-drinkers ages 18 to 39 were asked age of drinking onset, not counting tastes or sips. They were also asked if they were ever in motor vehicle crashes, unintentionally injured, or in physical fights after drinking and when not drinking. GEE logistic regression models for repeated measures dichotomous outcomes compared whether odds ratios between age of onset and these adverse outcomes significantly differed when they occurred after drinking vs. when not drinking, controlling for respondents’ demographic characteristics, cigarette and marijuana use, family history of alcoholism, ever experiencing alcohol dependence, and frequency of binge drinking. Results Compared with persons who started drinking at age 21+, those who started at ages <14, 14–15, 16–17, and 18–20 had, after drinking, respectively greater odds: 6.3 (2.6, 15.3), 5.2 (2.2, 12.3), 3.3 (1.5, 7.3), and 2.2 (0.9, 5.1) of having been in a motor vehicle crash; 6.0 (3.4, 10.5), 4.9 (3.0, 8.6), 3.7 (2.4, 5.6), and 1.9 (1.2, 2.9) of ever being in a fight; and 4.6 (2.4, 8.7), 4.7 (2.6, 8.6), 3.2 (1.9, 5.6), and 2.3 (1.3, 4.0) of ever being accidentally injured. The odds of experiencing motor vehicle accidents or injuries when not drinking were not significantly elevated among early onset drinkers. The odds of earlier onset drinkers being in fights were also significantly greater when respondents had been drinking than not drinking. Conclusion Starting to drink at an earlier age is associated with greater odds of experiencing motor vehicle crash involvement

  20. An economic evaluation of setting up physical barriers in railway stations for preventing railway injury: evidence from Hong Kong.

    PubMed

    Law, C K; Yip, P S F

    2011-10-01

    Setting physical barriers, for example platform screen doors (PSDs), has been proven to be effective in preventing falls onto railway tracks, but its cost-effectiveness is not known. For economic evaluation of public health interventions, the importance of including non-health factors has been noted despite a lack of empirical studies. This study aimed to investigate the effectiveness and cost-effectiveness of PSDs, which are installed in part of the Hong Kong railway system, for preventing railway injuries. Data on railway injuries from 1997 to 2007 were obtained from the railway operators. Poisson regression was used to examine the risk reduction. Two incremental cost-effectiveness ratios (ICER) were calculated to assess the cost-effectiveness based on (1) disability-adjusted life years (DALYs) only and (2) DALYs with potential fare revenue and passengers' waiting time lost due to railway circulation collapse. The PSD installation has effectively reduced railway injuries (adjusted 5-year average percentage change: -68.8%, p<0.0001) with no apparent substitution effect to the other platforms observed. To be cost-effective, the cost of gaining a healthy life year (ICER) should not exceed three times the per capita GDP (US$74,700). The PSD installation would only be cost-effective if the loss of fare revenue and passengers' waiting time, in addition to DALY, were included (ICER: US$65,400), while the ICER based on DALY only would be US$77,900. The challenges of complexity for economic evaluation appear in many community-based health interventions. A more extensive perspective for exploring other outcome measurements and evaluation methods to reflect a fair and appropriate value of the intervention's cost-effectiveness is needed.

  1. Modeling and simulation of blast-induced, early-time intracranial wave physics leading to traumatic brain injury.

    SciTech Connect

    Ford, Corey C.; Taylor, Paul Allen

    2008-02-01

    The objective of this modeling and simulation study was to establish the role of stress wave interactions in the genesis of traumatic brain injury (TBI) from exposure to explosive blast. A high resolution (1 mm{sup 3} voxels), 5 material model of the human head was created by segmentation of color cryosections from the Visible Human Female dataset. Tissue material properties were assigned from literature values. The model was inserted into the shock physics wave code, CTH, and subjected to a simulated blast wave of 1.3 MPa (13 bars) peak pressure from anterior, posterior and lateral directions. Three dimensional plots of maximum pressure, volumetric tension, and deviatoric (shear) stress demonstrated significant differences related to the incident blast geometry. In particular, the calculations revealed focal brain regions of elevated pressure and deviatoric (shear) stress within the first 2 milliseconds of blast exposure. Calculated maximum levels of 15 KPa deviatoric, 3.3 MPa pressure, and 0.8 MPa volumetric tension were observed before the onset of significant head accelerations. Over a 2 msec time course, the head model moved only 1 mm in response to the blast loading. Doubling the blast strength changed the resulting intracranial stress magnitudes but not their distribution. We conclude that stress localization, due to early time wave interactions, may contribute to the development of multifocal axonal injury underlying TBI. We propose that a contribution to traumatic brain injury from blast exposure, and most likely blunt impact, can occur on a time scale shorter than previous model predictions and before the onset of linear or rotational accelerations traditionally associated with the development of TBI.

  2. Manual physical therapy combined with high-intensity functional rehabilitation for severe lower extremity musculoskeletal injuries: a case series*

    PubMed Central

    Crowell, Michael S.; Deyle, Gail D.; Owens, Johnny; Gill, Norman W.

    2016-01-01

    Objectives Severe lower extremity trauma accounts for large healthcare costs and often results in elective amputation and poor long-term outcomes. The purpose of this case series is to describe an orthopedic manual physical therapy (OMPT) approach combined with a return to run (RTR) clinical pathway consisting of high-intensity functional rehabilitation with a custom energy-storing orthosis. Methods Three consecutive male patients, aged 21–23 years, with severe lower extremity musculoskeletal injuries were treated with a combined intervention that included a mean (SD) of 12 (2·1) OMPT sessions and 24 (8·7) functional rehabilitation sessions over a mean of 6 weeks (1·0). Additional training with a custom energy-storing orthosis consisted of a mean of 15 (1·2) additional sessions over 4 weeks. Patient self-report outcome measures and a variety of physical performance tests captured change in function. Results Baseline lower extremity functional scale (LEFS) and foot and ankle ability measure activities of daily living subscale (FAAM-ADL) scores indicated severe disability. All patients exceeded the minimal clinically important difference (MCID) in at least one self-report outcome or physical performance test without a brace. Two of three patients exceeded the MCID for at least two physical performance tests after training with and utilizing a custom energy-storing orthosis. Discussion Clinically meaningful changes in self-reported function or physical performance were observed in all patients. A multi-modal approach, including manual therapy and functional exercise, may address the entire spectrum of impairments in patients with severe lower extremity trauma, resulting in improvements in both braced and un-braced function. PMID:27252581

  3. Participation in physical activity in persons with spinal cord injury: a comprehensive perspective and insights into gender differences.

    PubMed

    Rauch, Alexandra; Fekete, Christine; Cieza, Alarcos; Geyh, Szilvia; Meyer, Thorsten

    2013-07-01

    To prevent secondary conditions and to improve and maintain health, regular physical activity is recommended as an important component of a health-promoting lifestyle for persons with spinal cord injury (SCI). However, participation in physical activity is low in persons with SCI, especially in women. The objective of this study is to identify (1) categories of functioning, the environment and personal factors that influence participation in physical activity in persons with SCI and (2) gender differences within identified factors. An explorative qualitative study design using both focus groups and individual interviews based on a semi-structured interview guide was used. Statements were linked to categories or chapters of the four components of functioning (body structures, body functions, activities and participation) and of the environment included in the International Classification of Functioning, Disability and Health (ICF) and a recently developed list of personal factors. An in-depth analysis of the statements was performed to identify relevant associations and gender differences. Twenty-six persons (13 female, 13 male) participated in the study. Sixty-seven categories and four chapters from all components of functioning and environmental factors included in the ICF and 33 subdivisions of personal factors were found to be associated with physical activity in persons with SCI. Gender differences could be assigned to areas of gender roles, social support, athletic identity, interests, and general behavioral patterns. This study contributes to a comprehensive understanding of participation in physical activity in persons with SCI and presents a first step toward the identification of gender differences. The results should be validated by further quantitative research. Copyright © 2013 Elsevier Inc. All rights reserved.

  4. The New Zealand rugby injury and performance project. III. Anthropometric and physical performance characteristics of players.

    PubMed Central

    Quarrie, K L; Handcock, P; Waller, A E; Chalmers, D J; Toomey, M J; Wilson, B D

    1995-01-01

    OBJECTIVE: To investigate the anthropometric and physical performance characteristics of New Zealand rugby players of different ages and both sexes. METHODS: 356 rugby players (264 male, 92 female) took part in the study during a single season. Playing grade ranged from schoolboys and schoolgirls to senior men and women. Assessment of height, weight, neck circumference, and somatotype was performed before the competitive rugby season. A battery of six physical performance assessments was completed after the anthropometry. Analysis of variance was used to examine differences in these variables between field positions and grades. RESULTS: Significant differences between forwards and backs on anthropometric and physical performance variables were apparent at all grades assessed. In terms of anthropometric characteristics, forwards of a given grade were generally taller, possessed greater body mass, and were more endomorphic and less ectomorphic than backs of the same grade. The backs tended to perform better on physical performance measures than forwards, being more aerobically fit, faster, more agile, and possessing a higher degree of muscular endurance. Differences in anthropometry and physical performance attributes were also apparent between players from the various grades. The players at higher levels were generally larger, and performed better on tests of physical performance than the players at lower levels. These differences were found in both sexes. CONCLUSIONS: The greater body mass of the forwards allows them to obtain greater momentum than the backs when sprinting. The ability to obtain greater momentum is important in the body contact phases of the game. Forwards may compromise their aerobic fitness and speed to some extent in order to maintain a high body mass. The anthropometric and physical performance characteristics of players appear to reflect the demands placed on them by the sport. PMID:8808542

  5. Ergonomics and Beyond: Understanding How Chemical and Heat Exposures and Physical Exertions at Work Affect Functional Ability, Injury, and Long-Term Health.

    PubMed

    Ross, Jennifer A; Shipp, Eva M; Trueblood, Amber B; Bhattacharya, Amit

    2016-08-01

    To honor Tom Waters's work on emerging occupational health issues, we review the literature on physical along with chemical exposures and their impact on functional outcomes. Many occupations present the opportunity for exposure to multiple hazardous exposures, including both physical and chemical factors. However, little is known about how these different factors affect functional ability and injury. The goal of this review is to examine the relationships between these exposures, impairment of the neuromuscular and musculoskeletal systems, functional outcomes, and health problems with a focus on acute injury. Literature was identified using online databases, including PubMed, Ovid Medline, and Google Scholar. References from included articles were searched for additional relevant articles. This review documented the limited existing literature that discussed cognitive impairment and functional disorders via neurotoxicity for physical exposures (heat and repetitive loading) and chemical exposures (pesticides, volatile organic compounds [VOCs], and heavy metals). This review supports that workers are exposed to physical and chemical exposures that are associated with negative health effects, including functional impairment and injury. Innovation in exposure assessment with respect to quantifying the joint exposure to these different exposures is especially needed for developing risk assessment models and, ultimately, preventive measures. Along with physical exposures, chemical exposures need to be considered, alone and in combination, in assessing functional ability and occupationally related injuries. © 2016, Human Factors and Ergonomics Society.

  6. ACL Injuries

    MedlinePlus

    ... is an ACL injury? ACL refers to the anterior cruciate ligament. It is 1 of 4 ligaments in your ... best results. After surgery, you will need intense physical therapy to ... allow the ligament to heal naturally. Living with an ACL injury ...

  7. Development of Predictive Models of Injury for the Lower Extremity, Lumbar, and Thoracic Spine after Discharge from Physical Rehabilitation

    DTIC Science & Technology

    2015-10-01

    prevention titled “Prediction, Prevention , and Preemption: Screening for sports and training injuries . What are the possibilities?” The talk was...the risk of sustaining any injury as well as 2) the risk of reoccurrence of the same injury . A two-pronged injury prevention approach is required to...optimize return to duty rates after injury : Screening for known preventable musculoskeletal risk factors and ensuring these risk factors are mitigated

  8. Associations of Organizational Safety Practices and Culture With Physical Workload, Perceptions About Work, and Work-Related Injury and Symptoms Among Hospital Nurses.

    PubMed

    Lee, Soo-Jeong; Lee, Joung Hee

    The study aim was to examine the relationships of organizational safety practices with nurses' perceptions about job and risk and experiences of work-related injury and symptoms. Nursing professions report high rates of work-related injuries. Organizational safety practices have been linked to workers' safety outcomes and perceptions about work. This study analyzed data from a random sample of 280 California RNs in a cross-sectional statewide survey. Data were collected by both postal and online surveys. Higher perceptions of organizational safety practices (safety climate, ergonomic practices, people-oriented culture) were significantly associated with lower physical workload, lower job strain, higher job satisfaction, lower risk perception, and lower work-related injury and symptom experiences. Ergonomic practices and people-oriented culture were associated with less intention of leaving job. Organizational safety practices may play a pivotal role in improving positive perceptions about jobs, reducing injury risks, and promoting nurse retention.

  9. Pedagogies of Censorship, Injury, and Masochism: Teacher Responses to Homophobic Speech in Physical Education

    ERIC Educational Resources Information Center

    Sykes, Heather

    2004-01-01

    I examine how physical education teachers respond to homophobic name-calling, as revealed in life history interviews with 'lesbian', 'gay', and 'heterosexual' teachers in Canada and the USA. Censoring homophobic name-calling in schools is discussed as an important, but insufficient, response. Several 'lesbian' and 'gay' teachers responded with…

  10. Pedagogies of Censorship, Injury, and Masochism: Teacher Responses to Homophobic Speech in Physical Education

    ERIC Educational Resources Information Center

    Sykes, Heather

    2004-01-01

    I examine how physical education teachers respond to homophobic name-calling, as revealed in life history interviews with 'lesbian', 'gay', and 'heterosexual' teachers in Canada and the USA. Censoring homophobic name-calling in schools is discussed as an important, but insufficient, response. Several 'lesbian' and 'gay' teachers responded with…

  11. Effectiveness of passive physical modalities for shoulder pain: systematic review by the Ontario protocol for traffic injury management collaboration.

    PubMed

    Yu, Hainan; Côté, Pierre; Shearer, Heather M; Wong, Jessica J; Sutton, Deborah A; Randhawa, Kristi A; Varatharajan, Sharanya; Southerst, Danielle; Mior, Silvano A; Ameis, Arthur; Stupar, Maja; Nordin, Margareta; van der Velde, Gabreille M; Carroll, Linda; Jacobs, Craig L; Taylor-Vaisey, Anne L; Abdulla, Sean; Shergill, Yaadwinder

    2015-03-01

    Shoulder pain is a common musculoskeletal condition in the general population. Passive physical modalities are commonly used to treat shoulder pain. However, previous systematic reviews reported conflicting results. The aim of this study was to evaluate the effectiveness of passive physical modalities for the management of soft tissue injuries of the shoulder. MEDLINE, EMBASE, CINAHL, PsycINFO, and the Cochrane Central Register of Controlled Trials were searched from January 1, 1990, to April 18, 2013. Randomized controlled trials (RCTs) and cohort and case-control studies were eligible. Random pairs of independent reviewers screened 1,470 of 1,760 retrieved articles after removing 290 duplicates. Twenty-two articles were eligible for critical appraisal. Eligible studies were critically appraised using the Scottish Intercollegiate Guidelines Network criteria. Of those, 11 studies had a low risk of bias. The lead author extracted data from low risk of bias studies and built evidence tables. A second reviewer independently checked the extracted data. The findings of studies with a low risk of bias were synthesized according to principles of best evidence synthesis. Pretensioned tape, ultrasound, and interferential current were found to be noneffective for managing shoulder pain. However, diathermy and corticosteroid injections led to similar outcomes. Low-level laser therapy provided short-term pain reduction for subacromial impingement syndrome. Extracorporeal shock-wave therapy was not effective for subacromial impingement syndrome but provided benefits for persistent shoulder calcific tendinitis. Non-English studies were excluded. Most passive physical modalities do not benefit patients with subacromial impingement syndrome. However, low-level laser therapy is more effective than placebo or ultrasound for subacromial impingement syndrome. Similarly, shock-wave therapy is more effective than sham therapy for persistent shoulder calcific tendinitis. © 2015 American

  12. A Systematic Review of the Association Between Physical Fitness and Musculoskeletal Injury Risk: Part 1 - Cardiorespiratory Endurance.

    PubMed

    Lisman, Peter; de la Motte, Sarah J; Gribbin, Timothy C; Jaffin, Dianna Purvis; Murphy, Kaitlin; Deuster, Patricia A

    2017-02-13

    Musculoskeletal injuries (MSK-I) are a significant health problem for both military and athletic populations. Research indicates MSK-I is associated with physical fitness; however, the association between specific components of physical fitness and MSK-I in military and athletic populations has not been systematically examined. Our goal was to systematically review the literature to provide a best evidence synthesis on the relationship between components of physical fitness and MSK-I risk in military and civilian athletic populations. This first of three manuscripts focuses on cardiorespiratory endurance (CRE). MEDLINE, EBSCO, EMBASE, and the Defense Technical Information Center were searched for original studies published from 1970 through 2015 that examined associations between physical fitness and MSK-I. Forty-nine of 4,229 citations met our inclusion criteria. Primary findings indicate there is 1) strong evidence that poor performance on a set distance run for time is a predictor for MSK-I risk in both genders; 2) strong evidence that poor performance on timed shuttle runs is a predictor for MSK-I risk in males; 3) moderate evidence in males and limited evidence in females that poor performance on a timed step test is a predictor of MSK-I risk; and 4) limited or insufficient evidence that poor performance on the Cooper run test, maximal and submaximal aerobic graded exercise tests, and the Conconi test are predictors of MSK-I risk in males and/or females. Several measures of CRE are risk factors for training-related MSK-I in military and civilian athletic populations, indicating CRE may be an important measure for MSK-I risk stratification.

  13. Changes in pain catastrophizing following physical therapy for musculoskeletal injury: the influence of depressive and post-traumatic stress symptoms.

    PubMed

    Slepian, Peter; Bernier, Elena; Scott, Whitney; Niederstrasser, Nils Georg; Wideman, Timothy; Sullivan, Michael

    2014-03-01

    The aim of the present study was to investigate the factors that influence the change in pain catastrophizing during the course of a physical therapy intervention for musculoskeletal injury. 187 clients enrolled in a 7-week physical therapy intervention were divided into four mutually exclusive groups on the basis of a pre-treatment assessment: (1) clients whose pre-treatment catastrophizing scores and measures of mental health problems were below clinical threshold, (2) clients whose pre-treatment catastrophizing scores were above clinical threshold but who scores on measures of mental health problems were below clinical threshold, (3) clients whose pre-treatment catastrophizing scores were above clinical threshold and whose scores on measures of mental health problems were also above clinical threshold, and (4) clients whose pre-treatment catastrophizing scores were below clinical threshold but whose scores on measures of mental health problems were above clinical threshold. The most prevalent risk profile consisted of clients with high levels of pain catastrophizing and high mental health problems (37 %), followed by the low catastrophizing and low mental health problems profile (35 %), the high catastrophizing and low mental health problems profile (16 %), and low catastrophizing and high mental health problems profile (10 %). Clients were considered non-responders if their post-treatment catastrophizing score remained above clinical threshold following treatment. Chi square analyses revealed a significantly higher proportion of non-responders in the high catastrophizing and mental health problem group than in any other group. The presence of mental health symptoms markedly reduces the effectiveness of physical therapy for reducing catastrophizing scores. The 'risk value' of high catastrophizing scores thus appears to vary as a function of the presence or absence of mental health symptoms. The findings argue for the inclusion of measures of mental health

  14. EFFECTIVENESS OF THE EMERGENCY RESPONSE COURSE IN IMPROVING STUDENT PHYSICAL THERAPISTS' AND LICENSED PHYSICAL THERAPISTS' DECISION‐MAKING RELATED TO ACUTE SPORTS INJURIES AND MEDICAL CONDITIONS

    PubMed Central

    Cross, Patrick Stephen; Hauer, Patrick L.; Blom, Heather; Burcham, Jared; Myers, Amanda K.; Grimsrud, Casey

    2013-01-01

    Purpose: To analyze the effectiveness of the American Red Cross Emergency Response Course (ARC ERC) in improving decision‐making skills of physical therapists (PTs) and third semester clinical doctorate student physical therapists (SPTs) when assessing acute sports injuries and medical conditions. Methods: An existing questionnaire was modified, with permission from the original authors of the instrument. The questionnaire was administered to PTs and SPTs before the start of and immediately after the completion of 5 different ARC ERCs. The overall percentages of “Appropriate” responses for the 17 case scenarios were calculated for each participant for the pre‐and post‐tests. Participants also rated their perceived level of preparedness for managing various conditions using a 5‐point Likert Scale (ranging from Prepared to Unprepared). The overall percentage of “Prepared/Somewhat Prepared” responses for the 16 medical conditions was calculated for each participant for the pre‐and post‐tests. In addition, mean Likert scale scores were calculated for level of perceived preparedness for each of the 16 medical conditions. Paired t‐tests, calculated with SPSS 20.0, were used to analyze the data. Results: 37 of 37 (100.0%) of eligible PTs and 45 of 48 (93.8%) of eligible SPTs completed the pre‐ and post‐test questionnaires. The percentage of “Appropriate” responses for all 17 cases in the aggregate (PTs: 76.8% pre‐test, 89.0% post‐test; SPTs: 68.5%, 84.3%), as well as the percentage of “Prepared/Somewhat Prepared” responses for all conditions in the aggregate (PTs: 67.5%, 96.5%; SPTs: 37.1%, 90.6%) were significantly different from pre‐test to post‐test (P = .000). There was also a significant difference (P < .05) in the mean overall preparedness Likert scale scores from pre‐test to post‐test for each medical condition for the SPT's, and 15 of the 16 medical conditions (muscle strains: P = .119) for the PTs. Conclusions: The

  15. Effectiveness of the emergency response course in improving student physical therapists' and licensed physical therapists' decision-making related to acute sports injuries and medical conditions.

    PubMed

    Karges, Joy Renae; Cross, Patrick Stephen; Hauer, Patrick L; Blom, Heather; Burcham, Jared; Myers, Amanda K; Grimsrud, Casey

    2013-06-01

    To analyze the effectiveness of the American Red Cross Emergency Response Course (ARC ERC) in improving decision-making skills of physical therapists (PTs) and third semester clinical doctorate student physical therapists (SPTs) when assessing acute sports injuries and medical conditions. An existing questionnaire was modified, with permission from the original authors of the instrument. The questionnaire was administered to PTs and SPTs before the start of and immediately after the completion of 5 different ARC ERCs. The overall percentages of "Appropriate" responses for the 17 case scenarios were calculated for each participant for the pre-and post-tests. Participants also rated their perceived level of preparedness for managing various conditions using a 5-point Likert Scale (ranging from Prepared to Unprepared). The overall percentage of "Prepared/Somewhat Prepared" responses for the 16 medical conditions was calculated for each participant for the pre-and post-tests. In addition, mean Likert scale scores were calculated for level of perceived preparedness for each of the 16 medical conditions. Paired t-tests, calculated with SPSS 20.0, were used to analyze the data. 37 of 37 (100.0%) of eligible PTs and 45 of 48 (93.8%) of eligible SPTs completed the pre- and post-test questionnaires. The percentage of "Appropriate" responses for all 17 cases in the aggregate (PTs: 76.8% pre-test, 89.0% post-test; SPTs: 68.5%, 84.3%), as well as the percentage of "Prepared/Somewhat Prepared" responses for all conditions in the aggregate (PTs: 67.5%, 96.5%; SPTs: 37.1%, 90.6%) were significantly different from pre-test to post-test (P = .000). There was also a significant difference (P < .05) in the mean overall preparedness Likert scale scores from pre-test to post-test for each medical condition for the SPT's, and 15 of the 16 medical conditions (muscle strains: P = .119) for the PTs. The ARC ERC appears to be effective in improving both PTs' and SPTs' decision-making skills

  16. Predictive Ability of Pender's Health Promotion Model for Physical Activity and Exercise in People with Spinal Cord Injuries: A Hierarchical Regression Analysis

    ERIC Educational Resources Information Center

    Keegan, John P.; Chan, Fong; Ditchman, Nicole; Chiu, Chung-Yi

    2012-01-01

    The main objective of this study was to validate Pender's Health Promotion Model (HPM) as a motivational model for exercise/physical activity self-management for people with spinal cord injuries (SCIs). Quantitative descriptive research design using hierarchical regression analysis (HRA) was used. A total of 126 individuals with SCI were recruited…

  17. Social Cognitive and Planned Behavior Variables Associated with Stages of Change for Physical Activity in Spinal Cord Injury: A Multivariate Analysis

    ERIC Educational Resources Information Center

    Keegan, John; Ditchman, Nicole; Dutta, Alo; Chiu, Chung-Yi; Muller, Veronica; Chan, Fong; Kundu, Madan

    2016-01-01

    Purpose: To apply the constructs of social cognitive theory (SCT) and the theory of planned behavior (TPB) to understand the stages of change (SOC) for physical activities among individuals with a spinal cord injury (SCI). Method: Ex post facto design using multivariate analysis of variance (MANOVA). The participants were 144 individuals with SCI…

  18. Social Cognitive and Planned Behavior Variables Associated with Stages of Change for Physical Activity in Spinal Cord Injury: A Multivariate Analysis

    ERIC Educational Resources Information Center

    Keegan, John; Ditchman, Nicole; Dutta, Alo; Chiu, Chung-Yi; Muller, Veronica; Chan, Fong; Kundu, Madan

    2016-01-01

    Purpose: To apply the constructs of social cognitive theory (SCT) and the theory of planned behavior (TPB) to understand the stages of change (SOC) for physical activities among individuals with a spinal cord injury (SCI). Method: Ex post facto design using multivariate analysis of variance (MANOVA). The participants were 144 individuals with SCI…

  19. Predictive Ability of Pender's Health Promotion Model for Physical Activity and Exercise in People with Spinal Cord Injuries: A Hierarchical Regression Analysis

    ERIC Educational Resources Information Center

    Keegan, John P.; Chan, Fong; Ditchman, Nicole; Chiu, Chung-Yi

    2012-01-01

    The main objective of this study was to validate Pender's Health Promotion Model (HPM) as a motivational model for exercise/physical activity self-management for people with spinal cord injuries (SCIs). Quantitative descriptive research design using hierarchical regression analysis (HRA) was used. A total of 126 individuals with SCI were recruited…

  20. The influences of cognitive appraisal, physical injury, coping strategy, and forgiveness of others on PTSD symptoms in traffic accidents using hierarchical linear modeling.

    PubMed

    Hyun, Myoung-Ho; Bae, Sung-Man

    2017-09-01

    The purpose of this study was to identify how physical injury, perceived threat, forgiveness of others, and problem-focused coping influence the change of posttraumatic stress disorder (PTSD) symptoms. One hundred twenty patients who had experienced a traumatic vehicle accident participated in 1 to 2 months after the accident; 70 of these people involved at 6 months after the accident. We used a hierarchical linear model analysis to verify the impacts of predictors on change of PTSD symptoms as time passed. The results showed that PTSD symptoms decreased over time, and greater perceived threat would worsen PTSD symptoms and more forgiveness would decrease PTSD symptoms. On the other hand problem-focused coping and physical injury severity were not significantly related to the PTSD symptoms. Specifically, greater perceived threat was found to be related with a deceleration of the decrease in PTSD symptoms, whereas greater forgiveness of others was associated with an acceleration of this decrease. However, problem-focused coping and physical injury severity had no influence on the change rate of PTSD symptoms. Cognitive variable could be more important than physical injury to understand PTSD. In addition, forgiveness of other in a traumatic situation needs to be considered as one of coping strategies.

  1. The influences of cognitive appraisal, physical injury, coping strategy, and forgiveness of others on PTSD symptoms in traffic accidents using hierarchical linear modeling

    PubMed Central

    Hyun, Myoung-Ho; Bae, Sung-Man

    2017-01-01

    Abstract The purpose of this study was to identify how physical injury, perceived threat, forgiveness of others, and problem-focused coping influence the change of posttraumatic stress disorder (PTSD) symptoms. One hundred twenty patients who had experienced a traumatic vehicle accident participated in 1 to 2 months after the accident; 70 of these people involved at 6 months after the accident. We used a hierarchical linear model analysis to verify the impacts of predictors on change of PTSD symptoms as time passed. The results showed that PTSD symptoms decreased over time, and greater perceived threat would worsen PTSD symptoms and more forgiveness would decrease PTSD symptoms. On the other hand problem-focused coping and physical injury severity were not significantly related to the PTSD symptoms. Specifically, greater perceived threat was found to be related with a deceleration of the decrease in PTSD symptoms, whereas greater forgiveness of others was associated with an acceleration of this decrease. However, problem-focused coping and physical injury severity had no influence on the change rate of PTSD symptoms. Cognitive variable could be more important than physical injury to understand PTSD. In addition, forgiveness of other in a traumatic situation needs to be considered as one of coping strategies. PMID:28858087

  2. Identifying a Physical Indicator of Suicide Risk: Non-Suicidal Self-Injury Scars Predict Suicidal Ideation and Suicide Attempts

    PubMed Central

    Burke, Taylor A.; Hamilton, Jessica L.; Cohen, Jonah N.; Stange, Jonathan P.; Alloy, Lauren B.

    2015-01-01

    Background Suicide risk is challenging to quantify due to reliance on self-report, which is limited by individuals’ lack of insight and the desire to conceal such intentions. Non-suicidal self-injury (NSSI) is one of the most robust predictors of suicidal ideation (SI) and suicide attempts (SA). Although NSSI often leads to permanent scarring, which can be assessed by objective physical examination, no research has examined whether scarring denotes tangible risk for SI and SA. The present study examined whether NSSI scar presence and number predict current SI and SA history. Further, we examined whether brooding would exacerbate the effects of NSSI scarring on SI or SA. Methods Young adults (N = 231; M = 21.24 years; 78% female) completed self-report questionnaires assessing SA history, frequency of NSSI, presence/number of NSSI scars, brooding, current depressive symptoms, and SI. Results NSSI scar presence and number predicted current SI and SA history after controlling for current depressive symptoms. Moreover, scar presence and number predicted current SI over and above the effects of SA history and NSSI frequency, method, and medical severity. Further, NSSI scar presence and number predicted SI more strongly among individuals with greater levels of brooding than among individuals with lower levels of brooding. Conclusions The presence and number of NSSI scars are objective physical indicators of risk for SI and SAs. Brooding may further heighten the risk of SI for individuals bearing NSSI scars. PMID:26773994

  3. Inpatient physical therapy rehabilitation provided for a patient with complete vision loss following a traumatic brain injury.

    PubMed

    Warnecke, Jessica; Devine, Nancy; Olen, Christine

    2015-01-01

    Data from the World Health Organization estimates the global incidence of traumatic brain injury resulting in hospitalization or mortality to be close to 10 million people each year. People who sustain a blast-related TBI are more likely to sustain visual impairment than people injured by other means. There is a lack of published literature regarding the most effective means to assist a patient's recovery from TBI with new vision loss. The aim of this report is to describe the physical therapy management of a person regaining functional mobility when newly blind following a blast-related TBI. This case report describes the inpatient rehabilitation physical therapy (PT) services provided for a single subject who experienced a blast-related TBI with complete vision loss. The subject spent 3.5 weeks in IPR and participated in 21 PT sessions before being discharged home. Improvements in cognition, transfers and functional mobility with adaptations for vision loss were achieved, as well as caregiver training, to provide 24-hour supervision in the home. Collaborating with a blind specialist teacher assisted the rehabilitation of this subject. Further research is needed regarding the effective interventions for those with TBI and vision loss.

  4. A Quality Improvement Project Sustainably Decreased Time to Onset of Active Physical Therapy Intervention in Patients with Acute Lung Injury

    PubMed Central

    Dinglas, Victor D.; Reddy, Dereddi Raja S.; Colantuoni, Elizabeth; Zanni, Jennifer M.; Turnbull, Alison E.; Nelliot, Archana; Ciesla, Nancy; Needham, Dale M.

    2014-01-01

    Rationale: Rehabilitation started early during an intensive care unit (ICU) stay is associated with improved outcomes and is the basis for many quality improvement (QI) projects showing important changes in practice. However, little evidence exists regarding whether such changes are sustainable in real-world practice. Objectives: To evaluate the sustained effect of a quality improvement project on the timing of initiation of active physical therapy intervention in patients with acute lung injury (ALI). Methods: This was a pre–post evaluation using prospectively collected data involving consecutive patients with ALI admitted pre–quality improvement (October 2004–April 2007, n = 120) versus post–quality improvement (July 2009–July 2012, n = 123) from a single medical ICU. Measurements and Main Results: The primary outcome was time to first active physical therapy intervention, defined as strengthening, mobility, or cycle ergometry exercises. Among ICU survivors, more patients in the post–quality improvement versus pre–quality improvement group received physical therapy in the ICU (89% vs. 24%, P < 0.001) and were able to stand, transfer, or ambulate during physical therapy in the ICU (64% vs. 7%, P < 0.001). Among all patients in the post–quality improvement versus pre–quality improvement group, there was a shorter median (interquartile range) time to first physical therapy (4 [2, 6] vs. 11 d [6, 29], P < 0.001) and a greater median (interquartile range) proportion of ICU days with physical therapy after initiation (50% [33, 67%] vs. 18% [4, 47%], P = 0.003). In multivariable regression analysis, the post–quality improvement period was associated with shorter time to physical therapy (adjusted hazard ratio [95% confidence interval], 8.38 [4.98, 14.11], P < 0.001), with this association significant for each of the 5 years during the post–quality improvement period. The following variables were independently associated with a longer time to

  5. Athletic trainers' and physical therapists' perceptions of the effectiveness of psychological skills within sport injury rehabilitation programs.

    PubMed

    Hamson-Utley, J Jordan; Martin, Scott; Walters, Jason

    2008-01-01

    Psychological skills are alleged to augment sport-injury rehabilitation; however, implementation of mental imagery within rehabilitation programs is limited. To examine attitudes of athletic trainers (ATs) and physical therapists (PTs) on the effectiveness of mental imagery, goal setting, and positive self-talk to improve rehabilitation adherence and recovery speed of injured athletes. The ATs and PTs were contacted via electronic or physical mailings to complete a single administration survey that measured their beliefs about the effectiveness of psychological skills for increasing adherence and recovery speed of injured athletes undergoing rehabilitation. Professional member databases of the National Athletic Trainers' Association and the American Physical Therapy Association. Of the 1000 ATs and 1000 PTs who were selected randomly, 309 ATs (age = 34.18 +/- 8.32 years, years in profession = 10.67 +/- 7.34) and 356 PTs (age = 38.58 +/- 7.51 years, years in profession = 13.18 +/- 6.17) responded. The Attitudes About Imagery (AAI) survey measures attitudes about psychological skills for enhancing adherence and recovery speed of injured athletes. The AAI includes demographic questions and 15 items on a 7-point Likert scale measuring attitudes about the effectiveness of mental imagery, self-talk, goal setting, and pain control on rehabilitation adherence and recovery speed of injured athletes. Test-retest reliability ranged from .60 to .84 and Cronbach alphas ranged from .65 to .90. We calculated 1-way analyses of variance to determine whether differences existed in attitudes as a result of the professionals' education, training experience, and interest. Mean differences were found on attitudes about effectiveness of psychological skills for those who reported formal training and those who reported interest in receiving formal training (P < .05). In addition, ATs held more positive attitudes than PTs on 9 of 15 AAI items (P < .05). Overall, ATs and PTs held positive

  6. Attention and dual-task conditions: physical therapy implications for individuals with acquired brain injury.

    PubMed

    McCulloch, Karen

    2007-09-01

    The aim of this article is to consider how impairments in attention may affect the performance of two tasks during balance or walking in individuals recovering from acquired brain injury (ABI). Guidelines from the experimental dual-task paradigm from cognitive psychology are reviewed. In this paper, dual-task conditions are described as the use of two tasks performed simultaneously, but not necessarily following all the experimental guidelines of the dual-task paradigm. How and why dual-task costs may emerge are discussed as well as considerations for task selection. Review of literature that describes dual-task performance problems in older adults is summarized briefly as a foundation for considering how similar conditions may affect individuals with ABI. Studies of individuals with ABI of dual-task performance in balance or walking are reviewed in detail. Examination approaches including observational measures of attention as well as clinical measures of dual-task performance during walking are reviewed. Intervention concepts and approaches are described by review of intervention designs used with older adults and individuals with ABI that describe task selection and use of instructional set for dual-task training. Two intervention strategies described in the literature for treating attention problems are contrasted: (1) an explicit focus on cognitive impairments with the expectation that function will improve as a result and (2) an implicit focus on functional tasks through errorless learning with the expectation that cognition (and attention) will improve. An illustration of the use of both of these strategies in a complementary fashion to improve attention in a patient with ABI is reviewed. Current literature is limited in clearly directing assessment and intervention to improve attention after ABI, but strategies are presented and areas for future research are identified.

  7. The risk of PTSD and depression after an airplane crash and its potential association with physical injury: A longitudinal study.

    PubMed

    Gouweloos, Juul; Postma, Ingri L E; te Brake, Hans; Sijbrandij, Marit; Kleber, Rolf J; Goslings, J Carel

    2016-01-01

    In 2009, a commercial airplane crashed near Amsterdam. This longitudinal study aims to investigate (1) the proportion of survivors of the airplane crash showing a probable posttraumatic stress disorders (PTSD) or depressive disorder, and (2) whether symptoms of PTSD and depression were predicted by trauma characteristics. Identifying these trauma characteristics is crucial for early detection and treatment. Of the 121 adult survivors, 82 participated in this study 2 months after the crash and 76 participated 9 months after the crash. Risk for PTSD and depression was measured with the self-report instruments Trauma Screening Questionnaire and Patient Health Questionnaire-2. Trauma characteristics assessed were Injury Severity Score (ISS), hospitalisation, length of hospital stay, and seating position in the plane. Two months after the crash, 32 participants (of N=70, 46%) were at risk for PTSD and 28 (of N=80, 32%) were at risk for depression. Nine months after the crash, 35 participants (of N=75, 47%) were at risk for PTSD and 24 (of N=76, 35%) were at risk for depression. There was a moderate correlation between length of hospital stay and symptoms of PTSD and depression 9 months after the crash (r=.33 and r=.45, respectively). There were no differences in seating position between participants at high risk vs. participants at low risk for PTSD or depression. Mixed design ANOVAs showed also no association between the course of symptoms of PTSD and depression 2 and 9 months after the crash and ISS or hospitalisation. This suggests that health care providers need to be aware that survivors may be at risk for PTSD or depression, regardless of the objective severity of their physical injuries.

  8. Confirmation of the safety and accuracy of physical examination in the evaluation of knee dislocation for injury of the popliteal artery: a prospective study.

    PubMed

    Miranda, Fernando E; Dennis, James W; Veldenz, Henry C; Dovgan, Peter S; Frykberg, Eric R

    2002-02-01

    Knee dislocation, which poses a significant risk for injury of the popliteal artery, prompts many surgeons to evaluate these patients with arteriography routinely. Our hypothesis was that physical examination alone (without arteriography) accurately confirms or excludes surgically significant vascular injuries associated with knee dislocation. All patients diagnosed with a knee dislocation by an attending orthopedic surgeon between January 1990 and January 2000 were prospectively managed by protocol at our Level I trauma center according to their physical examination. Those with hard signs (active hemorrhage, expanding hematoma, absent pulse, distal ischemia, bruit/thrill) underwent arteriography followed immediately by surgical repair if indicated. Patients with no hard signs (negative physical examination) were admitted for 23 hours, underwent serial physical examination, and then followed as outpatients. There were 35 knee dislocations in 35 patients during this 10-year period. The average age was 31 years; 18 dislocations were on the right knee and 17 were on the left. Two patients died from closed head injuries and multisystem trauma. Eight patients were found to have hard signs (positive physical examination) either at presentation (six patients) or during their hospitalization after reduction of their dislocation (two patients). All eight patients demonstrated a loss of pulses only. Six of these patients showed occlusion of the popliteal artery on arteriography and underwent surgical repair without complication (five vein grafts, one primary repair), one demonstrated spasm of the popliteal artery, and one showed a normal artery that required no treatment. None of the 27 patients with negative physical examination during their hospitalization ever developed limb ischemia, needed an operation for vascular injury, or experienced limb loss. Sixteen patients were available for follow-up (46%). Twelve patients with negative physical examination (44%) were

  9. [Rehabilitation of war injuries of the upper extremities with peripheral nerve lesions at the and Praxis Clinic for physical medicine and rehabilitation in Sarajevo].

    PubMed

    Pecar, Dzemal; Masić, Izet; Karić, Mediha; Kulenović, Husein; Pecar, Muris; Mujić, Muzafer

    2003-01-01

    The war injuries are the most frequent multiple, with the difficult distructions of the tissue and the lesions of the peripheral nerves. By the injuries, the lesions of the nerv system represent the delicate problem for the physical medicine and the rehabilitation during the siege of Sarajevo (1992-1995), in the injuries with the lesions of the peripheral nerves, if they are not treated in the frame of the multiple las urgent, they are postponed the operative treatments longer than three months. This is from the aspect of the successfullness, prognostically and therapeutically, the limiting moment. The successfullness of the operative treatment of the lesions of the peripheral nerves significantly depends on that whether the operation was performed incide tree months. The more difficult consequences in these injuries can appear if simultaneously with the taking care of war injuries does not perform adequately surgical treatment adn the in time physical therapy trough the sufficient long time period. On the four year sample was analyzed the success fullness of the rehabilitation of the injuries of the upper extremities with the lesions of the peripheral nerves. Clinically, uniform, we valorized the success fullness of the treatment of all the patients by the marks from 0.5. In the complete sample the excellent success of the rehabilitation we confirmed in more than a half of patients. The better results show the group of the operated patients, in which is performed neuropathia or neurolisis. The capability of the regeneration of the injured peripheral nerves offers the real possibility for extraordinary recovery also in the most difficult injuries, then the preventions of the significant number of the consequences.

  10. Physical activity is related to lower levels of pain, fatigue, and depression in individuals with spinal cord injury: A correlational study

    PubMed Central

    Tawashy, A; Eng, JJ; Lin, KH; Tang, PF; Hung, C

    2011-01-01

    Study Design This was a prospective cross-sectional study for people with chronic SCI. Objectives To (1) evaluate the intensity level and nature of physical activity in community-dwelling individuals living with SCI, and (2) explore the relation between descriptive individual variables (e.g. lesion level), secondary complications, and participation in physical activity. Setting Urban community setting Methods Forty-nine subjects with SCI who used a manual wheelchair for primary mode of mobility (mean years since injury, 11.8; mean age, 43.7 years; 67% paraplegia) completed the physical activity recall assessment for people with spinal cord injury (PARA-SCI). Results Approximately 50% of reported physical activity among individuals with SCI is due to activities of daily living. The amount of physical activity was not related to lesion level, age, BMI, or waistline size. Greater heavy intensity activity was related to lower levels of pain and fatigue and higher levels of self efficacy while higher amounts of mild intensity activity and total activity were related to less depressive symptoms. Conclusions Activities of daily living are a large component for physical activity among individuals with SCI. It appears that greater physical activity is associated with less secondary complications (pain, fatigue and depression) in individuals with SCI. PMID:18936771

  11. Physical symptoms 14 months after a natural disaster in individuals with or without injury are associated with different types of exposure.

    PubMed

    Keskinen-Rosenqvist, Riitta; Michélsen, Hans; Schulman, Abbe; Wahlström, Lars

    2011-09-01

    To investigate whether different types of exposure to the 2004 tsunami were associated with physical symptoms 14 months after the disaster and to study correlations between survivors' physical and psychological symptoms. Using a cross-sectional design, 1505 survivors from the 2004 Indian Ocean Tsunami, tourists from Stockholm, who had been present in the disaster areas, responded to a postal questionnaire. Eight groups based on type of exposure were created. Physical symptoms occurring on a daily or weekly basis over the past year were investigated in four indices: musculoskeletal, cardiorespiratory, neurological, and gastrointestinal. Mental health symptoms (General Health Questionnaire-12) and posttraumatic stress symptoms (Impact of Event Scale-Revised) were also investigated. Multiple logistic regression analyses were conducted with controls for background variables and exposure, with physical symptoms as outcome variables. The association between physical and psychological symptoms was studied with the Spearman Rank Order Correlation. Different types of exposure during the disaster were associated with physical symptoms 14 months later for survivors both with and without severe physical injury. The single exposure of life threat, also in combination with other exposures, was associated with a higher risk for reporting of physical symptoms. Physical symptoms showed modest yet significant correlation with psychological symptoms. It is important to pay attention to both physical and psychological symptoms among disaster survivors whether they have been injured or not. A relatively simple questionnaire about physical symptoms may be a good complement to the scales used to assess psychological problems after disaster. Copyright © 2011 Elsevier Inc. All rights reserved.

  12. A Randomized, Controlled Trial of Immersive Virtual Reality Analgesia during Physical Therapy for Pediatric Burn Injuries

    PubMed Central

    Schmitt, Yuko S.; Hoffman, Hunter G.; Blough, David K.; Patterson, David R.; Jensen, Mark P.; Soltani, Maryam; Carrougher, Gretchen J.; Nakamura, Dana; Sharar, Sam R.

    2010-01-01

    This randomized, controlled, within-subjects (crossover design) study examined the effects of immersive virtual reality as an adjunctive analgesic technique for hospitalized pediatric burn inpatients undergoing painful physical therapy. Fifty-four subjects (6–19 years old) performed range-of-motion exercises under a therapist’s direction for one to five days. During each session, subjects spent equivalent time in both the virtual reality and the control conditions (treatment order randomized and counterbalanced). Graphic rating scale scores assessing the sensory, affective, and cognitive components of pain were obtained for each treatment condition. Secondary outcomes assessed subjects’ perception of the virtual reality experience and maximum range-of-motion. Results showed that on study day one, subjects reported significant decreases (27–44%) in pain ratings during virtual reality. They also reported improved affect (“fun”) during virtual reality. The analgesia and affect improvements were maintained with repeated virtual reality use over multiple therapy sessions. Maximum range-of-motion was not different between treatment conditions, but was significantly greater after the second treatment condition (regardless of treatment order). These results suggest that immersive virtual reality is an effective nonpharmacologic, adjunctive pain reduction technique in the pediatric burn population undergoing painful rehabilitation therapy. The magnitude of the analgesic effect is clinically meaningful and is maintained with repeated use. PMID:20692769

  13. Objective functional assessment after a head injury using movement and activity in physical space scores: a case report.

    PubMed

    Farnsworth, James L; McElhiney, Danielle; David, Shannon; Sinha, Gaurav; Ragan, Brian G

    2014-01-01

    To describe the potential benefit of using a global positioning system (GPS) and accelerometry as an objective functional-activity measure after concussion by creating Movement and Activity in Physical Space (MAPS) scores. A 21-year-old female soccer player suffered a blow to the back of the head from an opponent's shoulder during an away match. No athletic trainer was present. She played the remainder of the match and reported to the athletic training facility the next day for evaluation. Concussion. The athlete was removed from all athletic activities. Her symptoms were monitored based on the Zurich guidelines. She was also instructed to wear an accelerometer on her hip and to carry an on-person GPS receiver at all times for 10 days. Her total symptom scores for the 4 symptomatic days were 82, 39, 49, and 36. Her mean MAPS functional score for symptomatic days 3 through 5 was 900.9 and for asymptomatic days 6 through 11 was 2734.9. We monitored the patient's function during the concussion-recovery process using an on-person GPS receiver and accelerometer to calculate personalized MAPS scores. This novel approach to measuring function after injury may provide a useful complementary tool to help with return-to-play decisions. An on-person GPS receiver and accelerometer were used to observe the patient's physical activity in a free-living environment, allowing for an objective measure of function during recovery. Her MAPS scores were low while she was symptomatic and increased as she became asymptomatic. We saw the expected inverse relationship between symptoms and function. In situations where accuracy of reported symptoms may be a concern, this measure may provide a way to verify the validity of, or raise doubts about, self-reported symptoms.

  14. Physical impaction injury effects on bacterial cells during spread plating influenced by cell characteristics of the organisms.

    PubMed

    Thomas, P; Mujawar, M M; Sekhar, A C; Upreti, R

    2014-04-01

    To understand the factors that contribute to the variations in colony-forming units (CFU) in different bacteria during spread plating. Employing a mix culture of vegetative cells of ten organisms varying in cell characteristics (Gram reaction, cell shape and cell size), spread plating to the extent of just drying the agar surface (50-60 s) was tested in comparison with the alternate spotting-and-tilt-spreading (SATS) approach where 100 μl inoculum was distributed by mere tilting of plate after spotting as 20-25 microdrops. The former imparted a significant reduction in CFU by 20% over the spreader-independent SATS approach. Extending the testing to single organisms, Gram-negative proteobacteria with relatively larger cells (Escherichia, Enterobacter, Agrobacterium, Ralstonia, Pantoea, Pseudomonas and Sphingomonas spp.) showed significant CFU reduction with spread plating except for slow-growing Methylobacterium sp., while those with small rods (Xenophilus sp.) and cocci (Acinetobacter sp.) were less affected. Among Gram-positive nonspore formers, Staphylococcus epidermidis showed significant CFU reduction while Staphylococcus haemolyticus and actinobacteria (Microbacterium, Cellulosimicrobium and Brachybacterium spp.) with small rods/cocci were unaffected. Vegetative cells of Bacillus pumilus and B. subtilis were generally unaffected while others with larger rods (B. thuringiensis, Brevibacillus, Lysinibacillus and Paenibacillus spp.) were significantly affected. A simulated plating study coupled with live-dead bacterial staining endorsed the chances of cell disruption with spreader impaction in afflicted organisms. Significant reduction in CFU could occur during spread plating due to physical impaction injury to bacterial cells depending on the spreader usage and the variable effects on different organisms are determined by Gram reaction, cell size and cell shape. The inoculum spreader could impart physical disruption of vegetative cells against a hard surface

  15. Shoulder Strength and Physical Activity Predictors of Shoulder Pain in People With Paraplegia From Spinal Injury: Prospective Cohort Study.

    PubMed

    Mulroy, Sara J; Hatchett, Patricia; Eberly, Valerie J; Haubert, Lisa Lighthall; Conners, Sandy; Requejo, Philip S

    2015-07-01

    Shoulder joint pain is a frequent secondary complaint for people following spinal cord injury (SCI). The purpose of this study was to determine predictors of shoulder joint pain in people with paraplegia. A 3-year longitudinal study was conducted. Participants were people with paraplegia who used a manual wheelchair for at least 50% of their mobility and were asymptomatic for shoulder pain at study entry. Participants were classified as having developed shoulder pain if they experienced an increase of ≥10 points on the Wheelchair User's Shoulder Pain Index in the 3-year follow-up period. Measurements of maximal isometric shoulder torques were collected at study entry (baseline), 18 months, and 3 years. Daily activity was measured using a wheelchair odometer, and self-reported daily transfer and raise frequency data were collected by telephone every 6 weeks. Two hundred twenty-three participants were enrolled in the study; 39.8% developed shoulder pain over the 3-year follow-up period. Demographic variables and higher activity levels were not associated with shoulder pain onset. Baseline maximal isometric torque (normalized by body weight) in all shoulder muscle groups was 10% to 15% lower in participants who developed shoulder pain compared with those who remained pain-free. Lower shoulder adduction torque was a significant predictor of shoulder pain development (log-likelihood test=11.38), but the model explained only 7.5% of shoulder pain onset and consequently is of limited clinical utility. Time since SCI varied widely among participants, and transfer and raise activity was measured by participant recall. Participants who developed shoulder pain had decreased muscle strength, particularly in the shoulder adductors, and lower levels of physical activity prior to the onset of shoulder pain. Neither factor was a strong predictor of shoulder pain onset. © 2015 American Physical Therapy Association.

  16. A systematic review of the efficacy of self-management programs for increasing physical activity in community-dwelling adults with acquired brain injury (ABI).

    PubMed

    Jones, Taryn M; Dean, Catherine M; Hush, Julia M; Dear, Blake F; Titov, Nickolai

    2015-04-19

    Individuals living with acquired brain injury, typically caused by stroke or trauma, are far less likely to achieve recommended levels of physical activity for optimal health and well-being. With a growing number of people living with chronic disease and disability globally, self-management programs are seen as integral to the management of these conditions and the prevention of secondary health conditions. However, to date, there has been no systematic review of the literature examining the efficacy of self-management programs specifically on physical activity in individuals with acquired brain injury, whether delivered face-to-face or remotely. Therefore, the purpose of this review is to evaluate the efficacy of self-management programs in increasing physical activity levels in adults living in the community following acquired brain injury. The efficacy of remote versus face-to-face delivery was also examined. A systematic review of the literature was conducted. Electronic databases were searched. Two independent reviewers screened all studies for eligibility, assessed risk of bias, and extracted relevant data. Five studies met the inclusion criteria for this review. Studies were widely heterogeneous with respect to program content and delivery characteristics and outcomes, although all programs utilized behavioral change principles. Four of the five studies examined interventions in which physical activity was a component of a multifaceted intervention, where the depth to which physical activity specific content was covered, and the extent to which skills were taught and practiced, could not be clearly established. Three studies showed favorable physical activity outcomes following self-management interventions for stroke; however, risk of bias was high, and overall efficacy remains unclear. Although not used in isolation from face-to-face delivery, remote delivery via telephone was the predominant form of delivery in two studies with support for its inclusion

  17. Effects of aerobic endurance, muscle strength, and motor control exercise on physical fitness and musculoskeletal injury rate in preprofessional dancers: an uncontrolled trial.

    PubMed

    Mistiaen, Wilhelm; Roussel, Nathalie A; Vissers, Dirk; Daenen, Liesbeth; Truijen, Steven; Nijs, Jo

    2012-06-01

    The purpose of this study was to evaluate musculoskeletal injury rate and physical fitness before and 6 months after an endurance, strength, and motor control exercise program in preprofessional dancers. This uncontrolled trial was completed at a college offering a professional bachelor degree in dance. Forty preprofessional dancers underwent a test battery before and after a 6-month lasting exercise program in addition to their regular dance lessons. Physical fitness was evaluated by means of a submaximal exercise test with continuous physiological monitoring and by a field test for explosive strength. Anthropometric measurements were taken to analyze the influence of fitness training on body composition. Musculoskeletal injury incidence and quality of life were recorded during the 6-month lasting intervention. An intention-to-treat analysis ("last observation carried forward" method) was used with a Student t test for normally distributed variables. The Wilcoxon signed rank and Mann-Whitney U tests were used as nonparametric tests. Physical fitness improved after the 6 months of additional training program (P<.05). The waist:hip ratio (P=.036) and the sum of the measured subcutaneous skin thickness (P=.001) significantly decreased. Twelve dancers developed musculoskeletal complaints, requiring temporary interruption of dancing. The combination of regular dance lessons with an additional exercise program resulted in improved physical fitness in preprofessional dancers, without affecting the aesthetical appearance. A relatively high injury rate was observed during the intervention period. These results suggest that a randomized, controlled trial should be performed to examine the effectiveness of additional exercise in dancers on physical fitness and musculoskeletal injury rate. Copyright © 2012 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

  18. Outcome Measures for Persons With Moderate to Severe Traumatic Brain Injury: Recommendations From the American Physical Therapy Association Academy of Neurologic Physical Therapy TBI EDGE Task Force.

    PubMed

    McCulloch, Karen L; de Joya, Anna Lisa; Hays, Kaitlin; Donnelly, Erin; Johnson, Tammie Keller; Nirider, Coby D; Roth, Heidi; Saliga, Sue; Ward, Irene

    2016-10-01

    The use of standardized outcome measures (OMs) is essential in assessing the effectiveness of physical therapy (PT) interventions. The purposes of this article are (1) to describe the process used by the TBI EDGE task force to assess the psychometrics and clinical utility of OMs used with individuals with moderate to severe traumatic brain injury (TBI); (2) to describe the consensus recommendations for OM use in clinical practice, research, and professional (entry-level) PT education; and (3) to make recommendations for future work. An 8-member task force used a modified Delphi process to develop recommendations on the selection of OMs for individuals with TBI. A 4-point rating scale was used to make recommendations based on practice setting and level of ambulation. Recommendations for appropriateness for research use and inclusion in entry-level education were also provided. The TBI EDGE task force reviewed 88 OMs across the International Classification of Functioning, Disability, and Health (ICF) domains: 15 measured body functions/structure only, 21 measured activity only, 23 measured participation only, and 29 OMs covered more than 1 ICF domain. Recommendations made by the TBI EDGE task force provide clinicians, researchers, and educators with guidance for the selection of OMs. The use of these recommendations may facilitate identification of appropriate OMs in the population with moderate to severe TBI. TBI EDGE task force recommendations can be used by clinicians, researchers, and educators when selecting OMs for their respective needs. Future efforts to update the recommendations are warranted in order to ensure that recommendations remain current and applicable.Video Abstract available for more insights from the authors (see Supplemental Digital Content 1, http://links.lww.com/JNPT/A140).

  19. Development of Predictive Models of Injury for the Lower Extremity, Lumbar, and Thoracic Spine after Discharge from Physical Rehabilitation

    DTIC Science & Technology

    2016-10-01

    injury prevention approach is required to optimize return to duty rates after injury: Screening for known preventable musculoskeletal risk factors...medical care is ready to return to full duty. Because history of prior injury is a well-established risk factor, every service member that is...provides the ability for secondary and tertiary prevention programs to optimize return to duty rates. Hypothesis 1: Risk factors shown to be

  20. Low-intensity wheelchair training in inactive people with long-term spinal cord injury: A randomized controlled trial on fitness, wheelchair skill performance and physical activity levels.

    PubMed

    van der Scheer, Jan W; de Groot, Sonja; Tepper, Marga; Faber, Willemijn; Veeger, DirkJan H; van der Woude, Lucas H V

    2016-01-01

    To investigate the effects of low-intensity wheelchair training on wheelchair-specific fitness, wheelchair skill performance and physical activity levels in inactive people with long-term spinal cord injury. Randomized controlled trial. Inactive manual wheelchair users with spinal cord injury for at least 10 years (n = 29), allocated to exercise (n = 14) or no exercise. The 16-week training consisted of wheelchair treadmill-propulsion at 30-40% heart rate reserve or equi-valent in terms of rate of perceived exertion, twice a week, for 30 min per session. Wheelchair-specific fitness was determined as the highest 5-s power output over 15-m overground wheelchair sprinting (P5-15m), isometric push-force, submaximal fitness and peak aerobic work capacity. Skill was determined as performance time, ability and strain scores over a wheelchair circuit. Activity was determined using a questionnaire and an odometer. Significant training effects appeared only in P5-15m (exercise vs control: mean +2.0 W vs -0.7 W, p = 0.017, ru=0.65). The low-intensity wheelchair training appeared insufficient for substantial effects in the sample of inactive people with long-term spinal cord injury, presumably in part owing to a too-low exercise frequency. Effective yet feasible and sustainable training, as well as other physical activity programmes remain to be developed for inactive people with long-term spinal cord injury.

  1. Physical exam and occult post-traumatic vascular lesions: implications for the evaluation and management of arterial injuries in modern warfare in the endovascular era.

    PubMed

    Johnson, O N; Fox, C J; White, P; Adams, E; Cox, M; Rich, N; Gillespie, D L

    2007-10-01

    Based on complexity of extremity wounds sustained in recent combat, arteriography had been used routinely in evaluations for delayed or occult arterial injuries. This report aims to quantitatively analyze the sensitivity and specificity of physical exam (PE) in predicting the presence of these injuries. United States service members sustaining extremity trauma in the Global War on Terrorism were evacuated to our medical center and evaluated by a senior vascular surgeon. Those with an abnormal PE, at risk based on wounding patterns, or previously treated for vascular injury underwent arteriography. Data from each patient were prospectively entered into a Vascular Injury registry. Comprehensive information about the injuries, interventions, arteriogram results, and any periprocedural complications were analyzed. Twenty-five endovascular or open surgical interventions were performed in forty-six of 99 patients that had lesions on arteriography. Seventy-three patients had a normal PE, of which 36 had lesions that prompted 6 subsequent interventions. Twenty-two of 26 patients with an abnormal PE had lesions that prompted 19 interventions. For PE, sensitivity was 38%, specificity was 90%, and positive predictive value (PPV) and negative predictive value (NPV) were 85% and 51%, respectively. In proximity injuries, PPV improved to 100%, but was only 15% sensitive with a NPV of 60%. In conclusion normal PE did not reliably predict post-traumatic arterial lesions in these military extremity injuries. These lesions are amenable to endovascular therapies, and should be considered in cases of complex trauma involving high amounts of energy, penetrating mechanisms, or wounding patterns in proximity to named vessels.

  2. 2015 JOSPT Awards: Back Pain and Anterior Cruciate Ligament Injuries Are a Continued Focus of Research and Clinical Attention in Physical Therapy.

    PubMed

    Simoneau, Guy G

    2016-04-01

    During the American Physical Therapy Association's Combined Sections Meeting in Anaheim, California in February 2016, JOSPT recognized the authors of the most outstanding research and clinical practice manuscripts published in JOSPT during the 2015 calendar year. The 2015 JOSPT Excellence in Research Award was presented to Björn Aasa, Lars Berglund, Peter Michaelson, and Ulrika Aasa for their paper titled "Individualized Low-Load Motor Control Exercises and Education Versus a High-Load Lifting Exercise and Education to Improve Activity, Pain Intensity, and Physical Performance in Patients With Low Back Pain: A Randomized Controlled Trial." The 2015 George J. Davies-James A. Gould Excellence in Clinical Inquiry Award was presented to Anne Benjaminse, Alli Gokeler, Bert Otten, Ariel V. Dowling, Avery Faigenbaum, Kevin R. Ford, Timothy E. Hewett, James A. Onate, and Gregory D. Myer for their work titled "Optimization of the Anterior Cruciate Ligament Injury Prevention Paradigm: Novel Feedback Techniques to Enhance Motor Learning and Reduce Injury Risk."

  3. Current NRC activities related to MQA

    SciTech Connect

    Trottier, C.A.; Nellis, D.O.

    1993-12-31

    The U.S. Nuclear Regulatory Commission`s (NRC`s) interest in measurement quality assurance (MQA) goes back to before 1963, when the Atomic Energy Commission (AEC) published a notice in the Federal Register concerning the need for establishing a Film Dosimetry Calibration Laboratory, and also provided a set of minimum performance criteria to be used by the laboratory in evaluating film dosimetry services used by licensees. The proposed laboratory was not established, but in 1967 the AEC contracted with Battelle`s Pacific Northwest Laboratory (PNL) to evaluate film dosimeter performance criteria and provide a basis for establishing a Film Dosimetry Calibration Laboratory if the study showed that it was needed. Then, in 1973, the Conference of Radiation Control Program Directors (CRCPD), concerned with the state of dosimetry processing and the lack of adequate standards, recommended that the National Bureau of Standards (NBS) direct a performance testing program for personnel dosimetry processing services. Later, in 1976, NRC asked PNL to conduct a study to evaluate the four existing performance standards for personnel dosimetry processing. One result of this study was that the HPSSC standard, which later became ANSI N13.11, was recommended as the standard for use in a national dosimetry processing program. The rest is common knowledge. With the support of numerous other federal agencies and the CRCPD, NRC published a regulation, effective in 1988, that required all processors of personnel dosimeters be accredited under the National Voluntary Laboratory Accreditation Program (NVLAP), operated by the NBS, which is now called the National Institute of Standards and Technology (NIST). At present, there are 75 dosimetry processing laboratories accredited under NVLAP. NRC has also been involved in extremity dosimeters, health physics survey instruments, bioassay measurements, electronic personnel dosimeters, and environmental monitoring around nuclear power plants.

  4. Physical Fitness and Injuries Before and After Deployments of the United States (US) Army to Afghanistan and Iraq

    DTIC Science & Technology

    2009-10-01

    Comparisons of cumulative injury incidence between each of the four periods were determined by the McNemar Test. The McNemar Test allows for...IQ, n=3242). Cohort Injury Incidence p-value ( McNemar Test) Pre Deployment Post-Deployment Period 1 Period 2 Period 3 Period 4 Period1 vs Period2

  5. Evaluation of Chronic Physical and Psychological Stress Induction on Cardiac Ischemia / Reperfusion Injuries in Isolated Male Rat Heart: The Role of Sympathetic Nervous System.

    PubMed

    Rakhshan, Kamran; Imani, Alireza; Faghihi, Mahdieh; Nabavizadeh, Fatemeh; Golnazari, Masoumeh; Karimian, SeyedMorteza

    2015-08-01

    Exposure to stress leads to physiological changes called "stress response" which are the result of the changes in the adrenomedullary hormone system, hypothalamus-pituitary-adrenal (HPA) and sympathetic nervous system (SNS) activity. In the present study, the effects of chronic physical and psychological stress and also the role of sympathetic system effects in stress on ischemia/reperfusion (I/R) injuries have been studied in isolated rat heart. Rat heart was isolated and subjected to 30 min regional ischemia and 120 min reperfusion. The daily stress was induced for one week prior to I/R induction. Sympathectomy was done chemically by injection of hydroxyl-dopamine prior to stress induction. There were no significant changes in heart rate and Coronary Flow between groups. Left ventricular developed pressure (LVDP) and rate product pressure (RPP) in both physical and psychological stress groups decreased significantly compared to those in control group (P<0.05), but there was no significant difference between physical and psychological stress groups. Infarct size significantly increased in both physical and psychological stress groups and control group(P<0.05. Sympathectomy before induction of stress led to the elimination of the deleterious effects of stress as compared with stress groups (P<0.05). These results show that induction of chronic physical and psychological stress prior to ischemia/reperfusion causes enhancement of myocardial injuries and it seems that increased sympathetic activity in response to stress is responsible for these adverse effects of stress on ischemic/reperfused heart.

  6. A Systematic Review of the Association Between Physical Fitness and Musculoskeletal Injury Risk: Part 2 - Muscular Endurance and Muscular Strength.

    PubMed

    de la Motte, Sarah J; Gribbin, Timothy C; Lisman, Peter; Murphy, Kaitlin; Deuster, Patricia A

    2017-08-04

    This is a systematic review and evaluation of the current evidence on the association between muscular endurance (ME) and/or muscular strength (MS) and musculoskeletal injury (MSK-I) risk in military and civilian populations. MEDLINE, EBSCO, EMBASE, and the Defense Technical Information Center were searched for original studies published from 1970 through 2015 that examined associations between physical fitness (ME and MS) and MSK-I in military or civilian populations. Methodological quality and strength of the evidence were determined following criteria adapted from previously published systematic reviews. Forty-five of 4,229 citations met our inclusion criteria. Although results for some tests did vary by sex, taken together, our primary findings indicate there is 1) strong evidence that poor performance on a push-up test is associated with MSK-I risk; 2) moderate evidence that poor performance on sit-up test is associated with MSK-I risk; 3) moderate evidence that isokinetic ankle and knee flexion strength, and isometric strength assessments at the back, elbow, or knee are associated with MSK-I risk; and 4) limited evidence that poor performance on a pull-up test and isotonic assessments of muscular strength are associated with MSK-I. Several measures of ME/MS are moderately or strongly associated with risk for MSK-I, but additional research is needed to identify and recommend specific assessments of ME/MS that predict MSK-I in both males and females. Future studies should also consider measures of ME and MS as a function of upper body, lower body, and core strength, and their potential association with specific, rather than general, MSK-I.

  7. Shoulder Strength and Physical Activity Predictors of Shoulder Pain in People With Paraplegia From Spinal Injury: Prospective Cohort Study

    PubMed Central

    Hatchett, Patricia; Eberly, Valerie J.; Lighthall Haubert, Lisa; Conners, Sandy; Requejo, Philip S.

    2015-01-01

    Background Shoulder joint pain is a frequent secondary complaint for people following spinal cord injury (SCI). Objective The purpose of this study was to determine predictors of shoulder joint pain in people with paraplegia. Methods/Design A 3-year longitudinal study was conducted. Participants were people with paraplegia who used a manual wheelchair for at least 50% of their mobility and were asymptomatic for shoulder pain at study entry. Participants were classified as having developed shoulder pain if they experienced an increase of ≥10 points on the Wheelchair User's Shoulder Pain Index in the 3-year follow-up period. Measurements of maximal isometric shoulder torques were collected at study entry (baseline), 18 months, and 3 years. Daily activity was measured using a wheelchair odometer, and self-reported daily transfer and raise frequency data were collected by telephone every 6 weeks. Results Two hundred twenty-three participants were enrolled in the study; 39.8% developed shoulder pain over the 3-year follow-up period. Demographic variables and higher activity levels were not associated with shoulder pain onset. Baseline maximal isometric torque (normalized by body weight) in all shoulder muscle groups was 10% to 15% lower in participants who developed shoulder pain compared with those who remained pain-free. Lower shoulder adduction torque was a significant predictor of shoulder pain development (log-likelihood test=11.38), but the model explained only 7.5% of shoulder pain onset and consequently is of limited clinical utility. Limitations Time since SCI varied widely among participants, and transfer and raise activity was measured by participant recall. Conclusions Participants who developed shoulder pain had decreased muscle strength, particularly in the shoulder adductors, and lower levels of physical activity prior to the onset of shoulder pain. Neither factor was a strong predictor of shoulder pain onset. PMID:25721123

  8. Whiplash injuries.

    PubMed

    Malanga, Gerard; Peter, Jason

    2005-10-01

    Whiplash injuries are very common and usually are associated with rear-end collisions. However, a whiplash injury can be caused by any event that results in hyperextension and flexion of the cervical spine. These injuries are of serious concern to all consumers due to escalating cost of diagnosis, treatment, insurance, and litigation. Most acute whiplash injury cases respond well to conservative treatments, which result in resolution of symptoms usually within weeks to a few months after the injury occurred. Chronic whiplash injuries often are harder to diagnose and treat and often result in poor outcomes. Current research shows that various structures in the cervical spine receive nociceptive innervation and potentially may be the cause of chronic pain symptoms. One potential pain generator showing promise is the facet or zygapophyseal joints. Various researchers have proven that these joints are injured during whiplash injuries and that diagnosis and temporary pain relief can be obtained with facet joint injections. The initial evaluation of any patient should follow an organized and stepwise approach, and more serious causes of neck pain must first be ruled out through the history, physical examination, and diagnostic testing. Treatment regimens should be evidence-based, focusing on treatments that have proven to be effective in treating acute and chronic whiplash injuries.

  9. Lipoprotein heterogeneity in persons with Spinal Cord Injury: a model of prolonged sitting and restricted physical activity.

    PubMed

    La Fountaine, Michael F; Cirnigliaro, Christopher M; Emmons, Racine R; Kirshblum, Steven C; Galea, Marinella; Spungen, Ann M; Bauman, William A

    2015-07-28

    Persons with spinal cord injury (SCI) often have low levels of physical activity, which predispose to increased adiposity and decreased high density lipoprotein cholesterol (HDL-C) concentrations, and, generally, normal low density lipoprotein cholesterol (LDL-C) concentrations. In spite of the mixed lipoprotein profile, the SCI population has been reported to have an elevated risk of cardiovascular-related morbidity and mortality. Nuclear magnetic resonance spectroscopy may permit a more precise quantification of lipoprotein particle (P) species, enabling a more accurate inference of risk for cardiovascular disease (CVD) in the SCI population. Fasting blood samples were obtained on 83 persons with chronic SCI and 62 able-bodied (AB) subjects. Fasting plasma insulin (FPI), triglycerides (TG), and P number and size of VLDL (very low density lipoprotein), LDL, and HDL subclasses were determined. AB and SCI subjects were stratified based on HDL-C (i.e., Low <40 and Normal ≥ 40 mg/dl): AB-Normal (n = 48), AB-Low (n = 14), SCI-Normal (n = 49), and SCI-Low (n = 34). Factorial analyses of variance were performed to identify group differences in lipoprotein measurements. Pearson correlations were performed between the number of P by lipoprotein subclass, size, FPI, and TG. The SCI-Normal group was not significantly different from the AB-Normal group for body composition, FPI, TG or LP-IR and had negligible differences in the lipoprotein P profile, except for fewer number and smaller size of HDL-P. The SCI-Low group had a similar lipoprotein profile to that of the AB-Low group, but with a lipid P composition associated with a heightened atherogenic risk and greater tendency toward insulin resistance by the Lipoprotein-Insulin Resistance (LP-IR) score. In the SCI-Low group, the decreased number and reduced size of lipoprotein P were more prevalent and may be associated with increased waist circumference (i.e., abdominal adiposity), relatively elevated TG values (compared

  10. Psychological distress and physical disability in patients sustaining severe injuries in road traffic crashes: Results from a one-year cohort study from three European countries.

    PubMed

    Papadakaki, Maria; Ferraro, Ottavia Eleonora; Orsi, Chiara; Otte, Dietmar; Tzamalouka, Georgia; von-der-Geest, Marco; Lajunen, Timo; Özkan, Türker; Morandi, Anna; Sarris, Markos; Pierrakos, George; Chliaoutakis, Joannes

    2017-02-01

    The current study aimed to follow-up a group of road crash survivors for one year and assesses the impact of injury on their psychological and physical condition. All crash survivors that were admitted to the intensive or sub-intensive care units of selected hospitals in Greece, Germany and Italy over one year period (2013-2014), were invited to participate in the study and were interviewed at three different time-points as follows: (a) at one month (baseline data), (b) at six months, and (c) at twelve months. The study used widely recommended classifications for injury severity (AIS, MAIS) and standardized health outcome measures such as the Disability Assessment Schedule II (WHODAS 2.0) to measure disability, "Impact of Event Scale" (IES-R) to measure Post-Traumatic Stress Disorder (PTSD), Center for Epidemiological Studies Depression Scale (CES-D Scale) to measure depression. A total of 120 patients were enrolled in the study in all the partner countries and 93 completed all follow up questionnaires. The risk of physical disability was 4.57 times higher [CI 1.98-2.27] at the first follow up and 3.43 times higher [CI 1.43-9.42] at the second follow up as compared with the time before the injury. There was a 79% and an 88% lower risk of depression at the first and the second follow up respectively, as compared with the baseline time. There was also a 72% lower risk of Post-Traumatic Stress at the second follow up as compared with the baseline time. A number of factors relevant to the individuals, the road crash and the injury, were shown to distinguish those at higher risk of long-lasting disability and psychological distress including age, marital status, type of road user, severity and type of the injury, past emotional reaction to distress. The study highlights the importance of a comprehensive and holistic understanding of the impact of injury on an individual and further underlines the importance of screening and treating psychological comorbidities in injury

  11. Pain Acceptance Decouples the Momentary Associations Between Pain, Pain Interference, and Physical Activity in the Daily Lives of People With Chronic Pain and Spinal Cord Injury.

    PubMed

    Kratz, Anna L; Ehde, Dawn M; Bombardier, Charles H; Kalpakjian, Claire Z; Hanks, Robin A

    2017-03-01

    Pain acceptance is a robust predictor of adjustment to chronic pain; however, the dynamics of pain acceptance in daily life are largely unexamined. Furthermore, research on pain acceptance in those with pain and physical disability is needed. To examine pain acceptance in daily life, we collected 7 days of ecological momentary assessments of pain intensity and pain interference (5 times per day) with continuous accelerometry (physical activity) in 128 individuals with chronic pain and spinal cord injury. Multilevel modeling revealed that pain acceptance significantly moderated the momentary association between pain intensity and pain interference; those with higher pain acceptance experienced a blunted increase in interference when pain was high. Pain acceptance also moderated the association between pain intensity and physical activity; high pain acceptance was associated with an increase and low pain acceptance with a decrease in physical activity in the context of high pain. The activities engagement component of pain acceptance was a slightly more robust driver of these interaction effects; whereas activities engagement significantly moderated the association between momentary pain and pain interference as well as physical activity, pain willingness exerted a significant moderating effect on the momentary association between pain intensity and pain interference only. These findings suggest that both components contribute to the decoupling effects of pain acceptance. Task persistence did not show the same moderating effects, indicating that pain acceptance may be unique from other types of behavioral pain coping in its ability to decouple expected associations between pain intensity, pain interference, and physical activity. In the daily lives of individuals with chronic pain and spinal cord injury, pain acceptance buffered expected increases in pain interference and decreases in physical activity in the context of high pain. These findings can inform further

  12. Physical activity levels and torso orientations of hospitalized patients at risk of developing a pressure injury: an observational study.

    PubMed

    Chaboyer, Wendy; Mills, Peter M; Roberts, Shelley; Latimer, Sharon

    2015-02-01

    Pressure injury guidelines recommend regular repositioning yet patients' mobility and repositioning patterns are unknown. An observational study using activity monitors was undertaken to describe the 24 h activity patterns of 84 hospitalized patients at risk of developing a pressure injury. The vast majority of participants' time was spent in the sedentary activity range (94% ± 3%) followed by the light range (5% ± 4 %). Patients changed their posture a median of 94 (interquartile range 48) time in the 24-h period (range 11-154), or ≈ 3.8 times per hour. Although a main focus for pressure injury prevention has been on repositioning, this study shows that patients with restricted mobility are actually moving quite often. Therefore, it might be appropriate to focus more attention on other pressure injury prevention strategies such as adequate nutrition, appropriate support surfaces and good skin care.

  13. An internet survey of the characteristics and physical activity of community-dwelling Australian adults with acquired brain injury: Exploring interest in an internet-delivered self-management program focused on physical activity.

    PubMed

    Jones, Taryn M; Dean, Catherine M; Dear, Blake F; Hush, Julia M; Titov, Nickolai

    2016-01-01

    Individuals with acquired brain injury (ABI) are more likely to be physically inactive and experience barriers to accessing services to address inactivity. This study was designed to guide the development of an internet-delivered self-management program to increase physical activity after ABI. The aims of this study were to examine the current physical activity status of community-dwelling Australian adults with ABI, the barriers to physical activity they experience and to explore interest an internet-delivered self-management program aimed at increasing physical activity. An online survey of Australian adults with ABI was used to collect information about demographic characteristics; general health; emotional well-being; mobility and physical activity status, and satisfaction; barriers to physical activity; confidence in overcoming barriers, and; interest in an internet self-management program. Data were analyzed descriptively and correlational analyses examined relationships between variables. Data were analyzed from 59 respondents. Over half were not satisfied with their current physical activity status. The most frequently reported barriers were pain/discomfort, fatigue and fear, and confidence to overcome these barriers was very low. Interest in an internet-delivered self-management program was high (74%) and not related to the amount of physical activity, satisfaction with physical activity and mobility status or total number of barriers. Australian adults with ABI are not satisfied with their activity levels and experience barriers in maintaining their physical activity levels. Participants were interested in accessing an internet-delivered self-management program aimed at improving physical activity levels. Therefore such a program warrants development and evaluation. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Effect of structured physical activity on prevention of serious fall injuries in adults aged 70-89: randomized clinical trial (LIFE Study)

    PubMed Central

    Pahor, Marco; Guralnik, Jack M; McDermott, Mary M; King, Abby C; Buford, Thomas W; Strotmeyer, Elsa S; Nelson, Miriam E; Sink, Kaycee M; Demons, Jamehl L; Kashaf, Susan S; Walkup, Michael P; Miller, Michael E

    2016-01-01

    Objective To test whether a long term, structured physical activity program compared with a health education program reduces the risk of serious fall injuries among sedentary older people with functional limitations. Design Multicenter, single blinded randomized trial (Lifestyle Interventions and Independence for Elders (LIFE) study). Setting Eight centers across the United States, February 2010 to December 2011. Participants 1635 sedentary adults aged 70-89 years with functional limitations, defined as a short physical performance battery score ≤9, but who were able to walk 400 m. Interventions A permuted block algorithm stratified by field center and sex was used to allocate interventions. Participants were randomized to a structured, moderate intensity physical activity program (n=818) conducted in a center (twice a week) and at home (3-4 times a week) that included aerobic, strength, flexibility, and balance training activities, or to a health education program (n=817) consisting of workshops on topics relevant to older people and upper extremity stretching exercises. Main outcome measures Serious fall injuries, defined as a fall that resulted in a clinical, non-vertebral fracture or that led to a hospital admission for another serious injury, was a prespecified secondary outcome in the LIFE Study. Outcomes were assessed every six months for up to 42 months by staff masked to intervention assignment. All participants were included in the analysis. Results Over a median follow-up of 2.6 years, a serious fall injury was experienced by 75 (9.2%) participants in the physical activity group and 84 (10.3%) in the health education group (hazard ratio 0.90, 95% confidence interval 0.66 to 1.23; P=0.52). These results were consistent across several subgroups, including sex. However, in analyses that were not prespecified, sex specific differences were observed for rates of all serious fall injuries (rate ratio 0.54, 95% confidence interval 0.31 to 0.95 in men

  15. Effect of structured physical activity on prevention of serious fall injuries in adults aged 70-89: randomized clinical trial (LIFE Study).

    PubMed

    Gill, Thomas M; Pahor, Marco; Guralnik, Jack M; McDermott, Mary M; King, Abby C; Buford, Thomas W; Strotmeyer, Elsa S; Nelson, Miriam E; Sink, Kaycee M; Demons, Jamehl L; Kashaf, Susan S; Walkup, Michael P; Miller, Michael E

    2016-02-03

    To test whether a long term, structured physical activity program compared with a health education program reduces the risk of serious fall injuries among sedentary older people with functional limitations. Multicenter, single blinded randomized trial (Lifestyle Interventions and Independence for Elders (LIFE) study). Eight centers across the United States, February 2010 to December 2011. 1635 sedentary adults aged 70-89 years with functional limitations, defined as a short physical performance battery score ≤ 9, but who were able to walk 400 m. A permuted block algorithm stratified by field center and sex was used to allocate interventions. Participants were randomized to a structured, moderate intensity physical activity program (n=818) conducted in a center (twice a week) and at home (3-4 times a week) that included aerobic, strength, flexibility, and balance training activities, or to a health education program (n=817) consisting of workshops on topics relevant to older people and upper extremity stretching exercises. Serious fall injuries, defined as a fall that resulted in a clinical, non-vertebral fracture or that led to a hospital admission for another serious injury, was a prespecified secondary outcome in the LIFE Study. Outcomes were assessed every six months for up to 42 months by staff masked to intervention assignment. All participants were included in the analysis. Over a median follow-up of 2.6 years, a serious fall injury was experienced by 75 (9.2%) participants in the physical activity group and 84 (10.3%) in the health education group (hazard ratio 0.90, 95% confidence interval 0.66 to 1.23; P=0.52). These results were consistent across several subgroups, including sex. However, in analyses that were not prespecified, sex specific differences were observed for rates of all serious fall injuries (rate ratio 0.54, 95% confidence interval 0.31 to 0.95 in men; 1.07, 0.75 to 1.53 in women; P=0.043 for interaction), fall related fractures (0.47, 0

  16. Developing physical exposure-based back injury risk models applicable to manual handling jobs in distribution centers.

    PubMed

    Lavender, Steven A; Marras, William S; Ferguson, Sue A; Splittstoesser, Riley E; Yang, Gang

    2012-01-01

    Using our ultrasound-based "Moment Monitor," exposures to biomechanical low back disorder risk factors were quantified in 195 volunteers who worked in 50 different distribution center jobs. Low back injury rates, determined from a retrospective examination of each company's Occupational Safety and Health Administration (OSHA) 300 records over the 3-year period immediately prior to data collection, were used to classify each job's back injury risk level. The analyses focused on the factors differentiating the high-risk jobs (those having had 12 or more back injuries/200,000 hr of exposure) from the low-risk jobs (those defined as having no back injuries in the preceding 3 years). Univariate analyses indicated that measures of load moment exposure and force application could distinguish between high (n = 15) and low (n = 15) back injury risk distribution center jobs. A three-factor multiple logistic regression model capable of predicting high-risk jobs with very good sensitivity (87%) and specificity (73%) indicated that risk could be assessed using the mean across the sampled lifts of the peak forward and or lateral bending dynamic load moments that occurred during each lift, the mean of the peak push/pull forces across the sampled lifts, and the mean duration of the non-load exposure periods. A surrogate model, one that does not require the Moment Monitor equipment to assess a job's back injury risk, was identified although with some compromise in model sensitivity relative to the original model.

  17. A 2-Year Follow-Up After a 2-Year RCT with Vitamin D and Exercise: Effects on Falls, Injurious Falls and Physical Functioning Among Older Women.

    PubMed

    Uusi-Rasi, Kirsti; Patil, Radhika; Karinkanta, Saija; Kannus, Pekka; Tokola, Kari; Lamberg-Allardt, Christel; Sievänen, Harri

    2017-09-01

    Both exercise and vitamin D are recommended means to prevent falls among older adults, but their combined effects on fall-induced injuries are scarcely studied. A 2-year follow-up of a previous 2-year randomized controlled trial with vitamin D and exercise (Ex) of 409 older home-dwelling women using a factorial 2 × 2 design (D-Ex-, D+Ex-, D-Ex+, D+Ex+). Besides monthly fall diaries, femoral neck bone mineral density (fn-BMD), and physical functioning were assessed at 1 and 2 years after the intervention. After the intervention, S-25OHD concentrations declined to baseline levels in both supplement groups. The groups did not differ for change in fn-BMD or physical functioning, except for leg extensor muscle strength, which remained about 10% greater in the exercise groups compared with the reference group (D-Ex-). There were no between-group differences in the rate of all falls, but medically attended injurious falls reduced in D+Ex- and D-Ex+ groups compared with D-Ex-. However, all former treatment groups had less medically attended injured fallers, HRs (95% CI) being 0.62 (0.39-1.00) for D+Ex-, 0.46 (0.28-0.76) for D-Ex+, and 0.55 (0.34-0.88) for D+Ex+, compared with D-Ex-. Exercise-induced benefits in physical functioning partly remained 2 years after cessation of supervised training. Although there was no difference in the rate of all falls, former exercise groups continued to have lower rate of medically attended injured fallers compared with referents even 2 years after the intervention. Vitamin D without exercise was associated with less injurious falls with no difference in physical functioning.

  18. Physics.

    ERIC Educational Resources Information Center

    Bromley, D. Allan

    1980-01-01

    The author presents the argument that the past few years, in terms of new discoveries, insights, and questions raised, have been among the most productive in the history of physics. Selected for discussion are some of the most important new developments in physics research. (Author/SA)

  19. Physics.

    ERIC Educational Resources Information Center

    Bromley, D. Allan

    1980-01-01

    The author presents the argument that the past few years, in terms of new discoveries, insights, and questions raised, have been among the most productive in the history of physics. Selected for discussion are some of the most important new developments in physics research. (Author/SA)

  20. Lightning injury: a review.

    PubMed

    Ritenour, Amber E; Morton, Melinda J; McManus, John G; Barillo, David J; Cancio, Leopoldo C

    2008-08-01

    Lightning is an uncommon but potentially devastating cause of injury in patients presenting to burn centers. These injuries feature unusual symptoms, high mortality, and significant long-term morbidity. This paper will review the epidemiology, physics, clinical presentation, management principles, and prevention of lightning injuries.

  1. Play-based interventions improve physical function for people with adult-acquired brain injury: a systematic review and meta-analysis of randomised controlled trials.

    PubMed

    Saywell, Nicola; Taylor, Nick; Rodgers, Emma; Skinner, Luke; Boocock, Mark

    2017-02-01

    To undertake a systematic review and meta-analysis of the effectiveness of play-based interventions compared to traditional therapy in rehabilitation of adults with adult-acquired brain injury. The search was performed using Medline; Cinahl Plus; Health Source (Nursing/Academic Edition); Psychology and behavioural sciences collection; Biomedical reference collection (basic). Studies included were randomised controlled trials that investigated the effect of play-based interventions on physical function of adults with adult acquired brain injury. Two independent reviewers identified eligible studies and assessed methodological quality using a modified Downs and Black. Meta-analysis compared standardised differences in means, to determine effect sizes for grouped functional outcome measures. The GRADE scoring system was used to determine the level of clinical evidence. Thirty studies met the inclusion criteria, 13 were considered high quality and 17 moderate quality. Studies predominantly involved post-stroke participants, with only three studies including participants with traumatic brain injury. When compared to traditional therapy, dose-matched studies of play-based interventions showed a significant effect on independence (Effect size (ES) = 0.6) and physical performance (ES = 0.43), as measured using the Fugl -Meyer. For non-dose matched studies, play-based interventions showed a significant improvement for balance (ES = 0.76) compared with traditional therapy. In all studies that measured participant enjoyment, play-based therapy was rated as more enjoyable than traditional therapy. Play-based interventions for people with adult acquired brain injury are more effective in improving balance and independence, which may be due to them being more enjoyable than traditional therapy.

  2. Diagnostic value of medical history and physical examination of anterior cruciate ligament injury: comparison between primary care physician and orthopaedic surgeon.

    PubMed

    Geraets, Stijn E W; Meuffels, Duncan E; van Meer, Belle L; Breedveldt Boer, Hans P; Bierma-Zeinstra, Sita M A; Reijman, Max

    2015-04-01

    Well-designed validity studies on the clinical diagnosis of anterior cruciate ligament (ACL) injury are scarce. Our purpose is to assess the diagnostic value of ACL-specific medical history assessment and physical examination between primary and secondary care medical specialists. Medical history assessment and physical examination were performed by both an orthopaedic surgeon and a primary care physician, both blinded to all clinical information, in a secondary care population. A knee arthroscopy was used as reference standard. A total of 60 participants were divided into an index group with an arthroscopically proven complete ACL rupture and a control group with an arthroscopically proven intact ACL. The orthopaedic surgeon recognized 94 % of the participants with an ACL rupture through a positive medical history combined with a positive physical examination; of the participants with an intact ACL, 16 % were misclassified by the orthopaedic surgeon. The primary care physician recognized 62 % of the participants with an ACL rupture and misclassified 23 % of the participants with an intact ACL. Physical examination appeared to have no additional value for the primary care physician. Combined medical history and physical examination have strong diagnostic value in ACL rupture diagnostics performed by an orthopaedic surgeon, whereas for the primary care physician, only medical history appeared to be of value. For current practice, this could mean that only orthopaedic surgeons can perform an ACL physical examination with accuracy. III.

  3. The Moderating Role of Purging Behaviour in the Relationship Between Sexual/Physical Abuse and Nonsuicidal Self-Injury in Eating Disorder Patients.

    PubMed

    Gonçalves, Sónia; Machado, Bárbara; Silva, Cátia; Crosby, Ross D; Lavender, Jason M; Cao, Li; Machado, Paulo P P

    2016-03-01

    This study sought to examine predictors of nonsuicidal self-injury (NSSI) in eating disorder patients and to evaluate the moderating role of purging behaviours in the relationship between a theorised predictor (i.e. sexual/physical abuse) and NSSI. Participants in this study were 177 female patients with eating disorders (age range = 14-38 years) who completed semistructured interviews assessing eating disorder symptoms and eating disorder-related risk factors (e.g. history of sexual and physical abuse, history of NSSI and feelings of fatness). Results revealed that 65 participants (36.7%) reported lifetime engagement in NSSI, and 48 participants (27.1%) reported a history of sexual/physical abuse. Early onset of eating problems, lower BMI, feeling fat, a history of sexual/physical abuse and the presence of purging behaviours were all positively associated with the lifetime occurrence of NSSI. The relationship between sexual/physical abuse before eating disorder onset and lifetime NSSI was moderated by the presence of purging behaviours, such that the relationship was stronger in the absence of purging. These findings are consistent with the notion that purging and NSSI may serve similar functions in eating disorder patients (e.g. emotion regulation), such that the presence of purging may attenuate the strength of the association between sexual/physical abuse history (which is also associated with elevated NSSI risk) and engagement in NSSI behaviours. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.

  4. Are Passive Physical Modalities Effective for the Management of Common Soft Tissue Injuries of the Elbow?: A Systematic Review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration.

    PubMed

    Dion, Sarah; Wong, Jessica J; Côté, Pierre; Yu, Hainan; Sutton, Deborah; Randhawa, Kristi; Southerst, Danielle; Varatharajan, Sharanya; Stern, Paula J; Nordin, Margareta; Chung, Chadwick; D'Angelo, Kevin; Dresser, Jocelyn; Brown, Courtney; Menta, Roger; Ammendolia, Carlo; Shearer, Heather M; Stupar, Maja; Ameis, Arthur; Mior, Silvano; Carroll, Linda J; Jacobs, Craig; Taylor-Vaisey, Anne

    2017-01-01

    To evaluate the effectiveness of passive physical modalities for the management of soft tissue injuries of the elbow. We systematically searched MEDLINE, EMBASE, CINAHL, PsycINFO, and Cochrane Central Register of Controlled Trials from 1990 to 2015. Studies meeting our selection criteria were eligible for critical appraisal. Random pairs of independent reviewers critically appraised eligible studies using the Scottish Intercollegiate Guidelines Network criteria. We included studies with a low risk of bias in our best evidence synthesis. We screened 6618 articles; 21 were eligible for critical appraisal and 9 (reporting on 8 randomized controlled trials) had a low risk of bias. All randomized controlled trials with a low risk of bias focused on lateral epicondylitis. We found that adding transcutaneous electrical nerve stimulation to primary care does not improve the outcome of patients with lateral epicondylitis. We found inconclusive evidence for the effectiveness of: (1) an elbow brace for managing lateral epicondylitis of variable duration; and (2) shockwave therapy or low-level laser therapy for persistent lateral epicondylitis. Our review suggests that transcutaneous electrical nerve stimulation provides no added benefit to patients with lateral epicondylitis. The effectiveness of an elbow brace, shockwave therapy, or low-level laser therapy for the treatment of lateral epicondylitis is inconclusive. We found little evidence to inform the use of passive physical modalities for the management of elbow soft tissue injuries.

  5. Physical complaints, medical service use, and social and employment changes following mild traumatic brain injury: a 6-month longitudinal study.

    PubMed

    Kraus, Jess; Schaffer, Kathryn; Ayers, Kathi; Stenehjem, Jerome; Shen, Haikang; Afifi, A A

    2005-01-01

    Using a prospective, dual-cohort study design in which selected preinjury factors were controlled, we present outcomes of 235 patients in a case cohort and 235 patients in a comparison cohort following emergency-department-diagnosed mild traumatic brain injury (MTBI). Symptoms, medical services use, and social and employment concerns were evaluated 6 months after the injury. After adjusting for preinjury characteristics, headaches, dizziness, vision difficulties, memory or learning problems, and alcohol intolerance were found to occur significantly more often in the MTBI cohort than in the comparison cohort. Problems sleeping, use of prescribed medications, and changes in employment were less likely in the MTBI cohort. Although MTBI is not life threatening, our findings suggest that 6 months after injury persons still have related health problems that require routine medical management.

  6. Physical and Cognitive Performance of Patients with Acute Lung Injury 1 Year after Initial Trophic versus Full Enteral Feeding. EDEN Trial Follow-up

    PubMed Central

    Dinglas, Victor D.; Morris, Peter E.; Jackson, James C.; Hough, Catherine L.; Mendez-Tellez, Pedro A.; Wozniak, Amy W.; Colantuoni, Elizabeth; Ely, E. Wesley; Rice, Todd W.; Hopkins, Ramona O.

    2013-01-01

    Rationale: We hypothesized that providing patients with acute lung injury two different protein/calorie nutritional strategies in the intensive care unit may affect longer-term physical and cognitive performance. Objectives: To assess physical and cognitive performance 6 and 12 months after acute lung injury, and to evaluate the effect of trophic versus full enteral feeding, provided for the first 6 days of mechanical ventilation, on 6-minute-walk distance, cognitive impairment, and secondary outcomes. Methods: A prospective, longitudinal ancillary study of the ARDS Network EDEN trial evaluating 174 consecutive survivors from 5 of 12 centers. Blinded assessments of patients’ arm anthropometrics, strength, pulmonary function, 6-minute-walk distance, and cognitive status (executive function, language, memory, verbal reasoning/concept formation, and attention) were performed. Measurements and Main Results: At 6 and 12 months, respectively, the mean (SD) percent predicted for 6-minute-walk distance was 64% (22%) and 66% (25%) (P = 0.011 for difference between assessments), and 36 and 25% of survivors had cognitive impairment (P = 0.001). Patients performed below predicted values for secondary physical tests with small improvement from 6 to 12 months. There was no significant effect of initial trophic versus full feeding for the first 6 days after randomization on survivors’ percent predicted for 6-minute-walk distance, cognitive impairment status, and all secondary outcomes. Conclusions: EDEN trial survivors performed below predicted values for physical and cognitive performance at 6 and 12 months, with some improvement over time. Initial trophic versus full enteral feeding for the first 6 days after randomization did not affect physical and cognitive performance. PMID:23805899

  7. Effects of voluntary physical exercise, citicoline, and combined treatment on object recognition memory, neurogenesis, and neuroprotection after traumatic brain injury in rats.

    PubMed

    Jacotte-Simancas, Alejandra; Costa-Miserachs, David; Coll-Andreu, Margalida; Torras-Garcia, Meritxell; Borlongan, Cesar V; Portell-Cortés, Isabel

    2015-05-15

    The biochemical and cellular events that lead to secondary neural damage after traumatic brain injury (TBI) contribute to long-term disabilities, including memory deficits. There is a need to search for single and/or combined treatments aimed at reducing these TBI-related disfunctions. The effects of citicoline and of voluntary physical exercise in a running wheel (3 weeks), alone or in combination, on TBI-related short-term (3 h) and long-term (24 h) object recognition memory (ORM) deficits and on neurogenesis and neuroprotection were examined using a rodent model of TBI (controlled cortical impact injury). Citicoline improved memory deficits at the two times tested, while physical exercise only in the long-term test. Physical exercise had a clear neuroprotective effect as indicated by reduced interhemispheric differences in hippocampal formation and lateral ventricle volumes and in density of mature neurons in the hilus of the dentate gyrus and the perirhinal cortex. Physical exercise also increased cell proliferation and neurogenesis in the granular cell layer of the dentate gyrus. Some degree of neuroprotection of citicoline was suggested by reduced interhemispheric differences in the volume of the hippocampal formation. Contrary to what was expected, the effects of citicoline and physical exercise did not sum up. Further, a negative interference between both treatments was found in several behavioral and histological variables. The promising profiles of both treatments as therapeutic tools in TBI when applied singly underscore the need to perform further works looking for other combined treatment regimens that increase the benefit of each treatment alone.

  8. Predictive Models to Estimate Probabilities of Injuries, Poor Physical Fitness, and Attrition Outcomes in Australian Defense Force Army Recruit Training

    DTIC Science & Technology

    2015-11-01

    n=19,769; 7,692 [28- day reservists course]; 12,077 [80- day standard]. The 28- day incurred 17.6% injury rate, 1 stress fracture, 5.2% attrition, 30.0...fitness test failure. The 80- day : 34.3% injury rate, 44 stress fractures, 5.0% attrition, 12.1% fitness test failure. Separate models were derived to...accuracy was poor, accuracy was improved in models that included course length (28 vs. 80 day ) as a predictor; suggesting the potential for using duration

  9. Assessing risk factors for early hip osteoarthritis in activity-related hip pain: a Delphi study

    PubMed Central

    Jackson, K A; Glyn-Jones, S; Batt, M E; Arden, N K; Newton, J L

    2015-01-01

    Objective Hip pain and injury as a result of activity can lead to the development of early hip osteoarthritis (OA) in susceptible individuals. Our understanding of the factors that increase susceptibility continues to evolve. The ability to clearly identify individuals (and cohorts) with activity-related hip pain who are at risk of early hip OA is currently lacking. The purpose of this study was to gain expert consensus on which key clinical measures might help predict the risk of early hip OA in individuals presenting with activity-related hip pain. The agreed measures would constitute a standardised approach to initial clinical assessment to help identify these individuals. Methods This Dephi study used online surveys to gain concordance of expert opinion in a structured process of ‘rounds’. In this study, we asked ‘What outcome measures are useful in predicting hip OA in activity-related hip pain?’ The Delphi panel consisted of experts from sport and exercise medicine, orthopaedics, rheumatology, physiotherapy and OA research. Results The study identified key clinical measures in the history, examination and investigations (plain anteroposterior radiograph and femoroacetabular impingement views) that the panel agreed would be useful in predicting future risk of hip OA when assessing activity-related hip pain. The panel also agreed that certain investigations and tests (eg, MR angiography) did not currently have a role in routine assessment. There was a lack of consensus regarding the role of MRI, patient-reported outcome measures (PROMs) and certain biomechanical and functional assessments. Conclusions We provide a standardised approach to the clinical assessment of patients with activity-related hip pain. Assessment measures rejected by the Delphi panel were newer, more expensive investigations that currently lack evidence. Assessment measures that did not reach consensus include MRI and PROMs. Their role remains ambiguous and would benefit from further

  10. School Reentry for the Elementary School Child with an Altered Physical Appearance as a Result of Injury or Illness

    ERIC Educational Resources Information Center

    Badger, Karen

    2008-01-01

    This article provides a model that school social workers can use to prepare elementary school children for the return of classmates whose appearances have been significantly altered as a result of illness or injury (e.g., loss of limbs, severe scarring), for whom return to school is often difficult. School social workers can be instrumental in…

  11. Incorporating Physical Activity with Dialectical Behavior Therapy to Treat Non Suicidal Self Injury in Freshman Female University Students

    ERIC Educational Resources Information Center

    Lovelady, Tiffany T.

    2016-01-01

    As Non-Suicidal Self Injury (NSSI) is increasing in prevalence among adolescents and young adults, College Counseling Centers (CCC's) are tasked with treating this population of students. CCC's are designed to provide counseling services to all students seeking assistance and therapy is typically relegated to short term psychotherapy with…

  12. Ethnic/racial differences in the prevalence of injurious spanking and other child physical abuse in a National Survey of Adolescents.

    PubMed

    Hawkins, Alesia Oscea; Danielson, Carla Kmett; de Arellano, Michael A; Hanson, Rochelle F; Ruggiero, Kenneth J; Smith, Daniel W; Saunders, Benjamin E; Kilpatrick, Dean G

    2010-08-01

    Limited research has examined whether similar patterns in injurious spanking and other forms of child physical abuse (CPA) exist across specific ethnic/racial groups. The authors examined and compared differences in the lifetime prevalence of injurious spanking and CPA in two national samples of adolescents across ethnic/racial groups and over time. Participants were 4,023 youth (12-17 years) and 3,614 youth (12-17 years) who participated in the 1995 National Survey of Adolescents (NSA) and 2005 National Survey of Adolescents-Replication (NSA-R), respectively. Adolescents, who were identified through random digit dial procedures, completed a telephone interview assessment. Results indicated significant ethnic/racial variation across groups in reports of injurious spanking in the NSA and the NSA-R samples; however, significant differences were not observed within groups between the two samples over time. Ethnic/racial differences also were found between groups in reports of CPA in the NSA-R sample. Limitations and future directions of this research are discussed.

  13. The use of noncontingent reinforcement and contingent restraint to reduce physical aggression and self-injurious behaviour in a traumatically brain injured adult.

    PubMed

    Persel, C S; Persel, C H; Ashley, M J; Krych, D K

    1997-10-01

    Many different intervention programmes for reducing undesirable behaviour with people with traumatic brain injury (TBI) have been investigated in recent years. The purpose of this study was to examine the potential of using noncontingent reinforcement (NCR) in combination with contingent restraint to reduce severe behaviour. The subject (E.L.) was a 40-year-old male with TBI admitted to a rehabilitation long-term care programme. E.L. had a history of physical aggression (PA) and self-injurious behaviour (SIB). Assessment conditions included a descriptive analysis, response scatterplot and Self-Injury Trauma (SIT) Scale. Attention was identified as the maintaining positive reinforcement for PA and SIB. Treatment conditions were compared using a reversal (ABAB) design. Attention (NCR) was delivered on a fixed-time schedule that was not dependent on the subject's behaviour. Contingent restraint was applied when E.L. exhibited PA or SIB that was dangerous to himself or others. During treatment, PA occurred over 4 times less often and SIB over 2.5 times less often. Results demonstrated that PA and SIB were sensitive to NCR. NCR can be an effective procedure for reducing severe behaviour maintained by socially-mediated positive reinforcement.

  14. Respiratory, physical, and psychological benefits of breath-focused yoga for adults with severe traumatic brain injury (TBI): a brief pilot study report.

    PubMed

    Silverthorne, Colin; Khalsa, Sat Bir S; Gueth, Robin; DeAvilla, Nicole; Pansini, Janie

    2012-01-01

    This pilot study was designed to identify the potential benefits of breath-focused yoga on respiratory, physical, and psychological functioning for adults with severe traumatic brain injury (TBI). Ten individuals with severe TBI who self-selected to attend weekly yoga classes and 4 no-treatment controls were evaluated. Participants were assessed at pretreatment baseline and at 3-month intervals for a total of 4 time points over 40 weeks. Outcomes of interest included observed exhale strength, ability to hold a breath or a tone, breathing rate, counted breaths (inhale and exhale), and heart rate, as well as self-reported physical and psycho-logical well-being. Repeated within-group analyses of variance revealed that the yoga group demonstrated significant longitudinal change on several measures of observed respiratory functioning and self-reported physical and psychological well-being over a 40-week period. Those in the control group showed marginal improvement on 2 of the 6 measures of respiratory health, physical and social functioning, emotional well-being, and general health. The small sample sizes precluded the analysis of between group differences. This study provides preliminary evidence that breath-focused yoga may improve respiratory functioning and self-perceived physical and psychological well-being of adults with severe TBI.

  15. Weight matters: physical and psychosocial well being of persons with spinal cord injury in relation to body mass index.

    PubMed

    Chen, Yuying; Cao, Yue; Allen, Victoria; Richards, J Scott

    2011-03-01

    To examine the relationship of body mass index (BMI) with multiple health indices among persons with spinal cord injury (SCI). Multicenter cross-sectional study. A total of 16 SCI Model Systems throughout the United States. A total of 1107 men and 274 women (N=1381), mean age ± SD, 43.1±14.6 years (tetraplegia, 56.9%; complete injuries, 50.2%; mean years since injury ± SD, 7.8±8.6), who received follow-up in 2006 to 2009, were classified into 1 of the 4 BMI categories-underweight, normal, overweight, and obese-based on self-reported height and measured weight. Not applicable. Rehospitalization, pain, self-perceived health, FIM, Craig Handicap Assessment and Reporting Technique, Patient Health Questionnaire-9 (PHQ-9), and the Diener's Satisfaction With Life Scale (SWLS). The prevalence of underweight, overweight, and obesity was 7.5%, 31.4%, and 22.1%, respectively, which varied by age, sex, marital status, education, and neurologic impairment. For those with tetraplegia and functional motor-complete injuries, rehospitalization occurred more frequently among obese persons, while days rehospitalized were the longest among underweight persons. Pain was more severe in those classified as obese. Community mobility was lower in the underweight, overweight, and obese groups than in those with normal weight. There was no significant association between BMI and self-perceived health, FIM, PHQ-9, and SWLS beyond the effect of neurologic impairment. Prevention and intervention directed at those significantly overweight or underweight deserve consideration as priorities in the continuity of care for persons with SCI. Efforts should be targeted particularly to those at higher risk, including persons with more severe injuries, who are less educated, and who are living alone. Copyright © 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  16. Activity-Related Symptom Exacerbations After Pediatric Concussion.

    PubMed

    Silverberg, Noah D; Iverson, Grant L; McCrea, Michael; Apps, Jennifer N; Hammeke, Thomas A; Thomas, Danny G

    2016-10-01

    Recovery from concussion generally follows a trajectory of gradual improvement, but symptoms can abruptly worsen with exertion. This phenomenon is poorly understood. To characterize the incidence, course, and clinical significance of symptom exacerbations (spikes) in children after concussion. This secondary analysis of clinical trial data analyzes 63 eligible participants prospectively recruited from an emergency department who were asked to complete a postconcussion symptom scale and record their activities in a structured diary for the next 10 days. They completed standardized assessments of symptoms (postconcussion symptom scale), cognition (Immediate Post-Concussion Assessment and Cognitive Testing), and balance (Balance Error Scoring System) 10 days following the injury. Eligible participants were aged 11 to 18 years and sustained a concussion (according to the Centers for Disease Control and Prevention criteria) that did not result in an abnormal computed tomography scan or require hospital admission. The trial was conducted from May 2010 to December 2012, and the analysis was conducted from November 2015 to February 2016. The occurrence of symptom spikes, defined as an increase of 10 or more points on the postconcussion symptom scale over consecutive days. Of the 63 participants, there were 41 boys (65.1%) and 22 girls (34.9%), and the mean (SD) age was 13.8 (1.8) years. Symptom spikes occurred in one-third of the sample (20 participants [31.7%]). Symptom spikes tended to partially resolve within 24 hours. An abrupt increase in mental activity (ie, returning to school and extracurricular activities) from one day to the next increased the risk of a symptom spike (relative risk, 0.81; 95% CI, 0.21-3.21), but most symptom spikes were not preceded by a documented increase in physical or mental activity. Patients with symptom spikes were initially more symptomatic in the emergency department and throughout the observation period but did not differ from the group

  17. An Updated Review of the Applied Physiology of American Collegiate Football: The Physical Demands, Strength/Conditioning, Nutritional Considerations and Injury Characteristics of America's Favourite Game.

    PubMed

    Fullagar, Hugh H K; McCunn, Robert; Murray, Andrew

    2017-03-24

    Whilst there are various avenues for performance improvement within collegiate American football (AF), there is no comprehensive evaluation of the collective array of resources around performance, physical conditioning and injury and training/game characteristics to guide future research and inform practitioners. Accordingly, the aim of the present review was to provide a current examination of these areas within collegiate AF. Recent studies show that there is a wide range of body compositions and strength characteristics between players, which appear to be influenced by playing position, level of play, training history/programming and time of season. Collectively, game demands may require a combination of upper and lower body strength and power production, rapid acceleration (positive and negative), change of direction, high-running speed, high intensity and repetitive collisions and muscular strength endurance. These may be affected by the timing of, and between, plays and/or coaching style. AF players appear to possess limited nutrition and hydration practices, which may be disadvantageous to performance. AF injuries appear due to a multitude of factors: strength, movement quality, and previous injury whilst there is also potential for extrinsic factors such as playing surface type, travel, time of season, playing position and training load. Future proof of concept studies are required to determine the quantification of game demands with regards to game style, type of opposition and key performance indicators. Moreover, more research is required to understand the efficacy of recovery and nutrition interventions. Finally, the assessment of the relationship between external/internal load constructs and injury risk is warranted.

  18. A comparison of intimate partner violence and associated physical injuries between cohabitating and married women: a 5-year medical chart review.

    PubMed

    Wong, Janet Yuen-Ha; Choi, Anna Wai-Man; Fong, Daniel Yee-Tak; Choi, Edmond Pui Hang; Wong, John Kit-Shing; So, Fung Ling; Lau, Chu-Leung; Kam, Chak-Wah

    2016-11-29

    Cohabitation, referring to a co-residential romantic relationship between two intimate partners without a marriage license, has become widely accepted in contemporary societies. It has been found that cohabitating women have a higher risk of experiencing intimate partner violence (IPV) than married women. However, as yet, no studies have investigated the level and pattern of IPV-associated physical injuries and its mental health impact on cohabitating women. Therefore, we aim to compare IPV-associated physical injuries between cohabitating and married women by conducting a review of 5-year medical records from the emergency departments of two major public hospitals in Hong Kong. This is a retrospective cohort study. Using two computerized systems, we identified the medical charts of 1011 women who had experienced IPV and presented at emergency departments between 2010 and 2014, of which, 132 were cohabitating and 833 were married. Cohabitating women were significantly younger (p-value < .0001) and had obtained a higher educational level (p-value = .008) than married women. After adjusting for those two variables, the logistic regression models showed that cohabitating women were approximately 2.1 times more likely than married women to present with head, neck, or facial injuries (OR = 2.1, 95% CI = 1.30-3.40, p = .002), and the risk of having multiple injuries in different locations (head, neck, face, torso, limbs) was almost twice that for cohabitating women compared with married women (OR = 1.82, 95% CI = 1.25-2.65, p = .001). Furthermore, cohabitating women were almost two times as likely as married women to experience more than one method of physical violence (OR = 1.72, 95% CI = 1.18-2.51, p = .005). There were no significant differences regarding mental health, police reporting, and discharge plans. Owing to recent social changes to the family structure, including the growing acceptance of cohabitation, it is

  19. Data on amyloid precursor protein accumulation, spontaneous physical activity, and motor learning after traumatic brain injury in the triple-transgenic mouse model of Alzheimer׳s disease.

    PubMed

    Kishimoto, Yasushi; Shishido, Hajime; Sawanishi, Mayumi; Toyota, Yasunori; Ueno, Masaki; Kubota, Takashi; Kirino, Yutaka; Tamiya, Takashi; Kawai, Nobuyuki

    2016-12-01

    This data article contains supporting information regarding the research article entitled "Traumatic brain injury accelerates amyloid-β deposition and impairs spatial learning in the triple-transgenic mouse model of Alzheimer׳s disease" (H. Shishido, Y. Kishimoto, N. Kawai, Y. Toyota, M. Ueno, T. Kubota, Y. Kirino, T. Tamiya, 2016) [1]. Triple-transgenic (3×Tg)-Alzheimer׳s disease (AD) model mice exhibited significantly poorer spatial learning than sham-treated 3×Tg-AD mice 28 days after traumatic brain injury (TBI). Correspondingly, amyloid-β (Aβ) deposition within the hippocampus was significantly greater in 3×Tg-AD mice 28 days after TBI. However, data regarding the short-term and long-term influences of TBI on amyloid precursor protein (APP) accumulation in AD model mice remain limited. Furthermore, there is little data showing whether physical activity and motor learning are affected by TBI in AD model mice. Here, we provide immunocytochemistry data confirming that TBI induces significant increases in APP accumulation in 3×Tg-AD mice at both 7 days and 28 days after TBI. Furthermore, 3×Tg-AD model mice exhibit a reduced ability to acquire conditioned responses (CRs) during delay eyeblink conditioning compared to sham-treated 3×Tg-AD model mice 28 days after TBI. However, physical activity and motor performance are not significantly changed in TBI-treated 3×Tg-AD model mice.

  20. [Self-evaluation of physical, cognitive and mood symptoms in a cohort of traumatic and vascular brain injury patients participating in social and neuropsychological remediation programmes].

    PubMed

    Thomas-Antérion, C; Truche, A; Sciéssère, K; Guyot, E; Hibert, O; Paris, N

    2005-01-01

    We studied 23 vascular or traumatic head injury subjects, five years after their injury. Neuropsychological testing included language tests, memory performance, frontal lobe tests and standard tests of intelligence (QI). Behavior was evaluated with the neuropsychiatric interview (NPI). Using an analogic visual scale, subjects performed a self-evaluation of their memory, language, attention, physical and thymic complaints. Neuropsychological assessment was heterogeneous but seemed to show severe impairment. Mean NPI score was 31.4: 91 percent of patients showed depression or anxiety and 78 percent of them showed irritability. Mean memory and thymic complaints were scored 6 on the analogic visual scale. Thymic complaint was not correlated with neuropsychological tests but with physical complaints. Thymic complaint was correlated with NPI score. Language complaint was correlated with VIQ, attentional complaint was correlated with PIQ, memory complaint with memory tests. In a second part, we studied 21 patients again 6 months later and 14 patients 1 year later. Mean complaints were scored over 5 after 6 months and over 4 after 1 year. With neuropsychological remediation and social activities, memory complaints improved significantly after 6 months and attentional and thymic complaints after 1 year. Using of analogical visual scales appears to be feasible: patients were able to evaluate their difficulties. This could be useful to elaborate remediation programs and evaluate outcome.

  1. Mediating effects of forgiveness and emotion-focused coping on post-traumatic stress disorder symptoms caused by physical injury and perceived threat.

    PubMed

    Bae, Sung-Man; Hyun, Myoung-Ho; Ra, Young-Sun

    2015-06-01

    The purpose of this study was to develop and test a model (including cognitive appraisal, coping strategy, and forgiveness variables) predicting post-traumatic stress disorder (PTSD) in 127 adults who were involved in traffic accidents. Participants were recruited from the inpatient and outpatient departments of three urban hospitals in South Korea. We utilized the path analysis to identify the best fitting model to our data. Path analysis showed that the baseline model compared with an alternative model was more appropriate for our data. Our results indicated that the severity of physical injury was directly related to the participants' perceived threat. The perceived threat had direct and indirect effects on PTSD symptoms through forgiveness and emotion-focused coping strategies. One of the significant findings was that victims' forgiveness of the person at fault for the accident reduced their PTSD symptoms. The severity of physical injury was not related directly to PTSD symptoms. Our study demonstrates that victim's forgiveness of the person at fault in a traumatic situation can be useful in helping their recovery after trauma and the forgiveness process may be applied to traffic accident situations as well as other types of interpersonal trauma. © 2014 Wiley Publishing Asia Pty Ltd.

  2. A systematic review on the effectiveness of school and community-based injury prevention programmes on risk behaviour and injury risk in 8-12 year old children.

    PubMed

    Nauta, Joske; van Mechelen, Willem; Otten, René H J; Verhagen, Evert A L M

    2014-03-01

    To review existing literature on the effectiveness of community-based and school-based physical activity related injury prevention programmes implemented to increase safety behaviour and decrease injury risk in 8-12 year old children, considering the methodological quality of the studies. A systematic review with quality assessment. A systematic search was performed using the CINAHL, Cochrane, EMBASE, PubMed and Sportdiscus databases. Inclusion criteria included the following: children aged 8-12 years; school- or community-based injury prevention programmes; an outcome defined as number of injuries, injury incidence or safety behaviour; published in an English language journal. Methodological quality was assessed for all included studies. The search yielded 5377 records, of which 11 were included in the review; four studies were considered as being of high quality. The focus of studies that were included was on the use of safety devices (8), pedestrian safety (2) and physical activity-related injury prevention (1). For safety device use, short term effects of school- and community-based interventions are promising for 8-12 year olds. Results regarding sustainability of the effect are inconsistent. A mediating effect on the distribution of safety devices was observed. Both financial and non-financial barriers seemed to prevent participants from purchasing a safety device. The short term effects for school- and community-based interventions using safety devices for 8-12 year olds are promising. More high quality research is, however warranted, preferably shifting focus from safety behaviour change to actual physical activity injury reduction. Copyright © 2013 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  3. Voluntary physical activity protects from susceptibility to skeletal muscle contraction-induced injury but worsens heart function in mdx mice.

    PubMed

    Hourdé, Christophe; Joanne, Pierre; Medja, Fadia; Mougenot, Nathalie; Jacquet, Adeline; Mouisel, Etienne; Pannerec, Alice; Hatem, Stéphane; Butler-Browne, Gillian; Agbulut, Onnik; Ferry, Arnaud

    2013-05-01

    It is well known that inactivity/activity influences skeletal muscle physiological characteristics. However, the effects of inactivity/activity on muscle weakness and increased susceptibility to muscle contraction-induced injury have not been extensively studied in mdx mice, a murine model of Duchenne muscular dystrophy with dystrophin deficiency. In the present study, we demonstrate that inactivity (ie, leg immobilization) worsened the muscle weakness and the susceptibility to contraction-induced injury in mdx mice. Inactivity also mimicked these two dystrophic features in wild-type mice. In contrast, we demonstrate that these parameters can be improved by activity (ie, voluntary wheel running) in mdx mice. Biochemical analyses indicate that the changes induced by inactivity/activity were not related to fiber-type transition but were associated with altered expression of different genes involved in fiber growth (GDF8), structure (Actg1), and calcium homeostasis (Stim1 and Jph1). However, activity reduced left ventricular function (ie, ejection and shortening fractions) in mdx, but not C57, mice. Altogether, our study suggests that muscle weakness and susceptibility to contraction-induced injury in dystrophic muscle could be attributable, at least in part, to inactivity. It also suggests that activity exerts a beneficial effect on dystrophic skeletal muscle but not on the heart.

  4. Memories following physical trauma in patients treated in the ICU: does gender and head injury make a difference?

    PubMed

    Johansson, Lotta; Ringdal, Mona; Bergbom, Ingegerd

    2008-10-01

    The aim of this study was to explore differences between male and female survivors and describe the relation between head injury and memories in men and women. This multi-centre study included 239 trauma patients who answered a self-administered questionnaire (ICUM tool) 6-18 months after discharge from the ICU. Few gender differences were found regarding their memories before, during and after the ICU stay. The univariate and multivariate analyses showed that more women than men reported memories from the time in hospital before being admitted to the ICU. Women also recalled a significantly higher number of memories of feelings than men. Furthermore, patients without head injury had more memories from the time before and during their stay in the ICU than patients with head injury but did not report more memories from the time after the ICU. The ISS mean score was higher for men than for women, more men than women had renal failure and more men than women received opioid treatment. The conclusion is that gender is of less importance concerning memories from the time before, during and after the stay in the ICU.

  5. Traumatic Brachial Artery Injuries

    PubMed Central

    Ergunes, Kazim; Yilik, Levent; Ozsoyler, Ibrahim; Kestelli, Mert; Ozbek, Cengiz; Gurbuz, Ali

    2006-01-01

    We performed this retrospective study to analyze our strategies for managing and surgically treating brachial artery injuries. Fifty-seven patients with a total of 58 traumatic brachial artery injuries underwent surgery at our institution, from August 1996 through November 2004. Fifty-four patients were male and 3 were female (age range, 7 to 75 years; mean, 29.4 years). Forty-four of the patients had penetrating injuries (18 had stab wounds; 16, window glass injuries; and 10, industrial accidents), 10 had blunt trauma injuries (traffic accidents), and 3 had gunshot injuries. Fourteen patients (24.6%) had peripheral nerve injury. All patients underwent Doppler ultrasonographic examination. The repair of the 58 arterial injuries involved end-to-end anastomosis for 32 injuries (55.2%), reverse saphenous vein graft interpositional grafts for 18 (31%), and primary repair for 8 (13.8%). Venous continuity was achieved in 11 (84.6%) of 13 patients who had major venous injuries. Nine of the 57 patients (15.8%) required primary fasciotomy. Follow-up showed that 5 of the 14 patients with peripheral nerve injury had apparent disabilities due to nerve injury. One patient underwent amputation. There were no deaths. We believe that good results can be achieved in patients with brachial artery injuries by use of careful physical examination, Doppler ultrasonography, and restoration of viability with vascular repair and dbridement of nonviable tissues. Traumatic neurologic injury frequently leads to disability of the extremities. PMID:16572866

  6. The efficacy of self-management programmes for increasing physical activity in community-dwelling adults with acquired brain injury (ABI): a systematic review.

    PubMed

    Jones, Taryn M; Hush, Julia M; Dear, Blake F; Titov, Nickolai; Dean, Catherine M

    2014-04-21

    Acquired brain injury (ABI), often arising from stroke or trauma, is a common cause of long-term disability, physical inactivity and poor health outcomes globally. Individuals with ABI face many barriers to increasing physical activity, such as impaired mobility, access to services and knowledge regarding management of physical activity. Self-management programmes aim to build skills to enable an individual to manage their condition, including their physical activity levels, over a long period of time. Programme delivery modes can include traditional face-to-face methods, or remote delivery, such as via the Internet. However, it is unknown how effective these programmes are at specifically improving physical activity in community-dwelling adults with ABI, or how effective and acceptable remote delivery of self-management programmes is for this population. We will conduct a comprehensive search for articles indexed on MEDLINE, EMBASE, CINAHL, PsychINFO, AMED, Cochrane Central Register of Controlled Trials (CENTRAL), PEDro and Science Citation Index Expanded (SCI-EXPANDED) databases that assess the efficacy of a self-management intervention, which aims to enhance levels of physical activity in adults living in the community with ABI. Two independent reviewers will screen studies for eligibility, assess risk of bias, and extract relevant data. Where possible, a meta-analysis will be performed to calculate the overall effect size of self-management interventions on physical activity levels and on outcomes associated with physical activity. A comparison will also be made between face-to-face and remote delivery modes of self-management programmes, in order to examine efficacy and acceptability. A content analysis of self-management programmes will also be conducted to compare aspects of the intervention that are associated with more favourable outcomes. This systematic review aims to review the efficacy of self-management programmes aimed at increasing physical activity

  7. The efficacy of self-management programmes for increasing physical activity in community-dwelling adults with acquired brain injury (ABI): a systematic review

    PubMed Central

    2014-01-01

    Background Acquired brain injury (ABI), often arising from stroke or trauma, is a common cause of long-term disability, physical inactivity and poor health outcomes globally. Individuals with ABI face many barriers to increasing physical activity, such as impaired mobility, access to services and knowledge regarding management of physical activity. Self-management programmes aim to build skills to enable an individual to manage their condition, including their physical activity levels, over a long period of time. Programme delivery modes can include traditional face-to-face methods, or remote delivery, such as via the Internet. However, it is unknown how effective these programmes are at specifically improving physical activity in community-dwelling adults with ABI, or how effective and acceptable remote delivery of self-management programmes is for this population. Methods/Design We will conduct a comprehensive search for articles indexed on MEDLINE, EMBASE, CINAHL, PsychINFO, AMED, Cochrane Central Register of Controlled Trials (CENTRAL), PEDro and Science Citation Index Expanded (SCI-EXPANDED) databases that assess the efficacy of a self-management intervention, which aims to enhance levels of physical activity in adults living in the community with ABI. Two independent reviewers will screen studies for eligibility, assess risk of bias, and extract relevant data. Where possible, a meta-analysis will be performed to calculate the overall effect size of self-management interventions on physical activity levels and on outcomes associated with physical activity. A comparison will also be made between face-to-face and remote delivery modes of self-management programmes, in order to examine efficacy and acceptability. A content analysis of self-management programmes will also be conducted to compare aspects of the intervention that are associated with more favourable outcomes. Discussion This systematic review aims to review the efficacy of self-management programmes

  8. The relationship between physical performance measures and independence in instrumental activities of daily living. The FICSIT Group. Frailty and Injury: Cooperative Studies of Intervention Trials.

    PubMed

    Judge, J O; Schechtman, K; Cress, E

    1996-11-01

    Understanding the relationship between physical capacity and functional status is required to design exercise interventions to maintain independent living. This study assessed the importance of physical performance in maintaining independence in Instrumental Activities of Daily Living (IADL). A pre-planned meta-analysis of cross-sectional data from six sites of the Frailty and Injury: Cooperative Studies of Intervention Trials (FICSIT). Linear regression was used to estimate the relationship between physical performance and IADL. 2190 community-dwelling older subjects. IADL was the dependent variable; gait velocity, balance function, grip strength and chair rise time were the predictor variables. Age, gender, education, falls self-efficacy, and cognitive status were covariates. Gait velocity, balance function, and grip strength were independently related to IADL deficits, after correcting for covariates. The linear slopes were relatively steep. For gait, a decrease of 0.1 m s-1 was associated with 0.10 (95% Cl: 0.17, 0.04) increase in IADL deficits, which is equivalent to 1 ADL deficit in 10 subjects. The linear slopes for hand grip and balance were similar or steeper. In the sites where chair stand time was measured, an increase of 1 second in the time to rise was associated with a 0.14 (0.04, 0.24) increase in IADL deficits. The relationships found in the meta-analytic analysis were consistent across sites which enrolled subjects with widely varying levels of physical performance. Simple measures of physical performance were strongly associated with IADL independence after correcting for many previously identified predictors of functional status. The data from this meta-analysis support testing interventions designed to improve physical performance to determine whether improved performance can maintain or improve independence in IADLs.

  9. Documenting the content of physical therapy for children with acquired brain injury: development and validation of the motor learning strategy rating instrument.

    PubMed

    Levac, Danielle; Missiuna, Cheryl; Wishart, Laurie; Dematteo, Carol; Wright, Virginia

    2011-05-01

    A goal of physical therapy interventions for children and youth with acquired brain injury (ABI) is the learning and relearning of motor skills. Therapists can apply theoretically derived and evidence-based motor learning strategies (MLSs) to structure the presentation of a task and organize the environment in ways that may promote effective, transfer-oriented practice. However, little is known about how MLSs are used in physical therapy interventions for children with ABI. The purpose of this study was to develop and validate an observer-rated Motor Learning Strategy Rating Instrument (MLSRI) quantifying the application of MLSs in physical therapy interventions for children with ABI. A multi-stage, iterative, item generation and reduction approach was used. An initial list of MLS items was generated through literature review. Seven experts participated in face validation to confirm item comprehensiveness. In a content validation process, 12 physical therapists with pediatric ABI experience responded to a questionnaire evaluating feasibility and importance of items. Six physical therapy sessions with clients with ABI were videotaped at a children's rehabilitation center. The 12 physical therapists participated in a session where they: (1) rated session videos to test the MLSRI and (2) provided verbal feedback. Revisions were made sequentially to the MLSRI based on these processes. The MLSRI was scored during videotape observation rather than being given a live rating, which may be onerous in certain settings and may influence therapist or child behavior. Further reliability investigations will determine whether the 33-item MLSRI is of help in documenting strategy use during intervention, as an evaluation tool in research, and as a knowledge transfer resource in clinical practice.

  10. Previous physical exercise alters the hepatic profile of oxidative-inflammatory status and limits the secondary brain damage induced by severe traumatic brain injury in rats.

    PubMed

    de Castro, Mauro Robson Torres; Ferreira, Ana Paula de Oliveira; Busanello, Guilherme Lago; da Silva, Luís Roberto Hart; da Silveira Junior, Mauro Eduardo Porto; Fiorin, Fernando da Silva; Arrifano, Gabriela; Crespo-López, Maria Elena; Barcelos, Rômulo Pillon; Cuevas, María J; Bresciani, Guilherme; González-Gallego, Javier; Fighera, Michele Rechia; Royes, Luiz Fernando Freire

    2017-09-01

    An early inflammatory response and oxidative stress are implicated in the signal transduction that alters both hepatic redox status and mitochondrial function after traumatic brain injury (TBI). Peripheral oxidative/inflammatory responses contribute to neuronal dysfunction after TBI Exercise training alters the profile of oxidative-inflammatory status in liver and protects against acute hyperglycaemia and a cerebral inflammatory response after TBI. Approaches such as exercise training, which attenuates neuronal damage after TBI, may have therapeutic potential through modulation of responses by metabolic organs. The vulnerability of the body to oxidative/inflammatory in TBI is significantly enhanced in sedentary compared to physically active counterparts. Although systemic responses have been described after traumatic brain injury (TBI), little is known regarding potential interactions between brain and peripheral organs after neuronal injury. Accordingly, we aimed to investigate whether a peripheral oxidative/inflammatory response contributes to neuronal dysfunction after TBI, as well as the prophylactic role of exercise training. Animals were submitted to fluid percussion injury after 6 weeks of swimming training. Previous exercise training increased mRNA expression of X receptor alpha and ATP-binding cassette transporter, and decreased inducible nitric oxide synthase (iNOS), cyclooxygenase-2 (COX-2), tumor necrosis factor (TNF)-α and interleukin (IL)-6 expression per se in liver. Interestingly, exercise training protected against hepatic inflammation (COX-2, iNOS, TNF-α and IL-6), oxidative stress (decreases in non-protein sulfhydryl and glutathione, as well as increases in 2',7'-dichlorofluorescein diacetate oxidation and protein carbonyl), which altered hepatic redox status (increases in myeloperoxidase and superoxide dismutase activity, as well as inhibition of catalase activity) mitochondrial function (decreases in methyl-tetrazolium and Δψ, as well as

  11. Injury Prevention and Performance Enhancement in 101st Airbourne Soldiers

    DTIC Science & Technology

    2013-02-01

    prevalence of musculoskeletal injuries. Phase 2 research identified suboptimal physical and physiological characteristics, implications for physical readiness...Phase 4 research validated ETAP to mitigate musculoskeletal injuries. Injury prevention, performance decrement, biomechanics, musculoskeletal ...23 Musculoskeletal Flexibility

  12. Physics.

    PubMed

    Bromley, D A

    1980-07-04

    From massive quarks deep in the hearts of atomic nuclei to the catastrophic collapse of giant stars in the farthest reaches of the universe, from the partial realization of Einstein's dream of a unified theory of the forces of nature to the most practical applications in technology, medicine, and throughout contemporary society, physics continues to have a profound impact on man's view of the universe and on the quality of life. The author argues that the past few years, in terms of new discoveries, new insight-and the new questions-have been among the most productive in the history of the field and puts into context his selection of some of the most important new developments in this fundamental science.

  13. 29 CFR 780.122 - Activities relating to race horses.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Activities relating to race horses. Employees engaged in the breeding, raising, and training of horses on..., attendants, exercise boys, and watchmen employed at the breeding or training farm. On the other hand... horses which have been used in commercial racing and returned to a breeding or training farm for...

  14. 29 CFR 780.122 - Activities relating to race horses.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Activities relating to race horses. Employees engaged in the breeding, raising, and training of horses on..., attendants, exercise boys, and watchmen employed at the breeding or training farm. On the other hand... horses which have been used in commercial racing and returned to a breeding or training farm for...

  15. 29 CFR 780.122 - Activities relating to race horses.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Activities relating to race horses. Employees engaged in the breeding, raising, and training of horses on..., attendants, exercise boys, and watchmen employed at the breeding or training farm. On the other hand... horses which have been used in commercial racing and returned to a breeding or training farm for...

  16. 29 CFR 780.122 - Activities relating to race horses.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Activities relating to race horses. Employees engaged in the breeding, raising, and training of horses on..., attendants, exercise boys, and watchmen employed at the breeding or training farm. On the other hand... horses which have been used in commercial racing and returned to a breeding or training farm for...

  17. Acute effects of muscle stretching on physical performance, range of motion, and injury incidence in healthy active individuals: a systematic review.

    PubMed

    Behm, David G; Blazevich, Anthony J; Kay, Anthony D; McHugh, Malachy

    2016-01-01

    Recently, there has been a shift from static stretching (SS) or proprioceptive neuromuscular facilitation (PNF) stretching within a warm-up to a greater emphasis on dynamic stretching (DS). The objective of this review was to compare the effects of SS, DS, and PNF on performance, range of motion (ROM), and injury prevention. The data indicated that SS- (-3.7%), DS- (+1.3%), and PNF- (-4.4%) induced performance changes were small to moderate with testing performed immediately after stretching, possibly because of reduced muscle activation after SS and PNF. A dose-response relationship illustrated greater performance deficits with ≥60 s (-4.6%) than with <60 s (-1.1%) SS per muscle group. Conversely, SS demonstrated a moderate (2.2%) performance benefit at longer muscle lengths. Testing was performed on average 3-5 min after stretching, and most studies did not include poststretching dynamic activities; when these activities were included, no clear performance effect was observed. DS produced small-to-moderate performance improvements when completed within minutes of physical activity. SS and PNF stretching had no clear effect on all-cause or overuse injuries; no data are available for DS. All forms of training induced ROM improvements, typically lasting <30 min. Changes may result from acute reductions in muscle and tendon stiffness or from neural adaptations causing an improved stretch tolerance. Considering the small-to-moderate changes immediately after stretching and the study limitations, stretching within a warm-up that includes additional poststretching dynamic activity is recommended for reducing muscle injuries and increasing joint ROM with inconsequential effects on subsequent athletic performance.

  18. Deployment-related traumatic brain injury among Operation Enduring Freedom/Operation Iraqi Freedom veterans: associations with mental and physical health by gender.

    PubMed

    Iverson, Katherine M; Pogoda, Terri K; Gradus, Jaimie L; Street, Amy E

    2013-03-01

    Traumatic brain injury (TBI) research among Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) veterans has focused primarily on men. We examine associations between probable deployment-related TBI and postdeployment mental and physical health symptoms separately by gender. To identify unique associations of probable TBI with health symptoms, analyses were also conducted separately for veterans with and without probable posttraumatic stress disorder (PTSD). A mail survey, including self-report measures of probable deployment-related TBI and mental and physical health symptoms, was completed by 2348 OEF/OIF veterans (51% female), sampled randomly within gender from a national roster. We conducted logistic regressions stratified by gender and probable PTSD status to evaluate associations between probable TBI and health symptoms. Of the respondents, 10.7% of women and 19.7% of men screened positive for probable deployment-related TBI. Probable TBI was significantly associated with increased risk of mental and physical health symptoms for both genders, even after adjusting for potential confounders. Odds ratios for the associations of probable TBI with health symptoms ranged between 2.63 and 9.20 for women and between 1.94 and 7.44 for men. Among veterans with probable PTSD, symptomatic anxiety and symptomatic physical health remained associated with probable TBI. Among veterans without probable PTSD, TBI remained strongly associated with all health symptoms for women and symptomatic anxiety and physical health for men, suggesting an association between TBI and some health symptoms independent of PTSD. Strong associations between probable TBI and health symptoms for women and men confirm the importance of screening for TBI and treatment of associated health symptoms for all OEF/OIF veterans.

  19. Physical principles demonstrate that the biceps femoris muscle relative to the other hamstring muscles exerts the most force: implications for hamstring muscle strain injuries.

    PubMed

    Dolman, Bronwyn; Verrall, Geoffrey; Reid, Iain

    2014-07-01

    Of the hamstring muscle group the biceps femoris muscle is the most commonly injured muscle in sports requiring interval sprinting. The reason for this observation is unknown. The objective of this study was to calculate the forces of all three hamstring muscles, relative to each other, during a lengthening contraction to assess for any differences that may help explain the biceps femoris predilection for injury during interval sprinting. To calculate the displacement of each individual hamstring muscle previously performed studies on cadaveric anatomical data and hamstring kinematics during sprinting were used. From these displacement calculations for each individual hamstring muscle physical principles were then used to deduce the proportion of force exerted by each individual hamstring muscle during a lengthening muscle contraction. These deductions demonstrate that the biceps femoris muscle is required to exert proportionally more force in a lengthening muscle contraction relative to the semimembranosus and semitendinosus muscles primarily as a consequence of having to lengthen over a greater distance within the same time frame. It is hypothesized that this property maybe a factor in the known observation of the increased susceptibility of the biceps femoris muscle to injury during repeated sprints where recurrent higher force is required.

  20. Physical principles demonstrate that the biceps femoris muscle relative to the other hamstring muscles exerts the most force: implications for hamstring muscle strain injuries

    PubMed Central

    Dolman, Bronwyn; Verrall, Geoffrey; Reid, Iain

    2014-01-01

    Summary Of the hamstring muscle group the biceps femoris muscle is the most commonly injured muscle in sports requiring interval sprinting. The reason for this observation is unknown. The objective of this study was to calculate the forces of all three hamstring muscles, relative to each other, during a lengthening contraction to assess for any differences that may help explain the biceps femoris predilection for injury during interval sprinting. To calculate the displacement of each individual hamstring muscle previously performed studies on cadaveric anatomical data and hamstring kinematics during sprinting were used. From these displacement calculations for each individual hamstring muscle physical principles were then used to deduce the proportion of force exerted by each individual hamstring muscle during a lengthening muscle contraction. These deductions demonstrate that the biceps femoris muscle is required to exert proportionally more force in a lengthening muscle contraction relative to the semimembranosus and semitendinosus muscles primarily as a consequence of having to lengthen over a greater distance within the same time frame. It is hypothesized that this property maybe a factor in the known observation of the increased susceptibility of the biceps femoris muscle to injury during repeated sprints where recurrent higher force is required. PMID:25506583

  1. Does the Good Schools Toolkit Reduce Physical, Sexual and Emotional Violence, and Injuries, in Girls and Boys equally? A Cluster-Randomised Controlled Trial.

    PubMed

    Devries, Karen M; Knight, Louise; Allen, Elizabeth; Parkes, Jenny; Kyegombe, Nambusi; Naker, Dipak

    2017-04-10

    We aimed to investigate whether the Good School Toolkit reduced emotional violence, severe physical violence, sexual violence and injuries from school staff to students, as well as emotional, physical and sexual violence between peers, in Ugandan primary schools. We performed a two-arm cluster randomised controlled trial with parallel assignment. Forty-two schools in one district were allocated to intervention (n = 21) or wait-list control (n = 21) arms in 2012. We did cross-sectional baseline and endline surveys in 2012 and 2014, and the Good School Toolkit intervention was implemented for 18 months between surveys. Analyses were by intention to treat and are adjusted for clustering within schools and for baseline school-level proportions of outcomes. The Toolkit was associated with an overall reduction in any form of violence from staff and/or peers in the past week towards both male (aOR = 0.34, 95%CI 0.22-0.53) and female students (aOR = 0.55, 95%CI 0.36-0.84). Injuries as a result of violence from school staff were also lower in male (aOR = 0.36, 95%CI 0.20-0.65) and female students (aOR = 0.51, 95%CI 0.29-0.90). Although the Toolkit seems to be effective at reducing violence in both sexes, there is some suggestion that the Toolkit may have stronger effects in boys than girls. The Toolkit is a promising intervention to reduce a wide range of different forms of violence from school staff and between peers in schools, and should be urgently considered for scale-up. Further research is needed to investigate how the intervention could engage more successfully with girls.

  2. Health impact modelling of different travel patterns on physical activity, air pollution and road injuries for São Paulo, Brazil.

    PubMed

    Sá, Thiago Hérick de; Tainio, Marko; Goodman, Anna; Edwards, Phil; Haines, Andy; Gouveia, Nelson; Monteiro, Carlos; Woodcock, James

    2017-11-01

    São Paulo city, Brazil, faces challenges caused by rapid urbanization. We illustrate how future travel patterns could lead to different health consequences in the city. We evaluated the health impacts of different travel pattern scenarios for the São Paulo adult population by comparing the travel patterns of São Paulo in 2012 with counterfactual scenarios in which the city adopted travel patterns of i) those living in the city's expanded centre; ii) London (2012); iii) a highly motorized São Paulo (SP California); and iv) a visionary São Paulo (SP 2040), with high levels of walking and cycling and low levels of car and motorcycle use. For each scenario we estimated changes in exposure to air pollution, road injury risk, and physical activity. Health outcomes were estimated using disability adjusted life years (DALYs) and premature deaths averted. Sensitivity analyses were performed to identify the main sources of uncertainty. We found considerable health gains in the SP 2040 scenario (total 63.6k DALYs avoided), with 4.7% of premature deaths from ischemic heart disease avoided from increases in physical activity alone. Conversely, we found substantial health losses in the scenario favouring private transport (SP California, total increase of 54.9k DALYs), with an increase in road traffic deaths and injuries among pedestrians and motorized vehicles. Parameters related to air pollution had the largest impact on uncertainty. Shifting travel patterns towards more sustainable transport can provide major health benefits in São Paulo. Reducing the uncertainties in the findings should be a priority for empirical and modelling research on the health impacts of such shifts. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  3. Narrative environments and the capacity of disability narratives to motivate leisure-time physical activity among individuals with spinal cord injury.

    PubMed

    Perrier, Marie-Josée; Smith, Brett M; Latimer-Cheung, Amy E

    2013-01-01

    Few individuals with spinal cord injury (SCI) engage in the recommended amount of leisure time physical activity (LTPA). Yet little is known about how, and why, active individuals engage in specific types of LTPA. This study explored how a unique narrative environment and disability narratives motivated individuals with SCI to engage in LTPA. Fourteen individuals with SCI from a physical activity program participated in approximately hour-long interviews. Interviews were then subjected to a narrative analysis. Individuals who used a restitution narrative (n = 6) were motivated to engage in functional LTPA because of the desire to maintain the body and restore the past self. The individual who used the chaos narrative (n = 1) preferred solitary LTPA as exposure to others with SCI was a constant reminder of the lost, pre-injury self. Individuals who used a quest narrative (n = 7) explored LTPA options that fit with their interests; these individuals were open to new types of LTPA, such as sport and outdoor recreation. The plot of three disability narratives can all motivate the pursuit of LTPA; however, not all types of LTPA are seen as equal. LTPA interventions can be enhanced through the lessons learned from this unique type of environment. Despite individuals' views about their disability, they can still be motivated to engage in routine LTPA. Different theoretical determinants, such as health or social benefits, hold different relevance for LTPA among individuals with differing disability narratives. The environment provided by practitioners can therefore elicit some stories of SCI while stifling others. Open narrative environment will attract individuals to listen and maintain involvement in LTPA.

  4. Injuries and Physical Fitness Before and After Deployments of the 10th Mountain Division to Afghanistan and the 1st Cavalry Division to Iraq, September 2005 - October 2008

    DTIC Science & Technology

    2008-10-01

    determined using the McNemar Test. The McNemar Test allows comparison of frequency data involving repeated measures on the same individuals.(71) (3...and After Deployment of the 10thMt Cohort (n=505 Men) Injury Index Injury Incidence p-value ( McNemar Test) Predeployment Postdeployment Period 1...Injury Incidence Before and After Deployment of the 1stCav Cohort – Men (n=3242) Injury Index Injury Incidence p-value ( McNemar Test) Predeployment

  5. [Physical activity in wheelchair users with spinal cord injury: prerequisites for and effects of an active lifestyle].

    PubMed

    de Groot, Sonja; Valent, Linda J M; van Koppenhagen, Casper F; Broeksteeg, Rogier; Post, Marcel W M; van der Woude, Lucas H V

    2013-01-01

    Wheelchair users with spinal cord injury generally have a relatively inactive lifestyle. Several studies have shown that an inactive lifestyle is associated with a lower fitness level, poorer health, reduced social participation and a lower quality of life for wheelchair users. There are a number of ways in which wheelchair users can remain active in daily life, for instance, by using a wheelchair or handbike for mobility instead of taking the car, and by participating in sports or wheelchair sports. Some prerequisites should be met to enable wheelchair users to have a more active lifestyle: the wheelchair should be optimally adjusted and the everyday environment, including sport facilities, should be easily accessible. An active lifestyle often also requires a change in attitude or behaviour. General practitioners, other primary healthcare providers and rehabilitation professionals can help in this respect.

  6. Rehabilitation of extremity war injuries with lesion of peripheral nerves in "PRAXIS" Centre for Physical Medicine and Rehabilitation, Sarajevo.

    PubMed

    Pecar, Dzemal; Karić, Mediha; Kulenović, Husein; Masić, Izet; Kiseljaković, Emina

    2003-07-01

    Polytrauma with significant lesion of peripheral nerves is a specific war injury. It is also one of the most delicate problems in rehabilitation treatment because it requires a close cooperation with surgeon and timely surgical interventions. Based on our experience, the best results in the treatment of injured persons with lesion of peripheral nerves have been accomplished after the surgical treatment. Results in the neurolysis were better than those accomplished in neurorrhaphy. Total of 436 patients with lesion of peripheral nerves were recorded and 56 patients with plexus lesion. Out of this number, 78 patients (about 15%) had surgical treatment (41 neurorrhaphy and 37 neurolysis). Due to lack of adequate ENMG diagnostics, the objective valorisation of treatment outcome was not possible.

  7. Critical primary survey injuries.

    PubMed

    DeArmond, Dan; Carpenter, Andrea J; Calhoon, John H

    2008-01-01

    The primary survey as established by the advanced trauma life support protocol includes a directed history and physical exam aimed at the rapid diagnosis of life-threatening thoracic injuries. Most of these injuries can and should be found and treated during the initial evaluation of the patient without the need for additional diagnostic studies. In this article we review the role of the primary survey in the diagnosis and treatment of major thoracic injuries.

  8. The effectiveness of passive physical modalities for the management of soft tissue injuries and neuropathies of the wrist and hand: a systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) collaboration.

    PubMed

    D'Angelo, Kevin; Sutton, Deborah; Côté, Pierre; Dion, Sarah; Wong, Jessica J; Yu, Hainan; Randhawa, Kristi; Southerst, Danielle; Varatharajan, Sharanya; Cox Dresser, Jocelyn; Brown, Courtney; Menta, Roger; Nordin, Margareta; Shearer, Heather M; Ameis, Arthur; Stupar, Maja; Carroll, Linda J; Taylor-Vaisey, Anne

    2015-09-01

    The purpose of this systematic review was to determine the effectiveness of passive physical modalities compared to other interventions, placebo/sham interventions, or no intervention in improving self-rated recovery, functional recovery, clinical outcomes and/or administrative outcomes (eg, time of disability benefits) in adults and/or children with soft tissue injuries and neuropathies of the wrist and hand. We systematically searched MEDLINE, EMBASE, PsycINFO, and the Cochrane Central Register of Controlled Trials, accessed through Ovid Technologies, Inc, and CINAHL Plus with Full Text, accessed through EBSCO host, from 1990 to 2015. Our search strategies combined controlled vocabulary relevant to each database (eg, MeSH for MEDLINE) and text words relevant to our research question and the inclusion criteria. Randomized controlled trials, cohort studies, and case-control studies were eligible. Random pairs of independent reviewers screened studies for relevance and critically appraised relevant studies using the Scottish Intercollegiate Guidelines Network criteria. Studies with low risk of bias were synthesized following best evidence synthesis principles. We screened 6618 articles and critically appraised 11 studies. Of those, 7 had low risk of bias: 5 addressed carpal tunnel syndrome (CTS) and 2 addressed de Quervain disease. We found evidence that various types of night splints lead to similar outcomes for the management of CTS. The evidence suggests that a night wrist splint is less effective than surgery in the short term but not in the long term. Furthermore, a night wrist splint and needle electroacupuncture lead to similar outcomes immediately postintervention. Finally, low-level laser therapy and placebo low-level laser therapy lead to similar outcomes. The evidence suggests that kinesio tape or a thumb spica cast offers short-term benefit for the management of de Quervain disease. Our search did not identify any low risk of bias studies examining the

  9. The impact of physical therapy in patients with severe traumatic brain injury during acute and post-acute rehabilitation according to coma duration

    PubMed Central

    Lendraitienė, Eglė; Petruševičienė, Daiva; Savickas, Raimondas; Žemaitienė, Ieva; Mingaila, Sigitas

    2016-01-01

    [Purpose] The aim of study was to evaluate the impact of physical therapy on the recovery of motor and mental status in patients who sustained a severe traumatic brain injury, according to coma duration in acute and post-acute rehabilitation. [Subjects and Methods] The study population comprised patients with levels of consciousness ranging from 3 to 8 according to Glasgow Coma Scale score. The patients were divided into 2 groups based on coma duration as follows: group 1, those who were in a coma up to 1 week, and group 2, those who were in a coma for more than 2 weeks. The recovery of the patients’ motor function was evaluated according to the Motor Assessment Scale and the recovery of mental status according to the Mini-Mental State Examination. [Results] The evaluation of motor and mental status recovery revealed that the patients who were in a coma up to 1 week recovered significantly better after physical therapy during the acute rehabilitation than those who were in a coma for longer than 2 weeks. [Conclusion] The recovery of motor and mental status of the patients in acute rehabilitation was significantly better for those in a coma for a shorter period. PMID:27512262

  10. Head Injuries

    MedlinePlus

    ... before. Often, the injury is minor because your skull is hard and it protects your brain. But ... injuries can be more severe, such as a skull fracture, concussion, or traumatic brain injury. Head injuries ...

  11. Back Injuries

    MedlinePlus

    ... extending from your neck to your pelvis. Back injuries can result from sports injuries, work around the house or in the garden, ... back is the most common site of back injuries and back pain. Common back injuries include Sprains ...

  12. Effect of long-term physical activity and acute exercise on markers of systemic inflammation in persons with chronic spinal cord injury: a systematic review.

    PubMed

    Neefkes-Zonneveld, Céline R; Bakkum, Arjan J; Bishop, Nicolette C; van Tulder, Maurits W; Janssen, Thomas W

    2015-01-01

    To evaluate the effect of long-term physical activity (PA) and acute exercise on markers of systemic inflammation in persons with chronic spinal cord injury (SCI). We searched PubMed (MEDLINE), EMBASE, Central Register of Controlled Trials, CINAHL, and PEDro, involving variations of the Medical Subject Headings: SCI, PA, exercise, and inflammation. No time or language restrictions were applied. Except for case reports, we included any type of study, both sexes, all ages, with SCI, resulting in the inclusion of 11 studies. PA included leisure or work activity, including exercise. Two authors independently scanned titles and abstracts and read the articles included. One author extracted and the second double-checked the data. The methodological quality and evidence were rated by using the Cochrane Risk of Bias tool or the Newcastle-Ottawa Scale and the Grading of Recommendations Assessment, Development and Evaluation approach. The included studies had a high risk of bias and "very low" levels of evidence. Meta-analyses were performed (random-effects model or generic inverse variance method). The acute interleukin-6 (IL-6) response to exercise was the same for individuals with SCI and able-bodied individuals (P=.91); however, responses were higher in those with paraplegia than in those with tetraplegia (weighted mean difference, 1.19, P<.0001, and 0.25, P=.003, respectively). Compared with physically inactive people with SCI, physically active people with SCI had lower plasma C-reactive protein (CRP) levels (weighted mean difference, -0.38; P=.009). CRP concentrations were lower after the exercise intervention than before the exercise intervention (weighted mean difference, -2.76; P=.0001). PA and exercise may improve systemic markers of low-grade inflammation in those with SCI, particularly IL-6 and CRP. The change in IL-6 and CRP levels seems to be greater in those with paraplegia than in those with tetraplegia. Copyright © 2015 American Congress of Rehabilitation

  13. Effectiveness of intense, activity-based physical therapy for individuals with spinal cord injury in promoting motor and sensory recovery: Is olfactory mucosa autograft a factor?

    PubMed Central

    Larson, Cathy A.; Dension, Paula M.

    2013-01-01

    Background/objectives Rehabilitation for individuals with spinal cord injury (SCI) is expanding to include intense, activity-based, out-patient physical therapy (PT). The study's primary purposes were to (i) examine the effectiveness of intense PT in promoting motor and sensory recovery in individuals with SCI and (ii) compare recovery for individuals who had an olfactory mucosa autograft (OMA) with individuals who did not have the OMA while both groups participated in the intense PT program. Methods Prospective, non-randomized, non-blinded, intervention study. Using the American Spinal Injury Association examination, motor and sensory scores for 23 (7 OMA, 6 matched control and 10 other) participants were recorded. Results Mean therapy dosage was 137.3 total hours. The participants’ total, upper and lower extremity motor scores improved significantly while sensory scores did not improve during the first 60 days and from initial to discharge examination. Incomplete SCI or paraplegia was associated with greater motor recovery. Five of 14 participants converted from motor-complete to motor-incomplete SCI. Individuals who had the OMA and participated in intense PT did not have greater sensory or greater magnitude or rate of motor recovery as compared with participants who had intense PT alone. Conclusion This study provides encouraging evidence as to the effectiveness of intense PT for individuals with SCI. Future research is needed to identify the optimal therapy dosage and specific therapeutic activities required to generate clinically meaningful recovery for individuals with SCI including those who elect to undergo a neural recovery/regenerative surgical procedure and those that elect intense therapy alone. PMID:23433335

  14. The relationship between initial physical examination findings and failure on objective validity testing during neuropsychological evaluation after pediatric mild traumatic brain injury.

    PubMed

    Provance, Aaron J; Terhune, E Bailey; Cooley, Christine; Carry, Patrick M; Connery, Amy K; Engelman, Glenn H; Kirkwood, Michael W

    2014-09-01

    The symptomatology after mild traumatic brain injury (mTBI) is complex as symptoms are subjective and nonspecific. It is important to differentiate symptoms as neurologically based or caused by noninjury factors. Symptom exaggeration has been found to influence postinjury presentation, and objective validity tests are used to help differentiate these cases. This study examines how concussed patients seen for initial medical workup may present with noncredible effort during follow-up neuropsychological examination and identifies physical findings during evaluation that best predict noncredible performance. A portion of pediatric patients will demonstrate noncredible effort during neuropsychological testing after mTBI, predicted by failure of certain vestibular and cognitive tests during initial examination. Retrospective cohort. Level 4. Participants (n = 80) underwent evaluation by a sports medicine physician ≤3 months from injury, were subsequently seen for a neuropsychological examination, and completed the Medical Symptom Validity Test (MSVT). Variables included results of a mental status examination (orientation), serial 7s examination, Romberg test, and heel-to-toe walking test. The primary outcome variable of interest was pass/fail of the MSVT. Of the participants, 51% were male and 49% were female. Eighteen of 80 (23%) failed the MSVT. Based on univariable logistic regression analysis, the outcomes of the Romberg test (P = 0.0037) and heel-to-toe walking test(P = 0.0066) were identified as significant independent predictors of MSVT failure. In a multivariable model, outcome of Romberg test was the only significant predictor of MSVT failure. The probability of MSVT failure was 66.7% (95% CI, 33.3% to 88.9%) when a subject failed the Romberg test. A meaningful percentage of pediatric subjects present evidence of noncredible performance during neuropsychological examination after mTBI. Initial examination findings in some cases may represent symptom

  15. Does the knowledge-to-action (KTA) framework facilitate physical demands analysis development for firefighter injury management and return-to-work planning?

    PubMed

    Sinden, Kathryn; MacDermid, Joy C

    2014-03-01

    Employers are tasked with developing injury management and return-to-work (RTW) programs in response to occupational health and safety policies. Physical demands analyses (PDAs) are the cornerstone of injury management and RTW development. Synthesizing and contextualizing policy knowledge for use in occupational program development, including PDAs, is challenging due to multiple stakeholder involvement. Few studies have used a knowledge translation theoretical framework to facilitate policy-based interventions in occupational contexts. The primary aim of this case study was to identify how constructs of the knowledge-to-action (KTA) framework were reflected in employer stakeholder-researcher collaborations during development of a firefighter PDA. Four stakeholder meetings were conducted with employee participants who had experience using PDAs in their occupational role. Directed content analysis informed analyses of meeting minutes, stakeholder views and personal reflections recorded throughout the case. Existing knowledge sources including local data, stakeholder experiences, policies and priorities were synthesized and tailored to develop a PDA in response to the barriers and facilitators identified by the firefighters. The flexibility of the KTA framework and synthesis of multiple knowledge sources were identified strengths. The KTA Action cycle was useful in directing the overall process but insufficient for directing the specific aspects of PDA development. Integration of specific PDA guidelines into the process provided explicit direction on best practices in tailoring the PDA and knowledge synthesis. Although the themes of the KTA framework were confirmed in our analysis, order modification of the KTA components was required. Despite a complex context with divergent perspectives successful implementation of a draft PDA was achieved. The KTA framework facilitated knowledge synthesis and PDA development but specific standards and modifications to the KTA

  16. The University of Queensland study of physical and psychological outcomes for claimants with minor and moderate injuries following a road traffic crash (UQ SuPPORT): design and methods

    PubMed Central

    Kenardy, Justin; Heron-Delaney, Michelle; Bellamy, Nicholas; Sterling, Michele; Connelly, Luke

    2014-01-01

    Background To date research investigating how mental health impacts physical recovery following a road traffic crash (RTC) has focused on cohorts with severe injuries. The UQ SuPPORT study aims to study the physical and psychological outcomes of claimants with minor injuries following an RTC under the Queensland common law compulsory insurance scheme. Objectives This paper outlines the protocols of this study as a platform for future publications. Methods The 2-year longitudinal cohort study collected interview and survey data from claimants at 6, 12, and 24 months post-RTC. Measures used in the telephone interview included the DSM-IV Composite International Diagnostic Interview for posttraumatic stress disorder, generalized anxiety disorder, major depressive episode, panic attacks, agoraphobia; and self-reported disability (WHO-DAS-II). Quality of life (SF-36v2), alcohol use (AUDIT), social support (MSPSS), quality-adjusted life years (EQ-5D), and return to work outcomes were assessed via postal questionnaires. Results A total of 382 claimants consented to participate at the beginning of the study, and these participants were approached at each wave. Retention was high (65%). The average age of participants at Wave 1 was 48.6 years, with 65% of the sample sustaining minor injuries (Injury Severity Score=1–3). Conclusions This study has collected a unique sample of data to investigate recovery patterns of claimants with minor injuries. Future publications will more fully assess the effects of the collected measures on recovery rates 2 years post-RTC. PMID:24799996

  17. The University of Queensland study of physical and psychological outcomes for claimants with minor and moderate injuries following a road traffic crash (UQ SuPPORT): design and methods.

    PubMed

    Kenardy, Justin; Heron-Delaney, Michelle; Bellamy, Nicholas; Sterling, Michele; Connelly, Luke

    2014-01-01

    To date research investigating how mental health impacts physical recovery following a road traffic crash (RTC) has focused on cohorts with severe injuries. The UQ SuPPORT study aims to study the physical and psychological outcomes of claimants with minor injuries following an RTC under the Queensland common law compulsory insurance scheme. This paper outlines the protocols of this study as a platform for future publications. The 2-year longitudinal cohort study collected interview and survey data from claimants at 6, 12, and 24 months post-RTC. Measures used in the telephone interview included the DSM-IV Composite International Diagnostic Interview for posttraumatic stress disorder, generalized anxiety disorder, major depressive episode, panic attacks, agoraphobia; and self-reported disability (WHO-DAS-II). Quality of life (SF-36v2), alcohol use (AUDIT), social support (MSPSS), quality-adjusted life years (EQ-5D), and return to work outcomes were assessed via postal questionnaires. A total of 382 claimants consented to participate at the beginning of the study, and these participants were approached at each wave. Retention was high (65%). The average age of participants at Wave 1 was 48.6 years, with 65% of the sample sustaining minor injuries (Injury Severity Score=1-3). This study has collected a unique sample of data to investigate recovery patterns of claimants with minor injuries. Future publications will more fully assess the effects of the collected measures on recovery rates 2 years post-RTC.

  18. Physical Therapists

    MedlinePlus

    ... as stroke or cerebral palsy; injuries related to work and sports; and other conditions. Physical therapists are educated to use a variety of different techniques to care for their patients. These techniques include ... pain. The work of physical therapists varies by type of patient. ...

  19. Get in motion: an evaluation of the reach and effectiveness of a physical activity telephone counseling service for Canadians living with spinal cord injury.

    PubMed

    Arbour-Nicitopoulos, Kelly P; Tomasone, Jennifer R; Latimer-Cheung, Amy E; Martin Ginis, Kathleen A

    2014-12-01

    Telephone-based counseling is an efficacious intervention strategy for maintaining leisure-time physical activity (LTPA) intentions and increasing LTPA behavior among adults with spinal cord injury (SCI). However, no research has examined the real-world application of this intervention strategy within the SCI community. To assess the individual-level impact of a previously tested telephone-based counseling intervention among adults within the SCI community by using the first 2 components of the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework. A prospective study. General community, tertiary care. Community-dwelling adults with SCI (n = 65; 57% men; mean [standard deviation], 50.4 ± 12.8 years; mean (standard deviation) years after injury, 14.5 ± 12.7 years) living in Canada who enrolled in a national telephone-based counseling service. Of the 65 clients who enrolled, 53 participated in the effectiveness evaluation component of the Get In Motion service. A 6-month, individualized telephone-counseling program with a trained exercise counselor. The program was based on a previously tested intervention that used aspects of the Health Action Process Approach model, with a particular focus on developing and strengthening clients' social cognitions for engaging in self-managed LTPA. On enrollment, all 65 clients completed demographics and staging questionnaires. The 53 clients who participated in the effectiveness evaluation also completed a validated LTPA intentions item, and the 7-day, self-report LTPA Questionnaire for People with SCI over the telephone at baseline, and 2, 4, and 6 months. In terms of the reach of Get In Motion, a total of 65 clients enrolled in the service between June 2008 and June 2011, and were representative of the larger Canadian SCI population on most measured demographic characteristics. Evaluation of the effectiveness of the service showed that, as hypothesized, intentions for engaging in LTPA remained high

  20. Are intensive data collection methods in pain research feasible in those with physical disability? A study in persons with chronic pain and spinal cord injury.

    PubMed

    Kratz, A L; Kalpakjian, C Z; Hanks, R A

    2017-03-01

    Intensive repeated measures data collection procedures, such as ecological momentary assessment (EMA) and end-of-day (EOD) diaries, are becoming more prominent in pain research. Existing data on the feasibility of such methods is encouraging; however, almost nothing is known about feasibility in clinical populations with significant physical disabilities. Research methodology feasibility is crucial to the inclusion of individuals with physical disability in pain research given the high prevalence and impact of pain in these populations. The aim of this study was to examine study compliance, protocol acceptability, and reactivity of intensive data collection methods in adults with chronic pain and spinal cord injury (SCI). Secondary analysis of data from a 7-day EMA and EOD diary study in a sample of 131 community dwelling adults with SCI. Results showed rates of missing data ranged from 18.4 to 22.8% across measures. Participant compliance was related to time of day/presence of audible prompts, mobility aid use, race, and baseline levels of pain and pain interference, with more missing data at wake and bedtimes/no prompts, and for those who used hand-held mobility devices, identified as black/African American, and/or reported higher baseline pain and pain interference. Participants rated the study methodology as generally highly acceptable and expressed willingness to participate in similar studies of much longer duration. There was no evidence of reactivity, defined as temporal shifts in pain or pain interference ratings. Overall, intensive pain data collection is feasible in persons with SCI with no evidence that the methodology impacts pain intensity or pain interference ratings.

  1. [Early functional passive mobilization of flexor tendon injuries of the hand (zone 2) : Exercise with an exoskeleton compared to physical therapy].

    PubMed

    Gülke, Joachim; Mentzel, Martin; Krischak, Gert; Gulkin, David; Dornacher, Daniel; Wachter, Nikolaus

    2017-07-20

    These days there are different types of aftercare following flexor tendon injury. Patients in this study received a dynamic Kleinert protocol and additionally two different postoperative treatments. Both treatment groups were compared to each other and results were put into perspective when compared to other treatment options. Sixty-two patients presenting with clean lesions of the two flexor tendons in zone 2 received postoperative treatment with a dynamic Kleinert protocol. Patients were randomly divided into either Group I (physical therapy) or Group II (exoskeleton). Range of motion was assessed after 6, 12 and 18 weeks. In addition, we measured the Strickland score and grip strength at the 18-week follow-up. DASH scores were obtained at weeks 12 and 18. Regardless of the received postoperative treatment, range of motion was predominantly limited in the proximal interphalangeal and distal interphalangeal joints after 6 weeks. This deficit decreased with time and almost full range of motion was achieved after 18 weeks. Grip strength measured 75% (Group I) and 78% (Group II) of the healthy hand's level. Good functional outcome was observed in the DASH scores after 12 weeks, which improved further, measuring 7.5 (Group I) and 6.8 (Group II) at the 18-week follow-up. We did not see any clinically relevant differences between the two patient groups. Regarding possible reruptures, the Kleinert protocol delivers a safe treatment regime. The possible disadvantage of flexion contractures with the Kleinert protocol was not seen in our measurements. Additional motion exercises using an exoskeleton delivered comparable results to classic physical therapy.

  2. Objective and Self-Reported Physical Activity Measures and Their Association With Depression and Satisfaction With Life in Persons With Spinal Cord Injury.

    PubMed

    Mulroy, Sara J; Hatchett, Patricia E; Eberly, Valerie J; Haubert, Lisa Lighthall; Conners, Sandy; Gronley, JoAnne; Garshick, Eric; Requejo, Philip S

    2016-10-01

    To identify associations between objective and self-reported measures of physical activity (PA) and relationships with depression and satisfaction with life (SWL) in persons with spinal cord injury (SCI). Retrospective, cross-sectional study of objectively measured wheelchair propulsion (WCP) from 2 studies in which an odometer was attached to participants' wheelchairs to record daily speed and distance. Self-reported data were collected in a separate study examining dyspnea, PA, mood, and SWL. Outpatient clinic in a rehabilitation center. Individuals (N=86) with traumatic SCI who use a manual wheelchair. Not applicable. Objective measures of PA included average daily distance and speed of WCP measured by an odometer. Self-report questionnaires included demographics, the 24-hour recall of transfers, Physical Activity Recall Assessment for People with SCI, the Patient Health Questionnaire-2 (PHQ-2) to document depressive symptoms, and the Satisfaction With Life Scale (SWLS). Both objective measures of WCP, average daily distance and speed, were predicted by the combination of self-reported daily time away from home/yard and lower frequency of car transfers ([r=.367, P=.002] and [r=.434, P<.001], respectively). Daily distance of WCP was negatively correlated with depression (PHQ-2) (r=-.309, P=.004). Time in leisure PA was the only significant predictor of SWLS scores (r=.321, P=.003). Short-term recall of hours away from home/yard not spent driving or riding in a vehicle is suggested as a self-report measure that is moderately related to overall WCP PA in this population. Results of this study suggest that depression is related to decreased PA and WCP activity, while SWL is related to leisure PA. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  3. Combined robotic-aided gait training and physical therapy improve functional abilities and hip kinematics during gait in children and adolescents with acquired brain injury.

    PubMed

    Beretta, Elena; Romei, Marianna; Molteni, Erika; Avantaggiato, Paolo; Strazzer, Sandra

    2015-01-01

    To evaluate the combined effect of robotic-aided gait training (RAGT) and physical therapy (PT) on functional abilities and gait pattern in children and adolescents exiting acquired brain injury (ABI), through functional clinical scales and 3D-Gait Analysis (GA). A group of 23 patients with ABI underwent 20 sessions of RAGT in addition to traditional manual PT. All the patients were evaluated before and after the training by using the Gross Motor Function Measures (GMFM) and the Functional Assessment Questionnaire. Ambulant children were also evaluated through the 6 Minutes Walk Test (6MinWT) and GA. Finally, results were compared with those obtained from a control group of ABI children who underwent PT only. After the training, the GMFM showed significant improvement in both dimensions 'D' (standing) and 'E' (walking). In ambulant patients the 6MinWT showed significant improvement after training and GA highlighted a significant increase in cadence, velocity and stride length. Moreover, hip kinematics on the sagittal plane revealed a statistically significant increase in range of motion (ROM) during the whole gait cycle, increased hip extension during terminal stance and increased ROM during the swing phase. The data suggest that the combined programme RAGT + PT induces improvements in functional activities and gait pattern in children and adolescents with ABI and demonstrated it to be an elective tool for the maintenance of the patients' full compliance throughout the rehabilitative programme.

  4. [Analysis of the effect of physical group activities in patients with acquired brain injury in the subacute phase].

    PubMed

    García-Hernández, Juan José; Mediavilla-Saldaña, Lázaro; Pérez-Rodríguez, Pérez-Rodríguez; Pérez-Tejero, Javier; González-Alted, Carlos

    2013-07-16

    Introduccion. El daño cerebral adquirido (DCA) hace referencia a cualquier tipo de lesion no degenerativa que se produce en el cerebro. Las actividades fisicas grupales (AFG) se presentan como un tratamiento efectivo para la mejora de la capacidad funcional. Objetivo. Analizar la eficacia de un programa de AFG en personas con DCA en fase subaguda para su integracion fisica en la comunidad. Pacientes y metodos. Treinta y tres pacientes con DCA, con una edad de 33,18 ± 10,39 años, participaron en un programa de AFG (talleres de circuito, equilibrio simple, equilibrio dual, desplazamiento dual y actividades fisico-deportivas) de 10 semanas. Al comenzar y concluir el programa se evaluaron las variables de velocidad (prueba de velocidad de la marcha en 10 metros), resistencia (prueba de marcha de seis minutos), equilibrio dinamico (Step Test), capacidad funcional (Timed Up and Go), escala de percepcion de seguridad (Activities-specific Balance Confidence Scale) y Physical Activity and Disability Survey (PADS), el promedio por hora de la intensidad de la actividad y el numero de pasos fuera del centro de rehabilitacion (usando monitores de actividad fisica). La prueba t para muestras relacionadas se utilizo para evaluar las diferencias en las variables. Resultados. Se hallaron diferencias significativas (p <= 0,05) en las variables de velocidad, resistencia, equilibrio, capacidad funcional, percepcion de seguridad, percepcion de realizacion de actividad general (pregunta 3 del PADS) y numero de pasos. Conclusion. Los programas de AFG mejoran las capacidades fisicas, percepcion de seguridad, realizacion de actividad en general y numero de pasos, lo que puede conllevar una mayor participacion en la comunidad.

  5. Sports injury prevention in your pocket?! Prevention apps assessed against the available scientific evidence: a review.

    PubMed

    van Mechelen, Daan M; van Mechelen, Willem; Verhagen, Evert A L M

    2014-06-01

    High costs and personal burden follow sports and physical activity-related injuries (SPRI). The last decades' knowledge on how to prevent SPRIs has grown. Past years' eHealth is emerging and mobile applications (apps) helping to prevent SPRIs are appearing. To review the content of iPhone and iPad apps containing a claim to prevent sports and physical activity-related injuries and to appraise this claim against best available scientific evidence. The US iTunes App Store was searched using the keywords 'injury', 'prevention' and 'rehabilitation'. Apps within the categories 'health & fitness', 'sports' and 'medical' containing a preventive claim in the app name, description or screenshots were included. Claims were extracted and a search for best available evidence was performed. Eighteen apps met our inclusion criteria. Four of these apps contained claims for which evidence was available: three apps covered ankle sprains and provided information on taping or neuromuscular training. Of these three apps, one app also provided information on prevention of dental injury with mouth guards. One app provided a routine to prevent anterior cruciate ligament injury. The main focus of the five apps was running injury prevention; for their content evidence of absence of efficacy was found. For nine apps no evidence supporting their content was found. f 18 apps included, only four contained claims that could be supported by available literature and five apps contained false claims. This lack of scientifically sound apps provides an opportunity for caretakers to develop apps with evidence-based claims to prevent SPRIs.

  6. Injuries in Irish dance.

    PubMed

    Stein, Cynthia J; Tyson, Kesley D; Johnson, Victor M; Popoli, David M; d'Hemecourt, Pierre A; Micheli, Lyle J

    2013-12-01

    Irish dance is growing in popularity and competitiveness; however, very little research has focused specifically on this genre of dance. The purpose of this study was to analyze the types of dance injuries incurred by Irish dancers. A chart review was performed to identify all injuries associated with Irish dance seen in the sports medicine or orthopaedic clinics at the investigators' hospital over an 11-year period. "Injury" was defined as any dance-related pain or disorder that led to evaluation in the clinics. Survey data were also collected from study participants. Ultimately, 255 patients from over 30 different schools of dance were seen with injuries directly related (726 clinic visits) or partially related (199 visits) to Irish dance. Participants ranged in age from 4 to 47, with 95% (243/255) under the age of 19. These 255 patients received 437 diagnoses. Almost 80% of the injuries (348/437) were attributable to overuse, and 20.4% were acute and traumatic injuries (89/437). Ninety-five percent (95.9%) of injuries involved the hip or lower extremity. The most common sites were the foot (33.2%), ankle (22.7%), knee (19.7%), and hip (14.4%). Typical diagnoses were tendon injury (13.3%), apophysitis (11.4%), patellofemoral pain and instability (10.8%), stress injury (10.1%), and muscle injury (7.8%). The majority of traumatic injuries were seen in clinic within 3 weeks, but less than a quarter of overuse injuries were seen that quickly. The most common treatment, prescribed to 84.3% of patients, was physical therapy and home exercises, and the majority of dancers (64.3%) were able to return to full dance activity after injury.

  7. Training-induced changes in physical performance can be achieved without body mass reduction after eight week of strength and injury prevention oriented programme in volleyball female players

    PubMed Central

    Sigmund, M; Lipinska, P; Vařeková, R; Hroch, M; Xaverová, Z; Stastny, P; Háp, P; Zmijewski, P

    2017-01-01

    The purpose of the study was to analyse the changes in muscle strength, power, and somatic parameters in elite volleyball players after a specific pre-season training programme aimed at improving jumping and strength performance and injury prevention. Twelve junior female volleyball players participated in an 8-week training programme. Anthropometric characteristics, isokinetic peak torque (PT) single-joint knee flexion (H) and extension (Q) at 60º/s and 180º/s, counter movement jump (CMJ), squat jump (SJ), and reactive strength index (RSI) were measured before and after intervention. Significant moderate effects were found in flexor concentric PT at 60º/s and at 180 º/s in the dominant leg (DL) (18.3±15.1%, likely; 17.8±11.2%, very likely) and in extensor concentric PT at 180º/s (7.4%±7.8%, very likely) in the DL. In the non-dominant leg (NL) significant moderate effects were found in flexor concentric PT at 60º/s and at 180º/s (13.7±11.3%, likely; 13.4±8.0%, very likely) and in extensor concentric PT at 180º/s (10.7±11.5%, very likely). Small to moderate changes were observed for H/QCONV in the DL at 60º/s and 180º/s (15.9±14.1%; 9.6±10.4%, both likely) and in the NL at 60º/s (moderate change, 9.6±11.8%, likely), and small to moderate decreases were detected for H/QFUNC at 180º/s, in both the DL and NL (-7.0±8.3%, likely; -9.5±10.0%, likely). Training-induced changes in jumping performance were trivial (for RSI) to small (for CMJ and SJ). The applied pre-season training programme induced a number of positive changes in physical performance and risk of injury, despite a lack of changes in body mass and composition. PMID:28566815