Quantifying the association between physical activity and injury in primary school-aged children

BACKGROUND. Regular physical activity is strongly advocated in children, with recommendations suggesting up to several hours of daily participation. However, an unintended consequence of physical activity is exposure to the risk of injury. To date, these risks have not been quantified in primary school-aged children despite injury being a leading cause for hospitalization and death in this population. OBJECT. Our goal was to quantify the risk of injury associated with childhood physical activity both in and out of the school setting and calculate injury rates per exposure time for organized and non-organized activity outside of school. METHODS. The Childhood Injury Prevention Study prospectively followed a cohort of randomly selected Australian primary school- and preschool-aged children (4 to 12 years). Over 12 months, each injury that required first aid attention was registered with the study. Exposure to physical activity outside school hours was measured by using a parent-completed 7-day diary. The age and gender distribution of injury rates per 10 000 hours of exposure were calculated for all activity and for organized and non-organized activity occurring outside school hours. In addition, child-based injury rates were calculated for physical activity-related injuries both in and out of the school setting. RESULTS. Complete diary and injury data were available for 744 children. There were 504 injuries recorded over the study period, 396 (88.6%) of which were directly related to physical activity. Thirty-four percent of physical activity-related injuries required professional medical treatment. Analysis of injuries occurring outside of school revealed an overall injury rate of 5.7 injuries per 10 000 hours of exposure to physical activity and a medically treated injury rate of 1.7 per 10 000 hours. CONCLUSION. Injury rates per hours of exposure to physical activity were low in this cohort of primary school-aged children, with < 2 injuries requiring medical treatment occurring for every 10 000 hours of activity participation outside of school.

Socio-economic distribution of environmental risk factors for childhood injury

Objective: Childhood injury remains the single most important cause of mortality in children aged between 1-14 years in many countries. It has been proposed that lower socio-economic status (SES) and poorer housing contribute to potential hazards in the home environment. This study sought to establish whether the prevalence of observed hazards in and around the home was differentially distributed by SES, in order to identify opportunities for injury prevention. Methods: This study was a cross-sectional, random sample survey of primary school children from 32 schools in Brisbane. Interviews and house audits were conducted between July 2000 and April 2003 to collect information on SES (income, employment and education) and previously identified household hazards. Results: There was evidence of a relationship between prevalence of household environmental hazards and household SES; however, the magnitude and direction of this relationship appeared to be hazard-specific. Household income was related to play equipment characteristics, with higher SES groups being more likely to be exposed to risk. All three SES indicators were associated with differences in the home safety characteristics, with the lower SES groups more likely to be exposed to risk. Conclusion:The differential distribution of environmental risk factors by SES of household may help explain the SES differential in the burden of injury and provides opportunities for focusing efforts to address the problem.

Injury risk from popular childhood physical activities: results from an Australian primary school cohort

Background: Children engage in various physical activities that pose different injury risks. However, the lack of adequate data on exposure has meant that these risks have not been quantified or compared in young children aged 5-12 years. Objectives: To measure exposure to popular activities among Australian primary school children and to quantify the associated injury risks. Method: The Childhood Injury Prevention Study prospectively followed up a cohort of randomly selected Australian primary and preschool children aged 5-12 years. Time (min) engaged in various physical activities was measured using a parent-completed 7-day diary. All injuries over 12 months were reported to the study. All data on exposure and injuries were coded using the International classification of external causes of injury. Injury rates per 1000 h of exposure were calculated for the most popular activities. Results: Complete diaries and data on injuries were available for 744 children. Over 12 months, 314 injuries relating to physical activity outside of school were reported. The highest injury risks per exposure time occurred for tackle-style football (2.18/1000 h), wheeled activities (1.72/1000 h) and tennis (1.19/1000 h). Overall, boys were injured more often than girls; however, the differences were non-significant or reversed for some activities including soccer, trampolining and team ball sports. Conclusion: Although the overall injury rate was low in this prospective cohort, the safety of some popular childhood activities can be improved so that the benefits may be enjoyed with fewer negative consequences.

A review of risk factors for hamstring injury in soccer: a biomechanical approach

The aim has been to review the literature about the risk factors of hamstring injury in soccer from a biomechanical point of view. METHODOLOGY. Data bases of bibliography references were Medline, Scopus and SportDiscuss. RESULTS AND DISCUSSION. Many prospective studies have shown that the previous injury is the greatest risk factor of sustaining the injury. However the primary causes of the injury are unclear in soccer. A lack of hamstring flexibility has been one of the main injury risk factors with controversies on the results. Imbalance of isokinetic force is a risk factor but electrical coactivation of all muscles participating during knee flexion and extension are unknown in football. While the importance of lumbopelvic-hamstrings muscles synchronization during running seems to be crucial for understanding the risk of injury, no research has been developed in this topic in football. CONCLUSIONS. More research using new data recording procedures as Dynamic Scanners, Surface EMG, Inverse Dynamic Analysis are needed. The analysis of more specific movements as running, kicking or jumping is clearly required. Managers, coaches, physical trainers, physiotherapists, sport physicians and researchers should work together in order to improve the injury prevention and rehabilitation programs of football players. Key Words: sports biomechanics, soccer, hamstring injury, risk factors

The Burden of Injury in Iowa, December 2008

Injuries are a major public health concern that affects the lives of all Iowans, regardless of age, race, gender, or size of county. Unintentional injuries are the leading cause of death for Iowans between the ages of 1 and 34, while suicides and/or homicides also rank among the top 5 leading causes of death for Iowans between the ages of 1 and 54. Unintentional injury is the 5th leading cause of death for all Iowans, with over 1,500 injury deaths occurring on average each year (from 2002‐ 2006) in Iowa. Injuries also lead to more than 17,000 hospitalizations in Iowa each year and more than 250,000 emergency department (ED) visits. Further, untold numbers of Iowans do not seek medical care for many of the injuries they may incur. Because injuries are preventable, they lead to unnecessary medical costs, economic losses, reduced productivity, and immense physical and emotional strain.

A comparison of lower limb EMG and ground reaction forces between barefoot and shod gait in participants with diabetic neuropathic and healthy controls

Background: It is known that when barefoot, gait biomechanics of diabetic neuropathic patients differ from nondiabetic individuals. However, it is still unknown whether these biomechanical changes are also present during shod gait which is clinically advised for these patients. This study investigated the effect of the participants own shoes on gait biomechanics in diabetic neuropathic individuals compared to barefoot gait patterns and healthy controls. Methods: Ground reaction forces and lower limb EMG activities were analyzed in 21 non-diabetic adults (50.9 +/- 7.3 yr, 24.3 +/- 2.6 kg/m(2)) and 24 diabetic neuropathic participants (55.2 +/- 7.9 yr, 27.0 +/- 4.4 kg/m(2)). EMG patterns of vastus lateralis, lateral gastrocnemius and tibialis anterior, along with the vertical and antero-posterior ground reaction forces were studied during shod and barefoot gait. Results: Regardless of the disease, walking with shoes promoted an increase in the first peak vertical force and the peak horizontal propulsive force. Diabetic individuals had a delay in the lateral gastrocnemius EMG activity with no delay in the vastus lateralis. They also demonstrated a higher peak horizontal braking force walking with shoes compared to barefoot. Diabetic participants also had a smaller second peak vertical force in shod gait and a delay in the vastus lateralis EMG activity in barefoot gait compared to controls. Conclusions: The change in plantar sensory information that occurs when wearing shoes revealed a different motor strategy in diabetic individuals. Walking with shoes did not attenuate vertical forces in either group. Though changes in motor strategy were apparent, the biomechanical did not support the argument that the use of shoes contributes to altered motor responses during gait.

Alcohol and other drug use disorders among older-aged people

In Australia people aged 65 years or older currently comprise 12.1% of the population. This has been estimated to rise to 24.2% by 2051. Until recently there has been relatively little research on alcohol and other drug use disorders among these individuals but, given the ageing population, this issue is likely to become of increasing importance and prominence. Epidemiological research shows a strong age-related decline in the prevalence of alcohol and other drug use disorders with age. Possible reasons for this include: age-related declines in the use and misuse of alcohol and other drugs; increased mortality among those with a lifetime history of alcohol and other drug use disorders; historical differences in exposure to and use of alcohol and other drugs. Despite the age-related decline in the prevalence of these disorders, they do still occur among those aged 65 years or older and, given historical changes in exposure to and use of illicit drugs, it likely that the prevalence of these disorders among older-aged individuals will rise. Specific issues faced by older-aged individuals with alcohol and other drug use problems are discussed. These include: interactions with prescribed medications, under-recognition and treatment of alcohol and drug problems, unintentional injury and social isolation. Finally, a brief discussion of treatment issues is provided.

Efeito de um programa de exercícios no tempo de reacção dos peroniais

Introdução: o futebol é o desporto mais popular e possui características que se traduzem numa grande incidência de lesões, sendo que a FIFA desenvolveu um programa de prevenção de lesões. Objectivos: o objectivo de estudo foi verificar se o programa promove alterações proprioceptivas, no tempo de reacção dos peroniais. Metodologia: é um estudo quase-experimental com 14 atletas, 7 em cada um dos grupos, experimental e controlo. Resultados: Os resultados mostraram um valor p=0,038 no tempo de reacção do curto peroneal. Conclusão: Verificaram-se algumas alterações significativas no tempo de reacção em resposta ao programa de exercícios.

A Eficácia do Programa Fifa 11+ na Prevenção de Lesões em Atletas de Futebol Sub18

Introdução: No futebol, as lesões são da mais fulcral importância pelo que a sua prevenção se revela de extrema pertinência. A FIFA criou o FIFA 11+, um programa de prevenção de lesões, que revelou resultados positivos em equipas jovens tanto femininas como masculinas. No entanto, em Portugal, os resultados da sua implementação são escassos, principalmente em camadas jovens. Objetivo: Estudar a eficácia do programa FIFA 11+ na prevenção de lesões em atletas de futebol – sub 18. Métodos: O presente estudo quasi experimental teve como amostra uma equipa de 24 atletas, divididos voluntariamente em 2 grupos: o grupo experimental (GE) (n=12), e o grupo controlo (GC) (n= 12). Ambos os grupos realizaram os treinos normais sendo o grupo experimental sujeito adicionalmente ao programa FIFA 11+ duas vezes por semana, durante 12 semanas. Foi utilizado ainda o Orchard Sports Injury Classification System (OSICS-10) como sistema de classificação de lesões, sendo estas divididas em graves, moderadas, leves e mínimas. O teste Mann-Whitney foi utilizado para a comparação entre grupos, e o teste de Wilcoxon para a comparação intra grupo. Resultados: Quando comparados o GE com o GC em M0 não se observaram diferenças estatisticamente significativas (p=0.065), no número de lesões entre os grupos. O mesmo se verificou após a implementação do programa FIFA 11+ (p=1,000). Na comparação intra-grupo de M0 e M1 o grupo controlo não apresentou diferenças estatisticamente significativas (p=0,317) enquanto que no grupo experimental se observou que existiam significativamente menos lesões após a implementação do programa. (p=0,025). Conclusão: O programa FIFA 11+ parece ser indicado para a prevenção e diminuição de lesões desportivas em jogadores amadores de equipas sub-18, quando aplicado duas vezes por semana. Apesar disso, para eleger o programa como uma ferramenta de eleição na promoção da saúde, mais estudos são sugeridos utilizando uma amostra maior e se possível num período superior.

Injuries and envenoming by aquatic animals in fishermen of Coxim and Corumbá municipalities, state of Mato Grosso do Sul, Brazil: identification of the causative agents, clinical aspects and first aid measures

INTRODUCTION: The fishes of continental Brazil have socioeconomic importance due to their potential for sport fishing and commercial and subsistence uses, as seen in the Upper Paraguay River Basin, particularly in the municipalities of the Pantanal region, where it is the second largest economic activity. Injuries caused in professional fishermen are common and poorly studied, as in other regions of the country. METHODS: Data were obtained from questionnaires and interviews with 100 professional fishermen, 50 in each municipality, between December 2008 and October 2009. RESULTS: All the fishermen reported some kind of injury caused by fish stings (78% of injuries) and fish, alligator and snake bites (22%) on the hands (46% of cases) and feet (35% of cases). Most of the patients had mild symptoms. The most severe cases were associated with secondary bacterial infections and required specific treatment and prolonged recovery associated with social and economic losses. CONCLUSIONS: The results of this study indicate that the stressful work conditions, inattention to basic preventive measures and carelessness were factors that contributed to accidents and that the toxicity and ability to inflict mechanical trauma of some aquatic species, plus the ineffective use of first aid and hospital treatment, contributed to the high morbidity and complications in many cases. Data from this study are relevant to the fishing communities of the Pantanal region, since they reveal high rates of accidents, lack of knowledge concerning first aid, initial treatment, injury prevention and lack of medical follow-up of the population.

A prevenção de Lesões por Esforço Repetitivo (LER) nas aulas de saxofone

Relatório de estágio de mestrado em Ensino de Música

Changes in Running Mechanics and Spring-Mass Behaviour during a 5-km Time Trial

Research into the biomechanical manifestation of fatigue during exhaustive runs is increasingly popular but additional understanding of the adaptation of the spring-mass behaviour during the course of strenuous, self-paced exercises continues to be a challenge in order to develop optimized training and injury prevention programs. This study investigated continuous changes in running mechanics and spring-mass behaviour during a 5-km run. 12 competitive triathletes performed a 5-km running time trial (mean performance: 17 min 30 s) on a 200 m indoor track. Vertical and anterior-posterior ground reaction forces were measured every 200 m by a 5-m long force platform system, and used to determine spring-mass model characteristics. After a fast start, running velocity progressively decreased (- 11.6%; P<0.001) in the middle part of the race before an end spurt in the final 400-600 m. Stride length (- 7.4%; P<0.001) and frequency (- 4.1%; P=0.001) decreased over the 25 laps, while contact time (+ 8.9%; P<0.001) and total stride duration (+ 4.1%; P<0.001) progressively lengthened. Peak vertical forces (- 2.0%; P<0.01) and leg compression (- 4.3%; P<0.05), but not centre of mass vertical displacement (+ 3.2%; P>0.05), decreased with time. As a result, vertical stiffness decreased (- 6.0%; P<0.001) during the run, whereas leg stiffness changes were not significant (+ 1.3%; P>0.05). Spring-mass behaviour progressively changes during a 5-km time trial towards deteriorated vertical stiffness, which alters impact and force production characteristics.

Activité physique et sportive à l'adolescence: un défi pour les médecins, un défi pour la société. [Sports activity during adolescence: a challenge for health professionals and for the society]

The rate of teenagers who engage in sports activity on a regular basis has decreased since ten years, whereas the rate of overweight and obesity is steadily increasing. This paper discusses the meaning as well as the limits of sports activity during adolescence. Guidelines for sports participation include: a discussion of the frequency and duration of sports training sessions, which have to be adapted to the growth and pubertal stage of the adolescent. Any symptoms suggesting overuse should be tackled seriously. Physician's counselling in the field of protective behaviour (injury prevention) is effective. Finally, the majority of chronic conditions are compatible with moderate sports activity.

Relation of cardiac troponin I measurements at 24 and 48 hours to magnetic resonance-determined infarct size in patients with ST-elevation myocardial infarction.

Levels of circulating cardiac troponin I (cTnI) or T are correlated to extent of myocardial destruction after an acute myocardial infarction. Few studies analyzing this relation have employed a second-generation cTnI assay or cardiac magnetic resonance (CMR) as the imaging end point. In this post hoc study of the Efficacy of FX06 in the Prevention of Mycoardial Reperfusion Injury (F.I.R.E.) trial, we aimed at determining the correlation between single-point cTnI measurements and CMR-estimated infarct size at 5 to 7 days and 4 months after a first-time ST-elevation myocardial infarction (STEMI) and investigating whether cTnI might provide independent prognostic information regarding infarct size at 4 months even taking into account early infarct size. Two hundred twenty-seven patients with a first-time STEMI were included in F.I.R.E. All patients received primary percutaneous coronary intervention within 6 hours from onset of symptoms. cTnI was measured at 24 and 48 hours after admission. CMR was conducted within 1 week of the index event (5 to 7 days) and at 4 months. Pearson correlations (r) for infarct size and cTnI at 24 hours were r = 0.66 (5 days) and r = 0.63 (4 months) and those for cTnI at 48 hours were r = 0.67 (5 days) and r = 0.65 (4 months). In a multiple regression analysis for predicting infarct size at 4 months (n = 141), cTnI and infarct location retained an independent prognostic role even taking into account early infarct size. In conclusion, a single-point cTnI measurement taken early after a first-time STEMI is a useful marker for infarct size and might also supplement early CMR evaluation in prediction of infarct size at 4 months.