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Background/Objectives: Falls and fractures are emerging as a near-pandemic and major global health concern, placing an enormous burden on ageing patients and public health economies. Despite the high risk of polypharmacy in the elderly patients, falls are usually attributed to age-related changes. For the "Individual Pharmacotherapy Management (IPM)" established at the University Hospital Halle, the IPM medication adjustments and their association with in-hospital fall prevention were analysed. Methods: On the basis of the most updated digital overall patient view via his inpatient electronic health record (EHR), IPM adapts each drug's Summary of Product Characteristics to the patient's condition. A retrospective pre-post intervention study in geriatric traumatology on ≥70 years old patients compared 200 patients before IPM implementation (CG) with 204 patients from the IPM intervention period (IG) for the entire medication list, organ, cardiovascular and vital functions and fall risk parameters. Results: Statistically similar baseline data allowed a comparison of the average 80-year-old patient with a mean of 11.1 ± 4.9 (CG) versus 10.4 ± 3.6 (IG) medications. The IPM adjusted for drug-drug interactions, drug-disease interactions, overdoses, anticholinergic burden, adverse drug reactions, esp. from opioids inducing increased intrasynaptic serotonin, psychotropic drugs, benzodiazepines, contraindications and missing prescriptions. IPM was associated with a significant reduction in in-hospital falls from 18 (9%) in CG to 3 (1.5%) in IG, a number needed to treat of 14, relative risk reduction 83%, OR 0.17 [95% CI 0.04; 0.76], p = 0.021 in multivariable regression analysis. Factors associated with falls were antipsychotics, digitoxin, corticosteroids, Würzburg pain drip (combination of tramadol, metamizole, metoclopramide), head injury, cognitive impairment and aspects of the Huhn Fall Risk Scale including urinary catheter. Conclusion: The results indicate medication risks constitute a major iatrogenic cause of falls in this population and support the use of EHR-based IPM in standard care for the prevention of falls in the elderly and for patient and drug safety. In terms of global efforts, IPM contributes to the running WHO and United Nations Decade of Healthy Ageing (2021–2030). [ABSTRACT FROM AUTHOR]

Featured Application: Seasonal analysis of the intensive team training and competition periods for non-contact injuries showed a correlation with pre-season endurance diagnostics, particularly individual lactate thresholds. Individual endurance performance levels should therefore always be taken into account when quantitatively assessing the intensive parts of training and competition periods. The chronic component of the ACWR in conjunction with endurance capacity appears to be a particularly sensitive indicator in the two weeks prior to an injury. Therefore, even during seasonal periods with large load fluctuations, e.g., due to the competition calendar, attention should be paid to constant weekly load management. Acute (AW) and chronic (CW) workload imbalances, including their ratio (ACWR), are largely associated with increased injury risk. However, the inclusion of personal endurance performance (EP) in this calculation as a means of improving accuracy has been neglected in previous studies. The aim of this longitudinal observational study was to evaluate the relevance of the high metabolic load distance (ACWRHMLD) to EP in relation to non-contact injuries. Twenty-three German male first division soccer players (age: 24.5 ± 3.5 years; VO2max: 53.7 ± 4.9 mL/min/kg; v4: 15.2 ± 0.9 km/h) were analyzed. Eleven players with non-contact injuries were identified and matched with players without any injuries within the same time interval. Players were monitored using GPS and LPS tracking to calculate ACWRHMLD on a daily basis over the course of one competitive season. Relationships between different endurance performance parameters (v2, v4, vLT, VO2max) and the ACWRHMLD, AW, CW were established for statistical analysis. An area under the curve analysis (AUC) was performed. Based on the four weeks preceding the non-contact injuries, the CW, especially for the last two weeks before the injury, proved to be the most suitable parameter to estimate the risk of injury. The highest significant AUC value (0.81, 95% CI: 0.59–1.00) was calculated for the CW (last week before injury) in relation to the vLT (suitable cut-off: 0.04 km; sensitivity: 78%, specificity: 80%). With regard to the injury rate, the ACWRHMLD seems to be the most appropriate method of calculation, especially for CW related to EP (vLT). The sole use of ACWR, AW, and CW is not recommended. [ABSTRACT FROM AUTHOR]

Featured Application: Ice hockey is a very fast and complex team sport. Consequently, it is necessary to develop performance diagnostics further, considering complexity and quality criteria (validity, reliability, practicability). The introduced ice hockey-specific complex test (IHCT) is one of the few tests that meet all criteria. In particular, the continually growing reference database gives the test a unique selling point. The high number of reference data helps coaches and sports scientists in ice hockey practice to interpret and discuss all data quickly and consistently. This real-life data collection aimed to expand an existing reference database regarding an extensively evaluated ice hockey-specific complex test (IHCT). One hundred and thirty-eight third-league professional ice hockey field players (mean ± SD; age: 26.4 ± 5.24 years; forwards: n = 94, defenders: n = 44) were investigated. IHCT data were collected over eight seasons from three third-league teams. The IHCT included parameters for the load (e.g., 10 m and 30 m sprint times, transition and weave agility times with and without a puck, slap and wrist shots on goal) and stress (e.g., lactate, heart rate). The only relevant (p < 0.002, ηp2 ≥ 0.10) difference between forwards and defenders for performance was found for 30 m backward sprint without a puck (p < 0.001, ηp2 = 0.10, d = 0.74). As expected, in this regard, defenders performed better than forwards. Significant differences were also found in 10 m backward sprint without a puck (p = 0.005), weave agility with a puck (p = 0.014), heart rate recovery minute 10 (p = 0.057), and goals after the test (p = 0.041). This study provides expanded position-specific third-league reference data for the IHCT. On this basis, coaches are able to evaluate players' performance (forwards vs. defenders) and the effect of the training periods. Further research is necessary to extend this database to first- and second-league players in order to enhance the scope of the IHCT. [ABSTRACT FROM AUTHOR]