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Drowning is a leading cause of fatality among children in the United States. In children younger than 15 years of age there were, on average, an estimated 371 pool- or spa-related fatal drownings reported per year for 2018 through 2020. This study reviewed narrative case reports obtained from the United States Consumer Product Safety Commission (CPSC) to understand pool barrier location, type, and functionality as methods of pool/spa access for childhood submersion incidents. Retroactive analysis of 1,523 fatal and non-fatal submersion incidents among children aged 13 years old and younger was conducted using the CPSC in depth investigation dataset from 2000-2017. Narrative descriptions were coded according to the attributes of barrier location, functionality, and method of access. To our knowledge, these characteristics of barriers have not been previously investigated to this depth. Outcomes indicate that consumer education campaigns should target households with swimming pools/spas and reiterate key findings that (1) submersion incidents occur even when barriers are present and (2) multiple layers of protection against unauthorized pool/spa access are critically important for residential pools/spas. Additionally, improved documentation of barriers is imperative to better understand and prevent drowning among children. [ABSTRACT FROM AUTHOR]

Clinical Scenario: Injuries that affect the groin region are among the most common in football players. To prevent this condition, studies have focused on strengthening the adductors, hip flexors, or abdominal muscles. Recent investigations have used an eccentric-biased exercise (Copenhagen Adduction Exercise [CAE]) that promotes functional and architectural adaptations in the muscle tissue, though its effect on injury risk reduction is unknown. Clinical Question: Can the Copenhagen Adduction Exercise prevent groin injuries in soccer players? Summary of Key Findings: The literature was searched for studies investigating the potential groin injury risk reduction effect of the CAE. (1) Three studies met the inclusion criteria and were used for this appraisal; (2) one study observed a significantly lower injury rate ratio favoring the group that used the CAE program; and (3) 2 studies found similar or higher injury rates in the intervention groups, not supporting the inclusion of the CAE as a preventative tool. Clinical Bottom Line: There is conflicting evidence that usage of the CAE is superior to not performing adductor strengthening exercises in mitigating the risk of sustaining groin injuries. Given the evidence supporting these findings, it is advisable to exercise caution when contemplating the incorporation of the CAE into training regimens aimed at preventing groin injuries. Strength of Recommendation: There is Grade B evidence to suggest that inclusion of the CAE may not be associated with reduced injury rates. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the effect of a Nordic hamstring exercise intervention on biceps femoris long head, semitendinosus, and semimembranosus muscle's activity and relative contributions through multichannel electromyography. Twenty-four injury-free male basketball players (mean age 20 [3] y) were randomly assigned to a 12-week intervention (n = 13) or control group (n = 11). The primary outcome measures were normalized muscle activity (percentage of maximal voluntary isometric contraction, %MVIC) and relative contribution of hamstring muscles over 12 weeks. No effects were found on any of the primary outcome measures. Between-group differences over 12 weeks were 2.7%MVIC (95% confidence interval 95% CI, −0.7 to 6.1) for the biceps femoris long head, 3.4%MVIC (95% CI, −1.4 to 8.2) for the semitendinosus, and 0.8%MVIC (95% CI, −3.0 to 4.6) for the semimembranosus, P =.366. Between-group differences over 12 weeks were 1.0% relative contribution (%con; 95% CI, −3.0 to 5.1) for the biceps femoris long head, 2.2% relative contribution (95% CI, −2.8 to 7.2) for the semitendinosus, and −3.3% relative contribution (95% CI, −6.4 to −0.1) for the semimembranosus P =.258. A positive value implies a higher value for the Nordic group. A Nordic hamstring exercise intervention did not affect the level of muscle activity and relative contribution of hamstring muscles in performance of the Nordic hamstring exercise. [ABSTRACT FROM AUTHOR]

BACKGROUND: Musculoskeletal pain is a prevalent concern among diverse populations, from the average individual to the elite athlete. Handheld percussive massage therapy devices like massage guns have gained much popularity in both medical and athletic settings. Its application has been prominently recognized in injury prevention and rehabilitation. The expansion of the market to provide handheld percussive therapy devices with varying features and price points has encouraged professional and novice use. While percussive therapy holds similarities to more studied therapeutic modalities, like vibration therapy and soft tissue mobilization, there is limited evidence-based information on the indications and contraindications. OBJECTIVE: This study aims to use a qualitative analysis of consumer perceptions to understand the perceived therapeutic potential of percussive massage therapy as a home-based intervention for musculoskeletal concerns of everyday users and elite athletes. Additionally, we aim to gain insight on valuable characteristics supporting its therapeutic potential as well as pertinent limitations. METHODS: The TOLOCO massage gun (TOLOCO) was identified as the best-selling percussive massage therapy device on Amazon. We performed an inductive thematic qualitative analysis on the top 100 positive comments and the top 100 critical comments of the device between June 2020 and April 2023 to determine 4 relevant themes. RESULTS: The 4 themes identified upon qualitative analysis were pain management, versatility, accessibility, and safety and user education. Consumer reviews indicated use for this percussive therapy device in adolescents, adults, and older people across a spectrum of activity levels. Consumers reported the therapeutic potential of percussive massage therapy in managing wide-ranging musculoskeletal concerns like acute pain, chronic pain, nonsurgical injury rehabilitation, postsurgical injury rehabilitation, and injury prevention. Consumers highlighted the versatility of the device to address person-specific needs as a key feature in supporting its perceived therapeutic benefits. Additionally, consumers frequently commented on the affordability and availability of this device to increase accessibility to home-based care. Some critical reviews emphasized a concern for the quality of the device itself. However, this concern did not translate to the overall modality of percussive massage therapy. Of note, despite strong approval for its therapeutic potential, consumer reviews lacked evidence-based insights on appropriate usage. CONCLUSIONS: Home-based percussive massage therapy holds value with its perceived efficacy in pain management for acute and chronic conditions, as well as in injury prevention and rehabilitation. As a low-cost and readily available device for everyday users and high-performing athletes, percussive massage therapy works toward establishing increased health care accessibility and optimizing health care usage. This home-based intervention can serve to reduce the significant personal and economic burden of prevalent musculoskeletal concerns. However, the limited scientific research on percussive massage therapy raises concerns about the lack of evidence-based care and indicates the need for future studies.

Purpose: To test the effects of mental fatigue (MF) on tackling technique on the dominant and nondominant shoulders in rugby union. Methods: Twenty male amateur rugby union players and a total of 953 tackles were analyzed. A randomized crossover counterbalanced design was used across a non-MF (control) and an MF condition. During each condition, each player performed 24 tackles, divided into 4 sets of 6 tackles (3 tackles on each shoulder). In the MF condition, players performed the Stroop Task between each set of tackles. A video recording of each tackle was used to evaluate each player's technical proficiency. A score of 1 point was awarded if a specific technique was performed correctly, and 0 point was given if not. The total score, measured in arbitrary units (AU) out of 11, represents the player's overall tackling proficiency. Results: Overall, players displayed a significantly lower technical proficiency score in the MF condition compared to control (set 2: control 7.30 [7.04–7.57] AU vs MF 6.91 [6.70–7.12] AU, P =.009, effect size (ES) = 0.30 small and set 3: control 7.34 [7.11–7.57] AU vs MF 6.88 [6.66–7.11] AU, P =.002, ES = 0.37 small). For the nondominant shoulder, players had a significantly lower technical proficiency score during the MF condition at set 2 (control 7.05 [6.68–7.41] AU vs MF 6.69 [6.42–6.96] AU, P =.047, ES = 0.29 small) and set 3 (control 7.14 [6.83–7.45] AU vs MF 6.61 [6.35–6.87] AU, P =.007, ES = 0.49 small). Conclusions: MF can diminish a player's overall tackling proficiency, especially when tackling on the nondominant shoulder. The physiological mechanism for this finding may be impaired executive function and suboptimal functioning of neural signals and pathways, which result in less skillful coordination of movement. To further understand and explain MF-induced physiological changes in tackling, the feasibility of monitoring brain activity (such as electroencephalogram) and neuromuscular function (such as electromyogram) needs to be investigated. The findings from this study may also contribute to the development of more effective tackle training programs for injury prevention and performance. [ABSTRACT FROM AUTHOR]

Single-leg landings with or without subsequent jumping are frequently used to evaluate landing biomechanics. The purpose of this study was to investigate the effects of subsequent jumping on the external knee abduction moment and trunk and hip biomechanics during single-leg landing. Thirty young adult female participants performed a single-leg drop vertical jumping (SDVJ; landing with subsequent jumping) and single-leg drop landing (SDL; landing without subsequent jumping). Trunk, hip, and knee biomechanics were evaluated using a 3-dimensional motion analysis system. The peak knee abduction moment was significantly larger during SDVJ than during SDL (SDVJ 0.08 [0.10] N·m·kg−1·m−1, SDL 0.05 [0.10] N·m·kg−1·m−1, P =.002). The trunk lateral tilt and rotation angles toward the support-leg side and external hip abduction moment were significantly larger during SDVJ than during SDL (P <.05). The difference in the peak hip abduction moment between SDVJ and SDL predicted the difference in the peak knee abduction moment (P =.003, R2 =.252). Landing tasks with subsequent jumping would have advantages for evaluating trunk and hip control as well as knee abduction moment. In particular, evaluating hip abduction moment may be important because of its association with the knee abduction moment. [ABSTRACT FROM AUTHOR]

Context: Aberrant movement patterns among individuals with concussion history have been reported during sport-related movement. However, the acute postconcussion kinematic and kinetic biomechanical movement patterns during a rapid acceleration–deceleration task have not been profiled and leaves their progressive trajectory unknown. Our study aimed to examine single-leg hop stabilization kinematics and kinetics between concussed and healthy-matched controls acutely (≤7 d) and when asymptomatic (≤72 h of symptom resolution). Design: Prospective, cohort laboratory study. Methods: Ten concussed (60% male; 19.2 [0.9] y; 178.7 [14.0] cm; 71.3 [18.0] kg) and 10 matched controls (60% male; 19.5 [1.2] y; 176.1 [12.6] cm; 71.0 [17.0] kg) completed the single-leg hop stabilization task under single and dual task (subtracting by 6's or 7's) at both time points. Participants stood on a 30-cm tall box set 50% of their height behind force plates while in an athletic stance. A synchronized light was illuminated randomly, queuing participants to initiate the movement as rapidly as possible. Participants then jumped forward, landed on their nondominant leg, and were instructed to reach and maintain stabilization as fast as possible upon ground contact. We used 2 (group) × 2 (time) mixed-model analyses of variance to compare single-leg hop stabilization outcomes separately during single and dual task. Results: We observed a significant main group effect for single-task ankle plantarflexion moment, with greater normalized torque (mean difference = 0.03 N·m/body weight; P =.048, g = 1.18) for concussed individuals across time points. A significant interaction effect for single-task reaction time indicated that concussed individuals had slower performance acutely relative to asymptomatic (mean difference = 0.09 s; P =.015, g = 0.64), while control group performance was stable. No other main or interaction effects for single-leg hop stabilization task metrics were present during single and dual task (P ≥.051). Conclusions: Greater ankle plantarflexion torque coupled with slower reaction time may indicate stiff, conservative single-leg hop stabilization performance acutely following concussion. Our findings shed preliminary light on the recovery trajectories of biomechanical alterations following concussion and provide specific kinematic and kinetic focal points for future research. [ABSTRACT FROM AUTHOR]

BACKGROUND: Injuries, the leading cause of death in children 1-17 years old, are often preventable. Injury patterns are impacted by changes in the childs environment, shifts in supervision, and caregiver stressors. The objective of this study was to evaluate the incidence and proportion of injuries, mechanisms, and severity seen in Pediatric Emergency Departments (PEDs) during the COVID-19 pandemic. METHODS: This multicenter, cross-sectional study from January 2019 through December 2020 examined visits to 40 PEDs for children

This study assessed activity distribution among the hamstring muscles during the Nordic hamstring exercise (NHE). The objective was to compare muscle activity between and within muscles during the NHE to add insights in its underlying protective mechanism. Through multichannel electromyography, we measured muscle activity in male basketball players during the NHE. Electromyography was assessed at 15 locations: 5 for biceps femoris long head, 4 for semitendinosus, and 6 for semimembranosus. For each percent of the eccentric phase of the NHE, muscle activity was calculated for each electrode location within each hamstring muscle individually. To quantify whole muscle head activity, means and variances across electrodes within each muscle were calculated. Thirty-five noninjured participants were included (mean age, 18 [2] y; mass, 87 [12] kg; height, 192 [9] cm). Heterogeneous muscle activity was found between 38% and 62% and over the whole eccentric contraction phase within the semitendinosus and the semimembranosus, respectively. Muscle activity of the semitendinosus was significantly higher than that of the biceps femoris long head. During the NHE, the relative contribution of the semitendinosus is the highest among hamstring muscles. Its strong contribution may compensate for the biceps femoris long head, the most commonly injured hamstring muscle head. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this study is to evaluate the concordance of predicted maturity status classifications (pre-, circa-, or post-peak height velocity (PHV)) relative to observed age at PHV in youth soccer players. Methods: Longitudinal height records for 124 male soccer players were extracted from academy records spanning the 2000 to 2022 seasons. Age at PHV for each player was estimated with the Superimposition by Translation and Rotation model. Players were classified as pre-, circa-, or post-PHV using both ±1- and ±0.5-yr criteria to define the circa-PHV interval. Maturity status was estimated with several prediction protocols: maturity offset (Mirwald, Moore-1, Moore-2), maturity ratio (Fransen), and percentage of predicted adult height (PAH%) using the Khamis-Roche and Tanner-Whitehouse 2 equations using several bands: 85% to 96%, 88% to 96%, 88% to 93%, and 90% to 93% for the circa-PHV interval, and visual evaluation of individual growth curves alone or with PAH% based on Khamis-Roche and Tanner-Whitehouse 2. Concordance of maturity status classifications based on complete growth curves and predicted estimates of maturity status was addressed with percentage agreement and Cohen's kappa. Results: Visual evaluation of the growth curves had the highest concordance (≈80%) with maturity status classifications (pre-, circa-, post-PHV) based on longitudinal data for individual players. Predicted maturity offset with the Mirwald, Moore-1, and Fransen equations misclassified about one-third to one-half of the players, whereas concordance based on PAH% varied with the band used, but not with the method of height prediction. Conclusions: Visual assessment of the individual growth curves by an experienced assessor provides an accurate estimate of maturity status relative to PHV. Maturity offset prediction equations misclassify the majority of players, whereas PAH% provides a reasonably valid alternative. [ABSTRACT FROM AUTHOR]

Road traffic injuries (RTIs) are a significant cause of death and disability among young people worldwide. Programs that use injury prevention strategies have been shown to effectively reduce the number of injuries. This systematic review aims to present the available evidence on the effectiveness of intervention programs in preventing RTIs among adolescents and young adults. Articles were identified and retrieved from databases including PubMed, Embase, Web of Science, Scopus, Science Direct, Magiran, SID, and Iran Medex. Two reviewers independently screened the articles. Articles published from the first year of publication until January 2018 that met the eligibility criteria were included in the review. These articles covered randomized controlled trials, pretest/post-test interventions, and controlled pretest/post-test interventions aimed at reducing RTIs among adolescents and young people aged 12-26 years. The framework, provided by Murphy and Haddon, were used to categorize the interventions. According to this framework, the interventions were categorized into five groups including education/behavior change, incentive, engineering/technology, legislation/enforcement, and multifaceted programs. The methodological quality of the studies was assessed using the Effective Public Health Practice Project. Of the initial 3165 findings, 13 studies met the inclusion criteria. Eleven of these studies used educational/behavioral approaches, while two employed multifaceted programs. In the educational/behavioral approach, participants' behaviors were considered as outcome variables. Only one of these studies was not successful. Multifaceted interventions were successful in changing behaviors. No studies were found on the effectiveness of other interventions. Eight studies were assessed as having moderate quality. The systematic review shows that educational/behavioral strategies and multifaceted programs are effective in reducing RTIs among young adults and adolescents. However, there is a lack of studies on other potential interventions. The quality of the included studies was moderate, suggesting a need for more rigorous research. [ABSTRACT FROM AUTHOR]

Potential harms of stationary bike injuries in pediatric patients have been highlighted in the literature, but prior work is limited to case series and without population-level analysis. The purpose of this study is to examine the epidemiology of pediatric stationary bike injuries occurring in the US over the last decade using a national database. Injuries resulting from stationary bike use in pediatric patients from 2012 to 2021 were identified using coding from the National Electronic Injury Surveillance System (NEISS) database. Patient demographics, injury characteristics, and case narratives were examined. National annual estimates of injury frequency/incidence were calculated using weighting and survey package in R. Univariate analyses were used to compare injuries among groups. We identified 525 stationary bike injuries representing an estimated total of 15,509 injuries in the population. Pediatric patients sustained an average of 1,551 injuries annually, with an estimated yearly increase of 288 injuries (p < 0.01) after 2019. While males sustained more injuries, there were age-dependent differences in frequency of injuries between sexes (p < 0.01). The upper extremity was the most commonly injured body region overall, but children 5 and under sustained more injuries to the head/neck. The most common overall injury type was lacerations, while fractures predominated in the 6 to 11-year-old age group. Fifty-six percent of injuries were sustained not while riding the bike, most notably among children under 12. Our findings indicate that the impact of stationary bike injury in the pediatric population is not insignificant, and most injuries are related to improper play rather than traditional exercise use. Gender and age-related patterns differed in regard to the type and mechanism of injury sustained. Children 5 and under sustain a disproportionate amount of injuries to the head, neck, and upper extremity. As stationary bikes grow in popularity, preventative measures should be considered to reduce injuries to young children. [ABSTRACT FROM AUTHOR]

The objective of this study was to examine the relationship between creatine kinase (CK) concentration following official matches and the risk of subsequent muscle injury in professional male football (soccer) players. Blood samples were collected on the second post-match day for CK analysis over four consecutive seasons in a professional football club. Players were then followed for five days to observe any occurrence of indirect muscle injury (structural or functional in nature). Players exposed to at least 45 minutes in two consecutive matches within seven days were considered valid cases for analysis. Eighty players participated in the study, generating 1,656 cases eligible for analysis, of which 229 resulted in muscle injuries. The hamstrings were the most frequently injured muscle group (54%), followed by the adductor (21%), triceps surae (19%), quadriceps (5%), and psoas (1%). While CK concentration was higher in muscle injury cases [783 ± 507 U/L (95%CI, 717 to 849; min–max, 105–2,800)] compared with uninjured cases [688 ± 446 U/L (95%CI, 665 to 711; min–max, 100–2,950)], it was not an accurate predictor of subsequent muscle injury risk in professional football players (sensitivity = 56%; specificity = 55%; odds ratio = 1.00; area under curve = 0.557). CK concentration on the second post-match day cannot be used to effectively screen subsequent muscle injury risk in professional male football players. [ABSTRACT FROM AUTHOR]

Firearm injuries have become the leading cause of death among American children. Here we review the scope of the problem, and the pivotal role pediatric surgeons have in preventing pediatric firearm injury. Specific methods for screening and counseling are reviewed, as well as how to overcome barriers. Community and hospital resources as well as organizational efforts are discussed. Finally, a path for surgeon advocacy is outlined as is a call to action for the pediatric surgeon, as we are uniquely poised to identify pediatric patients and deliver timely interventions to reduce the impact of firearm violence. Level IV. • What is currently known about this topic? Firearm injuries are now the number one killer of children. Physicians are uniquely positioned to harness the doctor-patient relationship and provide anticipatory guidance to families regarding firearm safety. Yet there are barriers to this counseling and it is not a standard practice by most pediatric surgeons. • What new information is contained in this article? We provide guidance of firearm injury prevention tailored to the pediatric surgeon including self-education, patient education and address known barriers to providing this anticipatory guidance. Tools to incorporate injury prevention strategies in one's clinical practice are offered. Topics of policy and advocacy also highlight the pediatric surgeon's role. [ABSTRACT FROM AUTHOR]

Objective: To explore perspectives and experiences of adolescent ballet dancers in Australia in relation to dance-related injuries and their impact, injury risk factors, prevention, and treatment. Design: Adolescent ballet dancers aged from 12 to 19 years in Australia were invited to participate in an online qualitative survey. Methods: Responses to openended questions were analyzed thematically using grounded theory while quantitative information was summarized with descriptive statistics and triangulated with qualitative data. Results: Nineteen adolescent dancers reported experiencing pain and multiple injuries but hiding or ignoring injuries due to fear. Dancers recognized the significant physical and psychosocial impact of dance-related injuries on themselves and others. Several risks and injury prevention strategies were identified by dancers. Dancers perceived that treatments were not always informed or effective. Conclusion: Findings suggest that adolescent ballet dancers experience multiple dance-related injuries but require support to disclose injuries, participate in injury prevention, and access treatment. Health professionals may improve quality of care by increasing their understanding of ballet and providing specific management advice. Dance teachers may benefit from further education to support their students. Clinical trials are required to confirm or negate the validity of proposed injury risks and the effectiveness of injury prevention strategies and treatments. [ABSTRACT FROM AUTHOR]

Background: The Fire service Organizational Culture of Safety (FOCUS) survey is an assessment tool comprised of psychometrically validated metrics of safety climate, safety behavior, and downstream outcomes (organizational and injury) that are specific to the U.S. fire and rescue service. Methods: This analysis consists of a descriptive summary of two independent survey waves (FOCUS 1.0 and 2.0). The fire departments included in these survey waves were from convenience sampling (n1.0 = 275; n2.0 = 170). In addition to department level characteristics, we examined individual level characteristics for firefighters and EMS providers in participating departments (n1.0 = 22,719; n2.0 = 16,882). We conducted regression analyses to examine the associations between safety climate and safety behaviors, organizational outcomes, and safety outcomes. All analyses were stratified by organization type (career, volunteer). Results: Our analysis indicated that a majority of respondents were males (90.7%FOCUS 1.0; 90.4%FOCUS 2.0), non-officers (68.4%FOCUS 1.0; 66.4%FOCUS 2.0), and non-Hispanic Whites (70.8%FOCUS 1.0; 69.5%FOCUS 2.0). For both samples there was a higher prevalence of injuries among individuals in career departments (nFOCUS 1.0 = 3778 [17.5%]; nFOCUS 2.0 = 3072 [18.7%]) than volunteer departments (nFOCUS 1.0 = 103 [8.8%]; nFOCUS 2.0 = 34 [7.4%]). We observed an approximate 10-point difference between the mean scores of Management Commitment to Safety for career and volunteer departments in both samples. We observed associations for two organizational outcomes, Safety Behavior and Job Satisfaction, with Management Commitment to Safety and Supervisor Support for Safety overall and when stratified by organization type. We observed a decrease in the odds of injuries associated with a one-unit increase in Management Commitment to Safety (OR1.0 overall: 0.98, 95% CI 0.97–0.99; OR2.0 volunteer: 0.90, 95% CI 0.85–0.95) and Supervisor Support for Safety (OR1.0 overall: 0.95, 95% CI 0.93–0.97; OR1.0 career: 0.95, 95% CI 0.92–0.98). Conclusions: From our current study, and a prior analysis of a geographically stratified random sample of U.S. fire departments, we identified that from all the organizational outcomes, job satisfaction was most consistently associated with FOCUS safety climate. Further, firefighters in our samples consistently rated Supervisor Support for Safety higher than Management Commitment to Safety. Future interventions should support fire departments in improving their departmental Management Commitment to Safety and maintaining their Supervisor for Safety. [ABSTRACT FROM AUTHOR]

The aim of the study was to determine the effect of step load in hypoxia on the effectiveness of preoperative rehabilitation (PR) and hormone levels based on a case study. Introduction: We assessed the impact of variables such as rate of movement and time under tension (TUT) in normobaric hypoxia on the levels of growth hormone (GH), insulin-like growth factor 1 (IGF-1), and erythropoietin (EPO). Additionally, the impact of step load on the hypertrophy and strength of knee extensors and flexors was assessed. Methods: The work uses a case study, the research subject of which was a 23-year-old female professional handball player. The tests included an isokinetic assessment of the peak torque of knee extensors and flexors as well as body composition analysis. Results: The results showed a more than (10.81-fold) increase in GH after the microcycle with time under tension (TUT). The deficit between the lower limbs was also reduced. Conclusions: Using a hypoxic environment based on an appropriate altitude, combined with changes such as a short rest break between sets and a controlled tempo of movement with an eccentric phase, TUT may offer an alternative to the PR process, especially among athletes who care about fast RTS. [ABSTRACT FROM AUTHOR]

Introduction: Trunk and shoulder strength are consistently shown to be involved in performance limitations, as well as contributing to stability, power output, and reducing the risk of injury. Although their biomechanical interaction is a critical aspect for athletes, there is limited research on the relationship between trunk and shoulder strength in sports where upper body mechanics are critical for optimal performance. Purpose: This study examined the differences and relationships between trunk rotational strength and shoulder rotational strength among athletes participating in mixed martial arts (MMA), tennis, swimming, and baseball. Methods: Maximal voluntary contraction tests were performed to evaluate strength of 39 professional adult male athletes from disciplines of MMA (n = 6), tennis (n = 11), swimming (n = 11) and baseball (n = 11). Peak force data were used in sports comparison and relationship analysis between trunk and shoulder rotation strength parameters. Results: The findings revealed a complex and significant relationship between trunk and shoulder strength, with unique patterns for each athletic discipline. Tennis players exhibited a strong correlation between trunk bilateral differences and internal shoulder rotation, while other disciplines demonstrated a more balanced use of trunk asymmetry. Swimmers displayed the best interactions between trunk and shoulder overall, emphasizing the aquatic environment's biomechanical demands. In MMA, the strongest correlation was between shoulder internal and external rotation with the trunk, mainly due to the number of defensive movements in addition to offensive ones. Baseball pitchers showed a significant correlation between internal/external shoulder rotation strength ratio and trunk asymmetry. Conclusion: While no differences in peak force variables were found, unique relationships between trunk and shoulder rotational performance were discovered. The results suggest a long-term sport-specific adaptation of the trunk-shoulder interaction in sports that require upper limb power movements. It seems, that the relationship between the various parameters of trunk and shoulder was influenced by the movement stereotype of each sport. Therefore, recognition of sport-specific interactions is critical to the development of effective training programs that enhance performance and potentially reduce injury risk in different sports. Researchers and practitioners should focus on longitudinally monitoring fluctuations in TRS and SRS relationships throughout each sport season and examining potential associations with injury incidence. [ABSTRACT FROM AUTHOR]

Background: Long-distance running is popular but associated with a high risk of injuries, particularly toe-related injuries. Limited research has focused on preventive measures, prompting exploration into the efficacy of raised toe box running shoes. Purpose: This study aimed to investigate the effect of running shoes with raised toe boxes on preventing toe injuries caused by distance running. Methods: A randomized crossover design involved 25 male marathon runners (height: 1.70 ± 0.02 m, weight: 62.6 + 4.5 kg) wearing both raised toe box (extended by 8 mm along the vertical axis and 3 mm along the sagittal axis) and regular toe box running shoes. Ground reaction force (GRF), in-shoe displacement, and degree of toe deformation (based on the distance change between the toe and the metatarsal head) were collected. Results: Wearing raised toe box shoes resulted in a significant reduction in vertical (p = 0.001) and antero–posterior (p = 0.015) ground reaction forces during the loading phase, with a notable increase in vertical ground reaction force during the toe-off phase (p < 0.001). In-shoe displacement showed significant decreased movement in the forefoot medial (p < 0.001) and rearfoot (medial: p < 0.001, lateral: p < 0.001) and significant increased displacement in the midfoot (medial: p = 0.002, lateral: p < 0.001). Impact severity on the hallux significantly decreased (p < 0.001), while impact on the small toes showed no significant reduction (p = 0.067). Conclusions: Raised toe box running shoes offer an effective means of reducing toe injuries caused by long-distance running. [ABSTRACT FROM AUTHOR]

This study was conducted to compare and analyze whether Pilates exercise and yoga exercise help improve the performance of female fencers and prevent injury, and the dynamic balance test (LQ-YBT) and functional movement screening (FMS) test score of the elite adult female fencers were compared and analyzed as evaluation indicators. Participants were randomly classified into Pilates (n = 10) and yoga groups (n = 10), members of which took part in 50 min of exercise (5 min of warm-up, 40 min of main exercise, and 5 min of cool-down) twice weekly for eight weeks. The results obtained from this study were analyzed via independent t-test and 2-way ANOVA. The results were as follows: LQ-YBT measures (reaching distance) increased significantly for both groups, as did FMS scores (deep squat, hurdle step, inline lunge, shoulder mobility, active straight-leg raise, trunk-stability push-up, and rotary stability). These results suggest that Pilates exercise and yoga exercise might be likely effective in improving the performance of adult female fencers and injury prevention by increasing their dynamic balance ability and functional movement. [ABSTRACT FROM AUTHOR]

The aim of this research was to analyse the psychometric properties of the Spanish version of the Self-Estimated Functional Inability due to Pain Questionnaire (SEFIP) in Dance Conservatory students. For this purpose, the Self-Estimated Functional Inability Because Of Pain (SEFIP) instrument was used, translated into Spanish, validated by experts and administered to a total of 451 students from the Professional and Superior Dance Conservatories of Andalusia (418 females = 92.7%; 33 males = 7.3%) aged 10 and 48 years (M = 18.66; SD = 5.296). The structure of the instrument was then analysed using confirmatory procedures. The Spanish version of the instrument was named Cuestionario de Incapacidad Funcional Autoestimada debido al Dolor. The results show that the model that presents correct fits in the confirmatory analysis is the one-factor model. The model fit data were very good: χ2/gl = 3.37, p = .000; CFI = .94; NFI = .95; GFI = .91; RMSEA = .07 (90% CI = .603; .821). The results support the validity and reliability of this instrument in this population to be used to prevent injuries in dancers. [ABSTRACT FROM AUTHOR]

Aims of this study were to investigate if changes in elbow and wrist joints loading and biomechanical characteristics of performance existed as a function of (a) different hand placement and (b) fundamental skills development in female gymnastics. Ten female gymnasts performed 54 successful trials of round-off skills (cartwheel [18], round-off [18], round-off to back handspring [18]), with three different hand positions (parallel, T-shape and reverse). Kinematic and kinetic data were collected for each trial. A two-way repeated measures ANOVA was used to analyse the injury risk factors. Findings of the current study showed that an increase in RO skill difficulty level significantly influences the mechanical load on the upper extremities. With the increase in mechanical load on the upper extremities during the reverse and parallel hand positions, this study suggests that that T-shape hand position should be used as the primary technique for the young female. Differences in vertical velocity from touchdown to take-off between the three hand positions for the RO and RO-BH suggested that the reverse position was less effective for young female gymnasts. The findings of the current study demonstrated no clear performance benefits between hand position selection. [ABSTRACT FROM AUTHOR]

Endoscopy-related musculoskeletal injuries (ERIs) are frequent among gastrointestinal, pulmonary, nasal, and urologic endoscopists, impacting the healthcare system. The present review aims to compare the ERI rates, risk factors, and ergonomic recommendations in the different endoscopic fields. A review was conducted using PubMed and Cochrane Library for articles based on surveys and published until 10 January 2024. Demographic, work, and ERI data from 46 publications were included, covering 10,539 responders. The ERI incidence ranged between 14% and 97%, highlighting the need of intervention independent of the specialties. The neck, back, and shoulder were the most frequent ERI locations, while gender, age, years of experience, and procedure volume the most common risk factors. Ergonomic recommendations suggest concentrating on endoscope design changes, especially in gastrointestinal endoscopy, to increase the comfort, adaptability of the equipment in the operating room, and workflow/institutional policy changes. The inclusion of an ergonomic timeout guarantees the correct equipment positioning, the neutralisation of the endoscopist's posture, and an indirect break between procedures. Ergonomic training to increase awareness and best practice should be promoted, also using new technologies. Future research should concentrate on intervention and comparative studies to evaluate to which extent prevention measures and newly designed equipment could reduce ERI incidence. [ABSTRACT FROM AUTHOR]

Barbequing can result in devastating burn injuries with unsafe practices. This study aims to characterize the demographics, injury characteristics, and outcomes of grill-related burns and identify ways of burn prevention. A retrospective review of patients admitted to a single-institution, metropolitan burn center from January 1, 2017, to July 1, 2023. Data included demographics, burn injury characteristics, and outcomes. Each Grill Cohort patient was matched to 3 nongrill controls by mBaux score and burn location. Of 2355 patients, 69 (2.9%) met Grill Cohort inclusion criteria. The Grill Cohort had 55 (79.7%) males and an average age of 41.7 ± 17.5 years old. In the Grill Cohort, 25 (36.2%) patients had positive blood alcohol, 8 (11.6%) tested positive for amphetamines, and 5 (7.2%) for cocaine at the time of admission. A total of 61 (88.4%) Grill Cohort burns involved the upper extremity, 43 (62.3%) the head/neck, 34 (49.3%) the lower extremity, and 30 (43.5%) the trunk. Compared with the Control Cohort, the Grill Cohort had smaller proportions of patients who were undomiciled (P <.01) or had a history of mental illness (P <.001). Grill-related burns had a greater proportion of flash/flame burns (P <.001). This study suggests that middle-aged, domiciled males without psychiatric comorbidities are more likely to make preventable grilling errors resulting in burn injuries. Prevention strategies targeting this demographic group should emphasize the risks of grilling while intoxicated, proper handling of propane tanks and lighter fluid, and the use of flash/flame-resistant gear protecting the upper extremities and head/neck. [ABSTRACT FROM AUTHOR]

Background: As youth participation in contact and overhead sports has increased in recent decades, so has the occurrence of injuries of the shoulder. Rotator cuff injury (RCI) is an infrequent shoulder pathology in pediatric patients and its description in the literature has been scarce. A greater understanding of RCI characteristics and treatment outcomes in children and adolescents would improve our understanding of this pathology and help to better guide clinical decision-making. Hypothesis: To identify pediatric patients with magnetic resonance imaging-confirmed RCI treated at a single center to summarize injury characteristics, treatment, and outcomes. It was hypothesized that injuries would occur predominantly in overhead throwing athletes and would demonstrate good outcomes among both operatively and nonoperatively treated patients. Study Design: Cross-sectional study. Level of Evidence: Level 4. Methods: A retrospective review of pediatric patients (<18 years old) diagnosed with and treated for an RCI between January 1, 2011 and January 31, 2021. Patient demographics, injury mechanism and type, treatment, and outcomes were collected. Descriptive statistics were performed. Bivariate testing was used to compare operatively and nonoperatively treated cohorts. Results: A total of 52 pediatric patients treated for a rotator cuff avulsion, partial tear, or complete tear were identified. Mean age was 15 years and 67% of patients were male. Injuries were related most commonly to participation in throwing sports. Operative management occurred in 23% of patients, while 77% were managed nonoperatively. Treatment cohorts differed based on tear type, with all complete tears being managed operatively (P < 0.01). Associated shoulder pathology was common, with the most frequent finding being anterior shoulder instability pathology. Return to play was longer for operatively managed patients (7.1 vs 4.5 months; P < 0.01). Conclusion: The present study expands the limited data available regarding RCIs in pediatric patients. Most injuries are associated with sports and involve the supraspinatus tendon. RCIs were associated with good outcomes and low rates of reinjury in patients managed both nonoperative and operatively. RCI should be considered in throwing athletes with shoulder pain, even in skeletally immature patients. Clinical Relevance: This retrospective study fills the hole in the literature by detailing the patterns associated with RCI characteristics and treatment outcomes. In contrast to studies of adult RCIs, our results suggest that outcomes are good regardless of treatment type. [ABSTRACT FROM AUTHOR]

Firearm injuries are the leading cause of pediatric deaths. The objective of this study was to describe the location and timing of pediatric firearm injuries and to determine the proportion of these injuries that occur within schools in the United States. In this retrospective cohort study, we used national emergency medical services (EMS) data from 2019 to evaluate dispatches to firearm injuries involving school-aged children (age 5–18). We extracted incident location type, patient demographics, number of patients on scene, and injury intent. We identified 4764 EMS dispatches for firearm injuries in school-aged children during 2019. Assault was the most common cause of injury (53.9 %), followed by unintentional shootings (12.1 %) and self-inflicted injuries (6.1 %). Most incidents involved a single patient (91.4 %). Private residence (51.5 %) was the most common location, followed by street/road (23.8 %). 81 firearm injuries (1.7 %) occurred in a school. Private residence was the most common location of injury across all injury intents. During school hours, most firearm injuries occurred in a private residence (51.6 %) or on a street/road (19.9 %). A total of 63 dispatches (1.3 %) were considered a mass casualty incident, of which 9 (14 %) occurred in a school. Regardless of injury intent or time of day, the most common location for pediatric firearm injuries was a private home. Firearm injuries within schools were far less frequent. In designing prevention strategies, our data calls for renewed focus on preventing children from accessing firearms in the home and instituting comprehensive, community-based after school programs. Retrospective cohort. III. [ABSTRACT FROM AUTHOR]

Overhead throwing activity induces elbow valgus loading. The medial elbow dynamic stabilizers are thought important for medial elbow joint protection, but the effects of repetitive pitching on stabilizing function are largely unknown. This study aimed to investigate changes in the dynamic stabilizers during repetitive pitching, as well as factors related to dynamic stabilizing ability. Our hypothesis was that repetitive pitching would reduce dynamic stabilizer function, hence reducing the ability to minimize elbow valgus load. Thirty high school baseball pitchers (age, 16.6 ± 0.5 years) participated. Each participant pitched 100 times (5 blocks of 20 pitches). Prior to and after 100 pitches, medial elbow joint width and strain ratios, indicating the hardness of the ulnar collateral ligament (UCL) and forearm flexor-pronator muscles (FPMs), were measured using ultrasound at rest (non-contraction) and during gripping (contraction). Pre- and post-pitching data were compared using the paired t test. Multiple regression analysis was used to investigate factors related to the change rate of medial elbow joint width during gripping. Medial elbow joint width during gripping significantly increased from before pitching to after pitching (P <.001). Both the UCL and FPM strain ratios after pitching significantly decreased (ie, softer tissue) compared with those before pitching (P =.001 and P =.006, respectively). The ratio of the UCL and FPM strain ratios (UCL/FPM) during gripping prior to pitching was significantly and independently correlated with the change rate of medial elbow joint width during gripping (β = 0.44, P =.016). Pitching 100 balls induces a significant reduction in dynamic stabilizing ability against elbow valgus laxity. High school baseball pitchers should limit themselves to <100 pitches per game or should rest after 100 pitches before resuming. Furthermore, the ratio of hardness (UCL/FPM) during dynamic stabilization associated with gripping prior to pitching was significantly related to the change rate of elbow valgus laxity during dynamic stabilization. Maintaining the FPMs harder relative to the UCL during gripping prevents elbow valgus laxity associated with repetitive pitching and may protect the medial elbow joint during repetitive pitching. [ABSTRACT FROM AUTHOR]

Background: Although previous studies have reported that proprioceptive training methods (PTM) have positive effects, there is a relatively small number of studies regarding the impact of PTM in women's soccer. Therefore, there is a need to systematize the given results. In this regard, this systematic review aimed to investigate the effect of proprioceptive training methods in female soccer players. Methods: The studies' search and analysis were done according to the PRISMA guidelines. The following databases were checked (Google Scholar, PubMed Cochrane and ProQuest), with additional publication time criteria (2000–2023) using the following keywords: proprioceptive, balance, neuromuscular, training, exercise, intervention, method, activity, female football players, female soccer players, woman soccer players. Results: A total of 7 studies were included in the quantitative synthesis that meet all the criteria with the number of participants being 2.247. Based on the analysis of the previous research and detailed discussion, the main findings of the study resulted in the partial improvement of explosive strength (66%), strength (50%), muscle imbalance and flexibility (50%) and the prevention and reduction of lower extremity injuries in female soccer players (60%). Only one study reported no significant differences between groups, where rate of major injuries was higher in experimental group. Conclusion: The obtained results indicate the necessity to implement proprioceptive training in female soccer training programs, in order to influence the prevention and reduction of injuries and improve balance, proprioceptive ability and body control. Key points: - PMT can be used in women's soccer as an excellent weekly training strategy. - PTM reduces lower extremity injuries and improves explosive strength, strength, agility and muscle imbalance in female soccer players; - PMT should be an essential part of training programs to prevent injuries and improve athlete's performance. [ABSTRACT FROM AUTHOR]

Long‐track and short‐track ice speed skating are integral to the Winter Olympics. The state of evidence‐based injury prevention in these sports is unclear. Our goals were to summarize the current scientific knowledge, to determine the state of research, and to highlight future research areas for injury prevention in ice speed skating. We conducted a scoping review, searching all injury and injury prevention studies in competitive ice speed skaters. The six‐stage Translating Research into Injury Prevention Practice (TRIPP) framework summarized the findings. The systematic search yielded 1109 citations. Nineteen studies were included, and additional searches yielded another 13 studies, but few had high‐quality design. TRIPP stage 1 studies (n = 24) found competition injury rates from 2% to 18% of participants with various injury locations and types. Seasonal prevalence of physical complaints was up to 84% (for back pain) in long‐ and short‐track. Ten studies covered information on TRIPP stage 2, with two small etiological studies linking injuries to functional strength deficits (short‐track) and training load (long‐track). Questionnaire studies identified various perceived risk factors for injuries but lacked further scientific evidence. Most TRIPP stage 3 studies (five out of eight) focused on developing protective measures, while two studies found short‐track helmets performed poorly compared to helmets used in other sports. No study evaluated the efficacy, the intervention context, or the effectiveness (TRIPP stages 4–6) of the measures. Scientific knowledge on injury prevention in ice speed skating is limited. Future research should prioritize high‐quality studies on injury epidemiology and etiology in the sports. [ABSTRACT FROM AUTHOR]

Background and Objectives The RE-AIM (Reach , Effectiveness , Adoption , Implementation , and Maintenance) framework was used to describe the implementation of the Stopping Elderly Accidents, Deaths, and Injuries (STEADI) Initiative (2018–2021) for screening and assessing all older adults ≥65 years for falls risk across 34 outpatient rehabilitation clinics within a large health system. Research Design and Methods We described the Implementation process and strategies. Using Electronic Health Records (EHRs), we identified Reach, Adoption, and Maintenance of screenings and physical assessments to identify fall risk among older adults. Results STEADI Implementation strategies included health system mandates, EHR revisions, email instructions, educational sessions and resources, clinical leads and champions, and chart audits. Reach: 76.4% (50,023) had a completed screening, and 44.1% screened at risk for falls. Adoption: Clinic-level adoption varied, with most performing screenings. Profession-level adoption was highest for physical therapists (PTs; 94.2% initiated, 80.6% completed) and lowest for speech-language pathologists (SLPs; 79.8% initiated, 55.9% completed). Reach and Adoption of functional outcomes measures (FOM): PTs completed an FOM on 59.5% of at-risk patients, occupational therapists on 11.6%, and SLPs on 7.9%. Maintenance: All measures declined 1%–10% annually between 2018 and 2021. Discussion and Implications STEADI screening and FOMs were implemented systemwide in 34 outpatient rehabilitation clinics, reaching over 50,000 older adults. Screening adoption rates varied by clinic. PTs had the highest adoption rate. All adoption rates declined over time. Future research should consider an implementation science approach with input from key partners before implementation to identify barriers and develop strategies to support STEADI in outpatient rehabilitation. [ABSTRACT FROM AUTHOR]

Background: Research on the cause of lateral patellar dislocation (LPD) has focused on trochlear morphologic parameters, joint alignment, and patellofemoral soft tissue forces. A paucity of information is available regarding how patellar morphologic parameters influence the risk for LPD. Purpose/Hypothesis: The purpose was to assess whether patellar morphology is a risk factor for recurrent LPD. It was hypothesized that (1) patients with recurrent LPD would have decreased patellar width and volume and (2) patellar morphologic parameters would accurately discriminate patients with recurrent LPD from controls. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: A total of 21 adults with recurrent LPD (age, 29.7 ± 11.1 years; height, 170.8 ± 9.9 cm; weight, 76.1 ± 17.5 kg; 57% female) were compared with 21 sex- and height-matched controls (age, 27.2 ± 6.7 years; height, 172.0 ± 10.6 cm; weight, 71.1 ± 12.8 kg; 57% female). Three-dimensional axial fat-saturated magnetic resonance imaging scans were used to measure patellar medial, lateral, and total width; patellar volume; patellar medial and lateral facet length; the Wiberg index; and previously validated knee joint alignment and femoral shape measurements (eg, tibial tuberosity to trochlear groove distance, trochlear dysplasia). Results: The LPD group demonstrated reduced medial patellar width (Δ = −3.6 mm; P <.001) and medial facet length (Δ = −3.7 mm; P <.001) but no change in lateral width or facet length. This resulted in decreased total patellar width (Δ = −3.2 mm; P =.009), decreased patellar volume (Δ = −0.3 cm3; P =.025), and an increased Wiberg index (Δ = 0.05; P <.001). No significant differences were found for all other patellar shape measures between cohorts. Medial patellar width was the strongest single discriminator (83.3% accuracy) for recurrent LPD. Combining medial patellar width, patellofemoral tilt, and trochlear groove length increased the discrimination to 92.9%. Conclusion: The medial patellar width was significantly smaller in patients with recurrent LPD and was the single most accurate discriminator for recurrent LPD, even compared with traditional trochlear shape and joint alignment measures (eg, trochlear dysplasia, patella alta). Therefore, medial patellar morphology should be assessed in patients with LPD as a risk factor for recurrence and a potential means to improve treatment. [ABSTRACT FROM AUTHOR]

Background: Malignant hyperthermia (MH), a rare inherited condition seen almost exclusively in the perioperative setting, is triggered by volatile anesthetics or an intravenous paralytic drug, succinylcholine. It can, however, occur without any exposure to anesthetic drugs, being associated with heat illness and rhabdomyolysis, thus presenting a little-known risk to young athletes exercising in hot environments. Objective: This study aimed to determine the first responder awareness of MH and its association with heat illness in young athletes within athletic and clinical environments. Methods: Awareness within the clinical milieu was assessed by an institutional chart review of 3296 charts. The identified heat illness cases were examined for treatment consistent with the management of a suspected episode of MH. Awareness among first responders in an athletic setting was examined by a survey administered to a total of 1,500 coaches and athletic trainers at the high school level along with emergency medical services providers across the United States. Results: No treatment consistent with the suspicion of MH was noted among clinical first responders, suggesting a lack of awareness. Survey administration also revealed a limited amount of knowledge of MH and its potential role in heat illness. Conclusion: The results point to lack of awareness among pre-hospital and hospital-based first responders of the relationship between MH and heat illness in young athletes. An effort to educate these members of the healthcare community can contribute to an expeditious and life-saving intervention. Clinical Relevance: First responders who may interact with a young athlete have low knowledge of MH and its relationship to heat illness. Similar lack of awareness exists among hospital personnel who care for young individuals with heat illness. Educating the first responders about this condition can speed up the time to intervene and save lives. [ABSTRACT FROM AUTHOR]

Featured Application: Latin dance presents a safe, engaging form of weight-bearing exercise for older adults that could help to mitigate age-related physical decline. Quantifying limb impacts during dance using wearable sensors informs guidelines for an appropriate workload to strengthen lower extremity bones and muscles in older populations vulnerable to sarcopenia and falls. As global aging rises, identifying strategies to mitigate age-related physical decline has become an urgent priority. Dance represents a promising exercise modality for older adults, yet few studies have quantified the external loads older dancers experience. This study aimed to characterize the impacts accumulated across lower limb and spinal locations in older adults during Latin dance. Thirty older Latin dancers (age = 66.56 ± 6.38 years; female = 93.3%) wore inertial sensors on the scapulae, lumbar spine, knees, and ankles during a 1 h class. A distal-to-proximal gradient emerged in the total impacts (F = 429.29; p < 0.01; ωp2 = 0.43) and per intensities (F = 103.94-to-665.55; p < 0.01; ωp2 = 0.07-to-0.54), with the highest impacts sustained in the ankles (≈9000 total impacts) from 2 g to >10 g (p < 0.01; d = 1.03-to-4.95; ankles > knees > lower back > scapulae) and knees (≈12,000 total impacts) when <2 g (p < 0.01, d = 2.73-to-3.25; knees > ankles > lower back > scapulae). The majority of the impacts remained below 6 g across all anatomical locations (>94%). The impacts also increased in lower limb locations with faster tempos (r = 0.10-to-0.52; p < 0.01), while subtly accumulating over successive songs rather than indicating fatigue (r = 0.11-to-0.35; p < 0.01). The mild ankle and knee loads could strengthen the dancers' lower extremity bones and muscles in a population vulnerable to sarcopenia, osteoporosis, and falls. Quantifying the workload via accelerometry enables creating personalized dance programs to empower healthy aging. With global aging rising, this work addresses a timely public health need regarding sustainable lifelong exercise for older people. Ranging from low to moderate, the measured impact magnitudes suggest that dance lessons may provide enough osteogenic stimulus without overloading structures. [ABSTRACT FROM AUTHOR]

BACKGROUND: Load carriage tasks during United States Marine Corps (USMC) recruit training can cause injury. Load carriage conditioning, if optimized, can reduce injury risk. OBJECTIVE: To compare injuries sustained by USMC recruits following participation in either the Original Load Carriage (OLC) program or a Modified Load Carriage (MLC) program. METHODS: Retrospective musculoskeletal injury data were drawn from the USMC San Diego Sports Medicine injury database for recruits completing the OLC (n = 2,363) and MLC (n = 681) programs. Data were expressed as descriptive statistics and a population estimate of the OLC:MLC relative risk ratio (RR) was calculated. RESULTS: The proportion of injuries sustained in the MLC cohort (n = 268; 39% : OLC cohort, n = 1,372 : 58%) was lower, as was the RR (0.68, 95% CI 0.61– 0.75). The leading nature of injury for both cohorts was sprains and strains (OLC n = 396, 29%; MLC n = 66; 25%). Stress reactions were proportionally higher in MLC (n = 17, 6%; OLC n = 4, 0.3%), while stress fractures were proportionately lower (MLC n = 9, 3%; OLC n = 114, 8%). Overuse injuries were lower in MLC (– 7%). The knee, lower leg, ankle, and foot were the top four bodily sites of injuries and the Small Unit Leadership Evaluation (SULE), Crucible, overuse-nonspecific, running, and conditioning hikes were within the top five most common events causing injury. The prevalence rates of moderate severity injury were similar (MLC = 23%; OLC = 24%), although MLC presented both a higher proportion and prevalence of severe injuries (MLC = 6%; OLC = 3%, respectively). CONCLUSION: A periodized load carriage program concurrently increased exposure to load carriage hikes while reducing injuries both during the load carriage hikes and overall. [ABSTRACT FROM AUTHOR]

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Supplemental Digital Content is Available in the Text. Eccentric resistance training has been shown to elicit beneficial effects on performance and injury prevention in sports because of its specific muscular and neural adaptations. Within the different methods used to generate eccentric overload, flywheel eccentric training has gained interest in recent years because of its advantages over other methods such as its portability, the ample exercise variety it allows and its accommodated resistance. Only a limited number of studies that use flywheel devices provide enough evidence to support the presence of eccentric overload. There is limited guidance on the practical implementation of flywheel eccentric training in the current literature. In this article, we provide literature to support the use of flywheel eccentric training and present practical guidelines to develop exercises that allow eccentric overload. See Supplemental Digital Content 1, http://links.lww.com/SCJ/A380 for a video abstract of this article. [ABSTRACT FROM AUTHOR]

Objectives: To explore the usage and awareness of the FIFA 11 + (11 +) across multiple stakeholders involved with amateur football. Methods: Coaches, players, non-coaching staff and medical personnel in New South Wales (NSW), Australia, were invited to complete a cross-sectional online survey, which was disseminated using a targeted email to two Football NSW member organisations and a social media campaign. Categorical data (including age-groups and sex) are presented as counts and percentages and analysed using a Chi-square or Fisher's exact test. A significance level of 0.05 was used for all analyses. Results: In total 328 players, 55 coaches, 37 non-coaching staff and 16 medical personnel completed the survey (n = 436). Awareness of the 11 + was lowest among non-coaching staff (16.2%) and players (32.6%) but higher among coaches (52.7%) and medical personnel (93.8%). Once aware of the 11 +, 75.8% of all respondents used the program although 89.5% of them did so with modifications. In addition, only 40.0% of players reported completing all three parts of the 11 + program. Veteran players were less likely to complete any type of warm-up compared with junior players (63.7% vs. 96.3%, respectively). Conclusions: Although awareness of the 11 + varied amongst survey respondents, 3 out of 4 respondents who were aware of the 11 + adopted the program. However, respondents reported modifying the 11 + and not completing the program as intended, which suggests modification guidance is required to maintain the efficacy of the 11 +. [ABSTRACT FROM AUTHOR]

To examine the effectiveness of different exercise-based interventions to mitigate the risk of anterior cruciate ligament injury in football players, and to determine which is the most appropriate for them, specifically for female football players. Four databases were accessed in July 2023 using the keywords football, soccer, athletic injuries, anterior cruciate ligament, knee injuries, injury prevention, exercise-based programme, and risk factor. Randomised controlled trials that evaluated any exercise-based injury prevention intervention compared with a control group on the prevention of anterior cruciate ligament injury in football players were included. Eleven studies were included. Data were presented as logarithm hazard ratio, credible intervals and standard deviation. FIFA 11+ was the most effective in reducing anterior cruciate ligament injury risk in football players (logarithm hazard ratio = –1.23 [95% credible intervals: –2.20, –0.35]; SD = 0.47), followed by the Knäkontroll programme (logarithm hazard ratio = –0.76 [95% credible intervals: –1.60, –0.03]; standard deviation = 0.42). For females, only Knäkontroll had a significant impact on reducing the risk of anterior cruciate ligament injury (logarithm hazard ratio = –0.62 [95% credible intervals: –1.71, 0.62]; standard deviation = 0.58). Our results support the use of FIFA 11+ and Knäkontroll to mitigate injury incidence at overall level. However, the effectiveness of these interventions changed when adjusting for females. Knäkontroll is postulated as the programme with the greatest preventive nature, although these results should be interpreted with caution due to the lack of the sample. [ABSTRACT FROM AUTHOR]

Although the twenty-first century has seen major advances in evidence-based medicine to improve health, athletic performance, and injury prevention, our inability to implement these best practices across underserved American communities has limited the impact of these breakthroughs in sports medicine. Rochester, NY is stereotypical of American communities in which an economically challenged racially diverse urban center with grossly underperforming public schools is surrounded by adequately resourced predominantly Caucasian state-of-the-art education systems. As these great disparities perpetuate and further degrade our society in the absence of interventions, the need for community engagement initiatives is self-evident. [ABSTRACT FROM AUTHOR]

Abstract Background The Fire service Organizational Culture of Safety (FOCUS) survey is an assessment tool comprised of psychometrically validated metrics of safety climate, safety behavior, and downstream outcomes (organizational and injury) that are specific to the U.S. fire and rescue service. Methods This analysis consists of a descriptive summary of two independent survey waves (FOCUS 1.0 and 2.0). The fire departments included in these survey waves were from convenience sampling (n 1.0 = 275; n 2.0 = 170). In addition to department level characteristics, we examined individual level characteristics for firefighters and EMS providers in participating departments (n 1.0 = 22,719; n 2.0 = 16,882). We conducted regression analyses to examine the associations between safety climate and safety behaviors, organizational outcomes, and safety outcomes. All analyses were stratified by organization type (career, volunteer). Results Our analysis indicated that a majority of respondents were males (90.7%FOCUS 1.0; 90.4%FOCUS 2.0), non-officers (68.4%FOCUS 1.0; 66.4%FOCUS 2.0), and non-Hispanic Whites (70.8%FOCUS 1.0; 69.5%FOCUS 2.0). For both samples there was a higher prevalence of injuries among individuals in career departments (n FOCUS 1.0 = 3778 [17.5%]; n FOCUS 2.0 = 3072 [18.7%]) than volunteer departments (n FOCUS 1.0 = 103 [8.8%]; n FOCUS 2.0 = 34 [7.4%]). We observed an approximate 10-point difference between the mean scores of Management Commitment to Safety for career and volunteer departments in both samples. We observed associations for two organizational outcomes, Safety Behavior and Job Satisfaction, with Management Commitment to Safety and Supervisor Support for Safety overall and when stratified by organization type. We observed a decrease in the odds of injuries associated with a one-unit increase in Management Commitment to Safety (OR1.0 overall: 0.98, 95% CI 0.97–0.99; OR2.0 volunteer: 0.90, 95% CI 0.85–0.95) and Supervisor Support for Safety (OR1.0 overall: 0.95, 95% CI 0.93–0.97; OR1.0 career: 0.95, 95% CI 0.92–0.98). Conclusions From our current study, and a prior analysis of a geographically stratified random sample of U.S. fire departments, we identified that from all the organizational outcomes, job satisfaction was most consistently associated with FOCUS safety climate. Further, firefighters in our samples consistently rated Supervisor Support for Safety higher than Management Commitment to Safety. Future interventions should support fire departments in improving their departmental Management Commitment to Safety and maintaining their Supervisor for Safety.

Abstract Background Although previous studies have reported that proprioceptive training methods (PTM) have positive effects, there is a relatively small number of studies regarding the impact of PTM in women’s soccer. Therefore, there is a need to systematize the given results. In this regard, this systematic review aimed to investigate the effect of proprioceptive training methods in female soccer players. Methods The studies’ search and analysis were done according to the PRISMA guidelines. The following databases were checked (Google Scholar, PubMed Cochrane and ProQuest), with additional publication time criteria (2000–2023) using the following keywords: proprioceptive, balance, neuromuscular, training, exercise, intervention, method, activity, female football players, female soccer players, woman soccer players. Results A total of 7 studies were included in the quantitative synthesis that meet all the criteria with the number of participants being 2.247. Based on the analysis of the previous research and detailed discussion, the main findings of the study resulted in the partial improvement of explosive strength (66%), strength (50%), muscle imbalance and flexibility (50%) and the prevention and reduction of lower extremity injuries in female soccer players (60%). Only one study reported no significant differences between groups, where rate of major injuries was higher in experimental group. Conclusion The obtained results indicate the necessity to implement proprioceptive training in female soccer training programs, in order to influence the prevention and reduction of injuries and improve balance, proprioceptive ability and body control.

Objectives. Jumping and landing constitute two movements that are used with a very high frequency in all sports and are two skills that have received a lot of attention in the literature because of their relationship with injury risk. The aim of this study is to analyze the following aspects: (a) to determine whether fatigue negatively affects landing technique after a jump, and (b) to test whether different metabolic and neuromuscular exercises have an effect on the landing technique. Materials and methods. The sample is composed of young female soccer players Under 14 (n = 29, 13.06 ± 1.27 years, 47.8 ± 2.6 kg; 143.2 ± 3.4 cm). Before and after two training protocols aimed at determining the state of fatigue (functional agility short-term fatigue protocol, and RSA protocol), landing technique was assessed using the Landing ErrorScoring System (LESS). Results. The LESS assessment for the pre-fatigue and post-functional agility short-term fatigue protocol conditions showed a value of 6.78 ± 0.81 and 8.74 ± 0.77 respectively (p > 0.001, ES: 1.39). The LESS assessment for the post-RSA protocol condition was 8.52 ± 0.87; this score was statistically significantly higher than the pre-fatigue condition (p > 0.001, ES: 1.24). Conclusions. Intensive exercise, both neuromuscular and metabolic, appears to have an effect on the landing technique of young female soccer players.

Background: Elite football players are monitored daily to minimize injury risks and maximize performance. Objectives: The aim of the study was to investigate injury incidence differences between competition and training and differences in key external load indicators during 1-, 2-, 3- or 4-weeks prior to the injury (WPI) with respect to the season average week (SAW). Methods: Data of 224 unique players of five teams (1st, under-23, under-18, under-17, and under-16) were collected during 3.5 seasons of competition and training resulting in 467 player records in total. Collected data included kinematics from Global Positioning System tracking units (Viper Units, STATSports) and 528 injury incident records. External load was expressed in terms of acceleration counts (ACC), deceleration counts (DEC), total training time (TT), total distance (TD), and distance covered in high-speed zones: 14.4-19.7 km/h (Z4), 19.7-25.1 km/h (Z5), and >25.1 km/h (Z6). Injury incidence was derived as number of injuries per 1000 hours of exposure. Results: Incidence rate was on average 4-11 times higher during competition than training for all teams except under-16 (incidence rate: 2.5, p=.153). In the 1st Team, external load (i.e. ACC, TT, and TD) were significantly different between 1-, 2-, 3-, and 4-WPI and SAW (p=.041, p=.037, and p=.049 respectively). For ACC and TT, the 3-WPI loads, were significantly higher than during SAW (p=.044 and p=.038, respectively). Conclusion: These findings can assist professionals and scientists to improve their understanding of the relationship between external load indicators and injury incidence and consequently improve player health and performance.

Purpose: To investigate the relationship between training load and subjective wellness in English Premier League goalkeepers (GKs) and examine potential positional differences in subjective wellness. Methods: A total of 34 players (GK = 7, outfield = 27) completed a daily subjective wellness questionnaire assessing sleep quality, sleep hours, fatigue, mood, soreness, and total wellness over two and a half seasons. Ten-Hertz GPS devices were worn during training to calculate previous-day and 7-day total distance, player load, total dives, total dive load, average time to feet, and high, medium, and low jumps. Results: All previous 7-day training loads were associated with all wellness markers (r =.073 to.278, P <.05). However, associations between previous 7-day dive load and mood, average time to feet, and both sleep quality and quantity, and between low jumps and sleep quality, were not significant. For previous-day metrics, total distance was associated with all wellness markers (r =.097 to.165, P <.05). In addition, player load and high jump were associated with fatigue, soreness, and wellness (r =.096 to.189, P <.05). Total dives and soreness were also related (r =.098, P <.05), and relationships were evident between average time to feet, medium jumps, and all wellness markers excluding sleep quality (r =.114 to.185, P <.05). No positional differences in subjective wellness occurred (P >.05). Conclusion: Some GK GPS variables are associated with subjective wellness, which could inform training-load prescription to maximize recovery and performance. In addition, GKs are no more vulnerable to poorer subjective wellness when compared with outfield players. [ABSTRACT FROM AUTHOR]

Background/Purpose No studies have observed the effects of a collegiate lacrosse season on movement pattern quality, dynamic postural control, or the accuracy of athletes' perceived movement pattern quality. The purpose was to examine the effects of a nontraditional fall season on movement pattern quality, perceived movement pattern quality, and dynamic postural control in collegiate lacrosse athletes. Design Cross-sectional laboratory study. Methods Fifty men's (age=19.38±1.24 years, height=182.63±6.16 cm, mass=82.37±8.46 kg) and 22 women's (age=19.68±1.17 years, height=165.10±6.88 cm, mass=64.09±8.72 kg) lacrosse players were recruited. Outcome measures included individual Functional Movement Screen™ (FMS™) scores, self-reported perceived movement pattern quality scores, lower and upper extremity Y-Balance Test (YBT) measurements, and active dorsiflexion range of motion (ROM) before the start and again at the end of the fall lacrosse season. Preand post-season measurements were assessed using paired t-tests and chi-squared analyses. Results FMS™ composite scores did not significantly change from preseason to postseason for males (p=0.74) or females (p=0.07). Male perceived movement pattern quality was significantly higher than measured for 10 of 12 movements (p<0.05). Female perceived movement pattern quality was significantly higher than measured for four of 12 movements (p<0.05). Asymmetry frequency significantly increased in males in the hurdle step from two individuals to nine ( 1=25.52, p<0.01), inline lunge from 10 to 20 ( 1=12.50, p<0.01), and shoulder mobility from 4 to 21 ( 1=78.53, p<0.01). Asymmetries in male athletes significantly decreased in the active straight leg raise from 26 to 8 ( 1=25.96, p<0.01). YBT composite scores increased in males for the right leg (p=0.001) and left leg (p<0.03). Right dorsiflexion ROM (p<0.001) and left dorsiflexion ROM (p<0.001) significantly decreased in males from preseason to postseason. YBT scores for the right leg significantly increased in females from preseason to postseason (p=0.01). YBT scores for females for the right arm significantly increased from preseason to postseason (p=0.045). [ABSTRACT FROM AUTHOR]