Changes in physical activity during the COVID-19 lockdown based on the sociodemographic profile of 5569 students and academic staff of Austrian universities.

OBJECTIVES: The COVID-19 pandemic and the associated restrictions/lockdowns have influenced the health and lifestyle behaviour of university students and staff, particularly their physical activity (PA) habits. However, the association between the direction of PA changes and sociodemographic characteristics has not been studied. This nationwide study was conducted in Austrian colleges/universities and aimed to identify the magnitude and direction of changes in PA levels during the COVID-19 restrictions and compare participants who had unchanged vs decreased vs increased PA based on sociodemographic characteristics (sex, age, body mass index, study level, living area, nationality and Austrian regions). STUDY DESIGN: This was a cross-sectional study to measure the association between the explanatory variable and outcome measures. METHODS: A total number of 4528 students (mean age 24.9 years) and 1041 academic staff (mean age 46.4 years) participated in an online survey and provided self-reported data on sociodemographic characteristics and PA change during the pandemic. RESULTS: A total of 41.3% of students and 37.5% of academic staff reported a decrease in PA level, whereas PA levels increased in 36.3% and 27.9%, respectively. In students, all sociodemographic variables (including sex, age, body mass index, study level, living area, nationality and Austrian regions) were significantly associated with the direction of PA changes (P < 0.05). Living area and Austrian region were found to be significant indicators of direction of PA changes in academic staff (P < 0.05). CONCLUSIONS: These findings suggest that the inconsistency of previous studies in PA change during the pandemic may at least partly be explained by differences in the sociodemographic characteristics of the participants.

Association of modifiable factors with the development of physical fitness of Austrian primary school children: A 4-year longitudinal study.

Physical fitness (PF) shows favourable associations with several health indicators in children. Children's PF depends on a variety of non-modifiable (e.g., sex and age) and modifiable factors (e.g., weight status and sports participation). The aim of this study was to evaluate the impact of modifiable and non-modifiable factors on the development of PF during the 4 years of primary school. A longitudinal study was carried out with 265 children. PF was assessed using the German Motor Performance Test 6-18, whereas modifiable and non-modifiable factors with parent's and children's questionnaires. Total PF z-score increased by 1.4 standard deviations from 1st to 4th year and raw values of subtests improved by an average of about 40%. The variables "parents' physical activity", "never being overweight", "sports club participation", and "playing outside" were positively associated with PF development. The present study highlights that a variety of modifiable factors, both from children and their parents, are significantly associated with the development of children's PF during primary education. Interventions should not only focus on direct actions, such as proposing specific exercise programs, but also aim at increasing parents' awareness of their role model function in endorsing their children's healthy active lifestyle, especially at early ages.

[Physical activity as therapeutic intervention for depression]. / Körperliche Aktivität als therapeutische Intervention bei Depression.

AIM: This article gives a conspectus of the present state of research on the efficiency of exercise as a treatment for patients suffering from depression. METHODS: A systematic review of articles published between December 1980 and March 2016 was carried out. The review focused on studies that examined the effects of exercise compared to control conditions in the treatment of depression. Extracted and analyzed information from the articles included details about participants, characteristics of exercise and control conditions, assessments, study design and outcomes. RESULTS: A total of 34 of the 48 studies included in the literature search reported a significant reduction of depressive symptoms due to exercise interventions. There was a trend to reduced depressive symptoms following the exercise interventions in five studies. In nine studies no positive impact of exercise on depression and affective well-being could be detected. DISCUSSION: This review article shows that physical activity decreases depressive symptoms and increases affective well-being in patients with depressive diseases; therefore, exercise should be recommended as a component of depression treatment within the framework of a multi-dimensional approach.

Sports injuries and illnesses during the 2015 Winter European Youth Olympic Festival.

BACKGROUND: The prevention of injury and illness remains an important issue among young elite athletes. Systematic surveillance of injuries and illnesses during multi-sport events might provide a valuable basis to develop preventive measures, focusing especially on adequate information for youth athletes. AIM: To analyse the frequencies and characteristics of injuries and illnesses during the 2015 Winter European Youth Olympic Festival (W-EYOF). METHODS: All National Olympic Committees were asked to report daily the occurrence or non-occurrence of newly sustained injuries and illnesses on a standardised reporting form. RESULTS: Among the 899 registered athletes (37% female) with a mean age of 17.1±0.8 years, a total of 38 injuries and 34 illnesses during the 5 competition days of the W-EYOF were reported, resulting in an incidence of 42.3 injuries and 37.8 illnesses per 1000 athletes, respectively. Injury frequency was highest in snowboard cross (11%), Nordic combined (9%), alpine skiing (6%), and ice hockey (6%), taking into account the respective number of registered athletes. In snowboard cross, females showed a significant higher injury frequency compared to males (22% vs 4%, p=0.033). The lower back (16%), the pelvis (13%), the knee (11%), and the face (11%) were the most common injury locations. About 58% of injuries occurred in competition and about 42% in training. In total, 42% of injuries resulted in an absence of training or competition. The prevalence of illness was highest in figure skating (10%) and Nordic combined (9%), and the respiratory system was affected most often (53%). CONCLUSIONS: Four per cent of the athletes suffered from an injury and 4% from illnesses during the 2015 W-EYOF, which is about twofold lower compared to the first Winter Youth Olympic Games in 2012.

[Impact of Self-Reported Fatigue on ACL Injuries in Alpine Skiing: A Sex Comparison]. / Einfluss von subjektiver Ermüdung auf vordere Kreuzbandverletzungen beim alpinen Skifahren: Ein Geschlechtervergleich.

INTRODUCTION: In recreational alpine skiing, about one third of all injuries affect the knee joint, and the most common diagnosis in adult male and female skiers is a tear of the anterior cruciate ligament (ACL), which makes up 15 - 21 % of all injuries. General preventive recommendations to reduce the incidence of ski injuries include avoiding fatigue. However, it seems unclear to what extent ACL injuries in male and female recreational skiers are related to perceived fatigue. METHODS: This study was conducted as a prospective questionnaire-based investigation in two Austrian ski injury clinics during the five winter seasons between 2009/2010 and 2013/2014. In total, 588 skiers (67.9 % females) with a mean age of 42.1 ±â€Š10.9 years were interviewed about demographics, skiing ability, skiing behaviour, fitness, day and time of accident, skiing duration and perceived fatigue at the moment of accident. RESULTS: ACL injured males reported a significantly higher skiing ability and fitness level as well as a more risky behaviour on ski slopes compared to females. About one third of males and females injured their ACL within the first day of the ski trip and about 57 % within the first two days, with no sex differences. However, a significantly higher number of female skiers sustained an ACL injury during the first hour of skiing (28 vs. 17 %) as well as during the first two hours of skiing compared to males (52 vs. 44 %). About 81 % of males and females felt no fatigue or just a trace of fatigue in their legs at the time of accident, with no sex differences. CONCLUSION: Based on the findings of this study, fatigue does not seem to be a major risk factor for an ACL injury among male and female recreational skiers.

[Factors Associated with the Use of Protective Gear among Adults during Recreational Sledging]. / Einflussfaktoren auf das Tragen von Schutzausrüstung bei erwachsenen Rodlern.

BACKGROUND: Recreational sledging (tobogganing) is a very popular winter sport in the Alps. Therefore, injury prevention through the usage of protective gear seems important. Therefore, the aim of this study was to evaluate factors associated with the use of protective gear among adults during recreational sledging. METHODS: Adult recreational sledgers were interviewed during the winter seasons 2012/13 and 2013/14 at six sledging tracks in Austria on demographics, skill level, sledging frequency, risk taking behaviour, sitting alone or with another person on the sledge, previous sledging-related injuries, and use of protective gear, respectively. Interviews were conducted on all days of the week. RESULTS: A total of 1968 adult sledgers (49.4 % females) with a mean age of 37.1 ±â€Š14.4 years participated in this study. A (ski) helmet, sun or snow goggles, a back protector, and wrist guards were used by 42.3 %, 71.0 %, 5.9 %, 2.6 % of sledgers, respectively. Helmet use was significantly higher with increasing age and increasing skill level as well as when sitting alone compared to sitting together with another person. Females, Austrians, persons sitting alone on the sledge, a higher frequency of sledging and a higher skill level were significantly associated with an increasing use of goggles. A back protector was significantly more often worn by younger people, more risky sledgers, and persons with a previous sledging-related injury. Wrist guards were significantly more often used by persons with a previous sledging-related injury. CONCLUSION: During recreational sledging, the factors age, sex, nationality, skill level, sitting alone compared to sitting together with another person on the sledge, sledging frequency, and injury experience were associated with the frequencies of usage of different types of protective gear. These factors should be considered when implementing preventive measures for recreational sledging.

[Frequencies of injuries and causes of accidents during ski touring on ski slopes - a pilot study]. / Verletzungshäufigkeit und Unfallursachen beim Pistentourengehen - eine Pilotstudie.

INTRODUCTION: Ski touring along ski slopes (slope touring) increased in recent years on Austrian ski slopes. However, ascending on the border of the slope and skiing downhill on the slope might be associated with a certain injury risk. Thus, the aim of this pilot study was to evaluate frequencies of injuries, causes of accidents and potential risk factors during slope touring. METHODS: Slope-tourers were interviewed from March to April 2014 at the bottom of 4 Austrian ski areas. Interviews were conducted during the week and at the weekend from 7.30 a. m. to 8.45 p. m. RESULTS: A total of 451 slope-tourers (60.1 % males) with a mean age of 39.3 ±â€Š14.4 years were interviewed. Interviewed persons reported that they perform about 20.6 ±â€Š16.0 slope tours per season mainly with a partner (48 %) and during the day (51 %). Ski helmet use was 60 %. A total of 57 persons (12.6 %) reported that they suffered at least once from an injury during slope touring needing medical care. This corresponds to a rate of 6 injuries per 1000 slope tours. Main injury causes were a fall (78 %) and a collision with another person (15 %) and the main injured body part was the knee (36 %). Slope-tourers with an injury were wearing more often back protectors, and were falling more often during downhill skiing, and were abstaining less often from alcohol and were listening more often to music during downhill skiing compared to slope-tourers without an injury. CONCLUSION: Based on the findings of this pilot study we recommend abstaining from alcohol and not listening to music during downhill skiing to reduce the injury risk during slope touring.

Are self-reported risk-taking behavior and helmet use associated with injury causes among skiers and snowboarders?

Over the last 10 years, ski helmet use has steadily increased worldwide. According to the "risk compensation theory," however, studies found that up to one third of skiers and snowboarders self-reported to engage in more risk taking when wearing a ski helmet. Therefore, to evaluate whether self-reported risk taking and ski helmet use affect accident causes on ski slopes, more than 2000 injured skiers and snowboarders were interviewed during the 2011/2012 winter season about accident causes and potential intrinsic and extrinsic risk factors. Chi-square tests revealed that ski helmet use did not significantly differ between self-reported risky and cautious people (81% vs 83%). Multivariate regression analysis revealed younger age groups [odds ratios (ORs) 1.8-1.9, P < 005], male sex (OR 2.4, P < 0.001), Austrian nationality (2.2, P < 0.001), higher skill level (1.7, P < 0.001), and off-slope skiing (OR 2.2, P = 0.060) to be predictive for a risky behavior on ski slopes. Neither the use of skis or snowboards nor accident causes were significantly associated with a riskier behavior on ski slopes. In conclusion, self-reported risk-taking behavior and ski helmet use seem not to be associated with accident causes leading to an injury among recreational skiers and snowboarders.

[Current incidence of accidents on Austrian ski slopes]. / Aktuelles Unfallgeschehen auf österreichischen Skipisten.

BACKGROUND: Alpine skiing and snowboarding are the most popular winter sports. These sports are also associated with a certain injury risk which, however, has steadily decreased during the past decades. During the winter season 2002/2003 the last large survey on ski injuries in Austria was performed. Among others, modern skiing equipment and optimized slope preparation may impact on the injury risk. We hypothesise that these changes may have led to a further decrease in ski injuries during the past decade. METHODS: In the winter season 2012/2013, skiing injuries were recorded in 26 Austrian ski areas. Data were collected from rescue personnel on ski slopes and by physicians in the hospital or doctors practice with the help of a questionnaire. RESULTS: A total of 7325 injured skiers and snowboarders (age: 34.8 ±â€Š17.8 years) were recorded (49 % males and 51 % females; 80 % skiers, 14 % snowboarders, 6 % others). The most frequent causes of injury were self-inflicted falls (87 %) and collisions with other skiers/snowboarders (8 %). Most affected injury locations among skiers were the knee (41 %; predominantly in female skiers, > 50 %), shoulder/back (18 %) and arms (10 %). Most affected injury locations among snowboarders were arms (38 %) and shoulder/back (23 %). Head injuries were found at the same frequency (8 %) in skiers and snowboarders. The calculated injury rate was about 0.6 injuries per 1000 skier days and has decreased by more than 50 % during the past decade. CONCLUSIONS: Modern skiing equipment and optimised slope preparation may be at least partly responsible for the decreased injury risk on ski slopes which is supported by the observation of a reduced falling frequency. Future preventive measures should focus on a reduction of knee injuries in female skiers.

[How frequent and why are skiers and snowboarders falling?]. / Wie häufig und warum stürzen Skifahrer und Snowboarder?

BACKGROUND: Injuries in alpine skiing and snowboarding are mainly caused by falls. In 2002, a study was conducted to gain insight into the risk factors for falls when skiing or snowboarding. Since then, the evolution of skiing, snowboarding and safety equipment, as well as slope preparation, may have altered the frequency of falls while skiing or snowboarding. METHODS: In total, 1436 male and female skiers and snowboarders from all age groups were interviewed from February until April 2012, in 6 Tyrolean ski resorts. The questionnaire was nearly identical to that used in 2002. It contained questions concerning personal characteristics, falls, equipment and risk taking behaviour. RESULTS: The incidence of falls among skiers was 0.076 ±â€Š0.21 per hour and that among snowboarders was 0.429 ±â€Š0.70 per hour. Age (OR: 0.96; CI: 0.95 - 0.97), soft snow conditions (OR: 4.1; CI: 1.9 - 8.8) and poor skiing skills (beginners and intermediates) (OR: 2.6; CI: 1.2 - 8.1) were predictive for falls during skiing. Poor snowboarding skills (beginners and intermediates) (OR: 8.3; CI: 3.1 - 27.4), wearing a helmet (OR: 2.3; CI: 1.2 - 4.6) and alcohol consumption (OR: 2.1; CI: 1.2 - 3.9) were predictive for falls during snowboarding. CONCLUSIONS: The incidence of falls among skiers and snowboarders was substantially lower when compared to that in 2002. Improvements in skiing and snowboarding equipment as well as slope preparation may have contributed to this favourable development. We strongly assume that the lowering in fall incidence may positively affect the injury incidence.

Effect of wearing a ski helmet on perception and localization of sounds.

Helmet use on ski slopes has steadily increased worldwide over the past years. A common reason reported for helmet non-use, however, is impaired hearing. Therefore, an intra-subject design study was conducted to compare hearing thresholds and sound source localization of 21 adults with normal hearing in an anechoic chamber when wearing a ski helmet and ski goggles or wearing a ski cap and ski goggles to the condition head bare. Hearing thresholds while wearing a ski helmet (6.8 ± 1.6 dB HL) and ski cap (5.5 ± 1.6 dB HL) were significantly different (p = 0.030, d = 0.44). Compared to head bare (2.5 ± 1.2 dB HL), a significant difference was found for the ski helmet only (p = 0.040, d = 1.57). Regarding sound source localization, correct scores in the condition head bare (90%) showed a highly significant difference compared with those of condition cap (65%) and helmet (58%), respectively (p < 0.001; d > 2.5). Compared to the ski cap, wearing the helmet significantly reduced correct scores (p = 0.020, d = 0.59) irrespective of the tested sound pressure levels. In conclusion, wearing a ski helmet impairs hearing to a small though significantly greater extent compared with a cap, the degree, however, being less than what is termed as a hearing impairment. Compared to the condition head bare, wearing a ski cap or a ski helmet significantly reduced one's ability of sound source localization.

[Causes and factors associated with collisions on ski slopes]. / Ursachen und Einflussfaktoren von Personenkollisionen auf der Skipiste.

BACKGROUND: Annually, in Austria more than 10 million people participate in winter sport activities such as alpine skiing, snowboarding, cross country skiing and ski touring. About 80 - 90 % of all accidents are caused by a fall without other people involved and about 10 % are caused by collisions between people. METHODS: In the winter season 2011/2012, skiers and snowboarders injured due to a fall or a collision on a ski slope have been interviewed about potential intrinsic and extrinsic risk factors in the Austrian province Vorarlberg. RESULTS: In total, 1741 people injured by a self-inflicted fall and 137 people injured due to a collision have been interviewed. People injured due to a collision showed more often a head injury (15 vs. 8 %) and more often a concussion (15 vs. 6 %). Furthermore, people injured due to a collision were significantly older (41 vs. 33 years) and showed a higher proportion of skiers (86 vs. 79 %) as well as of higher skilled people (83 vs. 74 %) compared to those injured by a self-inflicted fall. Collisions between sport participants incurred significantly more often on slope intersections (11 vs. 4 %), when more people were on ski slopes (30 vs. 12 %) and when the sun was shining (85 vs. 69 %). CONCLUSION: According to the results of this study, preventive recommendations to reduce the risk of a collision include an adaptation of the individual skiing or snowboarding behaviour and the actual speed on skill level, weather conditions and number of other skiers and snowboarders on ski slopes. In addition, influences of adaptive visual information and supervision systems at slope intersections and in relation to weather and traffic conditions should be evaluated.

Does listening to music with an audio ski helmet impair reaction time to peripheral stimuli?

With the recent worldwide increase in ski helmet use, new market trends are developing, including audio helmets for listening to music while skiing or snowboarding. The aim of this study was to evaluate whether listening to music with an audio ski helmet impairs reaction time to peripheral stimuli. A within-subjects design study using the Compensatory-Tracking-Test was performed on 65 subjects (36 males and 29 females) who had a mean age of 23.3 ± 3.9 years. Using repeated measures analysis of variance, we found significant differences in reaction times between the 4 test conditions (p=0.039). The lowest mean reaction time (± SE) was measured for helmet use while listening to music (507.9 ± 13.2 ms), which was not different from helmet use alone (514.6 ± 12.5 ms) (p=0.528). However, compared to helmet use while listening to music, reaction time was significantly longer for helmet and ski goggles used together (535.8 ± 14.2 ms, p=0.005), with a similar trend for helmet and ski goggles used together while listening to music (526.9 ± 13.8 ms) (p=0.094). In conclusion, listening to music with an audio ski helmet did not increase mean reaction time to peripheral stimuli in a laboratory setting.

Effects of the performance level and the FIFA "11" injury prevention program on the injury rate in Italian male amateur soccer players.

AIM: Soccer is characterized by high injury rates that necessitate interventions for its reduction. The "11" is a multi-modal preventive program that was developed to reduce injury rate. However, outcomes on the effectiveness of the program are not unambiguous and data for the largest group at risk (i.e., male adult amateur players) are missing. The study aims to assess the injury rate in male adult amateur soccer players of different levels and to evaluate the effectiveness of the prevention program the "11". METHODS: Three amateur soccer teams participated in the study during the first round of a competition season. Two teams played at a regional level (6th Italian league) and one team at a provincial level (7th Italian league). The regional league is of a higher skill level compared to the provincial league. Duration and frequency of training and match sessions and the occurrence of time-loss injuries were recorded. One team of the 6th league performed an injury prevention program. RESULTS: The total injury rate for the intervention and the control team in the 6th league was 3.3 (CI 0.7-5.9) and 4.3 (CI 1.3-7.3) injuries/1000 h, respectively (P=0.841). The 6th league control team tended to have a lesser injury rate compared to the 7th league team (P=0.081). The relative risk was 2 fold higher in the 7th compared to the 6th league team (P=0.0285 one tailed). CONCLUSION: Present results show that injury rate in amateur soccer depended rather on the skill level than the prevention program. In this study the prevention program the "11" was not shown to be highly effective in soccer player of intermediate level (i.e., 6th Italian league).

Impact of environmental factors on knee injuries in male and female recreational skiers.

In alpine skiing, the knee represents the dominant injury location with marked gender differences. Snow, slope and weather conditions as well as altitude and low temperatures are thought to influence the prevalence of knee injuries. Therefore, ski patrol injury reports were used to compare gender-specific prevalence of knee injuries with regard to several environmental factors including the actual air temperatures. A total of 1039 non-contact knee injuries were reported with a corresponding prevalence of knee injuries of 44.4% (males: 30.1%; females: 57.4%). Temperature quartiles of all recorded injuries were calculated to compare gender-specific prevalence of knee injury with regard to temperatures. Comparing the first quartile (mean temperature -11°C) with the fourth quartile (mean temperature +3°C), the prevalence of knee injury in female skiers was higher at low ambient temperatures (61% vs 50%, odds ratio: 1.60, 95% confidence interval: 1.16-2.22; P=0.005) while no such association was found for male skiers. Additionally, knee-injured females showed a twofold prevalence when skiing during snowfall compared with females with other injuries (15.4% vs 8.6%; P=0.001). No other environmental factor showed a significant association with the gender-specific prevalence of knee injury. In conclusion, low ambient temperature and snowfall are important environmental risk factors for knee injuries in female skiers.

[Attitudes of winter sport participants toward ski helmet mandatory]. / Einstellungen von Wintersportlern zur Skihelmpflicht.

The aim of this study was to examine attitudes of winter sport participants toward a ski helmet mandatory. In total, 959 persons who had to estimate statements regarding ski helmet and helmet mandatory with the aid of a five level Likert scale were interviewed. About 85 % of interviewed persons totally agreed that a ski helmet reduces head injury risk although only 64 % are wearing a ski helmet. Significant more helmet wearers and females compared to non-wearers and males totally agreed that all winter sport participants should wear ski helmets on slopes as well as that all children on slopes should wear a ski helmet. Also, significant more helmet wearers and females compared to non-wearers and males totally agreed that a ski helmet mandatory for all people has to be recommended as well as that a ski helmet mandatory for children under 16 years has to be recommended. However, the acceptance for a helmet mandatory for all people as well as for children was significantly lower compared to recommendations for helmet use irrespective of helmet use or gender. Therefore, we conclude that preventive helmet campaigns possibly attain a higher acceptance leading to a higher helmet use compared to a helmet mandatory.

ACL injury mechanisms and related factors in male and female carving skiers: a retrospective study.

In recreational alpine skiing, ACL injury risk is 3 times greater in females. However, since the introduction of carving skis ACL injury risk seems to have decreased. No study has yet investigated the distribution of ACL injury mechanisms in male and female carving skiers. Therefore, the aim of the study was to investigate potential gender specific differences of ACL injury mechanisms and related factors among carving skiers. In total, 220 recreational carving skiers (59 males and 161 females) suffering from an ACL injury volunteered for this study. Demographic data, skiing ability, equipment related and environmental factors, circumstances and causes for the fall, and type of fall (injury mechanisms) were collected by questionnaire. The forward twisting fall is the most reported ACL injury mechanism in both gender (p=0.672) accounting for 54% of all injuries, although male and female skiers differed significantly with regard to circumstances of fall (p=0.001) and actions when ACL injury occurred (p=0.04). Bindings not releasing at the time point of accident occurred 2.6 times more with females than with males (p=0.005). The forward twisting fall seems to have become the dominant ACL injury mechanism both in male and female recreational skiers since the introduction of carving skis.

Interaction of potential intrinsic and extrinsic risk factors in ACL injured recreational female skiers.

The aim of this study was to investigate the interaction of potential intrinsic and extrinsic risk factors in ACL injured recreational female skiers. 93 female recreational skiers who had suffered a non-contact ACL injury and 93 age-matched controls completed a self-reported questionnaire relating to intrinsic risk factors (menstrual history, BMI, previous knee injuries, self reported weekly sports participation) and extrinsic risk factors (type of ski used, time of last binding adjustment, snow condition, weather and slope difficulty). A logistic regression model revealed the following independent ACL injury risk factors for female recreational skiers: icy snow conditions (odds ratio, 24.33; 95% confidence interval, 6.8-86.5, P<0.001), skiing during snowfall (odds ratio, 16.63; 95% confidence interval, 1.8-152.1, P=0.013), use of traditional skis (odds ratio, 10.49; 95% confidence interval, 2.0-54.5, P=0.005), and preovulatory phase of menstrual cycle (odds ratio, 2.59; 95% confidence interval, 1.2-5.5, P=0.013). In conclusion, ACL injuries in female recreational skiers are the result of a complex interaction of intrinsic and extrinsic risk factors.