The global state of play: A study of the demographic characteristics of disability golfers.

BACKGROUND: Golf is a moderate-intensity physical activity that provides positive physical and mental health benefits. However, the inclusiveness of the sport for individuals with disabilities globally is unknown. OBJECTIVE: To characterize the demographics and disability characteristics of individuals engaging in disability golf globally. It was hypothesized that the majority of participants would be middle-aged, male, and from countries with higher gross domestic product, similar to the nondisabled population. DESIGN: Descriptive, cross-sectional analysis using European Disability Golf Association (EDGA) database. SETTING: Various international golf tournaments. PARTICIPANTS: Golfers (n = 1734) with disability from 44 countries registered with the EDGA (2017-2021). INTERVENTIONS: Not applicable. MAIN OUTCOMES: Descriptive analyses of frequencies, distributions, and means differences of demographic characteristics (age, gender, type of disability, level of handicap, golf cart use, and country of origin) of golfers with disability were performed. Data provided analysis of the association between number of participants and a country's gross domestic product (GDP). RESULTS: Individuals had a mean age of 52.5 (±15.6) years: 1589 (91.6%) male and 145 (8.4%) female. Twenty-three countries had female participation. The most commonly reported primary disability diagnoses were neurologic (24.8%), orthopedic (21.4%), and amputation below the knee (14.4%). Neurologic impairments (24.7%) were most common in men and orthopedic impairments (29.7%) were most common in women. Individuals with neurological impairments (27.4%) most frequently required golf carts to play. The GDP of a country had a positive correlation (r = 0.68) with the number of registered golfers with disability. CONCLUSION: Golf is played by individuals with a variety of disabilities and provides numerous benefits. However, there is an underrepresentation of youth, women, and individuals with certain impairments and from lower-income countries. These are the potential areas of opportunity to improve engagement and inclusiveness of golf.

Rule Modifications to Reduce Checking-Related Injuries in High School Boys' Lacrosse.

CONTEXT: The National Federation of State High School Associations previously implemented 2 lacrosse rule modifications: Rule 5.4 in the 2012-2013 academic year to heighten the penalty for a head or neck hit to the head, face, or neck (HFN) and Rule 5.3.5 in the 2013-2014 academic year to minimize body checking. OBJECTIVE: To determine if the rates of overall injury, HFN injuries, and concussions due to intentional contact (checking) differed for boys' high school lacrosse players after Rule 5.4 and 5.3.5 modifications were enacted. DESIGN: Descriptive epidemiology study. SETTING: Web-based online surveillance system. PATIENTS OR OTHER PARTICIPANTS: Boys' high school lacrosse players during the 2008-2009 to 2016-2017 seasons whose teams involved athletic trainers participating in the High School Reporting Information Online sports injury-surveillance system. INTERVENTION(S): Rule 5.4 in the 2012-2013 academic year increased the penalty for any intentional hits to the HFN, and Rule 5.3.5 in the 2013-2014 year eliminated body checking to a player in a defenseless position. MAIN OUTCOME MEASURE(S): Overall, HFN, and concussion injury rate ratios (IRRs) by checking mechanism; overall and checking-related injury ratios by competitions and practices. RESULTS: A decrease was shown in checking-related HFN injuries (IRR = 0.29, 95% CI = 0.13, 0.65) and checking-related concussions (IRR = 0.29, 95% CI = 0.12, 0.70) during practices in the seasons after both rule modifications were imposed, but no decreases occurred in any checking-related injuries during competitions. By injury mechanism, no decreases were evident after the Rule 5.4 modification. When both rule modifications (Rules 5.4 and 5.3.5) were enacted together, concussion rates due to delivering body checks (IRR = 0.51, 95% CI = 0.29, 0.91) and overall injury risk due to being body checked (IRR = 0.72, 95% CI = 0.53, 0.97) decreased. CONCLUSIONS: When both Rule 5.4 and 5.3.5 modifications were in effect, concussion and overall injury risks decreased for the body checker and the player being body checked, respectively.

Anchored Transosseous-Equivalent Versus Anchorless Transosseous Rotator Cuff Repair: A Biomechanical Analysis in a Cadaveric Model.

BACKGROUND: The original approach for the repair of torn rotator cuffs involved an open technique with sutures passing through the greater tuberosity and tendon. The development of suture anchors allowed for an all-arthroscopic approach with anchor configurations attempting to re-create a transosseous fixation pattern. Presently, an arthroscopic approach can be combined with a transosseous suture configuration without using anchors. PURPOSE: To evaluate cyclic loading, ultimate load to failure, and the failure mechanisms of transosseous-equivalent (TOE) repair with anchors and anchorless transosseous (AT) repair of rotator cuff tears. STUDY DESIGN: Controlled laboratory study. METHODS: Supraspinatus tears (25 mm) were created in 20 fresh-frozen, human cadaveric shoulders, which were randomized to TOE or AT repair (10 in each group, paired experimental design). Biomechanical testing was performed with an initial preload, cyclic loading, and load to failure. Optical markers were used to monitor gap formation in 3 planes, and the failure mode was recorded. Paired t tests were used to make comparisons of biomechanical parameters between the groups. Multinomial logistic regression was used to compare failure modes between the groups. Significance was set to .05. RESULTS: The TOE group had a significantly higher mean (±SD) ultimate failure load (578.5 ± 123.8 N) than the AT group (468.7 ± 150.9 N) ( P = .034). The TOE group also had a significantly less mean first-cycle excursion (2.97 ± 1.97 mm) than the AT group (4.70 ± 2.04 mm) ( P = .046). There were no significant differences between the groups in cyclic elongation or linear stiffness during cyclic loading. Primary modes of failure were a type 2 tendon tear with medial tendon disruption in the TOE group (7/10) and a type 1 tendon tear with lateral tendon disruption in the AT group (6/10). CONCLUSION: TOE repair resulted in a significantly higher mean failure load compared with AT repair in a cadaveric model. The most common modes of failure were a type 2 tendon tear in the TOE group and a type 1 tendon tear in the AT group. CLINICAL RELEVANCE: A higher mean failure load in TOE versus AT constructs may come at the cost of a less favorable failure mode adjacent to medial anchors at the musculotendinous junction, potentially making revision difficult.