Development of a video camera-type kayak motion capture system to measure water kayaking.

Background: In kayaking, trunk motion is one of the important factors that prevent injury and improve performance. Kinematic studies in kayaking have been reported in laboratory settings using paddling simulators and ergometers. However, such studies do not reflect kayaking on water, the actual competitive environment. Therefore, we developed a video camera-type kayak motion capture system (KMCS) wherein action cameras were fixed to a kayak to capture images of markers attached to an athlete's body. This study aimed to compare the kinematic data between KMCS and an optical motion capture system (OMCS) in kayaking and to determine the accuracy of the KMCS analysis. Methods: In a competition, five elite junior female kayak athletes performed kayak paddling under the unloaded condition using a kayak. The kayak was secured using a tri-folding bench and a towel, and twenty strokes were recorded during maximal paddling. One stroke was defined as the period from right catch to left catch, and the first six strokes were used to evaluate the accuracy. Trunk angles (tilting, turning, and rotation) were examined with the simultaneous use of KMCS and OMCS, and the differences between these systems were evaluated. To ensure reliability, intraclass correlation coefficient (ICC; a two-way mixed model for absolute agreement) was calculated for each angle. Furthermore, Bland-Altman analysis was performed to understand the agreement between the two systems. Results: Root mean square errors (RMSEs) were 1.42° and 3.94° for turning and rotation, respectively, and mean absolute errors (MAEs) were 1.08° and 3.00° for turning and rotation, respectively. The RMSE and MAE for tilting were 2.43° and 1.76°, respectively, which indicated that the validity was comparable to that of other angles. However, the range of motion in tilting was lower than that in turning and rotation. Bland-Altman analysis showed good agreement in the total range of motion, with mean bias values of -0.84°, -0.07°, and -0.41° for tilting, turning, and rotation, respectively. The ICCs for tilting, turning, and rotation were 0.966, 0.985, and 0.973, respectively, and showed excellent reliability. Conclusions: The newly developed KMCS effectively measured the trunk motion with good accuracy in kayaking. In future studies, we intend to use KMCS to measure kayaking on water and collect data for performance improvement and injury prevention.

Prevalence and Determinants of Work-Related Injuries Among Healthcare Workers in Jeddah, Saudi Arabia.

Background and objective Work-related injuries (WRIs) are a major occupational health issue among healthcare workers (HCWs) worldwide. Unsafe work environments, including physical, chemical, and biological hazards, are significant contributing factors to WRIs. However, the prevalence of WRIs among HCWs in Jeddah, Saudi Arabia, and their associated risk factors remain largely unexplored. In light of this, this study aimed to investigate the prevalence of WRIs and associated risk factors among HCWs in Jeddah, Saudi Arabia. Methods This was an analytic cross-sectional study conducted at secondary hospitals of the Ministry of Health (MOH) in Jeddah by using a self-administered questionnaire to measure the prevalence of WRIs and their related factors. The Chi-squared test was used to compare variables. A p-value <0.05 was considered statistically significant. Results The study involved 387 participants, of whom 283 (73.1%) were female. Most of the participants (n=226, 58.4%) agreed that personal protective equipment (PPE) was always available at their hospitals. Approximately two-thirds (n=251, 64.9%) agreed that they always used PPE. The overall prevalence of WRIs was 52%, with back injuries (32.6%), eye/mouth splashes (20.4%), and needle stick injuries (19.9%) being the most common. Years of work experience (p=0.014), type of profession (p<0.001), training in safety management (p=0.028), working hours (p=0.0001), working shifts (p=0.001), PPE availability (p=0.010), and sharp container availability (p=0.030) were significantly associated with WRIs. Conclusion This study revealed a high prevalence of WRIs among HCWs in Jeddah, Saudi Arabia, with back injuries, eye/mouth splashes, and needle stick injuries being the most common types. The study also found that the injuries were significantly associated with the type of profession, experience, work hours, and shifts as well as the availability of safety management and equipment such as sharp containers and PPE.

Examining the Peer-Reviewed Published Literature Regarding Low Back Pain in Rowing: A Scoping Review.

Background: Low back pain (LBP) is highly prevalent in the rowing population. The body of existing research variously investigates risk factors, prevention, and treatment methods. Purpose: The purpose of this scoping review was to explore the breadth and depth of the LBP literature in rowing and to identify areas for future research. Study Design: Scoping review. Methods: PubMed, Ebsco and ScienceDirect were searched from inception to November 1, 2020. Only published, peer-reviewed, primary, and secondary data pertaining to LBP in rowing were included for this study. Arksey and O'Malley's framework for guided data synthesis was used. Reporting quality of a subsection of the data was assessed using the STROBE tool. Results: Following the removal of duplicates and abstract screening, a set of 78 studies were included and divided into the following categories: epidemiology, biomechanics, biopsychosocial, and miscellaneous. The incidence and prevalence of LBP in rowers were well mapped. The biomechanical literature covered a wide range of investigations with limited cohesion. Significant risk factors for LBP in rowers included back pain history and prolonged ergometer use. Conclusion: A lack of consistent definitions within the studies caused fragmentation of the literature. There was good evidence for prolonged ergometer use and history of LBP to constitute risk factors and this may assist future LBP preventative action. Methodological issues such as small sample size and barriers to injury reporting increased heterogeneity and decreased data quality. Further exploration is required to determine the mechanism of LBP in rowers through research with larger samples.

Workplace hazards and health among informally employed domestic workers in 14 cities, United States, 2011-2012: Using four approaches to characterize workers' patterns of exposures.

BACKGROUND: We characterized informally employed US domestic workers' (DWers) exposure to patterns of workplace hazards, as well as to single hazards, and examined associations with DWers' work-related and general health. METHODS: We analyzed cross-sectional data from the sole nationwide survey of informally employed US DWers with work-related hazards data, conducted in 14 cities (2011-2012; N = 2086). We characterized DWers' exposures using four approaches: single exposures (n = 19 hazards), composite exposure to hazards selected a priori, classification trees, and latent class analysis. We used city fixed effects regression to estimate the risk ratio (RR) of work-related back injury, work-related illness, and fair-to-poor self-rated health associated with exposure as defined by each approach. RESULTS: Across all four approaches-net of individual, household, and occupational characteristics, and city fixed effects-exposure to workplace hazards was associated with increased risk of the three health outcomes. For work-related back injury, the estimated RR associated with heavy lifting (the single hazard with the largest RR), exposure to all three hazards selected a priori (worker did heavy lifting, climbed to clean, and worked long hours) versus none, exposure to the two hazards identified by classification trees (heavy lifting, verbally abused) versus "no heavy lifting," and membership in the most- versus least-exposed latent class were, respectively, 3.4 (95% confidence interval [CI] 2.7-4.1); 6.5 (95% CI 4.8-8.7); 4.4 (95% CI 3.6-5.3), and 6.6 (95% CI 4.6-9.4). CONCLUSIONS: Measures of joint work-related exposures were more strongly associated than single exposures with informally employed US DWers' health profiles.

Facilitation of dependent transfers with functional neuromuscular stimulation: a computer simulation study.

A two-part simulation process was developed to investigate the facilitation of vertical patient lifts with functional neuromuscular stimulation (FNS) in individuals with spinal cord injury (SCI). First, external lifting forces representing caregiver assistance were applied to a 3D musculoskeletal model representing the patient and optimized to enforce a specific lifting trajectory during a forward dynamic simulation. The process was repeated with and without the activation of the knee, hip, and trunk extensor muscles of the patient model to represent contractions of the paralyzed muscles generated via FNS. Secondly, the spinal compression experienced by a caregiver at the L5/S1 joint while generating these external lifting forces was estimated using a second musculoskeletal model representing the caregiver. Simulation without muscle activation predicted spinal compression in the caregiver model approximately 1.3 × the National Institute for Occupational Safety and Health (NIOSH) recommended "Action Limit." Comparatively, simulations with two unique patterns of muscle activation both predicted caregiver spinal compressions below NIOSH recommendations. These simulation results support the hypothesis that FNS activation of a patient's otherwise paralyzed muscles would lower the force output required of a caregiver during a dependent transfer, thus lowering the spinal compression and risk of injury experienced by a caregiver.

Optimization-based biomechanical lifting models for manual material handling: A comprehensive review.

Lifting is a main task for manual material handling (MMH), and it is also associated with lower back pain. There are many studies in the literature on predicting lifting strategies, optimizing lifting motions, and reducing lower back injury risks. This survey focuses on optimization-based biomechanical lifting models for MMH. The models can be classified as two-dimensional and three-dimensional models, as well as skeletal and musculoskeletal models. The optimization formulations for lifting simulations with various cost functions and constraints are reviewed. The corresponding equations of motion and sensitivity analysis are briefly summarized. Different optimization algorithms are utilized to solve the lifting optimization problem, such as sequential quadratic programming, genetic algorithm, and particle swarm optimization. Finally, the applications of the optimization-based lifting models to digital human modeling which refers to modeling and simulation of humans in a virtual environment, back injury prevention, and ergonomic safety design are summarized.

Evaluating a wearable biofeedback device for reducing end-range sagittal lumbar spine flexion among home caregivers.

Caregivers who work in the home environment are at risk of back injury due to the awkward postures they have to adopt while providing care. Real-time biofeedback provided by a recently developed wearable device (PostureCoach) may be able to reduce this risk. The effectiveness of a two-day training intervention (including PostureCoach and an educational video) was evaluated for its ability to decrease the amount of time spent in end-range spine flexion. Twenty novice caregivers repeated a series of simulated care tasks. Real-time auditory biofeedback was provided to the intervention group (n = 10) when participants' sagittal lumbar spine flexion exceeded a preset threshold during training trials. Participants in the control group (n = 10) received no feedback. Participants repeated the tasks again two weeks and two months post-intervention. The intervention group maintained decreased end-range (80th and 95th percentile) spine flexion compared to controls at both post-intervention time points.

Trunk Posture during Manual Materials Handling of Beer Kegs.

Craft brewing is a rapidly growing industry in the U.S. Most craft breweries are small businesses with few resources for robotic or other mechanical-assisted equipment, requiring work to be performed manually by employees. Craft brewery workers frequently handle stainless steel half-barrel kegs, which weigh between 13.5 kg (29.7 lbs.) empty and 72.8 kg (161.5 lbs.) full. Moving kegs may be associated with low back pain and even injury. In the present study, researchers performed a quantitative assessment of trunk postures using an inertial measurement unit (IMU)-based kinematic measurement system while workers lifted kegs at a craft brewery. Results of this field-based study indicated that during keg handling, craft brewery workers exhibited awkward and non-neutral trunk postures. Based on the results of the posture data, design recommendations were identified to reduce the hazardous exposure for musculoskeletal disorders among craft brewery workers.

A mixed treatment comparison of selected osteopathic techniques used to treat acute nonspecific low back pain: a proof of concept and plan for further research.

CONTEXT: Back injuries have a high prevalence in the United States and can be costly for both patients and the healthcare system at large. While previous guidelines from the American College of Physicians for the management of acute nonspecific low back pain (ANLBP) have encouraged nonpharmacologic management, those treatment recommendations involved only superficial heat, massage, acupuncture, and spinal manipulation. Investigation about the efficacy of spinal manipulation in the management of ANLBP is warranted. OBJECTIVES: To compare the results in previously-published literature documenting the outcomes of osteopathic manipulative treatment (OMT) techniques used to treat ANLBP. The secondary objective of this study was to demonstrate the utility of using Bayesian network meta-analysis (NMA) to perform a mixed treatment comparison (MTC) of a variety of osteopathic techniques. METHODS: A literature search for randomized controlled trials (RCTs) of ANLBP treatments was performed in April 2020 according to PRISMA guidelines by searching MEDLINE/PubMed, OVID, Cochrane Central, PEDro, and OSTMED.Dr databases; scanning the reference lists of articles; and using the Canadian Agency for Drugs and Technologies in Health grey literature checklist. Each database was searched from inception to April 1, 2020. The following search terms were used: acute low back pain, acute low back pain plus physical therapy, acute low back pain plus spinal manipulation, and acute low back pain plus osteopathic manipulation. The validity of eligible trials was assessed by the single author using an adapted National Institute for Health and Care Excellence methodology checklist for randomized, controlled trials and an extraction form based on that checklist. The outcome measure chosen for this NMA was the Visual Analogue Scale of pain. The NMA were performed using the GeMTC user interface for automated NMA utilizing a Bayesian hierarchical model of random effects. RESULTS: The literature search initially found 483 unduplicated records. After screening and full text assessment, five RCTs were eligible for the MTC, yielding a total of 430 participants. Results of the MTC model suggested that there was no statistically significant decrease in reported pain when exercise, high-velocity low-amplitude (HVLA), counterstrain, muscle energy technique, or a mix of techniques were added to conventional treatment to treat ANLBP. However, the rank probabilities assessment determined that HVLA and the OMT mixed treatment protocol plus conventional care were ranked superior to conventional care alone for improving ANLBP. CONCLUSIONS: While this study failed to provide definitive evidence upon which clinical recommendations can be based, it does demonstrate the utility of performing NMA for MTCs of osteopathic modalities used to treat ANLBP. However, to take full advantage of this statistical technique, future studies should be designed with consideration for the methodological shortcomings found in past osteopathic research.

Development and Feasibility Testing of a Contextual Patient Movement Intervention.

INTRODUCTION: Nurses and emergency medical services workers frequently suffer musculoskeletal injuries at a disproportionate rate in relation to the rest of the population. The most common form of this musculoskeletal injury is lumbar spine injury. The purpose of this study was to develop and conduct phase 1 feasibility testing of a contextual lifting intervention that reduces the risks of low back injury. METHODS: This study was an intervention development and phase 1 feasibility test. The intervention was created on the basis of weightlifting techniques to specifically reduce the incidence injury related to valgus knee, asymmetrical lifting technique, and rotation of the trunk and pelvis. Motion capture technology (Xsens; Xsens Technologies) was used while 17 nursing students completed the direct patient lift from the floor, the lift from the floor with a manikin attached to a rigid spine board, the push portion of the horizontal transfer, and the pull portion of the horizontal transfer. Pre- and postintervention data were collected. Linear mixed model regression, with pairwise comparisons, was conducted for each lift at the time points of preintervention, immediately after the intervention, and 1-month postintervention. RESULTS: Significant changes were noted between the initial lifting techniques used and those used after the intervention. The maximum lever arm distance, defined as the distance from L5-S1 to the center of the force applied to the load, showed a significant reduction after the intervention in 3 of the 4 movements. DISCUSSION: Our results support the idea that injury risk can be reduced through appropriate contextual training methods.

Dorsal muscle fatigue increases thoracic spine curvature in all-out recreational ergometer rowing.

The purpose of this study was to investigate fatigue-related changes in spinal kinematics, kinetics, and muscle activity of back muscles during a 2000 m all-out ergometer rowing performance. We analyzed ten male subjects with experience in both rowing and CrossFit exercises. We applied a novel kinematic method to describe spine curvature, determined bending moments at the spine using inverse dynamics and collected EMG data. We identified significant increases in spine curvature of the thoracic spine (i.e. vertebrae Th6 to Th11). Significant increases in peak moments were found only at the upper spine (i.e. Th2). We found no significant changes in EMG amplitudes, while the frequency analysis showed significant decreases in the mean frequencies (MNF) for the M. latissimus dorsi, the M. trapezius descendens and the M. deltoideus posterior. No significant changes on MNF were found for the Mm. erector spinae. We hypothesize that the significant increase in curvature for the thoracic spine is connected to the fatigued back muscles, especially the Mm. trapezius descendens, and might lead to an unbalanced loading of intervertebral discs and other structures. These findings are particularly important for athletes and coaches in CrossFit as strenuous rowing intervals are combined with technical exercises with high loads on the back and spine (e.g. power and Olympic lifting) leading to impaired muscular stabilization and potentially to an increased injury risk.

Biomechanical assessment while using production tables on mast climbing work platforms.

The objective of this study was to assess the impact of using alternative mast climbing work platform (MCWP) designs on trunk motion and postural stability with masonry workers while performing bricklaying and stepping down tasks using a conventional MCWP setting (i.e. with a step deck) as well as two types of production tables (straight- and L-shaped). The trunk angles and postural sway parameters of twenty-five masonry workers were recorded for the following tasks: (1) standing on a simulated MCWP and laying bricks on an adjacent wall, and (2) stepping down onto the step deck to get into position for doing the bricklaying task. Results indicated that the use of the L-shaped production table resulted in the lowest trunk ranges of motion and significantly reduced the workers' trunk angles in all three planes when compared to both the straight-shaped production table and the conventional approach of not using a production table. Data showed that both body sway velocity and area were significantly reduced when using either one of the production tables. The use of production tables significantly reduced impact sway forces when workers stepped from the main platform to the step deck. The use of production tables on MCWPs improved workers' postures and overall stability, which could reduce the risk of injury.

Is average club head speed a risk factor for lower back injuries in professional golfers? A retrospective case control study.

BACKGROUND: Our hypothesis was that higher average club head speed is correlated with lower back injuries in professional golfers. METHODS: This was a retrospective case control study of male professional golfers who suffered lower back injuries while playing golf. The injured group was composed of 14 Professional Golfers' Association (PGA) golfers who withdrew from a PGA tour event due to a back injury during the years 2017-2019. The case-control matching procedure was used to randomly match cases and controls with a 2:1 allocation ratio, respectively, based on age. Variables were chosen based on currently proposed risk factors. Data was statistically analyzed using SPSS 25. RESULTS: There were 14 PGA golfers who suffered lower back injuries during the years 2017-2019 who were included in this study. There was no significant difference in age, height, weight or BMI between the injured and control group. The injured group had a higher mean club head speed than the control group (P < 0.01). CONCLUSION: This study found that average club head speed was significantly higher in PGA golfers who suffered back injuries while golfing during a two-year period (2017-2019) when compared with age-matched controls.

Physical exposure during patient transfer and risk of back injury & low-back pain: prospective cohort study.

BACKGROUND: Work-related musculoskeletal disorders (MSDs) are common among healthcare workers. Because frequent patient transfer has been associated with increased risk of MSDs, we aim to quantify the physical load associated with commonly-used assistive devices and to investigate associations between accumulated physical exposure and risk of MSDs. METHODS: By applying an exposure matrix based on objective measurements of electromyography and trunk flexion on a large (n = 1285) prospective cohort, intensity of low-back pain (LBP) and odds of back injury at 1-year follow-up were modelled using linear models and logistic regressions, respectively. The cohort was divided into groups according to physical exposure; i.e. low (1st quartile), moderate (2nd and 3rd quartiles) and high (4th quartile) exposure. RESULTS: Exposure profiles are provided for 9 groups of assistive devices, with ceiling lifts and intelligent beds eliciting the lowest physical exposure. In the fully-adjusted model, we report differences in LBP intensity at follow-up between the low and moderate exposure groups (p = 0.0085). No difference was found between the moderate and high exposure groups (p = 0.2967). Likewise, we find no associations between physical exposure and odds of back injury at 1-year follow-up, with a prevalence of 11, 13 and 11% for the three groups, respectively. CONCLUSIONS: Low physical exposure during patient transfer was prospectively associated with lower intensity of LBP. Consistent use of assistive devices associated with low physical exposure, namely ceiling-lifts and intelligent beds, may play a role in reducing the incidence of MSDs among healthcare workers.

Low Back Pain Among Weightlifting Adolescents and Young Adults.

Background Weightlifting is a common type of sports training that develops the strength and size of skeletal muscles. Low back pain (LBP) is one of its most common complaints. This sport has become prevalent among adolescents and young adults as they work to enhance their physique and body image. The aim of our study is to explore the nature and cause of LBP in weightlifting adolescents and young adults in an aim of extrapolating proper preventive measures. Methods Participants were patients who engaged in weightlifting sports and had presented to our clinic with nonspecific LBP. They were examined and asked to rate and localize their pain. Back positioning during weightlifting techniques along with other exercise habits was explored. Patients with congenital or systemic diseases and fractures were excluded from our study. Results A total of 93 patients presented with LBP (age range: 16-26 years), all of whom partook in weightlifting (N=93). Localized pain was found in 43 patients (46%). Pain radiating to the left side was found in 31 patients (33%), while pain radiating to the right was found in 19 patients (21%). LBP localized at the level of L4-L5 was found in 44 cases (47%), while that localized at L5-S1 was found in 43 cases (46%). Only six cases localized pain at the level of L3-L4 (7%). A total of 23 cases required surgery (25%), while others were managed conservatively. All the participants (100%) reported their pain to be initiated during or after weightlifting maneuvers. Psychological symptoms were found in 13 cases (19%). Factors that helped relieve the pain included surgery, swimming, and wearing a back brace. Conclusion Weightlifting is a sport that utilizes heavy weights to engage the muscles in the body, and consequently, predisposes athletes to LBP. Using excessive weights and performing improper techniques puts the back in a compromising position that may lead to injury. Medical and sports personnel should raise awareness on the biomechanical properties of the lumbar spine and the correct spine-protective posture during training to help prevent these injuries in the future.

Modifying bowling kinematics in cricket pace bowlers with exercise-based injury prevention: A cluster-randomised controlled trial.

OBJECTIVES: Undesirable bowling kinematics can increase the risk of low back injury. This study investigated if an exercise-based injury prevention program (IPP) could modify bowling kinematics in community-level adolescent pace bowlers. DESIGN: Cluster-randomised controlled trial. METHODS: Pace bowlers from eight cricket organisations were cluster-randomised into an intervention or control group. At baseline and follow-up sessions biomechanical bowling data were collected. Between sessions, the intervention group completed an eight-week IPP while the control continued their normal cricket activity. Treatment effects (95% CI) were estimated with linear mixed models. RESULTS: There were significant treatment effects favouring the intervention group for shoulder counter-rotation (-3.8°; -7.2° to -0.3°) and lateral trunk flexion relative to the pelvis (-2.2°; -4.0° to -0.5°). Shoulder counter-rotation also increased in the control group by 2.2° (Cohen's d=0.22). There were no effects of the intervention on: lateral trunk flexion at front foot contact (FFC) (1.2°; -2.5° to 4.8°), lateral trunk flexion at ball release (BR) (-0.5°; -3.0° to 2.0°), pelvis rotation at FFC (0.9°; -4.0° to 2.2°), pelvis rotation at BR (-1.1°; -5.7° to 3.6°), front hip angle at FFC (1.6°; -3.6° to 6.7°), front hip angle at BR (-1.6°; -5.0° to 1.9°), front knee angle at FFC (-1.1°; -4.5° to 2.3°), front knee angle at BR (1.7°; -5.6° to 9.1°), or ball velocity (1.1kmh-1; -7.5kmh-1 to 9.7kmh-1). CONCLUSIONS: The IPP maintained shoulder counter-rotation and lateral trunk flexion relative to the pelvis in the intervention group and this could attenuate injury risk. No treatment effects were observed for lower-limb kinematics.

Lumbar posture assessment with fabric strain sensors.

Astronauts are at risk for low back pain and injury during extravehicular activity because of the deconditioning of the lumbar region and biomechanical demands associated with wearing a spacesuit. To understand and mitigate injury risks, it is necessary to study the lumbar kinematics of astronauts inside their spacesuit. To expand on previous efforts, the purpose of this study was to develop and test a generalizable method to assess complex lumbar motion using 10 fabric strain sensors placed on the torso. Anatomical landmark positions and corresponding sensor measurements were collected from 12 male study participants performing 16 static lumbar postures. A multilayer principal component and regression-based model was constructed to estimate lumbar joint angles from the sensor measurements. Good lumbar joint angle estimation was observed (<9° mean error) from flexion and lateral bending joint angles, and lower accuracy (13.7° mean error) was observed from axial rotation joint angles. With continued development, this method can become a useful technique for measuring suited lumbar motion and could potentially be extrapolated to civilian work applications.

Lower Back Injuries in National Collegiate Athletic Association Football Players: A 5-Season Epidemiological Study.

BACKGROUND: Low back injuries are common in collegiate football players and can frequently lead to persistent pain, reinjuries, and time lost from participation. PURPOSE: To describe the epidemiology of back injuries in National Collegiate Athletic Association (NCAA) football players during the 2009/2010 through 2013/2014 academic years utilizing the NCAA Injury Surveillance Program (ISP) database. STUDY DESIGN: Descriptive epidemiology study. METHODS: A convenience sample of NCAA varsity football teams was utilized to determine the rates and patterns of back injuries as well as to generate national injury estimates. The rates and distribution of back injuries were identified within the context of mechanism of injury, injury chronicity, and time lost from sport. Injury rates were calculated as the number of injuries divided by the total number of athlete-exposures (AEs). Incidence rate ratios were calculated to compare the rates of injury between season, event type, mechanism of injury, injury chronicity, and time lost from sport. RESULTS: Nationally, there were 267 low back injuries reported in the database. These were used to estimate 7076 back injuries over the 5-year period, approximately 82% of which were new injuries. The injuries occurred at a rate of 2.70 per 10,000 AEs. Overall, injuries were 3.12 times more likely to occur in competitions than in practices. Athletes were 4.67 times more likely to sustain a back injury during the preseason compared with the postseason but were 1.41 times more likely to sustain a low back injury during the preseason compared with the regular season. Both contact and noncontact were reported equally as the mechanism of injury (37.8% and 38.3%, respectively), and unspecified low back pain was the most common injury (64.2%). Only 1.6% of patients required surgery for their injury, and the majority of athletes (59.6%) returned to play within 24 hours. CONCLUSION: There was a relatively high rate of lumbar back injuries at the collegiate level (2.70/10,000 AEs), the majority of which were new injuries. About 18% of reported injuries were reinjuries. Although very few required surgery, a careful examination and work-up should be conducted to evaluate each injury. Regimented physical therapy and reconditioning programs are recommended to avert reinjuries.

Assisting Frail Seniors With Toileting in a Home Bathroom: Approaches Used by Home Care Providers.

Home care providers experience high occupational injury rates. Improving safety is becoming increasingly urgent as this sector expands to support the aging population. Caregivers identify assisting with toileting as a particularly frequent and difficult activity. This mixed-methods observational study identified and analyzed the toileting subactivities that place care providers at the greatest risk of musculoskeletal injury. Eight personal support workers (home care aides) assisted a frail older adult (actor) in a simulated home bathroom. Overall technique and body postures were analyzed. Exposure to musculoskeletal injury risk factors (low back loads and time in extreme trunk postures) was greatest when removing/replacing clothing and providing posterior perineal care; high loads were also possible during transfers. Exposures can be reduced by lowering the pants only to knee level or squatting to raise them. A bidet seat or attachment can perform perineal cleaning, which accounted for 32% of time in severe trunk flexion.