Early Results of Orthopaedic Trauma and Anemia: Conservative Versus Liberal Transfusion Strategy.

INTRODUCTION: The purpose of this study was to determine whether it is safe to use a conservative packed red blood cell transfusion hemoglobin threshold (5.5 g/dL) compared with a liberal transfusion threshold (7.0 g/dL) for asymptomatic patients with musculoskeletal-injured trauma out of the initial resuscitative period. METHODS: This was a multicenter, prospective, nonblinded, randomized study done at three level 1 trauma centers. One hundred patients were enrolled. One patient was inappropriately enrolled, withdrawn from the study, and excluded from analysis leaving 99 patients (49 liberal and 50 conservative) with 30-day follow-up. After initial resuscitation, patients were enrolled and randomized to either a liberal or a conservative transfusion strategy. This strategy was followed throughout the index hospitalization. The primary outcome of the study was infection. Superficial infection was defined as clinical diagnosis of cellulitis or other superficial infection treated with oral antibiotics only. Deep infection was defined as clinical diagnosis of fracture-related infection requiring IV antibiotics and/or surgical débridement. RESULTS: Ninety-nine patients were successfully followed for 30 days with 100% follow-up during this time. Seven infections (14%) occurred in the liberal group and none in the conservative group ( P < 0.01). Five deep infections (10%) occurred in the liberal group and none in the conservative group ( P = 0.03). Three superficial infections (6%) occurred in the liberal and none in the conservative group, which was not a significant difference ( P = 0.1). No difference was observed in length of stay between groups. DISCUSSION: Transfusing young healthy asymptomatic patients with orthopaedic trauma for hemoglobin <7.0 g/dL increases the risk of infection. No increased risk of anemia-related complications was identified with a conservative transfusion threshold of 5.5 g/dL. DATA AVAILABILITY AND TRIAL REGISTRATION NUMBERS: Data are available on request. IRB protocol number is 1402557771. This study was registered with Clinicaltrials.gov identifier NCT02972593. LEVEL OF EVIDENCE: Level 2, unblinded prospective randomized multicenter study.

Musculoskeletal Injury Prevalence, Pain Perception, and Physical Activity Level Among Brazilian Strength and Cross-Training Practitioners.

In this study, we sought to determine the prevalence of musculoskeletal injuries, perceived pain, and physical activity level among Brazilian practitioners of strength training (ST) and functional fitness (FF). Participants were 311 men and women who trained in 10 FF training centers and seven ST gyms. Each participant completed surveys of the prevalence of musculoskeletal injuries, their pain perception, and their physical activity level. A chi square test was used to analyze associations between groups and distributions of injuries. When any significant difference was observed, the difference score was analyzed through the adjusted residual values. Fisher's exact test was used to determined the associations between musculoskeletal injury prevalence and training modality (FF and ST) and between musculoskeletal injury prevalence and practice frequency (times/wk). To measure the magnitude of association between variables, the Phi coefficient was calculated for 2x2 associations and Cramer's V was used whenever the distributions were outside this standard. When the dependent variable presented a dichotomous characteristic, an Odds Ratio (OR) was calculated with a confidence interval of 95%. We found a higher musculoskeletal injury prevalence in the axial skeleton (n = 52; 83.88%) in FF practitioners and in the lower limbs of ST practitioners (n = 9; 52.96%). When the physical activity level cutoff point was set at 300 minutes per week, there was a significant relationship between physical activity and training modality (p = 0.005). There was also a significant association between pain perception and musculoskeletal injury (p < 0.001). Clinical follow-up was a protective factor to being injured (OR = 0.18; CI = 0.06-0.49), and, even after multivariate analysis this significant association was maintained (OR = 0.03; CI = 0.01 - 0.08). Thus, FF practitioners reported more musculoskeletal injuries than STs, and follow-up medical or physical therapy was a protective factor to these injuries. FF practitioners also had a higher level of weekly physical activity weekly than ST practitioners. Functional fitness practitioners may be at a higher risk of injuries than those who participate in traditional strength training.

Deep vein thrombosis and validation of the Caprini risk assessment model in Chinese orthopaedic trauma patients: a multi-center retrospective cohort study enrolling 34,893 patients.

BACKGROUND: The risk of venous thromboembolism among orthopaedic trauma patients is high, but prevalence of deep vein thrombosis (DVT) remains unknown. In addition, the Caprini risk assessment model (RAM) score in orthopaedic trauma patients is undetermined in previous research. This study is aimed to determine the incidence of DVT and then validate the Caprini RAM in orthopaedic trauma patients. METHODS: This is a retrospective cohort study enrolling orthopaedic trauma inpatients from seven tertiary and secondary hospitals during a 3-year period (from April 1, 2018 through April 30, 2021). Caprini RAM scores were assessed by experienced nurses on admission. The patients with suspected DVT were verified through duplex ultrasonography by qualified radiologists, and then prospectively followed once a year after discharge. RESULTS: In total, 34,893 patients were enrolled in our study. The Caprini RAM identified 45.7% of patients at low risk (Caprini score 0-2), 25.9% at medium risk (3-4), and 28.3% at high risk (5-6), highest risk (7-8), and superhigh risk (> 8). Patients with Caprini score > 5 were likely to be older, female, and with longer length of hospital stay. Moreover, 8695 patients had received ultrasonography to detect DVT. The prevalence of DVT was determined to be 19.0% [95% confidence interval (CI) 18.2-19.9%], which significantly increased with Caprini score. The area under curve of the Caprini RAM for DVT was 0.77 (95% CI 0.76-0.78) with a threshold of 4.5. Furthermore, 6108 patients who had received ultrasonography completed the follow-up. DVT patients had a hazard ratio of 1.75 (95% CI 1.11-2.76; P = 0.005) in the mortality, compared to non-DVT ones. Caprini scores were significantly associated with increase in the mortality [odds ratio (OR) 1.14; 95% CI 1.07-1.21; P < 0.001]; DVT remained an independent effect (OR 1.5; 95% CI 1.02-2.26; P = 0.042). CONCLUSIONS: The Caprini RAM may be valid in Chinese orthopaedic trauma patients. Prevalence of DVT and higher Caprini score were significantly associated with increased all-cause mortality among orthopaedic trauma patients after discharge. Further study is warranted to explore the causes of higher mortality in patients with DVT.

Olympic Class Sailing Injuries and Illness: A 15-Year Study of a World Cup Regatta Venue.

INTRODUCTION: Olympic class sailing injuries are a minimally researched topic. Our study includes 15 y of data from medical coverage of the Miami venue during the Sailing World Cup. The objective was to examine the nature of Olympic class sailing injuries and illnesses during competition. METHODS: The records of the medical clinic encounters of a World Cup Sailing regatta were reviewed. Summary statistics and nominal categorized data regarding demographics, onset, mechanism, nature of condition, and referral were collected. RESULTS: There were 740 clinic encounters, ranging from 20 to 70 annually. Five hundred fifty-five (75%) were musculoskeletal in nature, and 184 (25%) were related to medical concerns. Twelve athletes were referred to the emergency department (ED), averaging <1 per year. However, 6 (50%) of the ED referrals came from NACRA 17, 49er, and 49er F-X classes, representing a 16% ED referral rate by fleet per year. In contrast, the remainder of the classes had a 0.04% ED referral rate. The lumbar spine, cervical spine, and foot/ankle were the most common body regions treated. Laser Radial sailors had 71(10%) visits, the most per class. Coaches and staff represented 59 (8%) visits. CONCLUSIONS: Olympic class sailing venue medical coverage should be equipped to treat a variety of acute and chronic injuries and illnesses among athletes as well as coaches and staff. Overall, rates of ED or other off-site referrals are low but higher for 49er, 49er F-X, and North American Catamaran Racing Association (NACRA)-17 classes.

Establishing a consensus on research priorities in orthopaedic trauma within South Africa.

BACKGROUND: Musculoskeletal (MSK) injuries are one of the leading causes of disability worldwide. Despite improvements in trauma-related morbidity and mortality in high-income countries over recent years, outcomes following MSK injuries in low- and middle-income countries, such as South Africa (SA), have not. Despite governmental recognition that this is required, funding and research into this significant health burden are limited within SA. This study aims to identify research priorities within MSK trauma care using a consensus-based approach amongst MSK healthcare practitioners within SA. METHOD: Members from the Orthopaedic Research Collaboration in Africa (ORCA), based in SA, collaborated using a two round modified Delphi technique to form a consensus on research priorities within orthopaedic trauma care. Members involved in the process were orthopaedic healthcare practitioners within SA. RESULTS: Participants from the ORCA network, working within SA, scored research priorities across two Delphi rounds from low to high priority. We have published the overall top 10 research priorities for this Delphi process. Questions were focused on two broad groups-clinical effectiveness in trauma care and general trauma public health care. Both groups were represented by the top two priorities, with the highest ranked question regarding the overall impact of trauma in SA and the second regarding the clinical treatment of open fractures. CONCLUSION: This study has defined research priorities within orthopaedic trauma in South Africa. Our vision is that by establishing consensus on these research priorities, policy and research funding will be directed into these areas. This should ultimately improve musculoskeletal trauma care across South Africa and its significant health and socioeconomic impacts.

Epidemiology of Musculoskeletal Injuries Among Naval Special Warfare Personnel.

BACKGROUND: Musculoskeletal injuries (MSIs) are an important cause of morbidity in the military, especially among Special Forces. The aim of this analysis was to describe MSIs among two groups of Naval Special Warfare (NSW) personnel-Special Warfare Combatant-Craft Crewman (SWCC) Operators and Crewman Qualification Training (CQT) students. METHODS: In this cross-sectional study, we describe self-reported MSIs that occurred during a one-year period and the calculated financial costs of MSIs. Group comparisons were conducted using Fisher's exact tests and independent samples t tests. RESULTS: Data were available for 142 SWCC Operators (26.9 ± 5.9 years, 1.8 ± 0.1 meters, 85.4 ± 10.4 kilograms) and 187 CQT students (22.8 ± 3.2 years, 1.8 ± 0.2 meters, 81.4 ± 8.9 kilograms). The one-year cumulative MSI incidence was significantly lower among SWCC Operators (21.1%) compared to CQT students (37.4%, p = 0.002). The most common anatomic location for MSIs was the lower extremity (SWCC: 50.0% of MSIs, CQT: 66.3%). Physical training was the predominant activity when MSIs occurred (SWCC: 31.6%, CQT: 77.6%). The lifetime cost of all the MSIs included in the analysis was approximately $580,000 among 142 SWCC Operators and $1.2 million among 187 CQT students. CONCLUSION: MSIs, especially those affecting the lower extremity and occurring during physical training, cause considerable morbidity and financial burden among NSW personnel. Many of the musculoskeletal injuries are to musculotendinous tissue, which typically results from tissue overload or inadequate recovery. Further investigation of the preventable causes of these MSIs and development of a customized, evidence-based MSI prevention program is required to reduce the burden of these MSIs.

No pain, no gain: The military overtraining hypothesis of musculoskeletal stress and injury.

The purpose of this manuscript is to present a model of military overtraining and subsequent injury, discharge, and disability. Military training and combat operations are physically and physiologically demanding, placing great strain on the musculoskeletal system of warfighters. Non-battle musculoskeletal injuries (MSKI) are common and present a serious threat to operational readiness in today's military. MSKI risk stratification and prevention are an active area of research and is steeped in the background of sports science. Here, a model is proposed that incorporates the theory of General Adaptation Syndrome to describe how military training stressors may exceed that of training in traditional athletics and may induce sub-optimal training stressors. Positive feedback loops are discussed to explain how military overtraining (MOT) creates a system of ever-increasing stressors that can only be fully understood in the greater context of all environmental factors leading to overtraining. The Military Overtraining Hypothesis (MOTH) is proposed as a model that encapsulates the elevated MSKI risk in combat arms and other operational military personnel as an effort to broaden understanding of multifactorial military MSKI etiologies and as a tool for researchers and commanders to contextualize MSKI research and risk mitigation interventions.

The effect of rapid weight loss on sports injury in elite taekwondo athletes.

OBJECTIVES: The purpose of this study was to reveal the relationship of injury patterns between normal training period and weight loss period in Korea elite taekwondo athletes. METHODS: Since 2021, data for elite taekwondo athletes have been collected prospectively by the Korean Training Institute, there were 102 male and 95 female. The data were classified by sex, weight class, injury location, injuries during the normal training and weight loss periods. The χ2 test was used to compare groups. The injury incidence rates were calculated as the number of injuries per 1,000 hours of training. RESULTS: A total of 703 injuries were recorded during normal training, and total of 149 injuries were recorded during the weight loss period. Taekwondo athletes showed a higher incidence of during the weight loss period than during the normal training period (3.66 VS 6.88; p < 0.001). The body parts affected by injury differed significantly between the normal training period and weight loss period (p = 0.033). Injury to the lower extremities or to the head and neck was relatively higher during the normal training period, while injury to the trunk and upper extremities was relatively higher during the weight loss period. Muscle, ligament, and bone injuries were common during both the normal training and weight loss periods. Level I injuries were relatively more frequent during normal training, while level II and III injuries were relatively more frequent during weight loss (p < 0.001). CONCLUSION: Rapid weight loss is related to the injury patterns in taekwondo athletes. Injury incidence rate increases during rapid weight loss periods. Moreover, the injury site and injury severity depend on during normal training and during the weight loss period.

Changes in Thoroughbred speed and stride characteristics over successive race starts and their association with musculoskeletal injury.

BACKGROUND: Certain stride characteristics have been shown to affect changes in biomechanical factors that are associated with injuries in human athletes. Determining the relationship between stride characteristics and musculoskeletal injury (MSI) may be key in limiting injury occurrence in the racehorse. OBJECTIVES: This study aimed to determine whether changes in race day speed and stride characteristics over career race starts are associated with an increased risk of MSI in racehorses. STUDY DESIGN: Case-control study. METHODS: Speed, stride length, and stride frequency data were obtained from the final 200 m sectional of n = 5660 race starts by n = 584 horses (case n = 146, control n = 438). Multivariable joint models, combining longitudinal and survival (time to injury) analysis, were generated. Hazard ratios and their 95% confidence intervals (CI) are presented. RESULTS: The risk of MSI increased by 1.18 (95% CI 1.09, 1.28; P < 0.001) for each 0.1 m/s decrease in speed and by 1.11 (95% CI 1.02, 1.21; P = 0.01) for each 10 cm decrease in stride length over time (career race starts). A more marked rate of decline in speed and stride length was observed approximately 6 races prior to injury. Risk of MSI was highest early in the horse's racing career. MAIN LIMITATIONS: Only final sectional stride characteristics were assessed in the model. The model did not account for time between race starts. CONCLUSIONS: Decreasing speed and stride length over multiple races is associated with MSI in racehorses. Monitoring stride characteristics over time may be beneficial for the early detection of MSI.

Epidemiology of Musculoskeletal Injuries in the Navy: A Systematic Review.

Objectives: This study aimed to critically review the results of recent studies that investigated the epidemiology of noncombat-related musculoskeletal injuries (MSIs) in the Navy. Methods: A systematic search was conducted of three major databases (Pubmed, Embase, and Cochrane) to identify epidemiological studies on MSIs in the Navy. Study selection and risk of bias assessment were conducted. Results: The overall prevalence of MSIs ranged from 12.69% to 48.81%. And the prevalence of head and face injuries, upper extremity injuries, spine injuries, chest injuries, and lower extremity injuries were 0.11%-0.66%, 0.53%-11.47%, 0.75%-12.09%, 0.43%-0.95%, and 0.4%-21.17%, respectively. For the specific MSIs, the incidence ranged from 0.03/1000 person-years to 32.3/1000 person-years in the Navy and Marines. The ankle-foot, lumbopelvic, knee and lower leg, and shoulder were identified as the most frequent location for MSIs. Conclusion: This systematic review summarized that the Navy population had a high prevalence of MSIs. And different risk factors for MSIs varied from different anatomic locations. This systematic review also provided valuable information on MSIs for sports medicine specialists.

Monitoring the beautiful adapted game: a 3-year prospective surveillance study of injuries in elite English Para football.

Para football is currently played in impairment-specific formats by thousands of people worldwide. To date, there have been no prospective longitudinal injury surveillance studies. This study aimed to implement a prospective injury surveillance study within elite English Para football and analyse the injury risk within the England Blind and Cerebral Palsy (CP) squads. Match and training injury data based on a 'time loss' definition were collected and analysed for each squad including incidence per 1,000 player hours, severity, injury location and associated event of injury. Injury incidence were lower in training than matches (CP 67.6/1000 player match hours (CI 33.8-135.2) and 5.7/1000 training hours (CI 3.8-8.7) and Blind 44.0/1000 player match hours (CI 26.1-74.3) and 5.5/1000 training hours (CI 3.5-8.6). Training injuries were more severe than match injuries across both squads (CP median 12 days lost in matches and 16 training and Blind median days 5 matches and 12 training). 73% Blind and 74% CP footballer injuries were to the lower limb and 17% head and neck equally across both Para football squads. 'Muscle and tendon injuries' (51%) represented the greatest proportion of injuries for CP footballers, and 'joint (non-bone)/ligament injuries' (43%) for Blind footballers. Collaboration and implementation of higher quality surveillance methodology and data collection in Para sport with greater athlete numbers are needed to inform injury prevention strategies.

A state-by-state and regional analysis of the direct medical costs of treating musculoskeletal injuries among US Army trainees.

INTRODUCTION: Low physical activity (PA) and physical fitness (PF) are well-known factors for chronic diseases generally and cardiovascular diseases specifically. The economic burden from these chronic diseases is also well documented, as is their disproportionate prevalence among states in the Southern region of the U.S. Low PA and PF have also become recognized factors impacting military readiness and national security. Specifically, low PA and PF are highly correlated with musculoskeletal injures (MSKIs), now considered the greatest medical impediment to military readiness. Prior research shows low PF and MSKI incidence are greater among Army recruits from Southern states, however no previous research has investigated the economic impact of MSKIs at the state- and regional-level. The aim of this study was to determine the economic impact of MSKIs among U.S. Army initial military trainees on a state- and regional-basis. METHODS: Rosters for recruits entering U.S. Army Initial Military Training (IMT) for fiscal year 2017 were obtained (n = 103,487). Roster data included the unique personal identifier, demographics with postal zip code, training start/end dates, and height and weight and were subsequently linked to medical encounters and cost data from the Military Health System Data Repository. Trainees with one or more MSKIs were considered injury cases (n = 33,509) and were stratified by gender. The percent of trainee MSKI cases was calculated as number of injury cases divided by total number of trainees. For each injury case, the direct medical cost for MSKIs was calculated. The percent of trainees and direct medical costs for MSKIs were aggregated to home-state and regional-levels for the four U.S. Census tract regions. A test for equality of proportions was performed at state- and regional-levels to investigate differences in percent of trainees with MSKIs by state/region. A one-way ANOVA was used to investigate possible differences in medical cost/trainee by region. RESULTS: 34% (n = 33,509) of all trainees sustained at least one MSKI. State-specific MSKI percentages showed ten states having the greatest percentage of trainees with at least one MSKI, eight of which were from the South region (AL, FL, GA, LA, MS, NC, SC, TN). The South was the only region to have a statistically significantly higher percentage of trainees with MSKIs at 34% (p < 0.001), as compared to all other regions. The total direct medical cost of treating MSKIs among all trainees was $14,891,563. The South was the costliest region ($7,168,997), accounted for nearly 50 % of the total national cost, and had the highest mean MSKI cost/trainee. DISCUSSION: This study was the first in demonstrating the disproportionate economic burden Southern states pose to the U.S. Department of Defense resulting from its significantly higher MSKI cost. PA and PF are known to ameliorate chronic disease and MSKI burden among general and military populations. Therefore, increasing PA and PF among all young Americans, and specifically those living in Southern states, is imperative for improving public health and reducing the economic and practical burden of MSKIs on military readiness and national security.

Does Military High-speed Boat Slamming Cause Severe Injuries and Disability?

BACKGROUND: Many operators of professional high-speed boats suffer severe, acute, and permanent injuries caused by slamming-induced hull impacts. As the number of professional high-speed boats and their speed capabilities increase, operators are reporting increasing numbers and severity of injuries. However, the actual incidence rate of acute injuries and the prevalence of chronic musculoskeletal disorders are still unknown. QUESTIONS/PURPOSES: We sought to investigate, among professional high-speed boat operators, (1) the self-reported incidence rate of impact-induced injuries, (2) the most common types of injuries or injury locations, (3) what impact characteristics were reported, and (4) the prevalence of self-reported sick leave, disability, and medical or orthopaedic treatment. METHODS: This study was an internet-based survey among retired military high-speed boat operators. The survey was given to members of the Combatant Craft Crewman Association online user group (360 members). Participants answered questions on demographics, service branch, service years and capacity, boat type, types of events, injury location, severity, pain, disability, and need for treatment. Values are presented as the mean ± SD and proportions. Incidence rates are presented as injuries per person-year. A total of 214 members of the Combatant Craft Crewman Association participated in the survey (213 men, mean age 50 ± 9 years, mean BMI 29 ± 4 kg/m 2 ). A total of 59% (214 of 360) of those we surveyed provided responses; all provided complete survey responses. RESULTS: The self-reported incidence rate of impact-induced injuries was 1.1 injuries per person-year served onboard. A total of 32% (775 of 2460) of respondents reported injuries that affected the back, and 21% (509 of 2460) reported injuries that affected the neck. Among those who responded, 33% (70 of 214) reported loss of consciousness onboard, and 70% (149 of 214) reported having experienced impaired capacity to perform their job onboard because of impact exposure. A total of 49% (889 of 1827) of the reported injuries were attributed to impacts containing lateral forces, 18% (333 of 1827) to frontal impacts, and 12% (218 of 1827) were attributed to purely vertical impacts. Finally, 67% (144 of 214) of respondents reported at least one occasion of sick leave from training or missions. Seventy-two percent (155 of 214) applied for a Veterans Affairs disability rating, and 68% (105 of 155) of these had a rating of 50% or higher. Additionally, 39% (84 of 214) reported having had surgery during active duty, and 34% (72 of 214) reported surgery after leaving active service. CONCLUSION: The results suggest that in the investigated military population, exposure to slamming-induced impacts onboard high-speed boats may cause more injuries than previously reported. Most reported injuries are musculoskeletal, but the high number of reported slamming-induced events of unconsciousness is concerning. LEVEL OF EVIDENCE: Level IV, prognostic study.

Rehabilitation After Pediatric and Adolescent Knee Injuries.

According to epidemiology studies, the majority of youth sports injuries presenting to primary care, athletic trainers, and emergency departments impact the musculoskeletal system. Both acute and overuse knee injuries can contribute to sports attrition before high school. Effective rehabilitation of knee injuries ensures a timely return to sports participation and minimizes the negative physical, psychological, and social consequences of becoming injured. The following article provides rehabilitation and returns to play strategies for postsurgical and nonsurgical injuries of the young athlete's knee.

Single-cell mapping of regenerative and fibrotic healing responses after musculoskeletal injury.

After injury, a cascade of events repairs the damaged tissue, including expansion and differentiation of the progenitor pool and redeposition of matrix. To guide future wound regeneration strategies, we compared single-cell sequencing of regenerative (third phalangeal element [P3]) and fibrotic (second phalangeal element [P2]) digit tip amputation (DTA) models as well as traumatic heterotopic ossification (HO; aberrant). Analyses point to a common initial response to injury, including expansion of progenitors, redeposition of matrix, and activation of transforming growth factor ß (TGF-ß) and WNT pathways. Surprisingly, fibrotic P2 DTA showed greater transcriptional similarity to HO than to regenerative P3 DTA, suggesting that gene expression more strongly correlates with healing outcome than with injury type or cell origin. Differential analysis and immunostaining revealed altered activation of inflammatory pathways, such as the complement pathway, in the progenitor cells. These data suggests that common pathways are activated in response to damage but are fine tuned within each injury. Modulating these pathways may shift the balance toward regenerative outcomes.

Auxetic structures used in kinesiology tapes can improve form-fitting and personalization.

Each year 65% of young athletes and 25% of physically active adults suffer from at least one musculoskeletal injury that prevents them from continuing with physical activity, negatively influencing their physical and mental well-being. The treatment of musculoskeletal injuries with the adhesive elastic kinesiology tape (KT) decreases the recovery time. Patients can thus recommence physical exercise earlier. Here, a novel KT based on auxetic structures is proposed to simplify the application procedure and allow personalization. This novel KT exploits the form-fitting property of auxetics as well as their ability to simultaneously expand in two perpendicular directions when stretched. The auxetic contribution is tuned by optimizing the structure design using analytical equations and experimental measurements. A reentrant honeycomb topology is selected to demonstrate the validity of the proposed approach. Prototypes of auxetic KT to treat general elbow pains and muscle tenseness in the forearm are developed.

Musculoskeletal Injury in Referees That Officiate Over Ladies Gaelic Football and Camogie.

Aim Ladies Gaelic football and Camogie are leading female sports in Ireland. Referees are essential to the game, however, no research has examined injury in referees that officiate over female Gaelic games to date. Therefore, this study aims to retrospectively examine the musculoskeletal injury profile and injury prevention practices of referees that officiate over female Gaelic games. Methods A retrospective anonymous questionnaire examined injuries that occurred in the previous 12 months in currently active Ladies Gaelic football and Camogie referees (n=170). Incidence and repeat incidence proportions were calculated along with descriptive statistics. Results In 2019, 42.9% (n=73) of referees sampled sustained an injury with 27.4% (n=20) sustaining two or more. Injuries primarily occurred to the lower extremity (79.6%,n=78), particularly the lower leg (20.4%,n=20) and knee (18.4%,18). Muscle strains and cramps (55.1%,n=54) were most frequent and injuries predominantly occurred during games (71.4%,n=70). Referees largely completed a warm-up but just 30.6% (n=52) conducted a cool-down. Over half had undertaken injury prevention education but only 37.6% (n=64) incorporated injury prevention elements into their training. Conclusion Just over two in five referees that officiate female Gaelic games became injured in the previous year, however their utilisation of injury prevention strategies, beyond completing a warm-up, is lacking. Thus, a referee specific injury prevention programme should be developed and if found to be effective, incorporated into a comprehensive injury prevention strategy by the governing bodies.

The Use of Force Plate Vertical Jump Scans to Identify Special Warfare Trainees at Risk for Musculoskeletal Injury: A Large Cohort Study.

BACKGROUND: Vertical jump scans from commercially available force plate systems are increasingly used in military settings to screen for musculoskeletal injury (MSKI) risk. However, to date, no studies have determined the ability of these tools to identify tactical athletes at elevated risk for MSKI. PURPOSE: To (1) determine associations between scores from a force plate vertical jump test and the likelihood of experiencing an MSKI and to (2) establish the test-retest reliability of the output scores from the force plate system used. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: A total of 823 male Air Force Special Warfare trainees underwent force plate vertical jump screenings before entering an 8-week training course at US Air Force Special Warfare Training Wing. MSKI data were collected for the 8-week surveillance period for each trainee. Logistic regression analyses were used to identify associations between baseline force plate jump scores and the likelihood of MSKI (any region) or a lower extremity MSKI (significance level, P = .05). The test-retest portion of the study collected force plate output scores from 12 trainees performing 3 trials of the standard test procedures. The reliability of 5 output scores was assessed with intraclass correlation coefficients (ICCs) using a single rater. RESULTS: All force plate output scores demonstrated excellent test-retest reliability (ICC >0.90). Overall 308 (36.4%) trainees had an MSKI during the surveillance period. However, no significant associations were found between the proprietary force plate vertical jump scan output scores and the likelihood of experiencing either an MSKI or a lower extremity MSKI. CONCLUSION: Output scores from this commercially available force plate system did not identify Air Force Special Warfare trainees at elevated risk of experiencing an MSKI.