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3.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue ; 32(1): 14-19, 2020 Jan.
Artigo em Chinês | MEDLINE | ID: mdl-32148225

RESUMO

OBJECTIVE: To investigate the effect and tolerance of non-invasive ventilation (NIV) with helmet in patients with respiratory failure caused by acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and the effect on improving blood gas, alleviating dyspnea and the occurrence of complications. METHODS: Patients with AECOPD and respiratory failure admitted to emergency intensive care unit (EICU) and respiratory intensive care unit (RICU) of the First Affiliated Hospital of Zhengzhou University from January 1st, 2018 to May 31st, 2019 were enrolled. After obtaining the informed consent of the patients or their authorized family members, the patients were divided into two groups: the helmet group and the facial mask group by random number table. NIV was carried out by using helmet or facial mask, respectively. During the course of NIV (immediately, 1 hour, 4 hours and at the end of NIV), the tolerance score, blood gas analysis, heart rate (HR), respiratory rate (RR) of patients were monitored, and the incidence of tracheal intubation, in-hospital mortality and complications were observed. Kaplan-Meier survival curve was plotted to analyze the 30-day cumulative survival of the two groups. RESULTS: A total of 82 patients with AECOPD and respiratory failure were included during the study period. After excluding patients with the oxygenation index (PaO2/FiO2) > 200 mmHg (1 mmHg = 0.133 kPa), with tracheal intubation or invasive ventilation, suffering from acute myocardial infarction, severe trauma within 2 weeks, excessive secretion, sputum discharge disorder or refusal to participate in the study, 26 patients were finally enrolled in the analysis, randomly assigned to the helmet group and the facial mask group, with 13 patients in each group. The PaO2/FiO2 after NIV of patients in both groups was increased significantly as compared with that immediately after NIV, without significant difference between the two groups, but the increase in PaO2/FiO2 at the end of NIV compared with immediately after NIV in the helmet group was significantly higher than that in the facial mask group (mmHg: 75.1±73.2 vs. 7.7±86.0, P < 0.05). RR at each time point after NIV in the two groups was lower than that immediately after NIV, especially in the helmet group. There were significant differences between the helmet group and facial mask group at 1 hour, 4 hours, and the end of NIV (times/min: 17.5±4.1 vs. 23.1±6.3 at 1 hour, 16.2±2.5 vs. 20.0±5.5 at 4 hours, 15.5±2.5 vs. 21.2±5.9 at the end of NIV, all P < 0.05). The NIV tolerance score of the helmet group at 4 hours and the end was significantly higher than that of the facial mask group (4 hours: 3.9±0.3 vs. 3.3±0.9, at the end of NIV: 3.8±0.6 vs. 2.9±0.9, both P < 0.05). There was no significant difference in the improvement of pH value, arterial partial pressure of carbon dioxide (PaCO2), or HR between helmet group and facial mask group. The total number of complications (cases: 3 vs. 8) and the nasal skin lesions (cases: 0 vs. 4) in the helmet group were significantly less than those in the facial mask group (both P < 0.05). Only 2 patients in the helmet group received endotracheal intubation, and 1 of them died; 5 patients in the facial mask group received endotracheal intubation, and 3 of them died; there was no significant difference between the two groups (both P > 0.05). The Kaplan-Meier survival curve analysis showed that the cumulative survival rate of 30 days in the helmet group was lower than that in the facial mask group, but the difference was not statistically significant (Log-Rank test: χ2 = 1.278, P = 0.258). CONCLUSIONS: NIV with helmet has better comfort for patients with AECOPD combined with respiratory failure, and better effect on improving oxygenation and relieving dyspnea, and its effect on carbon dioxide emissions is not inferior to that of traditional mask NIV.


Assuntos
Dispositivos de Proteção da Cabeça , Ventilação não Invasiva , Doença Pulmonar Obstrutiva Crônica/terapia , Insuficiência Respiratória/terapia , Humanos , Unidades de Terapia Intensiva , Máscaras , Doença Pulmonar Obstrutiva Crônica/complicações , Insuficiência Respiratória/etiologia
4.
PLoS One ; 15(2): e0228802, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32053658

RESUMO

Since World War I, helmets have been used to protect the head in warfare, designed primarily for protection against artillery shrapnel. More recently, helmet requirements have included ballistic and blunt trauma protection, but neurotrauma from primary blast has never been a key concern in helmet design. Only in recent years has the threat of direct blast wave impingement on the head-separate from penetrating trauma-been appreciated. This study compares the blast protective effect of historical (World War I) and current combat helmets, against each other and 'no helmet' or bare head, for realistic shock wave impingement on the helmet crown. Helmets included World War I variants from the United Kingdom/United States (Brodie), France (Adrian), Germany (Stahlhelm), and a current United States combat variant (Advanced Combat Helmet). Helmets were mounted on a dummy head and neck and aligned along the crown of the head with a cylindrical shock tube to simulate an overhead blast. Primary blast waves of different magnitudes were generated based on estimated blast conditions from historical shells. Peak reflected overpressure at the open end of the blast tube was compared to peak overpressure measured at several head locations. All helmets provided significant pressure attenuation compared to the no helmet case. The modern variant did not provide more pressure attenuation than the historical helmets, and some historical helmets performed better at certain measurement locations. The study demonstrates that both historical and current helmets have some primary blast protective capabilities, and that simple design features may improve these capabilities for future helmet systems.


Assuntos
Dispositivos de Proteção da Cabeça , Fenômenos Biomecânicos , Traumatismos por Explosões/prevenção & controle , Desenho de Equipamento , Traumatismos Cranianos Penetrantes/prevenção & controle , Dispositivos de Proteção da Cabeça/história , História do Século XX , Humanos , I Guerra Mundial
5.
Curr Sports Med Rep ; 19(1): 17-23, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31913919

RESUMO

Equestrian sports represent a variety of activities involving a horse and rider. Due to the unpredictable nature of horses, their height, and potential high speeds involved, equestrian athletes are at risk of head and spinal injuries. This review describes the epidemiology, injury mechanisms, and risk factors for equestrian sports-related head and spinal injuries. Traumatic brain injuries, including concussions, are more common than spinal injuries. Both injury types are most commonly related to a rider fall from a horse. Spinal injuries are less common but are associated with potentially significant neurological morbidity when spinal cord injury occurs. An improved understanding of preventable injury mechanisms, increased certified helmet use, improved helmet technologies, and educational outreach may help to address the risk of head and spinal injuries in equestrian sports.


Assuntos
Traumatismos em Atletas/prevenção & controle , Lesões Encefálicas Traumáticas/prevenção & controle , Traumatismos da Medula Espinal/prevenção & controle , Animais , Traumatismos em Atletas/epidemiologia , Lesões Encefálicas Traumáticas/epidemiologia , Dispositivos de Proteção da Cabeça , Cavalos , Fatores de Risco , Traumatismos da Medula Espinal/epidemiologia , Esportes
6.
PLoS One ; 15(1): e0227691, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31929580

RESUMO

A helmet is critical for preventing head injuries during motorcycle accidents. However, South Korean motorcyclists have a lower prevalence of wearing a helmet, compared to developed countries. Therefore, we aimed to evaluate whether helmet wearing was associated with the clinical outcomes in Korean motorcycle accidents. Data were obtained from the Emergency Department-based Injury In-depth Surveillance database 2011-2015. We considered the patients had experienced a motorcycle accident and were only diagnosed with a craniocerebral trauma (CCT). The primary outcome was mortality and the secondary outcomes were the severity and hospitalization duration. The patients were separated whether they were wearing a helmet and the outcomes were compared using multivariate logistic regression after propensity score matching (PSM). Among 1,254,250 patients in the database, 2,549 patients were included. After PSM, 1,016 patients in each group were matched. The univariate analyses revealed that helmet wearing was associated with lesser severity (P < 0.001) and shorter hospitalization (P < 0.001). The regression analysis revealed that mortality was also lower in a helmet-wearing group (odds ratio: 0.34, 95% confidence interval: 0.21-0.56). In conclusion, wearing a helmet may reduce the mortality from a CCT after a motorcycle accident and associated with lesser severity and shorter hospitalization.


Assuntos
Acidentes de Trânsito/mortalidade , Traumatismos Craniocerebrais/mortalidade , Dispositivos de Proteção da Cabeça , Motocicletas , Adulto , Traumatismos Craniocerebrais/prevenção & controle , Traumatismos Craniocerebrais/terapia , Monitoramento Epidemiológico , Feminino , Humanos , Tempo de Internação , Masculino , Pontuação de Propensão , República da Coreia , Estudos Retrospectivos , Índices de Gravidade do Trauma
7.
BMC Public Health ; 20(1): 78, 2020 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-31952485

RESUMO

BACKGROUND: Motorcycle full-coverage helmet use may reduce fatalities and head injuries. METHODS: This retrospective cohort study extracted injury data from eight level-I trauma centres in Taiwan and performed a questionnaire survey to investigate injuries sustained by motorcyclists for the period between January 2015 and June 2017. RESULTS: As many as 725 patients participated in the questionnaire survey and reported their helmet types or phone use during crashes. The results of multivariate logistic models demonstrated that nonstandard helmet (half or open-face helmet) use was associated with an increased risk of head injuries and more severe injuries (injury severity score ≥ 8). Drunk riding and phone use appeared to be two important risk factors for head injuries and increased injury severity. Anaemia was also found to be a determinant of head injuries." CONCLUSIONS: Compared to full-coverage helmets, nonstandard provide less protection against head injuries and increased injury severity among motorcyclists.


Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Traumatismos Craniocerebrais/prevenção & controle , Dispositivos de Proteção da Cabeça/estatística & dados numéricos , Motocicletas , Adolescente , Adulto , Idoso , Traumatismos Craniocerebrais/epidemiologia , Feminino , Humanos , Escala de Gravidade do Ferimento , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Taiwan/epidemiologia , Centros de Traumatologia , Adulto Jovem
8.
J Surg Res ; 245: 198-204, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31421362

RESUMO

BACKGROUND: Race and insurance status have been shown to predict outcomes in pediatric bicycle traumas. It is unknown how these factors influence outcomes in adult bicycle traumas. This study aims to evaluate the association, if any, between race and insurance status with mortality in adults. METHODS: This retrospective cohort study used the National Trauma Data Bank Research Data Set for the years 2013-2015. Multivariate logistic regression models were used to determine the independent association between patient race and insurance status on helmet use and on outcomes after hospitalization for bicycle-related injury. These models adjusted for demographic factors and comorbid variables. When examining the association between race and insurance status with outcomes after hospitalization, injury characteristics were also included. RESULTS: A study population of 45,063 met the inclusion and exclusion criteria. Multivariate regression demonstrated that black adults and Hispanic adults were significantly less likely to be helmeted at the time of injury than white adults [adjusted odds ratio of helmet use for blacks 0.25 (95% CI 0.22-0.28) and for Hispanics 0.33 (95% CI 0.30-0.36) versus whites]. Helmet usage was also independently associated with insurance status, with Medicare-insured patients [AOR 0.51 (95% CI 0.47-0.56) versus private-insured patients], Medicaid-insured patients [AOR 0.18 (95% CI 0.17-0.20)], and uninsured patients [AOR 0.29 (95% CI 0.27-0.32)] being significantly less likely to be wearing a helmet at the time of injury compared with private-insured patients. Although patient race was not independently associated with hospital mortality among adult bicyclists, we found that uninsured patients had significantly higher odds of mortality [AOR 2.02 (AOR 1.31-3.12)] compared with private-insured patients. CONCLUSIONS: Minorities and underinsured patients are significantly less likely to be helmeted at the time of bicycle-related trauma when compared with white patients and those with private insurance. Public health efforts to improve the utilization of helmets during bicycling should target these subpopulations.


Assuntos
Ciclismo/lesões , Disparidades em Assistência à Saúde/estatística & dados numéricos , Grupos Minoritários/estatística & dados numéricos , Ferimentos e Lesões/mortalidade , Adolescente , Adulto , Afro-Americanos/estatística & dados numéricos , Idoso , Conjuntos de Dados como Assunto , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Feminino , Dispositivos de Proteção da Cabeça/estatística & dados numéricos , Hispano-Americanos/estatística & dados numéricos , Mortalidade Hospitalar , Hospitalização/estatística & dados numéricos , Humanos , Escala de Gravidade do Ferimento , Cobertura do Seguro/estatística & dados numéricos , Seguro Saúde/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Sistema de Registros/estatística & dados numéricos , Estudos Retrospectivos , Resultado do Tratamento , Estados Unidos/epidemiologia , Ferimentos e Lesões/diagnóstico , Ferimentos e Lesões/terapia , Adulto Jovem
10.
J Vet Emerg Crit Care (San Antonio) ; 30(1): 41-49, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31872531

RESUMO

OBJECTIVE: To evaluate arterial blood gas parameters and pulmonary radiography, before and after provision of continuous positive airway pressure (CPAP) via a pediatric helmet in dogs with acute hypoxemic respiratory failure. DESIGN: Single-center, observational study conducted from 2016 to 2017. SETTING: University teaching hospital. ANIMALS: Seventeen dogs presenting with clinical signs compatible with respiratory failure, confirmed by arterial blood gas analyses. INTERVENTIONS: For each animal arterial blood samples and thoracic radiographs were performed at arrival (T0 ). Hypoxemic dogs (PaO2  <80 mm Hg), without evidence of pneumothorax or pleural effusion, received CPAP ventilation via a pediatric Helmet for at least 1 hour. At the end of CPAP ventilation, a second arterial blood gas analysis was performed at room air (T1 ). The F-shunt was also calculated. MEASUREMENT AND MAIN RESULTS: Respiratory rate, heart rate and rhythm, mean blood pressure, mucosal membrane color, and rectal temperature were recorded. Tolerance to the helmet was evaluated using a predetermined scoring system. Two dogs were excluded from the study for low tolerance to the helmet. In 15 of 17 dogs, a significant difference between T0 and T1 was noted for PaO2 (60.84 ± 3 mm Hg vs 80.2 ± 5.5 mm Hg), P(A-a)O2 (52.4 ± 4.4 mm Hg vs 35.2 ± 6 mm Hg), PaO2 /FiO2 (289.7 ± 14.3 vs 371 ± 21), and %SO2 (91.3 vs 98.8). In 15 of 17 dogs, the helmet was well tolerated. F-shunt significantly decreased following provision of CPAP (37%; range, 8.4-68% vs 6%; range, -5.6-64.3%). CONCLUSION: The use of a pediatric helmet appears to be a suitable device for delivery of CPAP in dogs with hypoxemic acute respiratory failure. The device appears to be reasonably tolerated and improved oxygenation in most dogs.


Assuntos
Pressão Positiva Contínua nas Vias Aéreas/veterinária , Doenças do Cão/terapia , Insuficiência Respiratória/veterinária , Animais , Gasometria/veterinária , Pressão Positiva Contínua nas Vias Aéreas/instrumentação , Doenças do Cão/sangue , Cães , Desenho de Equipamento , Feminino , Dispositivos de Proteção da Cabeça , Masculino , Insuficiência Respiratória/terapia , Resultado do Tratamento
11.
Accid Anal Prev ; 134: 105297, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31683233

RESUMO

The motorcyclist is exposed to the risk of falling and impacting ground head-first at a wide range of travelling speeds - from a speed limit of less than 50 km/h on the urban road to the race circuit where speed can reach well above 200 km/h. However, motorcycle helmets today are tested at a single and much lower impact speed, i.e. 30 km/h. There is a knowledge gap in understanding the dynamics and head impact responses at high travelling speeds due to the limitation of existing laboratory rigs. This study used a finite element head model coupled with a motorcycle helmet model to simulate head-first falls at travelling speed (or tangential velocity at impact) from 0 to 216 km/h. The effect of different falling heights (1.6 m and 0.25 m) and coefficient of frictions (0.20 and 0.45) between the helmet outer shell and ground were also examined. The simulation results were analysed together with the analytical model to better comprehend rolling and/or sliding phenomena that are often observed in helmet oblique impacts. Three types of helmet-to-ground interactions are found when the helmet impacts ground from low to high tangential velocities: (1) helmet rolling without slipping; (2) a combination of sliding and rolling; and (3) continuous sliding. The tangential impulse transmitted to the head-helmet system, peak angular head kinematics and brain strain increase almost linearly with the tangential velocity when the helmet rolls but plateaus when the helmet slides. The critical tangential velocity at which the motion transit from the rolling regime to the sliding regime depends on both the falling height and friction coefficient. Typically, for a fall height of 1.63 m and a friction coefficient of 0.45, the rolling/sliding transition occurs at a tangential velocity of 10.8 m/s (38.9 km/h). Low sliding resistance in helmet design, i.e. by the means of a lower friction coefficient between the helmet outer shell and ground, has shown a higher reduction of brain tissue strain in the sliding regime than in the rolling regime. This study uncovers the underlying dynamics of rolling and sliding phenomena in high-speed oblique impacts, which largely affect head impact biomechanics. Besides, the study highlights the importance of testing helmets at speeds covering both the rolling and sliding regime since potential designs for improved head protection at high-speed impacts can be more distinguishable in the sliding regime than in the rolling regime.


Assuntos
Fricção , Dispositivos de Proteção da Cabeça , Motocicletas/estatística & dados numéricos , Aceleração , Acidentes de Trânsito/classificação , Fenômenos Biomecânicos/fisiologia , Traumatismos Craniocerebrais/etiologia , Traumatismos Craniocerebrais/prevenção & controle , Humanos , Fatores de Risco
12.
Accid Anal Prev ; 134: 105319, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31706186

RESUMO

The continuous motorization of traffic has led to a sustained increase in the global number of road related fatalities and injuries. To counter this, governments are focusing on enforcing safe and law-abiding behavior in traffic. However, especially in developing countries where the motorcycle is the main form of transportation, there is a lack of comprehensive data on the safety-critical behavioral metric of motorcycle helmet use. This lack of data prohibits targeted enforcement and education campaigns which are crucial for injury prevention. Hence, we have developed an algorithm for the automated registration of motorcycle helmet usage from video data, using a deep learning approach. Based on 91,000 annotated frames of video data, collected at multiple observation sites in 7 cities across the country of Myanmar, we trained our algorithm to detect active motorcycles, the number and position of riders on the motorcycle, as well as their helmet use. An analysis of the algorithm's accuracy on an annotated test data set, and a comparison to available human-registered helmet use data reveals a high accuracy of our approach. Our algorithm registers motorcycle helmet use rates with an accuracy of -4.4% and +2.1% in comparison to a human observer, with minimal training for individual observation sites. Without observation site specific training, the accuracy of helmet use detection decreases slightly, depending on a number of factors. Our approach can be implemented in existing roadside traffic surveillance infrastructure and can facilitate targeted data-driven injury prevention campaigns with real-time speed. Implications of the proposed method, as well as measures that can further improve detection accuracy are discussed.


Assuntos
Aprendizado Profundo , Dispositivos de Proteção da Cabeça/estatística & dados numéricos , Motocicletas/estatística & dados numéricos , Acidentes de Trânsito/estatística & dados numéricos , Adulto , Cidades , Coleta de Dados/métodos , Humanos , Masculino , Mianmar
15.
South Med J ; 112(10): 547-550, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31583417

RESUMO

Sports-related encephalopathies are a growing concern among athletes who have experienced head trauma. Anxiety is heightened for the public and especially among parents of children playing contact sports. The most common neuropsychological conditions are concussions and traumatic encephalopathies. Concussions result from brain traumas that can be asymptomatic, but more serious concussions can include loss of consciousness, neurological abnormalities, and/or posttraumatic amnesias. Repetitive concussions lead to persistent brain pathology, known as chronic traumatic encephalopathies. This gradually progressive neurodegenerative disease frequently presents with cognitive and neurological deficits, which can result in significant parkinsonian features and dementia. Imaging studies may be noncontributory; however, diffusion tensor imaging, magnetic resonance spectroscopy, and functional magnetic resonance imaging can detect changes indicative of these encephalopathies. Progressive neuronal degeneration with tau proteins are documented on pathological examination. Prevention, early diagnosis, and proper treatment are the recommended approach to these conditions.


Assuntos
Traumatismos em Atletas/prevenção & controle , Concussão Encefálica/prevenção & controle , Encefalopatia Traumática Crônica/prevenção & controle , Traumatismos em Atletas/diagnóstico , Traumatismos em Atletas/patologia , Traumatismos em Atletas/terapia , Concussão Encefálica/diagnóstico , Concussão Encefálica/patologia , Concussão Encefálica/terapia , Encefalopatia Traumática Crônica/diagnóstico , Encefalopatia Traumática Crônica/patologia , Encefalopatia Traumática Crônica/terapia , Dispositivos de Proteção da Cabeça , Educação em Saúde , Humanos , Equipamento de Proteção Individual , Volta ao Esporte/normas
16.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue ; 31(9): 1118-1122, 2019 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-31657336

RESUMO

OBJECTIVE: To systematically evaluate the clinical efficacies of Helmet non-invasive ventilation and oxygen therapy on patients with hypoxemic respiratory failure. METHODS: The randomized controlled trials (RCTs) for comparison of efficacy between Helmet non-invasive ventilation and oxygen therapy for treatment of patients with hypoxemic respiratory failure published by Wanfang database, China National Knowledge Infrastructure (CNKI), China Biology Medicine (CBM), PubMed, Embase, Cochrane Library and Web of Science were retrieved. The retrieval time was from the establishment of database to February 1st, 2019. The indexes of the study outcomes included oxygenation index, arterial partial pressure of carbon dioxide (PaCO2), endotracheal intubation rate, hospital mortality and intolerance rate. Literature search and data extraction was performed separately by two researchers. Quality assessment of literature was conducted according to the risk of bias criterion provided by Cochrane collaboration net. The extractive data were Meta-analyzed by RevMan 5.1.0. Funnel plot and Egger regression analysis was employed to detect publication bias. RESULTS: Six RCTs including 5 English studies and 1 Chinese study were selected. Finally, 547 patients were enrolled, with 270 patients in Helmet non-invasive ventilation group and 277 in oxygen therapy group. The study quality assessment revealed that the overall risk of bias was low, and no publication bias was detected by the funnel plot and Egger regression analysis. Meta-analysis showed that the oxygenation index in Helmet non-invasive ventilation group was significantly higher than that in oxygen therapy group [mean difference (MD) = 73.47, 95% confidence interval (95%CI) was 52.01 to 94.92, P = 0.000 01], and PaCO2 (MD = -2.46, 95%CI was -4.54 to -0.39, P = 0.02), endotracheal intubation rate [relative risk ratio (RR) = 0.38, 95%CI was 0.20 to 0.73, P = 0.004] and hospital mortality (RR = 0.35, 95%CI was 0.19 to 0.65, P = 0.000 8) in Helmet non-invasive ventilation group were significantly lower than those in oxygen therapy group. There was no significant difference in patient's intolerance between the two groups (RR = 2.38, 95%CI was 0.74 to 7.67, P = 0.15). CONCLUSIONS: Compared with oxygen therapy, the Helmet non-invasive ventilation used for treatment of patients with hypoxemic respiratory failure can effectively improve the oxygenation index, decrease the PaCO2, reduce the endotracheal intubation rate and hospital mortality, and the patients are well tolerated to the Helmet method.


Assuntos
Ventilação não Invasiva , Insuficiência Respiratória , China , Dispositivos de Proteção da Cabeça , Humanos , Oxigênio , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
17.
N Z Med J ; 132(1502): 25-39, 2019 09 20.
Artigo em Inglês | MEDLINE | ID: mdl-31563925

RESUMO

AIM: To assess the attitudes of mountain bikers to the use of protective equipment and quantify the use of such equipment. METHOD: This was a prospective cohort study using an online questionnaire, offered to bikers participating in a series of Enduro races. The attitudes towards various factors that might contribute to a rider's choice to use protective equipment were quantified based on their responses to the questions. The actual reported use of various types of protective equipment was the outcome measure. The correlations between the factors and actual use were analysed for statistical significance, to assess their relative importance. RESULTS: Equipment use was similar in racing and non-racing settings and could be increased. 55% had experienced an injury requiring a week or more off work. Perceptions of the benefits, costs, cues, comfort and potential injury severity proved to be well correlated with the choice to use equipment, while harm, danger and exposure to media influences did not.


Assuntos
Traumatismos em Atletas , Ciclismo , Dispositivos de Proteção da Cabeça , Montanhismo , Serviços Preventivos de Saúde , Comportamento de Redução do Risco , Adulto , Traumatismos em Atletas/epidemiologia , Traumatismos em Atletas/etiologia , Traumatismos em Atletas/prevenção & controle , Ciclismo/psicologia , Ciclismo/estatística & dados numéricos , Feminino , Dispositivos de Proteção da Cabeça/normas , Dispositivos de Proteção da Cabeça/estatística & dados numéricos , Promoção da Saúde/organização & administração , Humanos , Masculino , Montanhismo/psicologia , Montanhismo/estatística & dados numéricos , Nova Zelândia , Serviços Preventivos de Saúde/métodos , Serviços Preventivos de Saúde/organização & administração , Medição de Risco , Inquéritos e Questionários , Índices de Gravidade do Trauma
19.
Aerosp Med Hum Perform ; 90(10): 834-840, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31558191

RESUMO

BACKGROUND: The aim of the study was to determine the characteristics of cervical muscle activity in different head postures when using helmet-mounted display in one fighter vs. two aircraft air combat within visual range (WVR).METHODS: Cervical EMG was measured with eight F/A-18 pilots using the Joint Helmet Mounted Cueing System (JHMCS) during air combat maneuvering. In-flight Gz acceleration and continuous head position were recorded. EMG activity is divided and presented in a matrix with three-class rotation and five-class flexion-extension postures.RESULTS: The mean muscle activity in sternocleidomastoids and cervical extensors was 28.9% of maximal voluntary contraction (MVC) and 44.8% MVC, respectively. Cervical flexor and extensor muscles are subjected to loading over MVC during high Gz sorties. Cervical rotation combined with extension exceeded muscle force-producing capacity during high Gz, resulting in a decline in muscle activity.DISCUSSION: Awkward postures, especially rotational ones, are more prone to increase loading over muscles' capacity. Overloading of muscles increases the risk of muscular and ligamentous injury. In addition, the lack of muscular support potentially leads to the Gz loading being transferred to spinal structures via intervertebral discs and the vertebral column. The JHMCS helmet seems to change the pattern of most loading muscles toward the extensor (posterior) neck muscles.Sovelius R, Mäntylä M, Heini H, Oksa J, Valtonen R, Tiitola L, Leino T. Joint helmet-mounted cueing system and neck muscle activity during air combat maneuvering. Aerosp Med Hum Perform. 2019; 90(10):834-840.


Assuntos
Medicina Aeroespacial , Dispositivos de Proteção da Cabeça/efeitos adversos , Músculos do Pescoço/fisiologia , Postura/fisiologia , Entorses e Distensões/etiologia , Adulto , Aviação , Sinais (Psicologia) , Eletromiografia , Humanos , Masculino , Militares , Contração Muscular/fisiologia , Músculos do Pescoço/lesões , Pilotos , Entorses e Distensões/fisiopatologia , Guerra
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