Impact of Environmental Factors on the ACL Injury Risk in Recreational Alpine Skiing.

In recreational alpine skiing, an ACL injury represents the most common injury. Skiing is a complex activity where the skier interacts with the environment, such as weather, snow conditions, temperature, etc. Thus, the aim of this study was to evaluate the potential impact of environmental factors on ACL injury risk in recreational alpine skiers. Among a cohort of 392 ACL-injured skiers and 392 uninjured controls matched for sex and skiing skill, environmental factors were collected by questionnaire. Factors included weather conditions, snow conditions, perceived temperature, and slope difficulty at the time-point of the accident (ACL-injured skiers) or of questioning during the ski day (uninjured controls).Multiple logistic regression revealed that in addition to age, five environmental factors were significantly predictive of an ACL injury: fresh snow (OR 10.5), grippy snow (OR 7.8), icy slope condition (OR 12.4), very cold/cold perceived temperature (OR 1.6), and skiing on easy slopes (OR 6.9). In conclusion, besides age, environmental factors such as fresh and grippy snow, icy slope conditions, low temperatures, and flat slopes are associated with an increased ACL injury risk in recreational alpine skiing. Those factors are at least partly modifiable and should be taken into consideration for preventive strategies.

Impact of ski geometry data and standing height ratio on the ACL injury risk and its use for prevention in recreational skiers.

OBJECTIVES: To evaluate the impact of ski geometry data and standing height ratio on anterior cruciate ligament (ACL) injury risk of male and female recreational skiers. METHODS: A retrospective questionnaire-based, case-control study of ACL-injured and uninjured recreational skiers was conducted during six consecutive winter seasons. Ski geometry data (ski length, side-cut radius, widths of the tip, waist and tail) were recorded from each participant's skis. Standing heights at the front and rear components of the ski binding were measured with a digital sliding calliper, and the standing height ratio between the front and rear was calculated. RESULTS: A total of 1817 recreational skiers participated in this study, of whom 392 (21.6%) sustained an ACL injury. Multiple logistic regression analysis indicates a higher age, a lower skill level and riskier behaviour as independent individual risk factors associated with an ACL injury. An increase in ski length, tip width of the ski, standing height at the rear ski binding component, and in standing height ratio were found to be independent equipment-related risk factors for an ACL injury. CONCLUSION: Reduced ski length, narrower ski tip width, lower rear standing height and a lower standing height ratio (ie, rear component of the ski binding is more elevated compared with the front component) were associated with a reduced likelihood for ACL injury. When buying or renting skis, these parameters could be considered to reduce the likelihood of ACL injury in recreational skiers.

Ski-geometric parameters do not differ between ACL injury mechanisms in recreational alpine skiing.

PURPOSE: It is not known so far if ski-equipment-related factors differ between the ACL injury mechanisms, potentially influencing the circumstances and causes of falling, finally resulting in ACL injury. More specifically focusing on the injury mechanisms will provide a deeper understanding of injury causation. The aim of the study was to evaluate whether ACL injury mechanisms in recreational alpine skiing differ with regard to ski-geometric parameters, self-reported circumstances and causes of accident and injury severity. METHODS: Among a cohort of 392 ACL-injured (57.9% females) skiers, age, sex, height, weight, skill level, risk-taking behavior, circumstances and causes of accident, and ACL injury severity were collected by questionnaire. Additionally, patients had to recall their type of fall (ACL injury mechanism) by classifying forward and backward falls with and without body rotation. Ski length, side cut radius and widths of the tip, waist and tail were directly notated from the ski. RESULTS: The forward fall with body rotation was the most common reported ACL injury mechanism (63%). A riskier behavior was associated with forward falls without body rotation. Ski-geometric parameters did not significantly influence the type of ACL injury mechanism. Regarding accident characteristics, catching an edge of the ski was more frequent (p < 0.001) the cause for forward falls (75% and 67%) when compared to the backward falls (46 and 15%) and executing a turn was the most frequent action in all falls (39-68%). A complete rupture of the ACL (66-70%) was more commonly reported than a partial tear (30-34%) among all four non-contact ACL injury mechanisms (n.s.). CONCLUSION: In contrast to risk-taking behavior and accident characteristics, ski-geometric parameters and injury severity do not significantly differ between ACL injury mechanisms in recreational skiing. Thus, an individual skiing style seems to have more impact on ACL injury mechanisms than ski equipment. Future studies should evaluate potential effects of ski geometry on the incidence of ACL injury. LEVEL OF EVIDENCE: III.

In recreational alpine skiing, the ACL is predominantly injured in all knee injuries needing hospitalisation.

PURPOSE: The knee joint still represents the most frequent anatomical injury location accounting for about one-third of all injuries in recreational alpine skiers. However, comprehensive information on current knee injury patterns in this populations is sparse. METHODS: During the winter seasons 2016/17 and 2019/20, this retrospective questionnaire-based study was conducted in an Austrian sportclinic situated in a large ski area. Among a cohort of 282 recreational skiers (51.8% females), all injuries were diagnosed by the use of magnetic resonance imaging. Additionally, data were recorded on anthropometric characteristics, the perceived speed at the moment of injury, type of fall, physical fitness, self-reported skill level and risk-taking behaviour. RESULTS: The anterior cruciate ligament (ACL) was injured in all knee injuries recorded. Of the total study sample, 64.5% (n = 182) were ACL injuries with concomitant injuries and about 35.5% (n = 100) were isolated ACL injuries, not involving any other structures of the knee joint. In general, most common concomitant injury diagnoses among ACL-injured recreational alpine skiers were injuries of the medial collateral ligament (MCL) (n = 92, 50.5%), medial meniscus (MM) (n = 73, 40.1%) and lateral collateral ligament (LCL) (n = 41, 22.5%). No significant differences regarding additionally recorded characteristics were found between ACL-injured individuals with concomitant injuries and those with isolated ACL injury. CONCLUSIONS: Whereas, before the introduction of carving skis, the MCL was reported being the most common injured part of the knee, currently, the majority of knee injuries are ACL injuries accompanied by injury of other knee joint structures, i.e. the MCL, MM and LCL. LEVEL OF EVIDENCE: Level III.

Is ski boot sole abrasion a potential ACL injury risk factor for male and female recreational skiers?

OBJECTIVES: To evaluate the potential impact of ski boot sole abrasion on the ACL injury risk of recreational skiers. METHODS: During the past two winter seasons 2016/17 and 2017/18, this retrospective case-control study was conducted in one Austrian ski area. Among a cohort of 148 ACL-injured (51.4% females) and 455 uninjured recreational skiers (43.3% females), age, sex, height, weight, and self-reported skill level were collected by questionnaire, ski length and sidecut radius were notated and sole abrasion of the toe and heel piece of the ski boot was measured using a digital caliper. RESULTS: ACL-injured skiers showed a higher proportion of female (51.4% vs 43.3%, P < 0.001) and less skilled skiers (48.6% vs 20.9%, P < 0.001), and ski length to height ratio was higher (94.7 ± 3.7 vs 93.8 ± 5.0%, P = 0.019) compared to uninjured skiers. ACL-injured skiers used ski boots of greater abrasion at the toe (4.8 ± 1.8 vs 2.4 ± 2.5 mm, P < 0.001) and heel piece (5.4 ± 1.8 vs 3.3 ± 2.3 mm, P < 0.001) compared to controls. Multivariate regression analysis revealed, beside female sex (OR 6.0, 95% CI, 3.1-11.5, P < 0.001), lower skill level (OR 3.2, 95% CI, 1.9-5.4, P < 0.001) and ski length to height ratio (OR 1.1, 95% CI, 1.0-1.2, P < 0.001), sole abrasion at the toe (OR 1.8, 95% CI, 1.5-2.1, P < 0.001) and heel piece (OR 1.4, 95% CI, 1.2-1.6, P < 0.001) to be independently associated with an ACL injury among recreational alpine skiers. CONCLUSIONS: Based on the underlying findings, ski boot sole abrasion was found to be an independent risk factor and may contribute to an increased ACL injury risk.

Long-term effect of migration background on the development of physical fitness among primary school children.

BACKGROUND: Children with a low socioeconomic status and migration background are more likely to exhibit unfavorable health behavior patterns and higher BMI scores as well as lower physical activity and physical fitness. AIM: To evaluate the effect of migration background on the development of physical fitness among primary school children from first to third grade. METHODS: In this longitudinal study, height, weight, and physical fitness of primary school children from Tyrol/Austria were measured five times over a period of 2.5 years using the German motor performance test DMT 6-18 consisting of eight items testing different subdomains of physical fitness. RESULTS: A total of 266 children (45% girls) participated in all five tests, of which 69 (26%) children reported to have a migration background (MB). Mixed-model ANOVA did not reveal a significantly different development of physical fitness (according to the mean total Z-score of DMT 6-18) over time, P = 0.883, partial ƞ2  < 0.01. However, children with MB showed significantly lower physical fitness compared to children without MB, P < 0.001, partial ƞ2  = 0.06. Controlling for BMI and age did not alter the interpretation of the results. Analyses of the single test items revealed significant differences in motor tests involving strength and endurance. CONCLUSION: Primary school children with and without MB significantly increased their physical fitness over time in a comparable manner. However, children with MB showed a significantly lower physical fitness at all test time points, which was only partly explained by a higher mean BMI in children with MB. Children with MB outreached the mean baseline fitness level of children without MB not until the fourth test time point, that is after two years. Therefore, a special focus on physical fitness particularly including strength and endurance capacities should be directed to children with MB already in young ages.

Prevalence and potential risk factors of flight-related neck, shoulder and low back pain among helicopter pilots and crewmembers: a questionnaire-based study.

BACKGROUND: Flight-related neck, shoulder and low back pain are the most common musculoskeletal disorders among helicopter pilots and their crewmembers, thus becoming a growing concern. Information on the combined prevalence of these types of pain and related risks are scarce. The aim of this study was therefore to estimate pain prevalence and to evaluate potential risk factors for neck pain among helicopter pilots and crewmembers within the armed forces, the airborne police and airborne rescue organizations in Austria. METHODS: Among a cohort of 104 helicopter pilots and 117 crewmembers (69.8% compliance), demographics, flying experience, use of Night Vision Goggles (NVG), helicopter type flown, prevalence and intensity of musculoskeletal symptoms (pain was defined as any reported pain experience, ache or discomfort) were collected by an online-based questionnaire. RESULTS: For helicopter pilots the 12-month prevalence of neck pain was 67.3%, followed by low back (48.1%) and shoulder pain (43.3%). Among crewmembers, the 12-month pain prevalence were 45.3, 36.8 and 30.8% among the neck, lower back and shoulder, respectively. During this period, 41.8% of these helicopter pilots had experienced 8-30 pain days in the areas of neck (45.7%), shoulder (37.8%) and lower back (42.0%) whereas 47.8% of crewmembers self-reported 1-7 days of neck (54.7%), low back (44.2%) and shoulder (44.4%) pain in the previous year. The 3-month prevalence of neck pain was 64.4% followed by low back (42.3%) and shoulder pain (38.5%) for helicopter pilots. Among crewmembers, 41.9% suffered from neck, 29.9% from low back and 29.1% from shoulder pain the previous 3 months. Multivariate regression analysis revealed NVG use (OR 1.9, 95% CI, 1.06-3.50, p = 0.032), shoulder pain (OR 4.9, 95% CI, 2.48-9.55, p < 0.001) and low back pain (OR 2.3, 95% CI, 1.21-4.31, p = 0.011) to be significantly associated with neck pain. CONCLUSIONS: The 12- and 3-month prevalence of neck, shoulder and low back is considerably high among both, helicopter pilots and crewmembers confirming the existence of this growing concern. The use of NVG devices, shoulder and low back pain in the previous 12 months represent independent risk factors for neck pain. These findings highlight the need for longitudinal studies.

The "FIFA 11+" injury prevention program improves body stability in child (10 year old) soccer players.

The suitability of the FIFA 11+ prevention programme to improve selected performance outcomes in children aged < 14 years has not been established yet. This study aimed to investigate the effects of the FIFA 11+ programme on jump ability and stability in 10-year-old child soccer players. Sixteen young soccer players (aged 10 years) were randomly assigned to a conventional or a FIFA 11+ warm-up group. During a 5-week training period with 2 sessions per week the FIFA 11+ group warmed up with the 11+ programme, whereas the control group subjects performed their usual warm-up programme (e.g. running exercises with dribbling and/or passing techniques included). After the warm-up, both groups performed the same training exercises during each session. Before and after the training period, standing long jump performance and body stability (S3 Check, unstable uniaxial platform) were assessed. Significant improvements in the stability index were found in both groups (5.6±1.1 to 3.5±1.0 and 5.5±0.8 to 4.0±1.5 for the FIFA 11+ and the control group, respectively, p<0.001, partial η²=0.886 for the training effect of the analysis of variance) with likely (qualitative inference analysis) greater improvements in the FIFA 11+ group compared to the control group (p=0.078, partial η²=0.205 for the training x group interaction effect of the analysis of variance). Training had no effect on standing long jump performance (p>0.05). Data indicate that in 10-year-old soccer players the FIFA 11+ programme may have the potential to improve stability. Thus, the FIFA 11+ programme might contribute to injury prevention and possibly to better soccer performance as well. This might especially apply if the programme is performed over a longer period and/or with more weekly training sessions. Based on the present results the inclusion of such a programme within the training practice of the child soccer player can be recommended.

Factors associated with self-reported failure of binding release among ACL injured male and female recreational skiers: a catalyst to change ISO binding standards?

BACKGROUND: Female recreational skiers have twice the rate of knee injuries and three time the rate of ACL injuries compared with their male counterparts. Female skiers suffering from a knee injury reported a significantly higher proportion of failure of binding release than knee injured male skiers. PURPOSE: To evaluate factors associated with failure of binding release among ACL injured male and female recreational skiers. STUDY DESIGN: Cohort study. METHODS: Among a cohort of 498 recreational skiers (68% females) suffering from an ACL injury (complete rupture or partial rupture), age, sex, height, weight, self-reported skill level and self-reported risk taking behaviour, gear origin, ski length, date of last binding adjustment, perceived speed at the moment of injury, type of fall, and failure of binding release of the ski of the injured knee, were collected by questionnaire. RESULTS: Failure of binding release was reported within 78% of cases and was significantly higher for females compared to males (83 vs 66%, p<0.001) with an adjusted OR of 2.7 (95% CI 1.7 to 4.4). A higher perceived speed at the moment of injury was significantly associated with a decreasing proportion of failure of binding release. A slow perceived speed was independently associated with failure of binding release (adjusted OR 2.0; 95% CI 1.2 to 3.5). There was a significantly higher proportion of failure of binding release during backward falling compared to forward falling (87 vs 72%, p=0.002); similarly, a higher proportion of failure of binding release occurred in cases of complete rupture compared with a partial tear of the ACL (81 vs 64%, p=0.001), respectively. CONCLUSIONS: Among this cohort of ACL-injured skiers, failure of binding release was significantly associated with female sex, a slow perceived speed at the moment of injury and complete rupture of the ACL.

Differences in Sensation Seeking Between Alpine Skiers, Snowboarders and Ski Tourers.

Despite different injury rates and injury patterns previous personality related research in the field of downhill winter sports did not subdivide between different alpine slope users. In this study, we tried to find out whether the personality trait sensation seeking differs between skiers, snowboarders and ski tourers. In a cross-sectional survey 1185 persons (726 alpine skiers, 321 snowboarders and 138 ski tourers comparable in age and sex) were electronically questioned with the sensation seeking scale (SSS-V) comprising the four factors thrill and adventure seeking, experiences seeking, disinhibition and boredom susceptibility. Kruskal-Wallis Tests revealed a significantly higher total score of the SSS-V for snowboarders in comparison to alpine skiers and ski tourers (H(2) = 41.5, p < 0.001). Ski tourers and snowboarders scored significantly higher in the dimensions "thrill- and adventure-seeking" and "experience-seeking" than alpine skiers. Furthermore, snowboarders showed higher scores in "disinhibition" related to alpine skiers and ski tourers and "boredom susceptibility" compared to alpine skiers. Data show differences in the personality trait sensation seeking in people practising different winter sports. As snowboarders showed higher SS-scores compared to alpine skiers and ski tourers prevention and information programs might benefit from a selective approach focusing on special characteristics of the respective group. Key pointsIt is the very first research trying to identify differences between different types of winter sport slope usersObtained results show higher sensation seeking scores in snowboardersThese results might stimulate new approaches in educational campaigns to reduce accident rates in winter sports.

Is There a Link Between Physical Activity and Alcohol use?

Physical activity (PA) is discussed as a protective factor as well as a risk factor for alcohol consumption. Therefore, this study aimed at exploring a potential relationship between these behaviors. In a population-based cross-sectional study of 15,474 people living in Austria physical activity, alcohol consumption and demographic variables were assessed. Regression analysis including age and gender revealed no significant relationship between PA and alcohol consumption for the total sample. More alcohol consumption was found in men with low PA-levels. Focusing on a part of the population who consumed alcohol the weekend before, men with high PA-levels reported more alcohol consumption in comparison to men with moderate PA-levels. This study does not support a common alcohol-physical activity relationship. Prevention programs to increase PA levels from low to moderate combined with a reduction of alcohol intake in men who regularly drink alcohol should be considered.

Validity, reliability, and invariance across sex of a German version of the Behavioral Regulation in Exercise Questionnaire.

Objective: Since there is no scientifically validated German version of the Behavioral Regulation in Exercise Questionnaire (BREQ-3), the aim of this study was to assess its psychometric parameters and invariance across sex in a sample of German-speaking young adults. The BREQ-3 is an instrument measuring the social and internal influences of motivation toward exercising. This tool is widespread within the scientific community and has been validated in several languages. Methods: A total of 271 participants (45% women; mean age = 20.67 ± 2.17 years; effect size ≥ 0.5) filled in the BREQ-3 at one time point, with a small sub-sample (n = 37) responding it a second time after 15 days. Confirmatory Factorial Analysis, Structural Modeling, and Intraclass Correlation Coefficient were used to examine the German version of the questionnaire. Results: Results highlighted a good fit of the six-dimensional model after the removal of two items (CFI = 0.912; SRMR = 0.0594; RMSEA = 0.064), as well as full invariance across sex (pχ2 = 0.218; ΔCFI < 0.01). Internal consistency and reliability were moderate to good. Conclusions: The 22-item German BREQ-3 is a scientifically valid instrument that can be used in cross-national studies dealing with social aspects of exercise behaviors.

Sex-specific analysis of hiking accidents in the Austrian Alps: a follow-up from 2015 to 2021.

Background: Hiking is one of the most popular leisure sport activities practiced in the Alps during the summer season, but bears the risk of mountain emergencies, accidents, and fatalities. This paper provides an updated analysis of hiking accidents for the years 2015 to 2021 in the Austrian Alps, thereby outlining fatal and non-fatal accident characteristics. Methods: For this retrospective analysis, mountain hiking accidents documented by the Austrian Alpine Police during a 7-year period were screened for potential exclusion criteria. The final sample size consisted of 7368 accidents and 7552 victims. The outcome measures were mainly specified by sex, age, injury degree, injury location, pathophysiological characteristics, and cause of injury. Results: The overall annual number of accidents showed a continuous increase from 428 in 2015 to 544 in 2021. In total, 7.1% of the total victims died during the 7-year period, with male hikers being significantly more affected than female hikers (m: 80.8%, f: 19.2%; p ≤ 0.001). The sex specific distribution for non-fatal hiking accidents was 55.9% in women and 44.1% in men. Male victims showed significantly more frequent cardiovascular events (m: 78.5%, f: 21.5%), multiple injuries (m: 60.2%, f: 39.8%), and wounds/blood loss (m: 57.4%, f: 42.6%) than female victims, whereas women showed more fractures (m: 31.5%, f: 68.5%) than men (p ≤ 0.001). Additionally, men were more likely to injure their abdomen/chest (3.7%), head (14.1%), and multiple body parts (26.5%), whereas women were more likely to injure their ankle or foot (42.3%). Finally, men were more likely to have an accident during the ascent (24.1%), whereas women during the descent (69.0%) (p ≤ 0.001). Conclusion: This paper provides the latest data and a deeper insight into sex-specific characteristics of mountain hiking accidents in the Austrian Alps.

Primary school children's health and its association with physical fitness development and health-related factors.

The health status (HS) of children is influenced by a variety of factors, including physical fitness (PF) or social and environmental characteristics. We present a 4-year longitudinal study carried out with 263 primary school children. PF was assessed yearly using the German Motor Performance Test 6-18. Demographic data, leisure time behavior and socioeconomic factors were collected using questionnaires for children and parents. Based on parents' ratings in year 4, children were categorized as either "very good health status" (VGHS) or "good health status or below" (GHSB). Children with VGHS (73%) showed a larger improvement of global PF (p < 0.001), a significantly higher proportion of being/playing outside (p < 0.001), significantly lower proportions of overweight (p < 0.001), of media availability in the bedroom (p = 0.011) and of daily media consumption > 2 h (p = 0.033) compared to children with GHSB. Regarding socio-economic factors, children with VGHS revealed significantly fewer parents with lower education (p = 0.002), lower physical activity levels (p = 0.030) and lower migration background (p < 0.001). Physical fitness (p = 0.019) and outdoors exercising (p = 0.050) were the only variables to provide significantly higher chances of perceiving one's own health as very good when tested within a complex model including all the variables studied in this work. Considering the little focus on PF in the current Austrian physical education curriculum and the favorable environmental features of the Tyrolean region, more emphasis should be given to promoting didactical and pedagogical approaches that allow schoolers to be active in the nature.

Life-style characteristics and cardiovascular risk factors in regular downhill skiers: an observational study.

BACKGROUND: Downhill skiing is part of active life style in many residents of Alpine regions. However, only very little information is available whether downhill skiing on a regular basis is associated with a healthier life style resulting in the reduction of major risk factors for cardiovascular diseases and memory deficits when compared to the general population. Thus, the aim of the study was to compare life-style characteristics and cardiovascular risk factors between regular downhill skiers and the general population. METHODS: Self-reported health and life-style data were collected by questionnaire from 1259 long-term downhill skiers (971 males, aged 57.3 ± 14.6 years; 288 females, aged 47.7 ± 16.4 years) and compared with data from the general population. RESULTS: Long-term skiers showed more favourable life-style characteristics and a better health status than the general population. Prevalences of hypercholesterolemia, systemic hypertension, diabetes, the frequency of mental stress and the occurrence of memory deficits declined with increasing yearly skiing frequency. CONCLUSION: Long-term alpine skiing on a regular basis may contribute to healthy aging by its association with a healthier life style.

Injuries in judo: a systematic literature review including suggestions for prevention.

BACKGROUND: There is limited knowledge on epidemiological injury data in judo. OBJECTIVE: To systematically review scientific literature on the frequency and characteristics of injuries in judo. METHODS: The available literature up to June 2013 was searched for prospective as well as retrospective studies on injuries in judo. Data extraction and presentation focused on the incidence rate, injury risk, types, location and causes of injuries. RESULTS: During the Olympic Games in 2008 and 2012, an average injury risk of about 11-12% has been observed. Sprains, strains and contusions, usually of the knee, shoulder and fingers, were the most frequently reported injuries, whereas being thrown was the most common injury mechanism. Severe injuries were quite rare and usually affected the brain and spine, whereas chronic injuries typically affected the finger joints, lower back and ears. The most common types of injuries in young judo athletes were contusions/abrasions, fractures and sprains/strains. Sex-differences data on judo injuries were mostly inconsistent. Some studies suggested a relationship between nutrition, hydration and/or weight cycling and judo injuries. Also, psychological factors may increase the risk of judo injuries. CONCLUSIONS: The present review provides the latest knowledge on the frequency and characteristics of injuries in judo. Comprehensive knowledge about the risk of injury during sport activity and related risk factors represents an essential basis to develop effective strategies for injury prevention. Thus, the introduction of an ongoing injury surveillance system in judo is of utmost importance.

Factors associated with the ability to estimate actual speeds in recreational alpine skiers.

OBJECTIVE: To measure on-slope speeds of alpine skiers and to compare their ability to accurately estimate their actual speed with regard to measured speed, age, sex, skill level, helmet use, and risk-taking behavior. METHODS: Skiing speeds of 416 adult skiers (62% men, 38% women) were measured with a radar speed gun. Skiers were interviewed about their age, sex, skiing ability, helmet use, and risk-taking behavior. Additionally, skiers had to estimate their measured speed as accurately as possible. The difference between estimated and measured speed was described as error of estimation (EE). RESULTS: Mean measured speed (±SD) of all participants was 48.2 (±14.3) km/h. Pearson correlation coefficient between the actual speed and the estimated speed was 0.57 (P < .001) for all participants. Skiers underestimated their measured speed on average by 5.8 km/h or 8.1%. A multiple hierarchical linear regression analysis revealed that when skiing speed is increased by 1 km/h the EE significantly decreases by 0.5 km/h. Male sex, higher skill level, risky skiing behavior, and younger age groups showed a significantly better ability to estimate skiing speed, whereas ski helmet use did not. CONCLUSIONS: Skiing speed, age, sex, skill level, and risk-taking behavior seem to influence the ability to estimate actual speeds in recreational alpine skiers.

Effects of helmet laws and education campaigns on helmet use in young skiers.

OBJECTIVE: Helmet-compulsory laws for young skiers, accompanied by educational campaigns, have recently been implemented in several countries. However, data regarding compliance to these interventions during adolescence are scarce. METHODS: In 2011, a questionnaire survey was performed among 10- to 16-year-old students in 62 Austrian secondary schools. RESULTS: A total of 2655 questionnaires were completed by 1376 males and 1279 females. Helmet use was reported in 99% of 10- to 15-year-old skiers (for whom helmets are mandatory) and in 91% of 16-year-old skiers (for whom helmets are not mandatory). CONCLUSION: Compliance with helmet laws, which were accompanied by educational campaigns, was very high among adolescent skiers. Nevertheless, helmet use decreased slightly during adolescence, and this decrease was particularly pronounced when helmet use was no longer mandatory. Sophisticated multifaceted interventions may have the potential to increase the use of ski helmets among individuals who refuse to wear helmets.

OBJECTIF: Des lois sur le port obligatoire du casque par les jeunes skieurs, accompagnées de campagnes de sensibilisation, ont récem-ment été adoptées dans plusieurs pays. Cependant, il existe très peu de données sur l'adhésion à ces interventions pendant l'adolescence. MÉTHODOLOGIE: En 2011, les élèves de dix à 16 ans de 62 écoles secondaires autrichiennes ont rempli un sondage par questionnaire. RÉSULTATS: Au total, 1 376 garçons et 1 279 filles ont rempli un total de 2 655 questionnaires. Ainsi, 99 % des skieurs de dix à 15 ans (pour qui le port du casque est obligatoire) et 91 % des skieurs de 16 ans (pour qui le port du casque n'est pas obligatoire) ont déclaré porter un casque. CONCLUSION: L'adhésion aux lois sur le port du casque, accompa-gnée de campagnes de sensibilisation, était très élevée chez les skieurs adolescents. Néanmoins, le port du casque a diminué légèrement pendant l'adolescence, et cette diminution était particulièrement pronon-cée lorsque le port du casque n'était plus obligatoire. Des interventions pluridimensionnelles élaborées permettraient peut-être d'accroître l'utilisation du casque chez les personnes qui refusent de le porter.