Risk of injury according to participation in specific physical activities: a 6-year follow-up of 14 356 participants of the SUN cohort

The effectiveness of customised 3D-printed insoles on perceived pain, comfort, and completion time among frequent Park Runners: Study protocol for a pragmatic randomised controlled trial (The ZOLES RCT)

BACKGROUND

Running, a popular recreational activity, often leads to the experience of pain and discomfort among participants impacting performance and participation longevity. The ZOLES trial evaluates customised 3D-printed insoles for reducing pain in frequent parkrunners aged 35 and over. An innovative process of foot-scanning and responses to questions relating to size, pain, discomfort, and previous medical conditions are combined leading to the production of personalised 3D-printed orthotics.

METHODS

The ZOLES trial is a pragmatic, outcome assessor blinded, randomised, controlled, superiority trial involving 200 recreational runners, randomised to receive either customised 3D-printed insoles (ZOLES) or to a "do-as-usual" control group. The study follows a robust protocol, ensuring adherence to established guidelines for clinical trials, and is based at St Mary's University, Twickenham, London. The primary outcome is change in running-related pain over a 10-week period, assessed using an 11-point Numeric Rating Scale. Secondary outcomes include overall pain and discomfort, running-related comfort, 5k-completion time, time-loss due to injuries, running exposure, and adherence to the intervention. A balanced-block randomisation process is stratified by sex and parkrun location, and an intention-to-treat analyses will be employed on all outcomes in the primary trial report. The trial includes a 52-week post-market surveillance to assess long-term effects of the customised insoles.

DISCUSSION

The ZOLES trial aims to provide insights into real-world applicability and effectiveness of customised 3D-printed insoles in reducing running-related pain and enhancing overall running experience. Despite the limitation of a subjective primary outcome measure without participant blinding, the methodological rigor, including external outcome assessment and data handling, we anticipate results that are academically credible and applicable in real-world settings The results of this trial may have important implications for runners, clinicians, and the sports footwear industry, as evidence for the use of individualised insoles to improve running experience and prevention of pain may become evident.

TRIAL REGISTRATION

The trial was pre-registered at ClinicalTrials.gov with the trial identifier NCT06034210 on September 4, 2023, and publicly posted on September 13, 2023 (https://clinicaltrials.gov/study/NCT06034210).

PROTOCOL VERSION

Version 1, September 27, 2023.

The longitudinal effects of the built environment on transportation and recreational walking, and differences by age and sex: systematic review protocol

BACKGROUND

In high-income countries, the prevalence of physical inactivity and non-communicable diseases is high, and it is now well-established that insufficient physical activity is a risk factor for non-communicable diseases. Walking for recreation and transportation are effective means of improving population levels of physical activity. Research finds that the built environment (BE) can encourage or discourage walking behaviour, and this association varies for different age groups and sexes. This systematic review aims to synthesise longitudinal evidence to better understand how the BE affects recreational and transportation walking for different age groups (above 64 years and 18-64 years) and sexes in high-income countries.

METHOD

We will use Scopus, PubMed, SPORTDiscus with Full Text (EBSCO), Business Source Complete (EBSCO), Art and Architecture Archive (Proquest), Avery Index to Architectural Periodicals (ProQuest), and Art, Design & Architecture Collection (ProQuest) databases to search for relevant studies. Reviewers will screen the search results according to pre-specified eligibility criteria for study inclusion in the review. Required data for the synthesis will be extracted from the included studies to answer the research questions. Further, the methodological quality of the studies included in this systematic review will be evaluated using an established instrument, and the resulting quality scores will be utilized in sensitivity analysis. The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) checklist will be followed when reporting the findings.

DISCUSSION

This review will identify BE attributes that are likely to influence transportation and recreational walking for younger and older adults and different sexes in high-income countries. The findings will help policymakers with making decisions around walkable built environments for older and younger adults and different sexes to keep them healthy.

TRIAL REGISTRATION

This protocol of the prospective systematic review is developed following PRISMA-P guidelines and is registered on the Prospective Register of Systematic Reviews (PROSPERO) (registration ID CRD42022351919).

Epidemiology of Dog Walking-Related Injuries among Adults Presenting to US Emergency Departments, 2001-2020

PURPOSE

Dog walking is a popular daily activity, yet information regarding its injury burden is limited. This study describes the epidemiology of injuries related to leash-dependent dog walking among adults presenting to US emergency departments from 2001 to 2020.

METHODS

A retrospective analysis was performed using the National Electronic Injury Surveillance System database to identify adults (≥18 yr) presenting to US emergency departments with leash-dependent dog walking-related injuries between 2001 and 2020. Outcomes included annual estimates of injury incidence, injury characteristics, and risk factors for sustaining a fracture or traumatic brain injury (TBI). Weighted estimates and 95% confidence intervals (CI) were generated using National Electronic Injury Surveillance System sample weights.

RESULTS

Between 2001 and 2020, an estimated 422,659 adults presented to US emergency departments with injuries related to leash-dependent dog walking. The annual incidence increased more than fourfold during this period ( n = 7282 vs n = 32,306, P < 0.001). Most patients were women (75%) and adults age 40 to 64 yr (47%), with a mean age of 53 ± 0.5 yr. Patients commonly injured their upper extremity (51%) and were injured while falling when pulled or tripped by the leash (55%). The three most common injuries were finger fracture (6.9%), TBI (5.6%), and shoulder sprain/strain (5.1%). On multivariate analysis, fracture risk among dog walkers was higher in adults age ≥65 yr (odds ratio [OR], 2.1; 95% CI, 1.8-2.5) and women (OR, 1.5; 95% CI, 1.3-1.7). Risk of TBI was also elevated among older dog walkers (OR, 1.6; 95% CI, 1.3-2.0).

CONCLUSIONS

Dog walking is associated with a considerable and rising injury burden. Dog owners should be informed of this injury potential and advised on risk-reduction strategies.

Cross-sectional study of gender differences in physical activity-related injuries amongst Chinese college students majoring in rehabilitation

The main objective of the paper was to explore the potential risk factors for physical activity-related injuries (PARI) amongst college students majoring in rehabilitation and to analyse gender differences. A random whole group sampling method was used to recruit freshmen to seniors aged 15-25 years from over 90 universities in China that offer rehabilitation. The total number of people included was 6,032, of which 1,989 were male and 4,043 were female. The underlying risk factors for PARI of different genders were assessed using a structured self-management questionnaire including sociodemographic characteristics, physical activity levels, risk-taking and protective behaviors, and PARI. Totally 6,032 questionnaires were obtained for final analysis, with 792 total number of injured persons (415 males, 377 females), the sum of the cumulative frequency of injuries to injured persons is 1,607 (881 males, 726 females) and a PARI risk of 0.27 (males: 0.44, females: 0.18; p < 0.001; sum of the cumulative frequency of injuries/total number of people surveyed/year). For male and female students, participation in sports teams, having a high level of PA as well as with antisocial behavior were risk factors for developing PARI. Regarding female students, regional differences was associated with elevated odds to suffer from PARI. The prevalence rates of PARI vary between male and female students. The research subjects were university students in rehabilitation. Compared to general college students, rehabilitation students have a certain knowledge base related to injuries, which defines the specificity and research value of this subjects. This study provides guidance for reducing PARI in students in rehabilitation and may provide a basis for developing future injury prevention mechanisms for university students in general.

Health challenges and acute sports injuries restrict weightlifting training of older athletes

Objectives

To quantify acute injuries sustained during weightlifting that result in training restrictions and identify potential risk factors or preventative factors in Master athletes and to evaluate potentially complex interactions of age, sex, health-related and training-related predictors of injuries with machine learning (ML) algorithms.

Methods

A total of 976 Masters weightlifters from Australia, Canada, Europe and the USA, ages 35–88 (51.1% women), completed an online survey that included questions on weightlifting injuries, chronic diseases, sport history and training practices. Ensembles of ML algorithms were used to identify factors associated with acute weightlifting injuries and performance of the prediction models was evaluated. In addition, a subgroup of variables selected by six experts were entered into a logistic regression model to estimate the likelihood of an injury.

Results

The accuracy of ML models predicting injuries ranged from 0.727 to 0.876 for back, hips, knees and wrists, but were less accurate (0.644) for shoulder injuries. Male Master athletes had a higher prevalence of weightlifting injuries than female Master athletes, ranging from 12% to 42%. Chronic inflammation or osteoarthritis were common among both men and women. This was associated with an increase in acute injuries.

Conclusions

Training-specific variables, such as choices of training programmes or nutrition programmes, may aid in preventing acute injuries. ML models can identify potential risk factors or preventative measures for sport injuries.

Maternal Pre-Pregnancy Nutritional Status and Physical Activity Levels and a Sports Injury Reported in Children: A Seven-Year Follow-Up Study

Objective: Our aim was to analyze dose–response associations between maternal pre-pregnancy body mass index and physical activity levels with childhood sports injury rates. Methods: Participants included pre-pregnant mothers (n = 4811) and their children at the age of 7 years (n = 3311). Maternal anthropometry (height, weight, and body mass index), time spent in physical activity, and education level were recorded. All sports injuries were defined as injuries reported in the past year by the children at the age of 7 years. Results: Children whose mothers were overweight/obese in the pre-pregnancy period were 2.04 (OR = 2.04, 95% CI = 1.12–3.71) times more likely to report a sports injury at the age of 7 years. Underweight mothers exhibited a 74% decrease in the odds of their children reporting a sports injury at follow-up (OR = 0.26, 95% CI = 0.10–0.68). Finally, an increase in maternal physical activity across the last three quartiles was associated with a lower odds of sports injuries. Conclusions: The risk of reporting a sports injury was greater for children whose mothers were overweight/obese in the pre-pregnancy period. However, there was a lower risk with both maternal underweight status and increasing minutes of physical activity.

[Comparison of acute sports injury between recreational skiers and skiers]

OBJECTIVE

To compare and analyze the difference between the injuries of recreational skiers in public ski resorts and those of skiing athletes in official competitions, and to explore the suggestions of medical insurance for these two types of skiers.

METHODS

The injury data of recreational skiers in Chongli District, Zhangjiakou City, Hebei Province during 2018-2019 and 2019-2020 snow seasons, and the injury data of skiers in two official international skiing competitions during 2019-2020 snow season and domestic test events in Chongli District of 2021 Winter Olympic Games were analyzed retrospectively, and the similarities and differences were compared.

RESULTS

A total of 1 187 injuries occurred to recreational skiers in the two public ski resorts during the 2018-2019 snow season, with an injury rate of 0.3%.There were 1 277 injury sites in total, and the most frequent injury sites were head and neck (230 cases, 18.0%), followed by knee joint (204 cases, 16.0%) and lower extremity (131 cases, 10.3%). Thirty-one skiers were injured in the two official international skiing competitions in the 2019-2020 and 2020-2021 snow season, and in the domestic test competitions in the 2021 Winter Olympic Games, and the injury rates were 11.5%, 17.2% and 12.0%, respectively. There were 37 injury sites in total, among which 11 (29.7%) were in the head and neck, followed by 6 (16.2%) in the knee joint and 5 (13.6%) in the chest, rib and abdomen.

CONCLUSION

In order to better guarantee the safety of skiers and timely provide corresponding medical help, safety facilities and technical guidance should be added to the snow resort for leisure skiing, and medical stations should be set up in the snow resort. As the formal ski racing for skiing athletes during the game has 30 to 80 times higher injury ratesthan recreational skiers, and compared with the recreational skiing, head and neck injury rate is higher, and the damage is much heavier, more complete first aid facilities and experienced medical workers are, needed so the field should be equipped with the circuit inside the quantities, track fixed outside the clinic, surrounding referral hospitals set up trauma centers to provide athletes with more timely medical care.

When Do Individuals Get More Injured? Relationship between Physical Activity Intensity, Duration, Participation Mode, and Injury

The present study examines the association between physical activity (PA) participation modes (i.e., family, friends, club members, and alone), PA volumes (i.e., intensity and duration), gender, and injury. A total of 9000 Koreans aged 10-89 years participated in the Korean Survey of Citizens' Sports Participation project. However, participants who did not respond to a question regarding PA participation modes (n = 2429) and those under 18 years old (n = 489) were excluded from this study. Analysis of variance (ANOVA) was used to compare the groups' characteristics and the association between PA participation modes and injury was demonstrated by conducting multinomial logistic regression analysis. The risk of injury was significantly higher in the friend and club member groups than in the alone group. In addition, PA intensity and gender were critical risk factors of injury, while PA duration showed no significant results. The results indicated a strong association between PA participation modes, PA intensity, gender, and injury, and an interesting finding is that more injuries derived from a higher intensity of PA, not from a longer duration of PA. Therefore, this present study directly documented that considerable attention should be placed on the factors that affect injuries, such as gender and PA intensity, to prevent unpredictable injury and encourage potential participants to exercise with diverse participation modes and appropriate intensity.

[Role of ski injury treatment system between the ski resort medical station of Winter Olympics and the nearby medical care hospital]

OBJECTIVE

To make a retrospective analysis of the situation and process of treating skiers' injuries in the medical station of the Wanlong ski resort in Chongli and the nearest treatment hospital, and to provide a basis for the establishment and optimization of the treatment process between the medical station of the Winter Olympics ski resort and the nearest treatment hospital, and to gain experience for medical security of mass skiing.

METHODS

The data of all ski injuries in Chongli District were collected from the medical station of the Wanlong ski resort during the 2018-2019 snow season (November 2018 to April 2019) and the nearest treatment hospital during two periods (March 2019, and November 2019 to January 2020). The differences of injury causes, injury types, injury sites, and treatment effects of the injured skiers were analyzed.

RESULTS

A total of 755 cases of ski injuries were recorded in the medical station of Wanlong ski resort, the estimated incidence of injury was 2.02‰ per day. The nearest treatment hospital treated a total of 838 injured skiers from different ski resorts in Chongli District in the two periods. In the records of the ski resort medical station, the main causes of injury were technical defects and turnovers (53.6%). Knee joint injury rate was the highest (18.7%), followed by head and neck (12.9%) and lower limb (11.9%). The number of injuries on intermediate roads was the highest (40.0%), the greatest number of injuries (81.2%) occurred when the age of skiing was less than 5 years. In the records of the nearest treatment hospital, the injury types were fracture or fissure fracture, contusion and trauma, and muscle and soft tissue injury, accounting for 30.5%, 27.4%, and 21.2% respectively. 9.6% of the injured took the snow field ambulance to the hospital, and 50% of them suffered from fractures or fissure fractures.

CONCLUSION

The injury rate of skiing in the 2018-2019 snow season of the Wanlong ski resort in Chongli was higher than that reported by foreign literature. Severe trauma (including severe fractures and concussions) could occur and patients needed to be transferred to the nearest hospital for treatment. The ski resort medical station and the nearest treatment hospital should be strengthened with adequate medical staff and equipment, and promote cooperation in the timely referral of seriously injured patients, the organization and construction of ski patrols and the medical security of large-scale competitions, thus playing an important role in forming a grassroots network of medical security and treatment system for skiing.

Effects of Combination Movement Patterns Quality and Physical Performance on Injuries in Young Athletes

Identifying the factors associated with the injuries is crucial to prevention, enabling apply effective methods to reduce injuries frequency. This is especially important for young athletes for whom an injury may impair development or prematurely end a sports career. Therefore, the objective of this study is to examine if the movement patterns quality and physical performance simultaneously affected injury occurrence in young athletes. The participants were 176 athletes aged 22.44 ± 1.64. The injury data were collected from the 12 months retrospective period. The functional movement screen test was conducted to assess the quality of movement patterns, and the physical performance tests were done for assessing strength, power, flexibility, and balance. Results showed relationships between movement patterns quality and flexibility with injuries. The receiver operating characteristic curve demonstrated growing injury frequency for 14 ≥ FMS and 21 cm ≥ Sit-and-reach test. Rank Transform ANOVA revealed a simultaneous effect of movement quality (F = 11.5361; p = 0.0008) and flexibility (F = 8.0514; p = 0.0050) on an injury. Post-hoc tests indicated that the group with low-quality movement patterns combined with a low level of flexibility is the most frequently injured (p < 0.05). It is recommended to include in training, routine exercises improving movement patterns and flexibility to prevent injuries.

Gender-specific physical activity-related injuries and risk factors among university students in China: a multicentre population-based cross-sectional study

OBJECTIVES

Data on the problem of physical activity-related injury (PARI) in university students and the risk factors for PARI among different genders are rare. We conducted a multicentre population-based study to investigate the occurrence of PARI and to explore the gender-specific risk factors for PARI among Chinese university students.

DESIGN

Cross-sectional study.

PARTICIPANTS

A total of 5341 students in grades 1-3 at eight universities in four Chinese cities were selected to complete the online questionnaires during March and April 2017. The questionnaires assessed sociodemographic characteristics, physical activity PA) involvement, sleep duration, sedentary behaviour and PARI experiences in the past 12 months.

MAIN OUTCOME MEASURES

PARI during the past 12 months.

RESULTS

Among the 5341 participants, 1293 suffered from at least one PARI in the past 12 months, with an overall incidence rate of 24.2% (males: 26.2%, females: 23.2%) and an injury risk of 0.38 injuries/student/year (males: 0.48, females: 0.32). Over half of the injured (57.3%) experienced a withdrawal time of PA and nearly two-fifths (39.6%) required medical attention. Irrespective of gender, Shantou and Xi'an students, sports team members and those who engaged in sports and leisure-time vigorous-intensity PA (VPA) at a higher frequency were more likely to suffer from PARI. Male students who participated in sports and leisure-time VPA for long durations had a greater likelihood of sustaining PARI, while having a chronic condition and being involved in sports and leisure-time moderate-intensity PA at a higher frequency and longer duration were potential contributors to PARI among females.

CONCLUSIONS

The occurrence of PARI and its risk factors differed by gender, which provides a direction towards developing targeted and effective gender-specific preventative programmes to protect Chinese university students from PARI.

Advancing health-enhancing physical activity at workplace: Sport4Heath 2020 scientific forum

Physical activity at workplace can positively impact various wellbeing outcomes yet developing and implementing exercise programs that are straightforward, time-efficient and widely applicable remains a notable public health challenge. Sport4Health Network (SPORT4H) project co-funded by the European Union Erasmus+ programme unites health and sport professionals in an effort to encourage participation in physical activity among working population and reduce health risk factors for lifestyle diseases. A two-day SPORT4H scientific forum on non-traditional types of work-place exercise interventions was organized from 14th to 15th September 2020, to critically evaluate evidence on stretching and resistance exercise programs targeted to working population in aim to identify knowledge gaps and future areas of research and application. Evidence on traditional interventions (e.g., walking initiatives, active travel) appears more robust while only few studies evaluated the applicability of non-traditional PA programs in working population. However, we identified a moderate-to-strong link between non-traditional PA programs at the workplace and several health-related physical fitness indices, with resistance exercise turned out to be superior to other exercise interventions analyzed. It appears that low-volume high-repetition resistance exercise favorably affects musculoskeletal disorders, work performance and health-related quality of life in employees who exercised at least 3 times per week for over 8 weeks. In terms of safety, screening protocols should employ health-related questionnaires, adopting a progressive training load, and prescribing training programs to individual participants' needs. Implementing non-traditional PA programs aimed to improve health-related physical fitness and counteract sedentary behavior at workplace might be therefore of utmost importance to contribute to health promotion in this sensible population.

[Analysis of the mass skiers' injury in a large ski resort in Chongli, China]

OBJECTIVE

To make a retrospective analysis of the injuries of skiing population in a large ski resort in Chongli, China and provide a basis for predicting the rapidly increasing medical needs for ski injuries in the context of the 2022 Winter Olympic Games.

METHODS

The basic data of all injured skiers who were treated in a medical station of a large ski resort in Chongli during the snow season from November 2017 to March 2018 and from November 2018 to March 2019 were collected. The number of skiers, the number of injuries, the causes of injuries, the types of injuries and the locations of injuries were compared.

RESULTS

A total of 753 skiers were injured in two snow seasons, and the estimated average incidence of injury was 4.53 and 4.46 per 1 000 skier days at the resort respectively. The average daily injury rate per 1 000 skiers in November of the two snow seasons was relatively low, with 2.20 and 1.38 cases respectively. The difference of injury rate in different months might have little to do with snowfall and more to do with passenger flow. In both the snow seasons, men accounted for more injuries than women, and injured skiers aged between 21 and 30 accounted for the largest proportion, reaching 36.8%. The main causes of injuries were falls (76.6%). The highest rate of injury was in the head and neck (17.9%), followed by the knee (17.4%) and wrist and fingers (13.3%). The most common types of injuries were contusion and trauma (29.5%) and joint and/or ligament injuries (22.2%). Children (2-12 years old) accounted for 12.7% of all the injured skiers. The rate of moderate to severe injuries (including fractures, concussions, etc.) was 34.8% among the injured patients over 50 years of age.

CONCLUSION

The snow resort should focus on injuries to children and elderly skiers and carry out targeted guidance and rescue work. In order to better ensure the medical safety of skiers, the ski resort medical station and nearby treatment hospitals should be equipped with a corresponding number of medical personnel and equipment, and the ski resort should further improve its safety management and rescue system.

Measures to Promote Rural Healthcare Tourism with a Scientific Evidence-Based Approach

The present study aimed to evaluate the effects of physical activities on human health in forests in countryside and rural areas. The test experiment was conducted in a countryside forest, whereas the controlled experiment was conducted in an urban area where the study participants resided. A total of 22 participants (aged 20.9 ± 1.3 years) were evaluated in this study. Heart rate variability and salivary cortisol level were used as indices of physiological conditions, and semantic differential method, profile of mood states (POMS), and state-trait anxiety inventory (STAI) were used to evaluate the participants’ emotional states. The participants were asked to walk around forest and urban areas for 15 min. The results were as follows. As compared to the urban area, in the forest area, (1) the power of the high-frequency (HF) component of the heart rate variability (HRV) was significantly higher; (2) low-frequency (LF)/(LF + HF) was significantly lower; (3) salivary cortisol level was significantly lower; (4) the participants felt more comfortable, natural, relaxed, and less anxious and showed higher levels of positive emotions and lower levels of negative emotions. Consequently, walking in the forest area induces relaxing short-term physiological and psychological effects on young people living in urban areas.

Characteristics and associated factors of physical activity-related injuries among university students in southern China

This cross-sectional study aimed to describe the characteristics of physical activity-related injury (PARI) and to explore its associated factors among university students in Chaoshan district. Selected from the baseline survey in March and April, 434 students graded 1-3 from two universities were interviewed face-to-face in April and May 2017. Socio-demographics, physical activity (PA) participation, risk-taking behaviors, and PARI occurrences in the past 12 months were collected. Group Lasso logistic regression was applied to identify the risk factors of PARI. Totally, 317 PARI episodes were reported by 184 subjects with an overall injury risk of 0.73 injuries/student/year (males: 1.00, females: 0.63) and an injury incidence density of 0.81 injuries per 1000 PA exposure hours (males: 1.13, females: 0.69). Most injuries involved the lower extremities and were sprains and strains. Males, sports team members, and those with high-risk rebellious and anti-social behaviors were more likely to sustain PARI compared to their counterparts. Those who participated in vigorous-intensity PA with longer duration (particularly ≥ 150 min/week) were at a higher risk for PARI. This study indicates that PARI is a health concern among university students and great efforts should be taken to prevent them from PARI when promoting a physically active lifestyle.

Physical-Activity-Related Injuries and Risk Factors among Secondary School Students in Hong Kong

Increase in physical activity (PA) might elevate risks for physical-activity-related injuries (PARIs). This study aimed to investigate the incidence rate and risk factors for PARIs among secondary school students in Hong Kong. All eligible students from three secondary schools were invited to participate in the study from November to December 2014. Information on PARI occurrences in the past 12 months, PA participation, and sociodemographics was collected. Multivariate and hierarchical logistic regression models were performed to estimate the risk of potential factors for PARIs. In total, 1916 students in forms 1-6 (aged 14.3 ± 1.7 years) completed valid questionnaires, with an overall yearly PARI incidence rate of 32.1% (boys: 34.3%; girls: 29.3%). There were sex differences in the risk factors identified, except that family size was associated with PARIs for all participants. Longer duration and higher intensity of PA increased the risk for PARI occurrences in both sexes. In conclusion, PARIs were prevalent among secondary school students in Hong Kong, and different sexes had different PARI incidence rates and were influenced by different risk factors. There is an urgent call for effective sex-specific interventions to prevent PARIs in this population.

Is consumer behaviour towards footwear predisposing for lower extremity injuries in runners and walkers? A prospective study

Background

Runners and walkers often suffer from lower extremity injuries. Little is known about the relationship between their consumer behaviour towards footwear and the development of those injuries. Therefore, the aim of this study was to investigate if consumer behaviour towards footwear is a risk factor for lower extremity injuries.

Methods

A prospective cohort study was set-up in leisure-time walkers and runners. Potential risk factors in consumer behaviour were obtained by means of a baseline questionnaire related to the acquisition of current walking or running shoes. Information on injuries sustained during a 24 week period after the baseline questionnaire was obtained in 104 runners and 104 walkers using a 2-weekly questionnaire. Binary logistic regression analysis was used to identify risk factors for lower extremity injuries in the consumer behaviour.

Results

Forty- nine (24%) subjects suffered a self-reported lower extremity injury. 35 injuries occurred in runners and 14 among walkers.Undergoing a gait analysis before buying shoes was associated with an increased occurrence of lower extremity injuries (odds ratio (OR) 4.76). A protective factor was caring a lot about the right fitting of the shoes (OR 0.11).

Conclusion

Runners and walkers should pay attention to the correct size when buying footwear to diminish the risk of lower extremity injury. Buying footwear after a gait analysis increased the risk of a lower extremity injury in runners and walkers, however, this might be associated with the increased risk that was already present because of previous injury.

Trial registration

This trial was not registered since this was an observational study and no intervention took place.

[Sport accidents in Haute-Savoie: Results from the EPAC 2004-2013 survey]

Regular physical activity and sport have many health benefits but they can also result in injury, which can be quite severe. Data recorded from 2004 to 2013 in an Haute-Savoie emergency department for the home and leisure injuries survey (EPAC) were analyzed in order to describe the characteristics of sport related injuries in an area particularly attractive for winter and air sports. A total of 43,505 sport related injuries were recorded: team sports (30%), winter sports (25%) and cycling (23%) accounted for the most accidents. Men were more at risk than women (sex ratio = 2.3), and the age group 10-14 years were mostly injured (21% of all injuries). Overall, falls were the most frequent mechanism of injury. Climbing, winter sports and air sports led to the most hospitalizations. The risk of hospitalization following a sport related injury was higher in men, when age increased and when the place of residence was located outside Haute-Savoie. Complementary surveys are necessary to estimate the impact on injury incidence of the use of protective equipment (helmet, gloves), the level of sporting proficiency, level of supervision, or whether or not the victim was a member of a sport club.

Gender-Specific Risk Factors of Physical Activity-Related Injuries among Middle School Students in Southern China

This cross-sectional study was carried out to explore the potential risk factors of physical activity-related injuries (PARI) among middle-school students of different genders. Selected by the random cluster sampling method, students aged from 12 to 16 years old in grades 7-8 from six middle schools in Shantou, southern China, were recruited for this investigation in November 2017. Information about socio-demographics, physical activity (PA) exposure time, individual exercise behaviors, risk-taking behaviors, and PARI experiences in the past 12 months was collected. A multivariate logistic regression model was used to explore the risk factors of PARI. A total of 1270 students completed valid questionnaires, with an overall injury incidence of 33.6% (boys: 42.0%; girls: 25.0%), an injury risk of 0.68 injuries/student/year, and an injury rate of 1.43 injuries per 1000 PA exposure hours. For boys, living in a school dormitory, participating in sports teams, exercising on a wet floor, rebellious behavior, and having longer PA exposure time were the risk factors of PARI. For girls, those who were sports team members, whose parents were divorced or separated, and those with longer PA exposure time were more vulnerable to suffer from PARI. In conclusion, PARI was a health problem among middle school students in southern China. Boys and girls differed in PARI occurrence and were affected by different risk factors, which provides a basis for targeted gender-specific intervention programs to reduce the occurrence of PARI among middle-school students.

An integrated core training program improves joint symmetry and metabolic economy in trained runners

BACKGROUND

Over 60 million Americans participate in running as a form of exercise or sport annually, making it the most popular form of physical activity in the country. Although there are numerous health benefits from a regular running routine, it is also an activity associated with a high risk of injury. Multiple factors, such as core muscle weakness and stride asymmetry, contribute to running injuries and loss of performance. The aim of this study was to assess how an integrated, functional core training intervention affects the components of performance (metabolic economy and speed) as well as a risk factor associated with injury (range of motion joint asymmetry). We hypothesized that economy, 5-km speed, and range of motion symmetry would increase in runners who added a 6-week integrated core-training intervention to their routine compared to a control group who simply maintained their current running routine.

METHODS

Twelve, healthy adult runners participated in the study and six of these participants completed the exercise intervention. Heart rate data were collected to estimate metabolic economy while kinematic data were collected to calculate joint range of motion asymmetry.

RESULTS

Our data demonstrated that running asymmetry decreased by a statistically significant 60% at the ankle in the sagittal plane while economy was 3% greater on both level and incline surfaces.

CONCLUSIONS

In summary, runners who completed the 6-week integrated, functional training intervention improved economy, 5-km speed, and range of motion symmetry in comparison to the runners who simply maintained their current training routine.

Can behavioral strategies increase physical activity and influence depressive symptoms and quality of life among children with epilepsy? Results of a randomized controlled trial

PURPOSE

This study examined whether increasing physical activity (PA) through 6 months of behavioral counseling positively influenced depressive symptoms and quality of life (QoL) over 12 months among children with epilepsy (CWE).

METHODS

A longitudinal multisite randomized controlled trial (RCT) was conducted with 8-14-year-old children with active epilepsy. Participants wore a pedometer to track daily PA and completed 3 measures at 4 time points to examine depressive symptoms and QoL. Stratified by site and activity level, participants were randomized to an intervention or control group. The 6-month intervention included 11 behavioral counseling sessions targeting self-regulation of PA. To assess the associations among PA, depression scores, and QoL, primary analysis involved mixed-effects models.

RESULTS

We recruited 122 CWE, of whom 115 were randomized (M_age = 11 ± 2; 50% female) and included in the analysis. The intervention did not increase PA in the treatment compared with the control group. No differences were found between groups over time during the subsequent 6 months, where PA decreased among all participants. Results did not show differences between the groups and over time for measures of depressive symptoms and QoL.

SIGNIFICANCE

The intervention did not improve or sustain PA levels over 12 months. Both groups demonstrated declines in PA over one year, but there were no changes in depression scores or QoL. As most participants were already nearly reaching the Canadian average of step counts of children their age, with a baseline daily step count of over 9000, there may be a challenge for further increasing PA over a longer period.

Physical activity-related injuries among university students: a multicentre cross-sectional study in China

OBJECTIVES

This study aimed to investigate the epidemiological characteristics and preliminarily explore possible risk factors of physical activity-related injury (PARI) occurrences among Chinese university students via a multicentre mixed survey.

DESIGN

Cross-sectional study.

PARTICIPANTS

A total of 4758 undergraduates graded 1-3 in nine universities in three Chinese cities were enrolled via cluster random sampling and completed the self-administered online questionnaires during March and April 2017.

MAIN OUTCOME MEASURES

PARI in the past 12 months.

RESULTS

Of the 4758 participants, 1081 sustained PARI in the past 12 months, with an overall PARI incidence rate of 22.7% (27.3% (367/1343) in males and 20.9%(714/3415) in females). Around one-quarter of the injured (26.4%) suffered from PARI over at least three episodes. More than half of the injured subjects experienced physical activity (PA) absenteeism and sought medical attention. All PA indicators were significantly and positively associated with PARI, with a frequency of sports and leisure-time vigorous-intensity PA (VPA) participation being the strongest (adjusted OR: 1.079, 95% CI: 1.018 to 1.144). Moreover, males (OR=1.199), Shantou students (OR=4.239), year 1 students (OR=1.287), university and other sports team members (OR=1.717-2.360) and those with insufficient sleep time (OR=1.262-1.333) were also at a higher risk of PARI.

CONCLUSIONS

PARI is prevalent among university students in China. The frequency of sports and leisure-time VPA participation was most strongly associated with PARI among all PA indicators. These data can inform future programmes for injury intervention among university students. Safety issues should also be emphasised when promoting PA among the public to reduce PARI.

Validity of injury self-reports by novice runners: comparison with reports by sports medicine physicians

This study examined the criterion validity of self-reported running-related injuries (RRI) by novice runners. Fifty-eight participants (41 females; age 46 ± 11 yrs) of the "Start-to-Run" program provided self-reports on their RRIs using an online questionnaire. Subsequently, they attended injury consultations with sports medicine physicians who provided physician-reports (blinded for the self-reports) as a reference standard. Self-reports and physician-reports included information on injury location (i.e., hip/groin, upper leg, knee, lower leg, and ankle/foot) and injury type (i.e., muscle-tendon unit, joint, ligament, or bone). Sensitivity, specificity, and positive predictive values were 100% for all five injury locations. For injury type, sensitivity was low (66% for muscle-tendon unit, 50% for ligament, and 40% for bone) and lowest for joint injuries (17%). In conclusion, the validity of self-reported RRIs by novice runners is good for injury locations but not for injury types. In particular for joint injuries, the validity of novice runners' self-reports is low. Abbreviations: RRI: Running Related Injury; SMC: Sports Medicine Centre; MTU: Muscle Tendon Unit; PPV: Positive Predictive Value.

Physical Activity-Related Injury and Its Associated Factors among Middle School Students in Southern China

Physical activity (PA) promotion is beneficial to gain and maintain optimal health, but might increase risks for physical activity-related injury (PARI). This cross-sectional study aimed to investigate the incidence rate and identify risk factors of PARI among Chinese middle school students. Selected via the method of cluster random sampling, students graded 7⁻8 (junior) and 10⁻11 (senior) from five middle schools (aged from 10 to 18 years old) in Shantou were invited to participate in the survey. Information on socio-demography, PA involvement, sleep duration, individual safety awareness and exercise behavior, and PARI experiences in the past 12 month was collected. Multivariate logistic regression model was performed to estimate the risk factors of PARI. A total of 3082 participants completed the valid questionnaires, with an overall incidence rate of 25.1%. Boys, junior school students, sports team members, and those with lower safety awareness, living with single parent, and without any chronic conditions were at higher risks for PARI. Moreover, exercising on wet floor or with illness frequently would also be more likely to experience injury, especially those with at least 120 min per day. In conclusion, PARI was prevalent among middle school students in southern China. The above data provide insights that were focused and effective actions should be taken to prevent school-aged adolescents from PARI and maximize the benefits of PA.

An epidemiologic analysis of winter sport accidents on ski slopes comparing two seasons

BACKGROUND

The aim of this investigation was to provide a detailed analysis of accidents on ski slopes of Styrian resorts comparing two winter seasons.

METHODS

Accident data requiring the presence of the ski patrol of the seasons 2007/08 (10 skiing resorts with 1029 injuries) and 2014/15 (8 resorts with 1844 injuries) were recorded. Accidents were normalized to 1000 skier days and 10000 lift transports. Patients were followed to hospitals to obtain information about injured body region, final diagnosis and type of treatment.

RESULTS

A slight increase of injuries from 0.5 to 0.7 per 1000 skier-days was found (P=0.046). Overall, the knee was most commonly affected followed by shoulder, lower leg, head and forearm. While the shoulder was most often affected in men the knee was most commonly affected in women. Patients <15 years had a higher prevalence of forearm injuries. Comparing the two seasons the use of helmets and spine protectors increased, associated with decreased injuries of these body regions. The hospitalization rate was 26% in both seasons; patients <15 years required less inpatient treatment than older ones.

CONCLUSIONS

Different injury patterns between gender and age-groups have to be taken into account for future preventive measures. The increased acceptance of safety equipment was associated with reduced injury rates of the respective body regions. Results of the present study can facilitate to develop future injury prevention strategies in order to further decrease the number of casualties on ski slopes.

Predicting sport and occupational lower extremity injury risk through movement quality screening: a systematic review

BACKGROUND

Identification of risk factors for lower extremity (LE) injury in sport and military/first-responder occupations is required to inform injury prevention strategies.

OBJECTIVE

To determine if poor movement quality is associated with LE injury in sport and military/first-responder occupations.

MATERIALS AND METHODS

5 electronic databases were systematically searched. Studies selected included original data; analytic design; movement quality outcome (qualitative rating of functional compensation, asymmetry, impairment or efficiency of movement control); LE injury sustained with sport or military/first-responder occupation. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were followed. 2 independent authors assessed the quality (Downs and Black (DB) criteria) and level of evidence (Oxford Centre of Evidence-Based Medicine model).

RESULTS

Of 4361 potential studies, 17 were included. The majority were low-quality cohort studies (level 4 evidence). Median DB score was 11/33 (range 3-15). Heterogeneity in methodology and injury definition precluded meta-analyses. The Functional Movement Screen was the most common outcome investigated (15/17 studies). 4 studies considered inter-relationships between risk factors, 7 reported diagnostic accuracy and none tested an intervention programme targeting individuals identified as high risk. There is inconsistent evidence that poor movement quality is associated with increased risk of LE injury in sport and military/first-responder occupations.

CONCLUSIONS

Future research should focus on high-quality cohort studies to identify the most relevant movement quality outcomes for predicting injury risk followed by developing and evaluating preparticipation screening and LE injury prevention programmes through high-quality randomised controlled trials targeting individuals at greater risk of injury based on screening tests with validated test properties.

Odds of Getting Adequate Physical Activity by Dog Walking

BACKGROUND

We aimed to determine the likelihood that adult dog owners who walk their dogs will achieve a healthy level of moderate-intensity (MI) physical activity (PA), defined as at least 150 mins/wk.

METHODS

We conducted a systematic search of 6 databases with data from 1990-2012 on dog owners' PA, to identify those who achieved MIPA. To compare dog-walkers' performance with non-dog walkers, we used a random effects model to estimate the unadjusted odds ratio (OR) and corresponding 95% confidence interval (CI).

RESULTS

We retrieved 9 studies that met our inclusion criterion and allowed OR calculations. These yielded data on 6980 dog owners aged 18 to 81 years (41% men). Among them, 4463 (63.9%) walked their dogs. Based on total weekly PA, 2710 (60.7%) dog walkers, and 950 (37.7%) non-dog walkers achieved at least MIPA. The estimated OR was 2.74 (95% CI 2.09-3.60).

CONCLUSION

Across 9 published studies, almost 2 in 3 dog owners reported walking their dogs, and the walkers are more than 2.5 times more likely to achieve at least MIPA. These findings suggest that dog walking may be a viable strategy for dog owners to help achieve levels of PA that may enhance their health.

Favourable changes of the risk-benefit ratio in alpine skiing

During the past five decades recreational alpine skiing has become increasingly safer. The numerous annual media reports on ski injuries have to be interpreted on the basis of the tremendous numbers of skiers. These favourable changes seem primarily be due to the introduction of short carving skis, more rigid and comfortable ski boots, the use of protective gear like helmets, and the optimized preparation of ski slopes. The associated health benefits from skiing, especially arising from its association with a healthier life style, and possibly also from effects related to hypoxia preconditioning and increasing subjective vitality by natural elements clearly outweigh the health hazards. Technical improvements will likely help further reducing the injury risk. At least hypothetically, each individual skier could help to prevent injuries by the development of an appropriate physical fitness and responsible behaviour on ski slopes thereby optimizing the risk-benefit ratio of alpine skiing.

Prevalence of Injury in Ultra Trail Running

Purpose. The purpose of the study was to find the rate of musculoskeletal injuries in ultra-trail runners, investigate the most sensitive anatomical areas, and discover associated predicting factors to aid in the effective prevention and rapid rehabilitation of trail running injuries. Methods. Forty ultra trail runners responded to an epidemiological questionnaire. Results. At least one running injury was reported by 90% of the sample, with a total of 135 injuries were reported (111 overuse injuries, 24 appeared during competing). Lower back pain was the most common source of injury (42.5%). Running in the mountains (p = 0.0004) and following a personalized training schedule (p = 0.0995) were found to be protective factors. Runners involved in physical labor are associated with more injuries (p = 0.058). Higher-level runners are associated with more injuries than lower-level cohorts (p = 0.067), with symptoms most commonly arising in the lower back (p = 0.091), hip joint (p = 0.083), and the plantar surface of the foot (p = 0.054). Experienced runners (> 6 years) are at greater risk of developing injuries (p = 0.001), especially in the lower back (p = 0.012), tibia (p = 0.049), and the plantar surface of the foot (p = 0 .028). Double training sessions could cause hip joint injury (p = 0.060). Conclusions. In order to avoid injury, it is recommended to train mostly on mountain trails and have a training program designed by professionals.

Toward environments and policies that promote injury-free active living--it wouldn't hurt

Although being active is vital to the health and well-being of children, increases in physical activity can lead to an elevated risk of injury, which is a leading cause of childhood mortality globally. This article provides an overview of the evidence base concerning unintentional injuries associated with popular forms of physical activities for youth, and describes how injury prevention and child obesity professionals can work together to prevent injuries while promoting active lifestyles. Policy and environmental interventions that are beneficial to both outcomes are highlighted and recommendations for future research for these complementary areas are also provided.