ABSTRACT
INTRODUCTION: The C-Brace microprocessor stance and swing control orthosis was designed to overcome safety and functional limitations of traditional knee-ankle-foot orthoses (KAFOs) for individuals with lower limb paresis. However, a systematic comparison to established KAFO types has not been performed in a bigger sample. METHODS: International multicenter, randomized, controlled, cross-over clinical trial. Legacy KAFO users at risk of falling were randomized to KAFO/C-Brace or C-Brace/KAFO use for three months with each orthosis. Primary outcome was balance assessed with the Berg Balance Scale (BBS). Secondary outcomes were falls, mobility, function, and quality of life. RESULTS: Intention-to-treat analysis with 102 participants. With the C-Brace, the BBS improved by 3.3 ± 6.3 points (p < 0.0001). Significantly fewer participants presented BBS scores <40 indicative of increased fall risk (16 vs. 36, p = 0.018). Mean falls reduced from 4.0 ± 16.8 to 1.1 ± 3.3 (p = 0.002). Outcomes for function, mobility, and quality of life showed significant improvements with the C-Brace. DISCUSSION: The improvements in fall risk and mobility can be attributed to the stumble recovery and controlled knee flexion during weight bearing of the C-Brace and have a positive impact on the quality of life of users. CONCLUSION: The C-Brace represents an option for KAFO users with increased fall risk and reduced mobility.
When prescribing traditional knee-ankle-foot orthoses (KAFOs), their known limitations, such as limited function and mobility, and the requirement to walk with compensatory mechanisms, especially on non-level terrains, should be considered.For patients with compromised balance and increased risk of falling when using a traditional KAFO, a microprocessor stance and swing control orthosis (MP-SSCO) may be considered as an orthotic option to reduce their fall risk.For patients with mobility restrictions using a traditional KAFO, a MP-SSCO may be considered to improve function, mobility, reintegration into normal living, and quality of life.
ABSTRACT
BACKGROUND: Wheelchair basketball is an adaptation of pedestrian basketball and one of the most popular Paralympic sports worldwide. The epidemiology of health problems in wheelchair basketball has been prospectively studied only during the Paralympic Games, the 2018 World Championships, the 2021 South America Wheelchair Basketball Championship, and one season of two American intercollegiate wheelchair basketball teams. The objective of the study was to prospectively monitor and analyze the prevalence, incidence, burden, and characteristics of injuries and illnesses in a wheelchair basketball league during an entire season for the first time. METHODS: All players of the highest German wheelchair basketball league (Bundesliga) were invited to participate in the study. Included players completed the Oslo Sports Trauma Research Center Questionnaire once a week during the entire season 2020/21 to report health problems. Exposure was captured by self-reported training time and officially-recorded competition time. RESULTS: Sixty of 117 players (51%, 47 male, 13 female) of the national league participated with an average response of 93%. Seventy health problems (5.5/1000 exposure hours [95% CI: 4.9-6.1]) were reported, including 54 injuries and 16 illnesses. Prevalence of health problems was 60% (95% CI: 48-72). Most injuries affected the shoulder (32% of all injuries), cervical spine/neck (17%), and hand (13%). More overuse injuries (2.9/1000 exposure hours [95% CI: 2.5-3.3]) than acute injuries (1.3/1000 exposure hours [95% CI: 1.0-1.6]) occurred. Of all health problems, 53% were associated with time-loss. The incidences of all health problems, illnesses, injuries, and overuse injuries were higher in women than in men. CONCLUSIONS: Characteristics and frequency of injuries and illnesses during wheelchair basketball season differed from those during major wheelchair basketball tournaments. The high proportion of overuse injuries and the higher injury rates in women should be regarded in the development of individualized prevention measures. Since results from previous studies during major tournaments are only partially comparable to wheelchair basketball league play, further studies should follow.
ABSTRACT
Several international sports federations have implemented a standardized injury reporting system during their championships. However, very few studies have investigated athletes with disabilities during major championships apart from the Paralympic Games. Therefore, the aim of this study was to assess the rate and characteristics of injuries during the Wheelchair Basketball World Championships 2018 (WBWC). This prospective cohort study was conducted during the WBWC held in Hamburg, Germany, from August 16 to August 26, 2018. Physicians or physiotherapists of all 28 participating teams (total 336 players) were asked to report all newly incurred injuries (with location, diagnosis, cause, and estimated duration of absence) daily on a standardized injury report form. Prevalence and incidence rates were calculated. Medical staff of 11 teams (132 players) reported 100 injuries, equivalent to 75.8 per 100 players (95% CI: 60.9-90.7) or 68.9 per 1000 player-days (55.4-82.4). Eight time-loss injuries were reported (6.1 injuries per 100 players [95% CI: 1.9-10.3] or 5.5 injuries per 1000 player-days [1.7-9.3]). More injuries were incurred during matches (n = 68) than during training. Most injuries affected the neck/cervical spine (16%), thoracic spine/upper back (15%), and shoulder (14%). The most frequent diagnosis was muscle spasms (25%), the most frequent cause was overuse (52%). A high rate of non-time-loss injuries compared to Paralympic Games was reported. Future studies should focus on the etiology of muscle spasms and further identify injury mechanisms of traumatic and overuse injuries in wheelchair basketball players to develop adequate preventive measures.
