Injury Prevalence Among Elite Adolescent Ballet Dancers is not Affected by Frequency of Questionnaire Administration: A 6-Month Exploratory Prospective Study.

INTRODUCTION: The Oslo Sports Trauma Research Centre Questionnaire on Health Problems (OSTRC-H) is a valid and reliable registration method for self-reported injuries and is regularly used among dancer populations. Monthly questionnaire administration is acceptable in athlete populations but has not been evaluated in dancers. The aim of this exploratory study was to assess the influence of weekly versus monthly administration of the OSTRC-H on estimated injury outcomes among elite adolescent ballet dancers. METHODS: Participants (n = 103) were prospectively followed for 6 months and completed the OSTRC-H online, evaluating perceived consequences of self-reported health problems during the previous week and the previous 4 weeks, respectively. Four definitions of dance-related injury were utilized: (1) all complaints, (2) substantial, (3) medical attention, and (4) time-loss injuries. Descriptive statistics estimated: (1) the number of injuries reported (count), (2) average injury prevalence [proportion, 95% confidence intervals (CI)], (3) average severity score (0-100), and (4) days of time loss (count) for each injury definition. The 4 outcome measures were then compared between weekly and monthly registration with paired sample t-tests (P < .05) and overlapping 95% CI. RESULTS: A significant difference between the number of all complaints injuries (weekly: 133; monthly: 94; P < .001) and substantial injuries (weekly: 64; monthly: 45; P = .012) was found. Regardless of injury definition, there were no significant differences between injury prevalence, severity scores, and days of time loss when reported weekly versus monthly. CONCLUSION: Monthly administration of the OSTRC-H is an acceptable method to estimate injury prevalence, severity scores, and days of time loss amongst elite adolescent ballet dancers.

Broadening our understanding of injury mechanisms to include at-risk situations: an overview of potential injuries at the FIFA men's World Cup Qatar 2022TM.

This study aims to examine and describe the characteristics of potential injury situations during a men's professional international tournament quantified using the FIFA Football Language Medical Coding. A prospective study was conducted during the 64 matches of the FIFA World Cup Qatar 2022™, during which five analysts recorded potential injury situations from video analysis. "Potential injuries" were recorded when players stayed down > 5 s and/or requested medical attention. Characteristics were further recorded for variables such as opponent's action and body location. In total, 720 potential injury situations were recorded of which 139 required medical assessment. The actions which resulted in most potential injuries were running while receiving a pass (74; 10%), while passing the ball (59; 8%), and while progressing with the ball (48; 7%). Duels and ball progression led to a potential injury in 3.0% and 2.1% of all similar actions in total. Both aerial duels and ball progression led to an potential injury that required medical assessment on 0.4% of occasions. Most potential injuries involved the head (149; 21%), foot (120; 17%), or lower leg (110; 15%) with most medical assessments of the head (35; 25%), lower leg (17; 12%), and knee (15; 11%) with a median duration of 47 seconds (IQR 28-61). This study provides a detailed overview of match circumstances that may have a higher injury risk. Although some variables within the coding system need improvement to increase reliability, its use will allow a more detailed comparison of differences between high-risk player actions leading to injury and those that do not, which can improve future prevention strategies.

Noncombat injury and illness prevalence and working score percentage quantify the impact on duty availability in US Army Special Operations military working dogs.

OBJECTIVE: This cross-sectional study determined the 2-year period prevalence and quantified the impact on working status of noncombat injury and illness by a working score percentage (WSP) based on the number of duty days lost (DDL). ANIMALS: 126 dogs from 9 US Army Special Operations kennels. METHODS: Dog injury and illness events between May 1, 2021, and April 30, 2023, were recorded to determine period prevalence and calculate a WSP metric to quantify loss of duty status. RESULTS: 93 health events occurred in 62 of 126 (49.2%) dogs over a 24-month period resulting in 4,130 DDL. The period prevalence was 25 of 126 (19.8%) for dental injuries, 20 of 126 (15.9%) for musculoskeletal injuries, and 13 of 126 (10.3%) for gastrointestinal illnesses. Musculoskeletal conditions resulted in the highest total DDL at 1,472 (35.6%) in 20 dogs, followed by neurologic conditions at 950 (23%) in 4 dogs and heat injuries at 521 (12.6%) in 7 dogs. The total population 24-month mean WSP was 88.1% (95% CI, 86.6 to 89.5). The mean WSP for 43 dogs with acute events was 96.0% (95% CI, 95.0 to 97.0), and the mean WSP for 14 dogs with chronic events was 55.2% (95% CI, 47.8 to 62.5). CLINICAL RELEVANCE: Quantifying the impact of noncombat illness and injury on the working status of military working dogs is the first step to identify risk factors, develop preventive strategies, resource veterinary care requirements, and improve these canine athletes' health and welfare. The metrics developed in this study can be used to evaluate the population health of working, herding, and sport dogs.

A nationwide analysis of upper extremity injuries in martial arts.

Objective: Given the rise of martial arts within the fitness and recreational industry, it is important to study trends in injury and note that practicing martial arts comes with a risk of injury, particularly to the upper extremities. By studying consumer product-related injuries to the upper extremities and addressing the current gap in the literature, future martial arts equipment can come with increased safety features, better provide information to healthcare providers treating such injuries, and improve risk mitigation through the Consumer Product Safety Commission. Methods: The National Electronic Injury Surveillance System Database was analyzed to collect data on martial arts equipment-related injuries on the upper extremities within the last 10 years. Results: Over the most recent span of 10 years (2013-2022), there were approximately 78,680 injuries reported to the ED. The majority of them took place in 2013 (12.8%). Men were 2.4 times more likely to get injured than women. Injuries peaked in the age group 10-19-year-olds (33%) and particularly age 12 (4.8%). The upper extremity most commonly affected was the shoulder (29.1%), and the most common diagnosis group was a fracture (29.2%). Most injuries presented to the emergency department were not hospitalized (98.7%). Conclusions: This study highlights the occurrence of upper extremity injuries due to martial arts within the last 10 years and provides new information on the prevalence of such injuries. The results highlight that these injuries are usually non-severe and most commonly affect adolescent males; however, future research should explore performance-based recovery post-injury and long-term pain.

Initial versus Subsequent Injury and Illness and Temporal Trends Among Professional Hockey Players.

Background: Research is limited investigating injuries/illness incidence among National Hockey League (NHL) players. This study sought to establish injury/illness incidence, initial versus subsequent injury risk among NHL players, and determine temporal trends of injury and illness incidence. Hypothesis: Variations in injury incidence by body region, and initial versus subsequent injury would be observed among positions. Study Design: Retrospective cohort study. Methods: Publicly available data were utilized. NHL players 18 years or older between 2007-2008 to 2018-2019 were included. Injury and illness was stratified by position and body segment. Incidence rate (IR), and initial versus subsequent injury and illness risk ratios were calculated. Temporal trends were reported. Results: Nine thousand, seven-hundred and thirty four injuries and illnesses were recorded. Centers had the highest overall IR at 15.14 per 1000 athlete game exposures (AGEs) (95%CI:15.12-15.15) and were 1.4 times more likely to sustain a subsequent injury compared to other positions. The groin/hip/thigh was the most commonly injured body region with an IR of 1.14 per 1000 AGEs (95%CI:1.06-1.21), followed by the head/neck (0.72 per 1000 AGEs, 95%CI:0.66-0.78). Combined injury and illness IR peaked in 2009-2010 season at 12.01 (95%CI: 11.22-12.79). The groin/hip/thigh demonstrated peak incidence during the 2007-2008 season (2.53, 95%CI:2.17-2.90); head/neck demonstrated a peak incidence in 2010-2011 season (Overall: 1.03, 95%CI:0.81-1.26). Injuries reported as 'lower body' increased over time. Conclusions: Positional differences were observed; centers demonstrated the highest overall IR, and subsequent injury risk. Injury by body region was similar to previous literature. Head/neck and concussion decreased over time supporting rule changes in body checking and visor wear. Clinicians should be aware that 'lower body' injuries increased over time; therefore, injuries to the groin/hip/thigh or knee are likely underreported. Level of Evidence: Level 3.

Agricultural Injury Surveillance in the United States and Canada: A Systematic Literature Review.

INTRODUCTION: Agricultural injuries remain a major concern in North America, with a fatal injury rate of 19.5 deaths per 100,000 workers in the United States. Numerous research efforts have sought to compile and analyze records of agricultural-related injuries and fatalities at a national level, utilizing resources, ranging from newspaper clippings and hospital records to Emergency Medical System (EMS) data, death certifications, surveys, and other multiple sources. Despite these extensive efforts, a comprehensive understanding of injury trends over extended time periods and across diverse types of data sources remains elusive, primarily due to the duration of data collection and the focus on specific subsets. METHODS: This systematic review, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, consolidates and analyzes agricultural injury surveillance data from 48 eligible papers published between 1985 and 2022 to offer a holistic understanding of trends and challenges. RESULTS: These papers, reporting an average of 25,000 injuries each, were analyzed by database source type, injury severity, nature of injury, body part, source of injury, event/exposure, and age. One key finding is that the top source of injury or event/exposure depends on the chosen surveillance system and injury severity, underscoring the need of diverse data sources for a nuanced understanding of agricultural injuries. CONCLUSION: This study provides policymakers, researchers, and practitioners with crucial insights to bolster the development and analysis of surveillance systems in agricultural safety. The overarching aim is to address the pressing issue of agricultural injuries, contributing to a safer work environment and ultimately enhancing the overall well-being of individuals engaged in agriculture.

Using State Agency Reports to Augment Ohio's Agricultural Injury Surveillance Efforts.

BACKGROUND: Agriculture is a hazardous industry with undocumented injury events. Credible surveillance measures are critical for this industry, especially to guide injury prevention programs with targeted recommendations for specific commodity groups and populations. This multi-phase study explored the feasibility for two state agency databases, the Ohio Bureau of Workers' Compensation (BWC) Program and the Emergency Medical Services Incident Reporting System (EMSIRS), to augment the state's Bureau of Labor Statistics (BLS) annual reports. METHODS: BWC data described injury claims in agricultural workplaces from 1999 to 2008. State EMSIRS data described the types of medical emergencies for which EMS services were requested to Ohio farms in 2013-2014. Descriptive analyses were performed on each distinctive source. RESULTS: Over 14,000 BWC claims were analyzed, with primary nature of injury identified as sprains and strains of bodily extremities; falls were the most common cause of injury. The EMSIRS data provided 1,376 cases, where EMS services were requested to Ohio farms at injury onset. Some cases had possibility to be excluded in CFOI or employment claims data, with 24% patients 65 years and older and 6% children 13 years and younger. The primary cause of injury was falls, and the highest reported injury type was blunt trauma. CONCLUSIONS: Both BWC and EMSIRS databases showed the potential to enhance Ohio's agricultural surveillance data with viable information not found in previously used systems. Each agency database had its own merits to further clarify and quantify morbidity. When used together, these sources enrich surveillance statistics to describe Ohio's agricultural injury incidents.

A systematic review and meta-analysis of data linkage between motor vehicle crash and hospital-based datasets.

Motor vehicle crash data linkage has emerged as a vital tool to better understand the injury outcomes and the factors contributing to crashes. This systematic review and meta-analysis aims to explore the existing knowledge on data linkage between motor vehicle crashes and hospital-based datasets, summarize and highlight the findings of previous studies, and identify gaps in research. A comprehensive and systematic search of the literature yielded 54 studies for a qualitative analysis, and 35 of which were also considered for a quantitative meta-analysis. Findings highlight a range of viable methodologies for linking datasets, including manual, deterministic, probabilistic, and integrative methods. Designing a linkage method that integrates different algorithms and techniques is more likely to result in higher match rate and fewer errors. Examining the results of the meta-analysis reveals that a wide range of linkage rates were reported. There are several factors beyond the approach that affect the linkage rate including the size and coverage of both datasets and the linkage variables. Gender, age, crash type, and roadway geometry at the crash site were likely to be associated with a record's presence in a linked dataset. Linkage rate alone is not the only important metric and when linkage rate is used as a metric in research, both police and hospital rates should be reported. This study also highlights the importance of examining and accounting for population and bias introduced by linking two datasets.

Use of Capture-Recapture Analysis to Estimate the Number of Agricultural Fatalities and Severe Agricultural Injuries in Indiana.

Conducting surveillance of agricultural injuries and fatalities in the United States has been an ongoing challenge, with many cases falling outside the criteria of national and local surveillance systems. In this research, capture-recapture analysis was used to estimate the number of fatal agricultural injuries in Indiana between 2016 and 2020. A limited analysis of non-fatal injuries is also provided. This analysis was possible because of two publicly available datasets containing incident descriptions with sufficient detail for case matching. The first dataset consisted of summary lists of fatal and nonfatal agricultural injuries in Indiana published in annual agricultural fatality reports produced by the Purdue Extension. The second data source was AgInjuryNews, which gathers reports of agricultural injuries and fatalities published in news media and other publicly available sources. Results of the capture-recapture analysis estimate that, every year in Indiana, the Purdue Extension misses 18% of fatal incidents and AgInjuryNews misses approximately 60%. AgInjuryNews identifies approximately 3 fatal incidents per year that are missed by Purdue Extension. Analysis of nonfatal incidents was limited by the fact that both data sources only included nonfatal injuries that were extremely severe and/or connected to a fatality. The Purdue Extension is estimated to miss 22% and AgInjuryNews is estimated to miss 25% of nonfatal agricultural injuries meeting that narrow definition. While capture-recapture analysis only provides estimates of true injury rates, the results provide evidence that Purdue Extension's surveillance captures most agricultural fatalities in the state. AgInjuryNews has been able to identify cases missed by Purdue, and this research takes an important step forward in quantifying how media reports found in this data source differ from extension surveillance. This research also highlights the continuing limitations in the surveillance non-fatal injuries and the ways in which publicly available data can aid researchers in filling gaps in surveillance.

Using a severity threshold to improve occupational injury surveillance: Assessment of a severe traumatic injury-based occupational health indicator across the International Classification of Diseases lexicon transition.

BACKGROUND: Traumatic injury is a leading cause of death and disability among US workers. Severe injuries are less subject to systematic ascertainment bias related to factors such as reporting barriers, inpatient admission criteria, and workers' compensation coverage. A state-based occupational health indicator (OHI #22) was initiated in 2012 to track work-related severe traumatic injury hospitalizations. After 2015, OHI #22 was reformulated to account for the transition from the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) to ICD-10-CM. This study describes rates and trends in OHI #22, alongside corresponding metrics for all work-related hospitalizations. METHODS: Seventeen states used hospital discharge data to calculate estimates for calendar years 2012-2019. State-panel fixed-effects regression was used to model linear trends in annual work-related hospitalization rates, OHI #22 rates, and the proportion of work-related hospitalizations resulting from severe injuries. Models included calendar year and pre- to post-ICD-10-CM transition. RESULTS: Work-related hospitalization rates showed a decreasing monotonic trend, with no significant change associated with the ICD-10-CM transition. In contrast, OHI #22 rates showed a monotonic increasing trend from 2012 to 2014, then a significant 50% drop, returning to a near-monotonic increasing trend from 2016 to 2019. On average, OHI #22 accounted for 12.9% of work-related hospitalizations before the ICD-10-CM transition, versus 9.1% post-transition. CONCLUSIONS: Although hospital discharge data suggest decreasing work-related hospitalizations over time, work-related severe traumatic injury hospitalizations are apparently increasing. OHI #22 contributes meaningfully to state occupational health surveillance efforts by reducing the impact of factors that differentially obscure minor injuries; however, OHI #22 trend estimates must account for the ICD-10-CM transition-associated structural break in 2015.

Does children's healthcare seeking change after participation in a musculoskeletal study? A register-based study.

BACKGROUND: Participating in research studies often involves interactions with healthcare professionals, potentially influencing the participant's future help-seeking behaviour. We investigated whether participating in the Childhood Health Activity and Motor Performance School Study - Denmark (CHAMPS) (2008-2014), which involved telephone consultations and clinical assessments by healthcare professionals with participants experiencing musculoskeletal complaints, changed frequency of contacts with primary public healthcare services among participants over the subsequent five-years-period, compared to non-participating children. METHODS: Using Danish health register data from 1998 to 2020, we compared CHAMPS participant's and two control group's contacts with private physiotherapists, chiropractors (outside hospitals), and general practitioners: a random 10% sample of children from Denmark (National Controls), and a secondary local control group (Local Controls) during three periods: Before (1998-31.10.2008), during (01.11.2008-20.06.2014), and after (21.06.2014-31.12.2019) the CHAMPS-study. Separate multivariable Poisson regression models were used to assess the differences between groups for the outcome variables: contacts with physiotherapists, chiropractors, and general practitioners, and overall contacts. RESULTS: Compared to National Controls, the CHAMPS-Group had fewer physiotherapy contacts before the study with an estimated mean of 0.01 vs 0.02 per person-year, and after (0.13 vs 0.18 per person-year), corresponding to a crude incidence rate ratio (IRR) of 0.69 (95% confidence intervals (CI): 0.58-0.83) after the study period. However, they had more chiropractor contacts before (0.05 vs 0.03), and after (0.21 vs 0.09) the study, with a crude IRR of 2.29 (95% CI: 1.93-2.71) after the study period. General practice contacts were equal for the CHAMPS-group compared to national controls (5.84 vs 5.84) before the study but reduced during and after (3.21 vs 3.71), with a crude IRR of 0.86 (95% CI: 0.83-0.90) after the study. Comparable patterns of contacts changes from before to after the study were observed between the CHAMPS-group and the Local Controls except for physiotherapy which was equal between the two groups after the study. CONCLUSION: Our findings suggest that research studies involving systematic engagement with participants experiencing musculoskeletal complaints can influence subsequent healthcare-seeking behaviour. Future research should address the influence of health literacy, health education, and healthcare provider recommendations on healthcare decisions during such research studies.

'After they see what you have, they contact you': a qualitative study of national team football players', coaches' and clinicians' experiences in engaging with a context-specific injury surveillance system.

BACKGROUND: Sports injury surveillance systems aid injury prevention, but their development without considering end-users' perspectives has led to low adherence and honesty in self-reporting by players, compromising their effectiveness. Context-specific injury surveillance systems have been proposed to address these challenges, but there is a limited understanding of stakeholders' perceptions and experiences in using them. OBJECTIVE: Following the implementation of a context-specific injury surveillance system with 100% player adherence over 60 weeks, the study aimed to investigate Under-21 Maltese national football team players', coaches' and clinicians' experiences of how and why they engaged with the system. METHOD: Seventeen semi-structured interviews with Under-21 Maltese male national football team players (n = 12), their coaches (n = 3) and clinicians (n = 2) were conducted. Data were analysed using reflexive thematic analysis. RESULTS: Participants highlighted questionnaire-related factors that motivated engagement with the context-specific injury surveillance system (theme 1) and factors influencing further engagement with the system based on stakeholders' actions (theme 2). Perceived outcomes experienced as a result of engaging with the injury surveillance system (theme 3), in turn, motivated players to continue reporting and engaging with the system. CONCLUSION: To encourage players' sustained reporting, injury-related information collected from well-designed questionnaires should serve to stimulate communication and teamwork among stakeholders, to prevent injuries and enhance performance.

Archery-Related Musculoskeletal Injuries: An Epidemiological Study Revealing Injury Sites, Risk Factors, and Implications for Prevention.

Objective: While generally considered a safe sport, archery injuries are often the result of overuse or penetration and largely affect the upper extremities. Studies have shown that during training periods the average risk of injury is 4.4%. By studying mechanisms of injury and their prevalence nationally, this study aims to educate coaches, athletes, and equipment manufacturers on ways the sport can be safer from a clinical perspective. Methods and Materials: The National Electronic Injury Surveillance System Database was queried to analyze archery-related musculoskeletal injuries that occurred between 2013 and 2022. Results: Approximately 43,083 injuries were recorded over a 10-year span, of which 8,038 were women and 35,367 were men. Men were thus 4.4 times more likely to experience injury during archery. Injury sites in men included the finger (66.2%), hand (17.1%), face (6.2%), shoulder (5.4%), and foot (5.1%). All reported injuries in women were finger-related. The most common diagnoses for men were lacerations (58.1%), fractures (12.7%), contusions and abrasions (7.5%), foreign body (5.9%), punctures (4.9%), and strains/sprains (4.9%). Women exclusively experienced lacerations, accounting for 100% of their injuries. Conclusion: The study identifies that lacerations were the most common archery-related injury that was treated in the ED. Additionally, the fingers were the most common site of injury. Findings from this study suggest that improved safety equipment, such as reinforced gloves, finger tabs, and forearm braces should be used by athletes to practice the sport more safely. Future research could involve studying injury rates in archers who use each combination of these safety precautions to investigate which gear is most protective.

A qualitative exploration of forensic pathology service staff perceptions of the implementation barriers and facilitators of manual- and electronic injury mortality surveillance system methods in South Africa.

BACKGROUND: Injury mortality surveillance systems are critical to monitor changes in a population's injury outcomes so that relevant injury prevention responses may be adopted. This is particularly the case in South Africa, where the injury burden is nearly twice the global rate. Regular evaluations of surveillance systems are pivotal to strengthening surveillance capacity, performance, and cost effectiveness. The National Injury Mortality Surveillance System (NIMSS) is an injury mortality surveillance system that is currently focused in Mpumalanga and utilises manual and electronic web-based systems for data collection. This study explored Forensic Pathology Service (FPS) staff perceptions of the implementation barriers and facilitators of manual- and electronic injury mortality surveillance system methods. METHODS: A qualitative study was employed using purposive sampling. Forty-seven participants, aged 29 to 59 years comprising 31 males and 16 females were recruited across 21 FPS facilities that serve the province. The formative evaluation occurred over the November 2019 to November 2022 period. Twelve focus group discussions were thematically analysed to determine emerging themes and patterns related to the use of the system using the WHO surveillance system guidelines as a framework. RESULTS: The key themes concerning the barriers and facilitators were located along WHO attributes of simplicity, acceptability, timeliness, flexibility, data quality and stability. Distinctions between the manual and e-surveillance systems were drawn upon across the attributes highlighting their experience with the system, user preference, and its contextual relevance. With Mpumalanga predominantly rural, internet connectivity was a common issue, with most participants consequently showing a preference for the manual system, even though the electronic system's automated internal validation process was of benefit. The data quality however remained similar for both methods. With program stability and flexibility, the manual system proved more beneficial as the dataset was reported to be easily transferrable across computer devices. CONCLUSION: Obtaining FPS perceptions of their experiences with the system methodologies are pertinent for the enhancement of injury surveillance systems so to improve prospective engagements with the systems. This will facilitate timely and accurate injury mortality information which is vital to inform public policy, and injury control and prevention responses.

Preventable tragedies: findings from the #NotAnAccident index of unintentional shootings by children.

BACKGROUND: Between 2015 and 2021, 3,498 Americans died from unintentional gun injuries, including 713 children 17 years and younger. Roughly 30 million American children live in homes with firearms, many of which are loaded and unlocked. This study assesses the scope of unintentional shootings by children 17 and younger in the US and the relationship between these shootings and state-level secure storage laws. METHODS: Demographic and injury data of both perpetrators and victims of unintentional shootings by children 17 and younger in the US from 1/1/2015-12/31/2021 were extracted from the #NotAnAccident Index. The #NotAnAccident Index contains media-report data, which is systematically flagged through Google Alerts. We describe characteristics of incidents and examine incident rates over time. The association between state-level secure storage laws and rates of unintentional shootings by children is assessed in multivariate negative binomial regression models. RESULTS: 2,448 unintentional shootings by children resulted in 926 deaths and 1,603 nonfatal gun injuries over a period of seven years. Most perpetrators (81%) and victims (76%) were male. The mean age was 10.0 (SD 5.5) for shooters and 10.9 (SD 8.1) for victims. Children were as likely to shoot themselves (49%) as they were to shoot others (47%). The majority of victims were under 18 years old (91%). Shootings most often occurred in or around homes (71%) and with handguns (53%). From March to December 2020, coinciding with the COVID-19 pandemic, incidents increased 24% over the same period in 2019, which was driven largely by an increase among shooters ages 0-5. Depending on the type of law, rates of unintentional shootings by children were 24% to 72% lower in states with secure storage laws, compared to states without such laws. CONCLUSIONS: Unintentional shootings by children are on the rise, particularly among children 0-5 years old, but are preventable tragedies. Our results show that secure firearm storage policies are strongly correlated with lower rates of unintentional shootings by children. Firearm storage policies, practices, and education efforts are needed to ensure guns are kept secured and inaccessible to children.

Epidemiology of musculoskeletal injury in military recruits: a systematic review and meta-analysis.

BACKGROUND: Injuries are a common occurrence in military recruit training, however due to differences in the capture of training exposure, injury incidence rates are rarely reported. Our aim was to determine the musculoskeletal injury epidemiology of military recruits, including a standardised injury incidence rate. METHODS: Epidemiological systematic review following the PRISMA 2020 guidelines. Five online databases were searched from database inception to 5th May 2021. Prospective and retrospective studies that reported data on musculoskeletal injuries sustained by military recruits after the year 2000 were included. We reported on the frequency, prevalence and injury incidence rate. Incidence rate per 1000 training days (Exact 95% CI) was calculated using meta-analysis to allow comparisons between studies. Observed heterogeneity (e.g., training duration) precluded pooling of results across countries. The Joanna Briggs Institute Quality Assessment Checklist for Prevalence Studies assessed study quality. RESULTS: This review identified 41 studies comprising 451,782 recruits. Most studies (n = 26; 63%) reported the number of injured recruits, and the majority of studies (n = 27; 66%) reported the number of injuries to recruits. The prevalence of recruits with medical attention injuries or time-loss injuries was 22.8% and 31.4%, respectively. Meta-analysis revealed the injury incidence rate for recruits with a medical attention injury may be as high as 19.52 injuries per 1000 training days; and time-loss injury may be as high as 3.97 injuries per 1000 training days. Longer recruit training programs were associated with a reduced injury incidence rate (p = 0.003). The overall certainty of the evidence was low per a modified GRADE approach. CONCLUSION: This systematic review with meta-analysis highlights a high musculoskeletal injury prevalence and injury incidence rate within military recruits undergoing basic training with minimal improvement observed over the past 20 years. Longer training program, which may decrease the degree of overload experienced by recruit, may reduce injury incidence rates. Unfortunately, reporting standards and reporting consistency remain a barrier to generalisability. TRIAL REGISTRATION: PROSPERO (Registration number: CRD42021251080).

Relationships Between Common Preseason Screening Measures and Dance-Related Injuries in Preprofessional Ballet Dancers.

OBJECTIVE: To examine modifiable and nonmodifiable factors for associations with dance-related injury among preprofessional ballet dancers over 5 academic years. DESIGN: Prospective cohort study. METHODS: Full-time preprofessional ballet dancers (n = 452; 399 female; median age [range], 15 years [11-21]) participated across 5 academic years at a vocational school. Participants completed baseline screening and online weekly injury questionnaires including dance exposure (hours/week). Zero-inflated Poisson regression models were used to examine associations between potential risk factors measured at baseline and self-reported dance-related injury. RESULTS: In count model coefficients, left one leg standing score (log coefficient estimate, -0.249 [95% CI: -0.478, -0.02]; P = .033) and right unipedal dynamic balance time (log coefficient estimate, -0.0294 [95% CI: -0.048, -0.01]; P>.001) carried a protective effect with increased years of training when adjusted for Athletic Coping Skills Inventory (ACSI) score. A significant association was found for left unipedal dynamic balance time and dance-related injury (log coefficient estimate, 0.013 [95% CI: 0.000, 0.026]; P = .045) when adjusted for years of training and ACSI score. There were no significant associations between dance-related injury and ankle and hip range of motion, active straight leg raise, or Y Balance Test measures. CONCLUSION: When adjusted for years of previous dance training and psychological coping skills, there was a significant association between limb-specific lumbopelvic control and dynamic balance tasks, as well as self-reported dance-related injury in preprofessional ballet. J Orthop Sports Phys Ther 2023;53(11):703-711. Epub 3 October 2023. doi:10.2519/jospt.2023.11835.

Two decades of nonfatal injury data: a scoping review of the National Electronic Injury Surveillance System-All Injury Program, 2001-2021.

BACKGROUND: Injury is a leading cause of preventable morbidity and mortality in the USA. Ongoing surveillance is needed to understand changing injury patterns to effectively target prevention efforts. Launched jointly in 2000 by the Consumer Product Safety Commission (CPSC) and the Centers for Disease Control and Prevention (CDC), the National Electronic Injury Surveillance System-All Injury Program (NEISS-AIP) provides national-level estimates of US emergency department visits for nonfatal injuries. A scoping review of peer-reviewed articles was conducted to characterize how NEISS-AIP data have been used for injury surveillance in the USA. MAIN BODY: This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Three bibliographic databases (PubMed, Scopus, and Google Scholar) were systematically searched for English language peer-reviewed articles that used NEISS-AIP data as the primary data source during 2001-2021. Key article characteristics from included articles were abstracted to generate descriptive summary statistics to understand the use and limitations of NEISS-AIP for injury surveillance. Database queries returned 6944 citations; 594 citations were manually reviewed, and 167 non-duplicate journal articles were identified. An average of 8.0 articles (range: 1-14) were published annually during 2001-2021. Articles appeared in 72 different journals representing a diverse audience with the majority of articles written by CDC authors. Starting in 2013, a higher proportion of articles were published by non-CDC authors. The largest number of articles examined injury among all age groups (n = 71); however, the pediatric population was the specific age group of greatest interest (n = 48), followed by older adults (n = 23). Falls (n = 20) and motor-vehicle-related injuries (n = 10) were the most studied injury mechanisms. The most commonly identified limitation identified by authors of reviewed articles was that NEISS-AIP only produces national estimates and therefore, cannot be used for state- or county-level injury surveillance (n = 38). CONCLUSIONS: NEISS-AIP has contributed to nonfatal injury surveillance in the USA. CDC and CPSC continue to work together to expand and enhance NEISS-AIP data collection. Researchers are encouraged to continue using this publicly available dataset for injury surveillance.

Adolescent track and field injuries presenting to US emergency departments.

OBJECTIVES: Track and field (T&F) is a highly popular sport for adolescents. The diversity of running, jumping, and throwing events within the sport can result in unique injury patterns for adolescent track and field participants. The purpose of this study was to estimate injury risk in adolescent T&F and describe the types of injuries resulting in ED visits, classified by T&F events. METHODS: Emergency department (ED) data from the National Electronic Injury Surveillance System were obtained for a 20-year period from 2000 through 2019. Cases involving 14- to 18-year-olds participating in T&F were classified by sex, case severity, involved body region, and the T&F event patients were engaged in at the time of their injury. National estimates and Injury rates were calculated using national high school T&F participation data. Longitudinal trends in ED visits were measured using linear regression. Rate ratios (RRs) were used to compare the risk and severity of ED visits by sex. RESULTS: 8,060 track and field related ED encounters were observed, representing an estimated 272,227 encounters nationally over the 20-year study period. The rate of ED encounters increased significantly over the study period (p < 0.001). Adolescent females exhibited a higher rate of ED encounters (RR: 1.23, 95% CI: 1.22-1.24), but a lower rate of hospital admissions (RR: 0.68, 95% CI: 0.64-0.73) compared to males. The lower extremity was the most commonly injured body region for most T&F events, but this differed for sprinting, high jumping, shot put, and javelin events. Most T&F events resulted in unique injury patterns characteristic of their athletic demands. CONCLUSIONS: There was an increasing trend of ED visits from adolescent T&F participants throughout the 20-year study period with different injury patterns observed by sex and T&F event discipline.

Epidemiology of shoulder dislocations presenting to United States emergency departments: An updated ten-year study.

BACKGROUND: Glenohumeral dislocation is a common injury that may predispose patients to chronic pain and instability. However, there is a paucity of current data available regarding the epidemiological trends of this injury. AIM: To provide an updated, comparative assessment of the epidemiology of shoulder dislocations presenting to emergency departments in the United States. We also sought to analyze patient demographic risk factors and consumer products associated with dislocation events. METHODS: Data were obtained from the national electronic injury surveillance system database for glenohumeral dislocations between 2012 and 2021. Incidence, age, sex, and injury characteristics were analyzed using weighted population statistics as well as incidence rates and 95% confidence intervals (CI). RESULTS: In total, an estimated 773039 shoulder dislocations (CI: 640598-905481) presented to emergency rooms across the United States during the study period. The annual incidence rate was 23.96 per 100000 persons and the average patient age at the time of injury was 37.1 years. Significantly more male patients sustained dislocations than female patients (537189, 69.5%, vs 235834, 30.5%, P < 0.001). With regard to associated consumer products, sports and recreation equipment were involved in the highest proportion of incidents (44.31%), followed by home structures and construction materials (21.22%), and home furnishings, fixtures, and accessories (21.21%). Regarding product sub-groups, stairs, ramps, landings, floors was cited in the greatest number of cases (131745). CONCLUSION: The national annual incidence rate of glenohumeral dislocations throughout the study period was approximately 23.92 per 100000 persons. Male adolescents sustained the highest proportion of dislocations, with a peak incidence in age group 15-20 years, predominantly secondary to participation in sporting and recreational activities. Conversely, women experienced a relatively consistent incidence of dislocation throughout their lifespan. After age 63, the incidence rate of dislocations in females was found to surpass that observed in males.