Injury survey in competitive sub-elite rhythmic gymnasts: results from a prospective controlled study.

AIM: The aim of this study was to determine the frequency, anatomical site and types of injury incurred in rhythmic gymnastics. METHODS: An 8-month prospective and controlled injury survey was planned, including 70 club-level competitive rhythmic gymnasts, aged 13-19 years. Information on injury events was recorded weekly in an injury record booklet for any event occurring over that week. Height, weight, anthropometric measurements and time spent in physical activity were recorded at baseline. Data from 72 age-matched non-athletic females served as controls. RESULTS: Forty-nine significant injuries were reported by gymnasts and 34 by controls (70% vs 47%, P<0.005, odds ratio 2.28); gymnasts sustained a rate of 1.08 injuries per 1 000 h of training. The most prevalent anatomical sites sustaining injury were the ankle and the foot (38.9%), followed by back (22.2%). Strains and sprains were frequently reported both in gymnasts and in controls. Gymnasts missed an average of 4.1 days of physical activity as compared to 18.9 days for the control females. Alternatively, modification of training sessions occurred more frequently for the gymnast group (32 vs 7 cases for controls). The total school days missed were lower for the injured gymnasts than for the injured controls (27 vs 64 days). CONCLUSION: Competitive, club-level rhythmic gymnastics show a higher prevalence of injuries than non-athletic controls, but considering the high number of hours spent in training sessions, it derives that rhythmic gymnasts is a sport discipline at relatively low risk of severe injuries. These are mainly limited to back and lower limbs, are generally not severe and do not significantly hinder the preparation for the competitions.

Low back pain in competitive rhythmic gymnasts.

AIM: It has been reported that rhythmic gymnasts are at risk of suffering from low back injuries, because of repetitive lumbar hyperextensions. On the other hand, this sport requires features of leanness, muscular strength and flexibility that should represent protective factors for back pain. METHODS: This cross-sectional study aimed to assess the prevalence of low back pain in 67 club-level competitive rhythmic gymnasts aged 13-19 years. A standardized questionnaire was used to evaluate back-pain symptoms. Anthropometric measurements, time spent in physical activity, psychological testing results, smoking habits and age of menarche were recorded. One hundred and four age-matched general females served as control group. RESULTS: Low back pain complaints were reported by 7 rhythmic gymnasts and by 27 controls (10.4% vs 26.0%, p<0.05); the prevalent location of back pain was bilateral in gymnasts and central in controls. Gymnasts had lower body weight, body mass index, fat body mass and delayed menarche. The females with low-back pain displayed higher body weight, body mass index, fat body mass, age, a greater smoking habit and more anxious/depressive behaviour, both in the gymnast and in the control group. CONCLUSION: Competitive, club-level rhythmic gymnasts show a reduced prevalence of low back-pain. Being younger in age, having greater leanness, not smoking, displaying less anxious/depressive behaviour, and developing increased muscle strength and flexibility, all can represent preventive factors for low back pain. This study suggests that rhythmic gymnastics is not a discipline at increased risk of low back pain.

Human and financial costs of noninvasive mechanical ventilation in patients affected by COPD and acute respiratory failure.

STUDY OBJECTIVES: It has been suggested that noninvasive mechanical ventilation (NIMV) may be a time-consuming procedure for medical and paramedical personnel. We carried out a prospective trial in 10 consecutive COPD patients aimed at assessing the human and economic resources needed to ventilate patients by NIMV and we compared these with those needed by a group of six patients receiving invasive mechanical ventilation (InMV). DESIGN: The daily cost and the minutes spent by medical doctors (MDs), respiratory therapists (RTs), and nurses (Ns) were recorded during the first 48 h of ventilation in 10 patients during NIMV (group A) and in six who received InMV (group B) after an initial unsuccessful attempt with NIMV. In two subgroups of patients (five for group A and four for group B), the analysis was also performed, except for RTs, for the total length of mechanical ventilation. SETTING: A respiratory ICU. PATIENTS: At hospital admission, the two groups of COPD patients did not differ for blood gas values (PaCO2 = 88.2+/-9.8 mm Hg for group A vs 90.5+/-12.8 mm Hg for group B, and pH = 7.21+0.08 vs 7.20+0.08, respectively) or for clinical and neurologic status, but patients of group B had not tolerated NIMV. MEASUREMENTS AND RESULTS: The total time spent at the bedside in the first 6 h did not differ between group A and B (group A = 72.3 min [MD], 87.2 min [RT], and 178.8 min [N] vs 98.8 min [MD], 12.5 min [RT], and 197.6 min [N] for group B). In the following 42 h, a plateau was reached so that there was a significant reduction for both groups in the time of assistance given by Ns (p<0.001) but not by MDs or RTs. The total costs were also not different between the two groups ($806+/-73 [US dollars per day] vs $864+/-44 for group A and B, respectively). In the subgroups monitored for the entire period of ventilation, a significant reduction in the time of assistance, for both MDs and Ns, was observed after approximately the first half. CONCLUSIONS: We conclude that in the first 48 h of ventilation, daily NIMV is neither more expensive nor time-consuming and staff demanding than InMV. After the first few days of ventilation, NIMV was significantly less time-consuming than InMV, for MDs and Ns, so that medical and paramedical time expenditure seems not to be a major problem during NIMV.

The incidence of nosocomial infections in a pneumology division and intermediate intensive care unit.

It has been shown that the problem of nosocomial infections is different in each specialist hospital division, and it is important to be aware of the local situation and to identify the specific problems. In order to set up an effective prevention programme and in the setting of a general system of control of nosocomial infection, we studied the incidence of infections and correlated the pathogenic organisms appearing during hospitalization in patients admitted to our Pneumology Division and Intermediate Intensive Care Unit over a period of 12 months. A nosocomial infections incidence of 13% was observed and 75% of these were respiratory, 21% urinary and 4% other infections. Seventy two percent of pathogenic agents were Gram-negative bacilli and 28% Gram-positive cocci. The site-specific rates of infections observed are related to intrinsic (host dependent) and extrinsic (non-host-dependent) risk factors that have not been exhaustively evaluated in the present study. However, the data so far collected will allow us to redirect the resources used in the control of nosocomial infections by targeting efforts at the surveillance of better defined groups of patients and by achieving data more suitable for comparisons between hospitals.