The Role of Age as a Risk Factor for Pickleball-Related Injuries

Pickleball is a popular sport that includes players from many different demographics. The popularity has resulted in not only increases in participation but also in activity related injuries. The purpose of this study was to identify risk factors along with potential mechanisms for injuries related to pickleball and identify effective countermeasures. Methods included the identification of pickleball related injuries from a US National Emergency Room database (NEISS). A narrative section of the database was used to identify and categorize potential mechanisms of injury. Results indicated that the types and mechanisms of injury relate to three specific age groups: younger, middle age, and older players. Injuries to younger players under the age of 26 are likely the result of misuse of sport equipment. Middle aged players from 26 to 50 sustained injuries more related activity overuse. However, there were more concerns with players over 50 years of age with a great percentage resulting in cardia arrest or symptoms leading to more severe cardiovascular conditions. While pickleball activity should be encouraged as it is a beneficial form of physical activity, there should be specific age-group interventions to reduce injury. It should be highly recommended that doctors approve the activity for individual at risk for heart conditions and supervision for adults in that age group.

Identifying sex-specific injury predictors as a key factor in maintaining optimal physical activity levels

BACKGROUND Optimal physical activity is known to reduce cardiovascular,respiratory and endocrine system diseases and,as a consequence,improve quality of life.An important risk factor for reinjuries during normal exercise is the initial connective tissue pathology.The variety of clinical dysplastic manifestations significantly complicate the timely diagnosis of this comorbidity.AIM To establish pathognomonic sex-specific dysplasia phenotypes that indicate a particular sensitivity to physical exertion.METHODS The study involved 117 participants with recurrent musculoskeletal injuries that occurred during normal exercise.There were 67 women(57.26%)and 50 men(42.74%),which made it possible to compare the presence of the identified signs between sexes.A validated questionnaire was used to screen their connective tissue status.RESULTS Ranking the most commonly revealed dysplasia signs depending on their clinical significance made it possible to establish pathognomonic sex-specific phenotypes that indicated a particular susceptibility to injuries.Individualized programs of optimal physical activity are necessary for men with chest deformities,flat-valgus feet,dolichostenomelia,arachnodactylia,hemorrhoids,abdominal muscle diastasis and recurrent hernias.In women,special sensitivity to physical exertion was associated with a combination of signs such as asthenic body,joint hypermobility,overly soft auricles,thin hyperelastic skin,atrophic striae,telangiectasias and varicose veins.Of particular importance were universal signs such as gothic palate,scoliosis,kyphosis,leg deformities,temporomandibular joint crunching,and moderate to high myopia.CONCLUSION Participants’connective tissue condition should be considered when designing optimal physical activity programs.Identifying the established sex-specific dysplasia phenotypes will allow timely optimization of training loads,thus reducing the risk of injury.

Physical restraint use rate and total fall and injurious fall rates: An exploratory study in two US acute care hospitals

This exploratory study used archived hospital data to investigate the relationships between the percentage of patients with physical restraints and the total fall rate as well as the injurious fall rate per 1000 patient-days. The two tested research questions were 1) What is the relationship between the restraint use rate and the total fall rate? 2) What is the relationship between the restraint use rate and the injurious fall rate? The results showed that a higher restraint use rate was associated with a higher total fall rate, yet a lower injurious fall rate in adult inpatient acute care settings. In efforts for fall and injurious fall prevention, front-line managers need to balance the frequency and appropriateness of physical restraint use with optimizing patients’ physical activity. Future research should explore the cause–effect relationship between physical restraint use and consequent injurious fall incidents.

物理治疗(Physical Therapy)专业在美国的发展——美国高校体育系新专业介绍

物理治疗专业培养专业的康复和治疗人员 ,对人的残障、损伤和疾病予以预防、治疗和康复 ,特别是对体育运动中出现的损伤与康复有着重要的作用。该专业在美国已有 80多年的发展历史 ,体育教育出现此专业只有近几十年的历程。随着大众体育运动的普及和人们对健康与安全的日益关心 ,物理治疗专业必将受到全社会的重视和欢迎。

Prevalence of musculoskeletal injuries and a proposal for neuromuscular training to prevent lower limb injuries in Brazilian Army soldiers:an observational study

Background: The activities carried out by soldiers in the army involve great physical demands and require intense trainings to perform combat-specific tasks. Musculoskeletal injury is a potential threat to the health and physical integrity of the soldier. This study aimed to evaluate the prevalence of lower limb musculoskeletal injuries among soldiers and to propose a training protocol to prevent the most frequent injuries.Methods: This observational(cross-sectional) study recruited a sample of 103 soldiers who required medical attention,from a total 202 new battalion soldiers. The medical records(paper and online) had a form of running text. All data collected were recorded by the registered physicians of the battalion medical post. The records were analyzed by the following variables: medical diagnosis, injury site, mechanism, type of treatment, time loss, existence of previous injury,and recurring injury.Results: A total of 112 musculoskeletal injuries were diagnosed in 71 soldiers, and other types of diseases/injuries were diagnosed in the other soldiers. Joint pain accounted for 55.4% of the diagnoses. The knee was the most affected site, while trauma and overload were the most common mechanisms of injury. Drug treatment was used most frequently, accounting for 58% of the cases. The majority of the sample obtained a temporary leave of absence for1 to 6 days or not at all. Previous injuries and recurrence were not presented as risk factors for injury. With the data received, a protocol for the prevention of injuries to the lower limbs was proposed.Conclusions: This study indicated that the most frequent site of injury is the knee, and joint pain is the most common diagnosis. These results may support the necessity to develop a neuromuscular training protocol to prevent lower limb injuries, which we suggest to be applied in future studies.

Establishing minimum clinically important difference values for the Patient-Reported Outcomes Measurement Information System Physical Function, hip disability and osteoarthritis outcome score for joint reconstruction, and knee injury and osteoarthritis out

AIM To establish minimum clinically important difference(MCID) for measurements in an orthopaedic patient population with joint disorders.METHODS Adult patients aged 18 years and older seeking care for joint conditions at an orthopaedic clinic took the Patient-Reported Outcomes Measurement Information System Physical Function(PROMIS~? PF) computerized adaptive test(CAT), hip disability and osteoarthritis outcome score for joint reconstruction(HOOS JR), and the knee injury and osteoarthritis outcome score for joint reconstruction(KOOS JR) from February 2014 to April 2017. MCIDs were calculated using anchorbased and distribution-based methods. Patient reports of meaningful change in function since their first clinic encounter were used as an anchor.RESULTS There were 2226 patients who participated with a mean age of 61.16(SD = 12.84) years, 41.6% male, and 89.7% Caucasian. Mean change ranged from 7.29 to 8.41 for the PROMIS~? PF CAT, from 14.81 to 19.68 for the HOOS JR, and from 14.51 to 18.85 for the KOOS JR. ROC cut-offs ranged from 1.97-8.18 for the PF CAT, 6.33-43.36 for the HOOS JR, and 2.21-8.16 for the KOOS JR. Distribution-based methods estimated MCID values ranging from 2.45 to 21.55 for the PROMIS~? PF CAT; from 3.90 to 43.61 for the HOOS JR, and from 3.98 to 40.67 for the KOOS JR. The median MCID value in the range was similar to the mean change score for each measure and was 7.9 for the PF CAT, 18.0 for the HOOS JR, and 15.1 for the KOOS JR.CONCLUSION This is the first comprehensive study providing a wide range of MCIDs for the PROMIS? PF, HOOS JR, and KOOS JR in orthopaedic patients with joint ailments.

Leisure-time physical activity,anthropometrics,and body composition as predictors of quality of life domains after spinal cord injury:an exploratory cross-sectional study

The objective of the current work was to examine the relationships between quality of life(QOL)domains in persons with spinal cord injury(SCI)and their levels of weekly leisure-time physical activity(LTPA),anthropometric variables,and body composition variables.This exploratory cross-sectional study consisted of baseline data collected as part of a randomized clinical trial at a VA Medical Center and SCI center.A convenience sample of 36 community-dwelling persons with SCI participated in the current study.Outcome measures included the World Health Organization Quality of Life Short Form(WHOQOL-BREF),Leisure-Time Physical Activity Questionnaire for People with Spinal Cord Injury(LTPAQ-SCI),anthropomorphic measures(waist,hip,and abdominal circumference),and dual-energy x-ray absorptiometry(DXA)to quantify regional and total body composition.Multiple regression models suggested that engagement in LTPA accounted for 35.7%of the variance in physical health QOL,33.5%in psychological QOL,14.2%in social relationships QOL,and 38.2%in environmental QOL.Anthropometric measures accounted for 11.3%,3.1%,12.0%,and 6.7%of the variance in these QOL indices,respectively,and DXA indices accounted for 18.7%,17.5%,27.4%,and 21.9%.Within these models,the number of minutes of heavy LTPA per day uniquely predicted physical health QOL,the number of mild LTPA days per week uniquely predicted psychological QOL,and the amount of mild LTPA per day uniquely predicted environmental QOL.Bivariate analyses also suggested that android and trunk fat,as well as supine waist and abdominal circumferences,were positively associated with social relationships QOL.Encouraging individuals with SCI to engage in LTPA may robustly enhance multiple aspects of QOL while reducing the risk for cardiovascular and metabolic morbidities associated with SCI.Moreover,this may lead to a further understanding of how QOL may impact longitudinal intervention trials.The study protocol and procedures were reviewed and approved by the McGuire VA Research Institutional Review Board(IRB#02152,approval date August 9,2015;IRB#02375,approval date May 2,2018).

Predictors of Chronic Physical and Mental Quality of Life Following Traumatic Brain Injury

Objective and Background: This study aimed at determining the predictors of chronic physical and mental quality of life (QOL) in patients with traumatic brain injury (TBI) focusing on neuropsychological functions post trauma. Materials and Methods: This is a longitudinal study in which 257 patients having inclusion criteria were enrolled. Neuropsychological tasks including logical memory, verbal paired associates, visual memory, verbal expression, auditory comprehension, semantic judgment and semantic categories were implemented. The appearance of psychiatric disorder, Agnosia, Apraxia, Dysarthria and pragmatic linguistic disorder post trauma were evaluated at discharge. QOL was studied 6 months after injury by filling SF-36 questionnaire via phone interview with patients. Results: Appearance of some post-traumatic disorders including agnosia, pragmatic linguistic disorder and psychiatric disorder were significantly correlated to poor QOL. The final step of logistic regression model showed that TBI severity, verbal memory, auditory comprehension and semantic acceptability scores were predictors of unfavorable mental QOL as well as TBI severity, injury severity scale (ISS) score and multifocal lesions for unfavorable physical QOL. Discussion: Thus, it is recommended that clinicians choose medical therapeutic priorities to improve the verbal neuropsychological sequela and provide preliminaries for a chronic favorable mental QOL. Furthermore, to prevent of chronic unfavorable physical QOL, early care of organic injuries should be considered especially in patients with severe and multifocal TBI.

Physical Training and Cardioprotection

Experimental, clinical and epidemiologic studies have provided strong evidence that physical training has beneficial effects on cardiovascular health. Numerous investigations have demonstrated that exercise increases coronary blood flow and myocardial perfusion. Importantly, training also can stimulate angiogenesis and accelerate collateral vessel growth in animal models with coronary artery occlusion. Cardiac adaptation such as increased vascularity or capillary density has been evidenced after regular endurance exercises. More recently, several studies indicate that physical training induces high levels of myocardial heat shock protein and antioxidant protein expression, which may play an important role in myocardial protection against ischemia-reperfusion injury.

体育训练中运动损伤的原因及预防策略

随着健康中国战略的提出,全民健康、全民运动成为我国民众身体素质提升的核心理念,体育训练作为实现健康中国战略的基本形式,不仅可以提高全民身体素质,还能够促进全民心理健康。但是,在体育训练中,运动损伤是不可避免的。基于此,该文将探讨体育训练中运动损伤的原因及预防策略,希望能够为健康中国战略布局及实施提供参考。

高职公共体育分层教学对学生体质健康的影响

促进学生体质健康是高职教育的重要任务,体育分层教学允许教师为学生制订符合其身体条件的运动计划,这有助于学生在安全的环境中提高体能,减少运动伤害的风险,进而有利于促进健康。为进一步明确其中机制和促进效果,以贵州交通职业技术学院学生为调查对象,根据分层教学的理论与实践基础,针对差异化学生设计不同的教学内容与教学方式,采取分组教学的授课方式对学生进行训练。通过数理统计方法对2020—2022年的体质测试数据进行分析并得出结论:分层教学对学生身体素质的提高具有显著效果,并且对学生的运动技能和兴趣需求有一定的促进作用,同时也有利于学生自感健康水平的提升。建议:精准评估学生体育水平;制定个性化学习目标;灵活调整分组;鼓励合作与竞争;优化教学内容和活动设计;进行持续性评价与反馈。

基于Haddon矩阵和ISM的学校体育教学伤害事故的致因分析

体育课是学校开展体育教育的主要途径,在学生全面发展的过程中扮演着重要角色。由于体育运动本身就是与风险相伴,因此无法做到完全杜绝风险。本文通过引入Haddon矩阵技术,从发生前、发生时、发生后3个维度对学校体育教学伤害事故进行剖析,较为直观地呈现伤害事故的各种致因;通过提取公因子的方式研究出学校体育教学伤害事故的15个风险因素,将其分为宿主因素、教师因素、物理环境因素、社会环境因素4大类;利用SPSSAU软件进行分析,构建出层次化的解释结构模型(ISM);对学校体育教学伤害事故的影响因素进行划分,以此系统解释学校体育教学伤害发生的深层根本因素、中间层间接因素、表层直接因素;提出了相应的风险管控措施,可为预防学校体育教学伤害事故的发生提供参考。

人体损伤残疾评定域外标准概要与启示

我国法庭科学/司法鉴定标准化体系正处于全面建设阶段,作为人身损害赔偿重要依据之一的残疾评定标准应根据医学、法医学的进步不断加以完善,是公正处置此类案件的必要前提。当前应通过专业领域的跨学科合作,例如医学、心理学、社会学等,更好地理解和把握残疾的多层次性质,并在此基础上提高我国残疾标准的制修订能力,健全标准体系,使之更具科学性、客观性和可操作性。同时,需重视国际经验的借鉴,提高我国残疾评定标准的国际化水平及国际交流。通过分析北美地区、欧洲地区、亚洲地区及大洋洲地区国家的残疾评定标准,从适用范围、标准体系之特点、架构和理念等展开讨论,为我国人体损伤残疾评定标准的研制和应用提供国际化视野和新的思路。

新时期消防员体能训练损伤现状调研与对策建议

改革转隶后,消防救援队伍救援职能的拓展和职业周期的延长对消防员的体能提出了更高的要求。本研究对我国不同地区的消防员体能训练现状开展调研,结果显示:消防救援队伍训练损伤率较高,主要表现为关节损伤和肌肉韧带拉伤,且损伤部位主要集中在膝、腰、踝、肩、腕5个部位;造成损伤的主要原因包括动作不标准、对损伤预防认识不足、拉伸放松不到位、准备活动不充分、过度疲劳尚未恢复等。针对调研结果,本研究从职业需求、训练科目、科学训练原则和运动防护装备等方面提出了消防员训练损伤的防护方法。

汽车碰撞驾驶员下肢行为响应及损伤分析

当前汽车碰撞试验中所用假人为标准姿态,忽略了驾驶员本能应急行为对自身损伤的影响。基于此问题,通过搭建沉浸式驾驶模拟器获取碰撞环境下驾驶员下肢姿态的变化特征并利用有限元方法对碰撞场景进行模拟仿真,最终通过数据分析对比驾驶员应急行为下人体各部位损伤情况。研究结果表明:当脚部位于油门踏板上时驾驶员头部以及大腿损伤较为严重,脚部踩压制动踏板时,胸部压缩量相较于其他姿态峰值增大了22.3%,脚部位于制动踏板上时颈部伸张力矩峰值最大,粘性指数峰值减小了25%。驾驶员下肢行为变化时其身体运动姿态、各部位的损伤程度有明显差异且与标准姿态相比各部位损伤情况也有显著不同。研究结果能够为针对中国驾乘人员的车辆安全防护设计提供新思路,同时对国内碰撞法规的完善具有很好的参考价值。

社会网络视域下我国学校体育伤害事故致因与化解研究

为加强学校体育伤害事故防控,基于187份学校体育伤害事故裁判文书,采用社会网络分析法构建学校体育伤害事故致因网络并进行分析,从动态网络视角探索学校体育伤害事故的化解策略。结果表明:(1)学校体育伤害事故致因网络具有小世界特征,致因在网络中传播速度较快且彼此之间具有较强连通性;(2)学生自身原因是导致学校体育伤害事故发生的主要致因;(3)学生忽视自身安全、忽视同学安全、个人实施危险行为和教师忽视体育课堂安全教育、教学中安全保护缺失、未对课堂进行有序组织增加学校体育伤害事故发生的可能性,通过将网络中的这些节点进行消除,使派系之间无法联通,能够有效降低学校体育伤害事故发生概率;(4)不同体育活动组织形式下子网络之间的特征向量中心度存在显著差异,且体育教学子网络的平均特征向量中心度相对较高,应加强对体育教学的风险防控;(5)学校体育伤害事故化解应重点消除学生、教师和学校层面的12个致因。

身体运动功能训练对陆军士兵训练伤病的影响及综合干预效果研究

对我军陆军士兵应用身体运动功能训练体系进行体能训练干预,以观察其对士兵功能水平、军事训练伤发生情况、体能水平以及主观感受度的影响。采用以下方法:从某军区陆军一线作战部队选取205名陆军士兵进行为期16周的实验,将205名士兵随机分成实验组(n=103)和对照组(n=102)。实验组士兵采用身体运动功能训练,对照组士兵采用陆军传统体能训练。在实验前后对两组士兵的FMS得分、训练伤发生率、体能素质等指标进行测试与评估。得到以下结果:在FMS 7个单项测试中,实验组士兵有5项得分高于对照组且具有统计学意义(p<0.05);在军事训练伤病的评估中,实验组总伤病率由58.3%下降到30.1%,对照组总伤病率由56.9%上升到61.8%,实验组伤病率对比对照组显著下降,具有统计学意义(p<0.01);在体能素质上,实验组的各项体能指标均高于对照组;通过主观感受量表调查显示,实验组士兵对身体运动训练体系非常认可,主观接受度较高。取得以下结论:基于身体运动功能训练理念设计的军事体能训练方案能够改善陆军士兵的身体功能性障碍,降低军事训练伤的发生率,且能够有效提高士兵的体能水平,综合效果较好,值得陆军大规模推广。

岩体物理模拟实验中的相似材料配比

为确定岩体物理模拟实验中常见相似材料的配比,首先选取河砂、重晶石粉、石膏和水泥四种原料,采用正交设计的方法,设置骨胶比(河砂和重晶石粉质量与石膏和水泥质量之比)、水膏比(水泥质量与石膏质量之比)和重晶石掺量(重晶石粉质量与骨料质量之比)3个因素,每个因素5个水平,开展单轴压缩情况下的密度试验和声发射试验,然后确定不同配比对相似材料物理力学指标和表征损伤程度指标(D)的敏感性。试验结果表明:在骨胶比影响下,相似材料密度、抗压强度和弹性模量的极差最大,分别为0.13 g/cm^(3)、2.60 MPa和247 MPa,F检验值最大,显著性最高;在重晶石掺量影响下,泊松比的极差最大,为0.09,同样显著性最高;在骨胶比影响下D的极差最大,为0.25,显著性最高。总的来说,骨胶比对相似材料密度、抗压强度、弹性模量和D起控制作用,重晶石掺量对泊松比起控制作用;重晶石掺量最优为20%。

元宇宙空间人身权利的刑法保护

身份型虚拟人是自然人在虚拟世界的数字分身,其本质是自然人身体在元宇宙的延伸。人格权要素是基于自然人的生物性和社会性形成的,虚拟人不具有独立人格,与自然人共享同一人格。元宇宙全真体验使自然人的身体可以通过网络触及,强调现实物理接触的人身权利刑事规范在元宇宙空间难以适用。脑机接口技术改变了人感知疼痛的路径,虚拟人受到暴力作用时,痛觉将直接传递至自然人的大脑,导致现行刑法无法应对非物质性伤害类型。元宇宙是人类社会的组成部分,元宇宙人机融合技术发展不应违背社会伦理,应坚持以刑法规制保障自然人在元宇宙的人身法益。元宇宙空间不会导致自然人名誉权、隐私权等精神性人格权保护的差异。由于虚拟人不具有生物性,生命权的保护不应延伸至元宇宙。元宇宙空间的暴力伤害行为应视为对自然人精神健康的伤害,应当受到刑法同等保护。虚拟空间的强奸罪和强制猥亵罪的危害后果主要体现为精神伤害,身体部位的现实接触不是两罪的必要构成要件。

Potential role of hippocampal neurogenesis in spinal cord injury induced post-trauma depression

It has been reported both in clinic and rodent models that beyond spinal cord injury directly induced symptoms, such as paralysis, neuropathic pain, bladder/bowel dysfunction, and loss of sexual function, there are a variety of secondary complications, including memory loss, cognitive decline, depression, and Alzheimer's disease. The largescale longitudinal population-based studies indicate that post-trauma depression is highly prevalent in spinal cord injury patients. Yet, few basic studies have been conducted to address the potential molecular mechanisms. One of possible factors underlying the depression is the reduction of adult hippocampal neurogenesis which may come from less physical activity, social isolation, chronic pain, and elevated neuroinflammation after spinal cord injury. However, there is no clear consensus yet. In this review, we will first summarize the alteration of hippocampal neurogenesis post-spinal cord injury. Then, we will discuss possible mechanisms underlie this important spinal cord injury consequence. Finally, we will outline the potential therapeutic options aimed at enhancing hippocampal neurogenesis to ameliorate depression.