Development of a preliminary evidence-based neuromusculoskeletal exercise guideline to reduce injury risk in the lower limb

2017 ◽  
Vol 25 ◽  
pp. 76-83 ◽  
Author(s):  
Michael E. Lehr ◽  
Devin Kime ◽  
Cayce Onks ◽  
Matthew Silvis ◽  
Megan Streisel
Keyword(s):  
Lower Limb ◽  
Injury Risk ◽  
Preliminary Evidence ◽  
Evidence Based ◽  
Exercise Guideline

Evidence-Based Assessment of Pediatric Injury and Injury Risk

2013 ◽  
Author(s):  
Bryan T. Karazsia ◽  
Keri J. Brown Kirschman
Keyword(s):  
Injury Risk ◽  
Evidence Based ◽  
Pediatric Injury

The Red Legs RATED tool to improve diagnosis of lower limb cellulitis in the emergency department

2021 ◽  
Vol 30 (12) ◽  
pp. S22-S29
Author(s):  
Gillian O'Brien ◽  
Patricia White
Keyword(s):  
Emergency Department ◽  
Lower Limb ◽  
Treatment Guidelines ◽  
Positive Impact ◽  
Data Gathering ◽  
Pilot Project ◽  
Accurate Diagnosis ◽  
Evidence Based ◽  
Significant Burden ◽  
User Friendly

Background: Lower limb cellulitis poses a significant burden for the Irish healthcare system. Accurate diagnosis is difficult, with a lack of validated evidence-based tools and treatment guidelines, and difficulties distinguishing cellulitis from its imitators. It has been suggested that around 30% of suspected lower limb cellulitis is misdiagnosed. An audit of 132 patients between May 2017 and May 2018 identified a pattern of misdiagnosis in approximately 34% of this cohort. Objective: The aim of this pilot project was to develop a streamlined service for those presenting to the emergency department with red legs/suspected cellulitis, through introduction of the ‘Red Leg RATED’ tool for clinicians. Method: The tool was developed and introduced to emergency department clinicians. Individuals (n=24) presenting with suspected cellulitis over 4 weeks in 2018 were invited to participate in data gathering. Finally, clinician questionnaire feedback regarding the tool was evaluated. Results: Fourteen participants consented, 6 female and 8 male with mean age of 65 years. The tool identified 50% (n=7) as having cellulitis, of those 57% (n=4) required admission, 43% (n=3) were discharged. The remainder who did not have cellulitis (n=7) were discharged. Before introduction of the tool, all would typically have been admitted to hospital for further assessment and management of suspected lower limb cellulitis. Overall, 72% (n=10) of patients who initially presented with suspected cellulitis were discharged, suggesting positive impact of the tool. Clinician feedback suggested all were satisfied with the tool and contents. Conclusion: The Red Leg RATED tool is user friendly and impacts positively on diagnosis treatment and discharge. Further evaluation is warranted.

Participation in Two Evidence-Based Falls Prevention Programs by Adults Aging With a Long-Term Disability: Case-Control Study of Reach and Effectiveness

2018 ◽  
Vol 31 (10_suppl) ◽  
pp. 39S-67S ◽  
Author(s):  
Thomas J. Eagen ◽  
Salom M. Teshale ◽  
Angelica P. Herrera-Venson ◽  
Anne Ordway ◽  
Joe Caldwell
Keyword(s):  
Older Adults ◽  
Fear Of Falling ◽  
Prevention Programs ◽  
Preliminary Evidence ◽  
Case Control ◽  
Falls Prevention ◽  
Evidence Based ◽  
Activity Restriction ◽  
Increased Risk

Objective: Adults aging with a long-term disability (LTD) are at an increased risk for falls. The Older Americans Act Title III-D and Prevention and Public Health Fund (PPHF) support several organizations to deliver falls prevention evidence-based programs designed to reduce risk factors; however, little is understood about the reach and effectiveness of these fall prevention programs for those with LTD compared to those without LTD. This study compared the reach and effectiveness of two evidence-based falls prevention programs between older adults with and without LTD. Method: Using a matched case-control design, 105 LTD older adults enrolled in A Matter of Balance (AMOB) or Stepping On were matched to 315 non-LTD older adults on age, sex, race, and education. Results: On average, LTD older adults attended a higher number of class sessions and were significantly more likely to complete the program compared with the matched-sample of non-LTD older adults. LTD older adults were equally likely as non-LTD older adults to report significant reductions in self-reported fear of falling, falls-related activity restriction, and improvement in falls self-efficacy following completion of the programs. Discussion: These findings provide preliminary evidence for the effectiveness of these evidence-based falls prevention programs for LTD older adults; however, more research is needed to extend these findings.

scholarly journals Developing a control framework for self-adjusting prosthetic sockets incorporating tissue injury risk estimation and Generalized Predictive Control

2021 ◽  
Author(s):  
Florence M Mbithi ◽  
Joshua Steer ◽  
Andrew J Chipperfield ◽  
Alexander Dickinson
Keyword(s):  
Predictive Control ◽  
Lower Limb ◽  
Injury Risk ◽  
Tissue Injury ◽  
Risk Estimation ◽  
Soft Tissue Injury ◽  
Estimation Method ◽  
Generalized Predictive Control ◽  
Prosthetic Socket ◽  
Interfacial Pressure

Purpose: To perform activities of daily living (ADL), people with lower limb amputation depend on the prosthetic socket for stability and proprioceptive feedback. Poorly fitting sockets can cause discomfort, pain, limb tissue injuries, limited device usage, and potential rejection. Semi-passively controlled adjustable socket technologies exist, but these depend upon the user’s perception to determine safe interfacial pressure levels. This paper presents a framework for automatic control of an adjustable transtibial prosthetic socket that enables active adaptation of residuum-socket interfacial loading through localized actuators, based on soft tissue injury risk estimation. Method: Using finite element analysis, local interfacial pressure vs. compressive tissue strain relationships were estimated for three anatomical actuator locations, for tissue injury risk assessment within a control structure. Generalized Predictive Control of multiple actuators was implemented to maintain interfacial pressure within estimated safe and functional limits. Results: Controller simulation predicted satisfactory dynamic performance in several scenarios, based on previous related studies. Actuation rates of 0.06 – 1.51kPa/s with 0.67% maximum overshoot, and 0.75 – 1.58kPa/s were estimated for continuous walking, and for a demonstrative loading sequence of ADL, respectively. Conclusion: The developed platform could be useful for extending recent efforts in adjustable lower limb prosthetic socket design, particularly for individuals with residuum sensory impairment.

scholarly journals A novel biomechanical injury risk score demonstrates correlation with lower limb posterior chain injury in fifty elite level rugby union athletes

2021 ◽  
Author(s):  
Rhys Hughes ◽  
Matt Cross ◽  
Keith Stokes
Keyword(s):  
Risk Score ◽  
Lower Limb ◽  
Injury Risk ◽  
Assessment Tool ◽  
Rugby Union ◽  
Biomechanical Assessment ◽  
Elite Level ◽  
Hip Extension ◽  
Spearman’S Correlation ◽  
And Training

ABSTRACTObjectivesLower limb posterior chain injury (PCI) is common amongst athletic populations, with multi-factorial risk factors including age, previous injury, strength measurements, range of motion and training load. Biomechanics are commonly considered in the prevention and rehabilitation of PCI by performance staff. However, there is no documented testing method to assess for associations between biomechanics and PCI. The aim of this study was to investigate whether there is an association between an easily applicable, novel biomechanical assessment tool and PCI.MethodsFifty male elite-level rugby union athletes (age 22.83±5.08) participating in the highest tier of England were tested at the start of the 2019 pre-season period and PCIs (N=48) were recorded over the 2019/20 playing season. Participants’ biomechanics were analysed using two-dimensional video analysis against an Injury Risk Score (IRS) system in the performance of the combined movement – prone hip extension and knee flexion. Participants’ biomechanics in carrying out this movement were scored against the 10-point IRS, where the more compensatory movement recorded sees an increase in an individual’s IRS. Participants’ IRS were then compared against the number of PCI sustained and Spearman’s correlation coefficient was utilised for analysis.ResultsThere is a good significant association between IRS and PCI (R=0.573, p<0.001). Linear Regression demonstrated that an increase of 1 in IRS was associated with a 35% increase in PCI incidence (R2=0.346).ConclusionA good significance between the IRS and PCI provides preliminary support for its use as an injury risk assessment tool.

scholarly journals Can foot angle influence the risk of injury to the lower limb joints during a field hockey hit?

2019 ◽  
Vol 5 (1) ◽  
pp. e000568
Author(s):  
Frances E Feeley ◽  
Graham P Arnold ◽  
Sadiq Nasir ◽  
Weijie W Wang ◽  
Rami Abboud
Keyword(s):  
Lower Limb ◽  
Injury Risk ◽  
Knee Injury ◽  
Body Part ◽  
Ankle Sprains ◽  
Field Hockey ◽  
Joint Angles ◽  
Lateral Ankle ◽  
Risk Of Injury ◽  
Foot Position

ObjectivesThe lower limb is widely reported as the most commonly injured body part in the field of hockey, more specifically lateral ankle sprains and internal knee injury. Despite this, there remains limited understanding of how the biomechanics of the sport could be adapted to minimise injury. The aim of this study was to propose a foot position during the hockey hit that results in the smallest joint angles and moments, from a total of four different foot positions: 0°, 30°, 60° and 90°, which may correlate to injury risk.MethodEighteen players from the local University Ladies Hockey Club participated in this study. Each player was required to perform a hit with their lead foot in four different positions: 0°, 30°, 60° and 90°, where 0° was a lead foot position perpendicular to the direction of motion of the ball. Angles and moments were calculated with the Vicon system using force plates and motion analysis.ResultsSignificant differences (p<0.05) were found between the angles and moments of the four foot positions tested, indicating that foot angle can influence the degree of angulation, and moments, produced in the lower limb joints during the hockey hit.ConclusionThere is a relationship between lead foot position and the angles and moments produced in the lower limb joints during the hockey hit, and this may correlate with injury risk.

Evidence-based practice in the management of lower limb lymphedema after gynecological cancer

2016 ◽  
Vol 33 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Lisandra Fossari Iwersen ◽  
Fabiana Flores Sperandio ◽  
Ariana Machado Toriy ◽  
Marina Palú ◽  
Clarissa Medeiros da Luz
Keyword(s):  
Lower Limb ◽  
Evidence Based Practice ◽  
Gynecological Cancer ◽  
Evidence Based
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