Bone stress injuries in male distance runners: higher modified Female Athlete Triad Cumulative Risk Assessment scores predict increased rates of injury

2018 ◽  
Vol 53 (4) ◽  
pp. 237-242 ◽  
Author(s):  
Emily Kraus ◽  
Adam S Tenforde ◽  
Aurelia Nattiv ◽  
Kristin L Sainani ◽  
Andrea Kussman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Assessment Tool ◽  
Cumulative Risk ◽  
Baseline Risk ◽  
Distance Runners ◽  
Bone Stress ◽  
Point Increase ◽  
Stress Injuries ◽  
Independent Variable

ObjectivesBone stress injuries (BSI) are common in runners of both sexes. The purpose of this study was to determine if a modified Female Athlete Triad Cumulative Risk Assessment tool would predict BSI in male distance runners.Methods156 male runners at two collegiate programmes were studied using mixed retrospective and prospective design for a total of 7 years. Point values were assigned using risk assessment categories including low energy availability, low body mass index (BMI), low bone mineral density (BMD) and prior BSI. The outcome was subsequent development of BSI. Statistical models used a mixed effects Poisson regression model with p<0.05 as threshold for significance. Two regression analyses were performed: (1) baseline risk factors as the independent variable; and (2) annual change in risk factors (longitudinal data) as the independent variable.Results42/156 runners (27%) sustained 61 BSIs over an average 1.9 years of follow-up. In the baseline risk factor model, each 1 point increase in prior BSI score was associated with a 57% increased risk for prospective BSI (p=0.0042) and each 1 point increase in cumulative risk score was associated with a 37% increase in prospective BSI risk (p=0.0079). In the longitudinal model, each 1 point increase in cumulative risk score was associated with a 27% increase in prospective BSI risk (p=0.05). BMI (rate ratio (RR)=1.91, p=0.11) and BMD (RR=1.58, p=0.19) risk scores were not associated with BSI.ConclusionA modified cumulative risk assessment tool may help identify male runners at elevated risk for BSI. Identifying risk factors may guide treatment and prevention strategies.

scholarly journals Training Load Capacity, Cumulative Risk, and Bone Stress Injuries: A Narrative Review of a Holistic Approach

2021 ◽  
Vol 3 ◽  
Author(s):  
Karrie L. Hamstra-Wright ◽  
Kellie C. Huxel Bliven ◽  
Christopher Napier
Keyword(s):  
Risk Factors ◽  
Load Capacity ◽  
Critical Role ◽  
Cumulative Risk ◽  
Risk Profile ◽  
Training Load ◽  
Narrative Review ◽  
Bone Stress ◽  
Orthopedic Injury ◽  
Stress Injuries

Bone stress injuries (BSIs) are a common orthopedic injury with short-term, and potentially long-term, effects. Training load capacity, influenced by risk factors, plays a critical role in the occurrence of BSIs. Many factors determine how one's body responds to repetitive loads that have the potential to increase the risk of a BSI. As a scientific community, we have identified numerous isolated BSI risk factors. However, we have not adequately analyzed the integrative, holistic, and cumulative nature of the risk factors, which is essential to determine an individual's specific capacity. In this narrative review, we advocate for a personalized approach to monitor training load so that individuals can optimize their health and performance. We define “cumulative risk profile” as a subjective clinical determination of the number of risk factors with thoughtful consideration of their interaction and propose that athletes have their own cumulative risk profile that influences their capacity to withstand specific training loads. In our narrative review, we outline BSI risk factors, discuss the relationship between BSIs and training load, highlight the importance of individualizing training load, and emphasize the use of a holistic assessment as a training load guide.

scholarly journals Cumulative Risks from Stressor Exposures and Personal Risk Factors in the Workplace: Examples from a Scoping Review

2021 ◽  
Vol 18 (11) ◽  
pp. 5850
Author(s):  
Mary A. Fox ◽  
Richard Todd Niemeier ◽  
Naomi Hudson ◽  
Miriam R. Siegel ◽  
Gary Scott Dotson
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Scoping Review ◽  
Multiple Stressors ◽  
Cumulative Risk ◽  
Real Life ◽  
Personal Factors ◽  
Exposure Limits ◽  
Personal Risk ◽  
Personal Risk Factors

Protecting worker and public health involves an understanding of multiple determinants, including exposures to biological, chemical, or physical agents or stressors in combination with other determinants including type of employment, health status, and individual behaviors. This has been illustrated during the COVID-19 pandemic by increased exposure and health risks for essential workers and those with pre-existing conditions, and mask-wearing behavior. Health risk assessment practices for environmental and occupational health typically do not incorporate multiple stressors in combination with personal risk factors. While conceptual developments in cumulative risk assessment to inform a more holistic approach to these real-life conditions have progressed, gaps remain, and practical methods and applications are rare. This scoping review characterizes existing evidence of combined stressor exposures and personal factors and risk to foster methods for occupational cumulative risk assessment. The review found examples from many workplaces, such as manufacturing, offices, and health care; exposures to chemical, physical, and psychosocial stressors combined with modifiable and unmodifiable determinants of health; and outcomes including respiratory function and disease, cancers, cardio-metabolic diseases, and hearing loss, as well as increased fertility, menstrual dysfunction and worsened mental health. To protect workers, workplace exposures and modifiable and unmodifiable characteristics should be considered in risk assessment and management. Data on combination exposures can improve assessments and risk estimates and inform protective exposure limits and management strategies.

Components of a risk assessment tool for prevention and control of bovine respiratory disease in preweaned dairy calves

2020 ◽  
pp. 1-7
Author(s):  
Sharif S. Aly ◽  
Betsy M. Karle ◽  
Deniece R. Williams ◽  
Gabriele U. Maier ◽  
Sasha Dubrovsky
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Risk Factor ◽  
Respiratory Disease ◽  
Scoring System ◽  
Prevention And Control ◽  
Assessment Tool ◽  
Bovine Respiratory Disease ◽  
And Control ◽  
Management Changes

Abstract Bovine respiratory disease (BRD) is the leading natural cause of death in US beef and dairy cattle, causing the annual loss of more than 1 million animals and financial losses in excess of $700 million. The multiple etiologies of BRD and its complex web of risk factors necessitate a herd-specific intervention plan for its prevention and control on dairies. Hence, a risk assessment is an important tool that producers and veterinarians can utilize for a comprehensive assessment of the management and host factors that predispose calves to BRD. The current study identifies the steps taken to develop the first BRD risk assessment tool and its components, namely the BRD risk factor questionnaire, the BRD scoring system, and a herd-specific BRD control and prevention plan. The risk factor questionnaire was designed to inquire on aspects of calf-rearing including management practices that affect calf health generally, and BRD specifically. The risk scores associated with each risk factor investigated in the questionnaire were estimated based on data from two observational studies. Producers can also estimate the prevalence of BRD in their calf herds using a smart phone or tablet application that facilitates selection of a true random sample of calves for scoring using the California BRD scoring system. Based on the risk factors identified, producers and herd veterinarians can then decide the management changes needed to mitigate the calf herd's risk for BRD. A follow-up risk assessment after a duration of time sufficient for exposure of a new cohort of calves to the management changes introduced in response to the risk assessment is recommended to monitor the prevalence of BRD.

scholarly journals Choice of a suitable diabetes risk assessment tool in Nepal – can we learn from Canada?

2016 ◽  
Vol 6 (2) ◽  
pp. 548-550
Author(s):  
Gina Agarwal ◽  
Brijesh Sathian ◽  
Sutapa Agrawal
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Health Outcomes ◽  
Assessment Tool ◽  
National Policy ◽  
Diabetes Risk ◽  
Risk Assessment Tool ◽  
Educational Tool ◽  
Diabetes Risk Factors ◽  
The Masses

If the population can be made more aware about diabetes by the use of a risk assessment tool as an educational tool as well, it could help to curb the diabetes epidemic in Nepal. Education of the masses about diabetes risk factors, prevention, and complications is urgently needed, using clear and simple messages. National policy efforts can be strengthened and health  outcomes improved when awareness is increased. Perhaps learning from Canada is a start, and Nepal will be able to make progress with something simple like ‘NEPAL-RISK’?

scholarly journals Comparison of Fall Risk Assessment Tools for Older Indonesian Adults in the Elderly Home and the Community

2019 ◽  
Vol 8 (3) ◽  
pp. 241
Author(s):  
Indri Hapsari Susilowati ◽  
Susiana Nugraha ◽  
Sabarinah Sabarinah ◽  
Bonardo Prayogo Hasiholan ◽  
Supa Pengpid ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Fall Risk ◽  
Assessment Tool ◽  
The Elderly ◽  
Risk Assessment Tool ◽  
Fall Risk Assessment ◽  
Elderly Home ◽  
Balance Confidence ◽  
Confidence Scale

Introduction: One of the causes of disability among elderly is falling. The ability to predict the risk of falls among this group is important so that the appropriate treatment can be provided to reduce the risk. The objective of this study was to compare the Stopping Elderly Accidents, Deaths, & Injuries (STEADI) Initiative from the Centers for Disease Control and Prevention (CDC) and The Johns Hopkins Fall Risk Assessment Tool (JHFRAT) from the Johns Hopkins University. Methods: This study used the STEADI tool, JHFRAT, Activities-Specific Balance Confidence Scale (ABC), and The Geriatric Depression Scale (GDS). The study areas were in community and elderly home in both public and private sectors and the samples were 427 after cleaning. Results: The results for the STEADI and JHFRAT tools were similar where the respondents at highest risk of falling among women (STEADI: 49%; JHFRAT: 3.4%), in Bandung area (63.5%; 5.4%), in private homes (63.3%; 4.4%), non-schools (54.6%; 6.2%), aged 80 or older (64.8%; 6.7%) and not working (48.9%;3.3%). The regression analysis indicated that there was a significant relationship between the risk factors for falls in the elderly determined by the JHFRAT and STEADI tools: namely, region, type of home, age, disease history, total GDS and ABC averages. Conclusion: Despite the similarity in the risk factors obtained through these assessments, there was a significant difference between the results for the STEADI tool and the JHFRAT. The test strength was 43%. However, STEADI is more sensitive to detect fall risk smong elderly than JHFRATKeywords: Activities-Specific Balance Confidence scale, elderly, fall risk,The Johns Hopkins Fall Risk Assessment Tool, the Stopping Elderly Accidents, Deaths, & Injuries

Abstract 31: Prediction of coronary artery and abdominal aortic calcium in middle-aged adults using the Pathobiological Determinants of Atherosclerosis in Youth (PDAY) risk score: the CARDIA study

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Christopher Prendergast ◽  
Jamal S Rana ◽  
Alex McMahan ◽  
Henry McGill ◽  
Jeff Carr ◽  
...  
Keyword(s):  
Risk Factors ◽  
Young Adults ◽  
Coronary Artery ◽  
Risk Score ◽  
Model Performance ◽  
Baseline Risk ◽  
Risk Scores ◽  
Abdominal Aortic ◽  
Point Increase ◽  
Better Than

Background: Risk scores to predict coronary and abdominal atherosclerosis have been developed from autopsy specimens from the right coronary artery and descending aorta and risk factors measured post-mortem in the Pathobiological Determinants of Atherosclerosis in Youth Study (PDAY), cohort aged 15-34 years. While the PDAY risk score predicts coronary artery calcium (CAC) up to 15 years before its assessment in Coronary Artery Risk Development in Young Adults (CARDIA), the clinical validity at 25 years follow up and of the abdominal score to predict abdominal aortic calcium (AAC) has not been tested. Objectives: To test the hypotheses: 1) PDAY risk scores at CARDIA baseline (cohort aged 18-30 years) predict CAC and abdominal aortic calcium (AAC) at year 25 better than PDAY risk scores measured at subsequent time points. 2) Change in risk over time will improve associations in Aim 1. Methods: The CARDIA study assessed CAC and AAC by computed tomography in young adults participating at year 25. The PDAY risk score was calculated from risk factors measured at the CARDIA examinations at years 0 (cohort aged 18-30 years), 5, 10, 15 and 25 (age 43-55 years). Results: Age and gender independent PDAY risk scores increased from CARDIA year 0 to year 25 (coronary from 1.80 to 4.95, abdomen from 1.88 to 3.18). Prevalence of any CAC was 28% and AAC was 53%. For a one point increase in risk score, baseline risk predicted CAC and AAC better than year 25 risk; change in risk improved the prediction further (Table). C-statistics for CAC prediction were higher at year 0 but similar at years 0 and 25 for AAC. Further analyses using PDAY scores calculated at 5 year intervals prior to the CT scan confirmed that CAC at baseline and AAC at year 5 had the highest Odds Ratios for a one point increase in score (AAC year 5 Odds Ratio 1.35 (1.30-1.41)). Conclusions: PDAY risk scores, applied to living adults in the CARDIA study, predicted CAC and AAC in 43-55 year old adults; including change in risk slightly improves model performance.

Female Athlete Triad Coalition cumulative risk assessment tool: proposed alternative scoring strategies

2020 ◽  
Vol 45 (12) ◽  
pp. 1324-1331
Author(s):  
Kristen J. Koltun ◽  
Nancy I. Williams ◽  
Mary Jane De Souza
Keyword(s):  
Risk Assessment ◽  
Risk Factor ◽  
Disordered Eating ◽  
Dietary Restriction ◽  
Female Athlete ◽  
Assessment Tool ◽  
Cumulative Risk ◽  
Female Athlete Triad ◽  
Energy Deficiency ◽  
Delayed Menarche

We (i) identified alternative scoring strategies for the Female Athlete Triad Coalition cumulative risk assessment (CRA) tool to be utilized when particular risk factors (bone mineral density (BMD), oligomenorrhea/amenorrhea) cannot be determined; (ii) objectively defined dietary restriction for use in the CRA tool; and (iii) explored proxy measures of energy deficiency. This cross-sectional investigation of exercising women (n = 166) utilized an existing database derived from multiple studies designed to assess health, exercise, and menstrual function. Data from the screening/baseline period of each study included: anthropometrics, dual-energy X-ray absorptiometry, disordered eating questionnaires, descriptive data, and proxy measures of energy deficiency (total triiodothyronine (TT3) and ratio of measured-to-predicted resting metabolic rate (mRMR/pRMR)). Substituting delayed menarche for BMD was the best-fit replacement resulting in 15 (9%) participants being categorized in different clearance categories. When menstrual status cannot be assessed, such as during hormonal contraceptive use, low energy availability (EA) determined using self-report and disordered eating questionnaires was the best substitution, resulting in 34 (20%) participants being categorized in different clearance categories. Based on original clearance categorizations, the provisional group had lower TT3 (78.3 ± 2.2 ng/dL; 92.7 ± 2.7 ng/dL) and Harris–Benedict mRMR/pRMR (0.85 ± 0.01; 0.90 ± 0.01) than the full group. Until an updated risk assessment tool is developed, delayed menarche can substitute for low BMD and low EA for oligomenorrhea/amenorrhea. Novelty This investigation addresses previous limitations of the Triad CRA tool. Disordered eating questionnaires can be used to objectively identify dietary restriction for the low EA risk factor. When a risk factor cannot be assessed, delayed menarche can substitute for low BMD and low EA for oligomenorrhea/amenorrhea.

Sign in / Sign up

Export Citation Format

Share Document