Conflicting trends in fall injury rates: implications for injury prevention

Injuries are among the leading causes of death and disability throughout the world and contribute disproportionately to premature life lost. Injury rates are highest among middle- and low-income countries. According to analyses of the 2016 Global Burden of Disease data, injuries cause over 4.6 million deaths per year, accounting for nearly 8.4% of all deaths and 10.7% of disability-adjusted life years. Many opportunities to implement injury prevention strategies exist, and a systematic approach to injury prevention can help identify the most effective and efficient approaches. Building capacity for injury prevention activities in low- and middle-income countries is an important public health priority.

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EARLY RESULTS OF AN INJURY-PREVENTION PROGRAM IN HIGH SCHOOL TRACK ATHLETES

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967119s00141 ◽

2019 ◽

Vol 7 (3_suppl) ◽

pp. 2325967119S0014

Author(s):

Celeste Quitiquit Dickason ◽

Whitney Marois ◽

Hannah Santos ◽

Sadie Grace ◽

Brian Krabak ◽

...

Keyword(s):

High School ◽

Injury Prevention ◽

Prevention Program ◽

Prevention Programs ◽

Years Of Experience ◽

Chi Square ◽

Injury Rates ◽

Injury Prevention Program ◽

Chi Square Analysis ◽

The Impact

Background Injury prevention programs have been shown to be effective for adolescent soccer, basketball, and handball athletes. Though injuries are common in high school runners, injury prevention programs have not been described for this population. Our objective was to trial an injury-prevention program styled after those found to be successful in other running and jumping sports to see if a group of running athletes sustained fewer and or less serious injuries during the course of a single high school track season. Methods Two suburban high school track coaches volunteered to participate in a program consisting of either injury-prevention exercises or no additional exercises as a part of pre-and in-season practice programs. All runners at each school were invited to participate, with informed consent obtained. The injury prevention program consisted of five jumping and plyometric exercises taught by a physical therapist, with a video of the exercises made available to the coach and team members throughout the season. Surveys pre- and post-season were collected which included demographic information, running history, diet, and injuries. Injuries were reported to coach and trainer at each school. Days of missed practice constituted an injured day, tallied for each runner and each team. A Chi-square analysis compared injury rates by team, and hence by intervention; injury rates by years of experience running; and injury rates by dietary preference. Results 24 runners, 13 from the intervention school and 11 from the control school participated. There was no significant difference in the number of running injuries reported when comparing the intervention group (4/13 runners) to the control group (3/11 runners, Chi-square = 0.035, p = 0.9). Runners with a greater number of years of competitive running experience trended towards having fewer injuries (p = 0.06). Those describing their diet as vegetarian (3/24) were significantly more likely to sustain an injury (p = 0.002). Conclusions / Significance With this limited comparison study examining the impact of an injury-prevention pre-season and in-season training program for running athletes participating on their high school track team, there was no evidence that the addition of a program of jumping and plyometric exercises had an impact on injury rates. However, combining the data from the two schools, we found a trend towards decreased injury likelihood in those with more years of experience running, and a significantly greater incidence of injuries in those who described their diet as vegetarian. These results suggest that novice runners should perhaps have a different set of expectations regarding the pre- and in-season training regimen, and that those whose diet is vegetarian consider review of their nutrition to optimize their energy level and reparative capacity with the increased activity of a high school track running program.

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The Epidemiology of Injuries in Middle School Football, 2015-2017: The Advancing Healthcare Initiatives for Underserved Students Project

The American Journal of Sports Medicine ◽

10.1177/0363546518825361 ◽

2019 ◽

Vol 47 (4) ◽

pp. 933-941 ◽

Cited By ~ 4

Author(s):

Zachary Y. Kerr ◽

Nelson Cortes ◽

Jatin P. Ambegaonkar ◽

Amanda M. Caswell ◽

Matt Prebble ◽

...

Keyword(s):

Middle School ◽

Injury Prevention ◽

Injury Rate ◽

Surveillance Systems ◽

Injury Incidence ◽

Prevention Strategies ◽

Certified Athletic Trainers ◽

Injury Rates ◽

Underserved Students ◽

Rate Ratios

Background: Although data exist on injuries in youth football leagues, there are limited recent data on injury incidence in middle school football. Updated injury incidence estimates can help drive the development of injury prevention strategies. Purpose: Describe the epidemiology of injuries in middle school football during school years 2015-2016 to 2017-2018. Study Design: Descriptive epidemiology study. Methods: Data originated from 9 public middle schools in Virginia during school years 2015-2016 to 2017-2018. Certified athletic trainers collected injury and athlete-exposure (AE) data from school-sanctioned games and practices in boys’, football. Injury counts and rates per 1000 AEs were calculated. Injury rate ratios with 95% CIs compared rates between games and practices. Results: Overall, 664 middle school boys’, football injuries were reported, leading to an overall injury rate of 20.54 per 1000 AEs (95% CI, 18.98-22.11). The time loss injury rate (inclusive of injuries with participation restriction time ≥24 hours) was 9.28 per 1000 AEs (95% CI, 8.23-10.33). The injury rate was higher in competition than practice (36.19 vs 17.97 per 1000 AEs; injury rate ratio, 2.01; 95% CI, 1.69-2.40). Most injuries were to the head/face (competition, 20.6%; practice, 15.8%) and hand/wrist (competition, 18.8%; practice, 16.4%) and were diagnosed as contusions (competition, 30.9%; practice, 25.9%) and sprains (competition, 19.4%; practice, 12.6%). Competitions also had a large proportion of concussions (10.3%). Overall, 80.0% and 66.9% of injuries were due to contact in competition and practice, respectively; of these contact-related injuries, 62.1% and 41.6% were specifically player contact. Conclusion: Injury distributions parallel those found in previous research from middle school and other sport settings. Injury rates in middle school football were higher than those reported in previous findings in high school and college. However, caution must be taken when interpreting findings in relation to other surveillance systems with varying methodologies. Still, the findings highlight the need for injury prevention strategies within middle school football, particularly as related to contact-related mechanisms.

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FAIR PLAY AS AN INJURY PREVENTION INTERVENTION: DO YELLOW CARD ACCUMULATION POLICIES REDUCE HIGH SCHOOL SOCCER INJURIES?

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120s00225 ◽

2020 ◽

Vol 8 (4_suppl3) ◽

pp. 2325967120S0022

Author(s):

Peter K. Kriz ◽

Jingzhen Yang ◽

Alan Arakkal ◽

Timothy Keeley ◽

R. Dawn Comstock

Keyword(s):

High School ◽

Injury Prevention ◽

Soccer Players ◽

Fair Play ◽

Yellow Card ◽

Time Loss ◽

Severe Injuries ◽

Injury Rates ◽

Illegal Activity ◽

The Impact

Background: Pediatric sports-related injuries are common, yet prevention efforts too often go unevaluated. Collins et al. studied nine U.S. high school (HS) sports during 2005/06-2006/07, finding boys’ and girls’ soccer had the highest injury rates related to illegal activity. Several states have implemented yellow card accumulation policies (YCPs) in an effort to prevent injuries. Hypothesis/Purpose: Purpose: Evaluate the effectiveness of YCPs in reducing HS soccer competition injuries by comparing injury rates and patterns in states with and without YCPs. Hypotheses: Athlete-athlete contact injury rates are lower in states with YCPs Severe injuries (concussion, fracture, ACL, injury requiring surgery, injury resulting in > 3 weeks’ time loss) are less prevalent in states with YCPs Gender differences influence the effectiveness of YCPs Methods: Retrospective cohort study of NHFS member state association HS soccer players injured during competition in 2005/06-2017/18. Athlete exposure (AEs) and injury data collected from a national sports injury surveillance system, High School RIO. Poisson regression assessed the effects of YCPs on injury rates and patterns. Results: Of 50 NFHS member states associations, high schools from 47 were represented. Overall, 901 athlete-athlete contact injuries occurred during 352,775 competition AEs in states with YCPs and 3,525 during 1,459,708 AEs in states without YCPs. There was no significant difference in overall contact injury rates (rate ratio [RR] 1.06; 95% confidence interval [CI]: 0.98-1.14) between schools in states with and without YCPs. A small, significant increase in overall contact injury rates was discernable after states’ adoption of YCPs (RR 1.17; 95% CI: 1.03, 1.34), particularly in boys’ soccer (RR 1.32; 95% CI 1.08-1.62). A significantly lower proportion of injuries resulting in > 3 weeks’ time loss occurred in states with YCPs (injury proportion ratio [IPR] 0.81; p=0.047), while other severe injuries did not differ. There were no significant differences in YCPs’ effect by gender (p=0.319). Conclusion: Among HS boys’ and girls’ soccer players, playing in states with YCPs did not lower athlete-athlete contact injury rates, although injuries resulting in > 3 weeks’ time loss were less prevalent in states with YCPs. Athlete-athlete contact injury rates were slightly higher in states following adoption of YCPs, particularly in boys’ soccer. Enactment of YCPs alone, without proper enforcement, may not be a sufficient injury prevention strategy. Further studies assessing the impact of HS soccer YCPs need to consider the effects of state level YCP enforcement, documented illegal activity/foul play, and Fair Play education. Tables/Figures: [Table: see text][Table: see text][Table: see text]

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Epidemiology of Injuries in National Collegiate Athletic Association Women's Tennis: 2014–2015 Through 2018–2019

Journal of Athletic Training ◽

10.4085/1062-6050-529-20 ◽

2021 ◽

Vol 56 (7) ◽

pp. 766-772

Author(s):

Hannah J. Robison ◽

Adrian J. Boltz ◽

Sarah N. Morris ◽

Christy L. Collins ◽

Avinash Chandran

Keyword(s):

Injury Prevention ◽

National Collegiate Athletic Association ◽

Injury Rate ◽

Surveillance Program ◽

Body Parts ◽

Prevention Strategies ◽

Time Loss ◽

Injury Rates ◽

Inflammatory Conditions ◽

Rate Ratios

Context The National Collegiate Athletic Association (NCAA) has sponsored women's tennis programs since 1966. Women's tennis has risen in global prominence and popularity within the NCAA. Background Continued surveillance of athletic injuries in the NCAA is critical for identifying emerging injury trends and assessing injury prevention strategies. Methods Exposure and injury data collected in the NCAA Injury Surveillance Program from 2014–2015 through 2018–2019 were analyzed. Injury counts, rates, and proportions were used to describe injury characteristics, and injury rate ratios were used to examine differential injury rates. Results The overall injury rate was 4.16 per 1000 athlete exposures. Injury to the shoulder, foot, and trunk were the most prevalent throughout the study period. Approximately 30% of all injury diagnoses were related to inflammatory conditions. Also, 32.1% of all injuries were time-loss injuries, and 45.0% of all injuries were non–time-loss injuries. Conclusions The findings of this study differed slightly from those of previous investigations, most notably with regard to injury rate by season segment and commonly injured body parts. Future surveillance efforts should attempt to capture the nuances of tennis competitions.

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