Incidence of injuries and factors related to injuries in combat soldiers

2020 ◽  
pp. jramc-2019-001312 ◽  
Author(s):  
Nirit Yavnai ◽  
S Bar-Sela ◽  
M Pantanowitz ◽  
S Funk ◽  
G Waddington ◽  
...  
Keyword(s):  
Postural Balance ◽  
Cox Regression ◽  
Ankle Instability ◽  
Musculoskeletal Injuries ◽  
Drop Out ◽  
Time Effects ◽  
Ankle Stability ◽  
Major Factors ◽  
Cumberland Ankle Instability Tool ◽  
Combat Soldiers

IntroductionMusculoskeletal injuries to the lower extremities are major factors contributing to drop out from military tasks. The aim of the present study was to determine the incidence of musculoskeletal injuries and the parameters that differentiate between the soldiers who incurred these injuries and those who did not along 14 weeks of an infantry commanders course.MethodsOne-hundred and sixty-eight participants were recruited from an infantry commanders course. The soldiers were tested before (pre), in the middle (middle) and at the end (last) of the course for anthropometric measurements, proprioceptive ability and dynamic postural balance (DPB), and filled out an ankle stability questionnaire (Cumberland Ankle Instability Tool (CAIT). A physiotherapist followed and recorded all musculoskeletal injuries incurred by the participants during the course.ResultsFifty-eight participants out of the 168 (34.5%) reported some pain/injury. Time effects were found for body mass index, DPB asymmetry, DPB in posterior-medial (P-M) direction and proprioception ability. Injury effects were found for DPB asymmetry, DPB in P-M direction, CAIT and proprioception ability. An interaction was found for proprioception ability. The Cox regression showed that the variables that are mostly effecting injuries were pretesting proprioception ability, DPB asymmetry and CAIT.ConclusionsMore than one out of three participants incurred musculoskeletal injuries, with deficits in proprioception ability, DPB and ankle stability in pretesting as major factors contributing to injuries. Further studies should look at the effect of specific exercises such as proprioception, DPB and ankle stability exercises for prevention and treatment of musculoskeletal injuries among combat soldiers.

scholarly journals The fibula and talus position difference in functional and mechanical ankle instability: MRI findings

2021 ◽  
Vol 29 (1) ◽  
pp. 230949902098457
Author(s):  
Chengjie Yuan ◽  
Genrui Zhu ◽  
Zhifeng Wang ◽  
Chen Wang ◽  
Xu Wang ◽  
...  
Keyword(s):  
Healthy Volunteers ◽  
Ankle Instability ◽  
Medial Malleolus ◽  
Mechanical Instability ◽  
Mri Findings ◽  
Functional Instability ◽  
Post Hoc Analysis ◽  
Ankle Stability ◽  
Post Hoc

Purpose: This study aimed to use MRI to evaluate the fibula and talus position difference in functional and mechanical ankle stability patients. Methods: 61 and 68 patients with functional and mechanical instability, and 60 healthy volunteers were involved. Based on the axial MRI images, the rotation of the talus was identified through the Malleolar Talus Index (MTI). The position relative to the talus (Axial Malleolar Index, AMI) and medial malleolus (Intermalleolar Index, IMI) were used to evaluated the displacement of the fibula. Results: Post hoc analysis showed that the values of malleolar talus index was significantly larger among mechanical instability (89.18° ± 2.31°) than that in functional instability patients (86.55° ±61.65°, P < 0.001) and healthy volunteers (85.59° ± 2.42°, P < 0.001). The axial malleolar index of the mechanical instability patients (11.39° ± 1.41°) were significantly larger than healthy volunteers (7.91° ± 0.83°) (P < 0.0001). There were no statistically significant differences in the above three indexes between the functional instability patients and healthy volunteers. Conclusion: The functional instability patients didn’t have a posteriorly positioned fibula and an internally rotated talus. The malleolar talus index was significantly larger among mechanical instability patients than that in functional instability patients. Increased malleolar talus index may become a new indirect MRI sign for identifying functional and mechanical instability patients.

The Influence of Profession on Functional Ankle Stability in Musicians

2010 ◽  
Vol 25 (1) ◽  
pp. 22-28 ◽  
Author(s):  
Susanne Rein ◽  
Tobias Fabian ◽  
Hans Zwipp ◽  
Jan Heineck ◽  
Stephan Weindel
Keyword(s):  
Reaction Time ◽  
Ankle Joint ◽  
Postural Balance ◽  
Balance Control ◽  
Ankle Sprains ◽  
Exact Test ◽  
Work Related ◽  
Ankle Stability ◽  
Ankle Joints ◽  
The Right

OBJECTIVE: The aim of this study was to examine the influence of extensive work-related use of the feet on functional ankle stability among musicians. METHODS: Thirty professional organists were compared to professional pianists and controls. All participants completed a questionnaire. Range of motion (ROM), peroneal reaction time, and positional sense tests of the ankle were measured. The postural balance control was investigated with the Biodex Stability System for the stable level 8 and unstable level 2. Statistical analysis was done with the Kruskal-Wallis test, Mann-Whitney test with Bonferroni-Holm correction, and Fisher’s exact test. RESULTS: Nine of 30 organists compared to 5 of 30 pianists and controls reported ankle sprains in their medical history. Pianists had a significant increased flexion of both ankle joints compared to organists (p≤0.01) and increased flexion of the right ankle joint compared to controls (p=0.02). The positional sense test and postural balance control showed no significant differences among groups. The peroneal reaction time of the right peroneus longus muscle was significantly increased in pianists compared to controls (p=0.008). CONCLUSIONS: Organists have shown a high incidence of ankle sprains. Despite their extensive work-related use of the ankle joints, organists have neither increased functional ankle stability nor increased ROM of their ankle joints in comparison to controls. Pianists have increased flexion of the ankle joint, perhaps due to the exclusive motion of extension and flexion while using the pedals. To minimize injuries of the ankle and improve functional ankle stability as well as balance control, proprioceptive exercises of the ankle in daily training programs are recommended.

scholarly journals PREVALENSI KEJADIAN CHRONIC ANKLE INSTABILITY PADA ATLET BASKET SMA DI KABUPATEN BADUNG

2020 ◽  
Vol 8 (1) ◽  
pp. 11
Author(s):  
Vimala Krishna Prasada ◽  
Ni Wayan Tianing ◽  
Putu Ayu Sita Saraswati ◽  
I Wayan Gede Sutadarma
Keyword(s):  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Cross Sectional ◽  
Purposive Sampling ◽  
Sprain Ankle ◽  
Cumberland Ankle Instability Tool

Cedera pergelangan kaki (ankle) merupakan cedera yang paling sering dialami oleh atlet basket, dan sprain pada ligamen bagian lateral merupakan diagnosis yang paling umum. Hal tersebut dapat menyebabkan seorang atlet mengalami chronic ankle instability (CAI). Kondisi ini ditandai dengan adanya cedera berulang dan perasaan goyang pada pergelangan kaki. Tujuan dari penelitian ini adalah untuk mengetahui prevalensi kejadian chronic ankle instability pada atlet basket SMA di Kabupaten Badung. Penelitian ini merupakan penelitian deskriptif cross-sectional yang dilakukan pada bulan Maret hingga Mei 2019. Pengambilan sampel menggunakan teknik purposive sampling dengan jumlah sampel sebanyak 162 orang. Kuisioner Cumberland Ankle Instability Tool digunakan untuk menentukan responden yang mengalami CAI. Faktor lain seperti jenis kelamin, indeks massa tubuh (IMT), riwayat cedera sprain ankle,  dan ada atau tidaknya perawatan medis pasca cedera sprain ankle juga dicatat pada penelitian ini. Hasil penelitian menunjukan prevalensi kejadian chronic ankle instability sebanyak 51,2%. Responden dengan jenis kelamin laki-laki, IMT overweight, memiliki riwayat sprain ankle dan memperoleh penanganan medis pasca mengalami cedera sprain ankle memiliki kecenderungan yang lebih besar untuk mengalami CAI. Kata Kunci: Chronic Ankle Instability, Atlet Basket SMA

scholarly journals Biomechanics of Ankle Ligament Reconstruction: A Cadaveric Study to Compare Stability of Reconstruction Techniques Using 1 or 2 Fibular Tunnels

2020 ◽  
Vol 8 (10) ◽  
pp. 232596712095928
Author(s):  
Martina Gautschi ◽  
Elias Bachmann ◽  
Camila Shirota ◽  
Tobias Götschi ◽  
Niklas Renner ◽  
...  
Keyword(s):  
Ligament Reconstruction ◽  
Ankle Instability ◽  
Intraoperative Complications ◽  
Lateral Ankle ◽  
Ankle Stability ◽  
Ankle Ligament ◽  
Significant Difference ◽  
Tunnel Technique ◽  
Lateral Ankle Ligament ◽  
Lateral Ankle Ligament Reconstruction

Background: Anatomic lateral ankle ligament reconstruction has been proposed for patients with chronic ankle instability. A reliable approach is a reconstruction technique using an allograft and 2 fibular tunnels. A recently introduced approach that entails 1–fibular tunnel reconstruction might reduce the risk of intraoperative complications and ultimately improve patient outcome. Hypothesis: We hypothesized that both reconstruction techniques show similar ankle stability (joint laxity and stiffness) and are similar to the intact joint condition. Study Design: Controlled laboratory study. Methods: A total of 10 Thiel-conserved cadaveric ankles were divided into 2 groups and tested in 3 stages—intact, transected, and reconstructed lateral ankle ligaments—using either the 1– or the 2–fibular tunnel technique. To quantify stability in each stage, anterior drawer and talar tilt tests were performed in 0°, 10°, and 20° of plantarflexion (anterior drawer test) or dorsiflexion (talar tilt test). Bone displacements were measured using motion capture, from which laxity and stiffness were calculated together with applied forces. Finally, reconstructed ligaments were tested to failure in neutral position with a maximal applicable torque in inversion. A mixed linear model was used to describe and compare the outcomes. Results: When ankle stability of intact and reconstructed ligaments was compared, no significant difference was found between reconstruction techniques for any flexion angle. Also, no significant difference was found when the maximal applicable torque of the 1-tunnel technique (9.1 ± 4.4 N·m) was compared with the 2-tunnel technique (8.9 ± 4.8 N·m). Conclusion: Lateral ankle ligament reconstruction with an allograft using 1 fibular tunnel demonstrated similar biomechanical stability to the 2-tunnel approach. Clinical Relevance: Demonstrating similar stability in a cadaveric study and given the potential to reduce intraoperative complications, the 1–fibular tunnel approach should be considered a viable option for the surgical therapy of chronic ankle instability. Clinical randomized prospective trials are needed to determine the clinical outcome of the 1-tunnel approach.

scholarly journals Predictors of Peritonitis and the Impact of Peritonitis on Clinical Outcomes of Continuous Ambulatory Peritoneal Dialysis Patients in Taiwan—10 Years’ Experience in a Single Center

2014 ◽  
Vol 34 (1) ◽  
pp. 85-94 ◽  
Author(s):  
Yao-Peng Hsieh ◽  
Chia-Chu Chang ◽  
Yao-Ko Wen ◽  
Ping-Fang Chiu ◽  
Yu Yang
Keyword(s):  
Peritoneal Dialysis ◽  
Clinical Outcomes ◽  
Cox Regression ◽  
Drop Out ◽  
Kaplan Meier ◽  
Underlying Mechanisms ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Impact ◽  
Technique Failure

ObjectivePeritoneal dialysis (PD) has become more prevalent as a treatment modality for end-stage renal disease, and peritonitis remains one of its most devastating complications. The aim of the present investigation was to examine the frequency and predictors of peritonitis and the impact of peritonitis on clinical outcomes.MethodsOur retrospective observational cohort study enrolled 391 patients who had been treated with continuous ambulatory PD (CAPD) for at least 90 days. Relevant demographic, biochemical, and clinical data were collected for an analysis of CAPD-associated peritonitis, technique failure, drop-out from PD, and patient mortality.ResultsThe peritonitis rate was 0.196 episodes per patient–year. Older age (>65 years) was the only identified risk factor associated with peritonitis. A multivariate Cox regression model demonstrated that technique failure occurred more often in patients experiencing peritonitis than in those free of peritonitis ( p < 0.001). Kaplan–Meier analysis revealed that the group experiencing peritonitis tended to survive longer than the group that was peritonitis-free ( p = 0.11). After multivariate adjustment, the survival advantage reached significance (hazard ratio: 0.64; 95% confidence interval: 0.46 to 0.89; p = 0.006). Compared with the peritonitis-free group, the group experiencing peritonitis also had more drop-out from PD ( p = 0.03).ConclusionsThe peritonitis rate was relatively low in the present investigation. Elderly patients were at higher risk of peritonitis episodes. Peritonitis independently predicted technique failure, in agreement with other reports. However, contrary to previous studies, all-cause mortality was better in patients experiencing peritonitis than in those free of peritonitis. The underlying mechanisms of this presumptive “peritonitis paradox” remain to be clarified.

Performance Differences Between the Modified Star Excursion Balance Test and the Y-Balance Test in Individuals With Chronic Ankle Instability

2020 ◽  
Vol 29 (6) ◽  
pp. 748-753
Author(s):  
Jupil Ko ◽  
Erik Wikstrom ◽  
Yumeng Li ◽  
Michelle Weber ◽  
Cathleen N. Brown
Keyword(s):  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Balance Test ◽  
Cross Sectional ◽  
Performance Differences ◽  
Movement Strategy ◽  
History Of ◽  
Star Excursion Balance Test ◽  
Dynamic Postural Stability ◽  
Cumberland Ankle Instability Tool

Context: The modified Star Excursion Balance Test (mSEBT) and Y-Balance Test (YBT) are common dynamic postural stability assessments for individuals with chronic ankle instability (CAI). However, the reach distance measurement technique and movement strategy used during the mSEBT and YBT differ. To date, no studies have compared task performance differences on these tests in CAI patients. Objective: To determine whether individuals with CAI perform the mSEBT and YBT differently. Design: Cross-sectional. Setting: Biomechanics laboratory. Participants: Of 97 consented participants, 86 (43 females, 43 males; age 21.5 [3.3] y, height 169.8 [10.3] cm, mass 69.5 [13.4] kg), who reported ≤25 on the Cumberland Ankle Instability Tool, ≥11 on the Identification of Functional Ankle Instability, and had a history of a moderate to severe ankle sprain(s) participated. Interventions: Participants were instructed to perform the mSEBT and YBT in a predetermined counterbalanced order. Three anterior, posteromedial, and posterolateral trials of each test were completed on the involved limb after 4 practice trials. Test direction order was randomized for each participant. Main Outcome Measures: Normalized (expressed in percentage) reach distance in each direction. Paired sample t tests were performed to compare each of the 3 directions between the mSEBT and YBT. Results: Significantly shorter reach distances in the anterior (58.9% [5.8%] vs 61.4% [5.4%], P = .001) and the posteromedial (98.8% [8.6%] vs 100.8% [8.1%], P = .003) directions were noted on the mSEBT relative to the YBT. No differences in the posterolateral directions were observed. Conclusions: Within those with CAI, mSEBT and YBT normalized reach distances differ in the anterior and posteriomedial directions. As a result, clinicians and researchers should not directly compare the results of these tests.

scholarly journals Effect of Plyometric versus Ankle Stability Exercises on Lower Limb Biomechanics in Taekwondo Demonstration Athletes with Functional Ankle Instability

2020 ◽  
Vol 17 (10) ◽  
pp. 3665
Author(s):  
Ha Min Lee ◽  
Seunghue Oh ◽  
Jung Won Kwon
Keyword(s):  
Kinetic Parameters ◽  
Lower Limb ◽  
Ankle Instability ◽  
Dynamic Balance ◽  
Exercise Group ◽  
T Test ◽  
Functional Ankle Instability ◽  
Shock Absorption ◽  
Ankle Stability ◽  
Plyometric Exercise

Background: This study aimed to compare the effects of plyometric and ankle stability exercises on the dynamic balance and lower limb kinematic and kinetic parameters of Taekwondo demonstration athletes with functional ankle instability. Methods: Fourteen subjects participated in this study and were randomly divided into two groups: a plyometric exercise group (n = 7) and an ankle stability exercise group (n = 7). Exercises were performed twice a week for 8 weeks. A Y-balance test was used to measure dynamic balance, and a motion analysis system and force plate were used to collect kinematic and kinetic parameters during single-leg drop landing. A paired t-test was used for intragroup comparisons, and an independent t-test was used for intergroup comparisons. Results: In both groups, exercise increased dynamic balance and shock absorption and reduced postural sway on the anteroposterior displacement (p < 0.05). The plyometric exercise group decreased their ankle dorsiflexion and increased their knee and hip joint flexion at maximum knee flexion (p < 0.05). In contrast, the stability exercise increased their ankle plantar flexion at initial contact (p < 0.05). Conclusions: The plyometric exercise group altered their landing strategies using their knee and hip joints to control ankle instability at landing. This study suggests that the application of plyometric exercises in ankle rehabilitation would improve stability and shock absorption and help prevent injuries during Taekwondo demonstrations.

scholarly journals The Role of Calcaneofibular Ligament (CFL) Injury in Ankle Instability

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0002
Author(s):  
Kenneth Hunt ◽  
Richard Fuld ◽  
Judas Kelley ◽  
Nicholas Anderson ◽  
Todd Baldini
Keyword(s):  
Contact Mechanics ◽  
Ankle Joint ◽  
Motion Capture ◽  
Contact Area ◽  
Subtalar Joint ◽  
Ankle Instability ◽  
Weight Bearing ◽  
Calcaneofibular Ligament ◽  
Tibiotalar Joint ◽  
Ankle Stability

Category: Ankle Introduction/Purpose: Acute inversion ankle sprains are among the most common musculoskeletal injuries. Higher grade sprains, which include anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) injury, can be particularly problematic and often require surgical repair. The implications of CFL injury on ankle instability are unclear. We aim to evaluate the impact of CFL injury on ankle stability and subtalar joint biomechanics. We hypothesized that CFL injury will result in decreased stiffness and torque, and alteration of ankle contact mechanics compared to the uninjured ankle in a cadaveric model. Methods: Twenty matched cadaveric ankles dissected of skin and subcutaneous tissue were mounted to an Instron with 20° of ankle plantar flexion and 15° of internal rotation. Intact specimens were axially loaded to body weight, then underwent inversion stress along the anatomic axis of the ankle from 0 to 20° (simulating inversion injury) for three cycles. ATFL and CFL were sequentially sectioned, and inversion testing repeated for each condition. Stiffness and change in torque were recorded using an Instron, and pressure and contact area were recorded using a calibrated Tekscan sensor system. Inversion angle of the talus and calcaneus relative to the ankle mortise were recorded using a three-dimensional motion capture system. Paired t tests were performed for inter and intra-group comparisons. Results: Stiffness and torque did not significantly decrease after sectioning of the ATFL, but did decreased significantly after sectioning of CFL. Peak pressures in the tibiotalar joint decreased significantly following CFL release compared to both the uninjured ankle and ATFL-only release. Mean contact area significantly increased following CFL release compared to both the uninjured ankle and ATFL release. There was a concentration of force in the anteromedial ankle joint during weight-bearing inversion. However, the center-of-force shifts 1.22 mm posteromedial after CFL release relative to an intact ankle. Motion capture showed a significant and sequential increase in inversion angle of both the calcaneus and talus, after release of each ligament. There was significantly more inversion in the subtalar joint than the tibiotalar joint with weight-bearing inversion. Conclusion: There is significantly lower stiffness and torque with weight-bearing inversion of the ankle joint complex following injury to both ATFL and CFL, and sequentially greater inversion of the talus and calcaneus with progressive ligament injury. This corresponds to a significant shift in the center of force in the tibiotalar joint. CFL contributes considerably to lateral ankle stability, and sprains that include CFL injury result in substantial alteration of contact mechanics at the ankle and subtalar joints. Repair of CFL may be beneficial during lateral ligament reconstruction, potentially mitigating long-term consequences (e.g., articular damage) of a loose or incompetent CFL.

scholarly journals Gait Pattern, Impact to the Skeleton and Postural Balance in Overweight and Obese Children: A Review

Sports ◽  
2018 ◽  
Vol 6 (3) ◽  
pp. 75 ◽  
Author(s):  
Nili Steinberg ◽  
Dan Nemet ◽  
Michal Pantanowitz ◽  
Alon Eliakim
Keyword(s):  
Physical Activity ◽  
Physical Exercise ◽  
Postural Balance ◽  
Exercise Program ◽  
Gait Pattern ◽  
Musculoskeletal Injuries ◽  
Overuse Injuries ◽  
Obese Children ◽  
Exercise Programs ◽  
Biomechanical Factors

The article reviews the biomechanical factors that may cause overweight/obese children to reduce their level of physical activity, while increasing their risk of overuse injuries and exercise-related pain. Recommendations would be to screen those children for any gait or postural impairments before they join any exercise program, and to provide them with specific gait treatments and/or physical exercise programs, in order to decrease their risk for future musculoskeletal injuries and pain.

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