RESUMEN
Active transport, including cycling, is promoted as an effective way of increasing children's physical activity and health. Parents can support children's riding by riding with them and it is important to address relevant safety issues. Little is known about parents' experience of safety-relevant aspects of riding with children. Participants in the Safer Cycling Study in New South Wales, Australia, who reported that they had ridden with children in the last 12 months were questioned about how they ride with children, and their experience of safety issues and crashes. Among the 187 respondents who had ridden with children on their bicycle, the most common form of carrier was a rear-mounted seat (48%) followed by a trailer (29%). Many respondents (79%) identified risks specific to riding carrying children, including those linked with specific carrier types and with use of footpaths. Most (92%) indicated that they change their behaviour when carrying a child on their bicycle; for example, riding more slowly, more carefully, and away from roads. Among crashes with a child on the bicycle, most were falls. Among the 345 participants who had ridden to accompany a child on a bicycle, approximately three quarters identified risks specific to accompanying children, such as managing the child's limited skill, awareness and predictability. Ninety-seven percent reported behavioural changes including positioning themselves as a barrier for their child and caution crossing roads. Findings suggest strategies to support parents in riding safely with children.
Asunto(s)
Ciclismo/psicología , Padres/psicología , Accidentes/estadística & datos numéricos , Adulto , Entorno Construido , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Persona de Mediana Edad , Nueva Gales del Sur , Estudios Prospectivos , Factores de Riesgo , AutoinformeRESUMEN
This paper investigates events in which cyclists perceive a cycling crash is narrowly avoided (henceforth, a near miss). A cohort of 2038 adult transport and recreational cyclists from New South Wales (Australia) provided self-reported prospectively collected data from cycling diaries to allow the calculation of an exposure-based rate of near misses and investigation of near miss circumstances. During 25,971days of cycling, 3437 near misses were reported. For a given time cycling, cyclists who rode mainly for transport (compared with those who rode mainly for recreation), and cyclists with less experience (compared to those with more experience) were more likely to report a near miss; older cyclists (60+ years) were less likely to report a near miss than younger cyclists (25-59 years). Where type of near miss was recorded, 72.0% involved motor vehicles, 10.9% involved pedestrians and 6.9% involved other cyclists. Results indicate some similarities between near misses and crashes reported by this cohort during the same reporting period. A bias toward reporting near misses with motor vehicles was suggested, which likely reflects cyclists' perceptions that crashes involving motor vehicles are particularly serious, and highlights their impact on perceived safety. Given the relative rarity of crashes, and the limited breadth and depth of administrative data, collection of near miss data may contribute to our understanding of cycling safety by increasing the volume and detail of information available for analysis. Addressing the causes of near misses may offer an opportunity to improve both perceived and actual safety for cyclists.
Asunto(s)
Accidentes de Tránsito/estadística & datos numéricos , Ciclismo/lesiones , Recreación , Seguridad , Transportes , Adulto , Recolección de Datos , Femenino , Humanos , Persona de Mediana Edad , Nueva Gales del Sur , Percepción , Estudios Prospectivos , AutoinformeRESUMEN
OBJECTIVES: The ability to determine risk management controls for quad bike use is confounded by limitations in crash and injury information. The aim of this article is to identify the injury mechanisms, crash characteristics, and contributing factors in fatal quad bike incidents in Australia by activity (recreation and work). METHODS: An in-depth case series study was undertaken of 106 Australian quad bike fatalities that had occurred between 2000 and 2013. All case material held by Australian coroners was obtained and reviewed. RESULTS: One hundred and six cases were categorized as occurring during recreation (53) and work (53). Fifty-two of the work cases occurred during farmwork. The mean age for those killed during a work activity was 56 years compared to 27 years for recreational riders. Two children under 16 years died while performing farmwork and 13 children under 16 years during recreational activities. The analyses show a very clear pattern for farmwork-related deaths: quad bike rolls or pitches over (farmworker, 85%; recreational rider, 55%), rider becomes pinned under quad bike (farmworker, 68%; recreational rider, 30%), and death by asphyxia (farmworker, 42%; recreational rider, 11%). In contrast, recreational riders suffered complex impact injuries to the head and chest that occurred when the rider was traveling at speed, lost control, was ejected, and collided with an object in the environment and/or interacted with the moving quad bike. CONCLUSIONS: The analyses support the need to improve safe quad bike operation through consideration of the age of the rider, training, helmet use, reducing the propensity of quad bikes to roll, and improving handling so that loss of control events are reduced and to prevent crushing and pinning by the vehicle during and after a rollover crash.
Asunto(s)
Agricultores , Traumatismos Ocupacionales/mortalidad , Vehículos a Motor Todoterreno , Recreación , Heridas y Lesiones/mortalidad , Adolescente , Adulto , Anciano , Australia/epidemiología , Agricultores/estadística & datos numéricos , Femenino , Dispositivos de Protección de la Cabeza/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
OBJECTIVE: Serious head and cervical spine injuries have been shown to occur mostly independent of one another in pure rollover crashes. In an attempt to define a dynamic rollover crash test protocol that can replicate serious injuries to the head and cervical spine, it is important to understand the conditions that are likely to produce serious injuries to these 2 body regions. The objective of this research is to analyze the effect that impact factors relevant to a rollover crash have on the injury metrics of the head and cervical spine, with a specific interest in the differentiation between independent injuries and those that are predicted to occur concomitantly. METHODS: A series of head impacts was simulated using a detailed finite element model of the human body, the Total HUman Model for Safety (THUMS), in which the impactor velocity, displacement, and direction were varied. The performance of the model was assessed against available experimental tests performed under comparable conditions. Indirect, kinematic-based, and direct, tissue-level, injury metrics were used to assess the likelihood of serious injuries to the head and cervical spine. RESULTS: The performance of the THUMS head and spine in reconstructed experimental impacts compared well to reported values. All impact factors were significantly associated with injury measures for both the head and cervical spine. Increases in impact velocity and displacement resulted in increases in nearly all injury measures, whereas impactor orientation had opposite effects on brain and cervical spine injury metrics. The greatest cervical spine injury measures were recorded in an impact with a 15° anterior orientation. The greatest brain injury measures occurred when the impactor was at its maximum (45°) angle. CONCLUSIONS: The overall kinetic and kinematic response of the THUMS head and cervical spine in reconstructed experiment conditions compare well with reported values, although the occurrence of fractures was overpredicted. The trends in predicted head and cervical spine injury measures were analyzed for 90 simulated impact conditions. Impactor orientation was the only factor that could potentially explain the isolated nature of serious head and spine injuries under rollover crash conditions. The opposing trends of injury measures for the brain and cervical spine indicate that it is unlikely to reproduce the injuries simultaneously in a dynamic rollover test.
Asunto(s)
Accidentes de Tránsito/estadística & datos numéricos , Vértebras Cervicales/lesiones , Traumatismos del Cuello/fisiopatología , Traumatismos Vertebrales/fisiopatología , Fenómenos Biomecánicos , Vértebras Cervicales/fisiopatología , Simulación por Computador , Análisis de Elementos Finitos , Humanos , Modelos BiológicosRESUMEN
This paper examines self-reported retrospective data for a 12 month period from 2038 adult cyclists from New South Wales (Australia), and compares cyclists according to whether they self-identify as riding mainly for transport or mainly for recreation. Statistically significant differences were found in the demographic characteristics, cycling patterns, and crash experiences between these two groups of cyclists. Transport cyclists tended to be younger, travel more days per week, and within morning and evening peak hours than recreational cyclists; recreational cyclists were more likely to identify fitness as a purpose for cycling. The proportion of cyclists experiencing a crash or crash-related injury in the previous 12 months was similar for transport and recreational cyclists, but there were differences in crash types and location which likely reflect different cycling environments. Heterogeneity within transport and recreational cyclists was also found, based on self-reported riding intensity. An understanding of the different cycling patterns and experiences of various types of cyclists is useful to inform road safety, transport and health promotion policy.
Asunto(s)
Accidentes de Tránsito/estadística & datos numéricos , Ciclismo/lesiones , Ciclismo/estadística & datos numéricos , Seguridad/estadística & datos numéricos , Heridas y Lesiones/epidemiología , Adulto , Estudios de Cohortes , Recolección de Datos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Nueva Gales del Sur/epidemiología , Recreación , Estudios Retrospectivos , Factores SocioeconómicosRESUMEN
This paper examines self-reported prospectively collected data from 2038 adult transport and recreational cyclists from New South Wales (Australia) to determine exposure-based incident crash and injury rates. During 25,971 days of cycling, 198 crashes were reported, comprising approximately equal numbers of falls and collisions. The overall crash rate was 0.290 (95% CI, 0.264-0.319) per 1000km or 6.06 (95% CI, 5.52-6.65) per 1000h of travel. The rate of crashes causing any injury (self-treated, or medically attended without overnight hospital stay) was 0.148 (95% CI, 0.133-0.164) per 1000km or 3.09 (95% CI, 2.79-3.43) per 1000h of travel. The rate of crashes causing a medically attended injury (without overnight hospital stay) was 0.023 (95% CI, 0.020-0.027) per 1000km or 0.49 (95% CI, 0.43-0.56) per 1000h of travel. No injuries requiring an overnight stay in hospital were reported on days meeting the inclusion criteria. After adjustment for exposure in hours, or for the risks associated with different infrastructure utilisation, the rates of crashes and medically attended injuries were found to be greater for females than males, less experienced than more experienced cyclists, and for those who rode mainly for transport rather than mainly for recreation. Comparison of estimated crash and injury rates on different infrastructure types were limited by the small number of events, however findings suggest that the separation of cyclists from motorised traffic is by itself not sufficient to ensure safe cycling.
Asunto(s)
Accidentes de Tránsito/estadística & datos numéricos , Ciclismo/lesiones , Heridas y Lesiones/epidemiología , Adolescente , Adulto , Anciano , Estudios de Cohortes , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Nueva Gales del Sur/epidemiología , Estudios Prospectivos , Recreación , Autoinforme , Factores Sexuales , Adulto JovenRESUMEN
OBJECTIVE: Studies performed previously of seat-belted occupants in real-world passenger vehicle rollover-only crashes have identified the head as one of the body regions most often seriously injured. However, there have been few studies investigating how these head injuries occur in any detail. This study aims to investigate the characteristics and patterns of head injury to seat-belted occupants in real-world rollover-only crashes and to identify possible biomechanical mechanisms responsible for head injury to aid in the development of a dynamic rollover test protocol. METHODS: National Automotive Sampling System-Crashworthiness Data System (NASS-CDS) data were used to generate summary statistics and perform logistic regression analysis of restrained and contained occupants in U.S. pure trip-over rollover crashes. Specific information from selected CDS cases focused on identifying potential mechanisms and patterns of serious head injury and the rollover conditions under which the injury occurred are also presented. RESULTS: Twenty-one percent of seriously injured occupants in pure trip-over rollovers had a serious head injury. On average, occupants seated on the far side of the rollover sustained serious head injuries more frequently and were more likely to receive injuries to the inboard side of the head than near-side occupants. Serious head injuries appear to be decoupled from serious injuries to other body regions except for a relationship found between basal skull fractures and cervical spine fractures. Serious head injuries were sustained by some occupants who had less than 15 cm of roof crush above their seated position. CONCLUSIONS: Serious brain injuries appear to occur frequently as a result of loading to the periphery of the head from contact with the roof assembly. Two mechanisms of injury for basal skull fractures in rollover crashes were identified. The injury patterns and locations of contact to the head are sensitive to the seated position of the occupant.
Asunto(s)
Accidentes de Tránsito/estadística & datos numéricos , Traumatismos Craneocerebrales/epidemiología , Cinturones de Seguridad/estadística & datos numéricos , Adolescente , Adulto , Fenómenos Biomecánicos , Bases de Datos Factuales , Femenino , Humanos , Masculino , Índices de Gravedad del Trauma , Estados Unidos/epidemiologíaRESUMEN
Around one in three contained and restrained seriously injured occupants in single-vehicle pure rollover crashes receive a serious injury to the thorax. With dynamic rollover test protocols currently under development, there is a need to understand the nature and cause of serious thoracic injuries incurred in rollover events. This will allow decisions to be made with regards to adoption of a suitable crash test dummy and appropriate thoracic injury criteria in such protocols. Valid rollover occupant protection test protocols will lead to vehicle improvements that will reduce the high trauma burden of vehicle rollover crashes. This paper presents an analysis of contained and restrained occupants involved in single-vehicle pure rollover crashes that occurred in the United States between 2000 and 2009 (inclusive). Serious thoracic injury typology and causality are determined. A logistic regression model is developed to determine associations between the incidence of serious thoracic injury and the human, vehicle and environmental characteristics of the crashes. Recommendations are made with regards to the appropriate assessment of potential thoracic injury in dynamic rollover occupant protection crash test protocols.
Asunto(s)
Accidentes de Tránsito , Automóviles/estadística & datos numéricos , Cinturones de Seguridad , Traumatismos Torácicos/epidemiología , Traumatismos Torácicos/etiología , Adolescente , Adulto , Anciano , Distribución de Chi-Cuadrado , Femenino , Humanos , Funciones de Verosimilitud , Modelos Logísticos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Rotación , Estados Unidos/epidemiologíaRESUMEN
Around one third of serious injuries sustained by belted, non-ejected occupants in pure rollover crashes occur to the spine. Dynamic rollover crash test methodologies have been established in Australia and the United States, with the aims of understanding injury potential in rollovers and establishing the basis of an occupant rollover protection crashworthiness test protocol that could be adopted by consumer new car assessment programmes and government regulators internationally. However, for any proposed test protocol to be effective in reducing the high trauma burden resulting from rollover crashes, appropriate anthropomorphic devices that replicate real-world injury mechanisms and biomechanical loads are required. To date, consensus regarding the combination of anthropomorphic device and neck injury criteria for rollover crash tests has not been reached. The aim of the present study is to provide new information pertaining to the nature and mechanisms of spine injury in pure rollover crashes, and to assist in the assessment of spine injury potential in rollover crash tests. Real-world spine injury cases that resulted from pure rollover crashes in the United States between 2000 and 2009 are identified, and compared with cadaver experiments under vertical load by other authors. The analysis is restricted to contained, restrained occupants that were injured from contact with the vehicle roof structure during a pure rollover, and the role of roof intrusion in creating potential for spine injury is assessed. Recommendations for assessing the potential for spine injury in rollover occupant protection crash test protocols are made.
Asunto(s)
Accidentes de Tránsito/estadística & datos numéricos , Automóviles/estadística & datos numéricos , Vértebras Cervicales/lesiones , Traumatismos Vertebrales/etiología , Vértebras Torácicas/lesiones , Adolescente , Adulto , Fenómenos Biomecánicos , Cadáver , Estudios de Casos y Controles , Femenino , Humanos , Puntaje de Gravedad del Traumatismo , Modelos Logísticos , Masculino , Estudios Retrospectivos , Factores de Riesgo , Rotación , TorqueRESUMEN
Motorcyclists contribute significantly to road trauma around the world through the high incidence of serious injuries and fatalities. The role of roadside safety barriers in such trauma is an area of growing concern amongst motorcyclists, road authorities and road safety researchers and advocates. This paper presents a case series analysis of motorcyclists that were fatally injured following a collision with a roadside barrier during the period 2001-2006 in Australia and New Zealand. Injury profiles and severities are detailed, and associations with crash characteristics are investigated. It is shown that the thorax region had the highest incidence of injury and the highest incidence of maximum injury in fatal motorcycle-barrier crashes, followed by the head region. This is in contrast to fatal motorcycle crashes in all single- and multi-vehicle crash modes, where head injury predominates. The injury profiles of motorcyclists that slid into barriers and those that collided with barriers in the upright posture were similar. However, those that slid in were more likely to receive thorax and pelvis injuries.
Asunto(s)
Prevención de Accidentes/instrumentación , Accidentes de Tránsito/mortalidad , Planificación Ambiental , Motocicletas , Heridas y Lesiones/etiología , Accidentes de Tránsito/prevención & control , Accidentes de Tránsito/estadística & datos numéricos , Adulto , Australia/epidemiología , Bases de Datos Factuales , Femenino , Humanos , Puntaje de Gravedad del Traumatismo , Modelos Logísticos , Masculino , Nueva Zelanda/epidemiología , Factores de Riesgo , Heridas y Lesiones/mortalidad , Heridas y Lesiones/prevención & controlRESUMEN
BACKGROUND: The effects of foot posture on the dynamic function of the lower limb during gait remains relatively unknown. OBJECTIVES: The purpose of this study was to investigate lower limb kinematics between the normal and low arched foot during the gait cycle, particularly in the transverse plane. METHOD: Twenty-four children, twelve with normal and twelve with low arched feet, aged 11-12 years underwent a lower limb three dimensional gait analysis. Temporo-spatial parameters and patterns and ranges of motion of kinematic data were examined for the pelvis, hip, knee and ankle throughout the gait cycle. RESULTS: Overall, there were very few differences found in the kinematics of the lower limbs between the normal and low arched group. Increased external hip rotation (6-7°) in the low arched group was the only bilateral significant difference (p<0.05) between the two foot groups. No significant differences existed in any temporo-spatial parameters between the two groups. CONCLUSIONS: The increased external hip rotation and greater external foot progression angle in the low arched foot highlights the need to examine gait comprehensively to establish cause or effect of these differences observed and hence determine appropriate treatment.
Asunto(s)
Articulación del Tobillo/fisiopatología , Pie Plano/fisiopatología , Marcha/fisiología , Articulación de la Cadera/fisiopatología , Articulación de la Rodilla/fisiopatología , Extremidad Inferior/fisiopatología , Rango del Movimiento Articular/fisiología , Fenómenos Biomecánicos , Niño , Femenino , Humanos , Masculino , Postura/fisiología , Caminata/fisiologíaRESUMEN
An analysis of 2000-2007 single vehicle rollover fatalities in three Australian states was carried out using data from the Australian National Coroners Information System. In this paper, successive selection criteria were applied to the initial dataset to analyse:overall, rollovers accounted for 35% of all occupant fatalities in a single vehicle transport injury event. For these fatalities, the occupant was ejected or stayed contained in equal proportions. However, results showed strong disparities between the more urban and densely populated states of New South Wales and Victoria, compared to the Northern Territory in terms of crash type distribution and containment of the occupant. Differences were also found in rollover initiation, speed at initiation and number of turns. Overall, the strongest association of fatal neck/thoracic spine injuries with head injuries was found for the contained, restrained occupant. This analysis of single vehicle rollover fatalities is consistent with previous findings. It also shows that in Australia, strategies for rollover injury risk mitigation will need to take into account a broad range of characteristics to be effective.
Asunto(s)
Accidentes de Tránsito/mortalidad , Heridas y Lesiones/mortalidad , Aceleración , Accidentes de Tránsito/clasificación , Adolescente , Adulto , Causas de Muerte , Traumatismos Craneocerebrales/mortalidad , Estudios Transversales , Planificación Ambiental , Femenino , Humanos , Masculino , Persona de Mediana Edad , Traumatismos del Cuello/mortalidad , Nueva Gales del Sur , Northern Territory , Factores de Riesgo , Cinturones de Seguridad/estadística & datos numéricos , Traumatismos Vertebrales/mortalidad , Traumatismos Torácicos/mortalidad , Victoria , Adulto JovenRESUMEN
The purpose of this study was to investigate the kinematics of normal arched and low arched feet in children and use this data to quantify the differences between the two foot types during walking gait. Multi-segment foot motion was measured, using the Heidelberg foot measurement method (HFMM), for 25 normal arched feet and 27 low arched feet in 9-12-year-old children. The kinematic differences in the foot between the two groups during walking were relatively small, except for the medial arch and forefoot supination angles. The magnitude of the medial arch angle was approximately 10 degrees greater in the low arched group than the normal arched group throughout the gait cycle. There was a significant difference found in the forefoot supination angle (p<0.03), relative to the midfoot, between the two groups at initial heel strike, and maximum and minimum values throughout the gait cycle. The values for the normal group were significantly higher in all these angles indicating that the forefoot of the low arched foot remains less pronated during the gait cycle. There was no significant difference in the motion of the rearfoot between the two foot types. The results of this study provide normative values for children's feet and highlight the mechanical differences in flexible flat feet in this age group. This data contributes to knowledge on foot kinematics in children and will be valuable for future research on the structure, function and potential treatment of the flexible flat foot.
Asunto(s)
Deformidades Congénitas del Pie/fisiopatología , Pie/fisiología , Caminata/fisiología , Fenómenos Biomecánicos , Niño , Femenino , Marcha/fisiología , Hallux/fisiología , Humanos , Masculino , Rango del Movimiento Articular/fisiología , Articulación Talocalcánea/fisiología , Supinación/fisiología , Grabación en VideoRESUMEN
OBJECTIVES: In this study, the incidence of head, neck and facial injuries in youth rugby was determined, and the associated risk factors were assessed. DESIGN: Data were extracted from a cluster randomised controlled trial of headgear with the football teams as the unit of randomisation. No effect was observed for headgear use on injury rates, and the data were pooled. SETTING: General school and club-based community competitive youth rugby in the 2002 and 2003 seasons. PARTICIPANTS: Young male rugby union football players participating in under-13, under 15, under 18 and under 21 years competitions. Eighty-two teams participated in year 1 and 87 in year 2. MAIN OUTCOME MEASURES: Injury rates for all body regions combined, head, neck and face calculated for game and missed game injuries. RESULTS: 554 head, face and neck injuries were recorded within a total of 28 902 h of rugby game exposure. Level of play and player position were related to injury risk. Younger players had the lowest rates of injury; forwards, especially the front row had the highest rate of neck injury; and inside backs had the highest rate of injuries causing the player to miss a game. Contact events, including the scrum and tackle, were the main events leading to injury. CONCLUSION: Injury prevention must focus on the tackle and scrum elements of a youth rugby game.
Asunto(s)
Traumatismos Craneocerebrales/epidemiología , Traumatismos Faciales/epidemiología , Fútbol Americano/lesiones , Traumatismos del Cuello/epidemiología , Adolescente , Traumatismos en Atletas/epidemiología , Traumatismos en Atletas/prevención & control , Humanos , Incidencia , Masculino , Nueva Gales del Sur/epidemiología , Factores de Riesgo , Adulto JovenRESUMEN
OBJECTIVE: To identify risk factors for injury to cricket fast bowlers using field-based tests. DESIGN: Prospective cohort study. SETTING: High performance Australian cricket. PARTICIPANTS: Ninety-one male adolescent and adult fast bowlers (aged 12-33 years). ASSESSMENT OF RISK FACTORS: A field-based pre-participation screening, consisting of musculoskeletal, fitness and anthropometric assessments and analysis of bowling technique was undertaken. Bowlers were prospectively monitored over the 2003-4 season and bowling workload and injuries were recorded. Logistic regression was used to identify injury risk factors. MAIN OUTCOME MEASUREMENT: Repetitive microtrauma injury to the trunk, back or lower limb associated with fast bowling. RESULTS: Two variables were identified as independent predictors of injury in the multivariate logistic regression analysis. Bowlers with hip internal rotation of < or =30 degrees on the leg ipsilateral to the bowling arm were at a significantly reduced risk of injury (OR 0.20, 95% CI 0.06 to 0.73) compared with bowlers with >40 degrees of rotation. Bowlers with an ankle dorsiflexion lunge of 12.1-14.0 cm on the leg contralateral to the bowling arm were at a significantly increased risk (OR 4.03, 95% CI 1.07 to 15.21) than bowlers with a lunge of >14 cm. Bowlers with a lunge of < or =12 cm were also at an increased risk, but not significantly so (OR 1.38, 95% CI 0.40 to 4.84). CONCLUSIONS: Biomechanical research is needed to investigate how these two intrinsic risk factors increase injury risk so that appropriate interventions can be developed.
Asunto(s)
Fenómenos Biomecánicos , Atletismo/lesiones , Adolescente , Adulto , Traumatismos en Atletas/epidemiología , Traumatismos en Atletas/prevención & control , Niño , Métodos Epidemiológicos , Humanos , Masculino , Nueva Gales del Sur/epidemiología , Educación y Entrenamiento Físico/métodos , Queensland/epidemiología , Factores de Riesgo , Atletismo/fisiologíaRESUMEN
The greatest population of amputees in developed nations are elderly dysvascular transtibial amputees. Conventional prostheses, e.g. the solid ankle cushioned heel (SACH) foot, create difficulties in walking on inclines. The aim of this study was to analyse the gait characteristics of elderly amputees walking on an incline, through quantitative three-dimensional biomechanical analysis, by comparing them to age-matched controls. Participants walked up and down an inclined (5 degrees) instrumented walkway at a self-selected pace. A Vicon System 370 was used to acquire gait data, including temporo-spatial characteristics, ground reaction forces (GRF), electromyography (EMG), kinematics, and kinetics of the lower limb. Compared to the age-matched controls, the amputees demonstrated reduced speed, knee and hip range of motion, hip moments, vertical GRF, along with increased amplitude and periods of muscle activation. The residual limb also had shorter single support stance phase, small stance phase knee moments, and the smallest moments and powers. These differences demonstrate instability in stance of the residual limb. The sources of this instability include the prosthesis' limited range of ankle motion and ankle power generation, coupled with the residual limb's limited proprioception and tolerance of force. For these amputees to regain a gait pattern equivalent to their able-bodied counterparts on inclined walkways, they must be equipped with a prosthesis that has a full range of ankle motion and active power generation at the ankle. Prosthesis design and rehabilitation training should also improve the proprioception of their residual limb and increase their tolerance of force through the residual limb.
Asunto(s)
Amputados , Marcha/fisiología , Pierna , Anciano , Anciano de 80 o más Años , Amputados/rehabilitación , Análisis de Varianza , Fenómenos Biomecánicos , Electromiografía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Rango del Movimiento ArticularRESUMEN
Wide variations in the definitions and methodologies used for studies of injuries in rugby union have created inconsistencies in reported data and made interstudy comparisons of results difficult. The International Rugby Board established a Rugby Injury Consensus Group (RICG) to agree on appropriate definitions and methodologies to standardize the recording of injuries and reporting of studies in rugby union. The RICG reviewed the consensus definitions and methodologies previously published for football (soccer) at a meeting in Dublin to assess their suitability for and application to rugby union. Following this meeting, iterative draft statements were prepared and circulated to members of the RICG for comment; a follow-up meeting was arranged in Dublin at which time all definitions and procedures were finalized. At this stage, all authors confirmed their agreement with the consensus statement. The agreed-on document was presented to and approved by the International Rugby Board Council. Agreement was reached on definitions for injury, recurrent injury, nonfatal catastrophic injury, and training and match exposures together with criteria for classifying injuries in terms of severity, location, type, diagnosis, and causation. The definitions and methodology presented in this consensus statement for rugby union are similar to those proposed for football. Adoption of the proposals presented in this consensus statement should ensure that more consistent and comparable results will be obtained from studies of injuries within rugby union.
Asunto(s)
Consenso , Fútbol Americano , Heridas y Lesiones/clasificación , Humanos , Proyectos de Investigación/normas , Reino UnidoRESUMEN
The aim of this study was to develop and evaluate a kinematic measurement method for the foot that could be applied clinically to measure foot function including all typical foot deformities. The ankle was modelled as two anatomically based hinge joints rotating around anatomical axes estimated by the use of projection angles. For the mid- and forefoot a descriptive approach was chosen by defining angles between anatomical landmarks or reference points derived from these landmarks. The motion of 17 markers on the lower leg and foot was measured during walking gait on 10 adult participants with no known abnormalities to determine the pattern of normal foot motion, assess reliability and provide a reference against which pathological foot behaviour could be compared. Functional angles for mid- and forefoot motions were developed to improve clinical applications of the data. The combination of anatomically and technically oriented marker placement on the foot is a reliable basis for reproducible kinematic measurements and the method was shown to be viable for clinical practice.
Asunto(s)
Pie/fisiología , Marcha/fisiología , Modelos Biológicos , Adulto , Articulación del Tobillo/fisiología , Fenómenos Biomecánicos , Pie/anatomía & histología , Deformidades del Pie/fisiopatología , Humanos , Procesamiento de Imagen Asistido por Computador , Movimiento/fisiología , Reproducibilidad de los Resultados , Grabación en Video , CaminataRESUMEN
OBJECTIVES: To study match injury patterns and incidence during the Rugby World Cup 2003 (RWC 2003); to compare these patterns and rates with comparative rugby injury data; and to assess differences between teams playing at different levels (eight finalists v 12 non-finalists). METHODS: Data were collected prospectively during the tournament. All injuries were recorded by the 20 participating team physicians. These were submitted to the tournament medical officer. An injury was defined as an event which forced a player either to leave the field or to miss a subsequent game or both. RESULTS: 189 injuries were recorded over 48 matches. This corresponds to 97.9 injuries per 1000 player-hours. Pool matches yielded a higher injury rate than non-pool matches. The 12 non-finalist teams sustained significantly higher injury rates than the eight finalist teams. The player positions open side flanker, inside centre, and number 8 were the most frequently injured positions. There was a low concussion rate, which may reflect under-reporting. The non-finalist teams had a higher rate of recurrent injury. CONCLUSIONS: The injury rate was higher than comparative data. Mismatches in the areas of skill, fitness, and the availability of resources for medical care of players may explain these differences.
Asunto(s)
Traumatismos en Atletas/epidemiología , Fútbol Americano/lesiones , Humanos , Incidencia , Puntaje de Gravedad del Traumatismo , Masculino , Vigilancia de la Población , Estudios Prospectivos , Gestión de RiesgosRESUMEN
A wide range of head and neck injury risks are present in sport, including catastrophic injury. The literature since 1980 on prevention of head and neck injury in sport was reviewed, focusing on catastrophic and brain injury and identifying the range of injury prevention methods in use. There have been few formal evaluations of injury prevention methods. Approaches that are considered, or have been proven, to be successful in preventing injury include: modification of the baseball; implementation of helmet standards in ice hockey and American football and increased wearing rates; use of full faceguards in ice hockey; changes in rules associated with body contact; implementation of rules to reduce the impact forces in rugby scrums. Helmets and other devices have been shown to reduce the risk of severe head and facial injury, but current designs appear to make little difference to rates of concussion. Research methods involving epidemiological, medical, and human factors are required in combination with biomechanical and technological approaches to reduce further injury risks in sport.