RESUMEN

OBJECTIVES: To develop a patient-reported outcome that allows for tracking of return to activity after injury. By acknowledging that return to activity is not a discrete Yes/No question where participants return to their baseline activity may be unrelated to their treatment a more comprehensive understanding and measurement of the outcome of treatment after injury as it relates to activity participation was developed and evaluated. METHODS: Item development and evaluation were undertaken with the final version tested in an ongoing observational clinical trial. Descriptive statistics and test-re-test analysis using intra-class correlation and percent agreement were used. RESULTS: A 5-item set of questions was identified that assess return to activity from a multi-faceted perspective. The final 5 items record preferred activity, days and hours per week of participation, impact of change in participation in activity, degree of limitation in participation and if it is related to injury or external factors. Over 30% of the population reported that their participation in their preferred activity was no longer active and not related to their injury but other factors demonstrating the importance of documenting more than one variable. CONCLUSION: The Minnesota Activity Scale provides standardized questions to comprehensively assess return to activity as a marker of treatment effectiveness. LEVEL OF EVIDENCE: V.

RESUMEN

OBJECTIVE: Pitching injuries are getting increased attention in the mass media. Many references are made to pitch counts and the role they play in injury prevention. The original purpose of regulating the pitch count in youth baseball was to reduce injury and fatigue to pitchers. This article reviews the history and development of the pitch count limit in baseball, the effect it has had on injury, and the evidence regarding injury rates on softball windmill pitching. DATA SOURCE: Literature search through PubMed, mass media, and organizational Web sites through June 2015. RESULTS: Pitch count limits and rest recommendations were introduced in 1996 after a survey of 28 orthopedic surgeons and baseball coaches showed injuries to baseball pitchers' arms were believed to be from the number of pitches thrown. Follow-up research led to revised recommendations with more detailed guidelines in 2006. Since that time, data show a relationship between innings pitched and upper extremity injury, but pitch type has not clearly been shown to affect injury rates. Current surveys of coaches and players show that coaches, parents, and athletes often do not adhere to these guidelines. There are no pitch count guidelines currently available in softball. CONCLUSIONS: The increase in participation in youth baseball and softball with an emphasis on early sport specialization in youth sports activities suggests that there will continue to be a rise in injury rates to young throwers. The published pitch counts are likely to positively affect injury rates but must be adhered to by athletes, coaches, and parents.

Asunto(s)

RESUMEN

OBJECTIVES: The purpose of this study is to evaluate the predictive ability of the Orthopedic Trauma-Open Fracture Classification (OTA-OFC) system in regards to short-term (90 days) outcomes of amputation, infection necessitating intravenous antibiotics, and wound healing in clinical practice across multiple centers. DESIGN: Prospective observational study. SETTING: Academic and private practice. PATIENTS/PARTICIPANTS: Patients with open fractures. INTERVENTION: None. MAIN OUTCOME MEASUREMENTS: OTA-OFC, amputations, IV antibiotics, and wound healing. RESULTS: Three hundred seventy-three patients with a total of 419 open fractures were enrolled. Logistic regression to predict amputation demonstrated that arterial and skin injury were statistically significant contributors to the prediction of amputation. Bone loss and muscle injury were significant contributors to the prediction of readmission for IV antibiotics. None of the variables in the OTA-OFC were significant predictors of unhealed wounds. CONCLUSION: Our study demonstrates the predictive value of the OTA-OFC regarding the short-term (90 days) outcomes of amputation and infection necessitating IV antibiotics and is another step towards the validation of the OTA-OFC in widespread clinical practice. LEVEL OF EVIDENCE: Prognostic Level I. See Instructions for Authors for a complete description of levels of evidence.

Asunto(s)

RESUMEN

OBJECTIVE: The objective of this article was to explore the differences in practice injury rates for select National Collegiate Athletic Association (NCAA) sports within and across sport by preseason, in-season, and postseason. This article will explore the relationship of practice injury rates by fall, winter, and spring sports as well as by Divisions I, II, and III. DESIGN: Descriptive epidemiology study. SETTING: NCAA schools. PATIENTS: NCAA athletes. MAIN OUTCOME MEASURES: Injury. RESULTS: In all sports across all seasons, preseason practice injury rates [6.3 per 1000 athletic exposure (A-E)] were higher than in-season (2.3 per 1000 A-E). Fall sports had an overall preseason practice injury rate of 7.4 (per 1000 A-E) compared with 7.0 (per 1000 A-E) for winter and 3.5 (per 1000 A-E) for spring sports. Women's soccer had the highest preseason injury rate of 9.5 (per 1000 A-E). Men's football had the highest increased risk of injury comparing preseason with in-season practice injury (3.47 per 1000 A-E). CONCLUSIONS: The recognition that preseason practice injury rates are higher compared with in-season and postseason practice injury rates can create an opportunity for athletes, coaches, and medical personnel to identify prevention strategies to reduce preseason injury risk.

Asunto(s)