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PubMed2005

The perils of snowmobiling.

Snowmobiling is a popular winter sport in Wisconsin, but it can result in serious injury and death. From 1998-2002, 1090 people in Wisconsin were hospitalized due to injuries related to snowmobiling. From 2002 to 2004, 51 snowmobile-related fatalities were reported to the Wisconsin Department of Natural Resources. Multiple risk factors exist for snowmobile injury and death, with alcohol consumption and male gender being the 2 largest associated risks. Many of the risk factors are modifiable, and health care professionals can facilitate snowmobiling-related injury prevention.

Accident Prevention↗
PubMed2005

Influence of the postion of crew members on aerodynamics performance of two-man bobsleigh.

Bobsleigh aerodynamics has long been recognised as one of the crucial performance factors. Although the published research in the area is very limited, it is well known that the leading nations in the sport devote significant resources in research and development of sleds' aerodynamics. However, the rules and regulations pose strict design constraints on the shape modifications aiming at aerodynamics improvements. The reason for that is two-fold: (i) safety of the athletes and (ii) reduction of equipment impact on competition outcome. One particular area that has not been looked at and falls outside the current rules and regulations is the influence of the crew positioning and internal modifications on the aerodynamic performance. The current study presents results on numerical simulation of the flow in the cavity underpinned with some experimental measurements including flow visualisation of the air circulation around the bobsleigh. A simplified computational model was developed to assess the trends and its results validated by windtunnel tests. The results show that crew members influence the drag level significantly and suggest that purely internal modifications can be introduced to reduce the overall resistance drag.

Air Movements↗
PubMed2003

Snowblading injuries in Eastern Canada.

OBJECTIVES: To evaluate injury patterns of snowbladers and compare them with those of skiers and snowboarders. To determine possible effects of helmet use in these sports on injury to the head and neck. METHODS: This prospective case series observational study was conducted by collecting the injury reports from the ski patrol during the 1999-2000 season at Mont Tremblant ski resort, Quebec. All participants in downhill winter sports who presented themselves to the ski patrol with traumatic injury related to their sport were included. A concussion was defined as any loss of consciousness, amnesia, confusion, disorientation, vertigo, or headache that resulted from injury. The ski patroller reported helmet use on the accident report at the time of injury. RESULTS: Snowbladers present with a unique pattern of injury compared with skiers and snowboarders. The incidence of leg, knee, and ankle/foot injuries were 20.5%, 25.6%, and 10.3% respectively. Concussions represented 11% of all injuries. There was no increase in other injury, including neck injury, related to helmet use. CONCLUSIONS: Unique injury patterns in snowbladers warrant reconsideration of equipment design. Concussion is a common injury on the ski slope. Although the effects of helmet use on concussion rate are inconclusive based on this study, helmet use did not increase the rate of neck injury, even when adjusted for age.

Adolescent↗
PubMed2006

A pilot study on the effects of pre-event manipulation on jump height and running velocity.

PURPOSE: To compare changes in jump height and running velocity with and without pre-event high-velocity, low-amplitude manipulation (HVLA). METHODS: A crossover study design with elite healthy athletes was used. After a 15 min warm-up, the subjects were tested for countermovement jump height (CMJ) and flying 40 m sprint time (SPRINT). A sport chiropractor then evaluated each subject. Subjects were randomised to either HVLA (applied to joints based on examination) or placebo (simulated performance-enhancement stickers). They then rested for 60 min, performed another 15 min warm-up, and were retested. The protocol was repeated 48 h later with the alternative intervention. The mean of two sprints and three jumps were analysed, as well as peak performances. The sample size was based on prior results from the effects of stretching. RESULTS: 19 subjects involved in sprint sports were enrolled; two were too sore to participate on day 2, and one could only participate in the jump (all had HVLA on day 1). Of the 17 participants analysed, seven were female, age range was 19-35, and 17 were national or world-class athletes. The ranges for baseline measures were: SPRINT 4.1-5.5 s; CMJ 47.4-92.7 cm. Overall, the greater than expected variability in this pilot study led to the study being underpowered. Subjects tended to perform better after HVLA for both CMJ and SPRINT (both mean and peak results), but none of the results were statistically significant (p = 0.30-0.61). CONCLUSION: Although the larger than expected variability in the pilot study means that the observed clinically relevant differences were not statistically significant, the direction and magnitude of the changes associated with HVLA suggest that it may be beneficial. That said, the increased soreness after HVLA suggests that it may be detrimental. HVLA warrants further study.

Adult↗
PubMed2005

Skiing and snowboarding injuries.

OBJECTIVE: To critically examine the literature on skiing and snowboarding injuries in children and adolescents. DATA SOURCES: Searched English language articles from: Medline, SPORTDiscus, Cumulative Index to Nursing and Allied Health Literature, Current Contents, and HealthSTAR. The table of contents for Ski Trauma and Skiing Safety Series published by the American Society for Testing and Materials were also examined. MeSH headings included: Sports, Athletic Injuries, and Accidents. Keywords used within these headings were Skiing and/or Snowboarding with focus on children, adolescents, youth, students, or age group-related comparisons. MAIN RESULTS: The patterns and rates of injury differed markedly by activity and study design. Most studies were case-series investigations providing little useful information on risk factors. Intrinsic risk factors included: lower ability, younger age, past injury, and female sex. Extrinsic risk factors were improper binding adjustment, no helmet, certain slope characteristics, and no wrist guards. The literature on the effect of activity, equipment ownership and lessons on injury risk was equivocal. CONCLUSIONS: Suggestions for injury prevention include the use of helmets and wrist guards, participation on appropriate runs for ability level, proper fit and adjustment of bindings and other equipment, and taking lessons with the goal of increasing ability and learning hill etiquette. Many areas requiring further research are identified and discussed. New methodological approaches hold promise in advancing the field of ski and snowboard injury research.

Adolescent↗
PubMedDate not supplied

[Hygienic characteristics of children's sports-and-playing grounds in Moscow].

The hygienic state of 280 children's sports-and-playing grounds was studied in 9 Moscow okrugs in accordance with the proportion of vandalism and the level of greening, noise, and environmental pollution caused by motor transport. Technogenic load on children on the children's grounds was shown to be higher in Moscow than that in its Region, the levels of dust, chlorine ions, lead, and potassium were 10, 3, 5, and 2 times higher in Moscow than in the region. By significantly decreasing the pollution, the minimum distance of children's grounds from a road or a car park should be 15 m. It was found that 33-50% of the children's grounds in Moscow did not meet this criterion. The level noise more than 40 dB caused by motor transport on the children's grounds was noted in 53% of cases. The level of poor greening was directly correlated with that of noise. The problem associated with the durability of constructions for children's grounds (the broken constructions were an average of about 12.5%) may be solved, by using fiberglass materials.

Age Factors↗
PubMed2003

The effect of dance training on joint mobility, muscle flexibility, speed and agility in young cross-country skiers--a prospective controlled intervention study.

We evaluated a short-term (3 months) and a long-term (8 months) effect of dance training on joint mobility and muscle flexibility of the spine, hip and ankle and on speed and agility in young cross-country skiers. Twenty elite cross-country skiers - aged 12-15 years - participated in the study. Five males and five females received dance training (intervention group) and five males and five females did not dance (reference group). Joint mobility and muscle flexibility of the spine, hip and ankle joints were measured using a goniometer, a kyphometer, a measuring tape and a ruler. Two sports-related functional tests - the slalom-test and the hurdle-test - were also performed. These measurements/tests were performed before the start of the dancing period and after 3 and 8 months. The subjects from the intervention group increased their speed with 0.3 s after 3 (P = 0.05) and 8 months (P = 0.02), respectively, when measured with the slalom-test. They also improved their speed and agility according to the hurdle-test after 3 months with 0.8 s (P = 0.000) and 8 months with 0.6 s (P = 0.01). Furthermore, they increased flexion-extension of the thoracic spine with 7.5 degrees after 3 months (P = 0.05) and with 9 degrees degrees after 8 months (P = 0.03) and lateral flexion of the spine with 0.04 m (P = 0.005) and 0.03 m (P = 0.02) after 3 and 8 months, respectively. The reference group was impaired or unchanged in the studied parameters after both 3 and 8 months. We conclude that dance training has a positive effect on speed and agility and on joint mobility and muscle flexibility in flexion-extension and lateral flexion of the spine in young cross-country skiers.

Adolescent↗
PubMed2004

Shoe rim and shoe buckle pseudotumor of the ankle in elite and professional figure skaters and snowboarders: MR imaging findings.

OBJECTIVE: To review MR imaging of figure skaters and snowboarders presenting with painful soft-tissue swelling of the lateral supramalleolar region with a clinical provisional diagnosis of soft-tissue tumor. DESIGN AND PATIENTS: MR imaging was prospectively reviewed by two sub-specialized musculoskeletal radiologists. The findings were correlated with a second clinical review and examination of the shoe wear. The patients were four female athletes undergoing heavy training regimes, ranging in age between 16 and 25 years. Two patients were elite figure skaters, and two were professional snowboarders. Three patients had unilateral masses with pain, and one patient presented with bilateral clinical findings. RESULTS: MR imaging showed subcutaneous, focal soft-tissue masses of the supramalleolar region in five ankles at the same level above the ankle joint. MR imaging prompted a second clinical review and correlation with the shoe wear. The MR imaging findings correlated to the level of the shoe rim or shoe buckle in all patients, confirming the suspected MR imaging diagnosis of an impingement syndrome. All four sportswomen were training excessively, ignoring safety advice regarding training duration, timing of breaks, and shoe wear rotation. CONCLUSION: Ice skaters and snowboarders may present with persistent and disabling pain. On MR imaging, this corresponds to a focal soft-tissue abnormality, which may be due to subcutaneous fat impingement between the fibula and the shoe rim or shoe buckle.

Adolescent↗
PubMed2005

The appropriateness of snowmobiling in national parks: an investigation of the meanings of snowmobiling experiences in yellowstone national park.

The debate over snowmobiling and other types of motorized recreation in US national parks signals the need for a better understanding of the meanings of these experiences. The fundamental issue facing many parks is whether snowmobiling is an appropriate activity. The matter of appropriateness is anchored in two questions: (1) Does snowmobiling in national parks cause unacceptable biophysical and social impacts? (2) Are snowmobiling experiences consistent with the fundamental purposes of national parks? This article particularly addresses the appropriateness issue and presents the findings of an interpretive study of the meanings of snowmobiling experiences in Yellowstone National Park (YNP). Sixty-five semistructured interviews were conducted with winter visitors who used snowmobiles in the park during the winter season of 1999. Overall, the study findings reveal that visitors on snowmobiles view YNP as a place to experience its wildland attributes, such as natural scenery, geothermal features, and, especially, wildlife. Snowmobiling is perceived as a mode of transportation rather than the experience in and of itself. The results challenge the popular image of snowmobiles as thrill-craft and snowmobilers as thrill-seekers. The study demonstrates that snowmobiling in YNP affords highly meaningful recreational experiences, grounded in appreciating the park's unique natural features and attributes.

Conservation of Natural Resources↗
PubMed2006

Neuro-mechanical and chemical influences on locomotor respiratory coupling in humans.

Mechanisms of coordination between breathing and movement during dynamic exercise are still a matter of debate. This study aimed to examine the degree of coordination between breathing and arm propulsion patterns and to compare the relative contribution of neuro-mechanical and chemical factors. Thirteen trained cross-country skiers performed constant submaximal 6-min roller skiing exercises on a motorized driven treadmill in two different poling techniques (V2A and V2 skating techniques) at two exercise intensity levels corresponding to the first and second ventilatory thresholds. The timing of arm propulsion movements in V2A and V2 techniques was considered as a mechanical/neural influence on breathing whereas exercise intensity represented the metabolic demand to breathing. The degree of coordination, expressed as the percentage of breaths presenting a constant phase interval (time between an arbitrarily chosen point of the arm movement cycle and the onset of expiration) was significantly higher in V2A than V2 (P<0.05) while exercise intensity had no effect on the degree of coordination. We concluded that locomotor-respiratory coupling occurs in cross-country skiing as simulated by roller skiing because of strong influences from neuro-mechanical factors.

Adult↗
PubMedDate not supplied

Intracranial hypotension and recurrent pleural effusion after snow-boarding injury: a manifestation of cerebrospinal fluid-pleural fistula.

BACKGROUND DATA: Intracranial hypotension causing postural headaches has been described after occult and postsurgical cerebrospinal fluid (CSF) leaks and rarely isolated lumbar punctures. The occurrence of a CSF-pleural communication is much rarer, and a high level of suspicion aids in prompt recognition. PURPOSE: Early detection and anatomic delineation of the site of CSF-pleural fistula allows prompt intervention, results in resolution of symptoms and prevents the complication of meningitis. STUDY DESIGN: A case of intracranial hypotension with postural headaches is described after spinal surgery, with demonstration on computed tomography (CT) myelography of a rare CSF-pleural fistula. METHODS: The clinical presentation, postoperative intervention and imaging as well as laboratory data are presented. RESULTS: Chest X-ray showed recurrent pleural effusion after placement of chest tube, and serial head CT studies revealed decreasing ventricular size with development of severe headaches. Myelogram and CT postmyelogram demonstrate the CSF-pleural communication, allowing appropriate surgical repair. CONCLUSION: Severe headaches with a recurrent pleural effusion after thoracic spinal surgery may indicate presence of a CSF-pleural fistula, an unusual complication of thoracic spinal surgery.

Adolescent↗
PubMed2003

Snowmobile injuries and fatalities in children.

BACKGROUND/PURPOSE: Snowmobiling is a popular form of wintertime recreation but can be associated with significant morbidity and mortality. To better understand snowmobile trauma in children, medical records were reviewed, evaluating the relationships between demographic data, mechanisms, and resultant injuries. In addition, because prior studies of childhood snowmobile fatalities have reviewed only national databases, state and national data were combined to evaluate possible underreporting. METHODS: Medical records were reviewed of children </=17 years old admitted to one trauma center between 1991 and 2000 with snowmobile-related injuries. Demographics, helmet usage, driver versus passenger, mechanism, injuries, injury severity score (ISS), and outcome data were recorded. Statistical analyses were performed to identify relationships between potential causative factors and ISS. State mortality data were acquired from state agencies and 2 databases of the U.S. Consumer Product Safety Commission (CPSC). Data from the 3 sources were compared, and a single list of fatalities was compiled and evaluated. RESULTS: Thirty-one children (65% boys; mean age, 12 years) were admitted with snowmobile-related injuries. Fifty-two percent were driving the snowmobile. Helmet usage was 68%. The most common mechanisms were collisions with a fixed object (42%) and with a motor vehicle (35%). The head was the most commonly injured site (71%) followed by the extremities (58%). ISS ranged from 1 to 38 (median, 10). Increased age and the child driving were the only factors associated with increased ISS (P <.05). One child died of a massive head injury. Twenty-two fatalities (70% boys; mean age, 14 years) statewide were identified from state and national databases, only 12 of which were identified by the CPSC Death Certificate file. Head injury was the most common cause of death. CONCLUSIONS: Reckless snowmobiling leads to significant morbidity and mortality among children. Prior reports based on CPSC data likely underestimated the number of snowmobile-related fatalities. Our findings support previous American Academy of Pediatrics recommendations, including the restriction of snowmobile driving by children under 16, graduated licensing for older children, and universal helmet usage.

Accidents↗
PubMed2002

Nonoperative management of blunt extrahepatic biliary duct transection in the pediatric patient: case report and review of the literature.

An 11-year-old boy sustained a grade IV liver injury and complete disruption of the left hepatic duct (LHD) secondary to a sledding accident. Although he became hemodynamically stable after initial resuscitation in the emergency department and the intensive care unit (ICU), serial paracentesis procedures were necessary to manage abdominal compartment syndrome (ACS). The fluid initially was serosanguinous but subsequently became bile stained. A bile leak was confirmed by a technetium 99m dimethyliminodiacetic acid (HIDA) scan and an endoscopic retrograde cholangiogram (ERCP). The LHD transection was treated with percutaneous drainage of the subhepatic space and a transampullary biliary stent. The leak sealed within 8 days, and follow-up ERCP as an outpatient showed no extravasation but could not visualize the LHD. Repeat computed tomography (CT) scan 3(1/2) months after injury showed the liver laceration to be healed with atrophy of the left lobe and no ductal dilatation. The patient has had a complete recovery, resumed all activities, and currently is 20 months after his injury with no sequelae.

Abdominal Injuries↗
PubMed2003

Orthopedic injuries related to snowmobile use.

OBJECTIVES: To document the locations of injury, frequency of associated injuries, and need for operative intervention in patients presenting to a tertiary medical center after sustaining an orthopedic injury related to snowmobile use. DESIGN: Retrospective review. SETTING: Tertiary care center with level I trauma designation in southern Minnesota. PATIENTS/PARTICIPANTS: Seventy-eight patients who sustained orthopedic injuries from snowmobile accidents between January 1985 and December 1996 were treated at our institution. Information regarding patient demographics and injury characteristics was collected. These data were stratified into patient populations presenting directly to the emergency department (n = 47) and those referred from outside hospitals (n = 31). RESULTS: A total of 209 injuries (118 fractures, 31 orthopedic soft-tissue injuries, and 60 nonorthopaedic injuries) were diagnosed within the study population. Tibia (n = 20), radius (n = 14), ulna (n = 12), and spine (n = 14) fractures accounted for half of the fractures reported. There were 13 open fractures. Twenty-four fractures were treated operatively. Ligament injuries to the knees (n = 7) and compartment syndrome of the lower extremity (n = 5) represented the most common orthopedic soft-tissue injuries. The acromioclavicular joint was the most frequently dislocated joint (n = 4). Associated injuries commonly involved the head (n = 17), abdomen (n = 13), and chest (n = 9). As compared to patients presenting directly to the emergency department, referred patients on average had a statistically greater number of total injuries, total operations, and operations for fractures. CONCLUSION: Snowmobile accidents represent a frequent cause of orthopedic injuries in northern regions. An understanding of these injuries may help emergency departments prepare for patients injured on these machines. Recognition of the most common orthopedic injuries may help in the design of safer snowmobiles.

Adolescent↗