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At least 1,189 records · Page 66Linked to original sources
PubMed2002

Are components of a comprehensive medical assessment predictive of work disability after an episode of occupational low back trouble?

STUDY DESIGN: One hundred fifty-nine subacute low back work-injured patients completed a full medical assessment at baseline. A full repeat examination was performed 3 months later, when return-to-work status was determined. OBJECTIVE: To determine the prognostic value of a comprehensive medical assessment for the prediction of return-to-work status. SUMMARY OF BACKGROUND DATA: A systematic review of the work disability prediction literature of low back trouble prognosis revealed that no high-quality studies included a full medical history and physical examination in the design. The results of studies included in the systematic review were equivocal with respect to predictive usefulness of medical variables. METHODS: Participants completed medical history questionnaires and then were clinically examined by one of six experienced examiners (three physicians and three physiotherapists). Return-to-work status was measured 3 months later, and predictive validity was evaluated using logistic regression modeling. RESULTS: Medical variables (, medical history subscales, physical examination subscales, and lumbar range-of-motion tests) showed modest correct classification rates varying between 61.6% and 69.1% for participants. CONCLUSIONS: Comprehensive medical assessments play a crucial role in the early identification of serious pathology after low back trouble. We were unable to identify, however, any medical evaluation variables that would account for significant proportions of variance in return to work. The weight of evidence obtained in this study suggests that injured workers' subjective interpretations and appraisals may be more powerful predictors of the course of postinjury recovery than exclusively medical assessments.

Back Injuries↗
PubMed2003

Trunk extension effort in patients with chronic low back dysfunction.

STUDY DESIGN: Single-session measurement was performed. OBJECTIVE: To measure trunk extension strength and assess trunk extension effort in patients with chronic low back dysfunction using a novel test protocol and the DEC parameter. SUMMARY OF BACKGROUND DATA: In normal subjects, the DEC parameter effectively and reproducibly differentiates between maximal effort and feigned weakness of the trunk extensors, but its applicability to patients with chronic low back dysfunction has not yet been explored. METHODS: Isokinetic trunk extension strength was measured in 44 patients with chronic low back dysfunction (22 women and 22 men) who were not involved in litigation process. Tests were conducted using a range of motion of 20 degrees, angular velocities of 10 degrees and 40 degrees per second, and an isometric preactivation force of 50 N. The average strength at these velocities served for calculation of the DEC score, which is the difference between the eccentric and concentric strength ratios at these velocities. RESULTS: The strength scores resembled the characteristic physiologic moment-angular velocity relation, and were much reduced, as compared with the scores of normal subjects. The DEC scores for 39 patients (89%) were less than the cutoff value, which in normal subjects differentiates maximal effort (below cutoff) from feigned weakness (above cutoff) at tolerance limits of 99%. This figure was slightly lower (84%) at a corresponding 95% level. A principal finding in the false-positive cases was a particularly low concentric strength at 40 degrees per second. CONCLUSIONS: This study indicates that under the current protocol, the large majority of patients perform at a maximal level of effort.

Abdomen↗
PubMedDate not supplied

An epidemiologic investigation of injuries affecting young competitive female gymnasts.

A prospective study of injuries affecting 50 highly competitive young female gymnasts was conducted over a period of 1 year. Many of the findings of this investigation were consistent with previous studies and suggest particular injury trends in women's gymnastics. These results included injury location, injury severity, nature of onset, event, and activity at the time of injury. Some of the descriptive results, however, provided information that was heretofore unreported or inconsistent with previous investigations. These findings involved injury rate, reinjury rate, time loss, injury type, hours of practice, and incidence of physician-seen injuries. Some of these findings were disturbing and echo concerns registered in the professional literature. In particular, the reinjury rate is alarming and points to the need for complete rehabilitation before return to full participation. The results of the analytic component of the study alluded to the potential role of competitive level and maturation rate in the profile of the injury-prone gymnast. Specifically, rapid periods of growth and advanced levels of training and competition appeared to be related to injury proneness. Pursuant to the descriptive and analytic results of the investigation, recommendations for injury prevention and continued research are made.

Adolescent↗
PubMed1986

Swimming injuries of the knee, foot and ankle, elbow, and back.

The practitioner need not be an expert in swimming but should understand the rudiments of the stroke and training techniques such patients are subjected to. This will aid in proper identification and analysis of the problem. The solution may require the resources of physician, therapist, coach, and parent as well as swimmer.

Ankle Injuries↗
PubMed1996

Low back pain in elite cross-country skiers. A retrospective epidemiological study.

Low back pain is a common complaint among competitive cross-country skiers. Fifty-three top male and 34 female skiers in the age group 16-25 were interviewed with a questionnaire regarding anthropometric parameters, training variables, back pain and other injuries. The frequency of back pain was 64% in the whole group, men affected slightly more often than women. Back pain was defined as previous or present recurrent skiing correlated backache that more or less affected skiing ability. Diagonal skiing style was the most commonly back pain-inducing style, whereas no skier experienced back pain when "skating" only. The low back was the predominant location of pain. Anthropometric and training variables seemed to be of little value in predicting back pain.

Adolescent↗
PubMed1996

Epidemiological analysis of injury in one year of Canadian professional rodeo.

OBJECTIVES: To document injury rates and treatment use during one competitive season of Canadian professional rodeo. DESIGN: Prospective cohort study. SETTING: Canadian professional rodeo competition. SUBJECTS: Competitors, included professional cowboys from Australia, Brazil, New Zealand, the United States, and Canada. METHODS: Data were gathered prospectively at 15 of 68 professional rodeos in Canada, constituting 22% of all Canadian professional rodeos. Data were collected by four certified athletic therapists using a standardized form. MAIN RESULTS: Overall, 94 athletes were injured during 3,882 individual competitor exposures (CEs). The composite injury rate was 2.3 per 100 CEs. This rate is lower than that reported in contact sports. Within the context of rodeo injuries, bareback riders and bull riders had similar high injury rates (4.6 and 3.6 per 100 CEs, respectively). Saddle bronc riders and steer wrestlers had moderate injury rates (1.4 and 0.9 per 100 CEs, respectively), whereas calf ropers had low injury rates (0.5 per 100 CEs). The knee and ankle were the most frequently treated sites of the body, followed by the shoulder, elbow, and lower back. Acute injury care and prophylactic taping were the most frequent services provided. CONCLUSIONS: In order to study injury patterns in more detail and to assess risk factors for injury, a larger scale epidemiological study should be undertaken. Through such risk-based analysis, preventative strategies could be identified.

Athletic Injuries↗
PubMed1979

Extremity fractures in children with neuromuscular disease.

This report discusses the occurrence and management of fractures seen in 30 children with neuromuscular disorders. Twenty fractures were seen in 17 ambulatory patients, ages 5 to 16. Twelve of the patients in this group had Duchenne muscular dystrophy (DMD), 3 had spinal muscular atrophy (SMA) and 2 had Charcot--Marie--Tooth (CMT) disease. Treatment consists of reduction of the fractures followed by immobilization of the extremities; however, continuation of everyday activities, including ambulation, should be emphasized. In fact, five patients ceased walking as a direct result of immobilization following fracture. Sixteen fractures were seen in 13 non-ambulatory patients, ages 4 to 19. These fractures were generally caused by very small forces; the fractures were rarely displaced. Eight of the fractures in osteoporotic and contracted knee joints occurred in either the distal femur or proximal tibia. Functional loss can be minimized by splinting until the patient no longer complains of pain. Splinting should be followed by rapid return to full activity.

Adolescent↗
PubMed2004

Muscular and centre of pressure response to sudden release of load in symmetric and asymmetric stoop lifting tasks.

Sudden changes in load during asymmetric lifting may be associated with a particularly high risk of loss of balance and spinal injury. Centre of pressure (COP) motions and electromyographic responses of trunk and lower limb muscles were studied in 10 normal male volunteers during sudden release of 20, 40, 60 and 80N stoop lifting loads in symmetric and asymmetric postures. Similar overall COP responses and muscular response strategies to sudden release of load were seen in both postures, although the asymmetric posture showed a larger medio-lateral COP displacements and greater co-contraction asymmetries. While sudden release of load in asymmetric stoop lifting does not seem to involve a greater risk of fall than symmetric lifting, the muscular response results in more complex and asymmetric loading of the trunk, indicating greater localised segmental loading and therefore increased risk of tissue injury.

Abdominal Muscles↗
PubMed2006

Back pain in whitewater rafting guides.

OBJECTIVE: The purpose of this study was to quantify rates of back pain among whitewater rafting guides and to look for correlations between the presence of back pain and specific activities associated with guiding. The secondary objective was to provide suggestions for outfitters according to the results of this study, which may be of assistance to their guide staff. METHODS: A mail-out-mail-back survey was sent to 2510 rafting guides working in Washington, Oregon, Idaho, Utah, Colorado, and the Grand Canyon during the summer of 2004 to quantify whitewater raft guiding characteristics and incidence of back pain. RESULTS: Of the 390 surveys returned, 77.4% of guides reported back pain while guiding and 20.8% had back pain lasting longer than 1 week at the time of the survey. Stacking 5 or more inflated boats for transport was correlated with the presence of pain (chi(2) = 8.4, v = 1, P < .01), and loading and unloading rafts while guests are waiting was correlated with back pain lasting longer than 1 week (chi(2) = 8.1, v = 1, P < .01). CONCLUSIONS: The rates of back pain among, and activities of, whitewater rafting guides were reported. Rates of back pain among whitewater rafting guides who returned our survey appear similar to the general population. Although determining a particular cause of pain is difficult, the typical injury seems to be relatively minor in scope.

Adolescent↗
PubMed2002

Transfusion-related acute lung injury: report of a clinical look-back investigation.

CONTEXT: Transfusion-related acute lung injury (TRALI) is a syndrome that includes dyspnea, hypotension, bilateral pulmonary edema, and fever. TRALI is the third leading cause of transfusion-related mortality, but it is probably underdiagnosed and underreported. OBJECTIVE: To determine if blood products from a frequent plasma donor, whose blood product was implicated in a fatal case of TRALI, caused symptoms of TRALI in other recipients of her plasma. DESIGN, SETTING, AND PARTICIPANTS: Retrospective chart review (conducted from November 2000 through April 2001) of 50 patients who received blood components within 2 years (October 1998 through October 2000) from a donor linked to a transfusion-related fatality. MAIN OUTCOME MEASURE: Occurrence of mild/moderate (dyspnea with fever, chills, hypotension, and/or hypoxemia) or severe (acute pulmonary edema or need for mechanical ventilation) reaction associated with transfusion. RESULTS: Superimposed illness prevented assessment of TRALI in 14 patients. Of the 36 patient charts that could be reviewed, 7 mild/moderate reactions were reported in 6 patients (16.7%) and 8 severe reactions were reported in 8 patients (22.2%). Of 5 patients who received multiple transfusions from the same donor, 2 experienced 2 reactions: one had 2 mild/moderate reactions and the other had both a mild/moderate and a severe reaction. While 5 of the 7 mild/moderate reactions were reported to the hospital transfusion service, only 2 of the 8 severe reactions were reported. Only 2 reactions (1 mild/moderate and 1 severe) were reported to the regional blood collection facility. CONCLUSIONS: TRALI was frequently underdiagnosed and underreported in recipients of blood products from a donor whose blood products may have caused TRALI in several transfusion recipients. Clinical education and awareness of this often-overlooked diagnosis are imperative for appropriate prevention and treatment.

Acute Disease↗
PubMed1999

Validation of a questionnaire for assessing physical work load.

OBJECTIVES: Reliable, valid, and compatible methods are required for exploring the complex interactive effects of psychosocial and physical stressors on complaints and disorders. An instrument for assessing physical work load that integrates information from a biomechanical model of lumbar load is presented and validated. METHODS: Four hundred and fifty-five people working in nursing homes for elderly people in Germany filled out the developed questionnaire 3 times within 1 year. Test-retest reliability was calculated, and validity was checked several times. Relationships with other, theoretically related and unrelated variables were examined. RESULTS: The test-retest reliability of the questionnaire measures was about 0.65. The convergent and discriminant validity was satisfactory, and the questionnaire was able to separate professional subgroups with different physical work loads. The Spearman rank-order correlations between physical load and musculoskeletal complaints were about 0.30. CONCLUSIONS: The method developed in this study is a reliable and valid instrument for assessing physical work load. The integration of statistical methods from psychological testing and theory in the development of methods exploring the effects of physical work load is advocated.

Adult↗
PubMed1999

Injuries and risk factors in a 100-mile (161-km) infantry road march.

BACKGROUND: Light infantry soldiers (N = 218) completed a 161-km cross-country march over 5 days carrying an average +/- SD load mass (i.e., the weight of all equipment and clothing) of 47 +/- 5 kg. METHODS: Prior to the march, height, weight, body fat, and physical fitness (3.2-km run, sit-ups, push-ups) were measured. Soldiers completed a demographic questionnaire which included questions on age and tobacco use history. RESULTS: Thirty-six percent (78/218) of the soldiers suffered one or more injuries. Of the total injuries, 48% presented were blisters and 18% were foot pain (not otherwise specified). Eight percent (17/218) of the soldiers were unable to complete the march because of injuries. Thirty-five percent (27/78) of the injured soldiers had 1 or more limited duty days for a total of 69 days. Risk of injury was higher among smokers (risk ratio = 1.8, P = 0.03 compared to nonsmokers) and lower among older soldiers (risk ratio = 3.2, P = 0.02, < 20 years compared to > 24 years). CONCLUSIONS: Carrying heavy loads over long distances can result in a high injury incidence to the lower body, since 36% of soldiers were injured during the 161-km march. Smoking and younger age (< 20 years) were independent risk factors for injuries.

Adult↗
PubMedDate not supplied

Back pain in former intercollegiate rowers. A long-term follow-up study.

BACKGROUND: Research has shown that 32% of intercollegiate rowers develop back pain during their college career. HYPOTHESIS: Rowers who develop back pain in college are more likely than the general population to have back pain later in life. STUDY DESIGN: Survey. METHODS: Surveys from 1561 former intercollegiate rowing athletes were analyzed. Subjects who completed the surveys had graduated from college at a mean and median of 13 years previously, with a range of 0 to 20 years between graduation and completion of the survey. The survey was designed to determine the presence of back pain and its severity before, during, and after intercollegiate rowing. Back pain was defined as pain that lasted at least 1 week. RESULTS: Age was a significant predictor of back pain after college. Nevertheless, the lifetime prevalence of back pain in former intercollegiate rowers was no different from that of the general population (51.4% versus 60% to 80%). However, rowers who developed back pain in college had more subsequent back pain than rowers who were asymptomatic in college (78.9% versus 37.9%). Rowers who were asymptomatic in college had significantly lower rates of back pain as they aged than did the general population. The mean severity of current back pain was 3.5 +/- 1.9 on a scale of 1 to 10. CONCLUSIONS: Intercollegiate rowers are no more likely than the general population to have back pain later in life.

Adult↗