JSAMS plus最新文献

Objective

To investigate associations between postural orientation errors (POEs) in patients undergoing rehabilitation for anterior cruciate ligament reconstruction (ACLR) and patient-reported outcomes (PROMs) at 2-year follow-up.

Design

Prospective cohort study.

Methods

Fifty-three participants (mean (SD) 27 (6.5) years, 24 women), (mean (range) 7 (4–10) months post ACLR) were included. At baseline, all participants were visually assessed for POEs using a validated test battery. The POE subscales Activities of Daily Living and Sport were used in the analysis. At 2-years, the following PROMs were collected: Global knee function, Knee injury and Osteoarthritis Outcome Score, ACL Quality of Life (QoL), Knee Self-Efficacy Scale (K-SES), and ACL Return-to-Sport after Injury scale.

Results

Twenty-one participants answered the questionnaires at 2 years (7 women and 14 men). Worse baseline POE Sport was associated with worse scores on K-SES (r_s ​= ​–0.435, p ​≤ ​0.049) and ACL-QoL (r_s ​= ​−0.467 to −0.576, p ​≤ ​0.038) at follow-up. No statistically significant associations were observed between POEs and the other PROMs.

Conclusion

Postural orientation during the rehabilitation phase may be important for future knee self-efficacy and knee-related QoL after ACLR. Given the small population and low response rate, this result needs to be confirmed in future research.

Objective

Collisions with obstacles are among the most severe accidents recorded in ski areas. In France, the padding placed on these obstacles conforms to a design standard to assess its ability to dissipate energy when impacted by a skier/snowboarder. Padding performance, i.e. its ability to prevent or mitigate injuries and the changes in performance over time remain poorly understood. Considering the global objective to explore the padding's ability to protect from injuries during its cycle of use, a large experimental campaign was designed to investigate various padding performance.

Design

Experimental drop tests were performed on padding in ski areas using instrumented head and trunk impactors.

Method

The influences of the padding's properties (thickness, age, impact location, cover), environment (temperature, position on the obstacle) and impact conditions (speed, impactor) on head and chest accelerations were investigated. 180 drop tests were performed on 40 padding samples (with thicknesses ranging from 10 ​cm to 30 ​cm) with ages varying from 0 to 17 years old.

Results

This study showed a significant influence of speed, impactor and the padding's thickness (P ​< ​0.001) and also position. However, temperature, aging, impact location and cover type did not have a clear influence on impact accelerations for these impact conditions.

Conclusions

This study is an innovative step towards a better understanding of ski padding performance and behavior. These results provide quantitative information for the development of best practices aiming at ski areas increasing safety on their slopes. They also highlight challenges and perspectives for the design of future padding.

Objectives

To determine typical speeds of skiers and snowboarders on-piste groomed trails across the United States (US).

Design and methods

On-slope speeds of skiers and snowboarders were measured on trails of varying difficulty at 8 ski areas across the US. The trail difficulty designation and slope were documented for each location where speed measurements were taken. The equipment used (skis or snowboard), whether a helmet was worn, and the estimated ability (determined by the researchers) of snowsports participants were recorded. A multiple linear regression analysis was performed to determine the influence of these individual and environmental factors on the speeds of snowsports participants.

Results

4164 speed observations were made between 2004 and 2020 on groomed trails at 8 ski areas representing 5 geographic regions in the United States. Across all observations, the average speed was 34.9 ​± ​13.6 ​km/h. The ability of the snowsports participant had the largest effect on speed. Advanced snowsports participants traveled faster (44.5 ​± ​11.7 ​km/h) than intermediates (32.4 ​± ​9.9) and beginners (19.9 ​± ​7.2). Skiers on average were faster (35.8 ​± ​13.8 ​km/h) than snowboarders (33.0 ​± ​13.2 ​km/h) and beginner and intermediate snowboarders were slower on average than their skiing counterparts. While the average speeds increased with increasing trail difficulty and slope, the correlation was weak (R² ​= ​0.15).

Conclusions

The ability of the snowsports participant was found to be the most influential factor affecting speed.

Medical scepticism is on the rise worldwide. It is very important to differentiate between uneducated scepticism (e.g. the anti-vaccination movement) where valuable areas of medicine are disputed and well-informed scepticism, where legitimate experts reveal flaws in mainstream medicine. It is assumed that medicine being a science will be self-correcting and inevitably move towards a stronger evidence-base, but a competing factor is the profit motive. Three excellent books are reviewed, all Australian and all covering primarily musculoskeletal medicine (Back Up by Mannix; Surgery: The Ultimate Placebo and Hippocrasy by Harris and Buchbinder). These texts reveal that musculoskeletal medicine has many treatments where the desire to offer hope and, also, make a profit is taking precedence over scientific evidence. Because many healthcare presentations of young people are musculoskeletal, doctors risk losing the younger generation to medical scepticism in general if they continue to offer and promote flawed treatment options over effective ones. The most effective long-term treatments in musculoskeletal medicine (exercise load management and psychological reassurance) are less profitable because they require so much time investment. Health care professionals need to be true to their science background and aim to do only what is effective, not be drawn to drugs and procedures that are more profitable but ultimately more harmful.