The ups and downs of trampolines: Injuries associated with backyard trampolines and trampoline parks

A Review of 13,470 Head and Neck Injuries from Trampoline Jumping

Study Design

The authors designed a 20-year cross-sectional study using the National Electronic Injury Surveillance System (NEISS) database.

Objective

The purpose of the study is to determine the risk factors for hospital admission among individuals who suffer head and neck injuries secondary to trampoline use.

Methods

The primary predictor variables were a set of heterogenous variables that were categorized into the forementioned study variable groups (patient characteristics and injury characteristics). The primary outcome variable was hospital admission. Multivariate logistic regression was used to determine independent risk factors for hospital admission.

Results

The final sample consisted of 13,474 reports of trampoline injuries to the head and neck. Relative to females, males (OR 1.66, P < .05) were at an increased risk for hospital admissions. Fractures (OR 35.23, P < .05) increased the risk for hospital admissions relative to dental injuries. Concerning anatomical region of injury, neck injuries (OR 30.53, P < .05) were at an increased risk for hospital admissions.

Conclusions

Injuries to the neck from trampoline jumping significantly increased the risk for admission. The severity of neck injuries from trampoline jumping is well established in the literature. Additionally, male sex and fractures were each risk factors for hospital admission. Given the rising prevalence of trampoline-related head and neck injuries over the past 2 decades, it is crucial for individuals to take the necessary precautions when jumping on a trampoline.

Trampoline Park Injury Trends

OBJECTIVES

Trampolines are an important cause of childhood injury and focus of injury prevention. Understanding and prevention of trampoline park injury is constrained by inadequate exposure data to estimate the at-risk population. This study aimed to measure trampoline park injury incidence and time trends using industry data.

METHODS

Cross-sectional study to retrospectively analyze reported injuries and exposure in 18 trampoline parks operating in Australia and the Middle East, from 2017 to 2019. Exposure was derived from ticket sales and expressed as jumper hours. Exposure-adjusted incidence was measured using marginalized 0-inflated Poisson modeling and time trends using Joinpoint regression.

RESULTS

There were 13 256 injured trampoline park users reported from 8 387 178 jumper hours; 11% sustained significant injury. Overall, trampoline park injuries occurred at a rate of 1.14 injuries per 1000 jumper hours (95% confidence intervals 1.00 to 1.28), with rates highest for high-performance (2.11/1000 jumper hours, 1.66 to 2.56) and inflatable bag or foam pit (1.91/1000 jumper hours, 1.35 to 2.50) jumping. Significant injuries occurred at a rate of 0.11 injuries per 1000 jumper hours (0.10 to 0.13), with rates highest for high-performance (0.29/1000 jumper hours, 0.23 to 0.36), and parkour (0.22/1000 jumper hours, 0.15 to 0.28) jumping. Overall, injury rates decreased by 0.72%/month (-1.05 to -0.40) over the study period.

CONCLUSIONS

Trampoline park injuries occur in important numbers with sometimes serious consequences. However, within these safety standard-compliant parks, exposure-adjusted estimates show injuries to be uncommon and injury rates to be declining. Further reductions are required, especially severe injuries, and this study can enhance injury prevention initiatives.

Differences in Trampoline-Related Knee Injuries Between Children and Adults: A Cross-Sectional Study

Background

Little is known about the specific risk of knee injuries due to trampoline accidents in adults compared with children.

Purpose

To investigate the differences in trampoline-related knee injuries between children and adults and identify risk factors and protective strategies to reduce injury incidence.

Study Design

Cross-sectional study; Level of evidence, 3.

Methods

Data on 229 consecutive patients treated for trampoline-related knee injuries in a single institution were prospectively collected, analyzed, and included. Risk factors, injury patterns, and clinical treatments were compared between skeletally immature and skeletally mature patients. Logistic regression was used to determine the odds ratios for specific risk factors for trampoline-related injuries-including body mass index (BMI), trauma mechanism, patient age, and accident location.

Results

A total of 229 patients met the inclusion criteria; 118 (52%) patients (women, 54.2%; mean age, 8.5 ± 4.1 years) were skeletally immature at the time of injury, and 111 (48%) patients (women, 72%; mean age, 31.9 ± 13.1 years) had closed physes on initial presentation and were classified as skeletally mature. A total of 63 patients (28%) required surgical treatment for their knee injury. Overall, 50 anterior cruciate ligament (ACL) tears, 46 fractures, 39 meniscal tears, 31 ligamentous tears other than ACL, 22 patellar dislocations, and 38 soft tissue injuries, such as lacerations, were recorded. Skeletally mature patients had 7.8 times higher odds (95% CI, 1.6-46.8; P < .05) and 19.1 increased odds (95% CI, 5.5-74.9; P < .05) of an ACL tear or another ligamentous tear, respectively, compared with skeletally immature patients. Patients who described instability and giving way of the knee as relevant trauma mechanisms had odds of 3.11 (95% CI, 0.9-14.8; P < .05) of an ACL tear compared with other trauma mechanisms. Meniscal tears were observed more frequently in the skeletally mature cohort (P < .05). An elevated BMI was associated with a significantly higher relative risk of an ACL tear, a ligamentous tear other than the ACL, and an injury requiring surgery. A third of surgically treated patients were subject to a delayed diagnosis.

Conclusion

Adults had a significantly increased risk of ligamentous and meniscal tears and required operative intervention more often than skeletally immature individuals. Elevated BMI, age, and instability events in terms of trauma mechanism conveyed an increased risk of structural damage to the knee.

Trampoline centre injuries in children and adolescents: a systematic review and meta-analysis

CONTEXT

No evidence-based review has compared injury risks sustained on trampolines at home and in trampoline centres.

OBJECTIVE

To present pooled results for injury type, site and treatment from studies reporting injuries that occurred on trampolines at home and in trampoline centres.

DATA SOURCES

MEDLINE, Scopus, Google Scholar and Embase databases were searched to 31 December 2021.

STUDY SELECTION

Inclusion criteria: (1) assessment of trampoline injuries (home and trampoline centres); (2) children and adolescents; (3) the point estimate was reported as an odds ratio (OR); and (4) an internal comparison was used.

DATA EXTRACTION

Data were reported according to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. A random-effects model was used to estimate effect.

RESULTS

There were 1 386 843 injuries (n=11 studies). There was an increased likelihood of musculoskeletal and/or orthopaedic injuries (OR 2.45, 95% CI 1.66 to 3.61, p<0.001), lower extremity injury (OR 2.81, 95% CI 1.99 to 3.97, p<0.001), sprains (OR 1.64, 95% CI 1.36 to 1.97, p<0.001) and a need for surgery (OR 1.89, 95% CI 1.37 to 2.60, p<0.001) at trampoline centres compared with home trampolines. Conversely, upper extremity injury (OR 0.49, 95% CI 0.25 to 0.95, p=0.03), concussion (OR 0.48, 95% CI 0.35 to 0.65, p<0.001) and lacerations (OR 0.46, 95% CI 0.35 to 0.59, p<0.001) were less likely to occur at trampoline centres than at home.

CONCLUSIONS

Children using trampoline centres are more likely to suffer severe trauma and require surgical intervention than children using home trampolines. Development and implementation of preventative strategies, public awareness, and mandatory safety standards are urgently required for trampoline centres.

Seasonal variability and age-related risk in youth trampoline injuries

BACKGROUND

The aim of this work was to estimate the difference in severity between musculoskeletal trampoline park injuries (TPIs) and home trampoline injuries (HTI) and identify the factors that might mediate or modify that effect.

METHODS

The National Electronic Injury Surveillance System database was used to identify musculoskeletal home trampoline injuries and TPIs in pediatric patients occurring in the 2009-2017 period. Injury mechanism and body region were inductively coded. The effect of TPI on risk of admission was estimated using a doubly robust logistic regression model for confounding adjustment. Adjustments were made for date, age, gender, injury mechanism, and body region. The comparative importance of injury mechanism and location and the effect modification of patient characteristics was explored using likelihood ratio tests.

RESULTS

Trampoline park injuries were more likely to result in admission even in the model adjusted for injury mechanism and body region (odds ratio (OR) = 2.12 [1.30, 3.45]). Injuries sustained from falling off the trampoline were associated with significantly fewer hospitalizations (OR = 0.119 [0.029, 0.495]) than injuries from falling while on the trampoline. Patient age significantly modified the effect of setting on risk of admission (P = 0.042). Adolescents demonstrated an increased risk at trampoline parks (15 years old OR = 3.23 [1.38, 7.56]), whereas younger children demonstrated a marginally lower risk (5 years old OR = 0.77 [0.44, 1.35]).

CONCLUSIONS

Trampoline park musculoskeletal injuries demonstrate an increased risk of admission even after rigorous adjustment for confounding. Injuries to the proximal limbs were associated with a much higher risk of admission than distal injuries. Adolescents face an increased risk of admission after TPI, underscoring the importance of public health interventions that target this age group.

Home versus indoor trampoline park injuries: A four-year review of hospital admissions, associated costs, and impact on patients

Hospital admissions for trampoline-related injuries are a metric of injury severity. The literature shows hospital admissions are more likely to occur from trampoline park injuries rather than home trampoline injuries. The purpose of this study was to investigate the demographics, injury characteristics, patient experiences, and economic impact of home versus trampoline park injuries requiring admission to hospital before and after two indoor trampoline parks opened in the catchment area of a Level II trauma centre. A case series research design was used. All patients who were admitted to hospital following a trampoline injury were contacted. For those who consented, clinical data was recorded from patients' charts and electronic health records. A subset of participants consented to a telephone interview wherein patient narratives were collected on the mechanism of injury, recovery process, and impact of the injury. During the study period, 15 patients required 17 hospital admissions. Twelve consented to participate in the study. Nine of the 12 required an operative intervention. Eight of the 12 were trampoline park injuries. Anatomical location of the injuries, injury type and severity scores, hospital stay, and median age were similar. The economic impact of home trampoline and trampoline park injuries varied. Overall, there were more hospital admissions and more operative interventions for trampoline park injuries during the four-year study period. Seven participants who consented to be interviewed provided additional insights into the injury experience and long-term outcomes. This study contributes to the literature on trampoline-related injuries, focusing on hospital admissions, economic impact, and adds the important perspective of patients in evaluating the effect of these injuries.

Radiological trends in trampoline-related paediatric injuries in a major paediatric trauma centre: a 6-year experience

Aim

Review of visits to the radiology department related to trampoline injuries in a major trauma centre in the UK over a 6-year period, and analysis of imaging performed, injury type, and seasonal trends in children under 18 years of age.

Subject and methods

Retrospective review of the Radiology Information System (RIS) for requests and reports between January 2012 and December 2017 containing the search term “tramp*” with an age of < 18 years.

Results

A total of 1794 children (44% male, mean age 8.15) visited the radiology department 1871 times and received 2343 separate radiographic examinations, ten ultrasound examinations, 20 CT examinations, 19 MR examinations and two nuclear medicine examinations. Seven hundred and eighty-eight children (45.9% male) had injury demonstrated on radiographs (622 fractures and 183 soft-tissue injuries) during 796 visits to radiology. Positive CT, MRI, and US were seen in 55%, 47.3%, and 50% of cases respectively. Children under 7 years of age are more likely to have been injured compared to older children attending for X-rays, with the proportion of injuries seen in 6-year-old children being the highest (63.7%). Trampoline injury-related X-ray requests to radiology rose from 1.7% to 4% per year as a percentage of overall X-ray requests from the emergency department.

Conclusion

Trampoline injury-related visits to the radiology department and the number of injuries demonstrated on imaging studies have increased over the study period, putting greater pressure on the healthcare system. Younger children are especially prone to injury. Public health campaigns and mandatory national safety standards are needed to increase awareness of potential dangers of recreational trampoline use.

Trampoline safety in childhood and adolescence

Despite previous recommendations from the American Academy of Pediatrics discouraging home use of trampolines, recreational use of trampolines in the home setting continues to be a popular activity among children and adolescents. This policy statement is an update to previous statements, reflecting the current literature on prevalence, patterns, and mechanisms of trampoline-related injuries. Most trampoline injuries occur with multiple simultaneous users on the mat. Cervical spine injuries often occur with falls off the trampoline or with attempts at somersaults or flips. Studies on the efficacy of trampoline safety measures are reviewed, and although there is a paucity of data, current implementation of safety measures have not appeared to mitigate risk substantially. Therefore, the home use of trampolines is strongly discouraged. The role of trampoline as a competitive sport and in structured training settings is reviewed, and recommendations for enhancing safety in these environments are made.