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Pegoraro N, Rossini B, Giganti M, Brymer E, Monasterio E, Bouchat P, Feletti F. Telemedicine in Sports under Extreme Conditions: Data Transmission, Remote Medical Consultations, and Diagnostic Imaging. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6371. [PMID: 37510603 PMCID: PMC10380087 DOI: 10.3390/ijerph20146371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 06/11/2023] [Accepted: 06/17/2023] [Indexed: 07/30/2023]
Abstract
Telemedical technologies provide significant benefits in sports for performance monitoring and early recognition of many medical issues, especially when sports are practised outside a regulated playing field, where participants are exposed to rapidly changing environmental conditions or specialised medical assistance is unavailable. We provide a review of the medical literature on the use of telemedicine in adventure and extreme sports. Out of 2715 unique sport citations from 4 scientific databases 16 papers met the criteria, which included all research papers exploring the use of telemedicine for monitoring performance and health status in extreme environments. Their quality was assessed by a double-anonymised review with a specifically designed four-item scoring system. Telemedicine was used in high-mountain sports (37.5%; n = 6), winter sports (18.7%; n = 3), water sports (25%; n = 4), and long-distance land sports (18.7%; n = 3). Telemedicine was used for data transfer, teleconsulting, and the execution of remote-controlled procedures, including imaging diagnostics. Telemedical technologies were also used to diagnose and treat sport-related and environmentally impacted injuries, including emergencies in three extreme conditions: high mountains, ultraendurance activities, and in/under the water. By highlighting sport-specific movement patterns or physiological and pathological responses in extreme climatic conditions and environments, telemedicine may result in better preparation and development of strategies for an in-depth understanding of the stress of the metabolic, cardiorespiratory, biomechanical, or neuromuscular system, potentially resulting in performance improvement and injury prevention.
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Affiliation(s)
- Nicola Pegoraro
- Dipartimento di Medicina Traslazionale e per la Romagna, Università degli Studi di Ferrara, 44122 Ferrara, Italy
| | - Benedetta Rossini
- Dipartimento di Medicina Traslazionale e per la Romagna, Università degli Studi di Ferrara, 44122 Ferrara, Italy
| | - Melchiore Giganti
- Dipartimento di Medicina Traslazionale e per la Romagna, Università degli Studi di Ferrara, 44122 Ferrara, Italy
| | - Eric Brymer
- Humans Sciences, Faculty of Health, Southern Cross University, Southern Cross Drive, Bilinga, QLD 4225, Australia
| | - Erik Monasterio
- Christchurch School of Medicine, University of Otago, Hillmorton Hospital, Private Bag 4733, Christchurch 8024, New Zealand
| | - Pierre Bouchat
- Psychological Sciences Research Institute, Université Catholique de Louvain, B-1348 Louvain-la-Neuve, Belgium
| | - Francesco Feletti
- Dipartimento di Medicina Traslazionale e per la Romagna, Università degli Studi di Ferrara, 44122 Ferrara, Italy
- Dipartimento Diagnostica per Immagini-Ausl Romagna, U.O. Radiologia-Ospedale S. Maria delle Croci, 48121 Ravenna, Italy
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Brodmann Maeder M, Andenmatten S, Lienert JS, Von Wyl T, Exadaktylos AK. BASE Jumping in the Lauterbrunnen Valley: A Retrospective Cohort Study from 2007 to 2016. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3214. [PMID: 36833909 PMCID: PMC9965376 DOI: 10.3390/ijerph20043214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/05/2023] [Accepted: 02/07/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND BASE jumping, and especially BASE jumping with the help of wingsuits, is considered one of the most dangerous airborne sports. The valley of Lauterbrunnen in Switzerland has become infamous for the large number of BASE jumps and the high rate of accidents and fatalities. The aim of this study was to evaluate the morbidity and mortality of BASE jumping, to determine the severity of injuries and injury patterns of BASE jumping accidents and to compare preclinical assessment with clinical diagnoses to detect under- or overtriage. METHODS This retrospective, descriptive cohort study covers a period of 10 years (2007-2016). The evaluation covered all BASE jumping incidents in the valley of Lauterbrunnen that required either a helicopter mission by the local HEMS (Helicopter Emergency Medical Service) company of Lauterbrunnen, Air Glaciers, or medical care in the regional hospital, the level I trauma centre or the medical practice of the local general practitioner. Besides demographic data, experience in BASE jumping and skydiving as well as BASE jumping technique(s) and details about the rescue missions were collected. The medical data focused on the severity of injuries, as expressed by the National Advisory Committee of Aeronautics (NACA) score in the prehospital assessment as well as the Abbreviated Injury Scale (AIS) and Injury Severity Score (ISS) retrieved from the clinical records in the hospital or medical practice setting. RESULTS The patients were predominantly young, experienced male BASE jumpers. Morbidity (injury risk) ranged from 0.05% to 0.2%, and fatality risk from 0.02% to 0.08%. Undertriage was low, with only two cases. Overtriage was significant, with 73.2% of all NACA 4-6 cases not qualifying for major trauma. CONCLUSIONS BASE jumping remains a high-risk sport and is associated with significant rates of injuries and fatalities. Comparison with previous studies indicated that the injury rate may have decreased, but the fatality rate had not. In this known BASE jumping environment, prehospital assessment appears to be good, as we found a low undertriage rate. The high overtriage rate might be an expression of physicians' awareness of high-velocity trauma mechanisms and possible deceleration injuries.
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Affiliation(s)
- Monika Brodmann Maeder
- Department of Emergency Medicine, Bern University Hospital, Bern University, 3010 Bern, Switzerland
- Institute of Mountain Emergency Medicine, EURAC Research, 39100 Bolzano, Italy
| | - Simon Andenmatten
- Department of Emergency Medicine, Bern University Hospital, Bern University, 3010 Bern, Switzerland
| | | | - Thomas Von Wyl
- Department of Anesthesia and Critical Care, Hospital Interlaken, 3800 Interlaken, Switzerland
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Bigdon SF, Hecht V, Fairhurst PG, Deml MC, Exadaktylos AK, Albers CE. Injuries in alpine summer sports - types, frequency and prevention: a systematic review. BMC Sports Sci Med Rehabil 2022; 14:79. [PMID: 35501847 PMCID: PMC9063189 DOI: 10.1186/s13102-022-00468-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 04/18/2022] [Indexed: 01/03/2023]
Abstract
Introduction Summer alpine sports, including mountain biking, hiking and airborne pursuits, have experienced a recent surge in popularity. Accordingly, trauma associated with these activities has increased. There is a scarcity of literature exploring clinical aspects surrounding injuries. Specifically, no single article provides a general overview, as individual studies tend to focus on one particular sport. In the present study, we performed a systematic literature review to summarize existing knowledge and explore the potential for prevention and clinical decision making in this group. Method Literature searches were performed using the PubMed and Scopus database for the most commonly ventured sports associated with injury: mountain biking, climbing, airborne sports, paragliding, and base jumping. From this search, studies were identified for qualitative and quantitative analyses. These searches were done according to PRISMA guidelines for systematic reviews. Studies were then analyzed regarding epidemiology of injuries, relevant anatomical considerations and prevention strategies were discussed. Results A broad spectrum of injury sites and mechanisms are seen in mountain biking, climbing or airborne sports. Mountain biking related injuries commonly involve the upper extremity, with fractures of the clavicle being the most common injury, followed by fractures of the hand and wrist. Scaphoid fractures remain of paramount importance in a differential diagnosis, given their often subtle clinical and radiological appearance. Paragliding, skydiving, and base jumping particularly affect transition areas of the spine, such as the thoracolumbar and the spinopelvic regions. Lower limb injuries were seen in equal frequency to spinal injuries. Regarding relative risk, mountain biking has the lowest risk for injuries, followed by climbing and airborne sports. Male alpinists are reported to be more susceptible to injuries than female alpinists. Generally, the literature surrounding hiking and water-related mountain sports is insufficient, and further work is required to elucidate injury mechanisms and effective preventative measures. A helmet seems to decrease the likelihood of face and head injuries in mountain sports and be a meaningful preventive measurement.
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Affiliation(s)
- Sebastian Frederick Bigdon
- Department of Orthopaedic Surgery and Traumatology, Inselspital, University Hospital, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland.
| | - Verena Hecht
- Department of Orthopaedic Surgery and Traumatology, Inselspital, University Hospital, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland
| | - Paul Gilbert Fairhurst
- Department of Orthopaedic Surgery and Traumatology, Inselspital, University Hospital, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland
| | - Moritz C Deml
- Department of Orthopaedic Surgery and Traumatology, Inselspital, University Hospital, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland
| | - Aristomenis K Exadaktylos
- Department of Emergency Medicine, Inselspital, University Hospital, University of Bern, Freiburgstrasse 16C, 3010, Bern, Switzerland
| | - Christoph E Albers
- Department of Orthopaedic Surgery and Traumatology, Inselspital, University Hospital, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland
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Fatalities associated with ski touring and freeriding: A retrospective analysis from 2001 to 2019. FORENSIC SCIENCE INTERNATIONAL: REPORTS 2021. [DOI: 10.1016/j.fsir.2021.100239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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The Incidence of Pediatric and Adolescent Concussion in Action Sports: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238728. [PMID: 33255389 PMCID: PMC7727801 DOI: 10.3390/ijerph17238728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 11/19/2020] [Accepted: 11/20/2020] [Indexed: 11/17/2022]
Abstract
Background: This was a systematic review and meta-analysis of the incidence of concussion risk in youth athletes involved in action sports (AS). Methods: A search of PubMed and Web of Science (from January 1980 to August 2020). Titles, abstracts, and full text were screened according to predefined inclusion criteria to find relevant studies. Moreover, the methodological quality of the studies selected was assessed. Results: Nineteen of 1.619 studies were included in the systematic review and 14 in the meta-analysis. Motocross, sailing and snowboarding presented the highest incidence rates per 1000 athlete exposure at 39.22, 3.73 and 2.77 respectively, whereas alpine skiing had the lowest incidence rates resulting in 0.30. Overall risk of concussion was estimated at 0.33 (CI: 0.22, 0.45). Regarding the methodological quality, we have to report that 26.3% of the studies reported the definition of concussion while 36.8% presented age and gender-specific incidence rates. The mechanism of injury and follow up were reported only in one study. Conclusions: There are significant differences in the rates of incident youth concussion across AS. Despite some limitations, the data from this research can serve as the current sport-specific baseline risk of concussion among youth athletes who practice action sports.
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Sieker JW, Castillo EM, Vilke GM. Timing of fatal BASE jumping incidents: 1981-2018. J Forensic Leg Med 2019; 65:39-44. [PMID: 31078102 DOI: 10.1016/j.jflm.2019.04.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 04/29/2019] [Accepted: 04/30/2019] [Indexed: 11/15/2022]
Abstract
BASE jumping, or fixed object parachuting, is a high-risk sport that has evolved significantly since its inception in the 1960s. Differences in parachute technology, teaching methods, jumping locations, practices, and popularity, among other factors, have qualitatively transformed the sport, particularly since 2000. The current study seeks to better understand how the rate of BASE jumping fatalities have changed as BASE jumping has grown. Using data from the BASE Fatality List, a resource continuously compiled by the BASE community with information on all known BASE fatalities, temporal trends in BASE fatalities that accompanied these changes over time are explored. The number of annual fatalities stayed between 0 and 5 from 1981 to 1999, but around the year 2000 began an upward trend that has continued through 2018. There appears to be large seasonal variation in monthly fatality rate, with the most deaths occurring in the northern hemisphere's summer months, the peak being in August, and the fewest deaths occurring in the northern hemisphere's winter months. The years 2013-2018 have continued the increasing fatality trend, but have otherwise deviated through increased variability in short-term and seasonal trends. Potential causes of these short-term trends, changing trends in the causes of fatal accidents, factors potentially unique to anomalous events, and directions for future research are also discussed.
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Affiliation(s)
- Jeremy W Sieker
- University of California, San Diego School of Medicine, USA.
| | - Edward M Castillo
- University of California, San Diego Department of Emergency Medicine, USA
| | - Gary M Vilke
- University of California, San Diego Department of Emergency Medicine, USA
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Forrester JD, Yelorda K, Tennakoon L, Spain DA, Staudenmayer K. BASE Jumping Injuries Presenting to Emergency Departments in the United States: an Assessment of Morbidity, Emergency Department, and Inpatient Costs. Wilderness Environ Med 2019; 30:150-154. [PMID: 31003883 DOI: 10.1016/j.wem.2019.02.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 02/12/2019] [Accepted: 02/13/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND BASE (building, antenna, span, earth) jumping involves jumping from fixed objects with specialized parachutes. BASE jumping is associated with less aerodynamic control and flight stability than skydiving because of the lower altitude of jumps. Injuries and fatalities are often attributed to bad landings and object collision. METHODS We performed a retrospective analysis of the 2010-2014 National Emergency Department Sample database, a nationally representative sample of all visits to US emergency departments (EDs). BASE jumping-associated injuries were identified using International Classification of Diseases, Ninth Revision, Clinical Modification codes [E004.0]. Outcomes evaluated included morbidity, mortality, inpatient admission, and costs. Adjusted analyses accounting for survey methodology were performed. RESULTS After weighting, 1790 BASE-associated ED presentations were identified with 358±28 injuries annually. A total of 1313 patients (73%) were aged 18 to 44 y, and 1277 (71%) were male. Nine hundred seventy-six (55%) multiple body system injuries and 677 (38%) isolated extremity injuries were reported. There were 1588 (89%) patients discharged home from the ED; only 144 (7%) were admitted as inpatients. On multivariate logistic regression, only anatomic site of injury was associated with inpatient admission (odds ratio=0.6, P<0.001, 95% CI 0.5-0.8). Including ED and inpatient costs, BASE injuries cost the US healthcare system approximately $1.7 million annually. No deaths were identified within the limitations of the survey design. CONCLUSIONS Although deemed one of the most dangerous extreme sports, many patients with BASE injuries surviving to arrival at definitive medical care do not require inpatient admission.
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Affiliation(s)
| | - Kirbi Yelorda
- Department of Surgery, Stanford University, Stanford, CA
| | | | - David A Spain
- Department of Surgery, Stanford University, Stanford, CA
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Monasterio E, Cloninger CR. Self-Transcendence in Mountaineering and BASE Jumping. Front Psychol 2019; 9:2686. [PMID: 30687161 PMCID: PMC6334742 DOI: 10.3389/fpsyg.2018.02686] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 12/13/2018] [Indexed: 11/17/2022] Open
Abstract
The “extreme sports” of mountaineering and BASE Jumping are growing in popularity and are associated with significant risk of injury and death. In recent years there have also been increasing numbers of reports of reckless disregard and selfishness in the pursuit of mountaineering goals, including severe environmental degradation. Extant research has focused predominantly on personality variables that contribute to engagement, participation, and stress responsivity in these extreme sports. The Temperament and Character Inventory (TCI) provides a comprehensive account of personality traits, measuring seven dimensions of personality that are moderately heritable and associated with distinct brain networks and psychological characteristics. One of these traits is Self-Transcendence, which is associated with spiritual ideas and experiences, such as searching for something elevated and greater than one's individual self. High Self-Transcendence can motivate people to act altruistically even if that requires personal sacrifices and hardship. This article draws on the extant research literature, which has consistently found that despite substantial heterogeneity in their individual personality profiles, mountaineers, and BASE jumpers are adventurous in temperament and highly self-controlled and organized in character. Between 75 and 85% of the character configurations observed in these populations are associated with low Self-Transcendence. The purpose of this paper is to consider the role of Self-Transcendence and its effect on individual personality profiles of extreme athletes, in particular in moderating potentially self- destructive, and regressive ethical and moral behaviors in mountaineering and BASE jumping.
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Affiliation(s)
- Erik Monasterio
- Canterbury District Health Board Regional Forensic Service, Christchurch, New Zealand.,Psychological Medicine, Christchurch School of Medicine, University of Otago, Christchurch, New Zealand
| | - C Robert Cloninger
- Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, United States
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Sukerkar PA, Fast AM, Riley G. Extreme Sports Injuries to the Pelvis and Lower Extremity. Radiol Clin North Am 2018; 56:1013-1033. [PMID: 30322484 DOI: 10.1016/j.rcl.2018.06.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Extreme sports are growing in popularity, and physicians are becoming increasingly aware of injuries related to these activities. Imaging plays a key role in diagnosing and determining clinical management of many of these injuries. This article describes general imaging techniques and findings in various injuries specific to multiple extreme sports.
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Affiliation(s)
- Preeti Arun Sukerkar
- Department of Radiology, Stanford University, 300 Pasteur Drive, Stanford, CA 94305, USA
| | - Angela M Fast
- Department of Radiology, Stanford University, 300 Pasteur Drive, Stanford, CA 94305, USA
| | - Geoffrey Riley
- Department of Radiology, Stanford University, 300 Pasteur Drive, Stanford, CA 94305, USA.
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Monasterio E, Mei-Dan O, Hackney AC, Cloninger R. Comparison of the Personality Traits of Male and Female BASE Jumpers. Front Psychol 2018; 9:1665. [PMID: 30298029 PMCID: PMC6160869 DOI: 10.3389/fpsyg.2018.01665] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 08/20/2018] [Indexed: 11/29/2022] Open
Abstract
BASE jumping is an extreme adventure sport which consists of jumping from a fixed object with specially adapted parachutes. A few studies of the personality of BASE jumpers have been conducted, but little is known about how the women in this sport compare to the men. The purpose of this study is to compare the personality traits among a sample of men and women who are experienced BASE jumpers, as this provides an interesting and important opportunity to better understand the motivation for extreme sports. Eighty-three participants completed the Temperament and Character Inventory the day before the jump at the New River Gorge Bridge Day BASE Jumping event, West Virginia, United States. The sample included 64 men and 19 women. Results show that men and women BASE jumpers shared similar personality traits both in terms of temperament and character, except for the character trait of cooperativeness on which women scored higher than men. This suggests that the basic drive for participation in extreme sports is self-regulation of personal emotional drives and needs for self-actualization, rather than to oppose social pressure or cultural bias against female participation. These findings are discussed in relation with other studies conducted among extreme athletes and in terms of congruence between personality and activity.
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Affiliation(s)
- Erik Monasterio
- Canterbury District Health Board, Christchurch, New Zealand
- *Correspondence: Erik Monasterio,
| | - Omer Mei-Dan
- Department of Orthopedics, University of Colorado Boulder, Boulder, CO, United States
| | - Anthony C. Hackney
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Robert Cloninger
- Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, United States
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Feletti F, Brymer E. Injury in kite buggying: the role of the 'out-of-buggy experience'. J Orthop Surg Res 2018; 13:104. [PMID: 29716626 PMCID: PMC5930821 DOI: 10.1186/s13018-018-0818-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 04/23/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of this descriptive, epidemiological study is to classify injury patterns and determine dynamics of injuries, possible causes and preventive measures. METHODS A questionnaire was filled in by 127 kite buggying enthusiasts in 17 countries. Injuries were classified by type and anatomical site. Incident causes were analysed using the Haddon matrix. RESULTS Injuries classified as moderate or severe (AIS score ≥ 2) were sustained by 26% of kite buggy enthusiasts. The most common incident dynamic (61.8%) was the OBE (an acronym for 'out-of-buggy experience'). Causal factors were largely equipment-related (42.3%), with remaining incidents being equally attributable to environmental and human factors. While upper and lower limbs were equally involved in incidents, the most frequently affected anatomical site was the shoulder (23%). CONCLUSION Kite buggying can be considered a sport with the potential for serious injury. Injury prevention in this sport needs to be approached from several angles and should include the development and adoption of automatic release systems and shoulder guards, the establishment of formal training programs covering the subject of meteorology and the establishment of secure, designated kite buggying areas. Findings from this study are important for two reasons. First, they demonstrate the significance of understanding specific sports when considering health and safety, and second, the study provides specific data for the fast growing extreme sport of kite buggying.
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Affiliation(s)
- F Feletti
- Department of Diagnostic Imaging, Ausl della Romagna, S. Maria delle Croci Hospital, Ravenna, Italy. .,Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy.
| | - E Brymer
- School of Sport, Leeds Becket University, Leeds, UK
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Kay MC, Register-Mihalik JK, Gray AD, Djoko A, Dompier TP, Kerr ZY. The Epidemiology of Severe Injuries Sustained by National Collegiate Athletic Association Student-Athletes, 2009-2010 Through 2014-2015. J Athl Train 2017; 52:117-128. [PMID: 28118030 DOI: 10.4085/1062-6050-52.1.01] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Few researchers have described the incidence of the most severe injuries sustained by student-athletes at the collegiate level. OBJECTIVE To describe the epidemiology of severe injuries within 25 National Collegiate Athletic Association (NCAA) sports in the 2009-2010 through 2014-2015 academic years. DESIGN Descriptive epidemiology study. SETTING Aggregate injury and exposure data from 25 NCAA sports. PATIENTS OR OTHER PARTICIPANTS Collegiate student-athletes in the 2009-2010 through 2014-2015 academic years. MAIN OUTCOME MEASURE(S) Injury data from the NCAA Injury Surveillance Program were analyzed. A severe injury (1) occurred during a sanctioned competition or practice, (2) required medical attention by an athletic trainer or physician, and (3) resulted in at least 21 days lost from sport activity or a premature end to the sport season. Injury counts, proportions, rates per 1000 athlete-exposures (AEs), rate ratios (RRs), and injury proportion ratios were reported with 95% confidence intervals (CIs). RESULTS A total of 3183 severe injuries were reported, for an injury rate of 0.66/1000 AEs. Wrestling had the highest severe injury rate (1.73/1000 AEs), followed by women's gymnastics (1.40/1000 AEs) and football (0.97/1000 AEs). Overall, the severe injury rate was higher in competition than in practice (RR = 4.25, 95% CI = 3.97, 4.56). Most severe injuries were reported during the regular season (69.3%, n = 2206); however, severe injury rates did not differ between the preseason and regular season (RR = 0.98, 95% CI = 0.91, 1.06). Common severely injured body parts were the knee (32.9%, n = 1047), lower leg/ankle/foot (22.5%, n = 715), and head/face/neck (11.2%, n = 358). Common severe injury diagnoses were sprains (32.9%, n = 1048), strains (16.9%, n = 538), and fractures (14.4%, n = 458). Common severe injury mechanisms were player contact (39.3%, n = 1251), noncontact (25.1%, n = 800), and surface contact (12.0%, n = 383). CONCLUSIONS Severe injuries occurred across many sports and by numerous mechanisms. By identifying these sport-specific patterns, clinicians' efforts can be tailored toward improving injury-prevention strategies and health outcomes.
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Affiliation(s)
- Melissa C Kay
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
| | | | - Aaron D Gray
- School of Medicine, University of Missouri, Columbia
| | - Aristarque Djoko
- Datalys Center for Sports Injury Research and Prevention, Inc, Indianapolis, IN
| | - Thomas P Dompier
- Datalys Center for Sports Injury Research and Prevention, Inc, Indianapolis, IN
| | - Zachary Y Kerr
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
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Stress reactivity and personality in extreme sport athletes: The psychobiology of BASE jumpers. Physiol Behav 2016; 167:289-297. [PMID: 27693575 DOI: 10.1016/j.physbeh.2016.09.025] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 09/13/2016] [Accepted: 09/27/2016] [Indexed: 11/23/2022]
Abstract
This is the first report of the psychobiology of stress in BASE jumpers, one of the most dangerous forms of extreme sport. We tested the hypotheses that indicators of emotional style (temperament) predict salivary cortisol reactivity, whereas indicators of intentional goal-setting (persistence and character) predict salivary alpha-amylase reactivity during BASE jumping. Ninety-eight subjects completed the Temperament and Character Inventory (TCI) the day before the jump, and 77 also gave salivary samples at baseline, pre-jump on the bridge over the New River Gorge, and post-jump upon landing. Overall BASE jumpers are highly resilient individuals who are highly self-directed, persistent, and risk-taking, but they are heterogeneous in their motives and stress reactivity in the Hypothalamic-Pituitary-Adrenal (HPA) stress system (cortisol reactivity) and the sympathetic arousal system (alpha-amylase reactivity). Three classes of jumpers were identified using latent class analysis based on their personality profiles, prior jumping experience, and levels of cortisol and alpha-amylase at all three time points. "Masterful" jumpers (class 1) had a strong sense of self-directedness and mastery, extensive prior experience, and had little alpha-amylase reactivity and average cortisol reactivity. "Trustful" jumpers (class 2) were highly cooperative and trustful individuals who had little cortisol reactivity coincident with the social support they experienced prior to jumping. "Courageous" jumpers (class 3) were determined despite anxiety and inexperience, and they had high sympathetic reactivity but average cortisol activation. We conclude that trusting social attachment (Reward Dependence) and not jumping experience predicted low cortisol reactivity, whereas persistence (determination) and not jumping experience predicted high alpha-amylase reactivity.
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Abstract
Adventure and extreme sports often involve unpredictable and inhospitable environments, high velocities, and stunts. These activities vary widely and include sports like BASE jumping, snowboarding, kayaking, and surfing. Increasing interest and participation in adventure and extreme sports warrants understanding by clinicians to facilitate prevention, identification, and treatment of injuries unique to each sport. This article covers alpine skiing and snowboarding, skateboarding, surfing, bungee jumping, BASE jumping, and whitewater sports with emphasis on epidemiology, demographics, general injury mechanisms, specific injuries, chronic injuries, fatality data, and prevention. Overall, most injuries are related to overuse, trauma, and environmental or microbial exposure.
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Affiliation(s)
- Andrew Thomas Gomez
- Family Medicine, University of Washington, 331 Northeast Thornton Place, Box 358372, Seattle, WA 98125, USA
| | - Ashwin Rao
- Primary Care Sports Medicine Fellowship, Sports Medicine Section, Family Medicine, University of Washington, 3800 Montlake Boulevard, Box 354060, Seattle, WA 98195, USA.
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Mei-Dan O, Monasterio E, Carmont M, Westman A. Fatalities in wingsuit BASE jumping. Wilderness Environ Med 2014; 24:321-7. [PMID: 24238216 DOI: 10.1016/j.wem.2013.06.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Revised: 06/09/2013] [Accepted: 06/27/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To analyze fatality data associated with wingsuit use in an international case series of fixed-object sport parachuting (BASE jumping) to identify incident and injury mechanisms and to form a basis for potential prevention measures and future safety recommendations. METHODS A descriptive epidemiological study was performed of fatal injury events occurring in wingsuit BASE jumping. Fatalities (n = 180) were sequentially analyzed assessing human, equipment, and environmental factors from 1981 to 2011. Main outcome measures included descriptions of typical fatal incident and injury mechanisms. RESULTS Of the 180 fatal events, 39 (22%) were related to use of wingsuits; 38 (97%) launched from cliffs and 1 (3%) from a building. Of the 39 fatalities, 19 (49%) were caused from cliff strikes, 18 (46%) from ground impact, and 1 (3%) from a building strike. Thirty-eight (97%) of the fatalities were male. During 2002 to 2007 there was a total of 61 BASE jumping deaths, 10 (16%) of which were related to the use of wingsuits, whereas during 2008 to 2011 there was a total 59 fatal events, of which 29 (49%) were related to the use of wingsuits. Seventeen fatalities (39%) were attributed to wingsuit path miscalculation. In the first 8 months of 2013, 17 of 19 (90%) fatalities were wingsuit related. Most fatalities occurred between April and October, reflecting a seasonal increase in activity in the northern hemisphere summer. CONCLUSIONS Wingsuit-related BASE jump fatalities appear to be increasing as wingsuit BASE jumping increases in popularity. Most fatalities are attributed to cliff or ground impact, and are mostly the result of flying path miscalculation.
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Affiliation(s)
- Omer Mei-Dan
- Department of Orthopaedics, Division of Sports Medicine, University of Colorado School of Medicine, Aurora, CO.
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