Home exercise equipment-related injuries among children in the United States

Stationary bike injuries prompting emergency department presentation in pediatric patients: an epidemiological study

OBJECTIVES

Potential harms of stationary bike injuries in pediatric patients have been highlighted in the literature, but prior work is limited to case series and without population-level analysis. The purpose of this study is to examine the epidemiology of pediatric stationary bike injuries occurring in the US over the last decade using a national database.

METHODS

Injuries resulting from stationary bike use in pediatric patients from 2012 to 2021 were identified using coding from the National Electronic Injury Surveillance System (NEISS) database. Patient demographics, injury characteristics, and case narratives were examined. National annual estimates of injury frequency/incidence were calculated using weighting and survey package in R. Univariate analyses were used to compare injuries among groups.

RESULTS

We identified 525 stationary bike injuries representing an estimated total of 15,509 injuries in the population. Pediatric patients sustained an average of 1,551 injuries annually, with an estimated yearly increase of 288 injuries (p < 0.01) after 2019. While males sustained more injuries, there were age-dependent differences in frequency of injuries between sexes (p < 0.01). The upper extremity was the most commonly injured body region overall, but children 5 and under sustained more injuries to the head/neck. The most common overall injury type was lacerations, while fractures predominated in the 6 to 11-year-old age group. Fifty-six percent of injuries were sustained not while riding the bike, most notably among children under 12.

CONCLUSION

Our findings indicate that the impact of stationary bike injury in the pediatric population is not insignificant, and most injuries are related to improper play rather than traditional exercise use. Gender and age-related patterns differed in regard to the type and mechanism of injury sustained. Children 5 and under sustain a disproportionate amount of injuries to the head, neck, and upper extremity. As stationary bikes grow in popularity, preventative measures should be considered to reduce injuries to young children.

Effects of Jump-Rope-Specific Footwear Selection on Lower Extremity Biomechanics

Footwear is among the most important equipment in sports to decrease injuries and enhance performance during exercise. In this study, we investigated differences in lower extremity plantar pressure and muscle activations during jump rope activities. Ten participants performed jump rope under two landing conditions with different footwear. A force platform (AMTI, 1000 Hz), a Novel Pedar-X system (Nove, 100 Hz), and a wireless electromyography (EMG) system (Noraxon, 1500 Hz) were used to measure biomechanical parameters during the jump rope exercise. Vertical ground reaction forces (vGRF), plantar pressure, and lower extremity muscle activations were analyzed. One-leg landing resulted in a significantly greater vGRF and shorter fly time than two-leg landing (p < 0.05). A significantly higher peak pressure and lesser toe (LT) area pressure was shown with the jumping shoe (all p < 0.05), but lower plantar pressure resulted in the middle foot area (p < 0.05). The EMG results of tibialis anterior (TA) were significantly greater with one-leg landing (all p < 0.05) during the pre- and background activity (BGA) phases. The results suggest that plantar pressure distribution should be considered when deciding on footwear during jump rope exercises, but care should be taken with regards to recovery after repeated collisions and fatigue. The jumping shoe provides benefits in terms of decreased plantar pressure sustained during jump rope exercises.

Outcomes of Early Surgical versus Non-Surgical Management of Pediatric Hand Friction Injuries Caused by Treadmills

INTRODUCTION

Pediatric hand friction injuries caused by running treadmills are ever more prevalent due to the increasing presence of home exercise equipment. These and other related injuries have received recent attention in the media, leading to mass product recalls in some cases. These friction injuries are similar to deep thermal burns and these patients are usually cared for in the pediatric burn unit at our institution. We sought to describe our recent experience managing 22 patients with these injuries.

METHODS

Patients were queried from our urban pediatric burn center database. After IRB approval, a retrospective chart review of all patients admitted for a treadmill-related hand injury over a 5-year period was performed. Data collected included patient demographics, initial treatment methods (surgical vs. non-operative), type of dressing used, hospital length of stay (LOS), and compliance with follow-up. We collected patient-centered outcomes included the time to healing and the need for subsequent surgical and/or non-surgical interventions to treat the sequelae of these injuries.

RESULTS

Our center treated 22 hand friction injuries caused by treadmills over the 5-year period. Five patients (23%) underwent early surgical intervention (<30 days from injury), with a median time from injury of 7 days (IQR 1.75-13.5). This cohort required additional interventions to treat postoperative sequelae with 2 (40%) requiring additional surgery and 3 (60%) managed non-surgically. Of the 17 (77%) who were initially treatednon-operatively , 5 (29%) healed completely with dressing changes only and required no further treatment. Eleven (65%) had injury-related sequelae and were managed successfully with non-surgical interventions. Only 1 patient (6%) required scar modification by z-plasty. Average LOS was 14 hours and median number of weekly follow-up visits was 4 until complete healing.

CONCLUSION

Given the excellent outcomes observed in patients treated without acute surgical intervention in this case series, non-operative non-operative management appears to be feasible, safe and may reduce the need for operative intervention. These injuries, although small, are deep and require a prolonged period of dressing changes and aggressive therapy including post-healing time commitment to scar management in order to achieve best outcomes. Our study supports the need for increased community awareness of this type of injury.

Treadmill associated head injuries on the rise: an 18 year review of U.S. emergency room visits

OBJECTIVE

The treadmill is the most commonly used aerobic exercise equipment with studies showing many gym-related injuries are attributed to treadmills. The purpose of this study is to examine the incidence of treadmill-associated head injuries within the US.

METHODS

Retrospective data from 1997 to 2014 was collected via the National Electronic Injury Surveillance System, which provides annual es7timates of injuries associated with consumer products. Patients over 18 years who sustained treadmill-associated head injuries were included, and the estimated annual incidence was determined.

RESULTS

An estimated 4929 patients presented to US emergency departments with a head injury while exercising on a treadmill between 1997 and 2014. A >1000% increase in the number of head injuries was observed over the study period (p-value <0.001). Patients over 50 had a 14 times greater risk of admission than younger patients (p-value <0.001). Injuries were greater in women than men.

CONCLUSION

Our study demonstrates a significant increase treadmill-associated head injuries from 1997 to 2014. This phenomenon is most pronounced in older and female populations. The exact etiology of this large increase remains unclear. Education on the proper use of treadmills as well as further investigation into the cause of the increase are warranted.

ACIDENTES DOMICILIARES POR FORÇAS MECÂNICAS INANIMADAS EM CRIANÇAS, ADOLESCENTES E JOVENS

RESUMO Analisar o perfil dos atendimentos de urgência e emergência decorrentes de acidentes domiciliares causados por forças mecânicas inanimadas na população infantojuvenil. Trata-se de um estudo transversal com coleta retrospectiva de dados. Foram analisadas fichas de atendimento decorrentes de acidentes domiciliares por forças mecânicas inanimadas em pessoas com idade até 24 anos, atendidas por um serviço público de referência em urgência e emergência, durante o ano de 2013. Foram estudados 526 acidentes. Entre as vítimas prevaleceu o sexo masculino (56,1%) e faixa etária de 1 a 4 anos (47,9%). O acidente de maior frequência foi penetração de corpo entranho em orifício natural, sendo em maior proporção nas crianças de 1 a 4 anos (71,0%). Evidenciou-se grande variedade de acidentes por forças mecânicas inanimadas no ambiente domiciliar e presença de sequelas físicas imediatas em 0,8% das vítimas. Destaca-se a importância da implementação de medidas preventivas, único meio de se reduzir o evento, as lesões e sequelas decorrentes.

Emergency department-reported injuries associated with mechanical home exercise equipment in the USA

The goal of this study was to generate national estimates of injuries associated with mechanical home exercise equipment, and to describe these injuries across all ages. Emergency department (ED)-treated injuries associated with mechanical home exercise equipment were identified from 2007 to 2011 from the National Electronic Injury Surveillance System. Text narratives provided exercise equipment type (treadmill, elliptical, stationary bicycle, unspecified/other exercise machine). Approximately 70 302 (95% CI 59 086 to 81 519) mechanical exercise equipment-related injuries presented to US EDs nationally during 2007-2011, of which 66% were attributed to treadmills. Most injuries among children (≤4 years) were lacerations (34%) or soft tissue injuries (48%); among adults (≥25 years) injuries were often sprains/strains (30%). Injured older adults (≥65 years) had greater odds of being admitted, held for observation, or transferred to another hospital, compared with younger ages (OR: 2.58; 95% CI 1.45 to 4.60). Mechanical exercise equipment is a common cause of injury across ages. Injury awareness and prevention are important complements to active lifestyles.