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Ferraby D, Hayhurst D, Fallowfield J. Musculoskeletal injuries in UK service personnel and the impact of in-theatre rehabilitation during cold weather warfare training: Exercise CETUS 2020. BMJ Mil Health 2024; 170:1-3. [PMID: 35772792 DOI: 10.1136/bmjmilitary-2022-002139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2022] [Indexed: 11/03/2022]
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Ferraby DH, Hayhurst D, Strachan R, Knapman H, Wood S, Fallowfield JL. Musculoskeletal injuries in UK Service Personnel and the impact of in-theatre rehabilitation during Cold Weather Warfare training: Exercise CETUS 2020. BMJ Mil Health 2023; 169:517-522. [PMID: 35042762 DOI: 10.1136/bmjmilitary-2021-001972] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 12/07/2021] [Indexed: 11/04/2022]
Abstract
INTRODUCTION The Royal Marines provide the lead Service for UK Defence Mountain and Cold Weather Warfare capability. This is the first prospective study addressing musculoskeletal injury rates sustained during Cold Weather Warfare training, with the aim of informing injury mitigation interventions and assist military medical planning with respect to delivering primary care rehabilitation in theatre. METHODS All musculoskeletal injuries were surveyed by the Forward Rehabilitation Team (Nov 2019-Mar 2020) during a Cold Weather Deployment to Norway (Ex CETUS 2019/20). The frequency, nature of injury (new or recurrent), onset (sudden or gradual), cause, location and exercise/treatment outcome were recorded. RESULTS Eleven per cent (n=136 cases) of the deployed population (n=1179) reported a musculoskeletal injury, which were mainly 'new' (62%), and with a 'sudden' onset (64%). Injury rate was 17.8 injuries per 10 000 personnel days. The majority of injuries occurred due to military training (88%), specifically during ski-related (61%) and load carriage (10%) activities.The average Service Person treated by the Forward Rehabilitation Team improved from 'injured with restricted duties' to 'fully fit', and with an improvement in their self-reported Musculoskeletal Health Questionnaire from 33 to 45 over an average of two rehabilitation sessions. One hundred and seventeen Service Personnel were able to continue on Ex CETUS with rehabilitation in theatre, thus negating the requirement for aeromedical evacuation for continuation of rehabilitation in the UK. Nineteen patients were unable to continue their Cold Weather Deployment due to the nature of their musculoskeletal injury and returned to the UK for continued care in firm base rehabilitation centres. CONCLUSION This study identifies the nature, causation and injury location. It demonstrates the effectiveness of in-theatre rehabilitation and the ability to treat patients when deployed. Recommendations are presented to support strategies to mitigate musculoskeletal injury risk during future Cold Weather Warfare deployments to Norway.
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Affiliation(s)
| | - D Hayhurst
- Rehab Div, DMRC Headley Court, Epsom, UK
| | - R Strachan
- Aviation Medicine Training Wing, Centre of Aviation Medicine, RAF Henlow, Bedfordshire, UK
| | - H Knapman
- PCRF, Medical Reception Station, Medical Centre, Dhekelia, UK
| | - S Wood
- HDIS, Specialist Group Military Intelligence (SGMI), Hermitage, Berkshire, UK
| | - J L Fallowfield
- Environmental Medicine and Science Division, Institute of Naval Medicine, Alverstoke, Hampshire, UK
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Pocecco E, Wafa H, Burtscher J, Paal P, Plattner P, Posch M, Ruedl G. Mortality in Recreational Mountain-Biking in the Austrian Alps: A Retrospective Study over 16 Years. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11965. [PMID: 36231266 PMCID: PMC9565708 DOI: 10.3390/ijerph191911965] [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: 08/31/2022] [Revised: 09/16/2022] [Accepted: 09/20/2022] [Indexed: 06/16/2023]
Abstract
Despite recreational mountain-biking's growing popularity worldwide, the literature on mortality in this leisure sporting activity is scarce. Therefore, the aim of the present study was to investigate the characteristics of fatal accidents as well as resulting dead victims during recreational mountain-biking in the Austrian Alps over the past 16 years. For this purpose, a retrospective study based on Austrian institutional documentation from 2006 to 2021 was conducted. In total, 97 fatalities (1 woman) with a mean age of 55.6 ± 13.9 years were recorded by the Austrian Alpine Police. Of those, 54.6% died due to a non-traumatic (mostly cardio-vascular) and 41.2% due to a traumatic event. Mountain-bikers fatally accidented for non-traumatic reasons frequently belonged to older age classes (p = 0.05) and mostly (73.6%) died during the ascent, whereas traumatic events mainly (70.0%) happened during the descent (p < 0.001). Throughout the examined period, the absolute number of fatalities slightly increased, whereas the mortality index (proportion of deaths/accidented victims) did not (mean value: 1.34 ± 0.56%). Factors such as male sex in general, above average age and uphill riding for non-traumatic accidents, as well as downhill riding for traumatic events, seem to be associated with fatalities during recreational mountain-biking in the Austrian Alps. These results should be considered for future preventive strategies in recreational mountain-biking.
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Affiliation(s)
- Elena Pocecco
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria
| | - Hamed Wafa
- Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Johannes Burtscher
- Department of Biomedical Sciences, University of Lausanne, 1005 Lausanne, Switzerland
- Institute of Sport Sciences, University of Lausanne, 1015 Lausanne, Switzerland
| | - Peter Paal
- Austrian Board for Mountain Safety, 6020 Innsbruck, Austria
- Department of Anaesthesiology and Intensive Care Medicine, Paracelsus Medical University, 5020 Salzburg, Austria
| | - Peter Plattner
- Austrian Board for Mountain Safety, 6020 Innsbruck, Austria
| | - Markus Posch
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria
| | - Gerhard Ruedl
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria
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Fröhlich S. [Not Available]. PRAXIS 2020; 109:1093. [PMID: 33109000 DOI: 10.1024/1661-8157/a003534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Stefan Fröhlich
- Universitäres Zentrum für Prävention und Sportmedizin, Universitätsklinik Balgrist, Zürich
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Abstract
Injuries from Falls in Backcountry Skiing - an Analysis from the Swiss Alps Abstract. Ski mountaineering is becoming increasingly popular. In addition to positive aspects, there are also dangers involved whereby falls must be mentioned particularly. Using the central register of the SAC (Swiss Alpine Club), a total of 756 male and 593 female cases of falls in the ten-year period from 2009-2018 were analyzed using the NACA score and case reports. It was found that around 90 % of the analyzed cases in women concerned the lower extremity with the knee (55 %) as the most common localization. Similarly, in men around two thirds were affected by the lower extremity, with the knee being the most common location with around 43 %. This could be caused by an unoptimized binding behavior, which is why it is recommended not to set the bindings too hard and to test the correct release behavior regularly.
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Affiliation(s)
- Benedikt Gasser
- Swiss Registries and Data Linkage (Swiss RDL), Universität Bern
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Niedermeier M, Gatterer H, Pocecco E, Frühauf A, Faulhaber M, Menz V, Burtscher J, Posch M, Ruedl G, Burtscher M. Mortality in Different Mountain Sports Activities Primarily Practiced in the Winter Season-A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:ijerph17010259. [PMID: 31905912 PMCID: PMC6981978 DOI: 10.3390/ijerph17010259] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 12/19/2019] [Accepted: 12/20/2019] [Indexed: 11/30/2022]
Abstract
Annually, millions of people engage in mountain sports activities all over the world. These activities are associated with health benefits, but concurrently with a risk for injury and death. Knowledge on death rates is considered important for the categorization of high-risk sports in literature and for the development of effective preventive measures. The death risk has been reported to vary across different mountain sports primarily practiced in the summer season. To complete the spectrum, the aim of the present review is to compare mortality rates across different mountain sports activities primarily practiced in winter. A comprehensive literature search was performed on the death risk (mortality) during such activities, i.e., alpine (downhill) skiing, snowboarding, cross-country skiing, ski touring, and sledging. With the exception of ski touring (4.4 deaths per 1 million exposure days), the mortality risk was low across different winter sports, with small activity-specific variation (0.3–0.8 deaths per 1 million exposure days). Traumatic (e.g., falls) and non-traumatic (e.g., cardiac death) incidents and avalanche burial in ski tourers were the predominant causes of death. Preventive measures include the improvement of sport-specific skills and fitness, the use of protective gear, well-targeted and intensive training programs concerning avalanche hazards, and sports-medical counseling for elderly and those with pre-existing diseases.
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Affiliation(s)
- Martin Niedermeier
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria; (M.N.); (E.P.); (A.F.); (M.F.); (V.M.); (M.P.); (G.R.)
| | - Hannes Gatterer
- Institute of Mountain Emergency Medicine, EURAC Research, 39100 Bolzano, Italy;
| | - Elena Pocecco
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria; (M.N.); (E.P.); (A.F.); (M.F.); (V.M.); (M.P.); (G.R.)
- Center for Teaching Methodology, Pedagogical University Tyrol, 6020 Innsbruck, Austria
| | - Anika Frühauf
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria; (M.N.); (E.P.); (A.F.); (M.F.); (V.M.); (M.P.); (G.R.)
| | - Martin Faulhaber
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria; (M.N.); (E.P.); (A.F.); (M.F.); (V.M.); (M.P.); (G.R.)
- Austrian Society for Alpine and High-Altitude Medicine, 6020 Innsbruck, Austria
| | - Verena Menz
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria; (M.N.); (E.P.); (A.F.); (M.F.); (V.M.); (M.P.); (G.R.)
| | - Johannes Burtscher
- Laboratory of Molecular and Chemical Biology of Neurodegeneration, École Polytechnique Fédérale de Lausanne, 1015 Lausanne, Switzerland;
| | - Markus Posch
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria; (M.N.); (E.P.); (A.F.); (M.F.); (V.M.); (M.P.); (G.R.)
| | - Gerhard Ruedl
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria; (M.N.); (E.P.); (A.F.); (M.F.); (V.M.); (M.P.); (G.R.)
| | - Martin Burtscher
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria; (M.N.); (E.P.); (A.F.); (M.F.); (V.M.); (M.P.); (G.R.)
- Austrian Society for Alpine and High-Altitude Medicine, 6020 Innsbruck, Austria
- Correspondence:
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Injury-Related Behavioral Variables in Alpine Skiers, Snowboarders, and Ski Tourers-A Matched and Enlarged Re-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16203807. [PMID: 31658611 PMCID: PMC6843483 DOI: 10.3390/ijerph16203807] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 10/08/2019] [Accepted: 10/09/2019] [Indexed: 12/15/2022]
Abstract
Behavioral variables might play an important role in explaining the differences in injury rates across winter sport disciplines and injury prevention programs might be more specifically designed based on this knowledge. On ski slopes, alpine skiing, snowboarding, and ski touring are the predominant winter sport disciplines. Therefore, the aim of the present study was to investigate possible differences in injury-related behavioral variables between practitioners of these disciplines. Using a matched re-analysis approach of a cross-sectional survey, 414 winter sport participants (alpine skiers, snowboarders, ski tourers, each n = 138) were analyzed on the differences in sensation seeking, treated injuries, and injury-related behavioral variables. Cochran-Mantel-Haenszel and Friedman tests revealed significantly higher sensation seeking, p < 0.001, and a significantly higher percentage of participants reporting to have consumed alcohol in the past five skiing days, p = 0.006, in snowboarders compared to alpine skiers. The participants with treated injuries showed higher sensation seeking, p < 0.050, and a higher percentage of snowboarders, p = 0.020, compared to participants without treated injuries. Injury prevention programs for snowboarders, who remain an important risk group for injury prevention, might benefit from considering a possibly higher percentage of alcohol-consuming participants and from providing information on injury-related risks of sensation seeking.
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