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Zhao C, Huang Y, Cheng Y, Zhang R, Wang Y, Tong S, He J, Guo J, Xia F, Li Y, Yao X. Association between heatwaves and risk and economic burden of injury related hospitalizations in China. ENVIRONMENTAL RESEARCH 2024; 259:119509. [PMID: 38945512 DOI: 10.1016/j.envres.2024.119509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 06/26/2024] [Accepted: 06/28/2024] [Indexed: 07/02/2024]
Abstract
BACKGROUND Public health is greatly affected by heatwaves, especially as a result of climate change. It is unclear whether heatwaves affect injury hospitalization, especially as developing countries facing the impact of climate change. OBJECTIVES To assess the impact of heatwaves on injury-related hospitalization and the economic burden. METHODS The daily hospitalizations and meteorological data from 2014 to 2019 were collected from 23 study sites in 11 meteorological geographic zones in China. We conducted a two-stage time series analysis based on a time-stratified case-crossover design, combined with DLNM to assess the association between heatwaves and daily injury hospitalization, and to further assess the regional and national economic losses resulting from hospitalization by calculating excess hospitalization costs (direct economic losses) and labor losses (indirect economic losses). To determine the vulnerable groups and areas, we also carried out stratified analyses by age, sex, and region. RESULTS We found that 6.542% (95%CI: 3.939%, 9.008 %) of injury hospitalization were attributable to heatwaves during warm season (May to September) from 2014 to 2019. Approximately 361,447 injury hospitalizations were attributed to heatwaves each year in China, leading to an excess economic loss of 5.173 (95%CI: 3.104, 7.196) billion CNY, of which 3.114 (95%CI: 1.454, 4.720) billion CNY for males and 4.785 (95%CI: 3.203, 6.321) billion CNY for people aged 15-64 years. The attributable fraction (AF) of injury hospitalizations due to heatwaves was the highest in the plateau mountain climate zone, followed by the subtropical monsoon climate zone and the temperate monsoon climate zone. CONCLUSIONS Heatwaves significantly increase the disease and economic burden of injury hospitalizations, and vary across populations and regions. Our findings implicate the necessity for targeted measures, including raising public awareness, improving healthcare infrastructure, and developing climate resilience policies, to reduce the threat of heatwaves to vulnerable populations and the associated disease and economic burden.
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Affiliation(s)
- Cheng Zhao
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China.
| | - Yushu Huang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China; Department of Big Data in Health Science School of Public Health, and Center of Clinical Big Data and Analytics of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Yibin Cheng
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Rui Zhang
- Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Yu Wang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Shilu Tong
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China; School of Public Health, Institute of Environment and Population Health, Anhui Medical University, Hefei, 230032, China; School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Jiang He
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Jia Guo
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Fan Xia
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Yonghong Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China.
| | - Xiaoyuan Yao
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China.
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Wang IL, Chen YM, Yao S, Su Y, Mündel T, Lei TH. Whole-body passive heating at moderate hyperthermic state impairs static and dynamic balance in healthy females. Gait Posture 2024; 107:199-206. [PMID: 37852885 DOI: 10.1016/j.gaitpost.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 08/28/2023] [Accepted: 10/02/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND Whether static and dynamic balances can be impaired with increasing core temperature in female participants remains unknown. PURPOSE We tested the hypothesis that static and dynamic balances can be further impaired with systematic increases of core temperature by Δ1 °C and Δ 2 °C using whole-body passive heating. METHOD Eighteen female participants underwent a control trial (Con) and two progressive passive heating trials with Δ 1 °C and Δ 2 °C increase of oral temperature (TOral) using 45 °C water bath. In each trial, we assessed static balance with both eye open and closed and assessed dynamic balance using obstacle crossing at 10 %, 20 % and 30 % of the participant's leg length. RESULTS Static balance was not different between Con and Δ1 °C but was different between Δ1 °C and Δ 2 °C in an eye closed condition. Furthermore, Δ 2 °C greatly impaired both static and dynamic balances when compared to Con. The joint angles and toe clearance increased while leading heel-obstacle distance decreased during crossing obstacles at the height of 20 % and 30 % leg length with leading limbs in the Δ2 °C compared to Δ 1 °C and Con (All P < 0.05). However, no differences in joint kinematics and toe clearance with trailing limbs were observed (All P > 0.05). CONCLUSION In female participants, static and dynamic balances only became impaired when TOral increased 2 °C from baseline.
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Affiliation(s)
- I-Lin Wang
- College of Physical Education, Hubei Normal University, Huangshi, China
| | - Yi-Ming Chen
- Department of Food Science, Fu Jen Catholic University, Taipei, Taiwan
| | - Shun Yao
- Graduate Institute, Jilin Sport University, Changchun, China
| | - Yu Su
- Graduate Institute, Jilin Sport University, Changchun, China
| | - Toby Mündel
- College of Physical Education, Hubei Normal University, Huangshi, China; Department of Kinesiology, Brock University, St. Catharines, Canada
| | - Tze-Huan Lei
- College of Physical Education, Hubei Normal University, Huangshi, China.
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Pilanthananond M, Tharawadeepimuk K, Saengsirisuwan V, Limroongreungrat W. Muscle Activation and Ground Reaction Force between Single-Leg Drop Landing and Jump Landing among Young Females during Weight-Acceptance Phase. Sports (Basel) 2023; 11:185. [PMID: 37755862 PMCID: PMC10536380 DOI: 10.3390/sports11090185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 09/13/2023] [Accepted: 09/14/2023] [Indexed: 09/28/2023] Open
Abstract
Single-leg drop landing (SLDL) and jump landing (SLJL) are frequently used as assessment tools for identifying potential high-risk movement patterns; thus, understanding differences in neuromuscular responses between these types of landings is essential. This study aimed to compare lower extremity neuromuscular responses between the SLDL and SLJL. Thirteen female participants performed an SLDL and SLJL from a 30-cm box height. Vertical ground reaction force (vGRF), time to peak vGRF, and surface electromyography (sEMG) data were collected. Continuous neuromuscular responses, peak vGRF, and time to peak vGRF were compared between the tasks. Statistical parametric mapping (SPM) analysis demonstrated that the SLJL had a significantly higher sEMG activity in the rectus femoris (RF), vastus lateralis (VL) and vastus medialis (VM) within the first 10% of the landing phase compared with SLDL. At 20-30% of the landing phase, sEMGs in the RF and VL during the SLDL were significantly higher compared with SLJL (p < 0.05). A higher peak vGRF and shorter time to peak vGRF was observed during SLJL (p < 0.05). In conclusion, our findings highlight that SLJL exhibited greater RF, VL, and VM activities than SLDL at initial impact (10% landing), coinciding with a higher peak vGRF and shorter time to attain peak vGRF. Our findings support the role of the quadriceps as the primary energy dissipator during the SLJL.
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Affiliation(s)
- Metaneeya Pilanthananond
- Department of Physiology, Faculty of Science, Mahidol University, Bangkok 10400, Thailand; (M.P.); (V.S.)
| | | | - Vitoon Saengsirisuwan
- Department of Physiology, Faculty of Science, Mahidol University, Bangkok 10400, Thailand; (M.P.); (V.S.)
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Friedl KE, Looney DP. With life there is motion. Activity biomarkers signal important health and performance outcomes. J Sci Med Sport 2023:S1440-2440(23)00027-0. [PMID: 36775676 DOI: 10.1016/j.jsams.2023.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 12/30/2022] [Accepted: 01/28/2023] [Indexed: 02/05/2023]
Abstract
Measures of human motion provide a rich source of health and physiological status information. This paper provides examples of motion-based biomarkers in the form of patterns of movement, quantified physical activity, and characteristic gaits that can now be assessed with practical measurement technologies and rapidly evolving physiological models and algorithms, with research advances fed by the increasing access to motion data and associated contextual information. Quantification of physical activity has progressed from step counts to good estimates of energy expenditure, useful to weight management and to activity-based health outcomes. Activity types and intensity durations are important to health outcomes and can be accurately classified even from carried smart phone data. Specific gaits may predict injury risk, including some re-trainable injurious running or modifiable load carriage gaits. Mood status is reflected in specific types of human movement, with slumped posture and shuffling gait signaling depression. Increased variability in body sway combined with contextual information may signify heat strain, physical fatigue associated with heavy load carriage, or specific neuropsychological conditions. Movement disorders might be identified earlier and chronic diseases such as Parkinson's can be better medically managed with automatically quantified information from wearable systems. Increased path tortuosity suggests head injury and dementia. Rapidly emerging wear-and-forget systems involving global positioning system and inertial navigation, triaxial accelerometry, smart shoes, and functional fiber-based clothing are making it easier to make important health and performance outcome associations, and further refine predictive models and algorithms that will improve quality of life, protect health, and enhance performance.
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Affiliation(s)
- Karl E Friedl
- U.S. Army Research Institute of Environmental Medicine, USA.
| | - David P Looney
- U.S. Army Research Institute of Environmental Medicine, USA
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Buller M, Fellin R, Bursey M, Galer M, Atkinson E, Beidleman BA, Marcello MJ, Driver K, Mesite T, Seay J, Weed L, Telfer B, King C, Frazee R, Moore C, Williamson JR. Gait instability and estimated core temperature predict exertional heat stroke. Br J Sports Med 2022; 56:446-451. [PMID: 35022161 DOI: 10.1136/bjsports-2021-104081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Exertional heat stroke (EHS), characterised by a high core body temperature (Tcr) and central nervous system (CNS) dysfunction, is a concern for athletes, workers and military personnel who must train and perform in hot environments. The objective of this study was to determine whether algorithms that estimate Tcr from heart rate and gait instability from a trunk-worn sensor system can forward predict EHS onset. METHODS Heart rate and three-axis accelerometry data were collected from chest-worn sensors from 1806 US military personnel participating in timed 4/5-mile runs, and loaded marches of 7 and 12 miles; in total, 3422 high EHS-risk training datasets were available for analysis. Six soldiers were diagnosed with heat stroke and all had rectal temperatures of >41°C when first measured and were exhibiting CNS dysfunction. Estimated core temperature (ECTemp) was computed from sequential measures of heart rate. Gait instability was computed from three-axis accelerometry using features of pattern dispersion and autocorrelation. RESULTS The six soldiers who experienced heat stroke were among the hottest compared with the other soldiers in the respective training events with ECTemps ranging from 39.2°C to 40.8°C. Combining ECTemp and gait instability measures successfully identified all six EHS casualties at least 3.5 min in advance of collapse while falsely identifying 6.1% (209 total false positives) examples where exertional heat illness symptoms were neither observed nor reported. No false-negative cases were noted. CONCLUSION The combination of two algorithms that estimate Tcr and ataxic gate appears promising for real-time alerting of impending EHS.
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Affiliation(s)
- Mark Buller
- United States Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
| | - Rebecca Fellin
- United States Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
| | - Max Bursey
- Augusta University, Augusta, Georgia, USA
| | - Meghan Galer
- Martin Army Community Hospital, Fort Benning, Georgia, USA
| | - Emma Atkinson
- United States Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
| | - Beth A Beidleman
- United States Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
| | - Michael J Marcello
- United States Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
| | - Kyla Driver
- United States Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
| | - Timothy Mesite
- United States Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
| | - Joseph Seay
- United States Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA.,Natick Soldier Systems Center, Natick, Massachusetts, USA
| | - Lara Weed
- Massachusetts Institute of Technology Lincoln Laboratory, Lexington, Massachusetts, USA
| | - Brian Telfer
- Massachusetts Institute of Technology Lincoln Laboratory, Lexington, Massachusetts, USA
| | | | - Royce Frazee
- 75th Ranger Regiment, Fort Benning, Georgia, USA
| | | | - James R Williamson
- Massachusetts Institute of Technology Lincoln Laboratory, Lexington, Massachusetts, USA
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Gomez-Hixson K, Biagioni E, Brown ML. Significant differences in dietary intake of NCAA Division III soccer players compared to recommended levels. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:150-157. [PMID: 32101508 DOI: 10.1080/07448481.2020.1728279] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 12/23/2019] [Accepted: 02/02/2020] [Indexed: 06/10/2023]
Abstract
Objective: This study evaluated dietary intake patterns of NCAA Division III soccer players compared to recommended levels. Participants: NCAA Division III soccer players (n = 75). Methods: Actual dietary intake was determined by the analysis of a 3-day food record. Results: Results indicate that total energy, carbohydrate, and dietary fiber intake was significantly below the recommended levels. In addition, added sugar and total fat consumption were significantly above recommended levels. Potassium, magnesium, and vitamin D levels were consumed in levels significantly below the recommended levels. Sodium, iron, and vitamin C were consumed in significantly higher levels than the recommended target. Female athletes had significantly higher intakes of added sugar, saturated fat and vitamin C compared to male athletes. Female athletes had significantly lower intakes of calcium, potassium, sodium, iron, magnesium and vitamin D compared to male athletes. Conclusion: Based on the results of the present study, increased efforts should be put into development of nutrition education programs for NCAA Division III athletes.
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Affiliation(s)
- Kaneen Gomez-Hixson
- Department of Nutrition and Public Health, University of Saint Joseph, West Hartford, Connecticut, USA
| | - Ericka Biagioni
- Department of Nutrition and Public Health, University of Saint Joseph, West Hartford, Connecticut, USA
| | - Melissa L Brown
- Department of Nutrition and Public Health, University of Saint Joseph, West Hartford, Connecticut, USA
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Hanzlíková I, Hébert-Losier K. Clinical Implications of Landing Distance on Landing Error Scoring System Scores. J Athl Train 2021; 56:572-577. [PMID: 34375981 DOI: 10.4085/1062-6050-068-20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT The Landing Error Scoring System (LESS) screens for risk of noncontact anterior cruciate ligament injury. The LESS requires individuals to jump forward from a 30-cm box to a distance of 50% of their body height. However, different landing distances have been cited in the scientific literature. OBJECTIVE To examine whether landing distance influences LESS outcomes. DESIGN Cross-sectional study. SETTING Laboratory. PARTICIPANTS OR OTHER PARTICIPANTS Seventy young active individuals (34 males, 36 females). INTERVENTION(S) Participants performed 3 × 30-cm jump-landing tasks under 2 landing conditions in randomized order: (1) 50% of body height (d50%), (2) self-selected distance (dss). MAIN OUTCOME MEASURE(S) Mean LESS scores, proportions of individuals categorized at high (LESS: ≥ 5 errors) and low (LESS: < 5 errors) injury risk, and landing distances were compared between conditions using generalized estimating equations. Consistency of risk categorization was examined using odds ratios (ORs) and McNemar tests. McNemar and Wilcoxon signed rank tests were used to compare the occurrence of specific LESS errors. RESULTS Participants landed closer to the box under the dss condition (difference = -23.28 [95% CI = -20.73, -25.81]%, P < .001). Group mean LESS scores (difference = -0.01 [95% CI = -0.59, 0.57] error, P = .969) and risk categorization (OR = 0.94 [95% CI = 0.47, 1.88], P = .859) were similar between conditions. However, individual-level risk categorization was inconsistent in 33% of participants, as was the occurrence of specific errors. CONCLUSIONS Using dss during the LESS might lead to different LESS errors and risk categorizations at an individual level than using d50%. Given that individual LESS scores are of primary interest in clinical and sport settings and the injury-risk threshold has not been validated for dss, we recommend use of the original LESS protocol. When only group mean LESS scores or proportions of at-risk individuals are of interest, using dss is feasible to facilitate the testing of large cohorts.
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Affiliation(s)
- Ivana Hanzlíková
- Division of Health, Engineering, Computing and Science, Te Huataki Waiora School of Health, Adams Centre for High Performance, University of Waikato, New Zealand
| | - Kim Hébert-Losier
- Division of Health, Engineering, Computing and Science, Te Huataki Waiora School of Health, Adams Centre for High Performance, University of Waikato, New Zealand
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Adams WM, Scarneo-Miller SE, Vandermark LW, Belval LN, DiStefano LJ, Lee EC, Armstrong LE, Casa DJ. Movement Technique and Standing Balance After Graded Exercise-Induced Dehydration. J Athl Train 2021; 56:203-210. [PMID: 33449078 DOI: 10.4085/1062-6050-0436.19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Hypohydration has been shown to alter neuromuscular function. However, the longevity of these impairments remains unclear. OBJECTIVE To examine the effects of graded exercise-induced dehydration on neuromuscular control 24 hours after exercise-induced hypohydration. DESIGN Crossover study. SETTING Laboratory. PATIENTS OR OTHER PARTICIPANTS A total of 23 men (age = 21 ± 2 years, height = 179.8 ± 6.4 cm, mass = 75.24 ± 7.93 kg, maximal oxygen uptake [VO2max] = 51.7 ± 5.5 mL·kg-1·min-1, body fat = 14.2% ± 4.6%). INTERVENTION(S) Participants completed 3 randomized exercise trials: euhydrated arrival plus fluid replacement (EUR), euhydrated arrival plus no fluid (EUD), and hypohydrated arrival plus no fluid (HYD) in hot conditions (ambient temperature = 35.2°C ± 0.6°C, relative humidity = 31.3% ± 2.5%). Each trial consisted of 180 minutes of exercise (six 30-minute cycles: 8 minutes at 40% VO2max; 8 minutes, 60% VO2max; 8 minutes, 40% VO2max; 6 minutes, passive rest) followed by 60 minutes of passive recovery. MAIN OUTCOME MEASURE(S) We used the Landing Error Scoring System and Balance Error Scoring System (BESS) to measure movement technique and postural control at pre-exercise, postexercise and passive rest (POSTEX), and 24 hours postexercise (POST24). Differences were assessed using separate mixed-design (trial × time) repeated-measures analyses of variance. RESULTS The magnitude of hypohydration at POSTEX was different among EUR, EUD, and HYD trials (0.2% ± 1%, 3.5% ± 1%, and 5% ± 0.9%, respectively; P < .05). We observed no differences in Landing Error Scoring System scores at pre-exercise (2.9 ± 1.6, 3.0 ± 2.1, 3.0 ± 2.0), POSTEX (3.3 ± 1.5, 3.0 ± 2.0, 3.1 ± 1.9), or POST24 (3.3 ± 1.9, 3.2 ± 1.4, 3.3 ± 1.6) among the EUD, EUR, and HYD trials, respectively (P = .90). Hydration status did not affect BESS scores (P = .11), but BESS scores at POSTEX (10.4 ± 1.1) were greater than at POST24 (7.7 ± 0.9; P = .03). CONCLUSIONS Whereas exercise-induced dehydration up to 5% body mass did not impair movement technique or postural control 24 hours after a prolonged bout of exercise in a hot environment, postural control was impaired at 60 minutes after prolonged exercise in the heat. Consideration of the length of recovery time between bouts of exercise in hot environments is warranted.
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Affiliation(s)
- William M Adams
- Department of Kinesiology, University of North Carolina at Greensboro
| | - Samantha E Scarneo-Miller
- Korey Stringer Institute, University of Connecticut, Storrs.,Department of Kinesiology, University of Connecticut, Storrs
| | - Lesley W Vandermark
- Department of Health, Human Performance, and Recreation, University of Arkansas, Fayetteville
| | - Luke N Belval
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, University of Texas Southwestern Medical Center
| | | | - Elaine C Lee
- Department of Kinesiology, University of Connecticut, Storrs
| | | | - Douglas J Casa
- Korey Stringer Institute, University of Connecticut, Storrs.,Department of Kinesiology, University of Connecticut, Storrs
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Hanzlíková I, Athens J, Hébert-Losier K. Factors influencing the Landing Error Scoring System: Systematic review with meta-analysis. J Sci Med Sport 2020; 24:269-280. [PMID: 32951976 DOI: 10.1016/j.jsams.2020.08.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Revised: 08/24/2020] [Accepted: 08/25/2020] [Indexed: 01/20/2023]
Abstract
OBJECTIVES Systematically review the literature addressing age, sex, previous injury, and intervention program as influencing factors of the Landing Error Scoring System. DESIGN Systematic review with meta-analysis. METHODS Three databases (PubMed, Web of Science®, and Scopus®) were searched on 1 April 2020. Original studies using the Landing Error Scoring System as primary outcome and exploring age, sex, previous injury, and intervention program were included, assessed for risk of bias, and critically appraised. Three meta-analyses were performed using one random and two mixed effect models with dependent variables: sex, previous injury and intervention program, respectively. Grading of Recommendations Assessment, Development and Evaluation was used to evaluate the strength of the evidence. PROSPERO registration number CRD42018107210. RESULTS Fifty-two studies were included. Pooled data indicated that females have higher Landing Error Scoring System scores than males (p<0.001, mean difference=0.6 error). Participants with previous anterior cruciate ligament injury have higher LESS scores than healthy controls (p=0.004, mean difference 1.2 error). Neuromuscular training programs lasting a minimum of six weeks and other intervention programs decrease Landing Error Scoring System scores (p<0.001, mean difference 1.2 error and p=0.042, mean difference 0.5 error, respectively). There is limited evidence suggesting that age may influence Landing Error Scoring System scores in clinically meaningful manner. Overall, Grading of Recommendations Assessment, Development and Evaluation ratings suggest very low strength of evidence. CONCLUSIONS History of anterior cruciate ligament injury and undertaking neuromuscular training for a minimum of six weeks meaningfully altered Landing Error Scoring System scores. These findings, however, should be interpreted cautiously considering the very low Grading of Recommendations Assessment, Development and Evaluation rating of the evidence.
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Affiliation(s)
- Ivana Hanzlíková
- Division of Health, Engineering, Computing and Science, Te Huataki Waiora School of Health, Adams Centre for High Performance, University of Waikato, New Zealand.
| | - Josie Athens
- Department of Preventive and Social Medicine, University of Otago, New Zealand
| | - Kim Hébert-Losier
- Division of Health, Engineering, Computing and Science, Te Huataki Waiora School of Health, Adams Centre for High Performance, University of Waikato, New Zealand
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10
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Bond CW, Dorman JC, MacFadden LN, Munce TA. Dynamic Postural Stability in Active, Adolescent Males Following Repeated Bouts of Aerobic Exercise in Hot and Temperate Environments: A Pilot Study. Mil Med 2020; 185:368-375. [PMID: 32074301 PMCID: PMC7029836 DOI: 10.1093/milmed/usz286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Introduction Proper jump-landing neuromuscular control is crucial in mitigating lower-extremity musculoskeletal injuries. The presence of fatigue, especially in extreme environments, may degrade dynamic postural stability (DPS) and result in lower-extremity injuries. This study aimed to evaluate the influence of moderate intensity exercise in hot (HOT) and temperate (TEMP) ambient temperatures and residual effects of a previous bout on DPS during a single-legged jump-landing. It was hypothesized that the participants would display worse DPS after HOT compared to TEMP. Methods Six recreationally active young males (16.8 ± 0.7 year, 1.88 ± 0.12 m, 83.8 ± 19.8 kg) completed two, 60-minute bouts of exercise with 60 minutes of rest between bouts in both HOT (35°C) and TEMP (22.2°C). Heart rate and core body temperature (Tc) were monitored continuously, and DPS was assessed before and after each bout. Results The DPS time and condition effects were not identified (p > 0.05), but HOT elicited some notable (d > 0.20) increases in heart rate, Tc, and DPS compared to TEMP. Conclusions The DPS decrements varied between subjects suggesting individual-specific etiology. Repeated bouts of exercise in HOT may place an individual at a greater risk for injury than TEMP if proper prevention strategies are not used.
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Affiliation(s)
- Colin W Bond
- Sanford Sports Science Institute, Sanford Health, 2215 W Pentagon Pl, Sioux Falls, SD 57107
| | - Jason C Dorman
- Sanford Sports Science Institute, Sanford Health, 2215 W Pentagon Pl, Sioux Falls, SD 57107
| | - Lisa N MacFadden
- Sanford Sports Science Institute, Sanford Health, 2215 W Pentagon Pl, Sioux Falls, SD 57107
| | - Thayne A Munce
- Sanford Sports Science Institute, Sanford Health, 2215 W Pentagon Pl, Sioux Falls, SD 57107
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11
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Spector JT, Masuda YJ, Wolff NH, Calkins M, Seixas N. Heat Exposure and Occupational Injuries: Review of the Literature and Implications. Curr Environ Health Rep 2019; 6:286-296. [PMID: 31520291 PMCID: PMC6923532 DOI: 10.1007/s40572-019-00250-8] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE OF REVIEW The burden of heat-related adverse occupational health effects, as well as traumatic injuries, is already substantial. Projected increases in mean temperatures and extreme events may increase the risk of adverse heat health effects and enhance disparities among exposed workers. This article reviews the emerging literature on the relationship between heat exposure and occupational traumatic injuries and discusses implications of this work. RECENT FINDINGS A recent meta-analysis of three case-crossover and five time series studies in industrialized settings reported an association of increasing occupational injuries with increasing heat exposure, with increased effect estimates for male gender and age less than 25 years, although heterogeneity in exposure metrics and sources of bias were demonstrated to varying degrees across studies. A subsequent case-crossover study in outdoor construction workers reported a 0.5% increase in the odds of traumatic injuries per 1 °C increase in maximum daily humidex (odds ratio 1.005 [95% CI 1.003-1.007]). While some studies have demonstrated reversed U-shaped associations between heat exposure and occupational injuries, different risk profiles have been reported in different industries and settings. Studies conducted primarily in industrialized settings suggest an increased risk of traumatic injury with increasing heat exposure, though the exact mechanisms of heat exposure's effects on traumatic injuries are still under investigation. The effectiveness of heat-related injury prevention approaches has not yet been established. To enhance the effectiveness of prevention efforts, prioritization of approaches should take into account not only the hierarchy of controls, social-ecological models, community and stakeholder participation, and tailoring of approaches to specific local work settings, but also methods that reduce local and global disparities and better address the source of heat exposure, including conservation-informed land-use planning, built environment, and prevention through design approaches. Participation of occupational health experts in transdisciplinary development and integration of these approaches is needed.
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Affiliation(s)
- June T Spector
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, 1959 NE Pacific Street, Box 357234, Seattle, WA, 98195, USA.
- Department of Medicine, University of Washington, Seattle, WA, USA.
| | - Yuta J Masuda
- Global Science, The Nature Conservancy, Arlington, VA, USA
| | | | - Miriam Calkins
- Division of Field Studies and Engineering - Field Research Branch, National Institute for Occupational Safety and Health, Cincinnati, OH, USA
| | - Noah Seixas
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, 1959 NE Pacific Street, Box 357234, Seattle, WA, 98195, USA
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Brown ML, Tenison E. Creation of a Dual-Purpose Collegiate Athlete Nutrition Advising Program and Educational Curriculum. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2018; 50:1046-1052. [PMID: 30172699 DOI: 10.1016/j.jneb.2018.07.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 07/03/2018] [Accepted: 07/07/2018] [Indexed: 06/08/2023]
Abstract
The intent of this article is to describe the process of creating a dual-purpose athlete nutrition advising program at the collegiate level. The first goal was to help student athletes enhance their performance through optimal fuel and hydration. The second goal was to provide experiential learning for nutrition students. This program provided a platform for nutrition students to gain hands-on experience assessing, monitoring, and educating athletes in relation to nutrition for performance. The implication for practice is based on recent growth and increased interest in the performance nutrition field that drives the need for more formal training programs.
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Affiliation(s)
- Melissa L Brown
- Department of Nutrition and Public Health, University of Saint Joseph, West Hartford, CT.
| | - Elizabeth Tenison
- Department of Nutrition and Public Health, University of Saint Joseph, West Hartford, CT
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Spector JT, Krenz J, Calkins M, Ryan D, Carmona J, Pan M, Zemke A, Sampson PD. Associations between heat exposure, vigilance, and balance performance in summer tree fruit harvesters. APPLIED ERGONOMICS 2018; 67:1-8. [PMID: 29122180 PMCID: PMC5912891 DOI: 10.1016/j.apergo.2017.09.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Revised: 07/12/2017] [Accepted: 09/02/2017] [Indexed: 05/29/2023]
Abstract
BACKGROUND We sought to evaluate potential mediators of the relationship between heat exposure and traumatic injuries in outdoor agricultural workers. METHODS Linear mixed models were used to estimate associations between maximum work-shift Wet Bulb Globe Temperature (WBGTmax) and post-shift vigilance (reaction time) and postural sway (total path length) in a cross-sectional sample of 46 Washington State tree fruit harvesters in August-September 2015. RESULTS The mean (SD) WBGTmax was 27.4 (3.2)°C in August and 21.2 (2.0)°C in September. The mean pre-work-shift participant urine specific gravity indicated minimal dehydration. Twenty-four percent of participants exhibited possible excessive sleepiness. There was no association between WBGTmax and post-shift reaction time or total path length. CONCLUSIONS Heat exposure was not associated with impaired vigilance or balance in this study, in which the overall mean (SD) WBGTmax was 25.9 (4.2)°C. However, the study identified opportunities to ensure adequate pre-work-shift hydration and to optimize sleep and work-shift timing in order to reduce occupational injury and heat-related illness risk.
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Affiliation(s)
- June T Spector
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA; Department of Medicine, University of Washington, Seattle, WA, USA.
| | - Jennifer Krenz
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA.
| | - Miriam Calkins
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA.
| | - Dawn Ryan
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA.
| | - Jose Carmona
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA.
| | - Mengjie Pan
- Department of Statistics, University of Washington, Seattle, WA, USA.
| | - Anna Zemke
- College of Medicine, The Ohio State University, Columbus, OH, USA.
| | - Paul D Sampson
- Department of Statistics, University of Washington, Seattle, WA, USA.
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DiStefano LJ, Beltz EM, Root HJ, Martinez JC, Houghton A, Taranto N, Pearce K, McConnell E, Muscat C, Boyle S, Trojian TH. Sport Sampling Is Associated With Improved Landing Technique in Youth Athletes. Sports Health 2017; 10:160-168. [PMID: 29131779 PMCID: PMC5857728 DOI: 10.1177/1941738117736056] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Sport sampling is recommended to promote fundamental movement skill acquisition and physical activity. In contrast, sport specialization is associated with musculoskeletal injury risk, burnout, and attrition from sport. There is limited evidence to support the influence of sport sampling on neuromuscular control, which is associated with injury risk, in youth athletes. Hypothesis: Athletes who participated in only 1 sport during the previous year would demonstrate higher Landing Error Scoring System (LESS) scores than their counterparts. Study Design: Cross-sectional study. Level of Evidence: Level 3. Methods: A total of 355 youth athletes (age range, 8-14 years) completed a test session with a jump-landing task, which was evaluated using the LESS. Participants were categorized as single sport (SS) or multisport (MS) based on their self-reported sport participation in the past year. Their duration of sport sampling (low, moderate, high) was determined based on their sport participation history. Participants were dichotomized into good (LESS <5) or poor (LESS ≥5) categories. Chi-square tests were performed to evaluate for the association between control category (good, poor) and participation (MS, SS), as well as sport-sampling duration (low, moderate, high). Results: The MS group was 2.5 times (95% CI, 1.9-3.1) as likely to be categorized as having good control compared with the SS group (χ2(355) = 10.10, P < 0.01). Recreational participants in the “high” sport-sampling duration group were 5.8 times (95% CI, 3.1-8.5) and 5.4 times (95% CI, 4.0-6.8) as likely to be categorized as having good control compared with the moderate and low groups (χ2(216) = 11.20, P < 0.01). Conclusion: Sport sampling at a young age is associated with improved neuromuscular control, which may reduce injury risk in youth athletes. Clinical Relevance: Youth athletes should be encouraged to try participating in multiple sports to enhance their neuromuscular control and promote long-term physical activity.
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Affiliation(s)
- Lindsay J. DiStefano
- Lindsay J. DiStefano, PhD, ATC, Department of Kinesiology, University of Connecticut, 2095 Hillside Rd, Unit 1110, Storrs, CT 06269-1110 ()
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Nuccio RP, Barnes KA, Carter JM, Baker LB. Fluid Balance in Team Sport Athletes and the Effect of Hypohydration on Cognitive, Technical, and Physical Performance. Sports Med 2017; 47:1951-1982. [PMID: 28508338 PMCID: PMC5603646 DOI: 10.1007/s40279-017-0738-7] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Sweat losses in team sports can be significant due to repeated bursts of high-intensity activity, as well as the large body size of athletes, equipment and uniform requirements, and environmental heat stress often present during training and competition. In this paper we aimed to: (1) describe sweat losses and fluid balance changes reported in team sport athletes, (2) review the literature assessing the impact of hypohydration on cognitive, technical, and physical performance in sports-specific studies, (3) briefly review the potential mechanisms by which hypohydration may impact team sport performance, and (4) discuss considerations for future directions. Significant hypohydration (mean body mass loss (BML) >2%) has been reported most consistently in soccer. Although American Football, rugby, basketball, tennis, and ice hockey have reported high sweating rates, fluid balance disturbances have generally been mild (mean BML <2%), suggesting that drinking opportunities were sufficient for most athletes to offset significant fluid losses. The effect of hydration status on team sport performance has been studied mostly in soccer, basketball, cricket, and baseball, with mixed results. Hypohydration typically impaired performance at higher levels of BML (3-4%) and when the method of dehydration involved heat stress. Increased subjective ratings of fatigue and perceived exertion consistently accompanied hypohydration and could explain, in part, the performance impairments reported in some studies. More research is needed to develop valid, reliable, and sensitive sport-specific protocols and should be used in future studies to determine the effects of hypohydration and modifying factors (e.g., age, sex, athlete caliber) on team sport performance.
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Affiliation(s)
- Ryan P Nuccio
- Gatorade Sports Science Institute, 617 W. Main St., Barrington, IL, 60010, USA.
| | - Kelly A Barnes
- Gatorade Sports Science Institute, 617 W. Main St., Barrington, IL, 60010, USA
| | - James M Carter
- Gatorade Sports Science Institute, 617 W. Main St., Barrington, IL, 60010, USA
| | - Lindsay B Baker
- Gatorade Sports Science Institute, 617 W. Main St., Barrington, IL, 60010, USA
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Mtibaa K, Thomson A, Nichols D, Hautier C, Racinais S. Hyperthermia-induced Neural Alterations Impair Proprioception and Balance. Med Sci Sports Exerc 2017; 50:46-53. [PMID: 28863075 DOI: 10.1249/mss.0000000000001418] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
PURPOSE Hyperthermia has been shown to affect both central and peripheral nervous systems. However, the consequences of these alterations on the proprioceptive mechanisms underlying human movement control remain unclear. The aim of this study was to investigate the effect of passive hyperthermia on various measures of proprioception and balance, two key components of injury prevention and movement efficiency. METHODS After a familiarization session, 14 volunteers (8 males, 6 females) completed two experimental sessions in temperate (CON, 24°C) and hot (HOT, 44°C-50°C) conditions, in a counterbalanced order. Participants were tested for neural function (electrically evoked M-wave and Hoffman reflex, Soleus), active movement discrimination (five positions, 50 trials, dorsiflexion), dynamic balance (Star Excursion Balance Test, three directions), and static balance (single-leg stance). RESULTS Both rectal (39.0°C ± 0.3°C vs 36.9°C ± 0.6°C) and mean skin (37.9°C ± 1.0°C vs 32.0°C ± 2.7°C) temperatures were significantly higher in HOT than CON (P < 0.05). Hyperthermia significantly reduced the Hoffman reflex (P < 0.05) but not the M-wave (P > 0.05) amplitudes, increased the mean error for active movement discrimination (0.58°± 0.13° vs 0.50° ± 0.11°, +17%, P < 0.05), decreased the average distance reached in the posteromedial direction during dynamic balance (88.6 ± 7.9 cm vs 90.9 ± 6.1 cm, P < 0.05), and increased the contact area of the foot (126 ± 14 cm vs 122 ± 13 cm, +2.7%, P < 0.05) and the center of pressure excursion (64 ± 14 vs 57 ± 9 cm, +11.1%, P < 0.10) during single-leg stance. CONCLUSIONS The current study suggests that hyperthermia impairs the proprioception and balance parameters measured. These observations might be due to heat-induced alterations in efferent and afferent signals to and from the muscle.
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Affiliation(s)
- Khouloud Mtibaa
- 1Sport Science Program, College of Arts and Sciences, Qatar University, Doha, QATAR; 2Inter-university Laboratory of Human Movement Biology, University Claude Bernard Lyon 1, Villeurbanne, FRANCE; and 3Aspetar Orthopaedic and Sports Medicine Hospital, Doha, QATAR
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A Case-Crossover Study of Heat Exposure and Injury Risk in Outdoor Agricultural Workers. PLoS One 2016; 11:e0164498. [PMID: 27716794 PMCID: PMC5055365 DOI: 10.1371/journal.pone.0164498] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 09/26/2016] [Indexed: 11/29/2022] Open
Abstract
Background Recent research suggests that heat exposure may increase the risk of traumatic injuries. Published heat-related epidemiological studies have relied upon exposure data from individual weather stations. Objective To evaluate the association between heat exposure and traumatic injuries in outdoor agricultural workers exposed to ambient heat and internal heat generated by physical activity using modeled ambient exposure data. Methods A case-crossover study using time-stratified referent selection among 12,213 outdoor agricultural workers with new Washington State Fund workers’ compensation traumatic injury claims between 2000 and 2012 was conducted. Maximum daily Humidex exposures, derived from modeled meteorological data, were assigned to latitudes and longitudes of injury locations on injury and referent dates. Conditional logistic regression was used to estimate odds ratios of injury for a priori daily maximum Humidex categories. Results The mean of within-stratum (injury day and corresponding referent days) standard deviations of daily maximum Humidex was 4.8. The traumatic injury odds ratio was 1.14 (95% confidence interval 1.06, 1.22), 1.15 (95% confidence interval 1.06, 1.25), and 1.10 (95% confidence interval 1.01, 1.20) for daily maximum Humidex of 25–29, 30–33, and ≥34, respectively, compared to < 25, adjusted for self-reported duration of employment. Stronger associations were observed during cherry harvest duties in the June and July time period, compared to all duties over the entire study period. Conclusions Agricultural workers laboring in warm conditions are at risk for heat-related traumatic injuries. Combined heat-related illness and injury prevention efforts should be considered in high-risk populations exposed to warm ambient conditions in the setting of physical exertion.
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Ross JA, Shipp EM, Trueblood AB, Bhattacharya A. Ergonomics and Beyond: Understanding How Chemical and Heat Exposures and Physical Exertions at Work Affect Functional Ability, Injury, and Long-Term Health. HUMAN FACTORS 2016; 58:777-795. [PMID: 27125533 PMCID: PMC6894162 DOI: 10.1177/0018720816645457] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 03/12/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To honor Tom Waters's work on emerging occupational health issues, we review the literature on physical along with chemical exposures and their impact on functional outcomes. BACKGROUND Many occupations present the opportunity for exposure to multiple hazardous exposures, including both physical and chemical factors. However, little is known about how these different factors affect functional ability and injury. The goal of this review is to examine the relationships between these exposures, impairment of the neuromuscular and musculoskeletal systems, functional outcomes, and health problems with a focus on acute injury. METHOD Literature was identified using online databases, including PubMed, Ovid Medline, and Google Scholar. References from included articles were searched for additional relevant articles. RESULTS This review documented the limited existing literature that discussed cognitive impairment and functional disorders via neurotoxicity for physical exposures (heat and repetitive loading) and chemical exposures (pesticides, volatile organic compounds [VOCs], and heavy metals). CONCLUSION This review supports that workers are exposed to physical and chemical exposures that are associated with negative health effects, including functional impairment and injury. Innovation in exposure assessment with respect to quantifying the joint exposure to these different exposures is especially needed for developing risk assessment models and, ultimately, preventive measures. APPLICATION Along with physical exposures, chemical exposures need to be considered, alone and in combination, in assessing functional ability and occupationally related injuries.
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Affiliation(s)
- Jennifer A Ross
- Texas A&M University, College StationUniversity of Cincinnati, Ohio
| | - Eva M Shipp
- Texas A&M University, College StationUniversity of Cincinnati, Ohio
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Effects of mild hypohydration on cooling during cold-water immersion following exertional hyperthermia. Eur J Appl Physiol 2016; 116:687-95. [DOI: 10.1007/s00421-016-3329-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 01/05/2016] [Indexed: 10/22/2022]
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Cheung SS, McGarr GW, Mallette MM, Wallace PJ, Watson CL, Kim IM, Greenway MJ. Separate and combined effects of dehydration and thirst sensation on exercise performance in the heat. Scand J Med Sci Sports 2015; 25 Suppl 1:104-11. [DOI: 10.1111/sms.12343] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2014] [Indexed: 11/29/2022]
Affiliation(s)
- S. S. Cheung
- Environmental Ergonomics Laboratory; Department of Kinesiology; Brock University; St. Catharines Canada
| | - G. W. McGarr
- Environmental Ergonomics Laboratory; Department of Kinesiology; Brock University; St. Catharines Canada
| | - M. M. Mallette
- Environmental Ergonomics Laboratory; Department of Kinesiology; Brock University; St. Catharines Canada
| | - P. J. Wallace
- Environmental Ergonomics Laboratory; Department of Kinesiology; Brock University; St. Catharines Canada
| | - C. L. Watson
- Environmental Ergonomics Laboratory; Department of Kinesiology; Brock University; St. Catharines Canada
| | - I. M. Kim
- Environmental Ergonomics Laboratory; Department of Kinesiology; Brock University; St. Catharines Canada
| | - M. J. Greenway
- Niagara Regional Campus; Michael G. DeGroote School of Medicine, McMaster University; Hamilton Canada
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Abstract
Improving the recovery capabilities of the tennis athlete is receiving more emphasis in the research communities, and also by practitioners (coaches, physical trainers, tennis performance specialists, physical therapists, etc). The purpose of this article was to review areas of recovery to limit the severity of fatigue and/or speed recovery from fatigue. This review will cover four broad recovery techniques commonly used in tennis with the belief that the interventions may improve athlete recovery and therefore improve adaptation and future performance. The four areas covered are: (1) temperature-based interventions, (2) compressive clothing, (3) electronic interventions and (4) nutritional interventions.
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Affiliation(s)
- Mark S Kovacs
- Gatorade Sport Science Institute, , Barrington, Illinois, USA
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Cheuvront SN, Kenefick RW. Dehydration: physiology, assessment, and performance effects. Compr Physiol 2014; 4:257-85. [PMID: 24692140 DOI: 10.1002/cphy.c130017] [Citation(s) in RCA: 272] [Impact Index Per Article: 27.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
This article provides a comprehensive review of dehydration assessment and presents a unique evaluation of the dehydration and performance literature. The importance of osmolality and volume are emphasized when discussing the physiology, assessment, and performance effects of dehydration. The underappreciated physiologic distinction between a loss of hypo-osmotic body water (intracellular dehydration) and an iso-osmotic loss of body water (extracellular dehydration) is presented and argued as the single most essential aspect of dehydration assessment. The importance of diagnostic and biological variation analyses to dehydration assessment methods is reviewed and their use in gauging the true potential of any dehydration assessment method highlighted. The necessity for establishing proper baselines is discussed, as is the magnitude of dehydration required to elicit reliable and detectable osmotic or volume-mediated compensatory physiologic responses. The discussion of physiologic responses further helps inform and explain our analysis of the literature suggesting a ≥ 2% dehydration threshold for impaired endurance exercise performance mediated by volume loss. In contrast, no clear threshold or plausible mechanism(s) support the marginal, but potentially important, impairment in strength, and power observed with dehydration. Similarly, the potential for dehydration to impair cognition appears small and related primarily to distraction or discomfort. The impact of dehydration on any particular sport skill or task is therefore likely dependent upon the makeup of the task itself (e.g., endurance, strength, cognitive, and motor skill).
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Affiliation(s)
- Samuel N Cheuvront
- Thermal and Mountain Medicine Division, U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts
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Abstract
The objective of this article is to provide a review of the fundamental aspects of body fluid balance and the physiological consequences of water imbalances, as well as discuss considerations for the optimal composition of a fluid replacement beverage across a broad range of applications. Early pioneering research involving fluid replacement in persons suffering from diarrheal disease and in military, occupational, and athlete populations incurring exercise- and/or heat-induced sweat losses has provided much of the insight regarding basic principles on beverage palatability, voluntary fluid intake, fluid absorption, and fluid retention. We review this work and also discuss more recent advances in the understanding of fluid replacement as it applies to various populations (military, athletes, occupational, men, women, children, and older adults) and situations (pathophysiological factors, spaceflight, bed rest, long plane flights, heat stress, altitude/cold exposure, and recreational exercise). We discuss how beverage carbohydrate and electrolytes impact fluid replacement. We also discuss nutrients and compounds that are often included in fluid-replacement beverages to augment physiological functions unrelated to hydration, such as the provision of energy. The optimal composition of a fluid-replacement beverage depends upon the source of the fluid loss, whether from sweat, urine, respiration, or diarrhea/vomiting. It is also apparent that the optimal fluid-replacement beverage is one that is customized according to specific physiological needs, environmental conditions, desired benefits, and individual characteristics and taste preferences.
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Schmitz RJ, Cone JC, Tritsch AJ, Pye ML, Montgomery MM, Henson RA, Shultz SJ. Changes in drop-jump landing biomechanics during prolonged intermittent exercise. Sports Health 2014; 6:128-35. [PMID: 24587862 PMCID: PMC3931337 DOI: 10.1177/1941738113503286] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background: As injury rates rise in the later stages of sporting activities, a better understanding of lower extremity biomechanics in the later phases of gamelike situations may improve training and injury prevention programs. Hypothesis: Lower extremity biomechanics of a drop-jump task (extracted from a principal components analysis) would reveal factors associated with risk of anterior cruciate ligament injury during a 90-minute individualized intermittent exercise protocol (IEP) and for 1 hour following the IEP. Study Design: Controlled laboratory study. Level of Evidence: Level 4. Methods: Fifty-nine athletes (29 women, 30 men) completed 3 sessions. The first session assessed fitness for an IEP designed to simulate the demands of a soccer match. An experimental session assessed drop-jump biomechanics, after a dynamic warm-up, every 15 minutes during the 90-minute IEP, and for 1 hour following the IEP. A control session with no exercise assessed drop-jump performance at the same intervals. Results: Two biomechanical factors early in the first half (hip flexion at initial contact and hip loading; ankle loading and knee shear force) decreased at the end of the IEP and into the 60-minute recovery period, while a third factor (knee loading) decreased only during the recovery period (P ≤ 0.05). Conclusion: The individualized sport-specific IEP may have more subtle effects on landing biomechanics when compared with short-term, exhaustive fatigue protocols. Clinical Relevance: Potentially injurious landing biomechanics may not occur until the later stages of soccer activity.
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Affiliation(s)
- Randy J Schmitz
- Applied Neuromechanics Research Laboratory, Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, North Carolina
| | - John C Cone
- Portland Timbers Football Club, Portland, Oregon
| | - Amanda J Tritsch
- Department of Orthopaedics and Sports Medicine, University of South Florida, Tampa, Florida
| | - Michele L Pye
- Applied Neuromechanics Research Laboratory, Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, North Carolina
| | | | - Robert A Henson
- Department of Educational Research Methodology, University of North Carolina at Greensboro, Greensboro, North Carolina
| | - Sandra J Shultz
- Applied Neuromechanics Research Laboratory, Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, North Carolina
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