Week 3 - Epidemiology Flashcards
What is William Van Mechelen’s 4 stage conceptual epidemiological model?
Stage 1: establish the extent of the injury problem
- incidence
- severity
Stage 2: establish etiology and mechanisms of sports injuries
Stage 3: introduce a preventative measure
Stage 4: assess its effectiveness by repeating step 1
What’s the hierarchy of evidence from weakest to strongest?
- expert opinion
- case report/case series
- retrospective study/prospective study
- controlled clinical study
- randomised controlled trial
- systematic review/meta analysis
- umbrella review
When would an ideal RCT not be possible?
- if you can’t ensure blinding, if the intervention is clearly different (cryotherapy, exercise intervention)
- ethical considerations (skydiving example - one group has parachutes and the other does not)
- practicality issues - looking at ACL injuries, not overly frequent, would need large sample size (>8000) for well powered RCT
What is the prevalence and cost of sports related injuries in Australia?
- ~5+ million per year - serious enough that the participation had to miss a game or two
- ~$20 billion annual cost - health care budget
How much of sports injuries are preventable?
- 30-50% injuries are preventable
- 25% acute injuries preventable
- 90% chronic injuries preventable
How can we prevent & reduce sports injuries ?
- education / information
- rule changes
- modify environment
- technique changes
- protective equipment
What type of sports injury is most commonly requiring a stay in hospital? According to the Australian institute of health and welfare (AIHW)
Fracture
What are the AIHW percentages of hospitalised injuries?
- 32% sustained playing a “football” code
- 30% affecting hips or legs
- 25% head or neck
- greater proportion of hospitalisation injuries from Australian rules and rugby were for head and neck injuries (30 and 32% respectively)
- 72% hospitalisations were males
- 28% hospitalisations were females
What are the percentages and sports that injuries occurs (hospitalisations) for male and female?
Male
- 38% football
- 12% cycling
Female
- 15% football
- 10% netball
- 11% equestrian
What are prevalence of life threatening sports related injuries reported to hospital?
10% sports injuries life threatening
- 27% swimming and diving
- 24% cycling
- 24% equestrian
What is the prevalence of traumatic spinal cord injuries?
- 227 traumatic SCI’s in aus (2016-2017 ASCIR report)
- ~40% associated with sports or leisure activities
-80% males - 7% water related events (diving into shallow water, dumped by wave)
What did the Toohey et al (2017) study find about previous injury?
- concussion: 2.5 fold increase in odds of sustaining lower limb musculoskeletal injury in Div 1 NCAA athletes in initial 90 days following RTP
- association maintained 1 year post concussion: concussed athletes 64% more likely to experience lower limb musculoskeletal injury
hypothesis
- reduced dynamic balance and neuromuscular control
- reduced reaction times & cognitive processing speeds
- gait alterations
True or false, there are no significant relationship between strength ratio of the hamstring muscles, and hamstring injury
True
What is medial tibial stress syndrome and what are the findings of reinking et al (2017)?
- traction pain from the soleus/flexor digitorum longus attachment
- study showed 5/27 risk factors showing significant pooled effect
Non-modifiable;
- female sex
- previous running injury
Modifiable;
- increased body weight
- greater hip external rotation with hip in flexion
- higher navicular drop (measure of flat foot) - orthotics
What is a pars fracture and what are the prevalence?
Lumbar spine stress fractures (common in cricket fast bowlers)
- common overuse injury >20%
- general L5 (bilateral) pars defect
- specific L4 unilateral lesion (opposite bowling arm)
- mixed fast bowling technique (modifiable risk factor)
- increased shoulder counter-rotation (modifiable risk factor)
- increased quadratus lumborum asymmetry (predictive factor)
