Injuries

Prevalence of Musculoskeletal Disorders among Garment Workers: A Cross-Sectional Study in Bangladesh

Published on: 12th July, 2023

Background: The prevalence of musculoskeletal disorders is particularly high among garment workers, which poses a serious occupational health hazard. This issue is not taken seriously as an important issue in low-income countries like Bangladesh.Aim: Determine the prevalence of musculoskeletal conditions (MSDs) among garment workers in nine body regions and explore the relationship between MSDs and the general characteristics of the participants.Materials and methods: A cross-sectional study including 383 garment workers was done. A structured questionnaire (Standardized Nordic Musculoskeletal) was used. Results: The most common form of pain in the last year was lower back pain. Nine anatomical locations were studied, and workers most commonly experienced problems with their lower back (45.4%), upper back (36.6%), and knees (33.2%). Workers reported having more trouble in the knee (31.9%), upper back (35.0%), and lower back (43.9%) regions over the past seven days. In the past year and the last seven days, shoulder injuries were the least common. Conclusion: MSDs are widespread among garment industry employees. The back condition is the most commonly affected. The development of MSD is directly correlated with age and work experience.
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Physiotherapy Can Help Recover Functional Status in Community-dwelling Seniors Assessed in Emergency Departments for Minor Injuries

Published on: 1st August, 2023

Background: Around 75% of seniors seeking treatment for injuries in Emergency Departments (ED) are discharged home with minor injuries that put them at risk of functional decline in the following months. Objectives: To 1) describe seniors’ characteristics using or not physiotherapy services following ED visits for minor injuries and 2) examine their functional status according to physiotherapy use. Methods: Secondary data analyses of the Canadian Emergency Team Initiative cohort study. Participants were 65 years and older, discharged home after consulting EDs for minor injuries and assessed three times: ED, 3- and 6-months. Physiotherapy use was recorded as yes/no. Functional status was measured using the Older American Resources Scale (OARS). Multivariate linear regressions were used to examine change in OARS scores over time, accounting for confounders. Results: Among the 2169 participants, 565 (26%) received physiotherapy, and 1604 (74%) did not. Physiotherapy users were more likely females (71% vs. 64%), more educated, and less cognitively impaired. The overall change in OARS at 6 months was -0.31/28 points (95% CI: -0.55; -0.28) with no difference across groups after adjustment. Subgroup analyses among frail seniors showed that physiotherapy users maintained their function while non-users lost clinically significant function (-0.02 vs. -1.26/28 points, p = 0.03). Among the severely injured (Injury Severity Scale ≥ 5), physiotherapy users’ results were higher by almost 1/28 points (p = 0.03) compared to non-users. Conclusion: These results suggest that among seniors discharged home after consulting the ED for minor injuries, the frail and severely injured may benefit from being systematically referred to physiotherapy services. 
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High Magnification in Dentistry; Postural Benefits using Magnification Loupes to Improve Dental Work Performance

Published on: 17th August, 2023

Stress, pain, injuries, and errors in dental procedures are situations highly linked to dentistry derived from multiple factors making this profession a profession with high physical and mental demand to achieve quality treatment without deteriorating the health of those who perform it, in this case, the dentist, the assistant, and hygienist.The effects of wrong postures, but above all, the lack of knowledge of the proper postures, the modeling of bad habits acquired during the training stage in dental school, and the lack of work guidelines that not only take into account the dentist but also to all the work staff and the methodological organization of dental tasks can be found in the scientific literature.Magnification devices are known to improve vision, precision, and ergonomics in dentistry; advances in the area of ​​high magnification in dentistry are taking place by leaps and bounds. In recent years, a new magnification loupes design has appeared on the market, called ergonomic magnification loupes appeared that stands out from conventional Galilean and Keplerian through the lens (TTL) Flip-up loupes in terms of their postural benefits and is part of the arsenal of magnification loupes to consider in the market.The postural approach of high magnification equipment is necessary for professional practice, where the design of Ergonomic magnification loupes with consideration not only for magnification but also for the operator’s postural health which can have a significant impact on the performance and overall health of the dentist and hygienist, more if incorporated from the beginning of dental school education and training.
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Impact of Traumatic Sports Injury on an Athlete’s Psychological Wellbeing, Adherence to Sport and Athletic Identity

Published on: 20th September, 2023

Introduction: Sports injuries can affect athletes across all ages, sexes, and levels of competition. The mental aspect of acute sports injury is often overlooked by coaches, trainers, and medical professionals. This study investigated if and how an acute traumatic sports injury affects an athlete’s psychological well-being, adherence to sport, and athletic identity. Methods: The study consisted of surveys sent to former or current athletes over 18 with one or more athletic injuries. The Qualtrics surveys were anonymous, and participants consented to the study within the survey. Results: There were 101 total participants (20.2% response rate) with an average age of 36. All reported one or more acute athletic injuries throughout their athletic careers. Specific survey sets were compared against each other using a variable correlation analysis (p - value < 0.05) and via Pearson’s Correlation.Conclusion: The results indicated that injury impacts the lives of athletes most significantly on the field and can harm their performance based on their perception of the severity of the injury. However, this decline in performance and decrease in confidence does not correlate to an athlete’s desire to leave their sport or how they identify as being an athlete. 
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Cleat-surface Interface and Lower Extremity Injuries

Published on: 28th September, 2023

Non-contact injuries with playing surfaces occurring from applied player impact and frictional forces are a major source of lower extremity injuries in competitive sports. Artificial playing surfaces are a common alternative to natural grass surfaces; however, these surfaces are associated with player injury as well. The purpose of this manuscript is to explore the existing literature on the relationship between cleat surface interface and lower extremity injuries in athletes and the importance of proper playing surface conditions alongside proper cleat selection to optimize injury prevention and athletic performance. As artificial turf has become more advanced, studies have shown the rates of lower extremity injuries of the knee, ankle, and foot have decreased to be more similar to the rate of injury on natural grass. However, foot and ankle injury rates remain significantly higher on artificial turf. Furthermore, certain studies continue to demonstrate an increased rate of knee injuries in football players, suggesting that significant performance differences still exist between artificial turf and natural grass. Future studies warrant focusing on ways to improve the cleat-surface interface of new-generation turf, emphasizing proper cleat selection, and playing surface conditions for injury prevention thus optimizing athletic performance.
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Neuromuscular Training in Football: A Literature Review

Published on: 12th October, 2023

Introduction: Neuromuscular training (NT) involves a series of functionally focused exercises that address aspects such as postural stability, sensory perception, and muscle strengthening. These exercises are incorporated as an integral part of a currently used training protocol. Objective: To review the main effects of NT on injury prevention in soccer players and its impact on related physical performance. Methods: Review of the literature describing different studies on NT in soccer. The following databases were used to search and retrieve the scientific articles: PubMed, Scopus, and Ebsco. Combinations of the following keywords were used to perform the search (“neuromuscular training” OR “proprioceptive training” OR “sensorimotor training”) AND (“soccer” OR “football” OR “soccer players” OR “football players”). Results: A positive trend is observed in NT for the prevention of knee and ankle injuries, in addition to improving muscle strength and motor skills such as agility and coordination. Conclusion: This review managed to identify that NT is effective in reducing the risk of injury in soccer players; however, the literature has mainly addressed lower extremity injuries. Therefore, it may be necessary for future investigations to focus on the upper extremity and trunk. Likewise, it was determined that NT has a potential impact on improving physical performance, with the variables of strength, power, speed, agility, and balance being the most studied.
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Strategies to Prevent Lower-Extremity Positioning Injuries During Long-Duration Surgery in the Lithotomy Position: Our Techniques and Clinical Outcomes Following Genital Gender-Affirming Surgeries

Published on: 21st November, 2023

Purpose: Lower-extremity (LE) injuries due to prolonged surgery duration in the dorsal lithotomy (DL) position are often morbid and can significantly affect the patient’s short and long-term quality of life. These include the development of lower extremity pressure ulcers, neuropathies, rhabdomyolysis, and compartment syndromes. As compared to other surgeries, this risk is increased in patients undergoing genital gender-affirming surgery (gGAS) due to the relatively long operative time of these surgeries related to their high complexity. Our study aimed to describe our technique for preventing LE injuries in the DL position, and to evaluate our positioning-related post-operative complications and rates.Materials and Methods: We describe our technique for positioning in the dorsal lithotomy position, with an emphasis on injury prevention. We ensure a specific padding technique of the LE, we alert surgical assistants to not lean/rest on the LE, and we schedule LE checks and repositioning throughout the case to prevent and mitigate occult injuries. Herein, we report our clinical positioning-related outcomes and complications among all patients undergoing gGAS procedures lasting >300 minutes between January 2017 to March 2023. Results: A total of 227 patients underwent 310 surgical procedures (156 masculinizing, 154 feminizing gGAS procedures). Mean operative time was 495.5 minutes+/-156.5 minutes (SD) (Range 300–1095 minutes). A total of 6/227 (2.6%) patients (2 masculinizing and 4 feminizing surgical patients) had transient, self-limited LE pain post-op. No (0%) patients had major complications including chronic nerve injury, pressure ulcers, rhabdomyolysis, or compartment syndrome.Conclusions: Our study is the first to describe a replicable technique, and specifically which integrates the OR team and nursing staff, to prevent LE injuries during DL. We show that it is possible to achieve a 0%-to-rare incidence of major LE injury during long-duration surgeries.
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Superior Gluteal Artery Pseudoaneurysm following a Periacetabular Osteotomy

Published on: 1st March, 2024

Periacetabular Osteotomy (PAO) is the gold standard for the treatment of hip dysplasia or acetabular retroversion. Due to the proximity of intra-pelvic arteries, there is a risk of iatrogenic vascular injuries, which can present with a delay and should be part of the differential diagnosis of significant pain following a PAO. We present the case of a never-described vascular injury following a periacetabular osteotomy in a 25-year-old woman who presented with gluteal pain 3 weeks after surgery. A delayed diagnosis of a pseudoaneurysm of the superior gluteal artery was made and successfully treated by embolization. The lesion is most probably related to the tip of a screw or to the drilling process.
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Management of Non-contact Injuries, Nonspecific Chronic Pain, and Prevention via Sensory Conflicts Detection: Vertical Heterophoria as a Landmark Indicator

Published on: 25th March, 2024

Sensory and sensorimotor conflicts can lead to sensory and motor efficiency disturbances, such as pain and less efficient motor control. Vertical heterophoria (VH) and vertical orthophoria (VO) are respectively the latent vertical misalignment of the eyes when the retinal images are dissociated, or not. Mild VH (< 0.57°) could indicate the presence of a conflict resulting from eye refraction problems and/or a disruption of the somaesthetic cues. Canceling the conflict(s) can immediately restore VO, making it possible to observe an improvement in the mobility of spinal and peripheral joints, the performance in the motor and balance tests after initial alternation, and a decrease in pain. The Maddox Rod Test was used to detect mild VH but doesn’t determine the sensory conflict origin. The aim of this retrospective study is to show its use as a landmark in which sensory afferent conflict could induce symptoms (i.e. pain; decreased range of motion; nonoptimal postural and motor control) and how to manage it, analyzing data from 525 subjects. The clinical process is intended to inhibit or neutralize afferent signals involved in the sensorimotor loops required by the central nervous system in motor control in order to spot the locus of conflict (stomatognathic system, pelvis, plantar afferences, piercings (body art) or/and eye refraction problems). This investigation protocol based on VH detection provides trackers for the therapeutic intervention in the management of nonspecific chronic pain, non-contact injuries, and prevention, and a key role for practitioners in the multidisciplinary management required for patients/athletes, in the world of work/health.
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CVS: An Effective Strategy to Prevent Bile Duct Injury

Published on: 2nd April, 2024

Background: Bile duct injuries have been substantially increased after the introduction of laparoscopic cholecystectomy (LC). These are accompanied by major morbidity and mortality. Studies have shown varying degrees of success in the reduction of bile duct injury (BDI) using the Critical View of Safety (CVS) technique. The aim of this study was to see the efficacy of the CVS technique as the sole method of dissection in laparoscopic cholecystectomy. Methods: 1647 cases of LC were done between January 2012 and January 2022 for a period of 10 years in two hospitals. All were operated by the CVS dissection technique and none by the infundibular technique. Cases included acute cholecystitis, chronic cholecystitis, gangrenous cholecystitis, empyema, and Gallbladder (GB) polyp. Results: The average operating time was 42 minutes and the range was 13 to 80 minutes. In 92% of cases, all 3 criteria of CVS were achieved. In the remaining 8% cases were either converted to open or operated by a division of GB or subtotal cholecystectomy was done. There was only one case of cystic duct stump leak requiring drainage and common bile duct stenting.Conclusion: The excellent outcome of our study suggests that the CVS method will be the gold standard technique in the dissection of the gallbladder in LC. Further dissemination of the technique is necessary to improve safety in LC.
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Difference in Injury Risk between Male and Female Alpine Skiers: Review of the Literature

Published on: 3rd April, 2024

Alpine skiing is popular at varying levels of competitiveness with many skiers participating recreationally and elite skiers competing in downhill, super-G, giant slalom, slalom, and combined events in the World Cup and in the Winter Olympic Games. The rate of injury in alpine skiing is high both recreationally and competitively and methods to reduce injury rates are needed. Additionally, it is well-established in other sports that the risk of injury for an athlete varies based on gender. The purpose of this review is to determine how injury risk differs for each gender of alpine skier. Injury rates vary throughout the literature but point towards males being at a higher risk for overall injury and upper body injuries while females are at a higher risk for knee injuries. Even the specific knee injuries for which each gender is at risk varies with medial collateral ligament (MCL) injuries more common in males and anterior cruciate ligament (ACL) injuries more common in females. More studies are needed to confirm the differences in injury risks and how these risks may differ across levels of competition, thus allowing regulations and injury prevention methods that may be tailored specifically to the injuries an alpine skier is most susceptible to.
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