Comparison of soccer shin guards in preventing tibia fracture

The goal of this study was to evaluate the effectiveness of a number of shin guards in protecting against tibia fracture in soccer players. A secondary purpose was to determine the relationship between the material and structural differences in shin guard design and the protection provided. Twenty-three commercially available shin guards were tested on a model leg containing a synthetic tibia that had been calibrated against human cadaver specimens. Each guard was categorized into one of four material types: plastic (N = 9), fiberglass (N = 6), compressed air (N = 4), and Kevlar (N = 4). The maximum combined force at the ends of the tibia, the principal strain on the posterior side of the tibia, and the contact time of the impact were measured using a drop track impact simulation. Shin guards provided significant protection from tibia fracture at all drop heights. The average guard reduced force by 11% to 17% and strain by 45% to 51% compared with the unguarded leg. At the higher drop heights, material composition and structural characteristics of the shin guards showed significant differences in protective abilities. These findings indicate that all shin guards provide some measure of protection against tibia fracture, although the level of protection may vary significantly among the different guards.     

An Inflammatory Fibroma of the Gingiva Secondary to a Poorly Fitting Athletic Mouth Protector

In brief: Improved materials and fabrication techniques have enhanced the quality of athletic mouth guards, which are available in three types: custom-made, mouth-formed, and stock (ready-made). In addition, increased participation by dental schools and societies has resulted in greater availability of mouth protectors. However, problems still exist. This case report involves an athlete who sustained a lesion (most commonly known as an inflammatory fibroma) from wearing an ill-fitting mouth-formed protector.     

Mouth Protectors in Junior Football Players

This study tested Sta-Guard and Proform mouth protectors that were worn by 280 football players aged 9 to 12 years. Laboratory studies were also conducted to test tensile and tear strength, dynamic modulus and resilience, and hardness. The players received new mouth guards every two weeks for 12 weeks and reported any problems with gagging, taste, speech, feel, and durability. Ninety percent of the boys preferred the Sta-Guard mouth protector, stating that it was softer, more resilient, and more comfortable than the Proform mouth guard.     

Student of Motion Is a Study in Motion

In brief: The author discusses 19 ocular injuries in squash and racquetball players who wore eye guards with an opening between the upper and lower rim. The more recently developed eye guards that protect the eye with thick plastic should prevent direct injury from rackets or balls.     

Efficacy of thigh protectors in preventing thigh haematomas.

Thigh haematomas are extremely common in Australian Rules Football (ARF). This is in contrast to contact sports overseas, the likely reason is the increased use of thigh protectors as part of team uniforms in contact sports such as American football. Thigh haematomas can have a significant impact on an athlete's performance, ranging from short term performance impairment, muscle deconditioning and compartment syndromes, to long term problems, such as career threatening myositis ossificans and possibly muscle tears. To assess the efficacy of thigh protectors made for Australian Football, a prospective study was undertaken involving two teams in the elite junior (U 18) VSFL competition in SE Australia. One team wore thigh protectors over the course of the season while the other team acted as controls and did not wear thigh protectors. The control group suffered nine thigh haematomas, while the protected group had none (p<0.01). The possible de-conditioning effect of the haematomas was evidenced by two of the control group suffering torn quadriceps within four weeks of the haematoma. The protectors were generally well tolerated by all but one player, except in hot conditions, when they were uncomfortable.     

Direct radiation exposure of the eye lenses in cranial computed tomography and exposure reduction through radiographer training

IntroductionIonizing radiation can cause increased opacity of the lens and later lead to radiation-induced cataract.Therefore, the eye lens should be positioned outside of the direct radiation beam in cranial computed tomography (CCT). If this is not possible, protective measures must be taken, which includes the use of external lens protectors. In this study we assess whether direct radiation exposure of the eyes in CCT can be reduced by trained radiographers and whether the use of eye lens protectors improves after training.MethodsFirst, we evaluated 763 non-enhanced CCT regarding direct radiation exposure of eyeballs and eye lenses and usage of lens shielding. Afterwards, we trained radiographers to avoid radiation exposure of the eyes by head adjustment and protectors and assessed the improvements in a subsequent study of 678 CCT. We tried to identify factors that influenced radiation exposure of the eye lens.ResultsAfter training, frequency of radiation exposure of lenses was significantly reduced by 5.9% (220/763 patients in pre- vs. 155/678 patients in post-training group, p = 0.01). The use of external lens protectors significantly increased after training by 9.8% (37/763 patients in pre- vs. 99/678 patients in post-training group, p < 0.001). The absence of tiltable headrest was a risk factor for increased eye lens radiation exposure in the pre-training group. The presence of cervical spine immobilizer was associated with more frequent radiation exposure of the lenses in the pre- and post-training group.ConclusionsRadiographer training and the use of tiltable headrest lead to reduction of radiation exposure to the eye lens.Implications for practiceRadiographer training is an effective method to reduce eye lens exposure in CCT. The usage of tiltable headrest minimizes the radiation exposure of the lenses.     

Getting Patients to Protect Their Eyes During Sports

Statistics and especially photographs can prove to patients that serious eye injuries can occur during a leisurely game of racquetball and even tennis. But getting players to actually wear certified polycarbonate eye guards can be challenging. Here are a few strategies to show patients that eye protection is essential to the game.     

Means and methods of acoustic protection in aviation: current status and outlook for development

Analysis of the current status of acoustic protection in aviation shows that despite the material progress in the field, risk of professional pathologies in flying and technical personnel is still high. The situation is dramatized by the lack of effective personal and crew acoustic protectors. The authors speculate on applicability of innovative materials and technologies, ingenious designs of earphones and modular prefabricated demountable structures. Tests of proposed personal protectors demonstrated their competitiveness with foreign analogs. Prospective lines of development, e.g. incorporation of active sound absorption systems in existing passive protectors are discussed.     

Impact energy attenuation performance of football headgear

OBJECTIVES: Commercially available football head protectors were tested to determine their impact energy attenuation performance and ability to reduce the likelihood of concussion. METHODS: Prospective study using standardised impact test methods with both rigid (magnesium) and Hybrid III headforms. RESULTS: Eight commercially available head protectors from six manufacturers were tested. The magnitude of the headform accelerations increased as the drop height was increased, ranging from a minimum of 64 g from a height of 0.2 m to a maximum of 1,132 g from a height of 0.6 m. The head injury criterion and maximum headform acceleration values followed a similar trend. A steep increase was noted in the magnitude of maximum headform acceleration and head injury criterion when the drop height was increased from 0.4 to 0.5 m. This indicates that the foam material was completely compressed at an impact energy above about 20 J and therefore offers little protection against impacts of greater severity. Repeated tests using a drop height of 0.3 m showed that some helmets exhibit a "memory" effect, whereby impact performance is reduced by up to 50% with repeated impacts. CONCLUSIONS: Laboratory tests indicate that current commercially available football headgear performance will not reduce the likelihood of concussion. The absence of internationally recognised standards for soft headgear designed to ameliorate concussion is a major deficiency in sports injury prevention.     

The effect of wrist guards on bone strain in the distal forearm.

There are increasing epidemiologic and biomechanical data suggesting that wrist guards are effective in preventing wrist injuries in snowboarders and in-line skaters. However, there have been few studies designed to determine how they function. In this study we explored the load-sharing function of wrist guards at subfailure loading levels. To do so, we measured bone strain in the distal radius, distal ulna, and midshaft of the radius in cadaveric forearms with and without two types of commercially available wrist guards. We also measured construct stiffness and energy absorption during testing. Our most significant findings were that dorsal and volar distal radius bone strain were reduced with both wrist guards, and wrist guards increased energy absorption. We also found a reduction in dorsal distal ulnar bone strain, but only with the one guard in which the volar plate was elevated off the heel of the hand. In our loading configuration, wrist guards did not increase bone strain at the radial midshaft. These findings provide insight into how wrist guards protect the wrist: during low-energy falls they function partly by load-sharing, as well as by absorbing impact energy.     

Survey on eye comfort in aircraft: I. Flight attendants.

Extensive research in aviation medicine has been devoted to various aspects of vision, but there has been little attention to the eye problems of flight attendants. Flight attendants, especially contact lens wearers, have complained about eye discomfort in aircraft. The purpose of this study was to evaluate some of the conditions in aircraft that might influence their eye comfort. A questionnaire on eye comfort was developed in conjunction with the Air Safety Department of the Association of Flight Attendants and distributed through its Flightlog magazine. Of the 774 respondents, 95% reported some eye discomfort in aircraft. It is significant that both those who did and who did wear contact lenses reported similar eye problems. The most common eye problems reported were conjunctival redness and dried eyes. Smoking was indicated by the respondents to be the most noticeable factor causing eye symptoms. Aircraft cabin conditions are discussed, including relative humidity, atmospheric oxygen, and ozone concentration. Since air passengers are exposed to the same aircraft conditions as the attendants, they probably would manifest similar eye problems.     

The effects of ankle guards and taping on joint motion before, during, and after a squash match

The effects of ankle guards and taping on joint motion before, during, and after exercise were studied. Twelve league squash players played two matches, each lasting 1 hour. Two different ankle guards, and two types of tape applied by the same method, served as supports. A specially designed goniometer with electronic digital display (accuracy 1 degree) was used to determine joint range of motion: plantar-flexion and dorsiflexion, neutral inversion and eversion, plantar-flexed inversion and eversion. The results were statistically analyzed to determine the significance of the restriction provided by the supports. This revealed that the two ankle guards provided no significant support. The two tapes, however, provided significant support before exercise and after 10 minutes but not after 1 hour of exercise. Nonelastic (zinc oxide) tape proved to be the most restrictive at all times measured, especially prior to exercise, when the ankle's range of motion was decreased between 30% and 50%. However, once exercise commenced, the tape stretched, and restriction became less effective.     

Evolution of radiation exposure to operator in diagnostic and interventional radiology procedures and reduction of radiation exposure to operator with protective device

A study was performed to evaluate operator dose during diagnostic and interventional radiology procedures (IVR) and to establish methods of operator dose reduction with a radiation protective device. Operator dose was measured by glass dosimeters worn on the neck and on the abdomen outside the lead apron. In addition, the dose of the primary beam at the collimator surface was measured, which made it possible to define the correlation between the entrance air kerma, measured with Skin Dose Monitor, and operator dose exposed during the monitored procedure. IVR protectors were developed to decrease the amount of scatter radiation received by operators performing the procedures, and their effects were evaluated in abdominal and cardiac angiography procedures. The average effective dose and doses of the neck and abdomen outside the lead apron, estimated for individual procedures, were as follows: abdominal angiography procedures: effective dose, 0.07 mSv; neck area, 0.18 mSv; abdominal area, 0.51 mSv; cardiac angiography procedures: effective dose, 0.07 mSv; neck area, 0.13 mSv; abdominal area, 0.68 mSv. Operator doses were well correlated with exposure dose in abdominal angiography procedures (diagnostic procedure r=0.84, IVR r=0.77). It was found that 68.0% of the effective dose in abdominal angiography procedures and 43.0% of the effective dose in cardiac angiography procedures could be reduced by the use of IVR protectors. Operator and patient doses in interventional radiology were interdependent. The minimization of operator doses is particularly important during interventional radiology, and it is necessary to be aware of practical radiation protection procedures. Measures that reduce patient dose will also reduce occupational exposure. Moreover, operator dose could be substantially reduced by the use of IVR protectors in addition to wearing a protective lead apron during IVR. It was suggested that IVR protectors are effective radiation protective devices in interventional radiology procedures.     

Cme credit quiz

In brief: Increased interest in preventing dental injuries in sports has resulted in more testing of and improvement in protective equipment. In this study, hardness, tear strength, and tear energy were machine-tested in nine custom-made mouth-protector materials. Four of the materials made from polyvinyl acetate-polyethylene or hard polyurethane had high values for all three properties. Two materials debonded during the tear energy test. The soft polyurethane and the rubber had low values for all three properties. Visibility of clear and colored mouth protectors was tested with human subjects and observers. Yellow mouth protectors were visible at almost twice the distance of the clear protectors. This information could benefit officials who must enforce mouth-protector regulations.     

Anterior Neck Trauma

In brief: Sports-related injuries to the anterior neck can cause serious airway compromise, requiring life-saving fieldside skills on the part of physicians and trainers covering the event. After reviewing the case of a recreational lacrosse player whose laryngeal injury resulted in severe respiratory distress, the authors discuss field management of anterior neck trauma, including the options for reestablishing an injured athlete's airway and the clinical signs—such as aphonia, hemoptysis, tracheal deviation, or palpable crepitus—that necessitate immediate transport to the hospital. The authors also recommend the use of neck guards to prevent such injuries.     

Time-motion analysis and physiological data of elite under-19-year-old basketball players during competition

The physical demands of modern basketball were assessed by investigating 38 elite under-19-year-old basketball players during competition. Computerised time-motion analyses were performed on 18 players of various positions. Heart rate was recorded continuously for all subjects. Blood was sampled before the start of each match, at half time and at full time to determine lactate concentration. Players spent 8.8% (1%), 5.3% (0.8%) and 2.1% (0.3%) of live time in high "specific movements", sprinting and jumping, respectively. Centres spent significantly lower live time competing in high-intensity activities than guards (14.7% (1%) v 17.1% (1.2%); p<0.01) and forwards (16.6% (0.8%); p<0.05). The mean (SD) heart rate during total time was 171 (4) beats/min, with a significant difference (p<0.01) between guards and centres. Mean (SD) plasma lactate concentration was 5.49 (1.24) mmol/l, with concentrations at half time (6.05 (1.27) mmol/l) being significantly (p<0.001) higher than those at full time (4.94 (1.46) mmol/l). The changes to the rules of basketball have slightly increased the cardiac efforts involved during competition. The game intensity may differ according to the playing position, being greatest in guards.