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Musculoskeletal risk factors as predictors of injury in community-dwelling women.

ABSTRACT: Participating in health-related physical activity (PA) may increase risk for musculoskeletal injury (MSI).This study aimed to estimate the prevalence of structural/biomechanical risk factors in community-dwelling women and associated risk for incidence of MSI in women who are physically active.The Women's Injury study is a surveillance of PA behaviors and MSI in women age 20-83 yr. An orthopedic examination was performed before entry into the study to assess presence of structural/biomechanical risk factors. A total of 886 women completed data collection by reporting weekly PA behavior and MSI for up to 3 yr (2007-2009), with the average participant enrolled for 98 wk. To estimate MSI risk associated with each risk factor separately, time to first MSI was modeled using proportional hazard regression with time-dependent PA covariates, controlling for age, body mass index, and previous injury.Over the course of the study, 236 of the women (26.6%) reported at least one MSI that was PA related. We found a significant association between the number of high flexibility risk factors and PA-related injury at all levels of PA exposure (HR = 1.15 and confidence interval (CI) = 1.04-1.27 for moderate-to-vigorous PA; HR = 1.16 and CI = 1.05-1.28 for moderate PA; HR = 1.15 and CI = 1.04-1.27 for vigorous PA).When participating at any level of PA for health benefits, women with hypermobility in multiple muscle groups or joints should be watchful for musculoskeletal symptoms and should be counseled not to ignore symptoms when they first occur.

SUBMITTER: Trudelle-Jackson E

PROVIDER: S-EPMC4137467 | biostudies-literature | 2014 Sep

REPOSITORIES: biostudies-literature

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Musculoskeletal risk factors as predictors of injury in community-dwelling women.

Trudelle-Jackson Elaine E Leonard David D Morrow James R JR

Medicine and science in sports and exercise 20140901 9

<h4>Background</h4>Participating in health-related physical activity (PA) may increase risk for musculoskeletal injury (MSI).<h4>Purpose</h4>This study aimed to estimate the prevalence of structural/biomechanical risk factors in community-dwelling women and associated risk for incidence of MSI in women who are physically active.<h4>Methods</h4>The Women's Injury study is a surveillance of PA behaviors and MSI in women age 20-83 yr. An orthopedic examination was performed before entry into the st ...[more]

PMID: 25133999

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Project description:ObjectivesOur study aimed to identify the risk factors of incident falls between men and women.DesignProspective cohort study.SettingThe study recruited participants from the Central region of Singapore. Baseline and follow-up data were collected via a face-to-face survey.ParticipantsCommunity-dwelling adults aged 40 years and above from the Population Health Index Survey.Outcome measureIncident falls were defined as the experience of a fall between the baseline and 1-year follow-up but having no falls 1 year prior to baseline. Multiple logistic regressions were performed to determine the association of sociodemographic factors, medical history and lifestyle with incident falls. Sex subgroup analyses were conducted to examine sex-specific risk factors for incident falls.Results1056 participants were included in the analysis. At 1-year follow-up, 9.6% of the participants experienced an incident fall. Incidence of falls in women was 9.8% compared with 7.4% in men. In the multivariable analysis for the overall sample, older age (OR: 1.88, 95% CI: 1.10 to 2.86), being pre-frail (OR: 2.13, 95% CI: 1.12 to 4.00) and having depression or feeling depressed/anxious (OR: 2.35, 95% CI: 1.10 to 4.99) were associated with higher odds for incident falls. In subgroup analyses, older age was a risk factor for incident falls in men (OR: 2.68, 95% CI: 1.21 to 5.90) and pre-frail was a risk factor for incident falls in women (OR: 2.82, 95% CI: 1.28 to 6.20). There was no significant interaction effect between sex and age group (p value=0.341) and sex and frailty status (p value=0.181).ConclusionOlder age, presence of pre-frailty and having depression or feeling depressed/anxious were associated with higher odds of incident falls. In our subgroup analyses, older age was a risk factor for incident falls in men and being pre-frail was a risk factor for incident falls in women. These findings provide useful information for community health services in designing falls prevention programmes for community-dwelling adults in a multi-ethnic Asian population.

Project description:Frailty reflects an accelerated health decline. Frailty is a consequence of fracture and contributes to fracture. Greater frailty was associated with higher fracture risk. Frail women were at immediate risk (within 24 months) of a hip or major fracture. Fracture prevention could be improved by considering frailty status.IntroductionFrailty encompasses the functional decline in multiple systems, particularly the musculoskeletal system. Frailty can be a consequence of and contribute to fracture, leading to a cycle of further fractures and greater frailty. This study investigates this association, specifically time frames for risk, associated fracture types, and how grade of frailty affects risk.MethodsThe study is performed in the OPRA cohort of 1044, 75-year-old women. A frailty index was created at baseline and 5 and 10 years. Women were categorized as frail or nonfrail and in quartiles (Q1 least frail; Q4 most frail). Fracture risk was assessed over short (1 and 2 years) and long terms (5 and 10 years). Fracture risk was defined for any fracture, major osteoporotic fractures (MOFs), and hip and vertebral fracture, using models including bone mineral density (BMD) and death as a competing risk.ResultsFor women aged 75, frailty was associated with higher risk of fracture within 2 years (Hip SHRadj. 3.16 (1.34-7.47)) and MOF (2 years SHRadj. 1.88 (1.12-3.16)). The increased risk continued for up to 5 years (Hip SHRadj. 2.02 (1.07-3.82)); (MOF SHRadj. 1.43 (0.99-2.05)). Grade of frailty was associated with increased 10-year probability of fracture (p = 0.03). Frailty predicted fracture independently of BMD. For women aged 80, frailty was similarly associated with fracture.ConclusionFrail elderly women are at immediate risk of fracture, regardless of bone density and continue to be at risk over subsequent years compared to identically aged nonfrail women. Incorporating regular frailty assessment into fracture management could improve identification of women at high fracture risk.

Project description:ObjectiveThis analysis examined whether specific social, physical, and financial factors were associated with diet quality among older, community-dwelling women.MethodsThis cross-sectional analysis was conducted in a subset of 6,094 community-dwelling Women's Health Initiative participants who completed a food frequency questionnaire, administered from 2012 to 2013, and a self-administered supplemental questionnaire, administered approximately 1 year later. The supplemental questionnaire included five questions assessing social, physical, and financial factors related to eating. Diet quality was assessed with the Healthy Eating Index-2010 (HEI-2010; range of 0-100; higher score indicates a higher quality diet). The total HEI-2010 score was calculated by summing individual scores representing the intake of nine adequacy components (beneficial food groups) and three moderation components (food groups to limit). Associations of responses to the five questions on the supplemental questionnaire with HEI-2010 scores were examined with multiple linear regression, adjusting for relevant covariates.ResultsMean ± standard deviation age of participants was 78.8 ± 6.7 years. Reporting eating fewer than two meals per day, having dental or other mouth problems causing problems with eating, and not always being able to shop, cook, or feed oneself were associated with statistically significantly lower HEI-2010 scores, compared with those not reporting these issues, after multivariable adjustment: 5.37, 2.98, and 2.39 lower scores, respectively (all P values <0.0001). Reporting eating alone most of the time and not always having enough money to buy food were not associated with HEI-2010 scores.ConclusionsAmong older, community-dwelling women, eating fewer than two meals per day, dental and other mouth problems, and diminished ability to shop for food, prepare meals, and feed oneself were associated with lower diet quality. These are potential targets for interventions to improve diet quality in older women. : Video Summary:http://links.lww.com/MENO/A561.

Project description:Reablement is a rehabilitation intervention for community-dwelling older adults, which has recently been implemented in several countries. Its purpose is to improve functional ability in daily occupations (everyday activities) perceived as important by the older person. Performance and satisfaction with performance in everyday life are the major outcomes of reablement. However, the evidence base concerning which factors predict better outcomes and who receives the greatest benefit in reablement is lacking.The objective of this study was to determine the potential factors that predict occupational performance and satisfaction with that performance at 10 weeks follow-up.The sample in this study was derived from a nationwide clinical controlled trial evaluating the effects of reablement in Norway and consisted of 712 participants living in 34 municipalities. Multiple linear regression was used to investigate possible predictors of occupational performance (COPM-P) and satisfaction with that performance (COPM-S) at 10 weeks follow-up based on the Canadian Occupational Performance Measure (COPM).The results indicate that the factors that significantly predicted better COPM-P and COPM-S outcomes at 10 weeks follow-up were higher baseline scores of COPM-P and COPM-S respectively, female sex, having a fracture as the major health condition and high motivation for rehabilitation. Conversely, the factors that significantly predicted poorer COPM-P and COPM-S outcomes were having a neurological disease other than stroke, having dizziness/balance problems as the major health condition and having pain/discomfort. In addition, having anxiety/depression was a predictor of poorer COPM-P outcomes. The two regression models explained 38.3% and 38.8% of the total variance of the dependent variables of occupational performance and satisfaction with that performance, respectively.The results indicate that diagnosis, functional level, sex and motivation are significant predictors of outcomes following reablement.

Project description:BackgroundMusculoskeletal injuries are a primary source of disability. Understanding how risk factors predict injury is necessary to individualize and enhance injury reduction programs.HypothesisBecause of the multifactorial nature of musculoskeletal injuries, multiple risk factors will provide a useful method of categorizing warrior athletes based on injury risk.Study designProspective observational cohort study.Level of evidenceLevel 2.MethodsBaseline data were collected on 922 US Army soldiers/warrior athletes (mean age, 24.7 ± 5.2 years; mean body mass index, 26.8 ± 3.4 kg/m2) using surveys and physical measures. Injury occurrence and health care utilization were collected for 1 year. Variables were compared in healthy versus injured participants using independent t tests or chi-square analysis. Significantly different factors between each group were entered into a logistic regression equation. Receiver operating characteristic curve and accuracy statistics were calculated for regression variables.ResultsOf the 922 warrior athletes, 38.8% suffered a time-loss injury (TLI). Overall, 35 variables had a significant relationship with TLIs. The logistic regression equation, consisting of 11 variables of interest, was significant (adjusted R2 = 0.21; odds ratio, 5.7 [95% CI, 4.1-7.9]; relative risk, 2.5 [95% CI, 2.1-2.9]; area under the curve, 0.73). Individuals with 2 variables had a sensitivity of 0.89, those with 7 or more variables had a specificity of 0.94.ConclusionThe sum of individual risk factors (prior injury, prior work restrictions, lower perceived recovery from injury, asymmetrical ankle dorsiflexion, decreased or asymmetrical performance on the Lower and Upper Quarter Y-Balance test, pain with movement, slower 2-mile run times, age, and sex) produced a highly sensitive and specific multivariate model for TLI in military servicemembers.Clinical relevanceA better understanding of characteristics associated with future injury risk can provide a foundation for prevention programs designed to reduce medical costs and time lost.

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Musculoskeletal risk factors as predictors of injury in community-dwelling women.

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Musculoskeletal risk factors as predictors of injury in community-dwelling women.

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