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  • Author: Zachary Y. Kerr x
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Zachary Y. Kerr, Sarah Fields and R. Dawn Comstock

Background:

Little is known about the epidemiology of dog sport–related injuries. This study examines injuries among handlers and dogs in the sport of dog agility.

Methods:

A cross-sectional pilot study captured data on demographics, exposures, and injury for a sample of agility handlers and dogs. Logistic regressions predicted odds of injury.

Results:

Survey of 217 handlers and 431 dogs identified 31 handler injuries (1.55 training injuries per 1000 hours, 2.14 competition injuries per 1000 runs) and 38 dog injuries (1.74 training injuries per 1000 hours, 1.72 competition injuries per 1000 runs). Handlers most commonly injured knees (48.4%) and lower trunk (29.0%). Most common diagnoses were strains (51.6%) and sprains (32.3%). Obese handlers had increased odds of injury compared with normal weight handlers (OR = 5.5, P < .001). Dogs most commonly injured front paws (23.7%) and shoulders (15.8%). Most common diagnoses were strains (44.7%) and cut/scrapes (21.1%). Injury was positively associated with dog’s age (P < .05). Handlers more commonly reported positive physical, emotional, and social motivations for participation than competitive.

Conclusions:

Despite many health benefits, dog agility poses a risk of injury to both handlers and dogs. Future research on specific mechanisms of injury should drive evidence-based injury prevention strategies.

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Kelly R. Evenson, Semra A. Aytur, Sara B. Satinsky, Zachary Y. Kerr and Daniel A. Rodríguez

Background:

We surveyed North Carolina (NC) municipalities to document the presence of municipal walking- and bicycling-related projects, programs, and policies; to describe whether prevalence of these elements differed if recommended in a plan; and to characterize differences between urban and rural municipalities.

Methods:

We surveyed all municipalities with ≥ 5000 persons (n = 121) and sampled municipalities with < 5000 persons (216/420), with a response rate of 54% (183/337). Responses were weighted to account for the sampling design.

Results:

From a list provided, staff reported on their municipality’s use of walking- and bicycling-related elements (8 infrastructure projects, 9 programs, and 14 policies). The most commonly reported were projects on sidewalks (53%), streetscape improvements (51%), bicycle/walking paths (40%); programs for cultural/recreational/health (25%), general promotional activities (24%), Safe Routes to School (24%), and law enforcement (24%); and policies on maintenance (64%), new facility construction (57%), and restricted automobile speed or access (45%). Nearly all projects, programs, or policies reported were more likely if included in a plan and more prevalent in urban than rural municipalities.

Conclusion:

These results provide cross-sectional support that plans facilitate the implementation of walking and bicycling elements, and that rural municipalities plan and implement these elements less often than urban municipalities.

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Riana R. Pryor, Douglas J. Casa, Susan W. Yeargin and Zachary Y. Kerr

All high schools should implement exertional heat illness (EHI) safety strategies. We determined if there were differences in the implementation of EHI safety strategies between schools with and without additional paid athletic trainers (ATs) or a team physician present at preseason football practices. High schools with multiple ATs or a team physician implemented more EHI prevention and management strategies than schools with only a single AT, including training staff in EHI recognition and treatment and having an emergency action plan. However, schools with a paid team physician were more likely to have double practices in the first week of football practice. Schools with additional medical personnel at football preseason practices were more likely to implement EHI safety strategies.

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Zachary Y. Kerr, Andrew E. Lincoln, Shane V. Caswell, David A. Klossner, Nina Walker and Thomas P. Dompier

Context: Participation in collegiate women’s lacrosse has increased dramatically, but little recent epidemiological data exists regarding injuries. Objective: Describe the epidemiology of National Collegiate Athletic Association (NCAA) women’s lacrosse injuries during the 2009–10 through 2014–15 academic years. Setting: Aggregate injury and exposure data collected from 40 women’s lacrosse programs providing 83 team-seasons of data. Patients or Other Participants: Collegiate women’s lacrosse student-athletes. Intervention: Women’s lacrosse data from the NCAA Injury Surveillance Program were analyzed. Main Outcome Measures: Injury rates; injury rate ratios; and injury proportions by body site, diagnosis, and injury mechanism were reported with 95% confidence intervals (CI). Time loss (TL) injuries resulted in participation restriction time of at least 24 hours. Nontime loss (NTL) injuries resulted in participation restriction time under 24 hours. Results: There were 705 TL and NTL women’s lacrosse injuries, resulting in an injury rate of 4.93/1000 athlete-exposures (AEs; 95% CI: 4.57–5.30). The TL and NTL injury rates were 2.18/1000 AE (95% CI: 1.93–2.42) and 2.64/1000 AE (95% CI: 2.37–2.90), respectively. Most injuries were to the lower extremity (competition: 64.4%; practice: 71.2%). Most injuries in competition were sprains (26.0%), contusions (19.6%), and strains (19.2%); most injuries in practice were strains (21.4%), sprains (18.1%), and inflammatory conditions (15.8%). Concussions comprised the highest proportion of head/face injuries (competition: 82.1%; practice: 54.5%). No eye injuries were reported. The highest proportion of injuries were player contact (27.4%) in competitions and noncontact (32.1%) in practices. Contact with the ball and stick comprised 21.5% of competition and 14.0% of practice injuries. Conclusions: This study is the most robust assessment of collegiate women’s lacrosse injuries to date, utilizing surveillance data that includes both TL and NTL injuries. Over half of all injuries were NTL; inclusion of such injuries further highlights the breadth of injuries managed by team medical staff.

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Zachary Y. Kerr, Susan W. Yeargin, Yuri Hosokawa, Rebecca M. Hirschhorn, Lauren A. Pierpoint and Douglas J. Casa

Context: Recent data on exertional heat illness (EHI) in high school sports are limited yet warranted to identify specific settings with the highest risk of EHI. Objective: To describe the epidemiology of EHI in high school sports during the 2012/2013–2016/2017 academic years. Design: Descriptive epidemiology study. Setting: Aggregate injury and exposure data collected from athletic trainers working in high school sports in the United States. Patients or Other Participants: High school athletes during the 2012/2013–2016/2017 academic years. Intervention: High School Reporting Information Online surveillance system data from the 2012/2013–2016/2017 academic years were analyzed. Main Outcome Measures: EHI counts, rates per 10,000 athlete exposures (AEs), and distributions were examined by sport, event type, and US census region. EHI management strategies provided by athletic trainers were analyzed. Injury rate ratios with 95% confidence intervals (CIs) compared EHI rates. Results: Overall, 300 EHIs were reported for an overall rate of 0.13/10,000 AE (95% CI, 0.11 to 0.14). Of these, 44.3% occurred in American football preseason practices; 20.7% occurred in American football preseason practices with a registered air temperature ≥90°F and ≥1 hour into practice. The EHI rate was higher in American football than all other sports (0.52 vs 0.04/10,000 AE; injury rate ratio = 11.87; 95% CI, 9.22 to 15.27). However, girls’ cross-country had the highest competition EHI rate (1.18/10,000 AE). The EHI rate was higher in the South US census region than all other US census regions (0.23 vs 0.08/10,000 AE; injury rate ratio = 2.96; 95% CI, 2.35 to 3.74). Common EHI management strategies included having medical staff on-site at the onset of EHI (92.7%), removing athlete from play (85.0%), and giving athlete fluids via the mouth (77.7%). Conclusions: American football continues to have the highest overall EHI rate although the high competition EHI rate in girls’ cross-country merits additional examination. Regional differences in EHI incidence, coupled with sport-specific variations in management, may highlight the need for region- and sport-specific EHI prevention guidelines.