Most research on face mask removal has been performed on unused equipment.
To identify and compare factors that influence the condition of helmet components and their relationship to face mask ...removal.
A cross-sectional, retrospective study.
Five athletic equipment reconditioning/recertification facilities.
2584 helmets from 46 high school football teams representing 5 geographic regions.
Helmet characteristics (brand, model, hardware components) were recorded. Helmets were mounted and face mask removal was attempted using a cordless screwdriver. The 2004 season profiles and weather histories were obtained for each high school.
Success and failure (including reason) for removal of 4 screws from the face mask were noted. Failure rates among regions, teams, reconditioning year, and screw color (type) were compared. Weather histories were compared. We conducted a discriminant analysis to determine if weather variables, region, helmet brand and model, reconditioning year, and screw color could predict successful face mask removal. Metallurgic analysis of screw samples was performed.
All screws were successfully removed from 2165 (84%) helmets. At least 1 screw could not be removed from 419 (16%) helmets. Significant differences were found for mean screw failure per helmet among the 5 regions, with the Midwest having the lowest failure rate (0.08 +/- 0.38) and the Southern (0.33 +/- 0.72), the highest. Differences were found in screw failure rates among the 46 teams (F(1,45) = 9.4, P < .01). Helmets with the longest interval since last reconditioning (3 years) had the highest failure rate, 0.47 +/- 0.93. Differences in success rates were found among 4 screw types (chi(2) (1,4) = 647, P < .01), with silver screws having the lowest percentage of failures (3.4%). A discriminant analysis (Lambda = .932, chi(2) (14,n=2584) = 175.34, P < .001) revealed screw type to be the strongest predictor of successful removal.
Helmets with stainless steel or nickel-plated carbon steel screws reconditioned in the previous year had the most favorable combination of factors for successful screw removal. T-nut spinning at the side screw locations was the most common reason and location for failure.
When cervical spine injuries are suspected, the cervical spine should be immobilized in a neutral position and neck motion controlled in preparation for transport to an emergency facility. Protocols ...for emergency transport utilizing common devices (cervical collars) and methods (transfer techniques) during these procedures are not entirely evidence based.
The medical literature search covered the time period of January 1966 to June 2008 using the following keywords, either alone or in combination: extrication collars, cervical collars, spine orthoses, spinal immobilization, spine board, spinal board, transfer techniques, and back board. Biomedical databases searched included Medline, Web of Science, and Cumulative Index to Nursing and Allied Health Literature (CINAHL 1982 to 2008). The reference lists of all trials identified were also searched for additional trials.
Only trials that directly compared the efficacy or safety of transfer methods and/or immobilization devices were included. Studies that measured voluntary head movement after the fitting of the cervical orthoses and those that did not evaluate motion across individual spinal segments were not included.
A lift-and-slide transfer method with a full body immobilization device creates less motion than a log-roll maneuver. Extrication-type cervical immobilization collars are limited in their ability to control neck motion in the injured cadaveric model.
Allied health professionals responsible for the management of the cervical spine-injured patient should become familiar with and employ a lift-and-slide transfer technique in appropriate situations and should not rely exclusively on extrication-type collars to immobilize the neck.
The Inter-Association Task Force for the Appropriate Care of the Spine-Injured Athlete recommends leaving a football player's helmet in place and removing the face mask from the helmet "as quickly as ...possible and with as little movement of the head and neck as possible." Although 2 groups have studied face-mask removal from new equipment, to our knowledge no researchers have investigated equipment that has been previously used. A full season of play may have a significant effect on football equipment and its associated hardware. Countless impacts, weather, playing surfaces, sweat, and other unforeseen or unknown variables might make the face-mask removal process more difficult on equipment that has been used.
To determine the percentage of face masks that we could unscrew, with a cordless screwdriver, from football helmets used for a full season.
Cross-sectional.
Three New England high schools.
All football helmets used at 3 local high schools were tested (n = 222, mean games, 9.7 +/- 1.2; mean practice weeks, 13.7 +/- 1.2).
Each helmet was secured to a board, and a cordless screwdriver was used to attempt to remove all 4 screws attaching the face mask to the helmet.
Variables included overall success or failure, time required for face-mask removal, and success by screw location. Data were analyzed with chi2, analysis of variance, and Tamhane post hoc tests.
Overall, 832 (94%) of 885 screws were unscrewed, and 183 (82.4%) of 222 face masks were removed. Mean removal time was 26.9 +/- 5.83 seconds. Face-mask removal success was significantly different between school 1 (24 52.2% of 46) and schools 2 (84 91.3% of 92) and 3 (75 89.3% of 84; F(2,219) = 24.608; P < .001). The removal success rate was significantly higher at top screws (98%) than at screws adjacent to ear holes (90%) (P < .001).
Based on our results and previous findings that demonstrated quicker access time and reduced head movement associated with the use of the screwdriver compared with cutting tools, the former may be a good tool for face-mask removal. However, an appropriate cutting tool must be immediately available should the screwdriver fail. Helmet hardware adjacent to ear holes was more vulnerable to failure, perhaps because it is protected by less padding than the top hardware. Possible causes of the higher failure rate at school 1 are the use of hardware materials subject to rust and corrosion and differences in helmet brand; these areas warrant future research and rules consideration.
Healing in Acute Ankle Ligament Sprains Swartz, Erik E.; Magrane, Erin L.
Athletic training & sports health care,
11/2011, Letnik:
3, Številka:
6
Journal Article
The incidence of catastrophic cervical spine injury in sports is low compared with other injuries. However, cervical spine injuries necessitate delicate and precise management, often involving the ...combined efforts of a variety of health care providers. The outcome of a catastrophic cervical spine injury depends on the efficiency of this management process and timeliness of transfer to a controlled environment for diagnosis and treatment. The objective of the National Athletic Trainers' Association (NATA) position statement on the acute care of the cervical spine-injured athlete is to provide the certified athletic trainer, team physician, emergency responder, and other health care professionals with recommendations on how to best manage a catastrophic cervical spine injury in an athlete. Recommendations are based on current evidence pertaining to prevention strategies to reduce the incidence of cervical spine injuries in sport; emergency planning and preparation to increase management efficiency; maintaining or creating neutral alignment in the cervical spine; accessing and maintaining the airway; stabilizing and transferring the athlete with a suspected cervical spine injury; managing the athlete participating in an equipment-laden sport such as football, hockey, or lacrosse; and imaging considerations in the emergency department.
In a patient with a potential cervical spine injury, minimizing or eliminating movement at the head and neck during stabilization and transport is paramount because movement can exacerbate the ...condition. Any equipment or technique creating less movement will allow for a more effective and safe stabilization of an injured patient, reducing the likelihood of movement and potential secondary injury.
To compare the amount of head movement created during the log-roll and motorized spine-board (MSB) stabilization techniques.
A 2-condition, repeated-measures design.
Laboratory.
Thirteen certified athletic trainers, emergency first responders, and emergency medical technicians (6 men, 7 women).
Subjects rotated through 4 positions for the log roll and 2 positions for the MSB. Each subject performed 3 trials while maintaining manual, inline stabilization of the model's head for each condition.
Three-dimensional head movement was measured and expressed as degrees of motion.
The log roll created significantly more motion in the frontal and transverse planes compared with the MSB (P = .001 for both measures). No significant difference was noted for sagittal-plane motion (P = .028).
The MSB created less movement at the head than did the log roll in 2 planes of motion and created slightly more motion in 1 plane, although this difference was not significant. The MSB may provide emergency responders with an appropriate alternative method for stabilizing and transporting a supine injured athlete without requiring a log roll.
Study Selection: Eligible articles were those written in English that identified surgery, magnetic resonance imaging, or injection as the criterion standard; studied at least one shoulder special ...test; and reported or included data to calculate the paired statistics of sensitivity and specificity for individual tests. The overall diagnostic power of these special tests was determined through the diagnostic odds ratio (DOR) and the area under the curve (AUC) for the summary receiver operating characteristics (ROC) curve. ...these special tests were evaluated in only one study, often conducted by the originator of the test. ...more examinations into these special tests are warranted to better elucidate their value in diagnosing labral pathologies. The systematic review by Hegedus et al1 reviewed nearly 50 orthopedic special tests of the shoulder and determined there are few tests that provide diagnostic value when evaluating the shoulder for impingement (supraspinatus/empty can or infraspinatus tests), rotator cuff integrity (supine impingement sign, external rotation lag sign, hornblower sign, bear-hug test, and belly press test), glenoid labrum pathologies (Kim, jerk, and biceps load II tests), instability (apprehension, relocation, and anterior release tests), and AC joint pathology (pain with palpation and active compression tests).
OBJECTIVE: To evaluate the performance of specific face-mask removal tools during football helmet face-mask retraction using 3-dimensional (3-D) video. DESIGN AND SETTING: Four different tools were ...used: the anvil pruner (AP), polyvinyl chloride pipe cutters (PVC), Face Mask (FM) Extractor (FME), and Trainer's Angel (TA). Subjects retracted a face mask once with each tool. SUBJECTS: Eleven certified athletic trainers served as subjects and were recruited from among local sports medicine professionals. MEASUREMENTS: We analyzed a sample of movement by 3-D techniques during the retraction process. Movement of the head in 3 planes and time to retract the face mask were also assessed. All results were analyzed with a simple repeated-measures one-way multivariate analysis of variance. An overall efficiency score was calculated for each tool. RESULTS: The AP allowed subjects to perform the face-mask removal task the fastest. Face mask removal with the AP was significantly faster than with the PVC and TA and significantly faster with the TA than the PVC. The PVC and AP created significantly more movement than the FME and TA when planes were combined. No significant differences were noted among tools for flexion-extension, rotation, or lateral flexion. The AP had an efficiency score of 14; FME, 15; TA, 18; and PVC, 35. CONCLUSIONS: The subjects performed the face-mask removal task in the least amount of time with the AP. They completed the task with the least amount of combined movement using the FME. The AP and FME had nearly identical overall efficiency scores for movement and time.
OBJECTIVE: To quantify the amount of helmet movement, time for task completion, tool satisfaction, and overall efficiency for various face-mask removal tools during football helmet face-mask removal. ...DESIGN AND SETTING: Each subject performed one trial with the anvil pruner (AP), Face Mask Extractor (FME), PVC pipe cutter (PVC), and Trainer's Angel (TA). Each subject cut through 4 loop straps and removed the face mask while kneeling behind the athlete's head. SUBJECTS: Twenty-nine certified athletic trainers (age = 29.5 +/- 6.2 years, athletic training experience = 6.3 +/- 5.0 years). MEASUREMENTS: Time to complete the task was recorded. Total range of motion and total movement of the helmet were assessed using a 6-camera, 3-dimensional motion-capture system. Satisfaction scores were measured for each subject for each tool. Efficiency scores were calculated using time and total helmet-movement data. RESULTS: When using the FME, subjects were significantly faster than with all other tools (P <.05), and when using the AP and TA, they were significantly faster than with the PVC. No differences were noted between tools in either movement variable. Significant differences were noted for satisfaction (P <.05) for all comparisons except TA versus AP. Efficiency scores were FME, 11.6; AP, 14.3; TA, 14.5; and PVC, 22.9, with lower scores identifying increased efficiency. CONCLUSIONS: In general, subjects using the FME were superior in all variables except the movement variables. Future researchers should assess the removal task using specific protocols to determine whether the tools truly differ in terms of the movement created.
Should Helmets Be Worn in Rugby? Swartz, Erik E; Marshall, Stephen W
Athletic training & sports health care,
01/2011, Letnik:
3, Številka:
1
Journal Article
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