Injuries Following Implementation of a Progressive Load Carriage Program in United States Marine Corps Training

PURPOSE: The overall physical demands placed on recruits completing United States Marine Corps (USMC) training is high and comes concomitantly with high rates of injuries. Load carriage with heavy loads is of particular concern. However, load carriage conditioning, if optimised, can reduce injury risk. METHODS: Retrospective injury data of recruits completing training informed this study. Data were drawn from recruits completing an original load carriage (OLC) program (n=2,363) and those completing a modified load carriage (LCMOD) program (n=681). Musculoskeletal injury data were drawn from the USMC San Diego sports medicine injury database. A population estimate of the OLC:LCMOD relative risk ratio (RR) was calculated. RESULTS: The proportion of injuries sustained by the LCMOD cohort (n=268; 39%) was notably lower than that sustained by the OLC cohort (n=1,372; 58%). The reoccurrence rate *f injury for LCMOD soldiers compared to the OLC was 0.68 (95% CI 0.61 to 0.75). The leading nature of injury (i.e., sprains and strains) was consistent between both cohorts (OLC: n=396; 29% vs. LCMOD: n=66; 25%). Inflammation (n=172; 13%) and fractures (n=144; 11%) were next most common for OLC recruits; while pain (n=58; 22%) and medial tibial stress syndrome (n=18; 8%) were next most common for LCMOD recruits. While stress reactions were proportionally higher in LCMOD (n=17; 6%) when compared to OLC (n=4; 0.3%), stress fractures were proportionality lower (LCMOD: n=9; 3% vs. OLC: n=114; 8%). Pre-existing / chronic injuries were higher in LCMOD (+5%) while new overuse injuries were lower (-7%). Totalling 65% (OLC) and 70% (LCMOD) of reported injuries the knee, lower leg, ankle, and foot were the top 4 bodily sites of injuries, although there were variations in the orders of presentations (See Table 1 for top 10 bodily sites). RELEVANCE: Careful periodisation and planning of a load carriage program can reduce injuries without reducing training outcomes

Factsheet: politisering & inclusief leiderschap

The politics and administration of institutional chang

Gender differences in injuries sustained during United States Marine Corps training

Aim: To investigate gender-specific differences in injuries in United States Marine Corps (USMC) trainees.Design: Retrospective cohort study.Method: Point-of-care injury data for USMC recruits (females=94; males=681) completing training were drawn from the Marine Corps Recruit Depot San Diego sports medicine injury database and analysed descriptively. The male: female incidence rate ratio (IRR) was calculated.Results: Male trainees suffered more injuries (male=268; 39%; female n=22; 23%; IRR=1.68 (95% CI 1.33 to 2.1)). Sprains and strains were the leading nature of injury (female=41%; male=25%) followed by pain(female=23%; male=22%). The leading type of injury was ‘new overuse injuries’ for both genders (54% each). Female trainees experienced more acute injuries (36% versus 26%). While female (55%) and male (58%)rates of ‘moderate’ injuries were similar, female trainees experienced more ‘mild’ injuries (36% versus 25%). The knee (female=27%: male=23%) and lower leg (female=23%: male=21%) were the leading injury sites. All injuries were to the lower limbs in female trainees; male trainees also reported injuries to the upper limb (12%) and trunk (8%).Conclusion: Female trainees experienced fewer injuries than male trainees, with more being mild. Both genders had similar natures of injuries in similar body sites except that male trainees reported some upper body and trunk injuries.</div

Dutch guidelines for physiotherapy in patients with stress urinary incontinence: An update

Introduction and hypothesis: Stress urinary incontinence (SUI) is the most common form of incontinence impacting on quality of life (QOL) and is associated with high financial, social, and emotional costs. The purpose of this study was to provide an update existing Dutch evidence-based clinical practice guidelines (CPGs) for physiotherapy management of patients with stress urinary incontinence (SUI) in order to support physiotherapists in decision making and improving efficacy and uniformity of care. Materials and methods: A computerized literature search of relevant databases was performed to search for information regarding etiology, prognosis, and physiotherapy assessment and management in patients with SUI. Where no evidence was available, recommendations were based on consensus. Clinical application of CPGs and feasibility were reviewed. The diagnostic process consists of systematic history taking and physical examination supported by reliable and valid assessment tools to determine physiological potential for recovery. Therapy is related to different problemcategories. SUI treatment is generally based on pelvic floor muscle exercises combined with patient education and counseling. An important strategy is to reduce prevalent SUI by reducing influencing risk factors. Results: Scientific evidence supporting assessment and management of SUI is strong. Conclusions: The CPGs reflect the current state of knowledge of effective and tailor-made intervention in SUI patients

Skeletal Muscle Fiber Adaptations Following Resistance Training Using Repetition Maximums or Relative Intensity

The purpose of the study was to compare the physiological responses of skeletal muscle to a resistance training (RT) program using repetition maximum (RM) or relative intensity (RISR). Fifteen well-trained males underwent RT 3 d·wk−1 for 10 weeks in either an RM group (n = 8) or RISR group (n = 7). The RM group achieved a relative maximum each day, while the RISR group trained based on percentages. The RM group exercised until muscular failure on each exercise, while the RISR group did not reach muscular failure throughout the intervention. Percutaneous needle biopsies of the vastus lateralis were obtained pre-post the training intervention, along with ultrasonography measures. Dependent variables were: Fiber type-specific cross-sectional area (CSA); anatomical CSA (ACSA); muscle thickness (MT); mammalian target of rapamycin (mTOR); adenosine monophosphate protein kinase (AMPK); and myosin heavy chains (MHC) specific for type I (MHC1), type IIA (MHC2A), and type IIX (MHC2X). Mixed-design analysis of variance and effect size using Hedge’s g were used to assess within- and between-group alterations. RISR statistically increased type I CSA (p = 0.018, g = 0.56), type II CSA (p = 0.012, g = 0.81), ACSA (p = 0.002, g = 0.53), and MT (p \u3c 0.001, g = 1.47). RISR also yielded a significant mTOR reduction (p = 0.031, g = −1.40). Conversely, RM statistically increased only MT (p = 0.003, g = 0.80). Between-group effect sizes supported RISR for type I CSA (g = 0.48), type II CSA (g = 0.50), ACSA (g = 1.03), MT (g = 0.72), MHC2X (g = 0.31), MHC2A (g = 0.87), and MHC1 (g = 0.59); with all other effects being of trivial magnitude (g \u3c 0.20). Our results demonstrated greater adaptations in fiber size, whole-muscle size, and several key contractile proteins when using RISR compared to RM loading paradigms

Teamwerk in de wijk: een rapportage over het functioneren van wijkteams in vijf gemeentelijke organisaties 2020-2021

The politics and administration of institutional chang

Organizational rules and cognitive uncertainty among public professionals: a daily diary study

Although public management and human resource management research has extensively investigated the motivational effects of organizational rules, the original utility of organizational rules—uncertainty reduction—has remained overlooked. This study takes a cognitive perspective by examining how organizational rules relate to uncertainty experiences of public professionals. In this study, we provide a dynamic perspective on the relationship between organizational rules and uncertainty through a 2-week daily online diary study among 65 public professionals in the Netherlands. The results indicate that the amount and consistency of rules are related to professionals’ daily uncertainty experiences. Moreover, within-person experiences of rules and uncertainty are highly variable over time. We argue that a cognitive perspective of uncertainty reduction can broaden our understanding of the consequences of organizational rules in managing people, and that the dynamic nature of organizational rule experiences cannot be a mere footnote in future public administration and human resource management research.Public Health and primary carePrevention, Population and Disease management (PrePoD

‘Teamwerk in de wijk’. Overkoepelende rapportage 2021-2022

The politics and administration of institutional chang

Europe, listen and respond. Enhancing the European Commission´s online public consultation tool.

Fac. de Ciencias de la InformaciónFALSEpu