International Journal of Environmental Research and Public Health

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7 pages, 291 KiB

Open AccessEditorial

Editorial on the Special Issue on “Mountain Sports Activities: Injuries and Prevention”

by Martin Burtscher, Martin Niedermeier and Hannes Gatterer

Int. J. Environ. Res. Public Health 2021, 18(4), 1405; https://doi.org/10.3390/ijerph18041405 - 3 Feb 2021

Cited by 4 | Viewed by 2896

Abstract

Recreational outdoor activities like mountain sports are gaining large popularity all over the world and particularly in the Alpine regions [...] Full article

(This article belongs to the Special Issue Mountain Sports Activities: Injuries and Prevention)

Research

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8 pages, 632 KiB

Open AccessArticle

Incidences of Fatalities on Austrian Ski Slopes: A 10-Year Analysis

by Markus Posch, Alois Schranz, Manfred Lener, Martin Burtscher and Gerhard Ruedl

Int. J. Environ. Res. Public Health 2020, 17(8), 2916; https://doi.org/10.3390/ijerph17082916 - 23 Apr 2020

Cited by 16 | Viewed by 3104

Abstract

The study evaluated incidences and potential differences of traumatic and nontraumatic fatalities among recreational skiers and snowboarders on Austrian ski slopes within a 10-year analysis. Within this retrospective study, data were collected by the Federal Ministry of the Interior. Data comprised all traumatic [...] Read more.

The study evaluated incidences and potential differences of traumatic and nontraumatic fatalities among recreational skiers and snowboarders on Austrian ski slopes within a 10-year analysis. Within this retrospective study, data were collected by the Federal Ministry of the Interior. Data comprised all traumatic and nontraumatic deaths on Austrian ski slopes which occurred between the 2008/09 and 2017/18 winter seasons. Age, sex, nationality, gear used, altitude, slope difficulty, accident cause, primary cause of death and helmet use were collected at the death scene. Incidence of fatalities was calculated based on number of skier days. In total, 369 fatalities, with an average of 36.9 ± 7.9 fatalities per year, were registered. The yearly incidence of traumatic and nontraumatic deaths decreased by 25.8% and 40.1% during the 10-year time period, leading to an evaluated mean incidence of 0.70 deaths per million skier days, with an incidence of 0.36 traumatic deaths and 0.34 nontraumatic deaths per million skier days. Incidences of both traumatic and nontraumatic deaths decreased during the 10-year analysis, representing death as a rare event on Austrian ski slopes. However, adequate prevention measures to reduce potential risk factors to further reduce the mortality risk on ski slopes are needed. Full article

(This article belongs to the Special Issue Mountain Sports Activities: Injuries and Prevention)

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9 pages, 1177 KiB

Open AccessArticle

Importance and Diagnosis of Flexibility Preparation of Male Sport Climbers

by Paweł Draga, Mariusz Ozimek, Marcin Krawczyk, Robert Rokowski, Marcelina Nowakowska, Paweł Ochwat, Adam Jurczak and Arkadiusz Stanula

Int. J. Environ. Res. Public Health 2020, 17(7), 2512; https://doi.org/10.3390/ijerph17072512 - 7 Apr 2020

Cited by 11 | Viewed by 5650

Abstract

The objective of the study was to verify the relationships between sport skill levels and to identify the tests that accurately diagnose flexibility of sport climbers. This study examined 60 competitive advanced–higher elite male 7b–9a redpoint (RP) climbers. The athletes performed commonly used [...] Read more.

The objective of the study was to verify the relationships between sport skill levels and to identify the tests that accurately diagnose flexibility of sport climbers. This study examined 60 competitive advanced–higher elite male 7b–9a redpoint (RP) climbers. The athletes performed commonly used flexibility tests (stand-and-reach, straddle sit, straddle stand) and climbing-specific flexibility tests. Significant correlations were found between sport skill levels for the straddle stand test (r = −0.48) and the straddle sit test (r = −0.41). No significant correlations were observed between climbing-specific flexibility tests and sports skill level of climbers. Hip abduction evaluated using the straddle sit and straddle stand tests were significantly correlated with sports skill level and thus can be approached as a tool to diagnose flexibility of climbers. Flexibility is very specific and difficult to diagnose in climbing, but it should be developed. Full article

(This article belongs to the Special Issue Mountain Sports Activities: Injuries and Prevention)

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6 pages, 283 KiB

Open AccessArticle

Masticatory Muscles Activity in Sport Climbers

by Michał Ginszt, Grzegorz Zieliński, Aleksandra Byś, Piotr Gawda and Piotr Majcher

Int. J. Environ. Res. Public Health 2020, 17(4), 1378; https://doi.org/10.3390/ijerph17041378 - 21 Feb 2020

Cited by 9 | Viewed by 3250

Abstract

Masticatory muscle activity during teeth clenching is associated with changes in many physiological parameters throughout the body. Clenching can improve muscle activity, force production, rate of force development, and joint fixation. Hence, teeth clenching and masticatory muscle activity can be important in competitive [...] Read more.

Masticatory muscle activity during teeth clenching is associated with changes in many physiological parameters throughout the body. Clenching can improve muscle activity, force production, rate of force development, and joint fixation. Hence, teeth clenching and masticatory muscle activity can be important in competitive sports activities. Sport climbing is becoming increasingly popular and will be included for the first time in the Summer Olympic Games, Tokyo, 2020. However, masticatory muscle activity in sport climbers has not yet been studied. The aim of the presented study is to compare the bioelectrical activity of the masticatory muscles in sport climbers and non-climbers in order to determine the relationship between these muscles and climbing activity. 44 subjects without masticatory system disorders (16 women and 28 men, average age 26.3) were divided into two groups of 22 sport climbers (8 women, 14 men, climbing experience >4 years), while 22 people (8 women, 14 men, with no regular sports activity) were assigned to the control group. Electromyographic examination of temporalis anterior (TA) and masseter muscle (MM) was evaluated in three conditions: during resting mandibular position, during maximum intercuspation clenching, and during maximum voluntary clenching with cotton rolls between teeth. For statistical analysis, the W Shapiro-Wilk test and the Mann-Whitney U test were used. Sport climbers showed significantly higher bioelectrical activities of MM during maximum intercuspation clenching (238.45 μV vs. 83.87 μV, p = 0.002), and during maximum voluntary clenching with cotton rolls between teeth (300.01 μV vs. 101.38 μV, p = 0.001) compared to controls. The differences between groups in relation to the resting bioelectrical activity of the MM muscles, and TA muscles in all conditions were not statistically significant (p > 0.05). Higher bioelectrical activity of masseter muscles during clenching in climbers can be associated with this sports activity. However, the mechanism remains unknown and requires future research. Full article

(This article belongs to the Special Issue Mountain Sports Activities: Injuries and Prevention)

9 pages, 1791 KiB

Open AccessArticle

Characteristics of Victims of Fall-Related Accidents during Mountain Hiking

by Martin Faulhaber, Gerhard Ruedl, Friedemann Schneider, Dagmar Walter, Regina Sterr, Wolfgang Schobersberger, Fabian Schwendinger and Elena Pocecco

Int. J. Environ. Res. Public Health 2020, 17(3), 1115; https://doi.org/10.3390/ijerph17031115 - 10 Feb 2020

Cited by 20 | Viewed by 5773

Abstract

The study evaluated characteristics of non-fatal mountain hiking accidents caused by falls. Questionnaires were sent to mountain hikers who suffered a fall-related accident in Tyrol (Austria) during a 3-year period. The questionnaire included details of socio-demographic data, physical activity, medication intake, defective vision, [...] Read more.

The study evaluated characteristics of non-fatal mountain hiking accidents caused by falls. Questionnaires were sent to mountain hikers who suffered a fall-related accident in Tyrol (Austria) during a 3-year period. The questionnaire included details of socio-demographic data, physical activity, medication intake, defective vision, breaks, fluid intake, level of fatigue, muscle soreness, use of backpacks, use of hiking sticks, and type of shoes. Data of 405 individuals (57% females and 43% males) were included in the analyses. Victims were 56 ± 15 years of age, had a body mass index of 24.8 ± 3.5, and indicated 4.2 ± 3.9 h/week regular physical activity. A defective vision was reported by 70% of the victims, breaks were frequent (in 80%), and alcohol intake was rare (4%) among the interviewed hikers. Subjective level of fatigue was low and only 5% reported muscle soreness. A backpack was carried by 83% of the victims and the average weight was higher in males compared to females. The majority (61%) of the victims wore ankle-height hiking shoes with a profiled sole. Victims of non-fatal falls in mountain hiking are older than the general population of mountain hikers and are often afflicted with defective vision. Full article

(This article belongs to the Special Issue Mountain Sports Activities: Injuries and Prevention)

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9 pages, 842 KiB

Open AccessArticle

Equipment Became Better in Backcountry Skiing—Did Severity of Injuries Decrease? An Analysis from the Swiss Alps

by Benedikt Gasser

Int. J. Environ. Res. Public Health 2020, 17(3), 901; https://doi.org/10.3390/ijerph17030901 - 1 Feb 2020

Cited by 4 | Viewed by 3301

Abstract

Background: Large technical developments in avalanche transceivers as well as in ski–shoe-binding units should make backcountry skiing a safer sport and as a consequence, yield to a decrease in the number and severity of mountain emergency events. Methods: From 2009–2018, a total of [...] Read more.

Background: Large technical developments in avalanche transceivers as well as in ski–shoe-binding units should make backcountry skiing a safer sport and as a consequence, yield to a decrease in the number and severity of mountain emergency events. Methods: From 2009–2018, a total of 3044 mountain emergencies (953 females and 2091 males) were identified from the SAC (Swiss Alpine Club) central registry while backcountry skiing. These were classified descriptively by cause, whereby the severity of the mountain emergency was quantified with a NACA-Score (National Advisory Committee for Aeronautics Score). Results: A total of 1357 falls (44.6%), 558 emergencies caused by avalanches (18.3%), 408 cases of blocking (13.4%), 214 cases of illnesses (7.0%), 202 cases of losing way (6.6%), 138 cases of a crevasse accident (4.5%), and material failure in 30 cases (1%) were registered. For the remaining 137 cases (4.5%), no classification or rare forms were detected. No substantial sex differences were found in severity of injury, however looking at the two endpoints of the observed time frame, a significant increase in NACA-Score from 2009 to 2018 (2.1 ± 1.8 up to 2.6 ± 2.1, p < 0.01) was detected. Conclusions: The increase in the severity of mountain emergencies while backcountry skiing in the last decade might be due to the fact that too many inexperienced absolve backcountry tours. The tendency might be promoted by the improved material in the way that it seems easier to absolve a tour while underestimating potential hazards. Full article

(This article belongs to the Special Issue Mountain Sports Activities: Injuries and Prevention)

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10 pages, 1445 KiB

Open AccessArticle

Are Adolescent Climbers Aware of the Most Common Youth Climbing Injury and Safe Training Practices?

by Rachel N. Meyers, Steven L. Hobbs, David R. Howell and Aaron J. Provance

Int. J. Environ. Res. Public Health 2020, 17(3), 812; https://doi.org/10.3390/ijerph17030812 - 28 Jan 2020

Cited by 11 | Viewed by 4112

Abstract

Finger growth plate injuries are the most common youth climbing injuries. The purpose of our study was to understand youth awareness of the most common youth climbing injury and safe training practices. We surveyed climbers, ages eight to 18 years old, at the [...] Read more.

Finger growth plate injuries are the most common youth climbing injuries. The purpose of our study was to understand youth awareness of the most common youth climbing injury and safe training practices. We surveyed climbers, ages eight to 18 years old, at the 2017 USA Climbing Sport and Speed Youth National Championships. A total of 267 climbers completed the survey (mean age = 14 ± 2.7 years; 52% male). The A2 pulley injury was reported as the most common youth climbing injury by the largest portion of participants, 36%. The second most commonly identified injury was at the growth plate of the finger, 15% of participants, which was reported as significantly less than the A2 pulley injury, p < 0.001. Six percent of climbers reported the correct safe age to start double dyno campus board training. Roughly 18% of athletes identified growth plate injuries exclusively as a stress fracture, whereas 29.2% of those climbers self-reported as informed about finger growth plate injuries, but only 7.4% of climbers who self-reported as uninformed answered this question correctly. Misperceptions about skeletally-immature climbing injuries are prevalent amongst youth climbers. Education on the prevalence of finger growth plate injuries and the scarcity of A2 pulley injuries in youth climbers can increase diagnostic accuracy, improve care, and reduce long-term complications. Full article

(This article belongs to the Special Issue Mountain Sports Activities: Injuries and Prevention)

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10 pages, 316 KiB

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Relationship of Changes in Physical Fitness and Anthropometric Characteristics over One Season, Biological Maturity Status and Injury Risk in Elite Youth Ski Racers: A Prospective Study

by Lisa Steidl-Müller, Carolin Hildebrandt, Erich Müller and Christian Raschner

Int. J. Environ. Res. Public Health 2020, 17(1), 364; https://doi.org/10.3390/ijerph17010364 - 5 Jan 2020

Cited by 15 | Viewed by 4455

Abstract

Alpine ski racing is a sport with a high risk of injuries. In order to contribute to the longitudinal career development of young athletes, prevention measures should be elaborated. Therefore, the aim of the present study was to investigate prospectively the role of [...] Read more.

Alpine ski racing is a sport with a high risk of injuries. In order to contribute to the longitudinal career development of young athletes, prevention measures should be elaborated. Therefore, the aim of the present study was to investigate prospectively the role of biological maturity status, and changes in anthropometric characteristics and physical fitness parameters over one season in elite youth ski racers younger than 15 years. Eighty-nine elite youth ski racers (39 females, 50 males), aged 10–14 years (mean age: 12.1 ± 1.3), were investigated. Anthropometric characteristics and physical fitness parameters were assessed prior and after the winter season; traumatic and overuse injuries were recorded over the 32 weeks. Binary logistic regression analyses (R² = 0.202–0.188) revealed that the biological maturity (Wald = 4.818; p = 0.028), and changes over the season in the jump agility test (Wald = 4.692; p = 0.03), in body height (Wald = 6.229; p = 0.013), and in leg length (Wald = 4.321; p = 0.038) represented significant injury risk factors. Athletes who could improve their jump agility performance more, had smaller changes in the anthropometric characteristics and who were closer to their peak height velocity were at a lower injury risk. In the context of injury prevention, regular neuromuscular training should be incorporated, and phases of rapid growth have to be considered. Full article

(This article belongs to the Special Issue Mountain Sports Activities: Injuries and Prevention)

9 pages, 301 KiB

Open AccessArticle

Snowboarders’ Knowledge of the FIS Rules for Conduct on Ski Slopes

by Luis Carus and Isabel Castillo

Int. J. Environ. Res. Public Health 2020, 17(1), 316; https://doi.org/10.3390/ijerph17010316 - 2 Jan 2020

Cited by 3 | Viewed by 2918

Abstract

The objective of the present study is to assess snowboarders’ general perceptions of safety and knowledge of existing rules and both active and passive knowledge of the International Ski Federation (FIS) regulations in order to contribute to defining target groups for specific educational [...] Read more.

The objective of the present study is to assess snowboarders’ general perceptions of safety and knowledge of existing rules and both active and passive knowledge of the International Ski Federation (FIS) regulations in order to contribute to defining target groups for specific educational interventions in the field of injury prevention. Data were drawn from random interviews conducted with 918 snowboarders during the 2017–2018 winter season at five ski resorts located in the Spanish Pyrenees. To collect the data, a questionnaire assessing personal characteristics (gender, age, origin, and self-reported skill), general perception of safety, general request for rules, and knowledge of existing rules was used. Pearson’s Chi-squared tests were performed to compare characteristics between groups. The study revealed, for accident prevention purposes, a concerning lack of general knowledge of existing rules. Risk-inducing situations that could result in severe injuries were largely assessed incorrectly. The appropriate intuitive behavior increases with age and experience: youths and beginners are less able to implement the FIS rules than older and more experienced snowboarders. Stakeholders, such as parents, ski resorts, clubs or schools, should direct educational efforts at high-risk groups. Further research is needed to determine the causal relation between snowboard-related injuries and disregard of FIS rules. Full article

(This article belongs to the Special Issue Mountain Sports Activities: Injuries and Prevention)

12 pages, 303 KiB

Open AccessArticle

Injury Prevention: Freestylers’ Awareness of FIS Code of Conduct for Snow Parks

by Luis Carus and Isabel Castillo

Int. J. Environ. Res. Public Health 2020, 17(1), 308; https://doi.org/10.3390/ijerph17010308 - 1 Jan 2020

Cited by 2 | Viewed by 2645

Abstract

The objectives of the present study were to assess general perceptions of safety in snow parks (SPs), general knowledge of rules existence, and both active and passive awareness of the International Ski Federation (FIS) rules contained in its Code of Conduct for SPs [...] Read more.

The objectives of the present study were to assess general perceptions of safety in snow parks (SPs), general knowledge of rules existence, and both active and passive awareness of the International Ski Federation (FIS) rules contained in its Code of Conduct for SPs in order to define target groups for injury prevention-specific education interventions. Data were drawn from 436 freestylers randomly interviewed. The study was conducted during the 2018–2019 winter season in the SP of a major winter resort located in the Spanish Pyrenees. A questionnaire assessing personal data (gender, age, gear used, self-reported skill, and frequency of use), general perceptions on safety, general request for rules, and awareness of existing rules in SPs was developed. Chi-square goodness-of-fit tests were used to compare characteristics between groups. It was revealed, for accident prevention purposes, a concerning general lack of knowledge of existing rules in SPs (63% of participants ignored them). Risk-inducing situations that could result in severe injuries, such as familiarity with the right progression in choosing features and/or stunts or with safety equipment, were largely assessed incorrectly (94% and 70% of participants, respectively). Appropriate intuitive behavior increases with experience: youths and beginners are less able to implement FIS rules than more experienced freestylers. Full article

(This article belongs to the Special Issue Mountain Sports Activities: Injuries and Prevention)

9 pages, 279 KiB

Open AccessArticle

Climbing Accidents—Prospective Data Analysis from the International Alpine Trauma Registry and Systematic Review of the Literature

by Simon Rauch, Bernd Wallner, Mathias Ströhle, Tomas Dal Cappello and Monika Brodmann Maeder

Int. J. Environ. Res. Public Health 2020, 17(1), 203; https://doi.org/10.3390/ijerph17010203 - 27 Dec 2019

Cited by 24 | Viewed by 6064

Abstract

Climbing has become an increasingly popular sport, and the number of accidents is increasing in parallel. We aim at describing the characteristics of climbing accidents leading to severe (multisystem) trauma using data from the International Alpine Trauma Registry (IATR) and at reporting the [...] Read more.

Climbing has become an increasingly popular sport, and the number of accidents is increasing in parallel. We aim at describing the characteristics of climbing accidents leading to severe (multisystem) trauma using data from the International Alpine Trauma Registry (IATR) and at reporting the results of a systematic review of the literature on the epidemiology, injury pattern, severity and prevention of climbing accidents. We found that climbing accidents are a rare event, since approximately 10% of all mountain accidents are climbing related. Climbing accidents mainly affect young men and mostly lead to minor injuries. Fall is the most common mechanism of injury. Extremities are the most frequently injured body part. However, in multisystem climbing-related trauma, the predominant portion of injuries are to head/neck, chest and abdomen. The fatality rate of climbing accidents reported in the literature varies widely. Data on climbing accidents in general are very heterogeneous as they include different subspecialties of this sport and report accidents from different regions. A number of risk factors are accounted for in the literature. Appropriate training, preparation and adherence to safety standards are key in reducing the incidence and severity of climbing accidents. Full article

(This article belongs to the Special Issue Mountain Sports Activities: Injuries and Prevention)

8 pages, 523 KiB

Open AccessArticle

Mortality in Via Ferrata Emergencies in Austria from 2008 to 2018

by Mathias Ströhle, Matthias Haselbacher, Christopher Rugg, Alex Walpoth, Ricarda Konetschny, Peter Paal and Peter Mair

Int. J. Environ. Res. Public Health 2020, 17(1), 103; https://doi.org/10.3390/ijerph17010103 - 22 Dec 2019

Cited by 8 | Viewed by 3858

Abstract

Although the European Alps now have more than 1000 via ferratas, limited data exist on the actual incidence of fatal events in via ferratas and their causes. This retrospective study analysed data from a registry maintained by the Austrian Alpine Safety Board ( [...] Read more.

Although the European Alps now have more than 1000 via ferratas, limited data exist on the actual incidence of fatal events in via ferratas and their causes. This retrospective study analysed data from a registry maintained by the Austrian Alpine Safety Board (n = 161,855, per 11 September 2019). Over a 10-year period from 1 November 2008 to 31 October 2018, all persons involved in a via ferrata-related emergency were included (n = 1684), of which 64% were male. Most emergencies were caused by blockage due to exhaustion and/or misjudgement of the climber’s own abilities. Consequently, more than half of all victims were evacuated uninjured. Only 62 (3.7%) via ferrata-related deaths occurred. Falling while climbing unsecured was the most common cause of death, and males had a 2.5-fold higher risk of dying in a via ferrata accident. The mortality rate was highest in technically easy-to-climb sections (Grade A, 13.2%/B, 4.9%), whereas the need to be rescued uninjured was highest in difficult routes (Grade D, 59.9%/E, 62.7%). Although accidents in via ferratas are common and require significant rescue resources, fatal accidents are rare. The correct use of appropriate equipment in technically easy-to-climb routes can prevent the majority of these fatalities. Full article

(This article belongs to the Special Issue Mountain Sports Activities: Injuries and Prevention)

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13 pages, 310 KiB

Open AccessArticle

Canyoning Accidents in Austria from 2005 to 2018

by Mathias Ströhle, Ina Beeretz, Christopher Rugg, Simon Woyke, Simon Rauch and Peter Paal

Int. J. Environ. Res. Public Health 2020, 17(1), 102; https://doi.org/10.3390/ijerph17010102 - 22 Dec 2019

Cited by 12 | Viewed by 3734

Abstract

Canyoning has become a popular recreational sport. Nevertheless, little is known about injuries or diseases associated with canyoning. The aim of this study was to examine accident causes, injury patterns, out-of-hospital and in-hospital treatment and outcomes. For this purpose, national out-of-hospital data from [...] Read more.

Canyoning has become a popular recreational sport. Nevertheless, little is known about injuries or diseases associated with canyoning. The aim of this study was to examine accident causes, injury patterns, out-of-hospital and in-hospital treatment and outcomes. For this purpose, national out-of-hospital data from the Austrian Alpine Safety Board and regional in-hospital data from Innsbruck Medical University Hospital were analysed for the period from November 1, 2005 to October 31, 2018. Nationally, 471 persons were involved in such accidents; 162 (34.4%) were severely injured, nine of whom died. Jumping (n = 110, 23.4%), rappelling (n = 51, 10.8%), sliding (n = 41, 8.7%) and stumbling (n = 26, 5.5%) were the most common causes of canyoning accidents. A large proportion of injuries were documented for the lower extremities (n = 133, 47.5%), followed by the upper extremities (n = 65, 23.2%) and the spine (n = 44, 15.7%). Death was mainly caused by drowning. Overall mortality was 1.9% (n = 9), and the absolute risk was 0.02 deaths per 1000 hrs of canyoning. Many uninjured persons required evacuation (n = 116, 24.6%), which resulted in a substantial expense and workload for emergency medical services. Increased safety precautions are required to reduce accidents while jumping and rappelling and fatalities caused by drowning. Full article

(This article belongs to the Special Issue Mountain Sports Activities: Injuries and Prevention)

11 pages, 2069 KiB

Open AccessArticle

Prevalence of Falls on Mount Fuji and Associated with Risk Factors: A Questionnaire Survey Study

by Tadashi Uno, Masaya Fujino, Atsushi Ohwaki and Masahiro Horiuchi

Int. J. Environ. Res. Public Health 2019, 16(21), 4234; https://doi.org/10.3390/ijerph16214234 - 31 Oct 2019

Cited by 7 | Viewed by 3129

Abstract

Since little is known about the detailed situations of falls on Mount Fuji, the aim of this study was to clarify the risk factors of falls on Mount Fuji in Japan. We conducted a questionnaire survey of 556 participants who had climbed Mount [...] Read more.

Since little is known about the detailed situations of falls on Mount Fuji, the aim of this study was to clarify the risk factors of falls on Mount Fuji in Japan. We conducted a questionnaire survey of 556 participants who had climbed Mount Fuji and collected the following information: fall situation, mental status, fatigue feeling, sex, age, climbing experience on Mount Fuji and other mountains, summit success, whether staying at a lodge, use of a tour guide, and symptoms of acute mountain sickness. Among the 556 participants, 167 had a fall (30%). Among 167 participants who had experienced a fall, 30 had fallen more than three times (18%). The main cause (>60%) of fall were slips. The most optimal model using multiple logistic regression (no fall = 0, and fall = 1) found eight significant risk factors, including sex, prior climbing experience on Mount Fuji, staying overnight at a lodge, subjective feeling of relaxation, sleepiness, emotional stability, dullness, and eyestrain. These results suggest that females, people who have no prior climbing experience on Mount Fuji, and people who did not stay at a lodge should pay attention to an increased risk of falls on Mount Fuji. Full article

(This article belongs to the Special Issue Mountain Sports Activities: Injuries and Prevention)

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13 pages, 1218 KiB

Open AccessArticle

External Workload Indicators of Muscle and Kidney Mechanical Injury in Endurance Trail Running

by Daniel Rojas-Valverde, Braulio Sánchez-Ureña, José Pino-Ortega, Carlos Gómez-Carmona, Randall Gutiérrez-Vargas, Rafael Timón and Guillermo Olcina

Int. J. Environ. Res. Public Health 2019, 16(20), 3909; https://doi.org/10.3390/ijerph16203909 - 15 Oct 2019

Cited by 45 | Viewed by 4731

Abstract

Muscle and kidney injury in endurance athletes is worrying for health, and its relationship with physical external workload (eWL) needs to be explored. This study aimed to analyze which eWL indexes have more influence on muscle and kidney injury biomarkers. 20 well-trained trail [...] Read more.

Muscle and kidney injury in endurance athletes is worrying for health, and its relationship with physical external workload (eWL) needs to be explored. This study aimed to analyze which eWL indexes have more influence on muscle and kidney injury biomarkers. 20 well-trained trail runners (age = 38.95 ± 9.99 years) ran ~35.27 km (thermal-index = 23.2 ± 1.8 °C, cumulative-ascend = 1815 m) wearing inertial measurement units (IMU) in six different spots (malleolus peroneus [MP_left/MP_right], vastus lateralis [VL_left/VL_right], lumbar [L₁–L₃], thoracic [T₂–T₄]) for eWL measuring using a special suit. Muscle and kidney injury serum biomarkers (creatin-kinase [sCK], creatinine (sCr), ureic-nitrogen (sBUN), albumin [sALB]) were assessed pre-, -post_0h and post_24h. A principal component (PC) analysis was performed in each IMU spot to extract the main variables that could explain eWL variance. After extraction, PC factors were inputted in multiple regression analysis to explain biomarkers delta change percentage (Δ%). sCK, sCr, sBUN, sALB presented large differences (p < 0.05) between measurements (pre < post_24h < post_0h). PC’s explained 77.5–86.5% of total eWL variance. sCK Δ% was predicted in 40 to 47% by L₁–L₃ and MP_left; sCr Δ% in 27% to 45% by L₁–L₃ and MP_left; and sBUN Δ% in 38%-40% by MP_right and MP_left. These findings could lead to a better comprehension of how eWL (impacts, player load and approximated entropy) could predict acute kidney and muscle injury. These findings support the new hypothesis of mechanical kidney injury during trail running based on L₁–L₃ external workload data. Full article

(This article belongs to the Special Issue Mountain Sports Activities: Injuries and Prevention)

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10 pages, 319 KiB

Open AccessArticle

by Martin Niedermeier, Gerhard Ruedl, Martin Burtscher and Martin Kopp

Int. J. Environ. Res. Public Health 2019, 16(20), 3807; https://doi.org/10.3390/ijerph16203807 - 10 Oct 2019

Cited by 11 | Viewed by 3890

Abstract

Behavioral variables might play an important role in explaining the differences in injury rates across winter sport disciplines and injury prevention programs might be more specifically designed based on this knowledge. On ski slopes, alpine skiing, snowboarding, and ski touring are the predominant [...] Read more.

Behavioral variables might play an important role in explaining the differences in injury rates across winter sport disciplines and injury prevention programs might be more specifically designed based on this knowledge. On ski slopes, alpine skiing, snowboarding, and ski touring are the predominant winter sport disciplines. Therefore, the aim of the present study was to investigate possible differences in injury-related behavioral variables between practitioners of these disciplines. Using a matched re-analysis approach of a cross-sectional survey, 414 winter sport participants (alpine skiers, snowboarders, ski tourers, each n = 138) were analyzed on the differences in sensation seeking, treated injuries, and injury-related behavioral variables. Cochran–Mantel–Haenszel and Friedman tests revealed significantly higher sensation seeking, p < 0.001, and a significantly higher percentage of participants reporting to have consumed alcohol in the past five skiing days, p = 0.006, in snowboarders compared to alpine skiers. The participants with treated injuries showed higher sensation seeking, p < 0.050, and a higher percentage of snowboarders, p = 0.020, compared to participants without treated injuries. Injury prevention programs for snowboarders, who remain an important risk group for injury prevention, might benefit from considering a possibly higher percentage of alcohol-consuming participants and from providing information on injury-related risks of sensation seeking. Full article

(This article belongs to the Special Issue Mountain Sports Activities: Injuries and Prevention)

15 pages, 3438 KiB

Open AccessArticle

Leg Dominance as a Risk Factor for Lower-Limb Injuries in Downhill Skiers—A Pilot Study into Possible Mechanisms

by Arunee Promsri, Alessia Longo, Thomas Haid, Aude-Clémence M. Doix and Peter Federolf

Int. J. Environ. Res. Public Health 2019, 16(18), 3399; https://doi.org/10.3390/ijerph16183399 - 13 Sep 2019

Cited by 33 | Viewed by 5169

Abstract

Leg dominance has been reported as one potential risk factor for lower-limb injuries in recreational downhill skiers. The current study proposed and tested two possible mechanisms for a leg dominance effect on skiing injuries—imbalance of the knee muscle strength and bilateral asymmetry in [...] Read more.

Leg dominance has been reported as one potential risk factor for lower-limb injuries in recreational downhill skiers. The current study proposed and tested two possible mechanisms for a leg dominance effect on skiing injuries—imbalance of the knee muscle strength and bilateral asymmetry in sensorimotor control. We hypothesized that the knee muscle strength (Hypothesis 1; H1) or postural control (Hypothesis 2; H2) would be affected by leg dominance. Fifteen well-experienced recreational downhill skiers (aged 24.3 ± 3.2 years) participated in this study. Isometric knee flexor/extensor muscle strength was tested using a dynamometer. Postural control was explored by using a kinematic principal component analysis (PCA) to determine the coordination structure and control of three-dimensional unipedal balancing movements while wearing ski equipment on firm and soft standing surfaces. Only H2 was supported when balancing on the firm surface, revealing that when shifting body weight over the nondominant leg, skiers significantly changed the coordination structure (p < 0.006) and the control (p < 0.004) of the lifted-leg movements. Based on the current findings, bilateral asymmetry in sensorimotor control rather than asymmetry in strength seems a more likely mechanism for the previously reported effect of leg dominance on lower-limb injury risk in recreational downhill skiers. Full article

(This article belongs to the Special Issue Mountain Sports Activities: Injuries and Prevention)

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9 pages, 314 KiB

Open AccessFeature PaperArticle

Are Risk-Taking and Ski Helmet Use Associated with an ACL Injury in Recreational Alpine Skiing?

by Gerhard Ruedl, Markus Posch, Martin Niedermeier, Klaus Greier, Martin Faulhaber, Alois Schranz and Martin Burtscher

Int. J. Environ. Res. Public Health 2019, 16(17), 3107; https://doi.org/10.3390/ijerph16173107 - 26 Aug 2019

Cited by 17 | Viewed by 3893

Abstract

According to the risk compensation hypothesis, the use of a ski helmet might provide a false sense of security, resulting in a riskier behavior by skiing faster or more aggressively, which might lead to an increased injury risk. Injury of the anterior cruciate [...] Read more.

According to the risk compensation hypothesis, the use of a ski helmet might provide a false sense of security, resulting in a riskier behavior by skiing faster or more aggressively, which might lead to an increased injury risk. Injury of the anterior cruciate ligament (ACL) is a common diagnosis in downhill skiers. Thus, the aim of the study was to evaluate the potential impact of risk-taking and ski helmet use on ACL injury risk in recreational skiing. Eighty-two ACL injured and 446 uninjured skiers with a mean age of 37.3 ± 11.9 years (52% females) were surveyed during the winter season 2018/19 about age, sex, self-reported risk-taking behavior, self-reported skill level, perceived speed, and ski helmet use. Multiple regression analysis revealed that older age (OR: 1.3, 95% CI: 1.2–1.4), riskier behavior (OR: 5.4, 95% CI: 2.8–10.5), and lower skill level (OR: 6.7, 95% CI: 3.4–13.3) were found to be factors associated with ACL injury, while ski helmet use was not. In conclusion, no support for the risk compensation hypothesis was found with regard to ACL injuries. Therefore, we doubt that ski helmet use increases the risk for ACL injury and recommend wearing a ski helmet due to reported protective effects. Full article

(This article belongs to the Special Issue Mountain Sports Activities: Injuries and Prevention)

9 pages, 620 KiB

Open AccessArticle

Effects of Visual and Auditory Perturbations on Ski-Specific Balance among Males and Females—A Randomized Crossover Trial

by Martin Niedermeier, Elena Pocecco, Carolin Hildebrandt, Christian Raschner, Peter Federolf, Martin Kopp and Gerhard Ruedl

Int. J. Environ. Res. Public Health 2019, 16(15), 2665; https://doi.org/10.3390/ijerph16152665 - 25 Jul 2019

Cited by 5 | Viewed by 3396

Abstract

Injuries in skiing show sex-specific differences, especially when visual perception is reduced. Reduced visual perception impairs balance, which plays an important role in avoiding skiing injuries. However, males and females might cope differently with reduced visual perception. Thus, the aim of this study [...] Read more.

Injuries in skiing show sex-specific differences, especially when visual perception is reduced. Reduced visual perception impairs balance, which plays an important role in avoiding skiing injuries. However, males and females might cope differently with reduced visual perception. Thus, the aim of this study was to evaluate sex-related effects of environmental perturbations (reduced visual perception and listening to music) on ski-specific balance. Using a crossover design, ski-specific balance was tested in 50 young adults (50% female) in four conditions: with and without listening to music and/or with and without reduced visual perception (ski goggles with occlusion foil). A four × two (condition by sex) mixed ANOVA revealed a significant condition by sex interaction, partial η² = 0.06. Females showed an increase in balance from the condition without music/with normal visual perception to the condition with music/with normal visual perception, while males showed a decrease. Balance was significantly higher in females compared to males, partial η² = 0.31. The findings suggest that balance is affected differently by environmental perturbations in females and males. However, the differences observed were not in line with our initial hypotheses, which might be because the model was too simplistic for how visual/auditory perturbations may affect balance. Full article

(This article belongs to the Special Issue Mountain Sports Activities: Injuries and Prevention)

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14 pages, 316 KiB

Open AccessArticle

An Exploration of Hiking Risk Perception: Dimensions and Antecedent Factors

by Shengxiang She, Yunzhang Tian, Lin Lu, Iveta Eimontaite, Ting Xie and Yan Sun

Int. J. Environ. Res. Public Health 2019, 16(11), 1986; https://doi.org/10.3390/ijerph16111986 - 4 Jun 2019

Cited by 17 | Viewed by 5310

Abstract

Hiking is a form of green tourism which deserves promotion and popularization, especially in present day China. However, the risks inherent in hiking could have a negative impact on the development of hiking tourism. It is important to better understand how people perceive [...] Read more.

Hiking is a form of green tourism which deserves promotion and popularization, especially in present day China. However, the risks inherent in hiking could have a negative impact on the development of hiking tourism. It is important to better understand how people perceive the risks of hiking and what type of experience attributes they prefer. However, no studies have investigated the nature of risk perception from the perspective of hikers. This study explores the dimensions of the perceived risk of hiking and investigates the associated factors of hiking risk perception as well as hiking preference. A questionnaire with 18 items was used to capture people’s perception of hiking risks, and two groups of samples were surveyed. Generally, this study identified two dimensions of perceived risk towards hiking based on a sample of hikers, i.e., physical risk and psychological risk. Demographic variables such as gender, upbringing background, and hiking frequency were shown to predict hiking risk perception while gender and hiking frequency predicted route preference. The personality trait of sensation seeking appeared to be a significant predictor of hiking preference. These findings lend themselves to market segmentation and marketing strategies on hiking tourism. Full article

(This article belongs to the Special Issue Mountain Sports Activities: Injuries and Prevention)

8 pages, 766 KiB

Open AccessArticle

Amputation Risk Factors in Severely Frostbitten Patients

by Anna Carceller, Casimiro Javierre, Martín Ríos and Ginés Viscor

Int. J. Environ. Res. Public Health 2019, 16(8), 1351; https://doi.org/10.3390/ijerph16081351 - 15 Apr 2019

Cited by 18 | Viewed by 4138

Abstract

In recent years, the incidence of frostbite has increased among healthy young adults who practice winter sports (skiing, mountaineering, ice climbing and technical climbing/alpinism) at both the professional and amateur levels. Moreover, given that the population most frequently affected is healthy and active, [...] Read more.

In recent years, the incidence of frostbite has increased among healthy young adults who practice winter sports (skiing, mountaineering, ice climbing and technical climbing/alpinism) at both the professional and amateur levels. Moreover, given that the population most frequently affected is healthy and active, frostbite supposes a substantial interruption of their normal activity and in most cases is associated with long-term sequelae. It particularly has a higher impact when the affected person’s daily activities require exposure to cold environments, as either sports practices or work activities in which low temperatures are a constant (ski patrols, mountain guides, avalanche forecasters, workers in the cold chain, etc.). Clinical experience with humans shows a limited reversibility of injuries via potential tissue regeneration, which can be fostered with optimal medical management. Data were collected from 92 frostbitten patients in order to evaluate factors that represent a risk of amputation after severe frostbite. Mountain range, years of expertise in winter mountaineering, time elapsed before rewarming and especially altitude were the most important factors for a poor prognosis. Full article

(This article belongs to the Special Issue Mountain Sports Activities: Injuries and Prevention)

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Review

Jump to: Editorial, Research

11 pages, 313 KiB

Open AccessReview

Mortality in Different Mountain Sports Activities Primarily Practiced in the Winter Season—A Narrative Review

by Martin Niedermeier, Hannes Gatterer, Elena Pocecco, Anika Frühauf, Martin Faulhaber, Verena Menz, Johannes Burtscher, Markus Posch, Gerhard Ruedl and Martin Burtscher

Int. J. Environ. Res. Public Health 2020, 17(1), 259; https://doi.org/10.3390/ijerph17010259 - 30 Dec 2019

Cited by 36 | Viewed by 4832

Abstract

Annually, millions of people engage in mountain sports activities all over the world. These activities are associated with health benefits, but concurrently with a risk for injury and death. Knowledge on death rates is considered important for the categorization of high-risk sports in [...] Read more.

Annually, millions of people engage in mountain sports activities all over the world. These activities are associated with health benefits, but concurrently with a risk for injury and death. Knowledge on death rates is considered important for the categorization of high-risk sports in literature and for the development of effective preventive measures. The death risk has been reported to vary across different mountain sports primarily practiced in the summer season. To complete the spectrum, the aim of the present review is to compare mortality rates across different mountain sports activities primarily practiced in winter. A comprehensive literature search was performed on the death risk (mortality) during such activities, i.e., alpine (downhill) skiing, snowboarding, cross-country skiing, ski touring, and sledging. With the exception of ski touring (4.4 deaths per 1 million exposure days), the mortality risk was low across different winter sports, with small activity-specific variation (0.3–0.8 deaths per 1 million exposure days). Traumatic (e.g., falls) and non-traumatic (e.g., cardiac death) incidents and avalanche burial in ski tourers were the predominant causes of death. Preventive measures include the improvement of sport-specific skills and fitness, the use of protective gear, well-targeted and intensive training programs concerning avalanche hazards, and sports-medical counseling for elderly and those with pre-existing diseases. Full article

(This article belongs to the Special Issue Mountain Sports Activities: Injuries and Prevention)

13 pages, 327 KiB

Open AccessReview

Mortality in Different Mountain Sports Activities Primarily Practiced in the Summer Season—A Narrative Review

by Hannes Gatterer, Martin Niedermeier, Elena Pocecco, Anika Frühauf, Martin Faulhaber, Verena Menz, Johannes Burtscher, Markus Posch, Gerhard Ruedl and Martin Burtscher

Int. J. Environ. Res. Public Health 2019, 16(20), 3920; https://doi.org/10.3390/ijerph16203920 - 15 Oct 2019

Cited by 25 | Viewed by 6933

Abstract

Millions of people engage in mountain sports activities worldwide. Although leisure-time physical activity is associated with significant health benefits, mountain sports activities also bear an inherent risk for injury and death. However, death risk may vary across various types of mountain sports activities. [...] Read more.

Millions of people engage in mountain sports activities worldwide. Although leisure-time physical activity is associated with significant health benefits, mountain sports activities also bear an inherent risk for injury and death. However, death risk may vary across various types of mountain sports activities. Epidemiological data represent an important basis for the development of preventive measures. Therefore, the aim of this review is to compare mortality rates and potential risk factors across different (summer) mountain sports activities. A comprehensive literature search was performed on the death risk (mortality) in mountain sports, primarily practiced during the summer season, i.e., mountain hiking, mountain biking, paragliding, trekking, rock, ice and high-altitude climbing. It was found that the death risk varies considerably between different summer mountain sports. Mortality during hiking, trekking and biking in the mountains was lower compared to that during paragliding, or during rock, ice or high-altitude climbing. Traumatic deaths were more common in activities primarily performed by young adults, whereas the number of deaths resulting from cardiovascular diseases was higher in activities preferred by the elderly such as hiking and trekking. Preventive efforts must consider the diversity of mountain sports activities including differences in risk factors and practitioners and may more particularly focus on high-risk activities and high-risk individuals. Full article

(This article belongs to the Special Issue Mountain Sports Activities: Injuries and Prevention)

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