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Exertional compartment syndrome in athletes
Abstracts / Journal of Science and Medicine in Sport 12 (2010) e1–e232
417 Individual, physical–environmental and socio-cultural factors associated with walking to school in Perth primary school children G. Wood 1,∗ , B. Giles-Corti 1 , G. McCormack 2 , K. Van Niel 3 , M. Bulsara 4 , A. Timperio 5 , T. Pikora 4 , V. Learnihan 6 , R. Murray 1 1 Centre for the Built Environment and Health, The University of Western Australia 2 Population Health Intervention Research Centre, University of Calgary 3 School of Earth and Environment, The University of Western Australia 4 School of Population Health, The University of Western Australia 5 Centre for Physical Activity and Nutrition, Deakin University 6 (Formerly) Centre for the Built Environment and Health, The University Of Western Australia
Introduction: Active transport (AT) to school is a potential source of regular moderate-intensity activity and a target for intervention. As most surveys of children’s physical activity (PA) have focused on school or leisure-time, knowledge regarding transport-related PA and it’s determinants is limited. The aim of this study was to investigate individual, physical–environmental and socio-cultural factors associated with walking to school. Methods: The TRavel, Environment and Kids (TREK) project involved a cross-sectional survey of Year 5–7 children and their parents (n = 1480, 56.6% response rate) attending 25 Perth metropolitan public primary schools. GIS was used to develop a child-specific walkability index, which reflected levels of street connectivity and traffic exposure in environments within a 2 km radius of schools. Twelve of the most “walkable” and 13 of the least “walkable” schools agreed to participate. Results: Based on parent reports, the most common method of transport to school undertaken by children (i.e., ≥3 days in a usual week) was by car (boys = 42% and girls = 49%) followed by walking (boys = 24.4% and girls = 31.6%). Only 17% of boys and 7% of girls regularly cycled to school. Although levels of AT to school were low, the majority of boys (57%) reported that they would prefer to cycle while the majority of girls (51%) reported that they would prefer to walk to school. Only 10% of boys and 11% of girls reported being driven to school as their preferred method of travel. Age and weight status of the child was not associated with regular walking to school. Students were significantly more likely to walk to school ≥3 days/week if their school was situated within a “high walkable” neighbourhood compared with a “low walkable” neighbourhood (7.4% difference, p = 0.005). Irrespective of whether or not their child regularly walked to school, the vast majority of par-
e201
ents (= 80%) were fearful that “strangers” might approach, take or hurt their child. Also, parents of children who did not regularly walk to school were significantly more fearful (p < 0.05). Conclusions: The relationships found in this study have a number of important implications for developing effective walk-to-school programs. They highlight the need for a combination of strategies that aim to create safer routes to school, allay parental concerns and educate children about safely navigating their neighbourhoods (particularly in low walkable neighbourhoods). In addition, locating schools in neighbourhoods with connected streets and low exposure to traffic is likely to increase the prevalence of children’s walking to school. doi:10.1016/j.jsams.2009.10.418 Invited 418 Exertional compartment syndrome in athletes ACSP, SPA and SDrA session L. Micheli 1,2 1 Division 2 Harvard
of Sports Medicine, Children’s Hospital Boston Medical School, Boston, Massachusetts
Compartment syndromes are being seen with increased frequency in competitive athletes, particularly those involved in running or impact training. The early literature on this injury was based upon studies military recruits. In this population there was a preponderance of males sustaining this injury. It has been noted that when dealing with the athletic population there appears top be a preponderance of females sustaining this injury. While this injury can occur in the upper extremities as well as the upper and lower legs, studies have suggested that 95% of exertional compartment syndromes occur in the lower leg. While the specific etiology of this condition is not well known, clinically it appears that once this has occurred in an athlete, it does not resolve with relative rest or conservative techniques such as physical therapy. It has been our experience that athletes who have rested as much as 1 year will have resumption of symptoms when they return to sports. Therefore, it appears that once this condition is well established in one or another compartments particularly the lower leg, surgical intervention decompression appears to be the only viable option. We will overview the differential diagnosis of this condition as well as diagnostic techniques for its confirmation. We will then discuss our techniques of treatment for this condition and the outcomes of our own and other interventions in the Orthopaedic literature. doi:10.1016/j.jsams.2009.10.419
417 Individual, physical–environmental and socio-cultural factors associated with walking to school in Perth primary school children G. Wood 1,∗ , B. Giles-Corti 1 , G. McCormack 2 , K. Van Niel 3 , M. Bulsara 4 , A. Timperio 5 , T. Pikora 4 , V. Learnihan 6 , R. Murray 1 1 Centre for the Built Environment and Health, The University of Western Australia 2 Population Health Intervention Research Centre, University of Calgary 3 School of Earth and Environment, The University of Western Australia 4 School of Population Health, The University of Western Australia 5 Centre for Physical Activity and Nutrition, Deakin University 6 (Formerly) Centre for the Built Environment and Health, The University Of Western Australia
Introduction: Active transport (AT) to school is a potential source of regular moderate-intensity activity and a target for intervention. As most surveys of children’s physical activity (PA) have focused on school or leisure-time, knowledge regarding transport-related PA and it’s determinants is limited. The aim of this study was to investigate individual, physical–environmental and socio-cultural factors associated with walking to school. Methods: The TRavel, Environment and Kids (TREK) project involved a cross-sectional survey of Year 5–7 children and their parents (n = 1480, 56.6% response rate) attending 25 Perth metropolitan public primary schools. GIS was used to develop a child-specific walkability index, which reflected levels of street connectivity and traffic exposure in environments within a 2 km radius of schools. Twelve of the most “walkable” and 13 of the least “walkable” schools agreed to participate. Results: Based on parent reports, the most common method of transport to school undertaken by children (i.e., ≥3 days in a usual week) was by car (boys = 42% and girls = 49%) followed by walking (boys = 24.4% and girls = 31.6%). Only 17% of boys and 7% of girls regularly cycled to school. Although levels of AT to school were low, the majority of boys (57%) reported that they would prefer to cycle while the majority of girls (51%) reported that they would prefer to walk to school. Only 10% of boys and 11% of girls reported being driven to school as their preferred method of travel. Age and weight status of the child was not associated with regular walking to school. Students were significantly more likely to walk to school ≥3 days/week if their school was situated within a “high walkable” neighbourhood compared with a “low walkable” neighbourhood (7.4% difference, p = 0.005). Irrespective of whether or not their child regularly walked to school, the vast majority of par-
e201
ents (= 80%) were fearful that “strangers” might approach, take or hurt their child. Also, parents of children who did not regularly walk to school were significantly more fearful (p < 0.05). Conclusions: The relationships found in this study have a number of important implications for developing effective walk-to-school programs. They highlight the need for a combination of strategies that aim to create safer routes to school, allay parental concerns and educate children about safely navigating their neighbourhoods (particularly in low walkable neighbourhoods). In addition, locating schools in neighbourhoods with connected streets and low exposure to traffic is likely to increase the prevalence of children’s walking to school. doi:10.1016/j.jsams.2009.10.418 Invited 418 Exertional compartment syndrome in athletes ACSP, SPA and SDrA session L. Micheli 1,2 1 Division 2 Harvard
of Sports Medicine, Children’s Hospital Boston Medical School, Boston, Massachusetts
Compartment syndromes are being seen with increased frequency in competitive athletes, particularly those involved in running or impact training. The early literature on this injury was based upon studies military recruits. In this population there was a preponderance of males sustaining this injury. It has been noted that when dealing with the athletic population there appears top be a preponderance of females sustaining this injury. While this injury can occur in the upper extremities as well as the upper and lower legs, studies have suggested that 95% of exertional compartment syndromes occur in the lower leg. While the specific etiology of this condition is not well known, clinically it appears that once this has occurred in an athlete, it does not resolve with relative rest or conservative techniques such as physical therapy. It has been our experience that athletes who have rested as much as 1 year will have resumption of symptoms when they return to sports. Therefore, it appears that once this condition is well established in one or another compartments particularly the lower leg, surgical intervention decompression appears to be the only viable option. We will overview the differential diagnosis of this condition as well as diagnostic techniques for its confirmation. We will then discuss our techniques of treatment for this condition and the outcomes of our own and other interventions in the Orthopaedic literature. doi:10.1016/j.jsams.2009.10.419