CURRENT CONCEPTS IN ADULTS UPPER EXTREMITY FRACTURES

21452Ugur_TiftikciCurrent_Consept_in_adults.kapak

STRATEGIES FOR PREVENTING TRAUMATIC INJURIES: THE ROLE OF EXERCISE AND SAFETY PROTOCOLS

Cem Önder1 Çiğdem Şentüre Önder2

1Gaziantep Abdulkadir Yüksel State Hospital, Department of Orthopedics and Traumatology, Gaziantep, Türkiye
2Gaziantep City Hospital, Department of Physical Medicine and Rehabilitation, Gaziantep, Türkiye

Önder C, Şentüre Önder Ç. Strategies for Preventing Traumatic Injuries: The Role of Exercise and Safety Protocols. In: Tiftikçi U, Erdoğan E, Ergün C, Güneş Z, editors. Current Concepts in Adults Upper Extremity Fractures. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.401-407.

ABSTRACT

Therapeutic exercises have a great importance in preventing traumatic injuries as they improve strength, endurance, flexibility and proprioception. Strengthening exercises, by using resistance are a major exercise method in preventing traumatic injuries that may occur secondary to muscle, bone and connective tissue weakness, which may occur as a result of aging or various diseases. Thanks to strengthening exercises, the thickness and strength of the ligaments increases, muscles become more hypertrophic via expanding collagen content, the bone tissue undergoes compression and tension, and the cartilage thickness on the articular surface increases, resulting its increment of resistance to trauma. When planning these exercises, areas with potential for injury should be determined in advance, following the concept of prehabilitation. Predetermining areas prone to injury is achieved by knowing the person’s previous injury history and allows strengthening exercises to be designed more accurately. In addition to strengthening exercises, flexibility is also important in preventing injuries. In cases where sufficient joint range of motion is not provided, biomechanical harmony is lost and injuries occur easily due to abnormal stress distribution. To achieve this, different stretching techniques such as ballistic, static and proprioceptive neuromuscular facilitation and therapeutic modalities such as ultrasound can be used. In addition to strengthening exercises and flexibility, improving proprioception has also been identified as an important method. Although proprioception exercises, such as balance board, back and side walking, are designed primarily for the lower extremity, they also indirectly prevent upper extremity injuries due to their fall prevention feature. In addition to exercises, safety precautions are also important in preventing injuries. The frequency of falls, which increases with age, can be reduced by pre-injury measures such as social support, environmental modifications, weight maintenance and correction of impaired vision. Except form elderly, for the working population, it is envisaged that modifications to work stations will be beneficial in preventing workplace accidents, especially those with the potential for upper extremity injuries. Last but not least, it can be said that workplace modifications combined with therapeutic exercises will be more effective in preventing injuries.

Keywords: Exercise; Safety; Occupational health; Environment; Joints; Accidental falls

Referanslar

  1. Hoffman MD, Kreamer WJ, Judelson DA. Therapeutic exercises. In: Delisa JA, Frontera WR (eds). DeLisa's Physical Medicine and Rehabilitation Principles and Practice. 5th ed. Lippincott Williams & Wilkins; 2010;2:1619.
  2. Fleck SJ, Kreamer WJ. Designing Resistance Training Programs. 3rd ed. Champaign, IL: Human Kinetics; 2004.
  3. Stone MH. Connective tissue and bone response to strength training. In: Komi PV, ed. Strength and Power in Sports. The Encyclopedia of Sports Medicine. Oxford: Blackwell; 2003: 343-60. [Crossref]
  4. Zernicke R F, Loitz BJ. Exercise-related adaptations in connective tissue. In: Komi PV, ed. Strength and Power in Sports. The Encyclopedia of Sports Medicine. Oxford: Blackwell; 2003: 96-113. [Crossref]
  5. Tipton CM, Matthes RD, Maynard JA, et al. The influence of pyhsicl activity on ligaments and tendons. Med Sci Sports. 1975;7:165-75. [Crossref]
  6. Staff PH. The effect of physical activity on joints, cartilage, tendons and ligaments. Scand J Soc Med. 1982;29(suppl):59-63.
  7. Hoffman MD, Kreamer WJ, Judelson DA. Therapeutic exercises. In: Delisa JA, Frontera WR (eds). DeLisa's Physical Medicine and Rehabilitation Principles and Practice. 5th ed. Lippincott Williams & Wilkins; 2010;2:1641-3.
  8. Laurent GJ, Sparrow M P, Bates PC, et al. Collagen content and turnover in cardiac and skeletal muscles of the adult fowl Önder, Şentüre Önder Strategies for Preventing Traumatic Injuries: The Role of Exercise and Safety Protocols and the changes during stretch-induced growth. Biochem J. 1978;176:419-27. [Crossref]  [PubMed]  [PMC]
  9. Turto H, Lindy S, Halme J. Protocollagen proline hydroxylase activity in work-induced hypertrophy of rat muscle. Am J Physiol. 1974;226:63-5. [Crossref]  [PubMed]
  10. MacDougal JD. Hypertrophy or hyperplasia. In: Komi PV, ed. Strength and Power in Sports. The Encyclopedia of Sports Medicine. Oxford: Blackwell; 2003: 252-64. [Crossref]
  11. Conroy B P, Kreamer WJ, et al. Adaptive responses of bone to physical activity. Med Exerc Nutr Health. 1992;1:64-74.
  12. Holmdahl DC, Ingelmark RE. Der baud es gelenknorpels unterverschie-denen funktionellen verhaltnissen. Acta Anat. 1948;6:113-6. [Crossref]
  13. Ingelmark BE, Elsholm R. A study on variations in the thickness of the articular cartilage in association with rest and periodical load. Uppsala Lakaretorenings Foxhandlingar. 1948; 53: 61-4.
  14. Hoffman MD, Kreamer WJ, Judelson DA. Therapeutic exercises. In: Delisa JA, Frontera WR (eds). DeLisa's Physical Medicine and Rehabilitation Principles and Practice. 5th ed. Lippincott Williams & Wilkins; 2010;2: 1652-4.
  15. Noonan TJ, Best TM, Seaber AV, et al. Thermal effects on skeletal muscle tensile behavior. Am J Sports Med. 1993;21:517-22. [Crossref]  [PubMed]
  16. Strickler T, Malone T, Garrett WE. The effects of passive warming on muscle injury. Am J Sports Med. 1990;18:141-5. [Crossref]  [PubMed]
  17. Warren CG, Lehmann JF, Koblanski JN. Elongation of rat tatil tendon: effect of load and temperature. Arch Phys Med Rehabil. 1971;52:465-84.
  18. Lehmann J F, Warren CG, Scham SM. Therapeutic heat and cold. Clin Orthop Relat Res. 1974;99:207-45. [Crossref]  [PubMed]
  19. Simons DG, Travell JG, Simons LS. Myofascial Pain and Dysfunction: The Trigger Point Manual. 2nd ed. Baltimore, MD: Williams & Wilkins. 1999.
  20. Tropp H, Ekstrand J, Gillquist J. Stabilometry in functional instability of the ankle and its value in predicting injury. Med Sci Sports Exerc. 1984;16:64-6. [Crossref]  [PubMed]
  21. Barrett DS. Proprioception and function after anterior cruci ate reconstruction. J Bone Joint Surg (Br). 1991;73B:833-7. [Crossref]  [PubMed]
  22. Lach HW, Reed AT, Arfken CL, et al. Falls in elderly: reliability of a classification system. J Am Geriatric Soc. 1991;39:197-202. [Crossref]  [PubMed]
  23. Robbins AS, Rubenstein LZ, Josephson KR, et al. Predictors of falls among elderly people: results of two population-based studies. Arch Intern Med. 1989;149:1628-33. [Crossref]  [PubMed]
  24. Thurmann DJ, Stevens JA, Rao JD. Quality Standards Subcommittee of the American Academy of Neurology. Practice parameter: assessing patients in a neurology practice for risk of falls (an evidencebased review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2008;70:473-9. [Crossref]  [PubMed]
  25. Wolfson LI, Katzman R. The neurologic consultation at age80. In: Katzman R, Terry RD, eds. The Neurology of Aging. Philedelphia, PA: FA Davis; 1983:221-44.
  26. Tinetti ME. Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc. 1986;34:119-26. [Crossref]  [PubMed]
  27. King MB, Tinetti ME. Falls in community-dwelling older persons. J Am Geriatr Soc. 1995;43:1146-54. [Crossref]  [PubMed]
  28. Lipsitz L. An 85-year old woman with a history of falls. JAMA. 1996;276:59-66. [Crossref]  [PubMed]
  29. Studenski S, Duncan PW, Chandler J, et al. Predicting falls: the role of mobility and nonphysical factors. J Am Geriatr Soc. 1994;42:297-302. [Crossref]  [PubMed]
  30. Cummings SR, Nevitt MC, Browner WS, et al. Risk factors for hip fracture in white women. N Engl J Med. 1995;332:767-73. [Crossref]  [PubMed]
  31. Tinetti ME, Baker DI, McAvay G, et al. A multifactorial intervention to reduce the risk of falling among elderly people living in the community. N Engl J Med. 1994;331:821-7. [Crossref]  [PubMed]
  32. Oakley A, Dawson M F, Holland J, et al. Preventing falls and subsequent injury in older people. Qual Health Care. 1996;5:243-9. [Crossref]  [PubMed]  [PMC]
  33. Gillespie LD, Gillespie WJ, Robertson MC, et al. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2009;(2):CD007146. [Crossref]
  34. Tinetti ME. Clinical practice. Preventing falls in elderly persons. N Engl J Med. 2003;348:42-9. [Crossref]  [PubMed]
  35. Tinetti ME, Richman D, Powell L. Falls efficacy as a measure of fear of falling. J Gerontol. 1990;45:239-43. [Crossref]  [PubMed]
  36. Lawrence RH, Tennstedt SL, Kasten LE, et al. Intensity and correlates of fear of falling and hurting oneself in the next year: baseline findings from a Roybal Center fear of falling intervention. J Aging Health. 1998;10:267-86. [Crossref]  [PubMed]
  37. Van Eerd D, Munhall C, Irvin E, et al. Effectiveness of workplace interventions in the prevention of upper extremity musculoskeletal disorders and symptoms: an update of the evidence. Occup Environ Med. 2016;73:62-70. [Crossref]  [PubMed]  [PMC]