We recruited 918 community-dwelling women to report their physical activity behaviors and any musculoskeletal injuries incurred weekly via a secure Internet webpage. Baseline testing included an orthopedic examination conducted by licensed physical therapists to identify impairments in muscle strength and flexibility and biomechanical/structural abnormalities. A complete orthopedic and musculoskeletal injury history was obtained at baseline and 909 women began reporting data. At the end of data collection (nearly 3 years later), 731 women were still actively reporting physical activity data. More than 95% of the women remaining in the study at the end of data collection had reported =75% of the time. The average participant reported data for 1.89 years. Women were enrolled for nearly 90,000 person-weeks. More than 83,000 weeks of data were actually logged by the participants.
Women reporting a physical activity-related musculoskeletal injury were contacted by telephone within 48-72 hours to confirm the injury and provide a complete description of the injury, including impetus, surrounding characteristics, body part involved, and whether they were treated by a healthcare provider. Those seeing a healthcare provider were asked for contact information so that medical records could be requested. Medical records were requested but were often unavailable or not submitted. A post-study follow-up survey of muscle-strengthening, resistance exercises, and falls history was conducted. 609 of 731 women completed the on-line survey.
Numerous reports have been published in the peer-reviewed literature and presented at national scientific meetings. Importantly, this research provides nearly real-time assessment of physical activity behaviors and concurrent physical activity-related musculoskeletal injuries. Key findings are that the risk of musculoskeletal injury increases for those achieving the USDHHS Physical Activity Guidelines (=150 MVPA-minutes per week). However, the actual financial costs associated with these injuries are typically very small. The nature of the musculoskeletal injuries resulting from physical activity is generally consistent with those occurring as a result of non-physical activity behaviors. The best predictor of subsequent musculoskeletal injury is having a previous musculoskeletal injury. Biomechanical, muscular strength, and flexibility factors are generally unrelated to self-reported physical activity-related musculoskeletal injury.
Healthcare providers can feel comfortable recommending physically active lifestyle behaviors to community-dwelling women, knowing that there is a modest increase in risk of musculoskeletal injury, the actual medical costs are minimal, and that injury is generally unrelated to any specific musculoskeletal abnormality. The actual physical and financial costs associated with being physically active are small compared to the increased quality of life and positive health outcomes associated with a physically active lifestyle.
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