Étude d’efficacité des techniques de retrait d’équipements sportifs chez des joueurs de football lors de traumatismes vertébraux suspectés en contexte préhospitalier
Purpose: Current recommendations for sports first responder management of football players with suspected spinal injuries, support the removal of the helmet and shoulder pad combination by performing spinal motion restriction (SMR) before any mobilizations and transfers. However, current removal techniques are poorly documented and their ability to reduce the risk of further injury is undervalued. Objectives: (i) Determine the effect of athlete weight on the effectiveness of SMR application during the removal of sports equipment; (ii) Evaluate and compare the effectiveness of applying SMR using different sports equipment removal techniques; and (iii) Assess the impact of sports first responder expertise and experience on the effectiveness of using SMR to remove sports equipment. Methodology: A descriptive observational study without hypothesis was conducted. Fifty- six (n= 56) sports first responders were recruited according to 2 groups (25 students and 31 certified therapists with experience). Four removal scenarios combining a helmet removal technique (Antero-Posterior Stabilization -AP or Medio-Lateral Stabilization-ML) and a shoulder pad removal technique (Lateral Removal -RL or Posterior Removal -RP) were performed five times, by each participant, with 2 categories of simulated patients (small versus large). The effectiveness of SMR application during the performed trials was quantified as the scenario execution time and the global range of motion for head to trunk. The proposed effectiveness was measured by inertial measurement units (Xsens, MTX) which were positioned on the head and torso of simulated patients. An amplitude of motion <10 degrees were judged to be a successful application of SMR. Results: Our results show that the weight of the athlete does not affect the efficiency of SMR application during device removal, regardless of the used technique. In addition, effectiveness varies slightly for SMR applications according to the removal techniques. The combination of helmet removal with medio-lateral stabilization and lateral shoulder pad removal (ML+RL) demonstrated the best performance in providing the smallest observed degree of movement and the shortest execution time. In contrast, the success rate in the application of SMR during the total trials was relatively small (23.5% of the trials performed achieved successful removal with a degree of movement under 10°) with an overall success rate among certified therapists than students (30% versus 19%). Conclusion: The ML+RL combination could potentially be a reference technique for the management of football athletes with suspected spinal injuries in the prehospital setting. Regardless of the implemented technique, our outcomes on the success rate in applying SMR may suggest that practice of these techniques by sports first responder is necessary to attain a high level of effectiveness.
Football, Lésion médullaire traumatique, IMUs, Technique de retrait sécuritaire, Prise en charge, Efficacité, Simulation médicale, Traumatic spinal cord injury, Safe removal technique, Management, Effectiveness, Medical simulation
Networked Digital Library of Theses and Dissertations