INTRODUCTION: Personal mobility devices (PMDs), such as electronic scooters or motorised bicycles, are efficient modes of transportation. Their recent popularity has also resulted in an increase in PMD-related injuries. We aimed to characterise and compare the nature of injuries sustained by PMD users and bicycle riders. METHODS: This retrospective study compared injury patterns among PMD and bicycle users. 140 patients were admitted between November 2013 and September 2018. Parameters studied included patients' demographics (e.g. age, gender and body mass index), type of PMD, nature of injury, surgical intervention required, duration of hospitalisation and time off work. RESULTS: Of 140 patients, 46 (32.9%) patients required treatment at the department of orthopaedic surgery. 19 patients were PMD users while 27 were bicycle riders. 16 (84.2%) patients with PMD-related injuries were men. PMD users were significantly younger (mean age 45 ± 15 years) when compared to bicycle riders (mean age 56 ± 17 years; P <0.05). A quarter (n = 5, 26.3%) of PMD users sustained open fractures and over half (n = 10, 52.6%) required surgical intervention. Among 27 bicycle users, 7.4% (n = 2) of patients sustained open fractures and 70.4% (n = 19) required surgical intervention. Both groups had comparable inpatient stay duration and time off work. CONCLUSION PMD-related orthopaedic traumas are high-energy injuries, with higher rates of open fractures, when compared to bicycle injuries. In addition, PMD users are significantly younger and of economically viable age. Prolonged hospitalisation and time off work have socioeconomic implications. Caution should be exercised when using PMDs.
Male ; Humans ; Adult ; Middle Aged ; Aged ; Female ; Bicycling/injuries* ; Retrospective Studies ; Fractures, Open ; Orthopedics ; Hospitalization ; Accidents, Traffic

INTRODUCTION: Spinning is an indoor stationary cycling programme that can cause severe rhabdomyolysis. We compared the clinical characteristics of spinning-induced exertional rhabdomyolysis (SER) with other exertional rhabdomyolysis (ER) and non-exertional rhabdomyolysis (NER). METHODS: This was a retrospective observational study of adult patients presenting with rhabdomyolysis to an emergency department from August 2018 to August 2019. Patients were classified as SER, ER or NER based on chart review. We compared patient demographics, serum creatine kinase (CK), transaminase and creatinine levels, admission rates, duration of hospitalisation and treatment prescribed. RESULTS: 62 patients were analysed. SER patients were predominantly female (77% vs. 24% vs. 26%, P < 0.01), Chinese (100% vs. 47% vs. 79%, P < 0.01) and younger (mean age 27.7 vs. 34.6 vs. 59.4 years, P < 0.01) than those with ER and NER. The SER group had the highest CK level (20,000 vs. 10,465 vs. 6,007 U/L, P < 0.01) but the lowest mean serum creatinine level (53.5 vs. 80.9 vs. 143.5 μmol/L, P < 0.01) compared to the ER and NER groups. Admission rates were the highest in SER patients (100% vs. 57% vs. 90%, P < 0.01). SER mean inpatient length of stay was longer than ER but shorter than NER patients (4.3 vs. 1.9 vs. 6.0 days, P = 0.02). CONCLUSION SER is a unique form of rhabdomyolysis. Predominantly seen in young, healthy women, it often presents with extremely high CK levels. However, the prognosis is good and the rate of complication is low with fluid treatment.
Adult ; Humans ; Female ; Male ; Creatine Kinase ; Rhabdomyolysis/complications* ; Bicycling ; Hospitalization ; Retrospective Studies

Objective: To explore the effects of bicycle ergometer rehabilitation training on quadriceps and walking ability of patients with lower limb dysfunction caused by extensive burns. Methods: A prospective randomized controlled study was conducted. A total of 40 patients with extensive burns who met the inclusion criteria and were admitted to Tongren Hospital of Wuhan University＆Wuhan Third Hospital from December 2017 to December 2020 were selected. According to the random number table, the patients were divided into conventional training group (16 males, 4 females, aged (45±10) years) and combined training group (13 males, 7 females, aged (39±8) years). Patients in conventional training group were given conventional rehabilitation therapy such as joint loosening, lower limb strength training, walking training, and pressure therapy, while patients in combined training group were given additional bicycle ergometer rehabilitation training on the basis of conventional rehabilitation. For patients in the 2 groups before and after a 2-month's treatment, the thickness of quadriceps was measured by ultrasonic diagnostic instrument, the muscle strength of quadriceps was measured by portable muscle strength tester, the walking ability was tested with a 6-min and a 10-meter walk tests, and the patients' satisfaction for treatment effects was assessed using the modified Likert scale. Data were statistically analyzed with independent or paired sample t test, Mann-Whitney U test, Wilcoxon signed rank test, or chi-square test. Results: After 2-month's treatment, the quadriceps thickness of patients in combined training group was (3.76±0.39) cm, which was significantly thicker than (3.45±0.35) cm in conventional training group (t=2.67, P<0.05); quadriceps thickness of patients in conventional training group and combined training group after 2-month's treatment was significantly thicker than that before treatment (with t values of 5.99 and 8.62, respectively, P<0.01). After 2-month's treatment, the quadriceps muscle strength of patients in combined training group was significantly greater than that in conventional training group (Z=2.69, P<0.01); quadriceps muscle strength of patients in conventional training group and combined training group after 2-month's treatment was significantly greater than that before treatment (with Z values of 3.92 and 3.92, respectively, P<0.01). After 2-month's treatment, the 6-min walking distance of patients in combined training group was (488±39) m, which was significantly longer than (429±25) m in conventional training group (t=5.66, P<0.01); the 6-min walking distance of patients after 2-month's treatment in conventional training group and combined training group was significantly longer than that before treatment (with t values of 13.16 and 17.92, respectively, P<0.01). After 2-month's treatment, the 10-meter walking time of patients in combined training group was significantly shorter than that in conventional training group (t=3.20, P<0.01); and the 10-meter walking time in conventional training group and combined training group was significantly shorter than that before treatment (with t values of 7.21 and 13.13, respectively, P<0.01). The patients' satisfaction score for treatment effects in combined training group was significantly higher than that in conventional training group (Z=3.14, P<0.01), and the patients' satisfaction scores for treatment effects in conventional training group and combined training group after 2-month's treatment were significantly greater than those before treatment (with Z values of 3.98 and 4.04, respectively, P<0.01). Conclusions: Bicycle ergometer rehabilitation training can be used to improve quadriceps thickness, muscle strength, and walking ability of patients with lower limb dysfunction caused by extensive burns. It can also improve the satisfaction of patients with the treatment outcome, and therefore is worthy of promotion.
Bicycling ; Burns/therapy* ; Female ; Humans ; Lower Extremity ; Male ; Prospective Studies ; Quadriceps Muscle ; Treatment Outcome ; Walking

OBJECTIVE: This study examined the epidemiological characteristics of bicycle injuries and the wearing of a helmet. METHODS: A cross-sectional observational study was conducted using the emergency department-based Injury In-depth Surveillance data from 2013 to 2016. The study population consisted of patients related to bicycles of all ages. The variables associated with helmet wearing were sex, age, type of location, activity at injury, alcohol use at injury, and time of injury. Multivariable logistic regression analysis was conducted to estimate the risks of nonuse of helmets. RESULTS: Among the 31,923 eligible patients, 3,304 patients (10.3%) were wearing helmets at the time of the injury. The adjusted logistic regression model showed that females (adjusted odds ratio [aOR], 0.675; 95% confidence interval [CI], 0.614–0.742), teenagers (aOR, 0.265; 95% CI, 0.232–0.302), old age (aOR, 0.378; 95% CI, 0.326–0.438), road except for bicycle lanes (aOR, 0.510; 95% CI, 0.467-0.557), leisure (aOR, 0.290; 95% CI, 0.252–0.334) or vital activity (aOR, 0.188; 95% CI, 0.162–0.218) at injury, alcohol use at injury (aOR, 0.329; 95% CI, 0.253–0.427), night time (aOR, 0.609; 95% CI, 0.560–0.663), and winter (aOR 0.734; 95% CI 0.619–0.872) were significantly associated with the nonuse of helmets. CONCLUSION: This study identified the factors associated with helmet use during bicycle riding. Strategies aimed at increasing the use of bicycle helmets targeting the risk population are needed.
Adolescent ; Bicycling ; Emergencies ; Female ; Head Protective Devices ; Humans ; Leisure Activities ; Logistic Models ; Morinda ; Observational Study ; Odds Ratio

INTRODUCTIONRoad traffic accidents (RTAs) in Singapore involving children were evaluated, with particular focus on the epidemiology, surrounding circumstances and outcomes of these accidents. Key factors associated with worse prognosis were identified. We proposed some measures that may be implemented to reduce the frequency and severity of such accidents.

METHODSThis was a retrospective study of RTAs involving children aged 0-16 years who presented to the Children's Emergency at KK Women's and Children's Hospital, Singapore, from January 2011 to June 2014. Data was obtained from the National Trauma Registry and analysed in tiers based on the Injury Severity Score (ISS).

RESULTSA total of 1,243 accidents were reviewed. RTA victims included motor vehicle passengers (60.4%), pedestrians (28.5%), cyclists (9.9%) and motorcycle pillion riders (1.2%). The disposition of emergency department (ED) patients was consistent with RTA severity. For serious RTAs, pedestrians accounted for 63.6% and 57.7% of Tier 1 (ISS > 15) and Tier 2 (ISS 9-15) presentations, respectively. Overall use of restraints was worryingly low (36.7%). Not restraining increased the risk of serious RTAs by 8.4 times. Young age, high ISS and low Glasgow Coma Scale score predicted a longer duration of intensive care unit stay.

CONCLUSIONThe importance of restraints for motor vehicle passengers or helmets for motorcycle pillion riders and cyclists in reducing morbidity requires emphasis. Suggestions for future prevention and intervention include road safety education, regulation of protective restraints, use of speed enforcement devices and creation of transport policies that minimise kerbside parking.

Accidents, Traffic ; statistics & numerical data ; Adolescent ; Automobiles ; Bicycling ; Child ; Child, Preschool ; Female ; Head Protective Devices ; Humans ; Infant ; Infant, Newborn ; Injury Severity Score ; Male ; Motorcycles ; Pedestrians ; Prognosis ; Registries ; Retrospective Studies ; Severity of Illness Index ; Singapore ; epidemiology ; Wounds and Injuries ; epidemiology

Accidents, Traffic ; statistics & numerical data ; Adolescent ; Age Distribution ; Bicycling ; injuries ; Child ; Child, Preschool ; Cohort Studies ; Emergency Service, Hospital ; statistics & numerical data ; Female ; Follow-Up Studies ; Fracture Fixation ; methods ; statistics & numerical data ; Fractures, Bone ; diagnosis ; epidemiology ; surgery ; Humans ; Injury Severity Score ; Male ; Prevalence ; Radiography ; methods ; Registries ; Retrospective Studies ; Risk Assessment ; Sex Distribution ; Singapore ; epidemiology ; Tomography, X-Ray Computed ; methods ; Trauma Centers ; Treatment Outcome ; Wounds and Injuries ; diagnostic imaging ; epidemiology ; therapy

With the steady rise of health and environmental awareness, the number of bicyclists is increasing. However, there are few epidemiologic studies on bicycling under the influence (BUI). The aim of this study was to determine the prevalence of BUI and the associated risk factors in a representative Korean population. The data of 4,833 adult bicyclists who participated in the Korean National Health and Nutrition Examination Survey (2010–2012) were analyzed. Among the 4,833 participants investigated in this study, 586 (12.1%) had experienced BUI. As participants’ age increased, so did the prevalence of BUI (P < 0.001), with the participants who were aged 60–69 showing the highest prevalence of BUI (19.6%). With regard to BUI and drinking habits, the likelihood of being a heavy or high-risk drinker increased with the frequency of BUI (P < 0.001). In addition, there was a positive relationship between the frequency of BUI and alcohol use disorder identification score level. Finally, those who had previous experiences of BUI were significantly more likely to drive and ride motorcycles under the influence (P < 0.001). In conclusion, the prevalence of BUI was 12.1% and several associated risk factors for BUI were elucidated in this study. The development of specific preventive strategies and educational programs aimed at deterring individuals at a high risk of engaging in BUI is expected to reduce the number of alcohol-related bicycle injuries.
Adult ; Bicycling ; Drinking ; Epidemiologic Studies ; Humans ; Korea* ; Motorcycles ; Nutrition Surveys* ; Prevalence* ; Risk Factors*

To evaluate oxygenation and metabolic state of the non-brainstem stroke patients after the moderate intensity exercise using arterial blood gas analysis (ABGA). Fifty-two stroke patients were recruited. All the subjects were to follow the instructions for the exercise, not suffered cardiopulmonary diseases before, and not diagnosed with brainstem disorders. They were ordered to maintain 70% heart rate of maximal heart rate during exercise and checked blood pressure, pulse rate, respiratory rate (RR), and ABGA before and after the exercise, respectively. O² saturation, PaO², PaCO², O² content, HCO³⁻, pH, and anion gap were compared between the exercise, and those data changes were performed correlation analysis into age and the time after stroke onset. The data comparison was also done into the subgroup of the severity of stroke using National Institutes of Health Stroke Scale (NIHSS). The statistically significant results were observed in the change of O² saturation, PaO², PaCO², O² content, HCO3⁻, pH, and anion gap after the exercise. The decrease of HCO³⁻ and increase of RR were proportional to age, however the data showed no correlation with the NIHSS. These results suggest relatively preserved respiratory compensation mechanism and homeostatic effect to maintain metabolic balance among the non-brainstem stroke patients.
Acid-Base Equilibrium ; Bicycling ; Blood Gas Analysis ; Blood Pressure ; Brain Stem ; Compensation and Redress ; Heart Rate ; Humans ; Hydrogen-Ion Concentration ; National Institutes of Health (U.S.) ; Oxygen ; Oxygen Consumption ; Respiratory Rate ; Stroke*

PURPOSE: This study aimed to evaluate the epidemiology of bicycle injuries in Korea. It analyzed the injury severity of bicycle accidents by making a comparison between accidents that originated from bicycle lanes and accidents that originated in other sites since the inception of the Korea Promoting Bicycle Usage Act in 2011. METHODS: We performed a retrospective study on 23,038 cases from January 2011 to December 2014, utilizing the data from the emergent department-based, in-depth injury surveillance system. The main analysis of death was conducted by a multivariate logistic regression, using SPSS statistics ver. 18.0. We also classified bicycle accidents in accordance with the sites of accident bicycle lane and other sites, accident year, age, gender, injury location, activity, helmet use, and alcohol consumption. RESULTS: The entire study population of 23,038 patients were divided into two groups depending on accident site: 4045 from bicycle lane and 18,993 from other accident sites. According to the analysis, the percentage of accidents involving female was significantly higher in bicycle lane than in other accident sites (75.8% vs. 79.3% p<0.001). The highest bicycle accident occurred alone (77.3%) in bicycle lane and 57% in other accident sites. However, motor vehicle crash was significantly higher in other accident sites than in bicycle lane (32.9% vs. 10.2%). The result from a multivariate logistic regression demonstrates that bicycle lanes significantly decreases the severity of mortality on average (odd ratio, 0.46; 95% confidence interval 0.24-0.91). CONCLUSION: We found that bicycle lanes have a significant impact on decreasing not only general accidents caused by bicycles, but also mortality.
Alcohol Drinking ; Bicycling ; Epidemiology ; Female ; Head Protective Devices ; Humans ; Korea* ; Logistic Models ; Mortality ; Motor Vehicles ; Retrospective Studies

OBJECTIVETo understand the associations of physical activity domains with metabolic syndrome among a middle-aged Chinese population.

METHODSIn all, 3326 professional adults aged 35-64 years from Beijing and Zhejiang province were recruited with a cluster random sampling method. The Global Physical Activity Questionnaire was modified, and the recommended Asia-Pacific cut-offs of waist circumstance were introduced into the criteria for metabolic syndrome from the Adult Treatment Panel III. A binary logistic regression model was applied to examine the association of all physical activity domains with the risk of the syndrome.

RESULTSParticipants who engaged in domestic activity for ⋜1176 MET-min/week had a 41.6% less chance of having metabolic syndrome [odds ratio (OR), 0.584; 95% confidence interval (CI), 0.480-0.710] than those without this activity. In adjusted models, adults who actively commuted for ⋜33 MET-min/week but <528 MET-min/week had a 25% less chance of having the syndrome (OR, 0.750; 95% CI, 0.582-0.966) than those who did not. No interaction was detected between the two domains of activity and the syndrome.

CONCLUSIONThis study highlighted the independently negative association of traffic and house activity with the prevalence of the syndrome in this sample with a generally low level of moderate activity.

Activities of Daily Living ; Adult ; Bicycling ; physiology ; Blood Pressure ; physiology ; Body Mass Index ; Body Size ; China ; Exercise ; physiology ; Humans ; Lipids ; blood ; Logistic Models ; Metabolic Syndrome ; epidemiology ; etiology ; Middle Aged ; Motor Activity ; physiology ; Random Allocation ; Socioeconomic Factors ; Surveys and Questionnaires ; Walking ; physiology