title: Injury or activity-related pain sustained by a population of at-risk women during a 6-month exercise program.
abstract: BACKGROUND
  Exercise provides numerous cardiovascular (CV) benefits to women; however, identifying women who are likely to sustain musculoskeletal injury or discomfort is important when tailoring exercise activities.
  
  
  OBJECTIVE
  To evaluate factors associated with the incidence of injury in women at risk for CV disease (CVD) during their participation in a structured exercise intervention for primary CVD prevention.
  
  
  METHODS
  Retrospective comparative study.
  
  
  METHODS
  Baseline anthropometric measures, CV efficiency (via standardized submaximal treadmill testing), and questionnaire-based assessments of functional capacity (Duke Activity Status Index [DASI]), daytime sleepiness (Epworth Sleepiness Scale), and depression (9-item Patient Health Questionnaire) were compared between participants sustaining an injury or experiencing persistent pain, regardless of cause, with those reporting no such events.
  
  
  RESULTS
  Of 117 women enrolled in the study, 27 (23%) experienced an injury or activity-related musculoskeletal pain during the program (injured group). Baseline characteristics for the entire group were: age, 57.3 years; weight, 203 lb; body mass index, 34.8 kg/m 2 ; and waist circumference, 39.9 in. Characteristics did not differ significantly between the injured and non-injured groups for baseline demographics (P > 0.05), but obesity incidence (body mass index ≥ 30 kg/m 2 ) was more prevalent in the injured group (P = 0.02). On univariate analysis, 9-item Patient Health Questionnaire depression scores were higher for injured participants (5.6 vs 4.1, P = 0.16) and DASI activity scores were significantly lower for injured participants (31.3 vs 41.0, P = 0.004) despite there being no significant difference in baseline exercise capacity, expressed as metabolic equivalents (8.1 vs 7.5, P = 0.20) between groups. The DASI score was an independent predictor of injury by multivariate analysis (P = 0.0092).
  
  
  CONCLUSIONS
  Women study participants who were injured or experienced activity-related pain during a 6-month structured exercise intervention (injured group) had similar waist measurements, lipid/lipoprotein level profiles, and hemodynamic responses compared with women study participants who were event free (non-injured group); however, injured-group participants were more obese, more depressed, and reported lower functional capacity. Women who have the characteristics of the injured-group participants may be at greater risk for activity-induced injury when participating in exercise-based prevention programs for CV health.
authors.affiliation: Department of Cardiology, Beaumont Health System, Royal Oak, MI 48073, USA.
authors.forename: Scott S
authors.initials: SS
authors.lastname: Billecke
authors.forename: Pamela A
authors.initials: PA
authors.lastname: Marcovitz
authors.forename: Megan
authors.initials: M
authors.lastname: Donnelly
authors.forename: Barry A
authors.initials: BA
authors.lastname: Franklin
mesh_terms: D000203:Activities of Daily Living; D000886:Anthropometry; D001265:Athletic Injuries / Q000453:epidemiology*; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D016009:Chi-Square Distribution; D003863:Depression / Q000453:epidemiology; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000453:epidemiology*; D009765:Obesity / Q000453:epidemiology; D010147:Pain Measurement; D011788:Quality of Life; D012189:Retrospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires