title: Gymnastic Formation-related Injury to Children in Physical Education.
abstract: OBJECTIVE
  Current data indicate that the rate of trauma in children during gymnastic formation is increasing, especially while creating a structure with a certain height, such as the human pyramid. The goal of the present study was to clarify the clinical characteristics of these injuries.
  
  
  METHODS
  In this single-institution review, all children treated for a gymnastic formation-related injury at Nippon Medical School Hospital from 2013 through 2015 were identified through the institution's registry. The injury mechanism was classified, and injury severity, interventions, and outcome were examined.
  
  
  RESULTS
  Eight children were treated for a gymnastic formation-related injury. They were 7 boys and 1 girl aged 10 to 15 years (mean age, 13.1±1.8 years). Neurotrauma ranging from concussion to spinal cord injury without radiographic abnormality occurred in 6 patients (75%). No intracranial hemorrhagic lesions were detected. The Glasgow Coma Scale score on arrival was 15 in all 8 patients, and neurological deficits were present in 1 patient. No patient required surgical intervention. All patients made a full recovery after discharge from the hospital. No patients died. The average follow-up period was 2.1±0.9 weeks.
  
  
  CONCLUSIONS
  Neurotrauma is a frequent result of gymnastic formation accidents in children. Healthcare workers and teachers should recognize this type of injury, and public education that targets parents should be introduced.
authors.affiliation: Department of General Medicine and Health Science, Nippon Medical School Hospital.
authors.forename: Takashi
authors.initials: T
authors.lastname: Araki
authors.forename: Masato
authors.initials: M
authors.lastname: Miyauchi
authors.forename: Makoto
authors.initials: M
authors.lastname: Suzaki
authors.forename: Taro
authors.initials: T
authors.lastname: Wakakuri
authors.forename: Sonoko
authors.initials: S
authors.lastname: Kirinoki
authors.forename: Naoko
authors.initials: N
authors.lastname: Onodera
authors.forename: Taro
authors.initials: T
authors.lastname: Saigusa
authors.forename: Akihiro
authors.initials: A
authors.lastname: Takana
authors.forename: Hideya
authors.initials: H
authors.lastname: Hyodo
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Ohara
authors.forename: Makoto
authors.initials: M
authors.lastname: Kawai
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yasutake
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yokota
mesh_terms: D000293:Adolescent; D001924:Brain Concussion / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D002648:Child; D005260:Female; D050723:Fractures, Bone / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D015600:Glasgow Coma Scale / Q000706:statistics & numerical data; D006173:Gymnastics / Q000293:injuries*; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D010806:Physical Education and Training / Q000379:methods / Q000706:statistics & numerical data*; D012042:Registries / Q000706:statistics & numerical data; D013119:Spinal Cord Injuries / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D016896:Treatment Outcome