human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Military service in Finl and is compulsory for all male citizens and annually about 80 % of 19-year-old men enter into the service . The elevated risk for many chronic diseases and loss of function among those who are inactive and unfit can be often detected already in youth . On the other h and , activity-induced injuries among young are true public health issue . The purpose of the present prospect i ve cohort follow-up study was to evaluate predictive associations between acute or overuse injuries and their various intrinsic risk factors . Methods Four successive cohorts of conscripts who formed a representative sample of Finnish young men were followed for 6 months . At the beginning of the service , the risk factors of injuries were measured and recorded and then the acute and overuse injuries treated at the garrison clinic were identified . Predictive associations between injuries and their risk factors were examined by multivariate Cox ’s proportional hazard models . Results Of the 1411 participants , 27 % sustained an acute injury and 51 % suffered from overuse injury . Concerning acute injuries , highest risk for severe injuries were detected among conscripts with low fitness level in both the st and ing long-jump and push-up tests ( hazard rate , HR=5.9 ; 95 % CI : 1.6‒21.3 ) . A history of good degree in school sports was not a protective factor against acute injuries . High waist circumference and , on the other h and , being underweight according to BMI increased the HR for overuse injuries . Brisk leisure time physical activity before military entry was a protective factor against overuse injuries . Poor result in Cooper ’s test was a warning signal of elevated risk of overuse injuries . Conclusion We confirmed previous findings that low level of physical fitness is predictor for musculoskeletal injuries during intensive physical training . The U-shaped relationship between body composition and overuse injuries was noticed indicating that both obesity and underweight are risk factors for overuse injuries . Persons with excellent sports skills according to their earlier degrees in school sports had similar HR for acute injuries than those with poorer degrees . This indicates that school-age sports skills and fitness do not carry far and therefore preventive programmes are needed to prevent activity-induced injuries This prospect i ve study was conducted to determine whether hip muscle strength and flexibility play a role in the incidence of adductor and hip flexor strains in National Hockey League ice hockey team players .  Hip flexion , abduction , and adduction strength were measured in 81 players before two consecutive seasons . Thirty-four players were cut , traded , or sent to the minor league before the beginning of the season . Injury and individual exposure data were recorded for the remaining 47 players . Eight players experienced 11 adductor muscle strains , and there were 4 hip flexor strains . Preseason hip adduction strength was 18 % lower in the players who subsequently sustained an adductor muscle strain compared with that of uninjured players . Adduction strength was 95 % of abduction strength in the uninjured players but only 78 % of abduction strength in the injured players . Preseason hip adductor flexibility was not different between players who sustained adductor muscle strains and those who did not . These results indicate that preseason hip strength testing of professional ice hockey players can identify players at risk of developing adductor muscle strains . A player was 17 times more likely to sustain an adductor muscle strain if his adductor strength was less than 80 % of his abductor strength BACKGROUND This study examined whether assigning running shoes based on the shape of the bottom of the foot ( plantar surface ) influenced injury risk in Air Force Basic Military Training ( BMT ) and examined risk factors for injury in BMT . METHODS Data were collected from  BMT recruits during 2007 ; analysis took place during 2008 . After foot examinations , recruits were r and omly consigned to either an  experimental group ( E , n=1042 men , 375 women ) or a control group ( C , n=913 men , 346 women ) . Experimental group recruits were assigned motion control , stability , or cushioned shoes for plantar shapes indicative of low , medium , or high arches , respectively . Control group recruits received a stability shoe regardless of plantar shape .  Injuries during BMT were determined from outpatient visits provided from the Defense Medical Surveillance System . Other injury risk factors ( fitness , smoking , physical activity , prior injury , menstrual history , and demographics ) were obtained from a question naire , existing data bases , or BMT units . RESULTS Multivariate Cox regression controlling for other risk factors showed little difference in injury risk between the groups among men ( hazard ratio [E/C]=1.11 , 95 % CI=0.89 - 1.38 ) or women ( hazard ratio [E/C]=1.20 , 95 % CI= 0.90 - 1.60 ) . Independent injury risk factors among both men and women included low aerobic fitness and cigarette smoking . CONCLUSIONS This prospect i ve study demonstrated that assigning running shoes based on the shape of the plantar surface had little influence on injury risk in BMT even after controlling for other injury risk factors Background : Hamstring injuries are common in sprinters . Identifying preseason risk factors is essential to target injury-prone athletes and develop injury preventive measures . Objective : To investigate the incidence of hamstring muscle injury in sprinters over an athletic season and to explore the preseason predictor of this injury . Design : Prospect i ve cohort study . Participants : 44 sprinters from the Hong Kong Sports Institute , the Hong Kong Amateur Athletic Association and intercollegiate athletic teams were recruited . Methods : Preseason assessment of hamstring flexibility , concentric and eccentric isokinetic peak torque and peak torque angle were obtained at the beginning of an athletic season . The athletes were followed over 12 months and were asked to report all injuries result ing from training and competition . Results : Eight athletes sustained hamstring injuries over the season . The injury rate was 0.87 per 1000 h of exposure . The incidence of injuries was higher at the beginning of the season , with 58.3 % injuries occurring in the first 100 h of exposure . Cox regression analysis revealed that athletes with a decrease in the hamstring : quadriceps peak torque ratio of less than 0.60 at an angular velocity of 180 ° /s have a 17-fold increased risk of hamstring injury . Conclusion : Performing preseason hamstring : quadriceps peak torque ratio assessment s may be useful to identify sprinters susceptible to hamstring injury Physical training-related injuries are common among army recruits and other vigorously active population s , but little is known about their causation . To identify intrinsic risk factors , we prospect ively measured 391 army trainees . For 8 weeks of basic training , 124 men and 186 women ( 79.3 % ) were studied . They answered question naires on past activities and sports participa tion , and were measured for height , weight , and body fat percentage ; 71 % of the subjects took an initial army physical training test . Women had a significantly higher incidence of time-loss injuries than men , 44.6 % com pared with 29.0 % . During training , more time-loss in juries occurred among the 50 % of the men who were slower on the mile run , 29.0 % versus 0.0 % . Slower women were likewise at greater risk than faster ones , 38.2 % versus 18.5 % . Men with histories of inactivity and with higher body mass index were at greater injury risk than other men , as were the shortest women . We conclude that female gender and low aerobic fitness measured by run times are risk factors for training injuries in army trainees , and that other factors such as prior activity levels and stature may affect men and women differently Background A one-year prospect i ve examination of injury rates and injury risk factors was conducted in Federal Bureau of Investigation ( FBI ) new agent training . Methods Injury incidents were obtained from medical records and injury compensation forms . Potential injury risk factors were acquired from a lifestyle question naire and existing data at the FBI Academy . Results A total of 426 men and 105 women participated in the project . Thirty-five percent of men and 42 % of women experienced one or more injuries during training . The injury incidence rate was 2.5 and 3.2 injuries/1,000 person-days for men and women , respectively ( risk ratio ( women/men ) = 1.3 , 95 % confidence interval = 0.9 - 1.7 ) . The activities most commonly associated with injuries ( % of total ) were defensive tactics training ( 58 % ) , physical fitness training ( 20 % ) , physical fitness testing ( 5 % ) , and firearms training ( 3 % ) . Among the men , higher injury risk was associated with older age , slower 300-meter sprint time , slower 1.5-mile run time , lower total points on the physical fitness test ( PFT ) , lower self-rated physical activity , lower frequency of aerobic exercise , a prior upper or lower limb injury , and prior foot or knee pain that limited activity . Among the women higher injury risk was associated with slower 300-meter sprint time , slower 1.5-mile run time , lower total points on the PFT , and prior back pain that limited activity . Conclusion The results of this investigation supported those of a previous retrospective investigation emphasizing that lower fitness and self-reported pain limiting activity were associated with higher injury risk among FBI new agents Background : Injuries in collegiate ice hockey can result in significant time lost from play . The identification of modifiable risk factors relating to a player ’s physical fitness allows the development of focused training and injury prevention programs targeted at reducing these risks . Purpose : To determine the ability of preseason fitness outcomes to predict in-season on-ice injury in male collegiate ice hockey players . Study Design : Prognostic cohort study . Level of Evidence : Level 3 . Methods : Athlete demographics , percentage body fat , aerobic capacity ( 300-m shuttle run ; 1- , 1.5- , 5-mile run ) , and strength assessment ( sit-ups , push-ups , grip strength , bench press , Olympic cleans , squats ) data were collected at the beginning of 8 successive seasons for 1 male collegiate ice hockey team . Hockey-related injury data and player-level practice /game athlete exposure ( AE ) data were also prospect ively collected . Seventy-nine players participated ( 203 player-years ) . Injury was defined as any event that result ed in the athlete being unable to participate in 1 or more practice s or games following the event . Multivariable logistic regression was performed to determine the ability of the independent variables to predict the occurrence of on-ice injury . Results : There were 132 injuries ( mean , 16.5 per year ) in 55 athletes . The overall injury rate was 4.4 injuries per 1000 AEs . Forwards suffered 68 % of the injuries . Seventy percent of injuries occurred during games with equal distribution between the 3 periods . The mean number of days lost due to injury was 7.8 ± 13.8 ( range , 1 - 127 days ) . The most common mechanism of injury was contact with another player ( 54 % ) . The odds of injury in a forward was 1.9 times ( 95 % CI , 1.1 - 3.4 ) that of a defenseman and 3 times ( 95 % CI , 1.2 - 7.7 ) that of a goal ie . The odds of injury if the player ’s body mass index ( BMI ) was ≥25 kg/m2 was 2.1 times ( 95 % CI , 1.1 - 3.8 ) that of a player with a BMI < 25 kg/m2 . The odds ratios for bench press , maximum sit-ups , and Olympic cleans were statistically significant but close to 1.0 , and therefore the clinical relevance is unknown . Conclusion : Forwards have higher odds of injury relative to other player positions . BMI was predictive of on-ice injury . Aerobic fitness and maximum strength outcomes were not strongly predictive of on-ice injury Reliable data on the impact of physical training on light infantry units in terms of injuries and time loss are sparse . This study evaluated a light infantry unit ( n = 181 ) prospect ively and followed it throughout one year of infantry training and operations . Fifty-five percent of the soldiers ( n = 101 ) experienced one or more injuries . Eighty-eight percent of the injuries were training-related conditions , which result ed in 1,103 days of limited duty . Lower extremity overuse injuries were the most common type of injury documented . Fractures accounted for the greatest number of days of limited duty . Risk factors for training-related injuries identified by this study were cigarette smoking , high percentage of body fat , extremely high or low body mass index , low endurance levels , and low muscular endurance levels ( sit-ups ) . Logistic regression showed that cigarette smoking and low endurance levels were independent risk factors for training injuries . These data indicate that the incidence of training-related injuries in infantry units is high . A number of modifiable injury risk factors were identified , suggesting that many of these injuries may be preventable PURPOSE This study aim ed to prospect ively analyze the role of factors on the contralateral side of the kinetic chain in the development of exertional medial tibial pain ( EMTP ) . METHODS Eighty-one female physical education students were tested at the beginning of their first academic year . Within the testing protocol , contralateral isokinetic hip muscle strength and full-body kinematic parameters during a single-leg drop jump were evaluated . Online question naires were administered weekly , and personal interviews were conducted every 3 months to assess injury follow-up . EMTP was diagnosed by an experienced medical doctor . Cox regression analysis was used to identify the potential risk factors for the development of EMTP . RESULTS After exclusion of subjects with diagnosed bilateral EMTP , 11 subjects were included in the EMTP group . Fifty-three subjects did not develop any lower extremity overuse injury and were included in the control group . The leg not at risk within subjects who developed EMTP was compared with an 
    Output:
    
agent
Future studies should also consider measures of ME and MS as a function of upper body , lower body , and core strength , and their potential association with specific , rather than general ,
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Military service in Finl and is compulsory for all male citizens and annually about 80 % of 19-year-old men enter into the service . The elevated risk for many chronic diseases and loss of function among those who are inactive and unfit can be often detected already in youth . On the other h and , activity-induced injuries among young are true public health issue . The purpose of the present prospect i ve cohort follow-up study was to evaluate predictive associations between acute or overuse injuries and their various intrinsic risk factors . Methods Four successive cohorts of conscripts who formed a representative sample of Finnish young men were followed for 6 months . At the beginning of the service , the risk factors of injuries were measured and recorded and then the acute and overuse injuries treated at the garrison clinic were identified . Predictive associations between injuries and their risk factors were examined by multivariate Cox ’s proportional hazard models . Results Of the 1411 participants , 27 % sustained an acute injury and 51 % suffered from overuse injury . Concerning acute injuries , highest risk for severe injuries were detected among conscripts with low fitness level in both the st and ing long-jump and push-up tests ( hazard rate , HR=5.9 ; 95 % CI : 1.6‒21.3 ) . A history of good degree in school sports was not a protective factor against acute injuries . High waist circumference and , on the other h and , being underweight according to BMI increased the HR for overuse injuries . Brisk leisure time physical activity before military entry was a protective factor against overuse injuries . Poor result in Cooper ’s test was a warning signal of elevated risk of overuse injuries . Conclusion We confirmed previous findings that low level of physical fitness is predictor for musculoskeletal injuries during intensive physical training . The U-shaped relationship between body composition and overuse injuries was noticed indicating that both obesity and underweight are risk factors for overuse injuries . Persons with excellent sports skills according to their earlier degrees in school sports had similar HR for acute injuries than those with poorer degrees . This indicates that school-age sports skills and fitness do not carry far and therefore preventive programmes are needed to prevent activity-induced injuries This prospect i ve study was conducted to determine whether hip muscle strength and flexibility play a role in the incidence of adductor and hip flexor strains in National Hockey League ice hockey team players .  Hip flexion , abduction , and adduction strength were measured in 81 players before two consecutive seasons . Thirty-four players were cut , traded , or sent to the minor league before the beginning of the season . Injury and individual exposure data were recorded for the remaining 47 players . Eight players experienced 11 adductor muscle strains , and there were 4 hip flexor strains . Preseason hip adduction strength was 18 % lower in the players who subsequently sustained an adductor muscle strain compared with that of uninjured players . Adduction strength was 95 % of abduction strength in the uninjured players but only 78 % of abduction strength in the injured players . Preseason hip adductor flexibility was not different between players who sustained adductor muscle strains and those who did not . These results indicate that preseason hip strength testing of professional ice hockey players can identify players at risk of developing adductor muscle strains . A player was 17 times more likely to sustain an adductor muscle strain if his adductor strength was less than 80 % of his abductor strength BACKGROUND This study examined whether assigning running shoes based on the shape of the bottom of the foot ( plantar surface ) influenced injury risk in Air Force Basic Military Training ( BMT ) and examined risk factors for injury in BMT . METHODS Data were collected from  BMT recruits during 2007 ; analysis took place during 2008 . After foot examinations , recruits were r and omly consigned to either an  experimental group ( E , n=1042 men , 375 women ) or a control group ( C , n=913 men , 346 women ) . Experimental group recruits were assigned motion control , stability , or cushioned shoes for plantar shapes indicative of low , medium , or high arches , respectively . Control group recruits received a stability shoe regardless of plantar shape .  Injuries during BMT were determined from outpatient visits provided from the Defense Medical Surveillance System . Other injury risk factors ( fitness , smoking , physical activity , prior injury , menstrual history , and demographics ) were obtained from a question naire , existing data bases , or BMT units . RESULTS Multivariate Cox regression controlling for other risk factors showed little difference in injury risk between the groups among men ( hazard ratio [E/C]=1.11 , 95 % CI=0.89 - 1.38 ) or women ( hazard ratio [E/C]=1.20 , 95 % CI= 0.90 - 1.60 ) . Independent injury risk factors among both men and women included low aerobic fitness and cigarette smoking . CONCLUSIONS This prospect i ve study demonstrated that assigning running shoes based on the shape of the plantar surface had little influence on injury risk in BMT even after controlling for other injury risk factors Background : Hamstring injuries are common in sprinters . Identifying preseason risk factors is essential to target injury-prone athletes and develop injury preventive measures . Objective : To investigate the incidence of hamstring muscle injury in sprinters over an athletic season and to explore the preseason predictor of this injury . Design : Prospect i ve cohort study . Participants : 44 sprinters from the Hong Kong Sports Institute , the Hong Kong Amateur Athletic Association and intercollegiate athletic teams were recruited . Methods : Preseason assessment of hamstring flexibility , concentric and eccentric isokinetic peak torque and peak torque angle were obtained at the beginning of an athletic season . The athletes were followed over 12 months and were asked to report all injuries result ing from training and competition . Results : Eight athletes sustained hamstring injuries over the season . The injury rate was 0.87 per 1000 h of exposure . The incidence of injuries was higher at the beginning of the season , with 58.3 % injuries occurring in the first 100 h of exposure . Cox regression analysis revealed that athletes with a decrease in the hamstring : quadriceps peak torque ratio of less than 0.60 at an angular velocity of 180 ° /s have a 17-fold increased risk of hamstring injury . Conclusion : Performing preseason hamstring : quadriceps peak torque ratio assessment s may be useful to identify sprinters susceptible to hamstring injury Physical training-related injuries are common among army recruits and other vigorously active population s , but little is known about their causation . To identify intrinsic risk factors , we prospect ively measured 391 army trainees . For 8 weeks of basic training , 124 men and 186 women ( 79.3 % ) were studied . They answered question naires on past activities and sports participa tion , and were measured for height , weight , and body fat percentage ; 71 % of the subjects took an initial army physical training test . Women had a significantly higher incidence of time-loss injuries than men , 44.6 % com pared with 29.0 % . During training , more time-loss in juries occurred among the 50 % of the men who were slower on the mile run , 29.0 % versus 0.0 % . Slower women were likewise at greater risk than faster ones , 38.2 % versus 18.5 % . Men with histories of inactivity and with higher body mass index were at greater injury risk than other men , as were the shortest women . We conclude that female gender and low aerobic fitness measured by run times are risk factors for training injuries in army trainees , and that other factors such as prior activity levels and stature may affect men and women differently Background A one-year prospect i ve examination of injury rates and injury risk factors was conducted in Federal Bureau of Investigation ( FBI ) new agent training . Methods Injury incidents were obtained from medical records and injury compensation forms . Potential injury risk factors were acquired from a lifestyle question naire and existing data at the FBI Academy . Results A total of 426 men and 105 women participated in the project . Thirty-five percent of men and 42 % of women experienced one or more injuries during training . The injury incidence rate was 2.5 and 3.2 injuries/1,000 person-days for men and women , respectively ( risk ratio ( women/men ) = 1.3 , 95 % confidence interval = 0.9 - 1.7 ) . The activities most commonly associated with injuries ( % of total ) were defensive tactics training ( 58 % ) , physical fitness training ( 20 % ) , physical fitness testing ( 5 % ) , and firearms training ( 3 % ) . Among the men , higher injury risk was associated with older age , slower 300-meter sprint time , slower 1.5-mile run time , lower total points on the physical fitness test ( PFT ) , lower self-rated physical activity , lower frequency of aerobic exercise , a prior upper or lower limb injury , and prior foot or knee pain that limited activity . Among the women higher injury risk was associated with slower 300-meter sprint time , slower 1.5-mile run time , lower total points on the PFT , and prior back pain that limited activity . Conclusion The results of this investigation supported those of a previous retrospective investigation emphasizing that lower fitness and self-reported pain limiting activity were associated with higher injury risk among FBI new agents Background : Injuries in collegiate ice hockey can result in significant time lost from play . The identification of modifiable risk factors relating to a player ’s physical fitness allows the development of focused training and injury prevention programs targeted at reducing these risks . Purpose : To determine the ability of preseason fitness outcomes to predict in-season on-ice injury in male collegiate ice hockey players . Study Design : Prognostic cohort study . Level of Evidence : Level 3 . Methods : Athlete demographics , percentage body fat , aerobic capacity ( 300-m shuttle run ; 1- , 1.5- , 5-mile run ) , and strength assessment ( sit-ups , push-ups , grip strength , bench press , Olympic cleans , squats ) data were collected at the beginning of 8 successive seasons for 1 male collegiate ice hockey team . Hockey-related injury data and player-level practice /game athlete exposure ( AE ) data were also prospect ively collected . Seventy-nine players participated ( 203 player-years ) . Injury was defined as any event that result ed in the athlete being unable to participate in 1 or more practice s or games following the event . Multivariable logistic regression was performed to determine the ability of the independent variables to predict the occurrence of on-ice injury . Results : There were 132 injuries ( mean , 16.5 per year ) in 55 athletes . The overall injury rate was 4.4 injuries per 1000 AEs . Forwards suffered 68 % of the injuries . Seventy percent of injuries occurred during games with equal distribution between the 3 periods . The mean number of days lost due to injury was 7.8 ± 13.8 ( range , 1 - 127 days ) . The most common mechanism of injury was contact with another player ( 54 % ) . The odds of injury in a forward was 1.9 times ( 95 % CI , 1.1 - 3.4 ) that of a defenseman and 3 times ( 95 % CI , 1.2 - 7.7 ) that of a goal ie . The odds of injury if the player ’s body mass index ( BMI ) was ≥25 kg/m2 was 2.1 times ( 95 % CI , 1.1 - 3.8 ) that of a player with a BMI < 25 kg/m2 . The odds ratios for bench press , maximum sit-ups , and Olympic cleans were statistically significant but close to 1.0 , and therefore the clinical relevance is unknown . Conclusion : Forwards have higher odds of injury relative to other player positions . BMI was predictive of on-ice injury . Aerobic fitness and maximum strength outcomes were not strongly predictive of on-ice injury Reliable data on the impact of physical training on light infantry units in terms of injuries and time loss are sparse . This study evaluated a light infantry unit ( n = 181 ) prospect ively and followed it throughout one year of infantry training and operations . Fifty-five percent of the soldiers ( n = 101 ) experienced one or more injuries . Eighty-eight percent of the injuries were training-related conditions , which result ed in 1,103 days of limited duty . Lower extremity overuse injuries were the most common type of injury documented . Fractures accounted for the greatest number of days of limited duty . Risk factors for training-related injuries identified by this study were cigarette smoking , high percentage of body fat , extremely high or low body mass index , low endurance levels , and low muscular endurance levels ( sit-ups ) . Logistic regression showed that cigarette smoking and low endurance levels were independent risk factors for training injuries . These data indicate that the incidence of training-related injuries in infantry units is high . A number of modifiable injury risk factors were identified , suggesting that many of these injuries may be preventable PURPOSE This study aim ed to prospect ively analyze the role of factors on the contralateral side of the kinetic chain in the development of exertional medial tibial pain ( EMTP ) . METHODS Eighty-one female physical education students were tested at the beginning of their first academic year . Within the testing protocol , contralateral isokinetic hip muscle strength and full-body kinematic parameters during a single-leg drop jump were evaluated . Online question naires were administered weekly , and personal interviews were conducted every 3 months to assess injury follow-up . EMTP was diagnosed by an experienced medical doctor . Cox regression analysis was used to identify the potential risk factors for the development of EMTP . RESULTS After exclusion of subjects with diagnosed bilateral EMTP , 11 subjects were included in the EMTP group . Fifty-three subjects did not develop any lower extremity overuse injury and were included in the control group . The leg not at risk within subjects who developed EMTP was compared with an 
    Output:
    