While design modifications present on work boots improve safety, they may not always provide optimal human performance during work tasks. Understanding the impact of these different design features on biomechanical and physiological postural control and locomotion variables can aid in better design modifications that can provide a safe and efficient human performance. This brief review focuses on a series of studies conducted by the current research team, that have tested three different work boots (SB: high-top steel-toed work boots; TB: high-top tactical work boots; SR: low-top slip-resistant work boots). The series of studies included testing of these work boots or combinations of them under acute and chronic simulated occupational workloads, assessing biomechanical variable such as postural stability, gait, slips, and muscle activity, as well as physiological variables such as heart rate, energy expenditure, oxygen consumption, and pain perception. The impact of each of the work boots and their design feature on postural control and locomotion are summarized from these studies’ previously published literature. Finally, work boot design suggestions for optimal human performance are provided for better work boot selection, modification, and design.

Background: Postural strategies such as ankle, hip, or combined ankle-hip strategies are used to maintain optimal postural stability, which can be influenced by the footwear type and physiological workload. Purpose: This paper reports previously unreported postural strategy scores during the six conditions of the sensory organization test (SOT). Methods: Fourteen healthy males (age: 23.6 ± 1.2 years; height: 181 ± 5.3 cm; mass: 89.2 ± 14.6 kg) were tested for postural strategy adopted during SOT in three types of occupational footwear (steel-toed work boot, tactical work boot, low-top work shoe) every 30 min during a 4-h simulated occupational workload. Postural strategy scores were analyzed using repeated measures analysis of variance at 0.05 alpha level. Results: Significant differences among postural strategy scores were only evident between SOT conditions, and but not between footwear type or the workload. Conclusions: Findings indicate that occupational footwear and occupational workload did not cause a significant change in reliance on postural strategies. The significant changes in postural strategy scores were due to the availability of accurate and/or conflicting sensory feedback during SOT conditions. In SOT conditions where all three types of sensory feedback was available, the ankle strategy was predominantly adopted, while more reliance on hip strategy occurred in conditions with absent or conflicting sensory feedback.

It is difficult to overemphasize the function vision plays in information processing, specifically in maintaining postural control. Vision appears to be an immediate, effortless event; suggesting that eyes need only to be open to employ the visual information provided by the environment. This study is focused on investigating the effect of Occupational Safety and Health Administration regulated personal protective eyewear (29 CFR 1910.133) on physiological and cognitive factors associated with information processing capabilities. Twenty-one college students between the ages of 19 and 25 years were randomly tested in each of three eyewear conditions (control, new and artificially aged) on an inclined and horizontal support surface for auditory and visual stimulus reaction time. Data collection trials consisted of 50 randomly selected (25 auditory, 25 visual) stimuli over a 10-min surface-eyewear condition trial. Auditory stimulus reaction time was significantly affected by the surface by eyewear interaction (F_2,40 = 7.4; p < 0.05). Similarly, analysis revealed a significant surface by eyewear interaction in reaction time following the visual stimulus (F_2,40 = 21.7; p < 0.05). The current findings do not trivialize the importance of personal protective eyewear usage in an occupational setting; rather, they suggest the value of future research focused on the effect that personal protective eyewear has on the physiological, cognitive and biomechanical contributions to postural control. These findings suggest that while personal protective eyewear may serve to protect an individual from eye injury, an individual's use of such personal protective eyewear may have deleterious effects on sensory information associated with information processing and postural control.

Background: Military medical readiness plays a significant role in global military operations. While the severity of combat-related trauma is evident, musculoskeletal injuries (MSK’s), are the largest medical threat to deployment readiness, and accounted for more than 60% of limited duty days in 2019. Across MSK’s, the spine (lumbosacral: 30%; cervical: 22%; thoracic: 10%) accounts for 62% of MSKs. In the military population, there is a tremendous economic impact in training, retaining, and deploying a service member. Return-to-duty (RTD) rates and length of time for the treatment protocols for spine surgery vary significantly in published research. Research suggests RTD rates between 3-17 months following elective traditional open lumbar and cervical spine surgery, with a RTD rate of 64% within 1 year. When examining minimally invasive lumbar spine surgery (MIS), 100% of military personal had a RTD within 3 months. Research has yet to examine the impact of MIS of the cervical spine on the RTD rates of active-duty military. Methods: The current study retrospectively examined surgical outcomes, return to duty, and patient-centric outcomes among 156 active duty or reserve military patients who underwent an outpatient minimally invasive (n = 79) cervical spine surgery or an open (n = 77) (Laminotomy/Foraminotomy/Decompression) for the treatment of cervical spinal stenosis. Results: Significant reductions in visual analog scale of 3.31 and neck disability index of 16.01 were observed from preoperative to postoperative time points. 77% of service members RTD in less than 1 month, 19% RTD in 1-2 months and 4% RTD between 2-3 months. There were insignificant differences reported in the open surgery group. Discussions: MIS has been shown to reduce tissue trauma and patient complications. MIS procedures have resulted in reducing postoperative stress responses and improving the recovery process following surgery. In the active-duty military population this plays an important role in return to duty quickness. Our findings suggest that MIS procedures in an ambulatory surgery center on the cervical spine result in improved patient outcomes and reduced RTD time in active-duty military personnel.

This study examined the relationship between training load, mileage, and session rating of perceived exertion (s-RPE) as predictors of injury and illness in Division I women’s soccer players. Twenty-four athletes were monitored over a 13-week season including 69 athlete exposures (49 training sessions and 20 matches). Internal and external load were measured during each athlete exposure. Player injury and illness status were documented daily by medical staff and categorized as healthy, medical attention, or time-loss. Associations between athlete exposures and injury/illness status were analyzed using a mixed-effects ordinal logistic regression model with player ID as a random intercept. A total of 1560 athlete observations were included. Higher daily mileage was associated with increased odds of injury or illness (OR = 1.67, 95% CI: 1.19–2.34). Training load was associated with reduced odds of injury or illness, with each unit increase lowering the odds by 42% (OR = 0.58, 95% CI: 0.41–0.83). Session-RPE was not significantly associated with injury or illness (OR = 0.96, 95% CI: 0.65–1.42). These findings indicate that accumulated mileage elevates injury and illness risk, while structured increases in training load enhance athlete resilience, and reduce injury and illness risk. Monitoring both internal and external workload provides performance staff with a practical approach to optimize training stress, augment recovery, and prepare athletes for the demands of competition in women’s soccer.

Purpose: Anterior stromal puncture is an inexpensive and widely used technique at the slit lamp to treat recurrent corneal erosions (RCE), common sequelae of corneal abrasions, trauma, and epithelial basement membrane dystrophies (EBMDs). The purpose of this study was to determine safety of a novel anterior stromal micropuncture device (termed a “plexitome”) for use in the optical axis of the cornea. Methods: We performed an IRB-approved clinical pilot study on 45 patients with diverse corneal pathologies to determine the safety of the plexitome device and examined corneal healing responses clinically for a minimum of 30 days after treatment. Follow on efficacy data was collected for treated patients with RCE. Micropuncture treatment was performed either through loose epithelial tissue or after debridement using a cotton tip at the slit lamp. After “imprinting,” patients were treated with topical medications including antibiotics, hypertonic saline/ointment, bandage contact lenses, and/or patching according to the treating physician's routine care for the condition. Results: Micropuncture using the “plexitome” device did not create visible scars in the corneal stroma of the 45 patients treated and followed for at least 30 days. Photographic evidence of imprinting was seen at in 1 patient at 30 days. There were no significant adverse events associated with treatment. Conclusions: Micropuncture of the cornea using the “plexitome” device does not create optically evident anterior stromal scarring after treatment. Micropuncture using the device may be an effective way of treating RCE and other corneal manifestations of EBMD in the optical axis, which is not currently possible using standard anterior stromal puncture methods.