A Descriptive Study of Self-Reported Injury in Non-elite Adaptive Athletes

Occurrence of injuries and illnesses in athletes with a physical impairment; a forty-week prospective cohort study

OBJECTIVES

Currently, the knowledge about the epidemiology of sport-related health problems of athletes with a physical impairment is limited. Therefore, this study aims to describe the prevalence, incidence and severity of sport-related health problems of athletes with a physical impairment in the Netherlands over a one sport season.

DESIGN

Prospective cohort study.

METHODS

Athletes (n = 99) with a physical impairment participated in this study. After completing a baseline questionnaire, athletes started a 40-week health monitoring period, during which they completed the Dutch translation of the OSTRC Questionnaire on Health Problems every week. Based on the reported information, injury and illness prevalence, incidence, weekly cumulative severity score, weekly time loss from sport and the total burden were calculated.

RESULTS

A total of 368 health problems were reported by 95 athletes. These health problems consisted of 258 injuries and 110 illnesses. The average weekly prevalence of health problems was 48.0 %; for injuries 34.6 %, and illnesses 13.4 %. Differences were found when considering injury severity, with the highest severity scores for athletes with a limb deficiency. Furthermore, recreational athletes reported the highest injury severity scores, followed by athletes who competed nationally and athletes who competed internationally.

CONCLUSIONS

Data from this study show a high average weekly prevalence of health problems, and differences amongst various impairment categories and sport levels when considering the severity of injuries. These results add to the knowledge regarding sport-related health problem epidemiology in this population, indicating that impairment category and sport level should be taken into account when developing injury prevention strategies.

Characteristics of Wheelchair Basketball Falls During the Tokyo 2020 Paralympics by Sex and Physical Impairment Classification: A Video-Based Observational Study

OBJECTIVE

The aim of the study is to evaluate the fall characteristics of wheelchair basketball players by sex and impairment classification using the official videos of the Tokyo 2020 Summer Paralympic Games.

DESIGN

This was a video-based observational study. In total, 42 men's and 31 women's wheelchair basketball game videos were obtained from the official International Paralympic Committee. The videos were analyzed to assess the number of falls, playing time of the fall, playing phase, contact, foul judgment, fall location/direction, and the body part that first impacted the floor.

RESULTS

A total of 1269 falls (men, n = 944; and women, n = 325) occurred. The analysis of men demonstrated significant differences in rounds, playing phase, location of fall, and body part first impacted. Women demonstrated significant differences in all categories except in rounds. Comparisons by functional impairment showed different trends for men and women.

CONCLUSIONS

The detailed observation of videos suggested that men are more likely to have dangerous falls. There is a necessity for discuss the prevention measures based on sex and impairment classification.

Evaluation of hand functions and distal radioulnar joint instability in elite wheelchair basketball athletes: a cross-sectional pilot study

BACKGROUND

Wrist injury affects wheelchair basketball players' performance; however, the relationship between distal radioulnar joint (DRUJ) instability and hand functions is unclear. This cross-sectional pilot study investigated DRUJ instability in elite female wheelchair basketball athletes using force-monitor ultrasonography.

METHODS

Nine elite female wheelchair basketball athletes (18 wrists) were included in the study. A triangular fibrocartilage complex (TFCC) injury was confirmed using magnetic resonance imaging (MRI). Hand functions were evaluated based on the range of motion (ROM) of wrist palmar flexion, dorsiflexion, radial deviation, and ulnar deviation; grip strength; arm circumference; forearm circumference; and DRUJ instability or pain using the ballottement test. The Mann-Whitney U test was used to compare parameters between the TFCC-injured and intact wrists. Radioulnar displacement was measured using force-monitor ultrasonography and pressure data, and the displacement-to-force ratio was used as an indicator of DRUJ instability. The correlation between the DRUJ displacement-to-force ratio and each hand function assessment was evaluated using Pearson correlation coefficient for the TFCC-injured and intact wrists. A generalized linear mixed model (GLMM) was used to estimate the relationship between hand functions and DRUJ instability.

RESULTS

TFCC injuries in seven wrists were confirmed using MRI findings (38.9%). The ulnar deviation ROM values of the TFCC-injured wrist (n = 7) and intact (n = 11) groups were 38.6 ± 8.0° and 48.6 ± 7.8°, respectively. The ulnar deviation ROM was significantly smaller in the TFCC-injured wrists (p = 0.02, r = - 0.54). In the TFCC-injured wrists, no correlation was observed between the displacement-to-force ratio and the hand function assessment. In contrast, the displacement-to-force ratio negatively correlated with grip strength, arm circumference, and forearm circumference in the intact wrists (Pearson correlation coefficient r = - 0.78, - 0.61, and - 0.74, respectively). The GLMM showed that the displacement-to-force ratio significantly affected grip strength, arm circumference, and forearm circumference in the intact group.

CONCLUSIONS

In intact wrists, correlations were observed between hand functions such as upper arm/forearm strength and DRUJ stability evaluated using ultrasound. Maintaining and strengthening grip strength, forearm circumference, and arm circumference are associated with DRUJ stability and may be related to TFCC injury prevention in wheelchair basketball athletes.

TRIAL REGISTRATION

The protocol was registered with the UMIN Clinical Trials Registry (UMIN000043343) [Date of first registration: 16/02/2021].

A Scoping Review with Bibliometric Analysis of Para-Rowing: State of the Art and Future Directions

Para-rowing is a format of rowing practiced by people with different types of disabilities, thanks to adapted equipment set-ups and regulations. Para-rowing made its debut recently at the 2008 Paralympic Games. According to the mandate of the “International Paralympic Committee”, para-rowers should be enabled to pursue sporting excellence. Therefore, rigorous research is needed in terms of well-designed, high-quality studies. To the best of our knowledge, there are no systematic appraisals of the body of scholarly evidence in the field of para-rowing. As such, a scoping review enhanced by bibliometric analyses was carried out to provide a comprehensive synthesis of knowledge related to para-rowing for the perusal of practitioners and athletes. By mining eighteen major databases, 17 studies were retained in the present review. The included studies were found to focus on a range of aspects involving health, the etiology of injuries (n = 5), psychological and physiological responses (n = 5), performance, biomechanical analysis (n = 4), and new analytical approaches for kinematic assessments and predictions of mechanical outputs in para-rowers (n = 3). The scholarly community on para-rowing consists of 78 researchers, 16 (20.51%) of whom are highly interconnected. The most prolific author was Smoljanović T., from Croatia, with three items/documents. In total, 93.6% of scholars have authored one single document. Topological features indicated a highly fragmented and dispersed, poorly connected community characterized by a high number of clusters and a low strength of connections. In terms of publication years, the first scholarly article dates back to 2008, with four articles (23.5%) published in the current year, showing an increasing interest in this para-sports discipline. Finally, gaps in current research on para-rowing were identified in terms of overlooked topics, including sports nutrition, doping, and psychological aspects in para-rowers other than those with visual impairment.

Adaptive Sports in Spinal Cord Injury: a Systematic Review

Purpose of Review

Recent Findings

Summary

Injuries in Wheelchair Basketball Players: A Systematic Review

BACKGROUND

Sports injuries have physical and psychological effects that negatively affect sports performance. Although there are data available on sports injuries in wheelchair basketball, some aspects need to be clarified, such as the location, mechanisms and risk factors for injury, which are not well described due to variations and/or a lack of definition of injury. The aim of this study was to determine epidemiological information, primary injury characteristics and affected body regions in wheelchair basketball players; Methods: The PubMed, Science Direct, Scopus, Web of Science and Google Scholar databases were used; Results: eight articles were included in this review. The shoulder was the body region most affected (N = 60; 22.1%). When divided by body segments, the upper limbs were the most affected (N = 128; 47.2%), followed by the head and/or face (N = 53; 19.5%), trunk (included spine and ribs) (N = 48; 17.8%) and lower limbs (N = 42; 15.5%); Conclusions: wheelchair basketball players suffer a large number of injuries with different characteristics that are mainly linked to biomechanics and sport. These results can be used to guide coaches in structuring training to minimize recurring injuries, in addition to assisting in the organization of medical teams in competitions.

Shoulder pain and ultrasound findings: A comparison study of wheelchair athletes, nonathletic wheelchair users, and nonwheelchair users

BACKGROUND

Shoulder pain is one of the most common musculoskeletal concerns in manual wheelchair users including among athletes. However, there is a paucity of research characterizing both shoulder pain and shoulder pathology in this population.

OBJECTIVE

To characterize and compare the prevalence of current shoulder pain and ultrasound metrics of shoulder pathology between wheelchair athletes, nonathletic wheelchair users, and nonwheelchair users.

DESIGN

Cross-sectional.

SETTING

Chicago-area adaptive sport teams/programs and musculoskeletal clinics.

PARTICIPANTS

Thirty-four wheelchair athletes, six nonathletic wheelchair users, and 12 nonwheelchair users.

METHODS

Self-reported shoulder pain was assessed by questionnaire and Wheelchair User Shoulder Pain Index (WUSPI). Shoulder physiology and pathology were assessed by physical and ultrasound evaluation of both shoulders by a sports medicine physician.

MAIN OUTCOME MEASURES

Questionnaire outcomes: Prevalence of current shoulder pain, total WUSPI score. Physical examination outcomes: total Physical Examination of Shoulder Scale (PESS) score. Sonographic outcomes: Acromiohumeral distance (AHD) and presence of shoulder pathology.

RESULTS

The majority of wheelchair athletes (68%) and nonathletic wheelchair users (67%) experienced shoulder pain since using a manual wheelchair. Wheelchair basketball players had a mean WUPSI score of 17.2 (SD = 21.8), and athletes participating in handcycling, sled hockey, and quad rugby had mean scores of 4.91 (SD = 8.32), 7.76 (SD = 13.1), and 4.29 (SD = 7.75), respectively. Shoulder pathology was observed in 14 of 31 (45%) wheelchair athletes and 4 of 6 (67%) nonathletic wheelchair users (p = .41).

CONCLUSIONS

Although wheelchair use is a risk factor for shoulder pain, participation in amateur wheelchair sports may not be associated with increased risk of shoulder pain. It is possible that overhead sports such as wheelchair basketball may define a unique high-risk group. Further study is needed to examine this relationship and to determine whether there are differences between specific wheelchair sports.

Health-Related Incidents among Intercollegiate Wheelchair Basketball Players

BACKGROUND

Studies have revealed a higher incidence of injury and illness among elite adaptive athletes when compared to non-disabled athletes in the Paralympics and Olympics. However, sport-specific health care incidence rates and patterns outside of the Paralympics have been poorly described. To date, there are no prospective studies focused on injury or illness rates among intercollegiate wheelchair basketball players.

OBJECTIVE

To determine the incidence of sports-related injuries and illnesses among men's and women's intercollegiate wheelchair basketball teams throughout a season. We hypothesized that injury rates among the intercollegiate wheelchair basketball players would be similar to or greater than those of previously published National Collegiate Athletic Association (NCAA) nondisabled basketball players and that injuries would most commonly affect the upper extremities.

DESIGN

Prospective surveillance study.

SETTING

Men's and women's intercollegiate wheelchair basketball teams in Arlington, Texas.

PARTICIPANTS

Twenty-eight (14 male, 14 female) of the 29 (15 male, 14 female) eligible adult athletes playing on an intercollegiate men's or women's wheelchair basketball team during the 2018-2019 season.

INTERVENTIONS

Completion of a repeatable, electronic, web-app injury and illness survey during the season, as well as separate pre- and post-season injury and illness surveys.

MAIN OUTCOME MEASURES

Injury rates throughout the season based on athlete-exposures and relative risk (RR) of injury of intercollegiate wheelchair basketball players compared to NCAA nondisabled basketball players. Description of onset, location, diagnosis, medical evaluation, and missed time from sport related to injuries and illnesses.

RESULTS

Sixty-two health-related incidents, including 48 injuries and 14 illnesses, were prospectively reported during the season. Overall injury incidence rates were 12.2 (95% confidence interval [95% CI] 7.4 to 17.4) and 13.1 (95% CI 7.8 to 18.4) injuries per 1000 athlete-exposures among male and female athletes, respectively. These equated to RRs of 1.53 (95% CI 1.03 to 2.27) (male) and 2.01 (95% CI 1.34 to 3.02) (female) when compared to the rates published previously on NCAA nondisabled basketball players, indicating a statistically significant increase in injury risk. Injuries most commonly involved the upper extremities (56.3%). Illnesses commonly involved the gastrointestinal (35.7%) or respiratory (21.4%) systems.

CONCLUSIONS

This is the first prospective study to report incidence of sports-related injuries and illnesses throughout an intercollegiate wheelchair basketball season. Overall injury rates reported were higher than prior NCAA nondisabled intercollegiate basketball reports. This reinforces the need to establish an accessible network of health care support and injury prevention strategies for these athletes.