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Adam F, Derman W, Schwellnus M, Boer PH, Jordaan E, Runciman P. Injury incidence according to athlete impairment type during the 2012 and 2016 Summer Paralympic Games: a combined analysis of 101 108 athlete days. Br J Sports Med 2024; 58:852-859. [PMID: 38286574 DOI: 10.1136/bjsports-2023-107144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2024] [Indexed: 01/31/2024]
Abstract
OBJECTIVES The relationship between sport-related injuries and Para athlete impairment type has not yet been comprehensively studied. This study aimed to describe injury incidence according to athlete impairment type during the London 2012 and Rio 2016 Summer Paralympic Games, by sex, age, Games period, chronicity and anatomical area. METHODS A combined analysis of 7222 athletes was conducted comprising 101 108 athlete days, using pooled data. Internet sources were used to identify impairments of registered athletes. Impairment types: brain disorders (BD), limb deficiency, neuromuscular disorders (NMD), spinal cord-related disorders, visual impairment (VI) and 'all others' (OTH: impaired passive range of movement, intellectual impairment, leg length difference, short stature and unknown impairments). Results by impairment type are reported as univariate unadjusted incidences (injuries/1000 athlete days; 95% CIs). Statistical significance between impairment types was determined when 95% CIs did not overlap. RESULTS The overall crude unadjusted incidence of injury was 11.1 (95% CI 10.4 to 11.9), significantly higher in VI (13.7 (95% CI 11.0 to 15.7)) and NMD (13.3 (95% CI 11.1 to 16.1)) compared with BD (9.1 (95% CI 7.7 to 10.8)). Acute (sudden onset) (8.6 (95% CI 7.3 to 10.1)) and lower limb (6.6 (95% CI 5.4 to 8.1)) injuries were higher among athletes with VI, while athletes with NMD had a higher incidence of repetitive (gradual onset) (5.9 (95% CI 4.3 to 8.0)) and upper limb (6.9 (95% CI 5.2 to 9.0)) injuries compared with other impairments. CONCLUSIONS Incidence and type of injuries differed between athlete impairment types. Athletes with VI or NMD sustained the highest incidence of injury, and athletes with BD had the lowest. Findings of this study can inform the management of competition-related injuries in Para athletes.
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Affiliation(s)
- Faatima Adam
- Institute of Sport and Exercise Medicine, Department of Exercise, Sport and Lifestyle Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Wayne Derman
- Institute of Sport and Exercise Medicine, Department of Exercise, Sport and Lifestyle Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
- International Olympic Committee Research Centre, Pretoria, South Africa
| | - Martin Schwellnus
- International Olympic Committee Research Centre, Pretoria, South Africa
- Sport, Exercise Medicine and Lifestyle Institute, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Pieter-Henk Boer
- Department of Human Movement Science, Cape Peninsula University of Technology, Cape Town, South Africa
| | - Esme Jordaan
- Biostatistics Research Unit, South African Medical Research Council, Cape Town, South Africa
- Statistics and Population Studies Department, University of the Western Cape, Cape Town, South Africa
| | - Phoebe Runciman
- Institute of Sport and Exercise Medicine, Department of Exercise, Sport and Lifestyle Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
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Teodoro JI, Irving EL, Blaine JD, Dalton KN. An Urgent Call for Concussion Incidence Measures in Para Sport for Athletes with Vision Impairment: A Narrative Review. Healthcare (Basel) 2024; 12:525. [PMID: 38470636 PMCID: PMC10931318 DOI: 10.3390/healthcare12050525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 02/16/2024] [Accepted: 02/19/2024] [Indexed: 03/14/2024] Open
Abstract
Concussion in para athletes with vision impairment (VI) is poorly understood. Recently published studies have suggested that athletes with VI may be more likely to sustain sport-related concussions compared to non-disabled athletes and athletes with other impairment types. There is a critical need for objective concussion incidence measures to determine concussion injury rates and risks more accurately. The aim of this review was to examine the limited available evidence of concussion incidence rates across six different para sports for athletes with VI and encourage the future collection of concussion incidence data and the adoption of injury prevention strategies in VI para sport. A literature search was conducted using four unique databases, which formed the basis of this narrative review. Injury prevention strategies such as modifying sport rules, introducing protective equipment, and incorporating additional safety measures into the field of play have been introduced sporadically, but the effectiveness of most strategies remains unknown. More prospective, sport-specific research examining mechanisms of injury and risk factors for concussion injuries in athletes with VI in both training and competition is needed. This research will help inform the development of targeted injury prevention strategies to reduce the likelihood of concussion for athletes with VI.
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Affiliation(s)
- Juliette I. Teodoro
- Vision and Motor Performance Lab, School of Optometry and Vision Science, Faculty of Science, University of Waterloo, Waterloo, ON N2L 3G1, Canada;
| | - Elizabeth L. Irving
- School of Optometry and Vision Science, Faculty of Science, University of Waterloo, Waterloo, ON N2L 3G1, Canada;
| | - Jane D. Blaine
- British Columbia Blind Sports and Recreation Association, Burnaby, BC V5H 4K7, Canada;
| | - Kristine N. Dalton
- Vision and Motor Performance Lab, School of Optometry and Vision Science, Faculty of Science, University of Waterloo, Waterloo, ON N2L 3G1, Canada;
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Fagher K, Dahlström Ö, Lexell J. Mental health, sleep, and pain in elite Para athletes and the association with injury and illness-A prospective study. PM R 2023; 15:1130-1139. [PMID: 36270015 DOI: 10.1002/pmrj.12917] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 08/19/2022] [Accepted: 09/16/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION The interest in the health of Para athletes continues to increase. Still, there are few studies that have evaluated health parameters beyond injury and illness in this athlete population. OBJECTIVE To assess (1) the weekly proportion of elite Para athletes reporting anxiety/depression, low sleep levels (≤7 hours), and pain over 52 weeks; (2) and to explore whether these health parameters are associated with the risk for a sports injury or illness. DESIGN A 52-week prospective study, part of the Sports-related Injury and Illness in Paralympic Sport Study (SRIIPSS). SETTING A total of 107 Swedish elite Para athletes with physical, visual, and intellectual impairment participated. MAIN OUTCOME MEASURES Data on self-reported anxiety/depression, sleep levels, pain, and injuries/illnesses were collected weekly. Comparisons of these parameters preceding an injury/illness were made using Friedman's analysis of variance (ANOVA). RESULTS The proportion of athletes reporting weekly anxiety/depression was 34.1%; 60.9% of athletes reported sleeping ≤7 hours and 49.9% reported pain. In exploratory analyses, there were no significant differences between weeks before an injury for any of the variables. There were significant differences in levels of sleep over the weeks, where sleep levels were significantly higher (>10 hours) 4 weeks prior to an illness (p = .016). CONCLUSION This cohort of elite Para athletes reported relatively high levels of anxiety/depression, low sleep levels, and pain, which is a concern. High sleep levels and the risk for illness might be an indication of overtraining, which commonly leads to persistent fatigue and an increased susceptibility to infections. Monitoring of the health of elite Para athletes is recommended to be able to improve performance and health in this population.
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Affiliation(s)
- Kristina Fagher
- Department of Health Sciences, Rehabilitation Medicine Research Group, Lund University, Lund, Sweden
| | - Örjan Dahlström
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
- Athletics Research Center, Linköping University, Linköping, Sweden
| | - Jan Lexell
- Department of Health Sciences, Rehabilitation Medicine Research Group, Lund University, Lund, Sweden
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Jones E, Martin P, Barr M, Soundy A, Heneghan NR. "Knowing the Noise That Surrounds the Athlete": A Qualitative Study Exploring the Health-Seeking Behaviors of Athletes With Limb Deficiency Drawing on the Experiences and Perceptions of the Medical Staff and Athletes. Am J Phys Med Rehabil 2023; 102:738-745. [PMID: 35703201 DOI: 10.1097/phm.0000000000002065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
OBJECTIVE The aim of the study is to explore the health-seeking behaviors of athletes with limb deficiency, drawing on the experiences and perception of the sports medicine team and athletes. DESIGN The study used an interpretive hermeneutic phenomenological methodology with a subtle realist paradigmatic view to investigate commonality in unique experiences within reality. Data collection was completed with two focus groups in December 2019 and March 2020. Thirteen participants took part including athletes and sports medicine team members (physiotherapists, doctors, and strength and conditioning coaches) working in parasports. Focus group manuscripts were transcribed verbatim from audio recordings. An inductive, iterative process was used to identify themes and subthemes, with processes in place to establish rigor. RESULTS Two themes and five subthemes emerged in relation to the "internalization and adjustment to social identity" and "the importance and impact of factors, which impact the athlete social identity." CONCLUSIONS Health-seeking behaviors of athletes with limb deficiency were influenced by a unique blend of personal and environmental factors that contribute toward social identity. The sports medicine team require specific awareness of factors that may diminish health-seeking behaviors to deliver a personalized approach and negate consequences.
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Affiliation(s)
- Eleanor Jones
- From the English Institute of Sport, Lilleshall National Sports Centre, Newport, United Kingdom (EJ); School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom (EJ, AS, NRH); English Institute of Sport, London, United Kingdom (PM); and English Institute of Sport, Sheffield, United Kingdom (MB)
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Bentzen M, Kenttä G, Karls T, Fagher K. Monitoring mental distress in Para athletes in preparation, during and after the Beijing Paralympic Games 2022: A 22 week prospective mixed-method study. Front Sports Act Living 2022; 4:945073. [PMID: 36304569 PMCID: PMC9592753 DOI: 10.3389/fspor.2022.945073] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 09/15/2022] [Indexed: 11/07/2022] Open
Abstract
It is common in elite sport to monitor athletes' training load, injuries and illnesses, but mental distress is rarely included. An improved understanding of the epidemiology of mental distress among elite Para athletes and how their coaches perceive such monitoring would allow us to better develop and implement preventive measures. The purpose of this study was therefore to (1) prospectively describe elite Para athletes' mental distress, before, during and after the Beijing Paralympic Games (Paralympics Games 22 = PG22); and to (2) gain a better understanding of if and potentially how awareness of athletes' mental distress changed, through weekly monitoring, and influenced how coachers perceive athletes' mental distress and if they accounted for this before, during and after PG22. A mixed-method study design was used, in which prospective mental distress (depression and anxiety) data were collected weekly from 13 [Swedish] elite Para athletes in preparation, during and after PG22. Data were screened and evaluated weekly by a physiotherapist and a sports psychologist, and coaches also received weekly reports. A focus-group interview with the coaches were conducted post Paralympics to address coaches' awareness about mental distress and athlete health monitoring in Parasport. For data analyses, descriptive statistics was used for the quantitative data and a content analysis was conducted for the qualitative data. The results reveled the following proportion of datapoints indicating symptoms of anxiety and depression: before PG22 (15.8 and 19.1%); during PG22 (47.6 and 38.2%); and after PG22 (0 and 11.8%). The qualitative results indicated that coaches perceived athlete health monitoring as helpful for increasing their awareness of mental distress, and as a useful tool to initiate support for their athletes as well as improving their coaching. In summary, this cohort of elite Para athletes reported a high proportion of mental distress during the Winter Paralympic Games in Beijing. The results also show that it is important and feasible to monitor Para athletes' mental distress to detect and manage early symptoms of mental distress.
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Affiliation(s)
- Marte Bentzen
- Department of Teacher Education and Outdoor Studies, The Norwegian School of Sport Sciences, Oslo, Norway,*Correspondence: Marte Bentzen
| | - Göran Kenttä
- The Swedish School of Sport and Health Sciences, Stockholm, Sweden,School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
| | - Tommy Karls
- The Swedish School of Sport and Health Sciences, Stockholm, Sweden,Swedish Paralympic Committee, Stockholm, Sweden
| | - Kristina Fagher
- Rehabilitation Medicine Research Group, Department of Health Sciences, Lund University, Lund, Sweden
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Sacks H, Wu M, Carter C, Karamitopoulos M. Parasport: Effects on Musculoskeletal Function and Injury Patterns. J Bone Joint Surg Am 2022; 104:1760-1768. [PMID: 35975928 DOI: 10.2106/jbjs.21.01504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
➤ Sports participation can improve gait, muscle strength, and functional abilities in patients with a wide variety of disabilities. Para athletes are also at substantial risk for injury during sports participation. ➤ Ambulant athletes with cerebral palsy are at risk for soft-tissue injuries about the knee as well as foot and ankle injuries. Wheelchair athletes are at risk for osteoporotic fractures and shoulder girdle injuries. Limb-deficient athletes are prone to low back pain and overuse injuries of the contralateral extremity. ➤ Para athletes are vulnerable to abuse during sports participation, and physicians should promptly report any possible abuse or mistreatment. ➤ Orthopaedic surgeons should understand disability and sport-specific risk factors for injury in para athletes in order to initiate early management and injury prevention protocols.
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Affiliation(s)
- Hayley Sacks
- Department of Orthopedic Surgery, NYU Langone Health, New York, NY
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Lexell J, Lovén G, Fagher K. Incidence of sports-related concussion in elite para athletes - a 52-week prospective study. Brain Inj 2021; 35:971-977. [PMID: 34185611 DOI: 10.1080/02699052.2021.1942551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objective: To assess the 52-week incidence proportion and incidence rate of sports-related concussion (SRC) among elite Para athletes, and to analyze the injury mechanisms.Method: In total, 70 male and 37 female Swedish elite Para athletes (median age 29 years) with vision, physical and intellectual impairment, weekly self-reported sports-related injuries including concussion in an eHealth application adapted to Para athletes. Descriptive statistics were used to assess the incidence rate and incidence proportion. Chi-square statistics were used to analyze differences in the proportion of SRC.Results: A total of 13 SRC were reported: three athletes each sustained two SRC. The incidence proportion was 9.3% (95% CI 4.8-16.7), and the incidence rate 0.5 SRC/1000 hours (95% CI 0.3-0.9) of sports exposure. Athletes with vision impairment and female athletes reported a significantly higher proportion of SRC. A majority of the injuries (n = 9; 69%) occurred during sport-specific training. The injury mechanisms were collision with object (n = 7; 54%), collision with person (n = 4; 31%), and poor playing field conditions (n = 2; 16%).Conclusion: The incidence of concussion among elite Paralympic athletes is comparable to sports for able-bodied athletes. Athletes with vision impairment and female athletes reported a significantly higher incidence of SRC, and collisions were the most common injury mechanism. These results can form the basis for future preventive research studies.
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Affiliation(s)
- Jan Lexell
- Department of Health Sciences, Rehabilitation Medicine Research Group, Lund University, Lund, Sweden.,Department of Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden
| | - Gustav Lovén
- Department of Health Sciences, Rehabilitation Medicine Research Group, Lund University, Lund, Sweden
| | - Kristina Fagher
- Department of Health Sciences, Rehabilitation Medicine Research Group, Lund University, Lund, Sweden
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Heneghan NR, Collacott E, Martin P, Spencer S, Rushton A. Lumbosacral injuries in elite Paralympic athletes with limb deficiency: a retrospective analysis of patient records. BMJ Open Sport Exerc Med 2021; 7:e001001. [PMID: 33500786 PMCID: PMC7813422 DOI: 10.1136/bmjsem-2020-001001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2020] [Indexed: 11/15/2022] Open
Abstract
Background Compared to injury data in able-bodied athletes, relatively little literature exists for Paralympic athletes. Injury data underpins the design and evaluation of injury prevention strategies in elite sport. The aim of this study was to investigate frequency, characteristics and management of lumbosacral injuries in elite athletes with limb deficiency. Methods A retrospective analysis of injuries in elite athletes with limb deficiency (2008 to 2017) was conducted using available data extracted from The English Institute of Sport (EIS) clinical records. Eligibility criteria: funded athletes, eligible for EIS physiotherapy support with full or partial limb deficiency. Data were analysed descriptively using frequencies. Results A total of 107 injuries from 32 athletes were included. Participants comprised 18 men (59%), from 9 sports, with mean age for index injuries of 27 years (range 18 to 38 years) and 15 with congenital limb deficiency (47%). Average number of index injuries for congenital and traumatic limb deficient groups were 13 and 19, respectively. Where injury onset was recorded (n=79), half of injuries occurred during training (40%, n=43). Arthrogenic structures accounted for 32.7% of injuries, myogenic 26.2%, with neurogenic, discogenic and osteogenic each <5%. The number of treatments delivered in each injury episode ranged from 1 to 43, with symptom resolution taking 2 to 439 days. Conclusion Elite athletes with limb deficiency experience lumbosacral injuries predominantly involving muscles and joints. While consistency and accuracy of data recording limits definitive conclusions, findings highlight the importance of precision in recording injury data as part of surveillance to enable implementation of effective injury prevention strategies.
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Affiliation(s)
- Nicola R Heneghan
- Centre for Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Esther Collacott
- Centre for Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
- Physiotherapy, Birmingham Royal Ballet, Birmingham, UK
| | - Paul Martin
- Physiotherapy, The English Institute of Sport, London, UK
| | - Simon Spencer
- Physiotherapy, The English Institute of Sport, Newport, UK
| | - Alison Rushton
- Centre for Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
- School of Physical Therapy, Western University, London, Ontario, Canada
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Kasitinon D, Royston A, Wernet L, Garner D, Richard J, Argo LR. Health-Related Incidents among Intercollegiate Wheelchair Basketball Players. PM R 2020; 13:746-755. [PMID: 32799432 DOI: 10.1002/pmrj.12474] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 08/09/2020] [Accepted: 08/12/2020] [Indexed: 11/11/2022]
Abstract
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.
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Affiliation(s)
- Donald Kasitinon
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Alexa Royston
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Lauren Wernet
- University of Texas at Arlington, Arlington, TX, USA
| | - Doug Garner
- University of Texas at Arlington, Arlington, TX, USA
| | - Joshua Richard
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Lindsay Ramsey Argo
- University of Texas Southwestern Medical Center, Dallas, TX, USA.,WellMed Medical Management Inc., San Antonio, TX, USA
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Fagher K, Dahlström Ö, Jacobsson J, Timpka T, Lexell J. Injuries and illnesses in Swedish Paralympic athletes—A 52‐week prospective study of incidence and risk factors. Scand J Med Sci Sports 2020; 30:1457-1470. [DOI: 10.1111/sms.13687] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 03/13/2020] [Accepted: 03/27/2020] [Indexed: 12/21/2022]
Affiliation(s)
- Kristina Fagher
- Department of Health Sciences Rehabilitation Medicine Research Group Lund University Lund Sweden
| | - Örjan Dahlström
- Department of Medical and Health Sciences Athletics Research Center Linköping University Linköping Sweden
- Department of Behavioural Sciences and Learning Linköping University Linköping Sweden
| | - Jenny Jacobsson
- Department of Medical and Health Sciences Athletics Research Center Linköping University Linköping Sweden
| | - Toomas Timpka
- Department of Medical and Health Sciences Athletics Research Center Linköping University Linköping Sweden
| | - Jan Lexell
- Department of Health Sciences Rehabilitation Medicine Research Group Lund University Lund Sweden
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Fagher K, Dahlström Ö, Jacobsson J, Timpka T, Lexell J. Prevalence of Sports-Related Injuries and Illnesses in Paralympic Athletes. PM R 2019; 12:271-280. [PMID: 31260605 DOI: 10.1002/pmrj.12211] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 06/20/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND With increased participation in Paralympic sports, the burden of sports-related injuries and illnesses may increase. However, there is limited knowledge about the epidemiology of sports-related injuries and illnesses in Paralympic sports (SRIIPS). OBJECTIVE To describe among Swedish Paralympic athletes the 1-year retrospective period prevalence of severe SRIIPS and the point prevalence of all SRIIPS and to examine differences in prevalence proportions between athletes with different impairments, behaviors, and sport characteristics. DESIGN Cross-sectional study. SETTING Swedish Paralympic Programme. PARTICIPANTS One hundred and four Paralympic athletes with visual, physical, and intellectual impairment. METHODS An eHealth application adapted to Paralympic athletes was used to collect self-report data on existing and previous SRIIPS, as well as impairment, behavior, and sport characteristics. MAIN OUTCOME MEASUREMENTS One-year retrospective period prevalence and point prevalence. RESULTS The period prevalence of severe injuries was 31% (95% CI 23-40) and the point prevalence 32% (95% CI 24-41). The period prevalence of severe illnesses was 14% (95% CI 9-23), and 13% of the athletes (95% CI 8-22) reported a current illness. More severe injuries (P <.05) were reported by athletes aged 18 to 25 years, not using assistive device, having pain during sport, using analgesics, continuing training injured, and feeling guilt when missing exercise. Athletes who reported a previous severe injury, having pain in daily life and during sport, using analgesics, and being upset when unable to exercise had a higher prevalence of current injuries (P <.05). Being female, reporting previous severe illness, using prescribed medication, and feeling anxious/depressed were features associated with ongoing illnesses (P <.05). CONCLUSION Paralympic athletes report a high prevalence of SRIIPS. Behavioral and psychological aspects as well as pain and use of medication appear to be associated with the occurrence of SRIIPS. The results imply that factors leading to SRIIPS are complex and call for a broad biopsychosocial approach when developing preventive measures. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Kristina Fagher
- Department of Health Sciences, Rehabilitation Medicine Research Group, Lund University, Lund, Sweden
| | - Örjan Dahlström
- Department of Medical and Health Sciences, Athletics Research Center, Linköping University, Linköping, Sweden.,Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
| | - Jenny Jacobsson
- Department of Medical and Health Sciences, Athletics Research Center, Linköping University, Linköping, Sweden
| | - Toomas Timpka
- Department of Medical and Health Sciences, Athletics Research Center, Linköping University, Linköping, Sweden
| | - Jan Lexell
- Department of Health Sciences, Rehabilitation Medicine Research Group, Lund University, Lund, Sweden.,Department of Neuroscience, Rehabilitation Medicine, Uppsala University, Uppsala, Sweden
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Fagher K, Hassan Ahmed O, Pernheim N, Varkey E. Prevalence of sports-related injuries in paralympic judo: An exploratory study. J Sci Med Sport 2019; 22:902-906. [DOI: 10.1016/j.jsams.2019.03.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 03/07/2019] [Accepted: 03/12/2019] [Indexed: 01/09/2023]
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13
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Schipman J, Gallo P, Marc A, Antero J, Toussaint JF, Sedeaud A, Marck A. Age-Related Changes in Para and Wheelchair Racing Athlete's Performances. Front Physiol 2019; 10:256. [PMID: 30949064 PMCID: PMC6436002 DOI: 10.3389/fphys.2019.00256] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 02/25/2019] [Indexed: 11/14/2022] Open
Abstract
During the last decades, all para-athletes with disabilities have significantly increased their performance level due to technological progress and human investment, through better training or recovery protocols, medical care and nutritional monitoring. Among these elements, the athlete’s age is one of the determining factors in performance. The aim of this study was to investigate the effect of age on maximal performances for para-athletes and wheelchair racing athletes, scaled on able-bodied records. We collected 53,554 results including athlete’s best performance of the year, event, age and disability classification from the International Paralympic Committee competitions between 2009 and 2017 for both female and male para-athletics and wheelchair racing disciplines for a total of 472 sport events in Track and Field (considering each impairment type for each event) and gathered the all-time able-bodied records from the International Association of Athletics Federations (IAAF) at the end of 2017. Maximal performance by age was fitted with the Moore function for each para-athletics and wheelchair racing event. This study finds a similar age-related pattern in maximal performance among para-athletes and wheelchair racing athletes. The age at peak performance varies according to sex, impairment type and event and increases gradually from sprint to endurance events. The best Top 100 performances include a large age range suggesting that performance has probably not been optimized yet for most elite para-athletes and wheelchair racers. The next Paralympic Games of Tokyo 2020 and Paris 2024 will certainly offer exceptional performance.
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Affiliation(s)
- Julien Schipman
- Institut de Recherche Bio-Médicale et d'Épidémiologie du Sport, EA 7329, Institut National du Sport, de l'Expertise et de la Performance, Université Paris Descartes, Université Sorbonne Paris Cité, Paris, France
| | - Pasquale Gallo
- Institut de Recherche Bio-Médicale et d'Épidémiologie du Sport, EA 7329, Institut National du Sport, de l'Expertise et de la Performance, Université Paris Descartes, Université Sorbonne Paris Cité, Paris, France.,Institut de Formation en Masso-Kinésithérapie Valentin Haüy, Paris, France
| | - Andy Marc
- Institut de Recherche Bio-Médicale et d'Épidémiologie du Sport, EA 7329, Institut National du Sport, de l'Expertise et de la Performance, Université Paris Descartes, Université Sorbonne Paris Cité, Paris, France
| | - Juliana Antero
- Institut de Recherche Bio-Médicale et d'Épidémiologie du Sport, EA 7329, Institut National du Sport, de l'Expertise et de la Performance, Université Paris Descartes, Université Sorbonne Paris Cité, Paris, France
| | - Jean-François Toussaint
- Institut de Recherche Bio-Médicale et d'Épidémiologie du Sport, EA 7329, Institut National du Sport, de l'Expertise et de la Performance, Université Paris Descartes, Université Sorbonne Paris Cité, Paris, France.,Centre d'Investigations en Médecine du Sport, Hôtel-Dieu, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Adrien Sedeaud
- Institut de Recherche Bio-Médicale et d'Épidémiologie du Sport, EA 7329, Institut National du Sport, de l'Expertise et de la Performance, Université Paris Descartes, Université Sorbonne Paris Cité, Paris, France
| | - Adrien Marck
- Institut de Recherche Bio-Médicale et d'Épidémiologie du Sport, EA 7329, Institut National du Sport, de l'Expertise et de la Performance, Université Paris Descartes, Université Sorbonne Paris Cité, Paris, France.,Programme Interdisciplinaire de Recherche la Dynamique du Vieillir, Université Sorbonne Paris Cité, Paris, France.,Laboratoire Matière et Systèmes Complexes, UMR 7057 CNRS, Université Paris Diderot, Université Sorbonne Paris Cité, Paris, France
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14
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Derman W, Runciman P, Jordaan E, Schwellnus M, Blauwet C, Webborn N, Lexell J, van de Vliet P, Kissick J, Stomphorst J, Lee YH, Kim KS. High incidence of injuries at the Pyeongchang 2018 Paralympic Winter Games: a prospective cohort study of 6804 athlete days. Br J Sports Med 2019; 54:38-43. [DOI: 10.1136/bjsports-2018-100170] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2019] [Indexed: 11/03/2022]
Abstract
ObjectiveTo describe the epidemiology of sports injury at the Pyeongchang 2018 Paralympic Winter Games.Methods567 athletes from 49 countries were monitored daily for 12 days over the Pyeongchang 2018 Paralympic Winter Games (6804 athlete days). Injury data were obtained daily from teams with their own medical support (41 teams and 557 athletes) and teams without their own medical support (8 teams and 10 athletes) through two electronic data capturing systems.Results112 of 567 athletes (19.8%) reported a total of 142 injuries, with an injury incidence rate (IR) of 20.9 per 1000 athlete days (95% CI 17.4 to 25.0). The highest IR was reported for para snowboard (IR of 40.5 per 1000 athlete days [95% CI 28.5 to 57.5]; p<0.02), particularly in the lower limb and head/face/neck anatomical areas. Across all sports at the Games, acute traumatic injuries (IR of 16.2 per 1000 athlete days [95% CI 13.2 to 19.8]) and injuries to the shoulder/arm/elbow complex (IR of 5.7 per 1000 athlete days [95% CI 4.2 to 7.8]) were most common. However, most injuries (78.9%) did not require time loss.ConclusionThe new Paralympic Winter Games sport of Para snowboard requires attention to implement actions that will reduce injury risk. The shoulder was the most injured single joint—a consistent finding in elite para sport.
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15
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Derman W, Runciman P, Jordaan E, Schwellnus M, Blauwet C, Webborn N, Lexell J, van de Vliet P, Kissick J, Stomphorst J, Lee YH, Kim KS. Incidence rate and burden of illness at the Pyeongchang 2018 Paralympic Winter Games. Br J Sports Med 2019; 53:1099-1104. [DOI: 10.1136/bjsports-2018-100096] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2018] [Indexed: 11/03/2022]
Abstract
ObjectiveTo describe the incidence rate (IR) and illness burden (IB) at the Pyeongchang 2018 Paralympic Winter Games.MethodsA total of 567 athletes from 49 countries were monitored for 12 days over the Pyeongchang 2018 Games (6804 athlete days). Illness data were obtained daily from teams with (41 teams, 557 athletes) and teams without (8 teams, 10 athletes) their own medical support, through electronic data capturing systems.ResultsThere were 87 illnesses reported, with an illness IR of 12.8 illnesses per 1000 athlete days (95% CI 10.2 to 16.0) and IB of 6.8 days lost per 1000 athlete days (95% CI 3.4 to 13.5). The highest IR was reported for Para snowboard (IR of 19.7 [95% CI 12.0 to 32.2]). Illnesses in the respiratory system (IR of 4.1 [95% CI 2.9 to 5.9]; IB of 1.4 [95% CI 0.6 to 3.0]), skin and subcutaneous system (IR of 2.5 [95% CI 1.5 to 4.1]; IB of 0.6 [95% CI 0.1 to 2.9]), and eye and ocular adnexa (IR of 1.6 [95% CI 0.9 to 3.1]; IB of 0.5 [95% CI 0.1 to 3.3]) were the most common.ConclusionThis is the first study to report both the IR and IB in this setting. There was a high IR of illness in the new sport of Para snowboard. The respiratory system had both the highest IR and IB.
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16
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Igolnikov I, Gallagher RM, Hainline B. Sport-related injury and pain classification. HANDBOOK OF CLINICAL NEUROLOGY 2018; 158:423-430. [PMID: 30482370 DOI: 10.1016/b978-0-444-63954-7.00039-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Pain is common in athletes, and pain management in sport has traditionally been equated with injury management. Although both pain and injury interfere with sport performance, they are not synonymous. Acute musculoskeletal injury commonly manifests as nociceptive pain, inflammatory pain, or both. Pain that persists beyond expected injury recovery must account for all potential contributors to pain, including ongoing biomechanical abnormalities, underlying pathophysiology, and psychosocial issues. Pain chronification involves multiple pathophysiologic and neurobehavioral processes that lead from acute injury-related pain to subacute and chronic pain, and must be distinguished from an ongoing biomechanical overuse pattern. The foundation of pain management in athletes is proper pain classification, which involves assessing for any combination of nociceptive/inflammatory pain, neuropathic pain, central sensitization, and autonomic/motor/affective manifestations of pain. Understanding this foundation is critical because there are scant evidence-based guidelines for the management of pain in sport. This chapter will explore the relationship of sport-related injury and pain, and will provide a management framework that is consistent with International Olympic Committee consensus.
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Affiliation(s)
- Ilya Igolnikov
- Penn Spine Center, Physical Medicine and Rehabilitation Department, University of Pennsylvania, Philadelphia, PA, United States
| | - Rollin M Gallagher
- Penn Pain Medicine, University of Pennsylvania, Philadelphia, PA, United States.
| | - Brian Hainline
- National Collegiate Athletic Association, Indianapolis, IN, United States
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17
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Fagher K, Jacobsson J, Dahlström Ö, Timpka T, Lexell J. An eHealth Application of Self-Reported Sports-Related Injuries and Illnesses in Paralympic Sport: Pilot Feasibility and Usability Study. JMIR Hum Factors 2017; 4:e30. [PMID: 29187343 PMCID: PMC5729228 DOI: 10.2196/humanfactors.8117] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 10/04/2017] [Accepted: 10/30/2017] [Indexed: 11/19/2022] Open
Abstract
Background Sport participation is associated with a risk of sports-related injuries and illnesses, and Paralympic athletes’ additional medical issues can be a challenge to health care providers and medical staff. However, few prospective studies have assessed sports-related injuries and illnesses in Paralympic sport (SRIIPS) over time. Advances in mobile phone technology and networking systems offer novel opportunities to develop innovative eHealth applications for collection of athletes’ self-reports. Using eHealth applications for collection of self-reported SRIIPS is an unexplored area, and before initiation of full-scale research of SRIIPS, the feasibility and usability of such an approach needs to be ascertained. Objective The aim of this study was to perform a 4-week pilot study and (1) evaluate the monitoring feasibility and system usability of a novel eHealth application for self-reported SRIIPS and (2) report preliminary data on SRIIPS. Methods An eHealth application for routine collection of data from athletes was developed and adapted to Paralympic athletes. A 4-week pilot study was performed where Paralympic athletes (n=28) were asked to weekly self-report sport exposure, training load, general well-being, pain, sleep, anxiety, and possible SRIIPS. The data collection was followed by a poststudy use assessment survey. Quantitative data related to the system use (eg, completed self-reports, missing responses, and errors) were analyzed using descriptive statistics. The qualitative feasibility and usability data provided by the athletes were condensed and categorized using thematic analysis methods. Results The weekly response rate was 95%. The athletes were of the opinion that the eHealth application was usable and feasible but stated that it was not fully adapted to Paralympic athletes and their impairments. For example, it was difficult to understand how a new injury or illness should be identified when the impairment was involved. More survey items related to the impairments were requested, as the athletes perceived that injuries and illnesses often occurred because of the impairment. Options for description of multifactorial incidents including an injury, an illness, and the impairment were also insufficient. Few technical issues were encountered, but athletes with visual impairment reported usability difficulties with the speech synthesizer. An incidence rate of 1.8 injuries and 1.7 illnesses per 100 hours of athlete exposure were recorded. The weekly pain prevalence was 56% and the impairment contributed to 20% of the reported incidents. Conclusions The novel eHealth-based application for self-reported SRIIPS developed and tested in this pilot study was generally feasible and usable. With some adaptation to accommodate Paralympic athletes’ prerequisites and improved technical support for athletes with visual impairment, this application can be recommended for use in prospective studies of SRIIPS. Trial Registration ClinicalTrials.gov NCT02788500; https://clinicaltrials.gov/ct2/show/NCT02788500 (Archived by WebCite at http://www.webcitation.org/6v56OqTeP)
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Affiliation(s)
- Kristina Fagher
- Rehabilitation Medicine Research Group, Department of Health Sciences, Lund University, Lund, Sweden
| | - Jenny Jacobsson
- Athletics Research Center, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Örjan Dahlström
- Athletics Research Center, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Toomas Timpka
- Athletics Research Center, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Jan Lexell
- Rehabilitation Medicine Research Group, Department of Health Sciences, Lund University, Lund, Sweden.,Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden.,Department of Health Science, Luleå University of Technology, Luleå, Sweden
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18
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Hainline B, Derman W, Vernec A, Budgett R, Deie M, Dvořák J, Harle C, Herring SA, McNamee M, Meeuwisse W, Lorimer Moseley G, Omololu B, Orchard J, Pipe A, Pluim BM, Ræder J, Siebert C, Stewart M, Stuart M, Turner JA, Ware M, Zideman D, Engebretsen L. International Olympic Committee consensus statement on pain management in elite athletes. Br J Sports Med 2017; 51:1245-1258. [DOI: 10.1136/bjsports-2017-097884] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 06/10/2017] [Accepted: 06/26/2017] [Indexed: 12/18/2022]
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19
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Fagher K, Jacobsson J, Timpka T, Dahlström Ö, Lexell J. Erratum to: The Sports-Related Injuries and Illnesses in Paralympic Sport Study (SRIIPSS): a study protocol for a prospective longitudinal study. BMC Sports Sci Med Rehabil 2016; 8:30. [PMID: 27708785 PMCID: PMC5039784 DOI: 10.1186/s13102-016-0055-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Kristina Fagher
- Department of Health Sciences, Rehabilitation Medicine Research Group, Lund University, PO Box 157221 00, Lund, Sweden
| | - Jenny Jacobsson
- Department of Medical and Health Sciences, Athletics Research Center, Linköping University, 581 83 Linköping, Sweden
| | - Toomas Timpka
- Department of Medical and Health Sciences, Athletics Research Center, Linköping University, 581 83 Linköping, Sweden
| | - Örjan Dahlström
- Department of Medical and Health Sciences, Athletics Research Center, Linköping University, 581 83 Linköping, Sweden ; Department of Behavioural Sciences and Learning, Linköping University, 581 83 Linköping, Sweden
| | - Jan Lexell
- Department of Health Sciences, Rehabilitation Medicine Research Group, Lund University, PO Box 157221 00, Lund, Sweden ; Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, 221 85 Lund, Sweden ; Department of Health Science, Luleå University of Technology, 971 87 Luleå, Sweden
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