The Prevalence of Injuries and Traumas in Elite Goalball Players

An Urgent Call for Concussion Incidence Measures in Para Sport for Athletes with Vision Impairment: A Narrative Review

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.

The Underlying Mechanisms of Sports Injuries in Paralympic Goalball: A Mixed-Method Study

OBJECTIVE

Data from the Paralympic Games indicate a fluctuating injury incidence in the Paralympic sport goalball, but the mechanisms behind have not been explored. The aims of this study are to (1) quantitatively analyze goalball injuries reported in the London 2012 and Rio 2016 Paralympic Games, (2) qualitatively explain the differences between both games, and (3) qualitatively assess general injury mechanisms and prevention opportunities of injuries in Goalball.

DESIGN

This is a mixed-method study. Injury incidence rates were analyzed from data collected during the 2012 and 2016 Paralympic Games. Then, semistructured interviews of games participants qualitatively explored injury mechanisms and prevention opportunities.

RESULTS

A reduction of injuries occurred from 2012 (incidence rate, 19.5; 95% confidence interval, 12.5-26.5) to 2016 (incidence rate: 5.6; 95% confidence interval, 1.7-9.5). In both games, acute traumatic injuries were most common. Female athletes reported higher rate of injuries compared with males ( P = 0.05). Qualitative data revealed that causes of injuries were collisions, overuse, and poor physical conditioning. The differences between the two games were explained by equipment, environment, and preparations.

CONCLUSIONS

The result from this study indicates that injuries in goalball are multifactorial. Ultimately, the mixed-method data from this study can help the sports context develop prevention measures.

Determinants of the prevalence and location of musculoskeletal pain in elite Para athletes

The tendency for musculoskeletal complaints, injuries, and traumas remains significant among Para athletes. The aim of the study was to identify and verify the variables that impact the incidence and location of musculoskeletal pain in elite athletes with disabilities. It was assumed, that the type of disability and not the type of sport, or the type of injuries and traumas is the crucial determinant of the prevalence and location of musculoskeletal pain in Para athletes. A direct-participatory observation method was used in the study including both subjective (surveys questionnaires) and objective (anthropometric) methods of assessment. The study included 35 male and female elite Para athletes from the Polish national team (sitting volleyball [SG1: n = 21], para swimming [SG2 = 14]). Both groups of Para athletes mostly reported pain in the neck (37%), and the lower back (34%). The Spearman's rank-order correlation showed several large inversely proportional relationships between somatic parameters and the values in the Nordic Musculoskeletal Questionnaire from the last 7 days (NMQ-7) for SG2 and some moderate to large correlations between body adiposity index (BAI) and the prevalence of injuries, the total number of rehabilitation sessions, the number of humeral joint and fingers rehabilitation sessions, breaks from training over 4 weeks in SG1. In both groups relationships were found between the duration of Paralympic training and the number of injuries and rehabilitation sessions (R = -0.4; P < .02) and between the exclusion from training for less 4 and over 4 weeks (R = -0.4; P < .03). The age of the Para athletes correlated with the NMQ-7 (wrists) (R = 0.4; P < .01). Both duration of disability and the type and severity of the disability may be crucial determinants of the prevalence and location of pain in the musculoskeletal system in Para athletes. Sport-specific training seems to induce specific musculoskeletal complaints.

The importance of extrinsic and intrinsic compensatory mechanisms to body posture of competitive athletes a systematic review and meta-analysis

The aim of this systematic review (qualitative analysis) was to identify the variables of changes induced by extrinsic (sport specific training) and intrinsic (individual anatomical predispositions) compensatory mechanisms that impact on the physiological magnitude of spinal curvatures in the sagittal plane and their deviations in the frontal plane. Furthermore, the aim of the quantitative analysis was to verify and objectivize the impact of these variables on athlete’s body posture. A search of electronic database (PubMed, EBSCO, MEDLINE) was conducted to identify all studies on sports training and athlete’s spine and body posture from 2011 to 2021. In the sagittal plane, the pooled proportion accounted for 44.97% (95% CI 31.22–58.72%) for thoracic hyperkyphosis (TH), 4.98% (95% CI 1.60–8.36%) for lumbar hyperlordosis (hyperLL), and 12.35% (95% CI 1.60–8.36%) for lumbar hypolordosis (hypoLL). Furthermore, in the sagittal plane, the pooled mean of thoracic kyphosis angle was 37.59° (95% CI 34.45–40.73%), whereas lumbar lordosis angle was 29.79° (95% CI 26.46–33.12%). Professional athletes tend to have postural disturbances and/or spinal curvature disorders in the sagittal and frontal planes. The meta-analysis indicated which intrinsic and extrinsic components might induce spinal abnormalities.

Hand Grip Strength vs. Locomotor Efficiency in Sitting Volleyball Players

The objective of this paper was to determine the relationship between hand grip strength and movement time (locomotor efficiency in a seated position using the upper and lower extremities) in sitting volleyball players. In addition, a comparison was made between the velocity curves for forward and backward locomotion. Nine male members of the sitting volleyball team participated in the study. Hydraulic and spring manual dynamometers were used to measure hand grip strength. Movement times were registered for distances of 1, 2, 3, 4, 5, 6 and 10-m with the use of the Smart Speed System photocells. Significant relationships between hand grip strength of the left (r_s=-0.78) and right (r_s=-0.73) hands and the forward movement time over a distance of 1-m were found. Hand grip strength had no significant relationship with either forward movement times at other distances or backward movement times. Results suggest that hand strength is linked to locomotor efficiency of sitting volleyball players. High hand grip strength makes the start easier by pushing away from the ground with the upper limbs.

The Impact of Internal Compensatory Mechanisms on Musculoskeletal Pain in Elite Polish Sitting Volleyball Players – A Preliminary Study

The purpose of the study was to evaluate the impact of (1) maximal muscular strength of the upper body and (2) fat mass on musculoskeletal pain and sagittal spinal curvature deviations in elite Polish sitting volleyball players. The study examined twelve players (age = 35.4 ± 6.9 years). The assessments were performed based on objective (anthropometric examinations, Medi Mouse, 1RM test) and subjective (NMQ = 7) measurements. All statistical analyses were performed using the SPSS. The lower back, the upper back and the neck were the most frequent painful areas. Statistical analyses showed a significant relationship between lumbar lordosis (LL) sagittal standing extension (r = 0.62; p = 0.03) and thoracic kyphosis (TK) sagittal standing flexion (r = -0.63; p = 0.28) with the 1RM. Furthermore, correlations between a body adiposity index and TK sagittal standing flexion and extension (r = -0.65; p = 0.05, r = - 0.58; p = 0.0.05) as well as LL sagittal standing flexion (r = 0.61; p = 0.05) were found. The body mass index correlated with wrist pain, whereas a very high relationship was found between pain in the wrists and knee joints. Neck pain positively correlated with TK and LL sagittal standing. Low back pain correlated with LL sagittal standing flexion and TK sagittal standing extension. Fat mass impacts the depth of anteroposterior spinal curvatures, what may cause pain in the neck and the lower back. The 1 RM bench press may influence the prevalence and location of musculoskeletal pain, whereas its values might be predicted by the depth of TK. A lower 1RM in the bench press may impact sagittal spinal curvature deviations. Deepen TK and LL significantly contribute to the prevalence of the neck pain.

Injuries and Illnesses Observed in Athletes from Beginner to Elite Levels at the 18th National Sports Festival for Persons with Disabilities in Japan

Objectives

: This study aimed to describe the injuries and illnesses that occurred at the 18th National Sports Festival for Persons with Disabilities in Japan, which was attended by more than 3000 athletes from beginner to elite levels.

Methods

: Records from medical stations set up at the venues for each sport were reviewed. The incidence rates (IRs) were calculated as the number of medical station visits per 1000 athlete-days. The backgrounds of injuries and illnesses were investigated.

Results

: In total, 3277 athletes attended the festival, and 134 eligible medical station visits were analyzed. Overall, 102 athletes complained of injuries. For the whole schedule of the festival, IRs were 15.5 for injuries and illnesses and 11.8 for injuries alone. For injuries and illnesses, high IRs were seen in soccer (39.8), basketball (25.6), and foot baseball (22.4); for injuries alone, high IRs were also seen in soccer (33.6), basketball (25.6), and foot baseball (16.8). The most frequent symptoms were internal symptoms (n=32), contusions (n=30), and wounds (n=24). Joint sprains occurred in various sports, whereas muscle strains happened mainly in disciplines demanding sprinting or high agility. Of the 55 cases that occurred during events or public rehearsals, 45 were traumatic, whereas the relation to sports activities was not described in 51 cases. Of participants with internal symptoms, 11 were suggested to have viral infections. We identified 21 injuries caused by falls.

Conclusions

: Minor trauma and viral infection were the most frequently observed symptoms among injuries and illnesses, respectively. Structured medical records and organized surveillance systems should be utilized to improve data collection and understand the onset of injury and illness.

Prevalence and incidence of injuries in para athletes: a systematic review with meta-analysis and GRADE recommendations

OBJECTIVE

To investigate prevalence, incidence and profile of musculoskeletal injuries in para athletes.

DESIGN

Systematic review.

DATA SOURCES

Searches were conducted in MEDLINE, EMBASE, AMED, SPORTSDiscus, CINAHL and hand searching.

ELIGIBILITY CRITERIA

Studies were considered if they reported prevalence or incidence of musculoskeletal injuries in para athletes. Study selection, data extraction and analysis followed the protocol. Meta-analyses were conducted to estimate the prevalence and incidence rate among studies and subgroup analyses investigated whether methodological quality and sample size of the studies influenced on the estimated injury prevalence and incidence. The Grading of Recommendations Assessment, Development and Evaluation system determined the strength of evidence.

RESULTS

Forty-two studies were included. The prevalence of musculoskeletal injuries was 40.8% (95% CI 32.5% to 49.8%). Because of imprecision, indirectness and inconsistency, the strength of evidence was very low quality. The incidence of musculoskeletal injuries was 14.3 injuries per 1000 athlete-days (95% CI 11.9 to 16.8). The strength of evidence was low quality because of imprecision and indirectness. The subgroup analyses revealed that the sample size influenced on estimated injury prevalence and methodological quality influenced on estimated incidence. Injuries were more prevalent in the shoulder, for non-ambulant para athletes, and in the lower limbs, for ambulant para athletes.

SUMMARY/CONCLUSION

Para athletes show high prevalence and incidence of musculoskeletal injuries. Current very low-quality and low-quality evidence suggests that future high-quality studies with systematic data collection, larger sample size and specificities of para athletes are likely to change estimates of injury prevalence and incidence in para athletes.

PROSPERO REGISTRATION NUMBER

CRD42020147982.