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    Injury and Illness Surveys

    Under the IPC Medical Code, the IPC is dedicated to improving the safety of Paralympic sport, and pursues multiple courses of action to mitigate injury and illness risks. Among these initiatives, the IPC Medical Committee conducted an epidemiological study to monitor injury and illness in athletes competing at the London 2012 Paralympic Games.

    All but four nations participated in the project by reporting athlete injury and illness on a daily basis in a web-based surveillance system. The period of data collection was 14 days, from 27 August through 9 September 2012 (11 days of the competition period and three days of the pre-competition period). The outcomes have recently been published in scientific journals (see references below).

    Data has been captured from 3565 athletes from 160 delegations.

    The main findings can be summarised as follows:

    • the incidence rate for injury (injury per 1000 athlete-days) was 12.7. The incidence rate for illness was 13.2. Rates are similar across gender. These rates are slightly higher compared to findings in able-bodied elite sportsmen participating in multisport settings.

    • illnesses are at least as prevalent as injuries during Paralympic Games.

    • most injuries are acute injuries at the Games, and mostly related to upper limb regions (shoulder, elbow, wrist and hand).

    • the sports with the highest incidence rates are football 5-a-side, powerlifting, goalball, wheelchair fencing and wheelchair rugby. Safest sports are shooting, rowing and sailing.

    • most illnesses are reported for athletes competing in equestrian, powerlifting and athletics. Least vulnerable to illness are the athletes in football 7-a-side, shooting and football 5-a-side.

    • mainly illnesses of respiratory, skin, digestive, nervous and genitourinary systems are reported.

    It is the first time such a large scale epidemiological study has taken place on (elite) athletes with an impairment. These data have direct clinical relevance (e.g., a team physician travelling to a 10-day event with 100 Paralympic athletes can anticipate seeing about 12–13 injuries, about half of which will be new onsets, acute injuries). If the team composition includes athletes participating in the higher risk sports listed above, it is likely that the team will incur more than 12–13 injuries. The team physician should be ready to diagnose and treat a high percentage of upper limb injuries and anticipate a range of illnesses to deal with.

    More detailed analysis by sport and/or impairment type is currently ongoing.

    The work at the London 2012 Games builds on the experiences gained during epidemiological research at past Paralympic Winter Games. Injury surveillance systems were successfully implemented at the 2002, 2006 and 2010 Paralympic Winter Games. The patterns of injury are slowly emerging over time in winter sports, with higher risks in Para alpine skiing and Para ice hockey. The findings were discussed with the sports and, amongst other strategies, led to the revision of regulations on protective equipment and adaptive equipment. Over time a shift has been seen from acute to overuse injuries, which require further study of training and prevention strategies.

    Data from the Sochi 2014 Paralympic Winter Games are currently under analysis.

    In the spirit of promoting collaborative efforts with medical and scientific colleagues in International Sports Federations (IFs) and National Paralympic Committees (NPCs), requests for injury and illness data to be made available to IFs and NPCs can be considered. Interested parties should contact the IPC Medical Manager to receive the “Guidelines for sharing data from the Paralympic Injury and Illness Surveillance System.”

    Original Publications (available from the IPC upon request):

    Blauwet, C.A., Cushman, D., Emery, C., Willick, S.E., Webborn, N., Derman, W., Schwellnus, M., Stomphorst, J., & Van de Vliet, P. (2016). Risk of Injuries in Paralympic Track and Field Differs by Impairment and Event Discipline: A Prospective Cohort Study at the London 2012 Paralympic Games. American Journal of Sports Medicine, 44(6), 1455-1462.

    Derman, W., Schwellnus, M.P., Jordaan, E., Runciman, P., Van de Vliet, P., Blauwet, C., Webborn, N., Willick, S., & Stomphorst, J. (2016). High incidence of injury at the Sochi 2014 Winter Paralympic Games: a prospective cohort study of 6564 athlete days. British Journal of Sports Medicine, 50(17), 1069-1074.

    Derman, W., Schwellnus, M.P., Jordaan, E., Runciman, P., Van de Vliet, P., Blauwet, C., Webborn, N., Willick, S., & Stomphorst, J. (2016). The incidence and patterns of illness at the Sochi 2014 Winter Paralympic Games: a prospective cohort study of 6564 athlete days. British Journal of Sports Medicine, 50(17), 1064-1068.

    Willick, S.E., Cushman, D.M., Blauwet, C.A., Emery, C., Webborn, N., Derman, W., Schwellnus, M., Stomphorst, J., & Van de Vliet, P. (2015). The Epidemiology of Injuries in Powerlifting at the London 2012 Paralympic Games: An Analysis of 1411 Athlete-Days. Scandinavian Journal of Medicine & Science in Sports, 26(10), 1233-1238.

    Webborn, N., Cushman, D., Blauwet, C.A., Emery, C., Derman, W., Schwellnus, M., Stomphorst, J., Van de Vliet, P., & Willick, S.E. (2015). The Epidemiology of Injuries in Football at the London 2012 Paralympic Games. Physical Medicine and Rehabilitation, 8(6), 545-552.

    Derman, W., Schwellnus, M., Jordaan, E., Blauwet, C., Emery, C., Pit-Grosheide, P., Patino Marques, N.A., Martinez-Ferrer, O., Stomphorst, J., Van de Vliet, P., Webborn, N., & Willick, S. (2013). Illness and injury in athletes during the competition period at the London 2012 Paralympic Games – Development and implementation of a web-based surveillance system (web-IISS) for team medical staff. British Journal of Sports Medicine, 47, 420-425.

    Willick, S., Webborn, N., Emery, C., Blauwet, C., Pit-Grosheide, P., Stomphorst, J., Van de Vliet, P., Patino Marques, N.A., Martinez-Ferrer, O., Jordaan, E., Derman, W., & Schwellnus, M. (2013). The epidemiology of injuries at the London 2012 Paralympic Games. British Journal of Sports Medicine, 47, 426-432.

    Schwellnus, M., Derman, W., Jordaan, E., Blauwet, C., Emery, C., Pit-Grosheide, P., Patino Marques, N.A., Martinez-Ferrer, O., Stomphorst, J., Van de Vliet, P., Webborn, N., & Willick, S. (2013). Factors associated with illness in athletes participating in the London 2012 Paralympic Games – A prospective cohort study involving 49910 athlete days. British Journal of Sports Medicine, 47, 433-440.

    Webborn, N., Willick, S., & Reeser, C. (2006). Injuries among disabled athletes during the 2002 Winter Paralympic Games. Medicine and Science in Sports and Exercise, 38, 5, 811-815.

    Webborn, N., Willick, S., & Emery, C.A. (2012). The injury experience at the 2010 Winter Paralympic Games. Clinical Journal of Sports Medicine, 22, 1, 3-9.

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