The Sports-Related Injuries and Illnesses in Paralympic Sport Study (SRIIPSS): a study protocol for a prospective longitudinal study

Kristina Fagher, Jenny Jacobsson, Toomas Timpka, Örjan Dahlström, Jan Lexell, Kristina Fagher, Jenny Jacobsson, Toomas Timpka, Örjan Dahlström, Jan Lexell

Abstract

Background: Paralympic sport provides sporting opportunities for athletes with a disability, with the Paralympic Games as the main event. Participation in sport is, however, associated with a significant risk for sustaining injuries and illnesses. Our knowledge of sports-related injuries and illnesses in Paralympic sport is very limited and there are no large-scale epidemiological cohort studies. The purpose here is to present a protocol for a prospective longitudinal study: The Sports-Related Injuries and Illnesses in Paralympic Sport Study (SRIIPSS).

Methods/design: An argument-based method for investigation of design problems was used to structure the study protocol. The primary requirement of the protocol is to allow prospective studies over time and include exposure to both training and competition. To reflect the complexity of Paralympic sport with athletes' pre-existing impairments, use of assistive equipment, pain and other and medical issues, it is required that the data collection system is specifically adapted to Paralympic sport. To allow the collection of data, at the same time as there is limited access to coaches and medical personnel, it is advantageous that data can be collected online directly from the athletes. Based on this a self-report athlete monitoring system will be developed, where the athletes can enter data weekly via their mobile phones or lap-tops. Data will be collected from around 100 Swedish Paralympic athletes for approximately 1 year, which will allow us to i) prospectively estimate the annual incidence of sports-related injuries and illnesses and ii) explore risk factors and mechanisms for sustaining sports-related injuries and illnesses based on athlete exposure and training loads.

Discussion: For effective implementation of injury and illness prevention measures, comprehensive epidemiological knowledge is required. This study will be the first prospective longitudinal self-report study of sports-related injuries and illnesses in Paralympic sport over a longer period of time. The results will eventually contribute to the development of evidence-based preventive measures specifically adapted to Paralympic sport in order to provide safe and healthy sport participation. Thereby, the project will be of relevance for Paralympic athletes at all levels and to the Paralympic Movement.

Trial registration: The study is registered at ClinicalTrials.gov (Identifier: NCT02788500; Registration date: 22 May 2016).

Keywords: Athletic injuries; Epidemiology; Research protocol; Sports for persons with disabilities; Sports medicine.

Figures

Fig. 1
Fig. 1
Requirements and associations underlying the study protocol for The Sports-Related Injuries and Illnesses in Paralympic Sport Study (SRIIPSS)

References

    1. International Paralympic Committee: . Accessed 5 May 2016.
    1. Vanlandewijck YCTWR. The Paralympic athlete. Handbook of sports medicine and science. 2. Oxford: Wiley-Blackwell; 2011.
    1. World Health Organization . Global Recommendations on Physical Activity for Health. Geneva: World Health Organization; 2010.
    1. Mountjoy M, Andersen LB, Armstrong N, Biddle S, Boreham C, Bedenbeck HP, Ekelund U, Engebretsen L, Hardman K, Hills AP, et al. International Olympic Committee consensus statement on the health and fitness of young people through physical activity and sport. Br J Sports Med. 2011;45(11):839–848. doi: 10.1136/bjsports-2011-090228.
    1. Lee IM, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet. 2012;380(9838):219–229. doi: 10.1016/S0140-6736(12)61031-9.
    1. Zwinkels M, Verschuren O, Lankhorst K, van der Ende-Kastelijn K, de Groot J, Backx F, Visser-Meily A, Takken T. Sport-2-Stay-Fit study: Health effects of after-school sport participation in children and adolescents with a chronic disease or physical disability. BMC Sports Sci Med Rehabil. 2015;7:22. doi: 10.1186/s13102-015-0016-7.
    1. Alingh RA, Hoekstra F, van der Schans CP, Hettinga FJ, Dekker R, van der Woude LH. Protocol of a longitudinal cohort study on physical activity behaviour in physically disabled patients participating in a rehabilitation counselling programme: ReSpAct. BMJ Open. 2015;5(1):e007591. doi: 10.1136/bmjopen-2015-007591.
    1. Sahlin KB, Lexell J. Impact of Organized Sports on Activity, Participation, and Quality of Life in People With Neurologic Disabilities. PM R. 2015;7(10):1081–1088. doi: 10.1016/j.pmrj.2015.03.019.
    1. Verhagen E, van Mechelen W. Sports Injury Research. 2. New York: Oxford University Press; 2010.
    1. Ljungqvist A, Jenoure P, Engebretsen L, Alonso JM, Bahr R, Clough A, De Bondt G, Dvorak J, Maloley R, Matheson G, et al. The International Olympic Committee (IOC) Consensus Statement on periodic health evaluation of elite athletes March 2009. Br J Sports Med. 2009;43(9):631–643. doi: 10.1136/bjsm.2009.064394.
    1. Hägglund M, Waldén M, Magnusson H, et al. Injuries affect team performance negatively in professional football: an 11-year follow-up of the UEFA Champions League injury study. Br J Sports Med. 2013;47(12):738–42. doi: 10.1136/bjsports-2013-092215.
    1. Fagher K, Lexell J. Sports-related injuries in athletes with disabilities. Scand J Med Sci Sports. 2014;24(5):e320–331. doi: 10.1111/sms.12175.
    1. Webborn N, Van de Vliet P. Paralympic medicine. Lancet. 2012;380(9836):65–71. doi: 10.1016/S0140-6736(12)60831-9.
    1. Willick SE, Cushman DM, Blauwet CA, Emery C, Webborn N, Derman W, Schwellnus M, Stomphorst J, Van de Vliet P. The epidemiology of injuries in powerlifting at the London 2012 Paralympic Games: An analysis of 1411 athlete-days. Scand J Med Sci Sports. 2015. doi: 10.1111/sms.12554.
    1. Fagher K, Forsberg A, Jacobsson J, Timpka T, Dahlström Ö, Lexell J. Paralympic athletes’perceptions of their experiences of sports-related injuries, risk factors and preventive possibilities. Eur J Sport Sci. 2016
    1. Bernardi M, Guerra E, Di Giacinto B, Di Cesare A, Castellano V, Bhambhani Y. Field evaluation of paralympic athletes in selected sports: implications for training. Med Sci Sports Exerc. 2010;42(6):1200–1208.
    1. Walden M, Atroshi I, Magnusson H, Wagner P, Hagglund M. Prevention of acute knee injuries in adolescent female football players: cluster randomised controlled trial. BMJ. 2012;344:e3042. doi: 10.1136/bmj.e3042.
    1. Emery CA, Rose MS, McAllister JR, Meeuwisse WH. A prevention strategy to reduce the incidence of injury in high school basketball: a cluster randomized controlled trial. Clin J Sport Med. 2007;17(1):17–24. doi: 10.1097/JSM.0b013e31802e9c05.
    1. Quarrie KL, Gianotti SM, Hopkins WG, Hume PA. Effect of nationwide injury prevention programme on serious spinal injuries in New Zealand rugby union: ecological study. BMJ. 2007;334(7604):1150. doi: 10.1136/.
    1. van Mechelen W, Hlobil H, Kemper HC. Incidence, severity, aetiology and prevention of sports injuries. A review of concepts. Sports Med. 1992;14(2):82–99. doi: 10.2165/00007256-199214020-00002.
    1. Coutts A, Cormack S. Monitoring the Training Response. In: Joyce D, Lewindon D, editors. High-Performance Training for Sports. Champaign: Human Kinetics Publisher; 2014.
    1. Halson SL. Monitoring training load to understand fatigue in athletes. Sports Med. 2014;44(Suppl 2):S139–147. doi: 10.1007/s40279-014-0253-z.
    1. Derman W, Schwellnus M, Jordaan E, Blauwet CA, Emery C, Pit-Grosheide P, Marques NA, Martinez-Ferrer O, Stomphorst J, Van de Vliet P, et al. 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. Br J Sports Med. 2013;47(7):420–425. doi: 10.1136/bjsports-2013-092375.
    1. Webborn N, Emery C. Descriptive epidemiology of Paralympic sports injuries. PM R. 2014;6(8 Suppl):S18–22. doi: 10.1016/j.pmrj.2014.06.003.
    1. Weiler R, Van Mechelen W, Fuller C, Verhagen E. Sport Injuries Sustained by Athletes with Disability: A Systematic Review. Sports Med 2016. [Epub ahead of print].
    1. Ekegren CL, Gabbe BJ, Finch CF. Sports Injury Surveillance Systems: A Review of Methods and Data Quality. Sports Med. 2016;46(1):49–65. doi: 10.1007/s40279-015-0410-z.
    1. Fuller CW, Ekstrand J, Junge A, Andersen TE, Bahr R, Dvorak J, Hagglund M, McCrory P, Meeuwisse WH. Consensus statement on injury definitions and data collection procedures in studies of football (soccer) injuries. Br J Sports Med. 2006;40(3):193–201. doi: 10.1136/bjsm.2005.025270.
    1. Pluim BM, Fuller CW, Batt ME, Chase L, Hainline B, Miller S, Montalvan B, Renstrom P, Stroia KA, Weber K, et al. Consensus statement on epidemiological studies of medical conditions in tennis, April 2009. Br J Sports Med. 2009;43(12):893–897. doi: 10.1136/bjsm.2009.064915.
    1. Fuller CW, Molloy MG, Bagate C, Bahr R, Brooks JH, Donson H, Kemp SP, McCrory P, McIntosh AS, Meeuwisse WH, et al. Consensus statement on injury definitions and data collection procedures for studies of injuries in rugby union. Br J Sports Med. 2007;41(5):328–331. doi: 10.1136/bjsm.2006.033282.
    1. Junge A, Engebretsen L, Alonso JM, Renstrom P, Mountjoy M, Aubry M, Dvorak J. Injury surveillance in multi-sport events: the International Olympic Committee approach. Br J Sports Med. 2008;42(6):413–421. doi: 10.1136/bjsm.2008.046631.
    1. Jacobsson J, Timpka T, Kowalski J, Nilsson S, Ekberg J, Dahlstrom O, Renstrom P. Injury patterns in Swedish elite athletics: annual incidence, injury types and risk factors. Br J Sports Med. 2013;47(15):941–952. doi: 10.1136/bjsports-2012-091651.
    1. Florenes TW, Nordsletten L, Heir S, Bahr R. Recording injuries among World Cup skiers and snowboarders: a methodological study. Scand J Med Sci Sports. 2011;21(2):196–205. doi: 10.1111/j.1600-0838.2009.01048.x.
    1. Jacobsson J, Timpka T, Ekberg J, Kowalski J, Nilsson S, Renstrom P. Design of a protocol for large-scale epidemiological studies in individual sports: the Swedish Athletics injury study. Br J Sports Med. 2010;44(15):1106–1111. doi: 10.1136/bjsm.2009.067678.
    1. Clarsen B, Bahr R. Matching the choice of injury/illness definition to study setting, purpose and design: one size does not fit all! Br J Sports Med. 2014;48(7):510–512. doi: 10.1136/bjsports-2013-093297.
    1. Skille E. Understanding sports clubs as sport ploicy implementers: A Theoretical Framework for the Analysis of the Implementation of Central Sport Policy through Local and Voluntary Sport Organizations. Int Rev Sociol Sport. 2008;43(2):181–200. doi: 10.1177/1012690208096035.
    1. Ustun TB, Chatterji S, Kostansjek N, Bickenbach J. WHO’s ICF and functional status information in health records. Health Care Financ Rev. 2003;24(3):77–88.
    1. Meeusen R, Duclos M, Foster C, Fry A, Gleeson M, Nieman D, Raglin J, Rietjens G, Steinacker J, Urhausen A. Prevention, diagnosis, and treatment of the overtraining syndrome: joint consensus statement of the European College of Sport Science and the American College of Sports Medicine. Med Sci Sports Exerc. 2013;45(1):186–205. doi: 10.1249/MSS.0b013e318279a10a.
    1. Saw AE, Main LC, Gastin PB. Monitoring athletes through self-report: factors influencing implementation. J Sports Sci Med. 2015;14(1):137–146.
    1. Hauret KG, Jones BH, Bullock SH, Canham-Chervak M, Canada S. Musculoskeletal injuries description of an under-recognized injury problem among military personnel. Am J Prev Med. 2010;38(1 Suppl):S61–70. doi: 10.1016/j.amepre.2009.10.021.
    1. Timpka T, Jacobsson J, Ekberg J, Finch CF, Bichenbach J, Edouard P, Bargoria V, Branco P, Alonso JM. Meta-narrative analysis of sports injury reporting practices based on the Injury Definitions Concept Framework (IDCF): A review of consensus statements and epidemiological studies in athletics (track and field) J Sci Med Sport. 2015;18(6):643–650. doi: 10.1016/j.jsams.2014.11.393.
    1. Pollack KM, D’Angelo J, Green G, Conte S, Fealy S, Marinak C, McFarland E, Curriero FC. Developing and Implementing Major League Baseball’s Health and Injury Tracking System. Am J Epidemiol. 2016;183(5):490–496. doi: 10.1093/aje/kwv348.
    1. Raysmith BP, Drew MK. Performance success or failure is influenced by weeks lost to injury and illness in elite Australian track and field athletes: A 5-year prospective study. J Sci Med Sport. 2016; doi:10.1016/j.jsams.2015.12.515.
    1. Gabbett TJ. The training-injury prevention paradox: should athletes be training smarter and harder? Br J Sports Med. 2016;50(5):273–280. doi: 10.1136/bjsports-2015-095788.
    1. Centers for Disease Control and Prevention (CDC) Updated guidelines for evaluating public health surveillence systems: recommendations from the guidelines working group. MMWR. 2011;50:1–36.
    1. Ekegren C, Donaldsson A, Gabbe B, Finch C. Implementing injury surveillance systems alongside injury prevention programs: evaluation of an online surveillance system in a community setting. Inj Epidemiol. 2014;1(1):19. doi: 10.1186/s40621-014-0019-y.
    1. STROBE Statement. . Accessed 19 May 2016.
    1. Rittel H, Webber M. Dilemmas in a general theory of planning. Policy Sci. 1973;4:55–169. doi: 10.1007/BF01405730.
    1. Shum SB, Hammond N. Argumentation-based design rationale: what use at what cost? Int J Hum Comp Stud. 1994;40(4):603–652. doi: 10.1006/ijhc.1994.1029.
    1. Parasport Sweden. . Accessed 22 Apr 2016.
    1. Timpka T, Jacobsson J, Dahlstrom O, Kowalski J, Bargoria V, Ekberg J, Nilsson S, Renstrom P. The psychological factor ‘self-blame’ predicts overuse injury among top-level Swedish track and field athletes: a 12-month cohort study. Br J Sports Med. 2015;49(22):1472–1477. doi: 10.1136/bjsports-2015-094622.
    1. Tranaeus U, Johnson U, Engström B, Skillgate E. Psychological antecedents of overuse injuries in Swedish elite floorball players. Athletic Insight: Online J Sport Psychol. 2014;6(2):155–172.
    1. Timpka T, Alonso JM, Jacobsson J, Junge A, Branco P, Clarsen B, Kowalski J, Mountjoy M, Nilsson S, Pluim B, et al. Injury and illness definitions and data collection procedures for use in epidemiological studies in Athletics (track and field): consensus statement. Br J Sports Med. 2014;48(7):483–490. doi: 10.1136/bjsports-2013-093241.
    1. Polson P, Lewis C, Rieman J, Wharton C. Cognitive walkthroughs: a method for theory-based evaluation of user interfaces. Int J Man Mach Stud. 1992;36:741–773. doi: 10.1016/0020-7373(92)90039-N.
    1. Meeuwisse WH, Tyreman H, Hagel B, Emery C. A dynamic model of etiology in sport injury: the recursive nature of risk and causation. Clin J Sport Med. 2007;17(3):215–219. doi: 10.1097/JSM.0b013e3180592a48.
    1. Finch CF, Cook J. Categorising sports injuries in epidemiological studies: the subsequent injury categorisation (SIC) model to address multiple, recurrent and exacerbation of injuries. Br J Sports Med. 2014;48(17):1276–1280. doi: 10.1136/bjsports-2012-091729.
    1. Wilson TD, Gilbert DT. Explaining Away: A Model of Affective Adaptation. Perspect Psychol Sci. 2008;3(5):370–386. doi: 10.1111/j.1745-6924.2008.00085.x.
    1. McCracken LM, Morley S. The psychological flexibility model: a basis for integration and progress in psychological approaches to chronic pain management. J Pain. 2014;15(3):221–234. doi: 10.1016/j.jpain.2013.10.014.
    1. Miller LC, Murphy R, Buss AH. Consciousness of body: Private and public. J Pers Soc Psych. 1981;41(2):397–406. doi: 10.1037/0022-3514.41.2.397.
    1. Seifriz J, Duda J, Chi L. The Relationship of Perceived Motivational Climate to Intrinsic Motivation and Beliefs About Success in Basketball. J Sports Exerc Psychol. 1992;14:375–391. doi: 10.1123/jsep.14.4.375.
    1. Davis C, Brewer H, Ratusny D. Behavioral frequency and psychological commitment: necessary concepts in the study of excessive exercising. J Behav Med. 1993;16(6):611–628. doi: 10.1007/BF00844722.
    1. EuroQolGroup EuroQol-a new facility for the measurement of health-related quality of life. Health Policy. 1990;16(3):199–208. doi: 10.1016/0168-8510(90)90421-9.
    1. Gabbett TJ, Jenkins DG. Relationship between training load and injury in professional rugby league players. J Sci Med Sport. 2011;14(3):204–209. doi: 10.1016/j.jsams.2010.12.002.
    1. Foster C, Florhaug JA, Franklin J, Gottschall L, Hrovatin LA, Parker S, Doleshal P, Dodge C. A new approach to monitoring exercise training. J Strength Cond Res. 2001;15(1):109–115.
    1. Drew MK, Finch CF. The Relationship Between Training Load and Injury, Illness and Soreness: A Systematic and Literature Review. Sports Med. 2016;46(6):861–83. doi: 10.1007/s40279-015-0459-8.
    1. Derman W, Schwellnus M, Jordaan E. Clinical characteristics of 385 illnesses of athletes with impairment reported on the WEB-IISS system during the London 2012 Paralympic Games. PM R. 2014;6(8 Suppl):S23–30. doi: 10.1016/j.pmrj.2014.05.016.
    1. Barell V, Aharonson-Daniel L, Fingerhut LA, Mackenzie EJ, Ziv A, Boyko V, Abargel A, Avitzour M, Heruti R. An introduction to the Barell body region by nature of injury diagnosis matrix. Inj Prev. 2002;8(2):91–96. doi: 10.1136/ip.8.2.91.
    1. Clarsen B, Ronsen O, Myklebust G, Florenes TW, Bahr R. The Oslo Sports Trauma Research Center questionnaire on health problems: a new approach to prospective monitoring of illness and injury in elite athletes. Br J Sports Med. 2014;48(9):754–760. doi: 10.1136/bjsports-2012-092087.
    1. Saw AE, Main LC, Gastin PB. Monitoring the athlete training response: subjective self-reported measures trump commonly used objective measures: a systematic review. Br J Sports Med. 2016;50(5):281–291. doi: 10.1136/bjsports-2015-094758.

Source: PubMed

3
Předplatit