Injury incidence according to athlete impairment type during the 2012 and 2016 Summer Paralympic Games: a combined analysis of 101 108 athlete days

Faatima Adam; Wayne Derman; Martin Schwellnus; Pieter-Henk Boer; Esme Jordaan; Phoebe Runciman

doi:10.1136/bjsports-2023-107144

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 Jan 29:bjsports-2023-107144. doi: 10.1136/bjsports-2023-107144. Online ahead of print.

Authors

Faatima Adam¹, Wayne Derman^{1

2}, Martin Schwellnus^{2

3}, Pieter-Henk Boer⁴, Esme Jordaan^{5

6}, Phoebe Runciman⁷

Affiliations

¹ Institute of Sport and Exercise Medicine, Department of Exercise, Sport and Lifestyle Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa.
² International Olympic Committee Research Centre, Pretoria, South Africa.
³ Sport, Exercise Medicine and Lifestyle Institute, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
⁴ Department of Human Movement Science, Cape Peninsula University of Technology, Cape Town, South Africa.
⁵ Biostatistics Research Unit, South African Medical Research Council, Cape Town, South Africa.
⁶ Statistics and Population Studies Department, University of the Western Cape, Cape Town, South Africa.
⁷ Institute of Sport and Exercise Medicine, Department of Exercise, Sport and Lifestyle Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa para@sun.ac.za.

PMID: 38286574
DOI: 10.1136/bjsports-2023-107144

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.

Keywords: Disabled Persons; Epidemiology; Para-Athletes; Sporting injuries; Sports medicine.