Department of Exercise, Sport and Lifestyle Medicine

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Browsing Department of Exercise, Sport and Lifestyle Medicine by Author "Adam, Faatima"

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    Risk factors associated with sport-related injuries in para athletes: an analysis of the 2012 and 2016 Summer Paralympic Games
    (Stellenbosch : Stellenbosch University, 2025-01-01) Adam, Faatima; Runciman, Phoebe; Derman, Wayne; Schwellnus, Martin; Stellenbosch University. Faculty of Medical and Health Sciences. Dept. of Exercise, Sport and Lifestyle Medication.
    ENGLISH ABSTRACT: A Para athlete enters into competition with a pre-existing medical impairment, and perhaps an inherent risk for injury compared to able-bodied counterparts. For Para athletes, the risk and type of injury is dependent on the physiological or biomechanical dysfunction associated with their impairment. The relationship between an athletes’ medical impairment and sport-related injuries has not yet been comprehensively studied. In the first study, a narrative review of the literature was conducted summarising information regarding injury profiles associated with an athletes’ impairment type. Databases were searched for articles until June 2021. Impairment categories searched included: (1) Musculoskeletal (impaired passive range of movement (IPROM), limb deficiency (LD), leg length difference (LLD), short stature (SS)), (2) Neurological (brain disorders (BD), neuromuscular disorders (NMD), spinal cord injuries (SCI)), (3) Visual (VI), and (4) Intellectual (II) impairments. Twenty-one studies were identified that reported on injuries by impairment type. Most reviewed studies had variations in methodologies, limiting comparisons between studies. Impairment-specific studies showed differences in injury chronicity and anatomical area based on ambulatory status or impairment type. Studies with athletes who were ambulant reported higher numbers of lower limb injuries while shoulder injuries were only common amongst studies that investigated injuries during wheelchair sports yet were not reported by specific impairment type. The review showed that there is a substantial gap of impairment-related injury epidemiological literature in Para sport and a need for future studies to report on injuries by impairment type. In the second study, an epidemiological analysis of impairment-related injuries was conducted using the Paralympic Injury and Illness Surveillance Studies (PIISS) of the London 2012 and Rio 2016 Summer Paralympic Games (S-PGs). Combined analyses of injuries sustained were conducted for a total of 7222 athletes for 101 108 athlete-days. Injury incidence rates (IRs) and proportions were reported by impairment and age, sex, sport, period, chronicity, and anatomical area for athletes with BD, LD, NMD, SCI, VI and ‘all others’ (OTH: IMPROM, II, LLD, SS). The impairment group with the highest IR/1000 athlete-days was VI (13.6 (95% CI 11.9-15.7)), followed by NMD (13.3 (95%CI 10.9-16.1)), and SCI (11.1 (95% CI 9.7-12.8)). The precompetition period had an overall higher IR (13.8) for all impairment groups. Acute sudden-onset injuries (IR 5.8) were higher than gradual-onset injuries (IR 3.7), except for athletes with NMD (IR 5.8). Regression analysis showed that sport is a significant risk factor for injuries sustained by athletes with VI (p<0.0001). Sports with high IRs were football-5-a-side (25.9), athletics (16.9) and Judo (15.3). This study was the first study to report on impairment-specific injury risk factors from a combined analysis of two S-PGs. The findings from this thesis contribute towards advancing the understanding of impairment-related factors associated with injuries in athletes during a S-PGs. Clinicians working with Para athletes can gain impairment-specific information for training and injury prevention. Clinicians should work around; (1) decreasing precompetition injuries in athletes with musculoskeletal impairments, (2) prioritise postural control and balance in athletes with VI and (3) consider biomechanical compensations and assistive device usage as cause for injury in athletes with NMD.