Medication use by Team South Africa during the XXVIIIth Olympiad: A model for quantity estimation for multi-coded team events

Objective. This descriptive study was undertaken to report the medications used by the athletes and officials of Team South Africa at the 2004 Olympic Games and to provide a model for the estimation of quantities to be used for planning support to future events. Setting. South African medical facility, 2004 Olympic Games, Athens, Greece. Methods. The names of the medications, including the dosage and quantity of medications dispensed, were recorded in the pharmacy stock control book at the South African medical facility, 2004 Olympic Games, Athens, Greece. Retrospective review of patient files and medical encounter forms was also undertaken to check against the pharmacy stock control book to ensure complete data capture of dispensed medications. Main outcome measures. Quantities of medications consumed during the observation period. The units of medication consumed per travelling team member were calculated by dividing the number of units (tablets, capsules, tubes, inhalers, bottles and ampoules) used during the trip by the total number of travelling team members. Results. Complete records of medications included in the travelling pharmacy are described. Quantities of medications included ranged from single units to 2 250 units and percentage use of various medications varied from 0% to 100% of stocks. Units per team member ranged from 0 to 9.43. Medications were consumed from all categories of agents. The most utilised agents included the analgesics, musculoskeletal and non-steroidal anti-inflammatory agents as well as certain vitamin and mineral supplements. Conclusions. This study describes the consumption of pharmacological agents by the athletes and officials of Team South Africa during the Athens 2004 Olympic Games. It also provides a model to assist with the estimation of quantities of medications to be included in the travelling pharmacy for future international multi-coded sports events

Profile of medical and injury consultations of Team South Africa during the XXVIIIth Olympiad, Athens 2004

Objective. This descriptive study was undertaken to document the nature of medical and injury consultations of the athletes and officials of the South African Team at the 2004 Olympic Games, and to provide data for planning future events. Setting. South African medical facility, 2004 Olympic Games, Athens, Greece. Methods. Total number of consultations and diagnoses were ascertained from medical logs and patient files which were completed daily by the members of the medical team. A retrospective clinical audit of medical records was then undertaken and the data were then compared with similar data collected during the Sydney 2000 Olympic Games. Acute and chronic-soft tissue (muscle strain, ligament sprain, tendon injury, contusion or laceration) and bony injury were analysed in terms of nature of injury, grading of severity and anatomical region injured. Main outcome measures. Number of consultations due to medical complaints or injuries among athletes and officials. Results. A total of 180 medical consultations were logged during the time in Athens while 348 consultations were logged in Sydney. The daily consultation rate was 6 per day in Athens compared with 13 per day in Sydney. In Athens, 84% of consultations were with athletes and the remainder (16%) with officials - this was similar to Sydney. The most common medical complaints in Athens were dermatological (16%), ENT (13%), and respiratory (8%) in nature, which contrasts with the profile of consultations in Sydney (ENT 18%; neurological system 16% and respiratory 16%). Acute injury and chronic injury accounted for 26% and 14% of consultations respectively. In Athens, the most common acute and chronic injuries were soft-tissue injuries. The most common acute injury regions were the foot and ankle (25%), upper leg (17%) and knee (17%). A total 77% of acute injuries were grade I, 17% grade II and 6% grade III in severity. The most common chronic injury regions were foot and ankle (32%), lumbar spine (32%), and shoulder (11%). These injury profiles were similar to those documented in Sydney 2000. Conclusions. Injury and illness complaints of the South African team were fewer in Athens 2004 compared with those documented during Sydney 2000. This can be attributed to local environmental conditions and travel across time zones. These data should be useful for planning medical services for future multi-coded events. The analysis of the nature of consultations suggests that it should be a prerequisite for physicians travelling with a multi-coded events team to have broad knowledge of both medical and injury management of athletes. Specifically, a sound knowledge of the management of soft-tissue injury is an important prerequisite for the personnel of the medical team

If the shoe fits... should you just wear it? A complete calcaneal stress fracture in a female recreational runner

Shoe choice by runners may follow trends related to purported generalised benefits rather than following an individual risk- benefit analysis. The benefits and risks related to minimalist footwear for running has been a much debated topic. The authors report a case of a complete calcaneal stress fracture in an otherwise healthy female recreational runner in the first three weeks following her conversion from a traditional cushioned running shoe to a minimalist type of running shoe. Clinicians should be aware of the potential added bone stress with reduced cushioning and the potential risks in transitioning to new footwear

The effect of selective beta1-blockade on EMG signal characteristics during progressive endurance exercise

This study analysed the effect of selective b1- blockade on neuromuscular recruitment characteristics during progressive endurance exercise. Ten healthy subjects ingested a selective b1-blocker, acebutolol (200 mg b.d.), for 7 days (for one of two cycling trials), with a 10-day wash-out period between trials. On the last day of acebutolol ingestion subjects performed three successive 15-min rides at 30%, 50% and 70% of their peak power output and then cycled at increasing (15 W min-1) work rates to exhaustion. Force output, heart rate, submaximal V_O2, rate of perceived exertion (RPE), electromyographic (EMG) data and blood lactate were captured during the cycling activity. Peak work rate [270 (111) W vs 197 (75) W, CON vs BETA, P<0.01], time to exhaustion [49.7 (23.2) min vs 40.3 (23.7) min, CON vs BETA, P <0.05] and heart rate [mean, for the full ride 135.5 (38.3) beats min-1 vs 111.5 (30.0) beats min-1 CON vs BETA, P <0.05] were significantly lower for the group who ingested b1-blockade (BETA) compared to the control group (CON). Although not significant, submaximal V_O2 was reduced in BETA during the ride, while RPE was significantly higher during the ride for BETA (P <0.01). Mean integrated electromyography was higher in the BETA group although these differences were not significant. Mean power frequency values of the BETA group showed a significant (P <0.05) shift to the upper end of the spectrum in comparison to the control group. Lactate values [11.7 (3.5) mmol.l-1 vs 7.1 (4.1) mmol.l-1 CON vs BETA] were significantly lower (P <0.05) at exhaustion in BETA. Significant reductions in cycling performance were found when subjects ingested b1- blockers. This study has shown significant shifts to the upper end of the EMG frequency spectrum after b1- blocker ingestion, which could be caused by a change in neuromuscular recruitment strategy to compensate for the impaired submaximal exercise performance

Risk of injuries in Paralympic track and field differs by impairment and event discipline A prospective cohort study at the London 2012 Paralympic Games

Background: The incidence rates (IRs) and factors associated with injuries in the sport of Paralympic athletics (track and field) have not been comprehensively and prospectively studied. Purpose: To determine injury IRs, characteristics of injuries, and associated factors in the sport of athletics at the London 2012 Paralympic Games. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 977 athletes competing in the sport of athletics were followed over a total 10-day competition period of the Paralympic Games. Daily injury data were obtained via 2 databases: (1) a custom-built, web-based injury and illness surveillance system (WEB-IISS), maintained by team medical personnel; and (2) the organizing committee database, maintained by medical providers in the medical stations operated by the London Organising Committee of the Olympic and Paralympic Games. Athlete impairment and event discipline were obtained via the International Paralympic Committee athlete database. IRs (injuries per 1000 athlete-days) by impairment, event discipline, sex, and age were examined. Results: The overall IR was 22.1 injuries per 1000 athlete-days (95% CI, 19.5-24.7). In track disciplines, ambulant athletes with cerebral palsy experienced a lower incidence of injuries (IR, 10.2; 95% CI, 4.2-16.2) when compared with ambulant athletes from other impairment categories. Athletes in seated throwing experienced a higher incidence of injuries (IR, 23.7; 95% CI, 17.5-30.0) when compared with athletes in wheelchair racing (IR, 10.6; 95% CI, 5.5-15.6). In both track and field disciplines, the majority of injuries did not result in time loss from competition or training. Ambulant athletes experienced the greatest proportion of injuries to the thigh (16.4% of all injuries; IR, 4.0), observed predominantly in track athletes. Wheelchair or seated athletes experienced the greatest proportion of injuries to the shoulder/clavicle (19.3% of all injuries; IR, 3.4), observed predominantly in field athletes. Conclusion: This is the first prospective cohort study examining injury IRs and associated factors in the sport of athletics at the Paralympic Games. Injury patterns were specific to the event discipline and athlete impairment. The majority of injuries occurred to the thigh (ambulant athletes) or shoulder/clavicle (wheelchair or seated athletes) and did not result in time loss. </jats:sec

The incidence and patterns of illness at the Sochi 2014 Winter Paralympic Games:a prospective cohort study of 6564 athlete days

OBJECTIVE To describe the epidemiology of illness at the Sochi 2014 Winter Paralympic Games. METHODS A total of 547 athletes from 45 countries were monitored daily for 12 days over the Sochi 2014 Winter Paralympic Games (6564 athlete days). Illness data were obtained daily from teams without their own medical support (13 teams, 37 athletes) and teams with their own medical support (32 teams, 510 athletes) through electronic data capturing systems. RESULTS The total number of illnesses reported was 123, with an illness incidence rate (IR) of 18.7 per 1000 athlete days (95% CI 15.1% to 23.2%). The highest IR was reported for wheelchair curling (IR of 20.0 (95% CI 10.1% to 39.6%)). Illnesses in the respiratory system (IR of 5.6 (95% CI 3.8% to 8.0%)), eye and adnexa (IR of 2.7 (95% CI 1.7% to 4.4%)) and digestive system (IR of 2.4 (95% CI 1.4% to 4.2%)) were the most common. Older athletes (35–63 years) had a significantly higher IR than younger athletes (14–25 years, p=0.049). CONCLUSIONS The results of this study indicate that Paralympic athletes report higher illness incidence rates compared to Olympic athletes at similar competitions. The highest rates of illness were reported for the respiratory and digestive systems, eye and adnexa, respectively. Thus, the results of this study form a basis for the identification of physiological systems at higher risk of illness, which can in turn inform illness prevention and management programmes with eventual policy change to promote athlete safety in future editions of the Winter Paralympic Games.IOC Research Centre (South Africa) Grant, IPC Research Grant.http://bjsm.bmj.comam2016Sports Medicin

The epidemiology of injuries in football at the London 2012 Paralympic Games

BACKGROUND : The epidemiology of injury in Paralympic football has received little attention. A study of all sports at the London 2012 Paralympic Games identified football 5-a-side as the sport with the highest injury rate, meriting further detailed analysis, which may facilitate the development of strategies to prevent injuries. OBJECTIVE : To examine the injury rates and risk factors associated with injury in Paralympic football. DESIGN : Secondary analysis of a prospective cohort study of injuries to football 5-a-side and football 7-a-side athletes. SETTING : London 2012 Paralympic Games. Participants: Participants included 70 football 5-a-side athletes and 96 football 7-a-side athletes. Athletes from all but one country chose to participate in this study. METHODS : The Paralympic Injury and Illness Surveillance System was used to track injuries during the Games, with data entered by medical staff. MAIN OUTCOME MEASURMENTS : Injury incidence rate (IR) and injury incidence proportion (IP). RESULTS : The overall IR for football 5-a-side was 22.4 injuries/1000 athlete-days (95% confidence interval [CI], 14.1-33.8) with an IP of 31.4 injuries per 100 athletes (95% CI, 20.9- 43.6). In 5-a-side competition, 62.5% of injuries were associated with foul play. The overall IR for football 7-a-side was 10.4 injuries/1000 athlete-days (95% CI, 5.4-15.5), with an IP of 14.6 injuries per 100 athletes (95% CI, 7.5-21.6). The most commonly injured body region in both sports was the lower extremity. CONCLUSIONS : To our knowledge, this study is the first to examine IR and risk factors associated with injury in Paralympic football. Future studies are needed to determine mechanisms of injury and independent risk factors for injury, thus informing prevention strategies.http://www.pmrjournal.org2017-06-30hb2016Sports Medicin