Concussion in Para Sport

It is probably safe to say that there has been no sport medicine topic more newsworthy than concussion over the past decade. In addition to intense interest from athletes, parents, the media, and others, concussion has been a popular subject of research, which has grown exponentially over the years. For the Para athlete (the International Paralympic Committee [IPC] term for a sportsperson with a disability), however, concussion struggles to attract interest and attention.1,2 For example, a search strategy developed to find articles regarding athletes and concussion retrieved more than 6000 results, whereas one developed for athletes with disabilities and concussion only returned 60 articles. Furthermore, the recent Fifth International Consensus Conference on Concussion in Sport featured 202 oral and written abstracts, but only 2 were specific to athletes with a disability. Despite this, participation in sport by Para athletes continues to grow, and these athletes are exposed to the risk of concussion in sports that involve speed, collision, and contact. This review examines what is currently known about concussion in Para sport and how assessment, management, and risk reduction in this group of athletes might differ from the general athletic population. Current and future challenges are discussed, but, more importantly, opportunities for further study are identified

Sport, sex and age increase risk of illness at the Rio 2016 Summer Paralympic Games: a prospective cohort study of 51 198 athlete days

OBJECTIVETo describe the epidemiology of illness at the Rio 2016 Summer Paralympic Games. METHODS A total of 3657 athletes from 78 countries, representing 83.5% of all athletes at the Games, were monitored on the web-based injury and illness surveillance system (WEB-IISS) over 51 198 athlete days during the Rio 2016 Summer Paralympic Games. Illness data were obtained daily from teams with their own medical support through the WEB-IISS electronic data capturing systems. RESULTSThe total number of illnesses was 511, with an illness incidence rate (IR) of 10.0 per 1000 athlete days (12.4%). The highest IRs were reported for wheelchair fencing (14.9), para swimming (12.6) and wheelchair basketball (12.5) (p<0.05). Female athletes and older athletes (35–75 years) were also at higher risk of illness (both p<0.01). Illnesses in the respiratory, skin and subcutaneous and digestive systems were the most common (IRs of 3.3, 1.8 and 1.3, respectively). CONCLUSION (1) The rate of illness was lower than that reported for the London 2012 Summer Paralympic Games; (2) the sports with the highest risk were wheelchair fencing, para swimming and wheelchair basketball; (3) female and older athletes (35–75 years) were at increased risk of illness; and (4) the respiratory system, skin and subcutaneous system and digestive system were most affected by illness. These results allow for comparison at future Games

Concussion in para sport:the first position statement of the Concussion in Para Sport (CIPS) Group

Concussion is a frequent injury in many sports and is also common in para athletes. However, there is a paucity of concussion research related to para sport, and prior International Concussion in Sport (CIS) consensus papers have not substantively addressed this population. To remedy this and to improve concussion care provided to para athletes, the concussion in para sport (CIPS) multidisciplinary expert group was created. This group analysed and discussed in-depth para athlete-specific issues within the established key clinical domains of the current (2017) consensus statement on CIS. Due to the onset of the COVID-19 pandemic, the group held all meetings by video conferencing. The existing Sport Concussion Assessment Tool 5 (SCAT5) for the immediate on-field and office-based off-field assessment of concussion was evaluated as part of this process, to identify any para athlete-specific concerns. Regular preparticipation and periodic health examinations are essential to determine a baseline reference point for concussion symptoms but pose additional challenges for the interpreting clinician. Further considerations for concussion management for the para athlete are required within the remove, rest, reconsider and refer consensus statement framework. Considering return to sport (RTS), the 2017 CIS consensus statement has limitations when considering the RTS of the para athlete. Case-by-case decision making related to RTS following concussion is imperative for para athletes. Additional challenges exist for the evaluation and management of concussion in para athletes. There is a need for greater understanding of existing knowledge gaps and attitudes towards concussion among athlete medical staff, coaches and para athletes. Future research should investigate the use and performance of common assessment tools in the para athlete population to better guide their clinical application and inform potential modifications. Concussion prevention strategies and sport-specific rule changes, such as in Para Alpine Skiing and Cerebral Palsy Football, also should be carefully considered to reduce the occurrence of concussion in para athletes

High precompetition injury rate dominates the injury profile at the Rio 2016 Summer Paralympic Games:a prospective cohort study of 51 198 athlete days

This is the second significant dataset to document the incidence of injury in a Summer Paralympic Games setting. Pre-competition injury rates were significantly higher than competition injury rates. The sports of football 5-a-side, judo and football 7-a-side had a significantly higher incidence of injury, compared to all other sports, whilst boccia and Para swimming had a significantly lower injury rate. The shoulder joint was the most commonly injured anatomical area. Acute injuries constituted the highest injury rate at the Games

The Concussion Recognition Tool 5th Edition (CRT5): Background and rationale

The Concussion Recognition Tool 5 (CRT5) is the most recent revision of the Pocket Sport Concussion Assessment Tool 2 that was initially introduced by the Concussion in Sport Group in 2005. The CRT5 is designed to assist non-medically trained individuals to recognise the signs and symptoms of possible sport-related concussion and provides guidance for removing an athlete from play/sport and to seek medical attention. This paper presents the development of the CRT5 and highlights the differences between the CRT5 and prior versions of the instrument

High incidence of injuries at the Pyeongchang 2018 paralympic winter games: A prospective cohort study of 6804 athlete days

Given the increase in health surveillance research in the sporting arena, the International Paralympic Committee (IPC) seeks to preserve the health of the para athlete in several ways including high-quality epidemiological research on injury and illness in the Paralympic Games.1–5 Web-based studies began at the London 2012 Summer Paralympic Games1 and have continued at the Rio 20165 Summer Games and at Paralympic Winter Games at the Sochi 20144 and Pyeongchang 2018 Game

Incidence rate and burden of illness at the Pyeongchang 2018 Paralympic Winter Games

OBJECTIVE : To describe the incidence rate (IR) and illness burden (IB) at the Pyeongchang 2018 Paralympic Winter Games. METHODS : A total of 567 athletes from 49 countries were monitored for 12 days over the Pyeongchang 2018 Games (6804 athlete days). Illness data were obtained daily from teams with (41 teams, 557 athletes) and teams without (8 teams, 10 athletes) their own medical support, through electronic data capturing systems. RESULTS : There were 87 illnesses reported, with an illness IR of 12.8 illnesses per 1000 athlete days (95% CI 10.2 to 16.0) and IB of 6.8 days lost per 1000 athlete days (95% CI 3.4 to 13.5). The highest IR was reported for Para snowboard (IR of 19.7 [95% CI 12.0 to 32.2]). Illnesses in the respiratory system (IR of 4.1 [95% CI 2.9 to 5.9]; IB of 1.4 [95% CI 0.6 to 3.0]), skin and subcutaneous system (IR of 2.5 [95% CI 1.5 to 4.1]; IB of 0.6 [95% CI 0.1 to 2.9]), and eye and ocular adnexa (IR of 1.6 [95% CI 0.9 to 3.1]; IB of 0.5 [95% CI 0.1 to 3.3]) were the most common. CONCLUSION : This is the first study to report both the IR and IB in this setting. There was a high IR of illness in the new sport of Para snowboard. The respiratory system had both the highest IR and IB.http://bjsm.bmj.comhj2019Sports Medicin

Incidence of injury and illness at the Beijing 2022 Paralympic Winter Games held in a closed-loop environment : a prospective cohort study of 7332 athlete days

DATA SHARING STATEMENT : No data are available.OBJECTIVE : To describe the epidemiology of injuries and illnesses sustained during the Beijing 2022 Paralympic Winter Games, organised in a closed-loop environment to adhere with COVID-19 restrictions. METHODS : Injuries and illnesses from all teams were recorded on a daily basis by team medical staff on a web-based form and by local organising committee medical (polyclinic) facilities and venue medical support. Duplicates recorded on both systems were removed. Incidence of injuries and illnesses are reported per 1000 athlete days (95% CI). RESULTS : 564 athletes (426 male and 138 female) representing 46 countries were monitored for the 13-day period of the Beijing 2022 Paralympic Winter Games (7332 athlete days). The overall incidences were 13.0 injuries (10.6–15.8) and 6.1 illnesses (4.5–8.4) per 1000 athlete days. The incidence of injury in alpine skiing (19.9; 15.2–26.1) was significantly higher compared with Nordic skiing, ice hockey and wheelchair curling (p<0.05), while the incidence of respiratory illness was significantly higher in Nordic skiing (1.6; 0.9–2.9) compared with alpine skiing, ice hockey and snowboarding (p<0.05). CONCLUSION : The incidence of both injury and illness at the Beijing 2022 Games were the lowest yet reported in the Paralympic Winter Games. The incidence of injury was highest in alpine skiing. These findings underscore the importance of ongoing vigilance and continued injury risk mitigation strategies to safeguard the well-being of athletes in these high-risk competitions. Respiratory illnesses were most commonly reported in Nordic skiing, which included the three cases of COVID-19 recorded at the games.The IOC Research Centre South Africa grant and International Paralympic Committee research support.http://bjsm.bmj.comhj2024Sports MedicineSDG-03:Good heatlh and well-bein

Consensus Statement on Concussion in Sportâ The 4th International Conference on Concussion in Sport Held in Zurich, November 2012

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/147044/1/pmr2255.pd