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Dahlström, Ö., Adami, P. E., Fagher, K., Jacobsson, J., Bargoria, V., Gauffin, H., . . . Timpka, T. (2019). Efficacy of pre-participation cardiac evaluation recommendations among athletes participating in World Athletics Championships. European Journal of Preventive Cardiology, 1-11, Article ID UNSP 2047487319884385.
Open this publication in new window or tab >>Efficacy of pre-participation cardiac evaluation recommendations among athletes participating in World Athletics Championships
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2019 (English)In: European Journal of Preventive Cardiology, ISSN 2047-4873, E-ISSN 2047-4881, p. 1-11, article id UNSP 2047487319884385Article in journal (Refereed) Epub ahead of print
Abstract [en]

Background Athletes competing in athletics (track and field) at international level may be participating with underlying undiagnosed life-threatening cardiovascular conditions. Our objective was to analyse variations in pre-participation cardiac evaluation prevalence among athletes participating in two International Association of Athletics Federations (IAAF) World Athletics Championships, with regard to the human developmental level and global region of their home countries, as well as athletes’ age category, gender, event group and medical insurance type.

Design Cross-sectional web-based survey.MethodsA total of 1785 athletes competing in the IAAF World Under 18 Championships Nairobi 2017 and World Championships London 2017 were invited to complete a pre-participation health questionnaire investigating the experience of a pre-participation cardiac examination.

Results A total of 704 (39%) of the athletes participated. Among these, 59% (60% of women; 58% of men) reported that they had been provided at least one type of pre-participation cardiac evaluation. Athletes from very high income countries, Europe and Asia, showed a higher prevalence of at least one pre-participation cardiac evaluation.

Conclusions The prevalence of pre-participation cardiac evaluation in low to middle income countries, and the African continent in particular, needs urgent attention. Furthermore, increases in evaluation prevalence should be accompanied by the development of cost-effective methods that can be adopted in all global regions.

Place, publisher, year, edition, pages
Sage Publications, 2019
Keywords
Pre-participation cardiac evaluation, cardiac screening, sudden cardiac death prevention, athletics, track and field, IAAF, World Athletics
National Category
Sport and Fitness Sciences Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:liu:diva-161339 (URN)10.1177/2047487319884385 (DOI)000492624800001 ()31648553 (PubMedID)
Available from: 2019-10-30 Created: 2019-10-30 Last updated: 2019-11-18Bibliographically approved
Edouard, P., Junge, A., Sorg, M., Timpka, T. & Branco, P. (2019). Illnesses during 11 international athletics championships between 2009 and 2017: incidence, characteristics and sex-specific and discipline-specific differences. British Journal of Sports Medicine, 53(18), 1174-1182
Open this publication in new window or tab >>Illnesses during 11 international athletics championships between 2009 and 2017: incidence, characteristics and sex-specific and discipline-specific differences
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2019 (English)In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 53, no 18, p. 1174-1182Article in journal (Refereed) Published
Abstract [en]

Background Illnesses impair athletes’ participation and performance. The epidemiology of illness in athletics is limited.

Objective To describe the occurrence and characteristics of illnesses during international athletics championships (indoor and outdoor), and to analyse differences with regards to athletes’ sex and participation in explosive and endurance disciplines.

Methods During 11 international championships held between 2009 and 2017, physicians from both national medical teams and the local organising committees reported daily on all athlete illnesses using a standardised report form. Illness frequencies, incidence proportions (IPs) and rates (IRs), and relative risks (RR) with 95% CIs were calculated.

Results During the 59 days of the 11 athletics championships, 546 illnesses were recorded in the 12 594 registered athletes equivalent to IP of 43.4 illnesses per 1000 registered athletes (95% CI 39.8 to 46.9) or IR of 1.2 per 1000 registered athlete days (95% CI 1.1 to 1.2). The most frequently reported illnesses were upper respiratory tract infections (18.7%), exercise-induced fatigue/hypotension/collapse (15.4%) and gastroenteritis (13.2%). No myocardial infarction was recorded. A total of 28.8% of illnesses were expected to lead to time loss from sport. The illness IP was similar in male and female athletes, with few differences in illness characteristics. During outdoor championships, the illness IP was higher in endurance than explosive disciplines (RR=1.87; 95% CI 1.58 to 2.23), with a considerably higher IP of exercise-induced illness in endurance disciplines, but a similar upper respiratory tract infection IP in both discipline groups.

Conclusions Illness prevention strategies during international athletics championships should be focused on the most frequent diagnoses in each discipline group.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2019
National Category
Sport and Fitness Sciences
Identifiers
urn:nbn:se:liu:diva-162563 (URN)10.1136/bjsports-2018-100131 (DOI)000495986200011 ()30862705 (PubMedID)2-s2.0-85062978631 (Scopus ID)
Available from: 2019-12-09 Created: 2019-12-09 Last updated: 2019-12-16Bibliographically approved
Wickström, W., Spreco, A., Bargoria, V., Elinder, F., Hansson, P.-O., Dahlström, Ö. & Timpka, T. (2019). Perceptions of Overuse Injury Among Swedish Ultramarathon and Marathon Runners: Cross-Sectional Study Based on the Illness Perception Questionnaire Revised (IPQ-R). Frontiers in Psychology, 10, 1-11, Article ID 2406.
Open this publication in new window or tab >>Perceptions of Overuse Injury Among Swedish Ultramarathon and Marathon Runners: Cross-Sectional Study Based on the Illness Perception Questionnaire Revised (IPQ-R)
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2019 (English)In: Frontiers in Psychology, ISSN 1664-1078, E-ISSN 1664-1078, Vol. 10, p. 1-11, article id 2406Article in journal (Refereed) Published
Abstract [en]

Background: Long-distance runners’ understandings of overuse injuries are not well known which decreases the possibilities for prevention. The common sense model (CSM) outlines that runners’ perceptions of a health problem can be described using the categories identity, consequence, timeline, personal control, and cause. The aim of this study was to use the CSM to investigate perceptions of overuse injury among long-distance runners with different exercise loads.

Methods: The study used a cross-sectional design. An adapted version of the illness perception questionnaire revised (IPQ-R) derived from the CSM was used to investigate Swedish ultramarathon and marathon runners’ perceptions of overuse injuries. Cluster analysis was employed for categorizing runners into high and low exercise load categories. A Principal Component Analysis was thereafter used to group variables describing injury causes. Multiple logistic regression methods were finally applied using high exercise load as endpoint variable and CSM items representing perceptions of injury identity, consequence, timeline, personal control, and causes as explanatory variables.

Results: Complete data sets were collected from 165/443 (37.2%) runners. The symptoms most commonly associated with overuse injury were pain (80.1% of the runners), stiff muscles (54.1%), and stiff joints (42.0%). Overuse injury was perceived to be characterized by the possibility of personal control (stated by 78.7% of the runners), treatability (70.4%), and that the injury context was comprehensible (69.3%). The main injury causes highlighted were runner biomechanics (stated by 78.3%), the runner’s personality (72.4%), and running surface biomechanics (70.0%). Among men, a belief in that personality contributes to overuse injury increased the likelihood of belonging to the high exercise load category [Odds ratio (OR) 2.10 (95% Confidence interval (95% CI) 1.38–3.19); P = 0.001], while beliefs in that running biomechanics [OR 0.56 (95% CI 0.37–0.85); P = 0.006) and mileage (OR 0.72 (95% CI 0.54–0.96); P = 0.026] causes injury decreased the likelihood. In women, a strong perception that overuse injuries can be controlled by medical interventions decreased the likelihood of high exercise load [OR 0.68 (95% CI 0.52–0.89); P = 0.005].

Conclusion: This study indicates that recognition among long-distance runners of the association between own decisions in overuse injury causation is accentuated by increased exercise loads.

Place, publisher, year, edition, pages
Frontiers Media S.A., 2019
Keywords
Illness perceptions, long-distance running, overuse injury, exercise load, common sense model of illness, sports psychology
National Category
Public Health, Global Health, Social Medicine and Epidemiology Sport and Fitness Sciences Physiotherapy
Identifiers
urn:nbn:se:liu:diva-161230 (URN)10.3389/fpsyg.2019.02406 (DOI)000494658900001 ()
Note

Funding agencies: Swedish Centre for Sports Research (CIF) [P2018-0194]

Available from: 2019-10-24 Created: 2019-10-24 Last updated: 2019-11-19
Tillander, B., Gauffin, H., Lyth, J., Knutsson, A. & Timpka, T. (2019). Symptomatic Achilles Tendons are Thicker than Asymptomatic Tendons on Ultrasound Examination in Recreational Long-Distance Runners. SPORTS, 7(12), Article ID 245.
Open this publication in new window or tab >>Symptomatic Achilles Tendons are Thicker than Asymptomatic Tendons on Ultrasound Examination in Recreational Long-Distance Runners
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2019 (English)In: SPORTS, ISSN 2075-4663, Vol. 7, no 12, article id 245Article in journal (Refereed) Published
Abstract [en]

There is a need for clinical indicators that can be used to guide the treatment of Achilles tendon complaints in recreational runners. Diagnostic ultrasound has recently been introduced for clinical decision support in tendon pain management. The aim of this study was to determine whether tendon thickness and morphological changes in the Achilles tendon detected in ultrasound examinations are associated with local symptoms in middle-age recreational long-distance runners. Forty-two Achilles tendons (21 middle-aged runners) were investigated by ultrasound examination measuring tendon thickness and a morphology score indicating tendinosis. The Generalized Estimating Equations method was applied in multiple models of factors associated with reporting a symptomatic tendon. Eleven symptomatic and 31 asymptomatic Achilles tendons were recorded. In the multiple model that used tendon thickness measured 30 mm proximal to the distal insertion, an association was found between thickness and reporting a symptomatic tendon (p amp;lt; 0.001; OR 12.9; 95% CI 3.1 to 53.2). A qualitative morphology score was not found to be significantly associated with reporting a symptomatic tendon (p = 0.10). We conclude that symptomatic Achilles tendons were thicker than asymptomatic tendons on ultrasound examination among recreational long-distance runners and that the importance of parallel morphological findings need to be further investigated in prospective studies.

Place, publisher, year, edition, pages
MDPI, 2019
Keywords
running; ultrasound; achilles tendon; middle-aged
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:liu:diva-163765 (URN)10.3390/sports7120245 (DOI)000505578300008 ()31817429 (PubMedID)
Note

Funding Agencies|Swedish Centre for Sports Research (CIF) [P2018-0194]

Available from: 2020-03-19 Created: 2020-03-19 Last updated: 2020-03-26Bibliographically approved
Raysmith, B. P., Jacobsson, J., Drew, M. K. & Timpka, T. (2019). What Is Performance? A Scoping Review of Performance Outcomes as Study Endpoints in Athletics. SPORTS, 7(3), Article ID 66.
Open this publication in new window or tab >>What Is Performance? A Scoping Review of Performance Outcomes as Study Endpoints in Athletics
2019 (English)In: SPORTS, ISSN 2075-4663, Vol. 7, no 3, article id 66Article, review/survey (Refereed) Published
Abstract [en]

Purpose: This review set out to summarise, define, and provide future direction towards the use of performance outcome measures as endpoints in research performed at international benchmark events in athletics. Methods: Scoping review methodology was applied through a search of the PubMed and Sports Discus databases and a systematic article selection procedure. Articles that met the inclusion criteria underwent triage for further quantitative and qualitative analysis. A concept chart was generated to describe the methods by which performance had been measured and introduce descriptive labels for theoretical and practical application. Results: None of 2972 articles primarily identified from the database search met the triage standards for quantitative data extraction. Eleven articles were included in a qualitative analysis. The analysis identified the common methods by which performance has been measured, reported and analysed. The resulting concept chart collates labels from the qualitative analysis (categories, themes, and constructs) with sports practice labels (performance metrics, framework, and analysis). Conclusions: The state of knowledge concerning methods to employ performance metrics as endpoints in studies performed at major competitions in athletics has been summarised. Constructing a methodology that combines the performance metric variables (continuous and ordinal) that are currently utilised as endpoints remains a challenge.

Place, publisher, year, edition, pages
MDPI, 2019
Keywords
performance evaluation; success; achievement; athletic performance; ranking
National Category
Social Sciences Interdisciplinary
Identifiers
urn:nbn:se:liu:diva-164463 (URN)10.3390/sports7030066 (DOI)000464151700001 ()30884863 (PubMedID)
Available from: 2020-03-28 Created: 2020-03-28 Last updated: 2020-03-28
Rahimi, B., Nadri, H., Afshar, H. L. & Timpka, T. (2018). A Systematic Review of the Technology Acceptance Model in Health Informatics. Applied Clinical Informatics, 9(3), 604-634
Open this publication in new window or tab >>A Systematic Review of the Technology Acceptance Model in Health Informatics
2018 (English)In: Applied Clinical Informatics, ISSN 1869-0327, Vol. 9, no 3, p. 604-634Article in journal (Refereed) Published
Abstract [en]

Background One common model utilized to understand clinical staff and patients technology adoption is the technology acceptance model (TAM). Objective This article reviews published research on TAM use in health information systems development and implementation with regard to application areas and model extensions after its initial introduction. Method An electronic literature search supplemented by citation searching was conducted on February 2017 of the Web of Science, PubMed, and Scopus databases, yielding a total of 492 references. Upon eliminating duplicates and applying inclusion and exclusion criteria, 134 articles were retained. These articles were appraised and divided into three categories according to research topic: studies using the original TAM, studies using an extended TAM, and acceptance model comparisons including the TAM. Results The review identified three main information and communication technology (ICT) application areas for the TAM in health services: telemedicine, electronic health records, and mobile applications. The original TAM was found to have been extended to fit dynamic health service environments by integration of components from theoretical frameworks such as the theory of planned behavior and unified theory of acceptance and use of technology, as well as by adding variables in specific contextual settings. These variables frequently reflected the concepts subjective norm and self-efficacy, but also compatibility, experience, training, anxiety, habit, and facilitators were considered. Conclusion Telemedicine applications were between 1999 and 2017, the ICT application area most frequently studied using the TAM, implying that acceptance of this technology was a major challenge when exploiting ICT to develop health service organizations during this period. A majority of the reviewed articles reported extensions of the original TAM, suggesting that no optimal TAM version for use in health services has been established. Although the review results indicate a continuous progress, there are still areas that can be expanded and improved to increase the predictive performance of the TAM.

Place, publisher, year, edition, pages
GEORG THIEME VERLAG KG, 2018
Keywords
technology acceptance model; literature review; health information technology; technology acceptance; theoretical models; health informatics
National Category
Information Systems
Identifiers
urn:nbn:se:liu:diva-150878 (URN)10.1055/s-0038-1668091 (DOI)000441776700001 ()30112741 (PubMedID)
Note

Funding Agencies|Urmia University of Medical Sciences; [1395-01-52-2759]

Available from: 2018-09-06 Created: 2018-09-06 Last updated: 2019-05-01
Tillander, B., Gauffin, H., Dahlström, Ö. & Timpka, T. (2018). Associations between recreational runners anti-inflammatory drug use, coping strategies, and time loss due to injury and illness during preparations for a marathon event. Journal of Sports Medicine and Physical Fitness, 58(12), 1839-1843
Open this publication in new window or tab >>Associations between recreational runners anti-inflammatory drug use, coping strategies, and time loss due to injury and illness during preparations for a marathon event
2018 (English)In: Journal of Sports Medicine and Physical Fitness, ISSN 0022-4707, E-ISSN 1827-1928, Vol. 58, no 12, p. 1839-1843Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Due to the dominance of overuse injuries among runners, knowledge of how use of non-steroidal anti-inflammatory drugs (NSAIDs) and behavioral factors contribute to injury events is important. The aim of this study was to explore recreational marathon runners strategies for coping with injury and illness, including use of drugs for control of pain and inflammation, and to investigate whether these strategies were associated with the 1-year prevalence of time-loss injury and illness. METHODS: An online questionnaire was used for data collection in this cross-sectional study. The population consisted of runners who had registered for a marathon (N.=341). Strategies used to understand and manage perceptions of injury and illness were measured with the Brief COPE instrument and the use of NSAIDs was investigated. RESULTS: Complete survey data were provided by 161 runners (47%). 42% reported NSAID use. A notable injury in the past year was reported by 43%, and 19% reported having had a time-loss illness episode. Runners who reported NSAID use in the past year reported significantly fewer time-loss injuries (P=0.003). Time loss due to illness only showed a negative correlation with using emotional support for coping (P=0.010) and a positive correlation with self-blame (P=0.039). CONCLUSIONS: Runners stating NSAID use reported fewer time-loss running injuries than non-NSAID users. Time loss due to illness showed different correlates with NSAID use and coping strategies than time loss due to injury, i.e. no association with drug use, less use of emotional support for coping and more use of self-blame.

Place, publisher, year, edition, pages
EDIZIONI MINERVA MEDICA, 2018
Keywords
Running; Athletic injuries; Psychological adaptation; Non-steroidal anti-inflammatory drugs
National Category
Sport and Fitness Sciences
Identifiers
urn:nbn:se:liu:diva-154733 (URN)10.23736/S0022-4707.18.07747-2 (DOI)000456479400017 ()29308843 (PubMedID)
Note

Funding Agencies|Research Council of South East Sweden (FORSS) [forss-655801]

Available from: 2019-02-27 Created: 2019-02-27 Last updated: 2019-05-01
Timpka, T., Schyllander, J., Ekman, D. S., Ekman, R., Dahlström, Ö., Hägglund, M., . . . Jacobsson, J. (2018). Community-level football injury epidemiology: traumatic injuries treated at Swedish emergency medical facilities. European Journal of Public Health, 28(1), 94-99
Open this publication in new window or tab >>Community-level football injury epidemiology: traumatic injuries treated at Swedish emergency medical facilities
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2018 (English)In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 28, no 1, p. 94-99Article in journal (Refereed) Published
Abstract [en]

Despite the popularity of the sport, few studies have investigated community-level football injury patterns. This study examines football injuries treated at emergency medical facilities using data from three Swedish counties. An open-cohort design was used based on residents aged 0-59 years in three Swedish counties (pop. 645 520). Data were collected from emergency medical facilities in the study counties between 1 January 2007 and 31 December 2010. Injury frequencies and proportions for age groups stratified by sex were calculated with 95% confidence intervals (95% CIs) and displayed per diagnostic group and body location. Each year, more than 1/200 person aged 0-59 years sustained at least one injury during football play that required emergency medical care. The highest injury incidence was observed among adolescent boys [2009 injuries per 100 000 population years (95% CI 1914-2108)] and adolescent girls [1413 injuries per 100 000 population years (95% CI 1333-1498)]. For female adolescents and adults, knee joint/ligament injury was the outstanding injury type (20% in ages 13-17 years and 34% in ages 18-29 years). For children aged 7-12 years, more than half of the treated injuries involved the upper extremity; fractures constituted about one-third of these injuries. One of every 200 residents aged 0-59 years in typical Swedish counties each year sustained a traumatic football injury that required treatment in emergency healthcare. Further research on community-level patterns of overuse syndromes sustained by participation in football play is warranted.

Place, publisher, year, edition, pages
OXFORD UNIV PRESS, 2018
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:liu:diva-145472 (URN)10.1093/eurpub/ckx053 (DOI)000424126000018 ()28510641 (PubMedID)
Note

Funding Agencies|Swedish Centre for Sports Research [P2013-0153]

Available from: 2018-03-07 Created: 2018-03-07 Last updated: 2019-05-02
Karlsson, D., Timpka, T., Jacobsson, J., Alonso, J.-M., Kowalski, J., Nilsson, S., . . . Edouard, P. (2018). Electronic data capture on athletes pre-participation health and in-competition injury and illness at major sports championships: An extended usability study in Athletics. Health Informatics Journal, 24(2), 136-145
Open this publication in new window or tab >>Electronic data capture on athletes pre-participation health and in-competition injury and illness at major sports championships: An extended usability study in Athletics
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2018 (English)In: Health Informatics Journal, ISSN 1460-4582, E-ISSN 1741-2811, Vol. 24, no 2, p. 136-145Article in journal (Refereed) Published
Abstract [en]

This study set out to identify factors critical for the usability of electronic data collection in association with championships in individual sports. A qualitative analysis of electronic data collection system usability for collection of data on pre-participation health from athletes and in-competition injury and illness from team physicians was performed during the 2013 European Athletics Indoor Championships. A total of 15 athletes and team physicians participated. Athletes were found to experience few problems interacting with the electronic data collection system, but reported concerns about having to reflect on injury and illness before competitions and the medical terminology used. Team physicians encountered problems when first navigating through the module for clinical reporting, but they were not subjected to motivational problems. We conclude that athletes motivation to self-report health data and the design of the human-computer interface for team physicians are key issues for the usability of electronic data collection systems in association with championships in individual sports.

Place, publisher, year, edition, pages
Sage Publications, 2018
Keywords
electronic data capture; human-computer interaction; qualitative research methods; sports epidemiology; usability
National Category
Other Health Sciences
Identifiers
urn:nbn:se:liu:diva-148086 (URN)10.1177/1460458216661861 (DOI)000432068300003 ()27502408 (PubMedID)2-s2.0-85046813739 (Scopus ID)
Note

Funding Agencies|Swedish Center for Sports Research (CIF) [FO2014-0048, P2014-0167]

Available from: 2018-05-30 Created: 2018-05-30 Last updated: 2019-05-01Bibliographically approved
Timpka, T., Bargoria, V., Halje, K. & Jacobsson, J. (2018). Infographic: Elite athletes anxiety over illness ups risk of injury in competition. British Journal of Sports Medicine, 52(15), 955-955
Open this publication in new window or tab >>Infographic: Elite athletes anxiety over illness ups risk of injury in competition
2018 (English)In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 52, no 15, p. 955-955Article in journal, Editorial material (Other academic) Published
Abstract [en]

n/a

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2018
National Category
Basic Medicine
Identifiers
urn:nbn:se:liu:diva-150225 (URN)10.1136/bjsports-2017-098314 (DOI)000440172000007 ()28831015 (PubMedID)2-s2.0-85049161774 (Scopus ID)
Available from: 2018-08-22 Created: 2018-08-22 Last updated: 2019-05-01Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-6049-5402

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