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Injury patterns in Swedish elite athletics – part 2: risk indicators
Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.ORCID iD: 0000-0001-6049-5402
Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
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2012 (English)Manuscript (preprint) (Other academic)
Abstract [en]

Objective: To examine the risk indicators associated with sustaining musculoskeletal injuries in youth and adult elite athletics athletes competing at national and international levels.

Design: Prospective cohort study conducted during a 52-week period starting in March 2009. A web-based athlete electronic diary was administrated every week by email to athletes for self-reporting of data on training, competition and injuries.

Setting: Male and female youth and adult athletics athletes ranked in the top 10 in Sweden (n=292).

Results: One-hundred ninety-nine (68%) athletes reported an injury during the study season. The median time to first injury was 101 days (95% confidence interval (CI) 75–127). Univariate log-rank tests revealed risk differences with regard to athlete category (P=0.046), serious injury (>3 weeks time loss) during the previous season (P=0.039) and training load rank index (TLRI) (P=0.019). Multivariate Cox proportional hazards regression analyses showed that athletes in the third (hazard ratio (HR) 1.79; 95% CI 1.54–2.78) and fourth TLRI quartile (HR 1.79; 95% CI 1.16–2.74) had almost a twofold increased risk of injury compared with their peers in the first quartile and interaction effects between athlete category and previous injury; youth male athletes with a previous serious injury had more than a fourfold increased risk of injury (HR=4.39; 95% CI 2.20–8.77) compared with youth females with no previous injury.

Conclusions: A training load index combing hours and intensity and a history of severe injury the previous year are predictors for injury risk among elite athletic athletes. Future studies on measures to quantify training content and protocols for safe return to athletics are warranted.

Place, publisher, year, edition, pages
2012. Vol. 40
Keyword [en]
sports injury epidemiology, track and field, injury incidence, previous injury, training load, prevention
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-81398OAI: oai:DiVA.org:liu-81398DiVA: diva2:552226
Available from: 2012-09-13 Created: 2012-09-13 Last updated: 2013-09-05Bibliographically approved
In thesis
1. Towards systematic prevention of athletics injuries: Use of clinical epidemiology for evidence-based injury prevention
Open this publication in new window or tab >>Towards systematic prevention of athletics injuries: Use of clinical epidemiology for evidence-based injury prevention
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aims of this thesis were to outline the design protocol for a prospective clinical epidemiological study of injuries among athletics athletes; study the 1-year prevalence, the point prevalence and incidence of injuries in total cohorts of Swedish elite adult and talented youth athletics athletes; pinpoint the risk indicators and factors for different injury types/patterns in athletics.

In paper I, an argument-based method to investigate complex design problems was used to structure the collection and analysis of data. A requirement analysis showed that a central requirement of an injury surveillance protocol for elite athletics should allow for detailed epidemiological analyses of overuse injuries, requiring self-reported data from athletes. The resulting study protocol was centred on a web-based weekly athlete e-diary enabling continuous collection of individual-level data on exposure and injuries.

In paper II, the prevalence of injuries was examined and 278 athletes (87%) of the enrolled study population submitted their assessments via the web survey. The overall 1-year retrospective injury prevalence was 42.8% (95% CI 36.9–49.0%). The point prevalence of ongoing injury was 35.4% (95% CI 29.7–41.4%). The 1-year injury prevalence showed a tendency to vary with regard to gender and age (p = 0.11). The diagnostic group that displayed the highest 1-year prevalence (20.9%, 95% CI 16.2–22.2%) and point prevalence (23.2%, 95% CI 18.4–28.7%) of injury was inflammation and pain with gradual onset.

In paper III, during the 52-week period, 292 athletes (91% of the study population) submitted weekly reports reporting a cumulative injury incidence of 3.57 injuries per 1000 hours of exposure to athletics. Most injuries (73%) were reported from training. There was a statistically significant difference with regard to gender and age in the proportion of athletes who avoided injury (P=0.043). Differences between event groups could not be statistically demonstrated (P=0.937). Ninety-six percent of the reported injuries were nontraumatic (associated with overuse). About every second injury (51%) was severe, causing a period of absence from normal training exceeding 3 weeks. Seventy-seven percent of the injuries occurred in lower extremities.

In paper IV, 199 (68%) athletes reported an injury during the study year. The median time to first injury was 101 days (95% confidence interval (CI) 75–127). Univariate log-rank tests revealed risk differences with regard to athlete category (p = 0.046), serious injury (>3 weeks time loss) during the previous season (p = 0.039) and training load rank index (TLRI) (p = 0.019). Athletes in the third and fourth TLRI quartile had almost a twofold increased risk of injury compared to the first quartile. Youth male athletes with a previous serious injury had more than a fourfold increased risk of injury compared with youth females with no previous injury.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2012. 71 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1308
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-81400 (URN)978-91-7519-901-6 (ISBN)
Public defence
2012-10-09, Torben Grut salen, Stockholms Stadion, Lidingövägen, Stockholm, 13:00 (English)
Opponent
Supervisors
Available from: 2012-09-13 Created: 2012-09-13 Last updated: 2015-06-05Bibliographically approved

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Jacobsson, JennyTimpka, ToomasEkberg, JoakimDahlström, Örjan

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