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  • 1.
    Alonso, Juan-Manuel
    et al.
    Int Assoc Athlet Federat, Med & Antidoping Commiss, Monaco, Monaco; Qatar Orthoped & Sports Med Hosp, Sports Med Dept, Aspetar, Doha, Qatar.
    Jacobsson, Jenny
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Timpka, Toomas
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences. Region Östergötland, Center for Health and Developmental Care, Center for Public Health.
    Ronsen, Ola
    Int Assoc Athlet Federat, Med & Antidoping Commiss, Monaco, Monaco; Aker Solut, Lysaker, Norway.
    Kajenienne, Alma
    Int Assoc Athlet Federat, Med & Antidoping Commiss, Monaco, Monaco; Lithuanian Univ Hlth Sci, Inst Sport, Kaunas, Lithuania.
    Dahlström, Örjan
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences, The Swedish Institute for Disability Research.
    Spreco, Armin
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Edouard, Pascal
    Univ Hosp St Etienne, Fac Med, Sports Med Unity, Dept Clin & Exercise Physiol, St Etienne, France; Univ Lyon, Exercise Physiol Lab, LPE EA 4338, St Etienne, France; French Athlet Federat, Med Commiss, Paris, France.
    Preparticipation injury complaint is a risk factor for injury: a prospective study of the Moscow 2013 IAAF Championships.2015In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 49, no 17, p. 1118-U45Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To determine the health status of athletes before the start of an international athletics championship and to determine whether preparticipation risk factors predicted in-championship injuries.

    METHODS: At the beginning of the 2013 International Association of Athletics Federations (IAAF) World Championships, all registered athletes (n=1784) were invited to complete a preparticipation health questionnaire (PHQ) on health status during the month preceding the championships. New injuries that occurred at the championships were prospectively recorded.

    RESULTS: The PHQ was completed by 698 (39%) athletes; 204 (29.2%) reported an injury complaint during the month before the championships. The most common mode of onset of preparticipation injury complaints was gradual (43.6%). Forty-nine athletes in the study reported at least one injury during the championships. Athletes who reported a preparticipation injury complaint were at twofold increased risk for an in-championship injury (OR=2.09; 95% CI 1.16 to 3.77); p=0.014). Those who reported a preparticipation gradual-onset injury complaint were at an almost fourfold increased risk for an in-championship time-loss injury (OR=3.92; 95% CI 1.69 to 9.08); p=0.001). Importantly, the preparticipation injury complaint severity score was associated with the risk of sustaining an in-championship injury (OR=1.14; 95% CI 1.06 to 1.22); p=0.001).

    SUMMARY AND CONCLUSIONS: About one-third of the athletes participating in the study reported an injury complaint during the month before the championships, which represented a risk factor for sustaining an injury during the championship. This study emphasises the importance of the PHQ as a screening tool to identify athletes at risk of injuries before international championships.

  • 2.
    Dahlström, Örjan
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Jacobsson, Jenny
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Timpka, Toomas
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Health and Developmental Care, Center for Public Health.
    Overcoming the organization-practice barrier in sports injury prevention: A nonhierarchical organizational model2015In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 25, no 4, p. e414-e422Article in journal (Refereed)
    Abstract [en]

    The organization of sports at the national level has seldom been included in scientific discussions of sports injury prevention. The aim of this study was to develop a model for organization of sports that supports prevention of overuse injuries. The quality function deployment technique was applied in seminars over a two-season period to develop a national organizational structure for athletics in Sweden that facilitates prevention of overuse injuries. Three central features of the resulting model for organization of sports at the national level are (a) diminishment of the organizational hierarchy: participatory safety policy design is introduced through annual meetings where actors from different sectors of the sporting community discuss training, injury prevention, and sports safety policy; (b) introduction of a safety surveillance system: a ubiquitous system for routine collection of injury and illness data; and (c) an open forum for discussion of safety issues: maintenance of a safety forum for participants from different sectors of the sport. A nonhierarchical model for organization of sports at the national level - facilitated by modern information technology - adapted for the prevention of overuse injuries has been developed. Further research is warranted to evaluate the new organizational model in prospective effectiveness studies.

  • 3.
    Edouard, Pascal
    et al.
    University Hospital St Etienne, France; University of Lyon, France; French Athlet Federat FFA, France.
    Jacobsson, Jenny
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Swedish Athlet Assoc, Sweden.
    Timpka, Toomas
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Health and Developmental Care, Center for Public Health.
    Alonso, Juan-Manuel
    Int Assoc Athlet Federat, Monaco; Qatar Orthoped and Sports Medical Hospital, Qatar.
    Kowalski, Jan
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences. Swedish Athlet Assoc, Sweden.
    Nilsson, Sverker
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences. Swedish Athlet Assoc, Sweden.
    Karlsson, David
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Depiesse, Frederic
    French Athlet Federat FFA, France; Larrey Hospital University, France; European Athlet Assoc, Switzerland.
    Branco, Pedro
    Int Assoc Athlet Federat, Monaco; European Athlet Assoc, Switzerland.
    Extending in-competition Athletics injury and illness surveillance with pre-participation risk factor screening: A pilot study2015In: Physical Therapy in Sport, ISSN 1466-853X, E-ISSN 1873-1600, Vol. 16, no 2, p. 98-106Article in journal (Refereed)
    Abstract [en]

    Objectives: To explore the performance of retrospective health data collected from athletes before Athletics championships for the analysis of risk factors for in-competition injury and illness (IandI). Methods: For the 2013 European Athletics Indoor Championships, a self-report questionnaire (PHQ) was developed to record the health status of 127 athletes during the 4 weeks prior to the championship. Physician-based surveillance of in-competition IandI among all 577 athletes registered to compete was pursued during the championships. Results: 74 athletes (58.3%) from the sample submitted a complete PHQ, 21 (28%) of these athletes sustained at least one injury and/or illness during the championships. Training more than 12 h/week predisposed for sustaining an in-competition injury, and a recent health problem for in-competition illness. Among the 577 registered athletes, 60 injuries (104/1000 registered athletes) were reported. 31% of injuries were caused by the track, and 29% by overuse. 29 illnesses were reported (50/1000 registered athletes); upper respiratory tract infection and gastro-enteritis/diarrhoea were the most reported diagnoses. Conclusions: Pre-participation screening using athletes self-report PHQ showed promising results with regard to identification of individuals at risk. Indoor injury types could be attributed to extrinsic factors, such as small track size, track inclination, and race tactics. (C) 2014 Elsevier Ltd. All rights reserved.

  • 4.
    Fagher, Kristina
    et al.
    Department of Health Sciences, Lund University, Sweden.
    Forsberg, Anna
    Department of Health Sciences, Lund University, Sweden, Skåne University Hospital, Lund, Sweden.
    Jacobsson, Jenny
    Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Athletics Research Center, Linköping University, Sweden.
    Timpka, Toomas
    Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Health and Developmental Care, Center for Public Health. Linköping University, Department of Medical and Health Sciences, Division of Community Medicine.
    Dahlström, Örjan
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, The Swedish Institute for Disability Research. Linköping University, Faculty of Arts and Sciences. Athletics Research Center, Linköping University, Sweden.
    Lexell, Jan
    Department of Health Sciences, Lund University, Sweden, Skåne University Hospital, Lund, Sweden.
    Paralympic athletes’ perceptions of their experiences of sports-related injuries, risk factors and preventive possibilities2016In: European Journal of Sport Science, ISSN 1746-1391, E-ISSN 1536-7290, Vol. 22, no 8, p. 1240-1249Article in journal (Refereed)
    Abstract [en]

    Our knowledge of sports-related injuries in para-sport is limited and there are no data on how Paralympic athletes themselves perceive an injury. The aim of this qualitative study was to explore Paralympic athletes' perceptions of their experiences of sports-related injuries, risk factors and preventive possibilities. Eighteen Swedish Paralympic athletes with vision impairment, intellectual impairment, spinal cord injury, cerebral palsy, myelomeningocele, dysplasia and neuromuscular disorder, representing 10 different para-sports, were interviewed. The qualitative phenomenographic method was used to interpret the data. The analysis revealed nine categories of perceptions of experiences. The athletes perceived that their impairments were involved in the cause and consequential chains associated with a sports-related injury. Other categories that denoted and described these injuries were: sport overuse, risk behaviour, functional limitations, psychological stressors, the normalised pain, health hazards, individual possibilities to prevent sports-related injuries and unequal prerequisites. This qualitative study revealed that Paralympic athletes' perceptions of their experiences of sports-related injuries are complex and multifactorial, and in several ways differ from able-bodied athletes. This needs to be considered in the sports health and safety work within the Paralympic Movement as well as in the design of future injury surveillance systems and preventive programmes

  • 5.
    Fagher, Kristina
    et al.
    Rehabilitation Medicine Research Group, Department of Health Sciences, Lund University, Lund, Sweden.
    Jacobsson, Jenny
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Dahlström, Örjan
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Timpka, Toomas
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Business support and Development, Department of Health and Care Development.
    Lexell, Jan
    Rehabilitation Medicine Research Group, Department of Health Sciences, Lund University, Lund, Sweden; Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden; Department of Health Science, Luleå University of Technology, Luleå, Sweden.
    An eHealth Application of Self-Reported Sports-Related Injuries and Illnesses in Paralympic Sport: Pilot Feasibility and Usability Study2017In: JMIR Human Factors, E-ISSN 2292-9495, Vol. 4, no 4, article id e30Article in journal (Refereed)
    Abstract [en]

    Sport participation is associated with a risk of sports-related injuries and illnesses, and Paralympic athletes additional medical issues can be a challenge to health care providers and medical staff. However, few prospective studies have assessed sports-related injuries and illnesses in Paralympic sport (SRIIPS) over time. Advances in mobile phone technology and networking systems offer novel opportunities to develop innovative eHealth applications for collection of athletes self-reports. Using eHealth applications for collection of self-reported SRIIPS is an unexplored area, and before initiation of full-scale research of SRIIPS, the feasibility and usability of such an approach needs to be ascertained.

  • 6.
    Fagher, Kristina
    et al.
    Department of Health Sciences, Lund University, Sweden.
    Jacobsson, Jenny
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Timpka, Toomas
    Region Östergötland, Center for Health and Developmental Care, Center for Public Health. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Medical and Health Sciences, Division of Community Medicine.
    Dahlström, Örjan
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, The Swedish Institute for Disability Research. Linköping University, Faculty of Arts and Sciences. Athletics Research Center, Linköping University, Sweden.
    Lexell, Jan
    Department of Health Sciences, Lund University, Sweden; Skåne University Hospital, Lund, Sweden.
    The sports-related injuries and illnesses in paralympic sport study (SRIIPSS): a study protocol for a prospective longitudinal study2016In: BMC Sports Science, Medicine and Rehabilitation, ISSN 2052-1847, Vol. 8, no 1, article id 28Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Paralympic sport provides sporting opportunities for athletes with a disability, with the Paralympic Games as the main event. Participation in sport is, however, associated with a significant risk for sustaining injuries and illnesses. Our knowledge of sports-related injuries and illnesses in Paralympic sport is very limited and there are no large-scale epidemiological cohort studies. The purpose here is to present a protocol for a prospective longitudinal study: The Sports-Related Injuries and Illnesses in Paralympic Sport Study (SRIIPSS).

    METHODS/DESIGN:

    An argument-based method for investigation of design problems was used to structure the study protocol. The primary requirement of the protocol is to allow prospective studies over time and include exposure to both training and competition. To reflect the complexity of Paralympic sport with athletes' pre-existing impairments, use of assistive equipment, pain and other and medical issues, it is required that the data collection system is specifically adapted to Paralympic sport. To allow the collection of data, at the same time as there is limited access to coaches and medical personnel, it is advantageous that data can be collected online directly from the athletes. Based on this a self-report athlete monitoring system will be developed, where the athletes can enter data weekly via their mobile phones or lap-tops. Data will be collected from around 100 Swedish Paralympic athletes for approximately 1 year, which will allow us to i) prospectively estimate the annual incidence of sports-related injuries and illnesses and ii) explore risk factors and mechanisms for sustaining sports-related injuries and illnesses based on athlete exposure and training loads.

    DISCUSSION:

    For effective implementation of injury and illness prevention measures, comprehensive epidemiological knowledge is required. This study will be the first prospective longitudinal self-report study of sports-related injuries and illnesses in Paralympic sport over a longer period of time. The results will eventually contribute to the development of evidence-based preventive measures specifically adapted to Paralympic sport in order to provide safe and healthy sport participation. Thereby, the project will be of relevance for Paralympic athletes at all levels and to the Paralympic Movement.

  • 7.
    Jacobsson, Jenny
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences.
    Towards systematic prevention of athletics injuries: Use of clinical epidemiology for evidence-based injury prevention2012Doctoral 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.

    List of papers
    1. Design of a protocol for large-scale epidemiological studies in individual sports: the Swedish Athletics injury study
    Open this publication in new window or tab >>Design of a protocol for large-scale epidemiological studies in individual sports: the Swedish Athletics injury study
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    2010 (English)In: BRITISH JOURNAL OF SPORTS MEDICINE, ISSN 0306-3674, Vol. 44, no 15, p. 1106-1111Article in journal (Refereed) Published
    Abstract [en]

    Background Epidemiological studies have mainly been performed on team sports. The authors set out to develop a protocol for large-scale epidemiological studies of injuries among elite athletics athletes. Methods An argument-based method for investigation of complex design problems was used to structure the collection and analysis of data. Specification of the protocol was preceded by an examination of requirements on injury surveillance in individual sports and iterated drafting of protocol specifications, and followed by formative evaluations. Results The requirements analysis shows that the central demand on the protocol is to allow for detailed epidemiological analyses of overuse injuries, which subsequently requires regular collection of self-reported data from athletes. The resulting study protocol is centred on a web-based weekly athlete e-diary enabling continual collection of individual-level data on exposure and injuries. To be able to interpret the self-reported data on injury events, collection of a wide range of personal baseline data from the athlete, including a psychological profile, is included in the protocol. Conclusions The resulting protocol can be employed in intervention programmes that can prevent suffering among both adult elite and youth talent athletes who have made considerable life investments in their sport.

    Place, publisher, year, edition, pages
    BMJ Publishing, 2010
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-64580 (URN)10.1136/bjsm.2009.067678 (DOI)000285420500007 ()
    Available from: 2011-01-28 Created: 2011-01-28 Last updated: 2018-04-07Bibliographically approved
    2. Prevalence of Musculoskeletal Injuries in Swedish Elite Track and Field Athletes
    Open this publication in new window or tab >>Prevalence of Musculoskeletal Injuries in Swedish Elite Track and Field Athletes
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    2012 (English)In: American Journal of Sports Medicine, ISSN 0363-5465, E-ISSN 1552-3365, Vol. 40, no 1, p. 163-169Article in journal (Refereed) Published
    Abstract [en]

    Background: Little is known of injury patterns in track and field (athletics). Injury prevalence has been proposed as the most appropriate measure of the injury rate in sports where athletes are at risk for overuse problems. less thanbrgreater than less thanbrgreater thanPurpose: To ascertain 1-year retrospective and current prevalence of injury in elite track and field athletes to help plan injury prevention programs for this sport. less thanbrgreater than less thanbrgreater thanStudy Design: Descriptive epidemiology study. less thanbrgreater than less thanbrgreater thanMethods: Two hundred seventy-eight youth (16 years old) and adult athletes from an eligible study population of 321 athletes were included. less thanbrgreater than less thanbrgreater thanResults: The 1-year retrospective injury prevalence was 42.8% (95% confidence interval [CI], 36.9%-49.0%); the point prevalence was 35.4% (95% CI, 29.7%-41.4%). The diagnosis group displaying the highest injury prevalence was inflammation and pain in the gradual onset category (1-year prevalence, 20.9%; 95% CI, 16.2%-26.2%; and point prevalence, 23.2%; 95% CI, 18.4%-28.7%). A strong tendency for higher 1-year prevalence of 16.5% (95% CI, 12.2%-21.4%) than point prevalence of 8.5% (95% CI, 5.5%-12.5%) was recorded for sudden onset injuries in the diagnosis group sprain, strain, and rupture. The body region showing the highest injury prevalence was the knee and lower leg with 15.0% (95% CI, 11.0%-19.8%) 1-year prevalence and 13.7% (95% CI, 9.8%-18.3%) point prevalence, followed by the Achilles tendon, ankle, and foot/toe with 11.7% (95% CI, 8.2%-16.1%) 1-year prevalence and 11.4% (95% CI, 7.9%-15.8%) point prevalence. less thanbrgreater than less thanbrgreater thanConclusion: The injury prevalence is high among Swedish elite track and field athletes. Most of the injuries affect the lower extremities and are associated with a gradual onset. Although it is associated with a potential recall bias, the 1-year retrospective prevalence measure captured more sudden onset injuries than the point prevalence measure. Future prospective studies in track and field are needed to identify groups of athletes at increased risk.

    Place, publisher, year, edition, pages
    SAGE Publications (UK and US), 2012
    Keywords
    injury prevalence, track and field, overuse injuries, epidemiological methods
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-74643 (URN)10.1177/0363546511425467 (DOI)000298857200021 ()
    Note

    Funding Agencies|Swedish Centre for Research in Sports||Swedish Athletic Association, JK JK Biostatistics||Ren Idrott (Clean Sports in Sweden)||

    Available from: 2012-02-03 Created: 2012-02-03 Last updated: 2018-04-07Bibliographically approved
    3. Injury patterns in Swedish elite athletics – part 1: annual incidence and injury types
    Open this publication in new window or tab >>Injury patterns in Swedish elite athletics – part 1: annual incidence and injury types
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    2013 (English)In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 47, no 15Article in journal (Refereed) Published
    Abstract [en]

    Objective To estimate the incidence, type and severity of musculoskeletal injuries in youth and adult elite athletics athletes and to explore risk factors for sustaining injuries. Design Prospective cohort study conducted during a 52-week period. Setting Male and female youth and adult athletics athletes ranked in the top 10 in Sweden (n=292). Results 199 (68%) athletes reported an injury during the study season. Ninety-six per cent of the reported injuries were non-traumatic (associated with overuse). Most injuries (51%) were severe, causing a period of absence from normal training exceeding 3 weeks. Log-rank tests revealed risk differences with regard to athlete category (p=0.046), recent previous injury (>3 weeks time-loss; p=0.039) and training load rank index (TLRI; p=0.019). Cox proportional hazards regression analyses showed that athletes in the third (HR 1.79; 95% CI 1.54 to 2.78) and fourth TLRI quartiles (HR 1.79; 95% CI 1.16 to 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 to 8.77) compared with youth females with no previous injury. Conclusions The injury incidence among both youth and adult elite athletics athletes is high. A training load index combing hours and intensity and a history of severe injury the previous year were predictors for injury. Further studies on measures to quantify training content and protocols for safe return to athletics are warranted.

    Place, publisher, year, edition, pages
    BMJ PUBLISHING GROUP, 2013
    Keywords
    Sports injury epidemiology, track and field, injury incidence, overuse injuries, subsequent injuries
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-81397 (URN)10.1136/bjsports-2012-091651 (DOI)000324415300004 ()
    Available from: 2012-09-13 Created: 2012-09-13 Last updated: 2018-04-07Bibliographically approved
    4. Injury patterns in Swedish elite athletics – part 2: risk indicators
    Open this publication in new window or tab >>Injury patterns in Swedish elite athletics – part 2: risk indicators
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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.

    Keywords
    sports injury epidemiology, track and field, injury incidence, previous injury, training load, prevention
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-81398 (URN)
    Available from: 2012-09-13 Created: 2012-09-13 Last updated: 2018-04-07Bibliographically approved
  • 8.
    Jacobsson, Jenny
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Bergin, D.
    Swedish Athlet Assoc, Sweden.
    Timpka, Toomas
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Business support and Development, Department of Health and Care Development.
    Nyce, J. M.
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Dahlström, Örjan
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Injuries in youth track and field are perceived to have multiple-level causes that call for ecological (holistic-developmental) interventions: A national sporting community perceptions and experiences2018In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 28, no 1, p. 348-355Article in journal (Refereed)
    Abstract [en]

    Engaging in competitive sports as a youth can have many health benefits, but recent studies also report a high risk for injury. The long-term purpose of this Swedish research program is to develop a framework for safe track and field training for young athletes (aged 12-15years). The aim of this study was to establish what is perceived to contribute and cause injuries in youth track and field by compiling the best available experiential knowledge about the underlying factors and use this knowledge to identify appropriate areas to handle these in practical ways. Nine focus group interviews with in total 74 participants and confirming interviews with five individuals were performed in seven Swedish regions. Qualitative research methods were used for data analysis. Injuries in youth athletes were not considered to be strictly the result of individual factors but rather the result of the interactions between factors at different levels. Three major factors emerged as follows: Insufficient knowledge for athletic development in daily practice; shortsighted communities of practice and sports policies not adjusted to youth; and societal health behaviors. The experiential knowledge in the national sporting community suggests that if effective and sustainable injury prevention processes are to be implemented for youth track and field, an ecological (holistic-developmental) approach to injury prevention is needed. Such an approach allows a longitudinal development-focused strategy for prevention that spans an athletes entire career.

  • 9.
    Jacobsson, Jenny
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Timpka, Toomas
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Health and Developmental Care, Center for Public Health.
    Classification of Prevention in Sports Medicine and Epidemiology2015In: Sports Medicine, ISSN 0112-1642, E-ISSN 1179-2035, Vol. 45, no 11, p. 1483-1487Article in journal (Refereed)
    Abstract [en]

    It is today recognized that a large share of manifestations of ill health associated with sports participation is preventable and that a focus should be on implementation of effective prevention programs. One hindrance for implementation of effective preventive measures in sports medicine may be that an update of preventive frameworks to the current health challenges has not been performed. We introduce classifications of prevention that are adjusted to the health challenges faced by sports participants in the present day. To enable more precise characterizations of preventive measures, we find it necessary to describe them in two dimensions. In one dimension, pathological developments in the body are used as a basis for classification of preventive measures, while the other dimension classifies prevention on the grounds of epidemiological risk indicators. We conclude that longitudinal research combining diagnostic procedures, surveillance, and targeted interventions is needed to enable the introduction of prevention programs for athletes in the beginning of their sporting career at the pre-diagnostic stage, as well as suitable prevention measures for the adult elite athletes. A more distinct classification of prevention supports a specific and cost-effective planning and translation of sports injury prevention and safety promotion adjusted to the delivery settings, various injury types, and different groups of athletes. The present classifications constitute an additional conceptual foundation for such efforts.

  • 10.
    Jacobsson, Jenny
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Timpka, Toomas
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Public Health Sciences.
    Ekberg, Joakim
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Kowalski, Jan
    Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences.
    Nilsson, Sverker
    Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences.
    Renstrom, Per
    Karolinska Institute.
    Design of a protocol for large-scale epidemiological studies in individual sports: the Swedish Athletics injury study2010In: BRITISH JOURNAL OF SPORTS MEDICINE, ISSN 0306-3674, Vol. 44, no 15, p. 1106-1111Article in journal (Refereed)
    Abstract [en]

    Background Epidemiological studies have mainly been performed on team sports. The authors set out to develop a protocol for large-scale epidemiological studies of injuries among elite athletics athletes. Methods An argument-based method for investigation of complex design problems was used to structure the collection and analysis of data. Specification of the protocol was preceded by an examination of requirements on injury surveillance in individual sports and iterated drafting of protocol specifications, and followed by formative evaluations. Results The requirements analysis shows that the central demand on the protocol is to allow for detailed epidemiological analyses of overuse injuries, which subsequently requires regular collection of self-reported data from athletes. The resulting study protocol is centred on a web-based weekly athlete e-diary enabling continual collection of individual-level data on exposure and injuries. To be able to interpret the self-reported data on injury events, collection of a wide range of personal baseline data from the athlete, including a psychological profile, is included in the protocol. Conclusions The resulting protocol can be employed in intervention programmes that can prevent suffering among both adult elite and youth talent athletes who have made considerable life investments in their sport.

  • 11.
    Jacobsson, Jenny
    et al.
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences.
    Timpka, Toomas
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Kowalski, Jan
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Nilsson, Sverker
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Ekberg, Joakim
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Dahlström, Örjan
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Renström, Per
    Karolinska Institutet, Department of Molecular Medicine and Surgery, Stockholm, Sweden.
    Injury patterns in Swedish elite athletics – part 1: annual incidence and injury types2013In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 47, no 15Article in journal (Refereed)
    Abstract [en]

    Objective To estimate the incidence, type and severity of musculoskeletal injuries in youth and adult elite athletics athletes and to explore risk factors for sustaining injuries. Design Prospective cohort study conducted during a 52-week period. Setting Male and female youth and adult athletics athletes ranked in the top 10 in Sweden (n=292). Results 199 (68%) athletes reported an injury during the study season. Ninety-six per cent of the reported injuries were non-traumatic (associated with overuse). Most injuries (51%) were severe, causing a period of absence from normal training exceeding 3 weeks. Log-rank tests revealed risk differences with regard to athlete category (p=0.046), recent previous injury (>3 weeks time-loss; p=0.039) and training load rank index (TLRI; p=0.019). Cox proportional hazards regression analyses showed that athletes in the third (HR 1.79; 95% CI 1.54 to 2.78) and fourth TLRI quartiles (HR 1.79; 95% CI 1.16 to 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 to 8.77) compared with youth females with no previous injury. Conclusions The injury incidence among both youth and adult elite athletics athletes is high. A training load index combing hours and intensity and a history of severe injury the previous year were predictors for injury. Further studies on measures to quantify training content and protocols for safe return to athletics are warranted.

  • 12.
    Jacobsson, Jenny
    et al.
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences.
    Timpka, Toomas
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Kowalski, Jan
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Nilsson, Sverker
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Ekberg, Joakim
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Dahlström, Örjan
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Renström, Per
    Karolinska Institutet, Department of Molecular Medicine and Surgery, Stockholm, Sweden.
    Injury patterns in Swedish elite athletics – part 2: risk indicators2012Manuscript (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.

  • 13.
    Jacobsson, Jenny
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Timpka, Toomas
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Kowalski, Jan
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Nilsson, Sverker
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Ekberg, Joakim
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Renström, Per
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Prevalence of Musculoskeletal Injuries in Swedish Elite Track and Field Athletes2012In: American Journal of Sports Medicine, ISSN 0363-5465, E-ISSN 1552-3365, Vol. 40, no 1, p. 163-169Article in journal (Refereed)
    Abstract [en]

    Background: Little is known of injury patterns in track and field (athletics). Injury prevalence has been proposed as the most appropriate measure of the injury rate in sports where athletes are at risk for overuse problems. less thanbrgreater than less thanbrgreater thanPurpose: To ascertain 1-year retrospective and current prevalence of injury in elite track and field athletes to help plan injury prevention programs for this sport. less thanbrgreater than less thanbrgreater thanStudy Design: Descriptive epidemiology study. less thanbrgreater than less thanbrgreater thanMethods: Two hundred seventy-eight youth (16 years old) and adult athletes from an eligible study population of 321 athletes were included. less thanbrgreater than less thanbrgreater thanResults: The 1-year retrospective injury prevalence was 42.8% (95% confidence interval [CI], 36.9%-49.0%); the point prevalence was 35.4% (95% CI, 29.7%-41.4%). The diagnosis group displaying the highest injury prevalence was inflammation and pain in the gradual onset category (1-year prevalence, 20.9%; 95% CI, 16.2%-26.2%; and point prevalence, 23.2%; 95% CI, 18.4%-28.7%). A strong tendency for higher 1-year prevalence of 16.5% (95% CI, 12.2%-21.4%) than point prevalence of 8.5% (95% CI, 5.5%-12.5%) was recorded for sudden onset injuries in the diagnosis group sprain, strain, and rupture. The body region showing the highest injury prevalence was the knee and lower leg with 15.0% (95% CI, 11.0%-19.8%) 1-year prevalence and 13.7% (95% CI, 9.8%-18.3%) point prevalence, followed by the Achilles tendon, ankle, and foot/toe with 11.7% (95% CI, 8.2%-16.1%) 1-year prevalence and 11.4% (95% CI, 7.9%-15.8%) point prevalence. less thanbrgreater than less thanbrgreater thanConclusion: The injury prevalence is high among Swedish elite track and field athletes. Most of the injuries affect the lower extremities and are associated with a gradual onset. Although it is associated with a potential recall bias, the 1-year retrospective prevalence measure captured more sudden onset injuries than the point prevalence measure. Future prospective studies in track and field are needed to identify groups of athletes at increased risk.

  • 14.
    Karlsson, David
    et al.
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, The Institute of Technology.
    Timpka, Toomas
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Business support and Development, Department of Health and Care Development.
    Jacobsson, Jenny
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Swedish Athletics Association, Sweden.
    Alonso, Juan-Manuel
    Aspetar, Qatar.
    Kowalski, Jan
    Swedish Athletics Association, Sweden.
    Nilsson, Sverker
    Linköping University. Swedish Athletics Association, Sweden.
    Depiesse, Frederic
    French Athletics Federation (FFA), France; University Hospital of Toulouse, France; European Athletics Association (EAA), Switzerland.
    Branco, Pedro
    International Association of Athletics Federations (IAAF), Monaco; European Athletics Association (EAA), Switzerland.
    Edouard, Pascal
    French Athletics Federation (FFA), France; University Hospital of Saint-Etienne, France; University of Lyon, France.
    Electronic data capture on athletes pre-participation health and in-competition injury and illness at major sports championships: An extended usability study in Athletics2018In: Health Informatics Journal, ISSN 1460-4582, E-ISSN 1741-2811, Vol. 24, no 2, p. 136-145Article in journal (Refereed)
    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.

  • 15.
    Periard, Julien D.
    et al.
    Aspetar Orthopaed and Sports Medical Hospital, Qatar.
    Racinais, Sebastien
    Aspetar Orthopaed and Sports Medical Hospital, Qatar.
    Timpka, Toomas
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Business support and Development, Department of Health and Care Development.
    Dahlström, Örjan
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Spreco, Armin
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Jacobsson, Jenny
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Swedish Athlet Assoc, Sweden.
    Bargoria, Victor
    Linköping University. Moi University, Kenya.
    Halje, Karin
    Region Östergötland, Local Health Care Services in Central Östergötland.
    Alonso, Juan-Manuel
    Aspetar Orthopaed and Sports Medical Hospital, Qatar.
    Strategies and factors associated with preparing for competing in the heat: a cohort study at the 2015 IAAF World Athletics Championships2017In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 51, no 4, p. 264-271Article in journal (Refereed)
    Abstract [en]

    Purpose Assess exertional heat illness (EHI) history and preparedness in athletes competing in a World Athletics Championships under hot/humid conditions and identify the factors associated with preparedness strategies. Methods Of the 207 registered national teams invited to participate in the study, 50 (24%) accepted. The 957 athletes (49% of all 1965 registered) in these teams were invited to complete a precompetition questionnaire evaluating EHI history, heat stress prevention (heat acclimatisation, precooling and hydration) and recovery. Responses from 307 (32%) athletes were separated in field events, sprints, middle-distance and long-distance running, and decathlon/heptathlon for analysis. Results 48% of athletes had previously experienced EHI symptoms and 8.5% had been diagnosed with EHI. 15% heat acclimatised (similar to 20 days) before the championships. 52% had a precooling strategy, ice slurry ingestion (24%) being the most prevalent and women using it more frequently than men (p=0.005). 96% of athletes had a fluid consumption strategy, which differed between event categories (pamp;lt;0.001). The most common volumes planned on being consumed were 0.5-1 L (27.2%) and amp;gt;= 2 L (21.8%), water being the most frequent. 89% of athletes planned on using at least one recovery strategy. Female sex (p=0.024) and a previous EHI diagnosis increased the likelihood of using all 3 prevention strategies (pamp;lt;0.001). Conclusions At a World Championships with expected hot/humid conditions, less than one-fifth of athletes heat acclimatised, half had a precooling strategy and almost all a hydration plan. Women, and especially athletes with an EHI history, were more predisposed to use a complete heat stress prevention strategy. More information regarding heat acclimatisation should be provided to protect athlete health and optimise performance at major athletics competitions in the heat.

  • 16.
    Rodriguez-Serrano, L. I.
    et al.
    Linköping University.
    Timpka, Toomas
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Business support and Development, Department of Health and Care Development.
    Ekberg, Joakim
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Business support and Development, Department of Health and Care Development.
    Dahlström, Örjan
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Jacobsson, Jenny
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Young athletes health knowledge system: Qualitative analysis of health learning processes in adolescent sportspersons2018In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 28, no 3, p. 1272-1280Article in journal (Refereed)
    Abstract [en]

    Recognized side effects on health associated with sports participation in youth include overtraining, doping, and exposure to harassment and violence. Many of these effects originate in contexts where young athletes are beginning to make decisions about their sports practices on their own. This study sets out to explore knowledge and reasoning about health among adolescent athletes and to describe how health knowledge management structures are associated with different social systems. Qualitative data were collected from focus groups involving 65 young Swedish athletes aged 16-17years. The participants knowledge and reasoning about health were examined using a deductive thematic analysis, categories from Blooms taxonomy of educational objectives, and Luhmanns social systems theory. The meaning of health was found to have a dynamic character for the young athletes, associated with constantly striving to satisfy immediate needs and fulfill short-time life goals. The athletes thinking about health was associated with a pragmatic health-as-a-resource perspective, characterized by group self-comparisons, rapid cognitive processing, and opportunistic substitutions. They expressed a particular interest in experiential learning and personally relevant procedural knowledge, and they perceived that their factual knowledge about health was saturated. The results of this study add emphasis to the importance of involving adolescent sportspersons in the development of health education programs and contextualizing the programs to the athletes specific age and social environment.

  • 17.
    Rönnby, Sara
    et al.
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Lundberg, Oscar
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Fagher, Kristina
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Jacobsson, Jenny
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Tillander, Bo
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Orthopaedics in Linköping.
    Gauffin, Håkan
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Orthopaedics in Linköping.
    Hansson, Per-Olof
    Linköping University, Department of Management and Engineering, Political Science. Linköping University, Faculty of Arts and Sciences.
    Dahlström, Örjan
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Timpka, Toomas
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Business support and Development, Department of Health and Care Development.
    mHealth Self-Report Monitoring in Competitive Middle- and Long-Distance Runners: Qualitative Study of Long-Term Use Intentions Using the Technology Acceptance Model2018In: JMIR mhealth and uhealth, E-ISSN 2291-5222, Vol. 6, no 8, article id e10270Article in journal (Refereed)
    Abstract [en]

    Background: International middle- and long-distance running competitions attract millions of spectators in association with city races, world championships, and Olympic Games. It is therefore a major concern that ill health and pain, as a result of sports overuse, lead to numerous hours of lost training and decreased performance in competitive runners. Despite its potential for sustenance of performance, approval of mHealth self-report monitoring (mHSM) in this group of athletes has not been investigated. Objective: The objective of our study was to explore individual and situational factors associated with the acceptance of long-term mHSM in competitive runners. Methods: The study used qualitative research methods with the Technology Acceptance Model as the theoretical foundation. The study population included 20 middle- and long-distance runners competing at national and international levels. Two mHSM apps asking for health and training data from track and marathon runners were created on a platform for web survey development (Briteback AB). Data collection for the technology acceptance analysis was performed via personal interviews before and after a 6-week monitoring period. Preuse interviews investigated experience and knowledge of mHealth monitoring and thoughts on benefits and possible side effects. The postuse interviews addressed usability and usefulness, attitudes toward nonfunctional issues, and intentions to adhere to long-term monitoring. In addition, the runners trustworthiness when providing mHSM data was discussed. The interview data were investigated using a deductive thematic analysis. Results: The mHSM apps were considered technically easy to use. Although the runners read the instructions and entered data effortlessly, some still perceived mHSM as problematic. Concerns were raised about the selection of items for monitoring (eg, recording training load as running distance or time) and about interpretation of concepts (eg, whether subjective well should encompass only the running context or daily living on the whole). Usefulness of specific mHSM apps was consequently not appraised on the same bases in different subcategories of runners. Regarding nonfunctional issues, the runners competing at the international level requested detailed control over who in their sports club and national federation should be allowed access to their data; the less competitive runners had no such issues. Notwithstanding, the runners were willing to adhere to long-term mHSM, provided the technology was adjusted to their personal routines and the output was perceived as contributing to running performance. Conclusions: Adoption of mHSM by competitive runners requires clear definitions of monitoring purpose and populations, repeated in practice tests of monitoring items and terminology, and meticulousness regarding data-sharing routines. Further naturalistic studies of mHSM use in routine sports practice settings are needed with nonfunctional ethical and legal issues included in the evaluation designs.

  • 18.
    Timpka, Toomas
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Health and Developmental Care, Center for Public Health.
    Alonso, Juan-Manuel
    International Association of Athletics Federations (IAAF) Medical and Anti-doping Commission, Montecarlo, Monaco; Sports Medicine Department, Aspetar, Qatar Orthopedics and Sports Medicine Hospital, Doha, Qatar.
    Jacobsson, Jenny
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences. Swedish Athletics Association, Stockholm, Sweden .
    Junge, Astrid
    FIFA Medical Assessment and Research Centre (F-MARC), Zurich, Switzerland; Schulthess Klinik, Zurich, Switzerland; Medical School Hamburg (MSH), Germany .
    Branco, Pedro
    International Association of Athletics Federations (IAAF) Medical and Anti-doping Commission, Montecarlo, Monaco; European Athletics Medical & Anti-Doping Commission, European Athletics Association (EAA), Lausanne, Switzerland .
    Clarsen, Ben
    Oslo Sports Trauma Research Centre, Norway; Olympic Elite Sports Program (Olympiatoppen), Oslo, Norway .
    Kowalski, Jan
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences. Swedish Athletics Association, Stockholm, Sweden; Diamond League, Stockholm, Sweden; Karolinska Institutet, Stockholm, Sweden .
    Mountjoy, Margo
    International Olympic Committee (IOC) Medical Commission, Lausanne, Switzerland; Department of Sports Medicine, FINA Bureau, Lausanne, Switzerland; McMaster University School of Medicine, Hamilton, Ontario, Canada .
    Nilsson, Sverker
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences. Swedish Athletics Association, Stockholm, Sweden .
    Pluim, Babette
    Royal Netherlands Lawn Tennis Association, Amersfoort, The Netherlands .
    Renström, Per
    Karolinska Institutet, Stockholm, Sweden; International Olympic Committee (IOC) Medical Commission, Lausanne, Switzerland .
    Rønsen, Ola
    International Association of Athletics Federations (IAAF) Medical and Anti-doping Commission, Montecarlo, Monaco; Olympic Elite Sports Program (Olympiatoppen), Oslo, Norway .
    Steffen, Kathrin
    Oslo Sports Trauma Research Centre, Norway .
    Edouard, Pascal
    University Hospital of Saint-Etienne, France; University of Lyon, France.
    Injury and illness definitions and data collection procedures for use in epidemiological studies in Athletics (track and field): Consensus statement2014In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 48, no 7, p. 483-490Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Movement towards sport safety in Athletics through the introduction of preventive strategies requires consensus on definitions and methods for reporting epidemiological data in the various populations of athletes.

    OBJECTIVE:

    To define health-related incidents (injuries and illnesses) that should be recorded in epidemiological studies in Athletics, and the criteria for recording their nature, cause and severity, as well as standards for data collection and analysis procedures.

    METHODS:

    A 1-day meeting of 14 experts from eight countries representing a range of Athletics stakeholders and sport science researchers was facilitated. Definitions of injuries and illnesses, study design and data collection for epidemiological studies in Athletics were discussed during the meeting. Two members of the group produced a draft statement after this meeting, and distributed to the group members for their input. A revision was prepared, and the procedure was repeated to finalise the consensus statement.

    RESULTS:

    Definitions of injuries and illnesses and categories for recording of their nature, cause and severity were provided. Essential baseline information was listed. Guidelines on the recording of exposure data during competition and training and the calculation of prevalence and incidences were given. Finally, methodological guidance for consistent recording and reporting on injury and illness in athletics was described.

    CONCLUSIONS:

    This consensus statement provides definitions and methodological guidance for epidemiological studies in Athletics. Consistent use of the definitions and methodological guidance would lead to more reliable and comparable evidence.

  • 19.
    Timpka, Toomas
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Business support and Development, Department of Health and Care Development.
    Bargoria, Victor
    Moi Univ, Kenya.
    Halje, Karin
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Jacobsson, Jenny
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Infographic: Elite athletes anxiety over illness ups risk of injury in competition2018In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 52, no 15, p. 955-955Article in journal (Other academic)
    Abstract [en]

    n/a

  • 20.
    Timpka, Toomas
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Health and Developmental Care, Center for Public Health.
    Jacobsson, Jenny
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Bargoria, Victor
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Moi Univ, Kenya.
    Dahlström, Örjan
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Injury Pain in Track and Field Athletes: Cross-Sectional Study of Mediating Factors2019In: SPORTS, ISSN 2075-4663, Vol. 7, no 5, article id 110Article in journal (Refereed)
    Abstract [en]

    This exploratory study aimed to investigate whether data from track and field athletes support a conceptual model where the perception of pain affects self-evaluated health directly, yet is also indirectly mediated through personal factors and external stressors. A cross-sectional study was performed among athletes (n = 278) competing at the highest national level in the sport. Data for the dependent and independent variables were collected using the EuroQol-5 dimensions (EQ-5D) standardized measure of health status, and the mediator variables were collected by the Body Consciousness Scale (BCS-HA), Perceived Motivational Climate in Sport Questionnaire (PMCSQ), Commitment to Exercise Scale (CtES), and Brief Cope survey instruments. Two hundred and twenty-five (81%) athletes provided complete data sets. A strong direct association (c = -16.49; p amp;lt; 0.001) was found between pain and self-estimated health, and a global mediation was found through the mediators (mediation effect (ME), -1.814, 90% confidence interval (CI), -3.414, -0.351). Specific mediation was observed for body competence (ME, -0.721; 90% CI, -2.028, -0.097) and private body consciousness (ME, -0.514; 90% CI, -1.761, -0.017). In conclusion, we found a negative association between perceived pain and self-evaluated health among competitive track and field athletes, and we found that a portion of the association was mediated through mediating factors. Under the assumption that the analyzed pain data primarily represented noxious pain, the conceptual model of the relationships between pain and self-estimated health among high-level track and field athletes was supported.

  • 21.
    Timpka, Toomas
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Business support and Development, Department of Health and Care Development.
    Jacobsson, Jenny
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Swedish Athlet Assoc, Sweden.
    Bargoria, Victor
    Linköping University. Moi University, Kenya.
    Periard, Julien D.
    Aspetar Orthopaed and Sports Medical Hospital, Qatar.
    Racinais, Sebastien
    Aspetar Orthopaed and Sports Medical Hospital, Qatar.
    Ronsen, Ola
    Medical and Antidoping Commiss, Monaco; Aker Solut, Norway.
    Halje, Karin
    Region Östergötland, Local Health Care Services in Central Östergötland.
    Andersson, Christer A.
    Linköping University, Department of Clinical and Experimental Medicine, Orthopaedics and Sports Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Orthopaedics in Linköping.
    Dahlström, Örjan
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Spreco, Armin
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Edouard, Pascal
    University Hospital St Etienne, France; University of Lyon, France; Medical Commiss, France.
    Alonso, Juan-Manuel
    Medical and Antidoping Commiss, Monaco; Aspetar Orthopaed and Sports Medical Hospital, Qatar.
    Preparticipation predictors for championship injury and illness: cohort study at the Beijing 2015 International Association of Athletics Federations World Championships2017In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 51, no 4, p. 272-+Article in journal (Refereed)
    Abstract [en]

    Objectives To determine preparticipation predictors of injury and illness at a major Athletics championship. Methods A cohort study design was used. Before the 2015 International Association of Athletics Federations World Championships in Athletics, all 207 registered national teams were approached about partaking in a study of preparticipation health; 50 teams accepted. The athletes (n=957) in the participating teams were invited to complete a preparticipation health questionnaire (PHQ). New injuries and illnesses that occurred at the championships were prospectively recorded. Logistic regression analyses were performed with simple and multiple models using any in-championship injury and in-championship illness as outcomes. Results The PHQ was completed by 307 (32.1%) of the invited athletes; 116 athletes (38.3%) reported an injury symptom during the month before the championships, while 40 athletes (13%) reported an illness symptom. 20 (6.5%) of the participating athletes sustained a health problem during the championships. Endurance athletes were almost 10-fold more likely to sustain an in-championship illness than speed/power athletes (OR, 9.88; 95% CI 1.20 to 81.31; p=0.033). Participants reporting a preparticipation gradual-onset injury symptom were three times more likely (OR, 3.09; 95% CI 1.08 to 8.79; p=0.035) and those reporting an illness symptom causing anxiety were fivefold more likely (OR, 5.56; 95% CI 1.34 to 23.15; p=0.018) to sustain an in-championship injury. Summary and conclusions Analyses of preparticipation predictors of injury and illness at a major Athletics championship suggest that endurance athletes require particular clinical attention. Preparticipation symptoms causing anxiety are interesting predictors for in-championship health problems.

  • 22.
    Timpka, Toomas
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Health and Developmental Care, Center for Public Health.
    Jacobsson, Jenny
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Bickenbach, Jerome
    Queens University, Kingston, ON, Canada .
    Finch, Caroline F.
    Federation University Australia, Ballarat.
    Ekberg, Joakim
    University of Skövde, Sweden .
    Nordenfelt, Lennart
    Linköping University, Department of Medical and Health Sciences, Division of Health and Society. Linköping University, Faculty of Arts and Sciences.
    What is a Sports Injury?2014In: Sports Medicine, ISSN 0112-1642, E-ISSN 1179-2035, Vol. 44, no 4, p. 423-428Article in journal (Refereed)
    Abstract [en]

    Current sports injury reporting systems lack a common conceptual basis. We propose a conceptual foundation as a basis for the recording of health problems associated with participation in sports, based on the notion of impairment used by the World Health Organization. We provide definitions of sports impairment concepts to represent the perspectives of health services, the participants in sports and physical exercise themselves, and sports institutions. For each perspective, the duration of the causative event is used as the norm for separating concepts into those denoting impairment conditions sustained instantly and those developing gradually over time. Regarding sports impairment sustained in isolated events, sports injury denotes the loss of bodily function or structure that is the object of observations in clinical examinations; sports trauma is defined as an immediate sensation of pain, discomfort or loss of functioning that is the object of athlete self-evaluations; and sports incapacity is the sidelining of an athlete because of a health evaluation made by a legitimate sports authority that is the object of time loss observations. Correspondingly, sports impairment caused by excessive bouts of physical exercise is denoted as sports disease (overuse syndrome) when observed by health service professionals during clinical examinations, sports illness when observed by the athlete in self-evaluations, and sports sickness when recorded as time loss from sports participation by a sports body representative. We propose a concerted development effort in this area that takes advantage of concurrent ontology management resources and involves the international sporting community in building terminology systems that have broad relevance.

  • 23.
    Timpka, Toomas
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Health and Developmental Care, Center for Public Health.
    Jacobsson, Jenny
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Dahlström, Örjan
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Kowalski, Jan
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences. Karolinska Institute, Sweden.
    Bargoria, Victor
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences. Moi University, Kenya.
    Ekberg, Joakim
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Health and Developmental Care, Center for Public Health.
    Nilsson, Sverker
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Renström, Per
    Linköping University. Karolinska Institute, Sweden.
    The psychological factor self-blame predicts overuse injury among top-level Swedish track and field athletes: a 12-month cohort study2015In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 49, no 22, p. 1472-1477Article in journal (Refereed)
    Abstract [en]

    Background Athletes psychological characteristics are important for understanding sports injury mechanisms. We examined the relevance of psychological factors in an integrated model of overuse injury risk in athletics/track and field. Methods Swedish track and field athletes (n=278) entering a 12-month injury surveillance in March 2009 were also invited to complete a psychological survey. Simple Cox proportional hazards models were compiled for single explanatory variables. We also tested multiple models for 3 explanatory variable groupings: an epidemiological model without psychological variables, a psychological model excluding epidemiological variables and an integrated (combined) model. Results The integrated multiple model included the maladaptive coping behaviour self-blame (p=0.007; HR 1.32; 95% CI 1.08 to 1.61), and an interaction between athlete category and injury history (p<0.001). Youth female (p=0.034; HR 0.51; 95% CI 0.27 to 0.95) and youth male (p=0.047; HR 0.49; 95% CI 0.24 to 0.99) athletes with no severe injury the previous year were at half the risk of sustaining a new injury compared with the reference group. A training load index entered the epidemiological multiple model, but not the integrated model. Conclusions The coping behaviour self-blame replaced training load in an integrated explanatory model of overuse injury risk in athletes. What seemed to be more strongly related to the likelihood of overuse injury was not the athletics load per se, but, rather, the load applied in situations when the athletes body was in need of rest.

  • 24.
    Timpka, Toomas
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Health and Developmental Care, Center for Public Health.
    Jacobsson, Jenny
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Ekberg, Joakim
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Health and Developmental Care, Center for Public Health.
    Finch, Caroline F.
    Federat University of Australia, Australia.
    Bichenbach, Jerome
    Queens University, Canada.
    Edouard, Pascal
    University Hospital St Etienne, France; University of Lyon, France.
    Bargoria, Victor
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences. Moi University, Kenya.
    Branco, Pedro
    IAAF, Monaco.
    Manuel Alonso, Juan
    IAAF, Monaco; Aspetar, Qatar.
    Meta-narrative analysis of sports injury reporting practices based on the Injury Definitions Concept Framework (IDCF): A review of consensus statements and epidemiological studies in athletics (track and field)2015In: Journal of Science and Medicine in Sport, ISSN 1440-2440, E-ISSN 1878-1861, Vol. 18, no 6, p. 643-650Article, review/survey (Refereed)
    Abstract [en]

    Objectives: Consistency in routines for reporting injury has been a focus of development efforts in sports epidemiology for a long time. To gain an improved understanding of current reporting practices, we applied the Injury Definitions Concept Framework (IDCF) in a review of injury reporting in a subset of the field. Design: Meta-narrative review. Methods: An analysis of injury definitions reported in consensus statements for different sports and studies of injury epidemiology in athletics (track and field) published in PubMed between 1980 and 2013 was performed. Separate narratives for each of the three reporting contexts in the IDCF were constructed from the data. Results: Six consensus statements and 14 studies reporting on athletics injury epidemiology fulfilled the selection criteria. The narratives on sports performance, clinical examination, and athlete self-report contexts were evenly represented in the eligible studies. The sports performance and athlete self-report narratives covered both professional and community athletes as well as training and competition settings. In the clinical examination narrative, data collection by health service professionals was linked to studies of professional athletes at international championships. Conclusions: From an application of the IDCF in a review of injury reporting in sports epidemiology we observed a parallel usage of reporting contexts in this field of research. The co-existence of reporting methodologies does not necessarily reflect a problematic situation, but only provided that firm precautions are taken when comparing studies performed in the different contexts. (C) 2014 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  • 25.
    Timpka, Toomas
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences. Region Östergötland, Center for Health and Developmental Care, Center for Public Health.
    Janson, Staffan
    Karlstad University, Sweden.
    Jacobsson, Jenny
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Ekberg, Joakim
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Health and Developmental Care, Center for Public Health.
    Dahlström, Örjan
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Kowalski, Jan
    Karolinska Institute, Sweden.
    Bargoria, Victor
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences. Moi University, Kenya.
    Mountjoy, Margo
    McMaster University, Canada.
    Svedin, Carl Göran
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Protocol Design for Large-Scale Cross-Sectional Studies of Sexual Abuse and Associated Factors in Individual Sports: Feasibility Study in Swedish Athletics2015In: Journal of Sports Science and Medicine (JSSM), ISSN 1303-2968, Vol. 14, no 1, p. 179-187Article in journal (Refereed)
    Abstract [en]

    To ensure health and well-being for their athletes, sports organizations must offer preventive measures against sexual abuse. The aim of this study was to design and evaluate feasibility of a research protocol for cross-sectional epidemiological studies of sexual abuse in athletics. Examination of the requirements on the study of sexual abuse in athletics was followed by iterated drafting of protocol specifications and formative evaluations. The feasibility of the resulting protocol was evaluated in a national-level study among elite athletics athletes (n = 507) in Sweden. The definition of sexual abuse, the ethical soundness of the protocol, reference populations and study of co-morbidity, and the means for athlete-level data collection were identified as particularly complex issues in the requirements analyses. The web-based survey defined by the protocol facilitates anonymous athlete self-reporting of data on exposure to sexual abuse. 198 athletes (39%) fully completed the feasibility survey. 89% (n = 177) reported that they agreed with that the questions in the survey were important, and 95% (n = 189) reported that they answered truthfully to all questions. Similarly, 91% (n = 180) reported that they did not agree with that the questions were unpleasant for them. However, 16% (n = 32) reported that they did not find the survey to be of personal value, and 12% (n = 23) reported that the survey had caused them to think about issues that they did not want to think about. Responding that participation was not personally gratifying was associated with training more hours (p = 0.01). There is a scarcity of research on the prevention of sexual abuse in individual sports. The present protocol should be regarded as a means to overcome this shortcoming in athletics. When implementing the protocol, it is necessary to encourage athlete compliance and to adapt the web-based survey to the particular infrastructural conditions in the sports setting at hand.

  • 26.
    Timpka, Toomas
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Business support and Development, Department of Health and Care Development.
    Schyllander, Jan
    Swedish Civil Contingencies Agcy, Sweden.
    Ekman, Diana Stark
    Walden Univ, MN USA; Univ Skovde, Sweden.
    Ekman, Robert
    Chalmers Univ Technol, Sweden.
    Dahlström, Örjan
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Hägglund, Martin
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences.
    Kristenson, Karolina
    Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Anaesthesiology and Intensive Care in Linköping. Linköping University, Department of Medical and Health Sciences, Division of Community Medicine.
    Jacobsson, Jenny
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Community-level football injury epidemiology: traumatic injuries treated at Swedish emergency medical facilities2018In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 28, no 1, p. 94-99Article in journal (Refereed)
    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.

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