Background Injury profiles during Paralympic Games have been extensively studied, whereas longitudinal monitoring data of para-athletes are still sparse.

Objective Implementation of an injury and illness surveillance system in high-level Paralympic athletes.

Design Longitudinal monitoring of injuries and illnesses within the German National Paralympic Team.

Setting In preparation for the Paralympic Games in Rio de Janeiro 2016, all German elite athletes (n=178) were invited to take part in the weekly monitoring program using the Oslo Sports Trauma Research Center Questionnaire. The prevalence data on injury and illness were extracted and analysed with regard to age, sexes, impairement, sports and training volume. Acceptance of the program was evaluated at the end.

Patients (or Participants) 58 athletes comprised the final cohort (32 male, 26 female; main sports: paracycling (n=18), wheelchair basketball (n=12), swimming (n= 8). Main disabilities: SCI (n=19), limb pathologies (n=15), neurological impairments (n=17).

Interventions (or Assessment of Risk Factors) Prospective cohort study.

Main Outcome Measurements Weekly prevalence of injuries and ilneeses, injury rate per 1000 athlete-days.

Results With a weekly response rate of 92.4 ± 8.5%, 10.927 athlete-days were recorded with 306 (199) training-days being lost due to illnesses (injuries). The weekly prevalence of all health problems was 26% (95% CI 23% - 29%). Female athletes had a higher prevalence (30.6%) compared to males (22.4%). The number of substantial complaints did not change over time, whereas the overall prevalence declined. Wheelchair athletes had higher incidence rates for gastroenterological problems, urinary tract infections and neurological complaints as well as higher rates of shoulder and elbow injuries. The participating athletes reported a high satisfaction with the weekly monitoring program.

Conclusions The weekly prevalence of overuse injuries and illnesses in Paralympic athletes is high, even early in the season, and varies substantially between handicaps and disciplines. Illnesses seem to be even more important than injuries.