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High incidence of injury at the Sochi 2014 Winter Paralympic Games: a prospective cohort study of 6564 athlete days
  1. W Derman1,2,3,
  2. M P Schwellnus2,3,4,
  3. E Jordaan5,
  4. P Runciman1,
  5. P Van de Vliet6,
  6. C Blauwet7,
  7. N Webborn8,
  8. S Willick9,
  9. J Stomphorst10
  1. 1Institute of Sport and Exercise Medicine, Department of Surgery, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa
  2. 2Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
  3. 3International Olympic Committee (IOC) Research Centre, South Africa
  4. 4Institute for Sport, Exercise Medicine and Lifestyle Research, Faculty of Health Sciences, University of Pretoria, South Africa
  5. 5Biostatistics Unit, Statistics and Population Studies Department, Medical Research Council of South Africa, University of the Western Cape
  6. 6Medical & Scientific Department, International Paralympic Committee, Bonn, Germany
  7. 7Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
  8. 8Centre for Sport and Exercise Science and Medicine (SESAME), University of Brighton, Eastbourne, UK
  9. 9Department of Physical Medicine and Rehabilitation, University of Utah Orthopaedic Center, Salt Lake City, Utah
  10. 10Department of Sport Medicine, Isala Klinieken, Zwolle, The Netherlands
  1. Correspondence to Professor Wayne Derman, Institute of Sport and Exercise Medicine, Department of Surgery, Faculty of Medicine and Health Science, Institute of Sport and Exercise Medicine, Room 4019, 4th Floor, Clinical Building, Tygerberg Medical Campus, Francie van Zijl Drive, Bellville, Cape Town 7505, South Africa; ewderman{at}


Objective To describe the epidemiology of injuries at the Sochi 2014 Winter Paralympic Games.

Methods A total of 547 athletes from 45 countries were monitored daily for 12 days during the Sochi 2014 Winter Paralympic Games (6564 athlete days). Daily injury data were obtained from teams with their own medical support (32 teams, 510 athletes) and teams without their own medical support (13 teams, 37 athletes) through electronic data capturing systems.

Results There were 174 total injuries reported, with an injury incidence rate (IR) of 26.5 per 1000 athlete days (95% CI 22.7% to 30.8%). There was a significantly higher IR recorded in alpine skiing/snowboarding (IR of 41.1 (95% CI 33.7% to 49.6%) p=0.0001) compared to cross-country skiing/biathlon, ice sledge hockey or wheelchair curling. Injuries in the shoulder region were the highest single-joint IR (IR of 6.4 (95% CI 4.6% to 8.6%)), although total upper and lower body IR were similar (IR 8.5 vs 8.4 (95% CI 6.4% to 11.1%)). Furthermore, the IR of acute injuries was significantly higher than other types of injury onset (IR of 17.8 (95% CI 14.7% to 21.4%)).

Conclusions In a Winter Paralympic Games setting, athletes report higher injury incidence than do Olympic athletes or athletes in a Summer Paralympic Games setting. The highest incidence of injury was reported in the alpine skiing/snowboarding sporting category. There was a similar incidence of injury in the upper and lower limbs. The joint with the greatest rate of injury reported was the shoulder joint. Our data can inform injury prevention programmes and policy considerations regarding athlete safety in future Winter Paralympic Games.

  • Athlete
  • Disability
  • Injury

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