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High precompetition injury rate dominates the injury profile at the Rio 2016 Summer Paralympic Games: a prospective cohort study of 51 198 athlete days
  1. Wayne Derman1,2,
  2. Phoebe Runciman1,2,
  3. Martin Schwellnus2,3,
  4. Esme Jordaan4,
  5. Cheri Blauwet5,
  6. Nick Webborn6,
  7. Jan Lexell7,8,9,
  8. Peter van de Vliet10,
  9. Yetsa Tuakli-Wosornu11,
  10. James Kissick12,
  11. Jaap Stomphorst13
  1. 1 Institute of Sport and Exercise Medicine, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
  2. 2 International Olympic Committee (IOC) Research Centre, South Africa
  3. 3 Sport, Exercise Medicine and Lifestyle Institute (SEMLI) and Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
  4. 4 Biostatistics Unit, Medical Research Council, Parow, South Africa
  5. 5 Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
  6. 6 Centre for Sport and Exercise Science and Medicine (SESAME), University of Brighton, Eastbourne, UK
  7. 7 Department of Health Sciences, Lund University, Lund, Sweden
  8. 8 Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden
  9. 9 Department of Health Science, Luleå University of Technology, Luleå, Sweden
  10. 10 Medical and Scientific Department, International Paralympic Committee, Bonn, Germany
  11. 11 Yale School of Public Health, Department of Chronic Disease and Epidemiology, Department of Orthopaedics and Rehabilitation, Yale University, Connecticut, USA
  12. 12 Carleton University Sport Medicine Clinic, Department of Family Medicine, Ottawa, Canada
  13. 13 Department of Sport Medicine, Isala Klinieken, Zwolle, Netherlands
  1. Correspondence to Professor Wayne Derman, Institute of Sport and Exercise Medicine, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa; ewderman{at}


Objectives To describe the incidence of injury in the precompetition and competition periods of the Rio 2016 Summer Paralympic Games.

Methods A total of 3657 athletes from 78 countries, representing 83.4% of all athletes at the Games, were monitored on the web-based injury and illness surveillance system over 51 198 athlete days during the Rio 2016 Summer Paralympic Games. Injury data were obtained daily from teams with their own medical support.

Results A total of 510 injuries were reported during the 14-day Games period, with an injury incidence rate (IR) of 10.0 injuries per 1000 athlete days (12.1% of all athletes surveyed). The highest IRs were reported for football 5-a-side (22.5), judo (15.5) and football 7-a-side (15.3) compared with other sports (p<0.05). Precompetition injuries were significantly higher than in the competition period (risk ratio: 1.40, p<0.05), and acute traumatic injuries were the most common injuries at the Games (IR of 5.5). The shoulder was the most common anatomical area affected by injury (IR of 1.8).

Conclusion The data from this study indicate that (1) IRs were lower than those reported for the London 2012 Summer Paralympic Games, (2) the sports of football 5-a-side, judo and football 7-a-side were independent risk factors for injury, (3) precompetition injuries had a higher IR than competition period injuries, (4) injuries to the shoulder were the most common. These results would allow for comparative data to be collected at future editions of the Games and can be used to inform injury prevention programmes.

  • injury
  • disability
  • athlete
  • epidemiology
  • sporting injuries
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  • Funding This study was approved and supported by the International Paralympic Committee. Funding for the study was provided by the International Olympic Committee (IOC) Research Centre (South Africa) Grant.

  • Competing interests None declared.

  • Ethics approval Brighton University (FREGS/ES/12/11), Stellenbosch University (N16/05/067)

  • Provenance and peer review Not commissioned; externally peer reviewed.

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