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When van Mechelen's sequence of injury prevention model requires pragmatic and accelerated action: the case of para alpine skiing in Pyeong Chang 2018
  1. Cheri Blauwet1,2,
  2. Nick Webborn3,
  3. James Kissick4,
  4. Jan Lexell5,
  5. Jaap Stomphorst6,
  6. Peter van de Vliet7,
  7. Dimitrije Lazarovski8,
  8. Wayne Derman9,10
  1. 1 Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
  2. 2 Kelley Adaptive Sports Research Institute, Boston, Massachusetts, USA
  3. 3 University of Brighton, Center for Sport and Exercise Medicine and Science, Brighton, UK
  4. 4 Department of Family Medicine, University of Ottawa, Carleton University Sports Medicine Clinic, Ottawa, Ontario, Canada
  5. 5 Department of Neuroscience and Rehabilitation Medicine, Uppsala University, Uppsala, Sweden
  6. 6 Department of Sport Medicine, Isala Klinieken, Zwolle, Netherlands
  7. 7 Medical and Scientific Department, International Paralympic Committee, Bonn, Germany
  8. 8 World Para Snow Sports, International Paralympic Committee, Bonn, Germany
  9. 9 Department of Surgical Sciences, Institute of Sport and Exercise Medicine, Stellenbosch University, Cape Town, South Africa
  10. 10 International Olympic Committee Research Centre, Cape Town, South Africa
  1. Correspondence to Dr Cheri Blauwet, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA; cblauwet{at}bwh.harvard.edu

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Results of the Paralympic Injury and Illness Surveillance Study noted an unusually high injury incidence rate (IR) in the sport of Para alpine skiing at the 2014 Sochi Paralympic Games (IR 48.3, a sixfold increase in acute injuries in comparison to the Vancouver 2010 Paralympic Games).1–3 There were likely several associated factors. Some were clearly modifiable such as the course design, number of training runs permitted on the course and the command and control structure between the technical and medical staff. Additionally, Paralympic officials recognised that careful monitoring of weather data and timely management of snow production, taking advantage of modern technology, had the potential to reduce injury risk. Thus, for the 2018 PyeongChang Paralympic Winter Games (the Games), the International Paralympic Committee (IPC) Medical Committee, in collaboration with the World Para Alpine Skiing (WPAS) sport technical staff, implemented a series of changes following Professor Willem van Mechelen’s ‘Sequence of (Injury) Prevention’ model4:

Step 1: Establishing the extent of injury

The Paralympic Injury and Illness Surveillance Study carried out at the Sochi 2014 Paralympic Games demonstrated a dramatic …

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