Background Participation is sport is associated with a risk of sports injuries and illnesses. For athletes with an impairment, sports related health issues pose further burden upon an already restricted lifestyle. This underlines the importance of injury prevention in adapted sports.

Objective To provide an overview of the current evidence regarding injuries and their prevention in adapted sports.

Design A systematic review with quality assessment.

Setting Peer-reviewed literature on sports injuries in adapted sports.

Participants Individuals with a physical impairment that affects motor function, and who are active in sports or physical activity.

Assessment of Risk Factors This study was conducted in accordance with the ‘Preferred Reporting Items for Systematic Reviews and Meta-Analyses’ (PRISMA) guidelines.

Main Outcome Measurements Literature and evidence was categorised by the sequence of prevention; i.e. (1) problem magnitude; (2) aetiology of injury; (3) development of preventive measures; and (4) evaluation of effectiveness.

Results 52 studies were included. A total of 5 studies reported on the first step of the sequence of prevention (problem magnitude) only. 28 studies reported information on both the first and second step, 15 studies on only the second step and only 4 studies on the third and fourth step of the sequence. Most studies included participants of an elite level (82.7%). There is a wide range of injury and illness incidence between various sports (2.2 - 90.9 per 1000 athlete days) and impairment categories (0.6 - 50.0 per 1000 athlete days).

Conclusions Current evidence regarding injuries in adapted sports is mostly limited to elite level athletes. The evidence regarding the development of preventive measures and their effectiveness is limited in this target group. More knowledge is needed of the aetiology and risk factors of various adapted sports, physical impairments and level of performance to develop future prevention strategies for this population.