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Illness and injury among Norwegian Para athletes over five consecutive Paralympic Summer and Winter Games cycles: prevailing high illness burden on the road from 2012 to 2020
  1. Kathrin Steffen1,2,
  2. Benjamin Clarsen1,2,3,
  3. Hilde Gjelsvik2,
  4. Lars Haugvad2,
  5. Anu Koivisto-Mørk4,
  6. Roald Bahr1,2,
  7. Hilde Moseby Berge1,2
  1. 1Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
  2. 2Department of Sports Medicine, Norwegian Olympic Training Center (Olympiatoppen), Oslo, Norway
  3. 3Centre for Disease Burden, Norwegian Institute of Public Health, Oslo, Norway
  4. 4Department of Nutrition, Norwegian Olympic Training Centre (Olympiatoppen), Oslo, Norway
  1. Correspondence to Dr Kathrin Steffen, Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo 0806, Norway; kathrin.steffen{at}nih.no

Abstract

Objective To describe the illness and injury pattern of Norwegian Para athletes over five consecutive Paralympic Summer and Winter Games cycles and to identify which health problems should be targeted in risk management plans with respect to impairment types.

Methods We monitored athletes from 12 to 18 months prior to each Game using a weekly online questionnaire (Oslo Sports Trauma Research Center-H2 (OSTRC-H2)). We asked them to report all health problems they had experienced in the preceding 7 days, irrespective of their consequences on their sports participation or performance and whether they had sought medical attention.

Results Between 2011 and 2020, 94 candidate athletes were included in this monitoring programme and prepared to represent Norway; of these, 66 (71%) were finally selected for multiple Paralympic Games. The overall response rate to the weekly questionnaires was 87%. At any given time during the five observation cycles, 37% of the athletes (95% CI 36% to 38%) reported having at least one health problem. Athletes with neurological impairments (n=51) lost 10 days per year due to respiratory problems (95% CI 9 to 11) compared with 9 days (8-10) among those with musculoskeletal impairments (n=37). Gastrointestinal problems caused a time loss of on average 4 days per year in athletes with neurological impairments versus 1 day in athletes with musculoskeletal impairments (mean difference 2.7 days, 2.1–3.3). Musculoskeletal injuries generated a high burden for both athlete groups, in particular, to the elbow, shoulder and lumbosacral regions.

Conclusion At any given time, nearly two out of five elite Norwegian Para athletes reported at least one health problem. Respiratory tract and other infections; gastrointestinal problems, injuries to the shoulder, elbow and lumbosacral regions represented the greatest health burden. Our findings can help guide the allocation of clinical resources, which should include a broad network of medical specialists, together with dieticians and physiotherapists, to meet the health challenges in Para athletes.

  • epidemiology
  • health
  • infection
  • longitudinal studies
  • muscle
  • skeletal

Data availability statement

Data are available upon reasonable request. Request to access the data will be considered by the authors, within the constraints of privacy and consent.

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Data availability statement

Data are available upon reasonable request. Request to access the data will be considered by the authors, within the constraints of privacy and consent.

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Footnotes

  • Twitter @benclarsen, @koivisto_anu, @RoaldBahr, @HildeMBerge

  • Contributors KS, HMB, BC and RB planned and designed the study, and all authors contributed to data collection and interpretation. HMB reviewed all diagnostic codes with input from HG. AK-M followed up all the dietetical needs. KS analysed the data and drafted the paper with editorial input from HMB, BC and RB. All authors provided critical revisions and contributed to the final manuscript. KS and HMB are the guarantors.

  • Funding The Norwegian Olympic and Paralympic team health monitoring programme has been supported by a generous grant from Olympic Solidarity since 2016. The Norwegian Olympic Training Centre (Olympiatoppen) also highly appreciate having received funding from Stiftelsen VI.

  • Competing interests KS is the co-editor of the British Journal of Sports Medicine—Injury Prevention and Health Protection. In the period these data were collected, the Oslo Sports Trauma Research Center has had non-financial research partnerships with SpartaNova (2013–2016) and FitStats Technologies Inc. (2017–present).

  • Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.

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

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