Spectator medicine at an international mega sports event: Rugby World Cup 2019 in Japan

BACKGROUND@#The Rugby World Cup (RWC) is one of the biggest international mega sports events in the world. This study was conducted to identify and evaluate the volume, nature, and severity of spectator medical care in the stadiums of 12 venues across Japan during RWC 2019.@*METHOD@#This was a retrospective review of medical records from spectator medical rooms of 45 official matches of RWC 2019 between September 20 and November 2, 2019. All patients in the stadium who visited the spectator medical room and were transferred to a hospital were included. The wet bulb globe temperature (WBGT) value at the kick-off time of each match, the number of visits to the spectator medical room, and the number of transfers to a hospital were reviewed and analyzed. The patient presentation rate (PPR) was calculated per 10,000 attendees. Severity categories were defined as mild or severe. Mild cases were considered non-life threatening requiring minimal medical intervention, and severe cases required transport to a hospital.@*RESULT@#The total number of visits to the spectator medical room was 449 with a PPR of 2.63. Most cases (91.5%) were mild in severity. The PPR was significantly higher for the matches held with a WBGT over 25 °C than for the matches under 21 °C (PPR 4.27 vs 2.04, p = 0.04). Thirty-eight cases were transferred to a hospital by ambulance; the PPR was 0.22. The most common reasons for transfer to the hospital were heat illness and fracture/dislocation, at a rate of 15.8% each. The incidence rate of cardiopulmonary arrest per 10,000 attendees was 0.0059 during RWC 2019.@*CONCLUSION@#Preparation and provision of appropriate medical service for spectators is a key factor for mass-gathering events. During RWC 2019, the majority (91.5%) of patients who sought medical attention did so for minor complaints, which were easily assessed and managed. On the other hand, a higher WBGT situation contributes significantly to an increased PPR ( 25, 2.04 versus 4.27, p = 0.04). Careful medical preparation, management, and development of public education programs for higher WBGT situations will be required in the future for similar international mega sports events.

Locomotive Syndrome, Musculoskeletal Ambulation Disorder Symptom Complex, Frailty and Sarcopenia / The Japanese Journal of Rehabilitation Medicine

As Japan has become a super-aging society a new focus has been placed on locomotive syndrome (Locomo), musculoskeletal ambulation disorder symptom complex (MADS), frailty and sarcopenia. Locomo is a condition whereby long-term care or support is needed or may be needed in the future due to weakness of the locomotive organs. MADS is a condition presenting with unstable balance or walking difficulty, which leads to a high risk of the patient falling down or giving up excursions outside the home. In a broad sense, MADS patients also belong in the Locomo category. The prevention and treatment of Locomo and MADS are very important, because these conditions typically result in deterioration of the exercise function and loss of mental and physical health. The aim of Locomotive syndrome exercises is to reduce pain, and to restore and improve joint function. We need to take a comprehensive approach to Locomotive syndrome, including lifestyle modification, muscle exercise, stretching and therapeutic exercise. Two basic, simple and commonly used exercises are single-leg standing and squats exercises.