Olympic Games during nationwide lockdown: sports injuries and illnesses, including COVID-19, at the Beijing 2022 Winter Olympics.

OBJECTIVE: The objective of this study is to describe the incidence of injuries and illnesses sustained during the Beijing Winter Olympic Games from 4 February 2022 to 20 February 2022. METHODS: We recorded the daily number of athlete injuries and illnesses (1) through the reporting of all National Olympic Committee (NOC) medical teams and (2) in the polyclinic and medical venues by the Beijing 2022 medical staff. RESULTS: In total, 2848 athletes (1276 women, 45%; 1572 men, 55%) from 91 NOCs were followed prospectively for the occurrence of injury and illness. NOC and Beijing 2022 medical staff reported 289 injuries and 109 illnesses, equalling 10.1 injuries and 3.8 illnesses per 100 athletes over the 17-day period. The injury incidence was highest in ski halfpipe (30%), ski big air (28%), snowboard slopestyle (23%) and ski slopestyle (22%), and lowest (1%-2%) in curling, alpine mixed team parallel slalom, Nordic combined and alpine super-G. The illness incidence was highest in ski aerials (10%), skeleton (8%), cross-country skiing (8%) and Nordic combined (7%). In the study period, COVID-19 affected 32 athletes, accounting for 29% of all illnesses affecting 1.1% of all athletes. CONCLUSION: Overall, 10% of the athletes incurred an injury and 4% an illness during the Beijing Winter Olympic Games. The incidence of illnesses overall, which was the lowest yet recorded in the Winter Olympic Games, and COVID-19 was mitigated through comprehensive countermeasures.

New sports, COVID-19 and the heat: sports injuries and illnesses in the Tokyo 2020 Summer Olympics.

OBJECTIVE: To describe the incidence of injuries and illnesses sustained during the Tokyo Summer Olympic Games from 23 July to 8 August 2021. METHODS: We recorded the daily number of athlete injuries and illnesses (1) through the reporting of all National Olympic Committee (NOC) medical teams and (2) in the polyclinic and medical venues by the Tokyo 2020 medical staff. RESULTS: In total, 11 315 athletes (5423 women, 48%; 5892 men, 52%) from 206 NOCs were followed up prospectively for the occurrence of injury and illness. NOC and Tokyo 2020 medical staff reported 1035 injuries and 438 illnesses, equalling 9.1 injuries and 3.9 illnesses per 100 athletes over the 17-day period. Altogether, 9% of the athletes incurred at least one injury and 4% at least one illness. The incidence of injury was highest in boxing (27%), BMX racing (27%), BMX freestyle (22%), skateboarding (21%), karate (19%) and handball (18%), of which both BMX freestyle and skateboarding were new events, and lowest in diving, road cycling, rowing, marathon swimming and shooting (1-2%). Marathon and artistic swimming presented the highest illness incidences (both 8%), followed by skateboarding and karate (both 7%). In the study period, COVID-19 affected 18 athletes, accounting for 4% of all illnesses and 0.16% of all athletes. Exertional heat illness affected 78 athletes (18% of all illnesses, 0.7% of all athletes), the majority (88%) resulting in no time lost from sport. CONCLUSION: Overall, 9% of the athletes incurred an injury and 4% an illness during the Games. Comprehensive countermeasures helped mitigate both COVID-19 and exertional heat illnesses.

Athlete health and safety at large sporting events: the development of consensus-driven guidelines.

All sport events have inherent injury and illness risks for participants. Healthcare services for sport events should be planned and delivered to mitigate these risks which is the ethical responsibility of all sport event organisers. The objective of this paper was to develop consensus-driven guidelines describing the basic standards of services necessary to protect athlete health and safety during large sporting events. By using the Knowledge Translation Scheme Framework, a gap in International Federation healthcare programming for sport events was identified. Event healthcare content areas were determined through a narrative review of the scientific literature. Content experts were systematically identified. Following a literature search, an iterative consensus process was undertaken. The outcome document was written by the knowledge translation expert writing group, with the assistance of a focus group consisting of a cohort of International Federation Medical Chairpersons. Athletes were recruited to review and provide comment. The Healthcare Guidelines for International Federation Events document was developed including content-related to (i) pre-event planning (eg, sport medical risk assessment, public health requirements, environmental considerations), (ii) event safety (eg, venue medical services, emergency action plan, emergency transport, safety and security) and (iii) additional considerations (eg, event health research, spectator medical services). We developed a generic standardised template guide to facilitate the planning and delivery of medical services at international sport events. The organisers of medical services should adapt, evaluate and modify this guide to meet the sport-specific local context.

Sports injury and illness incidence in the PyeongChang 2018 Olympic Winter Games: a prospective study of 2914 athletes from 92 countries.

OBJECTIVE: To describe the incidence of injuries and illnesses sustained during the XXIII Olympic Winter Games, hosted by PyeongChang on 9-25 February 2018. METHODS: We recorded the daily number of athlete injuries and illnesses (1) through the reporting of all National Olympic Committee (NOC) medical teams and (2) in the polyclinic and medical venues by the PyeongChang 2018 medical staff. RESULTS: In total, 2914 athletes (1210 women, 42%; 1704 men, 58%) from 92 NOCs were observed for occurrence of injury and illness. NOC and PyeongChang 2018 medical staff reported 376 injuries and 279 illnesses, equalling 12.6 injuries and 9.4 illnesses per 100 athletes over the 17-day period. Altogether, 12% of the athletes incurred at least one injury and 9% at least one illness. The injury incidence was highest in ski halfpipe (28%), snowboard cross (26%), ski cross (25%), snowboard slopestyle (21%) and aerials (20%), and lowest in Nordic combined, biathlon, snowboard slalom, moguls and cross-country skiing (2%-6%). Of the 376 injuries recorded, 33% and 13% were estimated to lead to ≥1 day and >7 days of absence from sport, respectively. The highest incidences of illness were recorded in biathlon (15%), curling (14%), bobsleigh (14%) and snowboard slalom (13%). Thirty per cent of the illnesses were expected to result in time loss, and 70% affected the respiratory system. Women suffered 61% more illnesses than men. CONCLUSION: Overall, 12% of the athletes incurred at least one injury during the Games and 9% an illness, incidences that are similar to the Olympic Winter Games of 2010 and 2014.

Sports injury and illness incidence in the Rio de Janeiro 2016 Olympic Summer Games: A prospective study of 11274 athletes from 207 countries.

OBJECTIVE: To describe the pattern of injuries and illnesses sustained during the Games of the XXXI Olympiad, hosted by Rio de Janeiro from 5 to 21 August 2016. METHODS: We recorded the daily incidence of athlete injuries and illnesses (1) through the reporting of all National Olympic Committee (NOC) medical teams and (2) in the polyclinic and medical venues by the Rio 2016 medical staff. RESULTS: In total, 11 274 athletes (5089 women, 45%; 6185 men, 55%) from 207 NOCs participated in the study. NOC and Rio 2016 medical staff reported 1101 injuries and 651 illnesses, equalling 9.8 injuries and 5.4 illnesses per 100 athletes over the 17-day period. Altogether, 8% of the athletes incurred at least one injury and 5% at least one illness. The injury incidence was highest in BMX cycling (38% of the athletes injured), boxing (30%), mountain bike cycling (24%), taekwondo (24%), water polo (19%) and rugby (19%), and lowest in canoe slalom, rowing, shooting, archery, swimming, golf and table tennis (0%-3%). Of the 1101 injuries recorded, 40% and 20% were estimated to lead to ≥1 and >7 days of absence from sport, respectively. Women suffered 40% more illnesses than men. Illness was generally less common than injury, with the highest incidence recorded in diving (12%), open-water marathon (12%), sailing (12%), canoe slalom (11%), equestrian (11%) and synchronised swimming (10%). Illnesses were also less severe; 18% were expected to result in time loss. Of the illnesses, 47% affected the respiratory system and 21% the gastrointestinal system. The anticipated problem of infections in the Rio Olympic Games did not materialise, as the proportion of athletes with infectious diseases mirrored that of recent Olympic Games (3%). CONCLUSION: Overall, 8% of the athletes incurred at least one injury during the Olympic Games, and 5% an illness, which is slightly lower than in the Olympic Summer Games of 2008 and 2012.

Using criteria-based interview models for assessing clinical expertise to select physiotherapists at major multisport games.

BACKGROUND: Benchmarking is an established means of identifying levels of specialist practice and competence-based interviews are a tool used to facilitate this. The London 2012 Olympic and Paralympic Games (LOCOG) provided an opportunity to introduce a pragmatic approach to assess expert behaviour in large numbers of volunteer physiotherapists. AIM: To test inter-tester repeatability of an assessment matrix used to score clinical expertise in a sporting context, followed by reporting on the findings for physiotherapy selection. METHODS: Four volunteers were videoed answering an identical sport-specific clinical scenario. Recordings were initially scored by two experienced assessors (gold standard). Subsequently, nine assessors scored the same videos then compared with the gold standard. 602 physiotherapists were assessed during volunteer interviews for LOCOG. Scores were compared to those based on self-reported clinical experience. Cross-tabulation was used to determine levels of agreement for the initial scoring matrix and the relationship between the two scoring systems was analysed. RESULTS: Levels of agreement ranged from 22% to 88%. A good correlation (r=0.754 p>0.001) was found between self-reported clinical experience and scenario scores. Marginal data points in the correlational analysis indicated that only 52% of participants attained the same score across assessments. CONCLUSIONS: A tool to facilitate assessment for large scale selection could be used for Host Nation physiotherapist selection for Major Games. There is a need to train assessors in this environment, as well as provide detailed matrices, specific to each context being assessed, to ensure that observations can be made on domain-specific and general, non-technical aspects.

Sports injuries and illnesses in the Sochi 2014 Olympic Winter Games.

BACKGROUND: Systematic surveillance of injuries and illnesses is the foundation for developing preventive measures in sport. AIM: To analyse the injuries and illnesses that occurred during the XXII Olympic Winter Games, held in Sochi in 2014. METHODS: We recorded the daily occurrence (or non-occurrence) of injuries and illnesses (1) through the reporting of all National Olympic Committee (NOC) medical teams and (2) in the polyclinic and medical venues by the Sochi 2014 medical staff. RESULTS: NOC and Sochi 2014 medical staff reported 391 injuries and 249 illnesses among 2780 athletes from 88 NOCs, equalling incidences of 14 injuries and 8.9 illnesses per 100 athletes over an 18-day period of time. Altogether, 12% and 8% of the athletes incurred at least one injury or illness, respectively. The percentage of athletes injured was highest in aerial skiing, snowboard slopestyle, snowboard cross, slopestyle skiing, halfpipe skiing, moguls skiing, alpine skiing, and snowboard halfpipe. Thirty-nine per cent of the injuries were expected to prevent the athlete from participating in competition or training. Women suffered 50% more illnesses than men. The rate of illness was highest in skeleton, short track, curling, cross-country skiing, figure skating, bobsleigh and aerial skiing. A total of 159 illnesses (64%) affected the respiratory system, and the most common cause of illness was infection (n=145, 58%). CONCLUSIONS: Overall, 12% of the athletes incurred at least one injury during the games, and 8% an illness, which is similar to prior Olympic Games. The incidence of injuries and illnesses varied substantially between sports.

The role of sports physiotherapy at the London 2012 Olympic Games.

BACKGROUND: There is a lack of information on the utilisation of physiotherapy services at the Olympic Games. AIM: To better understand the athlete and non-athlete requirements of the physiotherapy services at the Olympic Village Polyclinic during the London 2012 Olympic Games. METHODS: From 16 July to 14 August 2012, physiotherapy encounters for athletes and non-athletes (National Olympic Committee (NOC) team officials, coaches, team managers, workforce, Olympic family, technical officials and press) were recorded on the ATOS electronic medical records system at the polyclinic in the main Athletes' Village in Stratford. RESULTS: Of the 1778 encounters, 1219 (69%) were administered to athletes and 559 (31%) to non-athletes. The anatomical areas most frequently recorded at the first visits for athletes were knee (15.4%), lumbar spine/lower back (15.2%) and upper leg (12.6%) and that for non-athletes were lumbar spine/lower back (19.8%), knee (15.8%) and neck/cervical spine. Muscle (33.3%) and joint injuries (24.8%) were the most common diagnoses in athletes and non-athletes (24.4% and 30.1%). The five most frequently used treatment modalities were therapeutic soft tissue techniques (23.3%), mobilisation techniques (21.8%), taping (8.9%), cryotherapy (6.9%) and exercise prescription (6.4%). The most common cause of athletes' injuries was overuse (43.6%). CONCLUSIONS: This study of the London 2012 Olympic Games workload highlights the physiotherapy needs of athletes as well as non-athletes and identifies the high numbers of pre-existing and overuse injuries in this setting, providing an insight into the reasons why the athletes seek physiotherapy support during the Olympic Games.

The usage of multidisciplinary physical therapies at the Rio de Janeiro 2016 Olympic Summer Games: an observational study.

BACKGROUND: This observational research study analyses the uptake of physical therapies treatments in the Polyclinic during the Rio 2016 Olympic Games. OBJECTIVE: To describe the usage of physical therapies services - physical therapy, osteopath, chiropractic, and sports massage - by athletes and non-athletes and across different sports. METHODS: The multidisciplinary team of physical therapies recorded treatment modalities, information on provider discipline and reason for attendance, in an Electronic Medical Record system throughout the 32 days of operation of the Olympic Polyclinic. Cold-therapy total immersion ice baths (TIIB) were provided as part of the services, but were reported and analysed separately. RESULTS: There were 4993 encounters (4038 athletes, 955 non-athlete encounters). 1395 athletes (12.4% of all athletes) and 393 non-athletes sought treatment. For all four provider disciplines, in addition to TIIB, the primary reason for athlete attendance was for recovery (52% of all encounters), followed by injury treatment (30%), and maintenance (16%). Athletes reported "injury" as the main reason for physical therapy (92% of all encounters, 2.8 encounters per athlete), chiropractic (94%, 1.9) and osteopathy (91%, 1.8) visits. Almost all TIIB visits were used for recovery (98% of all TIIB encounters; 2.1 encounters per athlete). Athletes from handball (37% of all handball athletes), followed by judo (22%), and athletics (21%), presented the largest user groups. CONCLUSION: This Olympic Polyclinic study evaluates the physical therapies' activity, and athlete's reason for use of the multidisciplinary physical therapies team, including total immersion ice bath provision. These results emphasise the importance of a multidisciplinary approach.

Review of physiotherapy service for athletes of 2018 Olympic Winter games: Consideration of preparation for two polyclinics.

OBJECTIVE: This study will provide to better understand the needs for physiotherapy services during the 2018 PyeongChang Olympic Winter Games (POG) from two polyclinics. It is necessary to understand the needs and what physiotherapists do during the Olympic Winter games for first time. DESIGN: An observational study. SETTING: 2018 PyeongChang Olympic Winter Games. PARTICIPANTS: Athletes who visited the physiotherapy department of polyclinics. RESULTS: During 25 the days of the POG, a total of 125 athletes (n = 125, 83 males, 42 females) visited the two polyclinics. Of all visits, 69.6% were from the mountain polyclinic and 30.4% from the city. There were three reasons for visit, most of the reason for visit was injury and injury with recovery or injury prevention. Overall, the injury rate (per 1000 athletes) was 42.8 across 13 sports visited the physiotherapy department during the POG. Total numbers of treatments sessions were 823 provided and electrophysical modalities (36.2%) was the most utilized service in POG. And also there were significant differences in the physiotherapy services provided at the two polyclinics. CONCLUSION: As each polyclinic differed in location, they addressed different populations of athletes; hence, the study provides insights into the injury trends and different physiotherapy treatments.