Prevalence and incidence of health problems and their characteristics in Brazilian para athletes: A one-season single-center prospective pilot study.

BACKGROUND: Para athletes experience high prevalence and incidence of health problems related to sport. Despite this, there are few longitudinal studies. OBJECTIVE: To describe the characteristics, prevalence, incidence, and severity of health problems in para athletes from one of the Brazilian Paralympic Reference Centers during a sports season and to compare the prevalence of health problems between para athletics, para powerlifting, and para swimming. METHODS: This prospective pilot study was conducted from October 2019 to March 2020. The Oslo Sports Trauma Research Center Questionnaire on Health Problems was used to record injuries and illnesses every week for 24 weeks. The characteristics, prevalence, incidence, and severity of health problems were described for each modality. The prevalence of health problems was compared among the three sport modalities. RESULTS: Thirty-five para athletes participated. Most of the injuries occurred in the shoulder, and most illnesses caused respiratory and gastrointestinal symptoms. The average weekly prevalence and the incidence rate of health problems were 40.6% (95% CI 17.0-64.4) and 12.7 (95% CI 9.6-15.9) per 1000 athlete hours, respectively. Para powerlifting had the highest prevalence of all and substantial health problems; para swimming had the lowest prevalence of injuries; and para athletics had the lowest prevalence of illnesses. CONCLUSIONS: This group of Brazilian para athletes showed a high prevalence and incidence of health problems throughout the season. Para athletics, para powerlifting, and para swimming each had a different prevalence of injuries and illnesses.

Prediction equation of hip external rotators maximum torque in healthy adults and older adults using the measure of hip extensors maximum torque.

BACKGROUND: The use of predictive equation of muscular torque can reduce physical effort and time spent during evaluation. OBJECTIVES: To establish, validate, and test the accuracy of a prediction equation to estimate the hip external rotators (HER) torque in adults and older adults by means of hip extensors (HEX) torque measurement. METHODS: Eighty-three healthy adults (development set) were assessed to test the association of HEX and HER torques and to establish the prediction equation. A separate 36 adults and 15 older adults (validation sets) were assessed to test the ability of the equation to estimate HER torque. Hip isometric strength was assessed by a handheld dynamometer. RESULTS: Simple linear regression analysis revealed that HEX torque was associated with HER torque (r=0.80; p<0.0001), resulting in the following prediction equation: HERtorque=-0.02+(0.58 * HEXtorque). Paired t-test revealed no difference between directly measured and predicted values of HER torque in adults (mean difference=0.02; 95% CI=-0.115, 0.072) and older adults (mean difference=0.05; 95% CI=-0.02, 0.12). CONCLUSION: The HEX and HER torques were strongly correlated. The prediction equation was valid, accurate, and can be used to estimate HER muscle strength in healthy adults and older adults, requiring only the direct measurement of HEX torque.

Prevalence and incidence of injuries in para athletes: a systematic review with meta-analysis and GRADE recommendations.

OBJECTIVE: To investigate prevalence, incidence and profile of musculoskeletal injuries in para athletes. DESIGN: Systematic review. DATA SOURCES: Searches were conducted in MEDLINE, EMBASE, AMED, SPORTSDiscus, CINAHL and hand searching. ELIGIBILITY CRITERIA: Studies were considered if they reported prevalence or incidence of musculoskeletal injuries in para athletes. Study selection, data extraction and analysis followed the protocol. Meta-analyses were conducted to estimate the prevalence and incidence rate among studies and subgroup analyses investigated whether methodological quality and sample size of the studies influenced on the estimated injury prevalence and incidence. The Grading of Recommendations Assessment, Development and Evaluation system determined the strength of evidence. RESULTS: Forty-two studies were included. The prevalence of musculoskeletal injuries was 40.8% (95% CI 32.5% to 49.8%). Because of imprecision, indirectness and inconsistency, the strength of evidence was very low quality. The incidence of musculoskeletal injuries was 14.3 injuries per 1000 athlete-days (95% CI 11.9 to 16.8). The strength of evidence was low quality because of imprecision and indirectness. The subgroup analyses revealed that the sample size influenced on estimated injury prevalence and methodological quality influenced on estimated incidence. Injuries were more prevalent in the shoulder, for non-ambulant para athletes, and in the lower limbs, for ambulant para athletes. SUMMARY/CONCLUSION: Para athletes show high prevalence and incidence of musculoskeletal injuries. Current very low-quality and low-quality evidence suggests that future high-quality studies with systematic data collection, larger sample size and specificities of para athletes are likely to change estimates of injury prevalence and incidence in para athletes. PROSPERO REGISTRATION NUMBER: CRD42020147982.

Lower limb kinematics and hip extensors strengths are associated with performance of runners at high risk of injury during the modified Star Excursion Balance Test.

BACKGROUND: Reduced trunk and lower limb movement and hip and trunk muscles weakness may compromise the athletes' performance on the modified Star Excursion Balance Test (mSEBT). OBJECTIVE: To investigate the relationship of trunk and lower limb kinematics and strength with the performance on the mSEBT of runners at high risk of injury. METHODS: Thirty-nine runners performed the mSEBT with the dominant limb as the support limb. An Inertial System was used to capture the trunk, hip, knee and ankle movement during the mSEBT. A handheld dynamometer was used to measure the strength of trunk extensors and lateral flexors muscles, and hip extensors, lateral rotators and abductors of the support limb. Multiple regressions were used to investigate if trunk and lower limbs kinematics and trunk and hip muscles strength are associated with performance during the mSEBT. RESULTS: Reduced hip flexion and greater knee flexion range of motion (ROM) were associated with anterior reach in the mSEBT (r2=0.45; p<.001), greater hip flexion ROM was associated with posteromedial reach (r2=0.15; p=.012) and greater knee flexion ROM was associated with posterolateral reach (r2=0.23; p<.001). Hip extensor strength was associated with posteromedial (r2=0.14; p=.017), posterolateral (r2=0.10; p=.038) and composite reaches (r2=0.16; p=.009). CONCLUSION: Hip and knee kinematics in the sagittal plane explained 15-45% of the runners' performance on the mSEBT and hip extensor strength explained 10-16% of the mSEBT performance. These findings provide useful information on the contribution of joints kinematics and strength when evaluating dynamic postural control in runners at high risk of injury.