Sociodemographic predictors of sport injury in adolescents

OBJECTIVE: To examine sociodemographic risk factors for sport injury in adolescents. METHODS: This is a cross-sectional survey design in which a random sample of high school students (ages 14-19) completed an in-class survey (N = 2721). Students were asked questions regarding sociodemographic factors, sport participation, and sport injury in the past year. RESULTS: The incidence proportion of self-reported and medically treated sports injury, adjusting for the clustering effect of school, was 67.5 (95% CI; 64.2-71.1) and 43.2 (95% CI; 40.4-46.3) per 100 adolescents per year, respectively. Students from small towns had a lower risk of injury than those in the larger urban center (ORadjusted = 0.76, 95% CI 0.63-0.92). Non-Caucasian students had a lower risk of injury than did Caucasian students (ORadjusted = 0.63 (95% CI 0.5-0.79) for all sport injury and 0.57 (95% CI 0.47 - 0.7) for medically treated sport injury. Students with BMI in the 50th-90th percentiles had the greatest risk of sport injury. The risk of injury increased with weekly hours of participation. CONCLUSIONS: Location of residence, weekly exposure (participation hours), ethnicity, and BMI were simultaneous predictors of sport injuries in adolescents.     

Survey of sport participation and sport injury in Calgary and area high schools.

OBJECTIVE: To examine (1) sport participation and (2) sport injury in adolescents. DESIGN, SETTING, AND PARTICIPANTS: This was a retrospective survey design. In total, 2873 adolescents were recruited from a random sample of classes from 24 Calgary and area high schools. Each subject completed an in-class questionnaire in March 2004. MAIN OUTCOME MEASUREMENTS: Overall and sport-specific participation rates (number of sport participants/number of students completing survey). Overall and sport-specific injury rates (number of injuries/number of participants). RESULTS: In the previous 1 year, 94% of students participated in sport. The top 5 sports by participation for males were basketball, hockey, football, snowboarding, and soccer, and for females, basketball, dance, volleyball, snowboarding, and soccer. The injury rate including only injuries requiring medical attention was 40.2 injuries/100 adolescents/y (95% CI, 38.4-42.1), presenting to a hospital emergency department was 8.1 injuries/100 adolescents/y (95% CI, 7.1-9.2), resulting in time loss from sport was 49.9 injuries/100 adolescents/y (95% CI, 48-51.8), and resulting in loss of consciousness was 9.3 injuries/100 adolescents/y (95% CI, 8.3-10.5). The greatest proportion of injuries occurred in basketball, hockey, soccer, and snowboarding. The top 5 body parts injured were the ankle, knee, head, back, and wrist. The top 5 injury types were sprain, contusion, concussion, fracture, and muscle strain. A previous injury was associated with 49% of the injuries and direct contact with 45% of injuries. CONCLUSIONS: Rates of participation in sport and sport injury are high in adolescents. Future research should focus on prevention strategies in sports with high participation and injury rates to maximize population health impact.     

Parental,socio and cultural factors associated with adolescents' sports participation in four Danish municipalities

Despite the well‐documented health effects of physical activity, few studies focus on the correlates of leisure‐time sports and exercise participation. The present study examined correlations between adolescent sports participation and demographic factors, socioeconomic status (SES) and sociocultural factors. A school‐based cross‐sectional cluster sample including 6356 Danish fifth‐ and ninth‐grade adolescents from four municipalities were included. Age (younger) and gender (boy) were associated with adolescents' sports participation. Girls were half as likely [odds ratio (OR) 0.49 95% confidence interval (CI): 0.44–0.55] to participate in sports than boys. Adolescents were more likely to participate in sports if they perceived their parents as active in exercise or sports. Adolescents with one or two unemployed parents were 0.75 (95% CI: 0.62–0.89) and 0.75 (95% CI: 0.56–1.00), respectively, less likely to participate in sports than adolescents with two employed parents. In a gender‐stratified analysis, parents' occupational status was only a predictor of sports participation in girls. Differences between municipalities in adolescents' sports participation remained significant when controlled for individual factors such as gender, age, parents' background or parents' physical activity. The association between sociocultural and SES was stronger for girls than boys. In conclusion, demographics, SES and sociocultural factors were the best determinants of adolescent sport participation.     

The epidemiology of medically attended sport and recreational injuries in Queensland

The Queensland Sport and Recreation Injury Survey (QSRIS) is a retrospective study describing the annual incidence of injuries in the state of Queensland, Australia, resulting from sport and recreational activity involvement. Data were collected by means of a computer-assisted-telephone-interview (CATI) survey of a representative sample of Queenslanders in the spring of 2000. The sample produced a total of 1337 respondents aged 18 to 94 years. The survey asked information regarding medically attended, non-fatal injuries resulting from sport and recreational activities in the past 12 months. Of the 1337 individuals surveyed, 191 of the respondents reported one or more injuries that required medical attention resulting in a total of 222 Injuries. This represents an overall rate of 1,666 medically attended injuries per 10,000 people. Among those reporting a sport or recreational injury, the most common types of injuries were a strained/pulled muscle (30.9%), sprained/torn ligament (24.1%), and fracture (12.6%). The most common bodily locations of injuries were the shoulders (13.0%) and knees (12.5%). Results detail the nature and type of injury, medical professional attending to the injury and the nature of the sport or recreational activity that led to the reported injury, highlighting the number of injuries associated with general fitness activities achieved through high participation rates and low injury rates. This remains an area of much needed attention given the promotional push towards raising the levels of physical activity at a population level.     

Risk factors for acute and overuse sport injuries in Swedish children 11 to 15 years old: What about resistance training with weights?

To determine the 1‐year self‐reported incidence of overuse and traumatic sport injuries and risk factors for injuries in children participating in a summer sports camp representing seven different sports. 4363 children, 11 to 15 years old participating in a summer camp in seven different sports answered a questionnaire. Injury in this cross‐sectional study was defined as a sport‐related trauma or overload leading to pain and dysfunction preventing the person from participation in training or competition for at least 1 week. A number of risk factors for injury were investigated such as sex, age, number of hours spent on training in general, and on resistance training with weights. Nearly half [49%, 95% confidence interval (CI) 48–51%] of the participants had been injured as a result of participation in a sport during the preceding year, significantly more boys than girls (53%, 95% CI 50–55% vs 46%, 95% CI 43–48%; P < 0.001). Three factors contributed to increased incidence of sport injuries: age, sex, and resistance training with weights. Time spent on resistance training with weights was significantly associated with sport injuries in a logistic regression analysis. In children age 11 to 15 years, the risk of having a sport‐related injury increased with age and occurred more often in boys than in girls. Weight training was the only modifiable risk factor that contributed to a significant increase in the incidence of sport injuries.     

Sports injuries: population based representative data on incidence, diagnosis, sequelae, and high risk groups

Objective

To generate national representative data on the incidence, diagnosis, severity, and nature of medically treated sports injuries and to identify high risk groups.

Methods

The first national health survey for the Federal Republic of Germany, conducted in the format of a standardised, written, cross sectional survey in the period October 1997 to March 1999, gathered data on the incidence of accident and injury and information on social demographics, injury related disability/time off work, and injury location/setting. The net sample comprised 7124 people aged 18–79.

Results

3.1% of adult Germans said they sustained a sports injury during the previous year, corresponding to an annual injury rate of 5.6% among those engaging in regular recreational physical activity and ranking sports injuries as the second most common type of accident. About 62% of all sports injuries result in time taken off work. The period of occupational disability is 14 days or less in around two thirds of these cases. The occupational disability rate after occupational and traffic accidents is much higher by comparison. Dislocations, distortions, and/or torn ligaments make up 60% of all sports injuries, followed by fractures (18%), contusions, surface wounds, or open wounds (12%). Three out of four sports injury casualties are male. The incidence declines noticeably in higher age groups.

Conclusions

Future injury prevention measures should focus on the high risk group of young male recreational athletes. The data indicate that the fear of damage to health and injury, believed to be significant internal psychological barriers to participation in sports, is largely unwarranted for the female population and/or older age groups. Sporting injuries are a marginal phenomenon among the female population and mobile seniors actively engaged in sports.     

Injuries treated at a sports injury clinic compared with a neighbouring accident and emergency department.

Previous reports relating to sports injuries treated at hospital Accident and Emergency departments (A&E) or Sports Injury Clinics (SIC) indicate differences between the groups. This study compared directly the sports injuries treated during overlapping time periods at an A&E department (n = 2490) and a SIC (n = 340) set within the same geographical area. The two populations were found to differ significantly in age, sport, injury and injury site. Hospital patients tended to be younger, with an acute injury to the upper body or head which occurred during participation in sports where contact is likely. SIC patients tended to be older, with chronic or overuse injuries to the back or lower limb. It was found that there are significant differences between the sports injuries treated at the sports injury clinic and the hospital casualty department. It is concluded that demand is clearly shown for both types of treatment site when both are available in the same geographical area.     

Bone mass of asian adolescents in China: influence of physical activity and smoking

INTRODUCTION/PURPOSE: Research addressing the role of biology and behavior on bone development during times of peak bone acquisition in adolescence is limited. The present investigation was conducted to address the influence of body composition (lean body mass, fat mass), menarche, leisure physical activity, sports team participation, smoking, and second-hand smoke on skeletal mass of a unique sample of Asian adolescents in China. METHODS: A total of 166 girls and 300 boys (ages 12-16 yr) participated in this study. Bone mineral density (BMD) and content (bone mineral content (BMC)) of the forearm and the os calcis were measured using dual energy x-ray absorptiometry (DXA); lean body mass (LBM) and fat mass were estimated by bioelectrical impedance analysis (BIA); grip strength was measured by isometric dynamometry. Menarche, leisure physical activity, sports team participation, and active and passive smoking were determined using questionnaire. RESULTS: In girls, a total of 44% of the variance in forearm BMC was attributed to a model which included LBM (32%), time since menarche (10%), and age (2%); heel BMC was best predicted by LBM alone (42%), with no significant contribution by other variables. In boys, a total of 39% of the variance in forearm BMC was attributed to a model which included LBM (28%), age (5%), sports team participation (4%), height (1%), and fat mass (1%); heel BMC was best predicted by LBM (50%) and height (3%), accounting for 53% of the variance. CONCLUSION: The findings of this study suggest that lean body mass is the primary determinant of bone mass in Chinese adolescents. Menarche is also an important contributor in girls, whereas age and sports team participation are secondary predictors of bone mass in boys.     

Assessment of lower limb neuromuscular control in prepubescent athletes

BACKGROUND: Although neuromuscular indices have been extensively studied in adolescents and adults, limited data exist for prepubescent children. HYPOTHESIS: No differences exist between prepubescent boys and girls in lower limb strength, symmetry on single-legged hop testing, and limb alignment during drop-jump testing. STUDY DESIGN: Cross-sectional study (prevalence); Level of evidence, 1. METHODS: The authors tested 27 female and 25 male athletes who were aged 9 to 10 years and matched for both body mass index and years of organized sports participation. In a drop-jump screening test, the distance between the right and left hips, knees, and ankles was measured as an indicator of lower limb axial alignment in the coronal plane. The distance between the knees and ankles was normalized by the hip separation distance. Quadriceps and hamstrings strengths were measured isokinetically at 180 deg/s. Lower limb symmetry was determined from 2 single-legged hop function tests. RESULTS: Boys demonstrated greater mean absolute and normalized knee and ankle separation distances on the drop-jump test. Even so, 76% of boys had a normalized knee separation distance of 60% or less of the hip separation distance, as did 93% of girls, indicating a distinctly valgus alignment. There were no differences between the sexes in quadriceps and hamstrings peak torques, hamstrings/quadriceps ratio, time to peak torque, total work, or lower limb symmetry values. CONCLUSIONS: A high percentage of the prepubescent athletes studied had a distinctly valgus lower limb alignment during the drop-jump test and a lack of lower limb symmetry during the hop tests. These same indices have been hypothesized to increase the risk for knee ligament injuries in older athletes. Neuromuscular training may be needed to address these issues in children.     

Common injuries in preadolescent and adolescent athletes. Recommendations for prevention

In general, children and youth sports are safe. The great majority of injuries which are sustained are minor and self-limiting. Fortunately, catastrophic acute injuries such as paraplegia, quadriplegia and major limb insults are rare. The 2 mechanisms of injuries at these age groups are acute traumatic insults and unresolved sequelae of repetitive microtrauma. The latter usually results from inappropriate training and coaching techniques. In the United States, adolescents and children are becoming involved in sport at earlier ages and with higher levels of intensity and competition. Factors which lead to injury include the athlete and his/her own psychobiology, inappropriate equipment, the sports environment (playing surfaces, temperature), training and coaching errors, and parental influences. Preparticipation assessment usually reveals extremely healthy children with rare factors which contribute to non-sports participation. Preventative efforts must be made to provide these children with the appropriate equipment and coaching to limit the number of overuse injuries. Management of acute sports problems and rehabilitation of significant injuries are as important in childhood and youth sports as in those of their older sibs in order to prevent lifelong sequelae of musculoskeletal injury. The appropriate goal of children and youth sports must remain one of enjoyment with acquisition of sport-specific skills.     

Epidemiology of physical activity‐related injuries in Chinese university students

Knowledge gaps of the physical activity‐related injury (PARI) problem among general undergraduates exist. We conducted a study in four universities, where 1421 students graded 1‐3 were interviewed face‐to‐face during April and May after their completion of the baseline survey in March and April 2017, aiming to describe the incidence and characteristics of PARI. PARI experience and physical activity (PA) participation in the past 12 months were collected. Injury incidence density (IID) and risk, and injury characteristics were evaluated for the overall sample and by gender. Pearson chi‐square or Fisher's exact tests and independent‐sample t tests were used to test between‐group differences. We found that 486 PARIs were reported totally by 289 participants , with an overall IID of 0.57 per 1000 hours of exposure (males: 1.07, females: 0.45) and an injury risk of 0.34 injuries/student/y (males: 0.52; females: 0.28) . Higher IIDs were found in roller skating, football, and basketball. The majority of injuries occurred outdoors and involved the lower extremities, with sprain and strain being the primary injury types. Moreover, most injuries were new, acute, and happened in non‐contact situations. Of all injuries, 52.1% required medical attention and 64.6% resulted in inactivity of one or more days. Some significant differences were observed between males and females. Our study indicates that PARI is a public health concern among Chinese university students, which can provide direction for targeted prophylactic interventions to underpin the sex‐specific injury mechanism to reduce PARI.     

The Harstad injury prevention study: the epidemiology of sports injuries. An 8 year study.

OBJECTIVE--To describe the epidemiology of sports injuries occurring in a community during 8 years and to evaluate the outcome of an intervention implemented against injuries occurring in downhill skiing. METHODS--Hospital treated sports injuries occurring in Harstad, Norway (population 22 600) were recorded prospectively during an 8 year period. A prevention programme targeting downhill skiing injuries was evaluated. RESULTS--2234 sports injuries accounted for 17.2% of recorded unintentional injuries. Two out of three injuries occurred in team sports. Soccer accounted for 44.8% of all sports injuries. Downhill skiing injuries had higher mean score on the abbreviated injury scale than all other sports analysed combined (P < 0.01). Postintervention injury rates for downhill skiing were reduced by 15% when adjusting for exposure (P = 0.24). Further observations are needed for assessing the effectiveness of the downhill skiing safety programme. CONCLUSIONS--Strategies for future sports injury prevention include community involvement, particularly sports organisations. Local data analysis seems to justify some priorities, for example, promotion of helmet use in downhill skiing for young adolescents and prevention of lower limb fractures in male soccer players 15+ years old. Prospective hospital recording of injuries provides a tool for the design and outcome evaluation of sports injury intervention research.     

Sports-related injuries in children. A study of their characteristics, frequency, and severity, with comparison to other types of accidental injuries

In 1981 to 1982, within a 1 year period, details were recorded of children aged 0 to 15 years and 3 months, who were treated for accidental injury in a French health care district; 789 sports-related accidents were registered, representing 11% of all accidents. Sports areas were the leading sites of accident among children over age 12. Out-of-school sports accidents were more frequent among boys, but boys and girls had similar injury rates in school physical education. Compared to home, school, and road accidents, sports accidents had the highest rate of upper limb injury. The fracture rate was 22% and the hospitalization rate 11%. In most cases children were injured without any participation of other players or sports equipment. Sports-related injuries were usually benign, but several hospital admissions for the same accident were required in 20% of the admitted children (significantly higher than in home, school, and road accidents), and the time elapsed between the accident and the end of the last stay in hospital was significantly greater than in other kinds of accidents. This might be explained by a higher rate of epiphyseal fractures (10%) and internal fixation (17%). Musculoskeletal sequelae were observed in 12% of inpatient children.     

Incidence of serious injury and death during sport and recreation activities in Victoria, Australia

Background: Participation in sport and recreation is widely encouraged for general good health and the prevention of some non-communicable diseases. However, injury is a significant barrier to participation, and safety concerns are a factor in the decision to participate. An understanding of the sport/recreation activities associated with serious injury is useful for informing physical activity choices and for setting priorities for the targeting of injury prevention efforts. Objectives: To describe the epidemiology of serious injuries sustained in sport/recreation activities by adults in Victoria, Australia. Methods: The Victorian State Trauma Registry and the National Coroner''s Information Service were used to identify and describe sport/recreation related serious injuries, including deaths, occurring during the period July 2001 to June 2003. Age adjusted rates of serious injury and death were calculated using participation figures for each sport and general population data. Results: There were 150 cases of serious injury and 48 deaths. The rates of serious injury and death were 1.8 and 0.6 per 100 000 participants per year respectively. Motor, power boat, and equestrian sports had the highest rates of serious injury. Most deaths were due to drowning. Conclusion: Although the risk of serious injury through sport/recreation participation is low, motor, power boat, and equestrian sports should be priorities for further research into injury prevention. Most sport/recreation related deaths are due to drowning, highlighting this area for prevention efforts.     

Analysis of sex‐specific injury patterns and risk factors in young high‐level athletes

This study analyzed sex‐specific injury patterns and risk factors in young athletes (n=256) from 12 sport disciplines practicing at the national or the international level in the Grand‐Duchy of Luxembourg. Injury occurrence as a result of sport practice was analyzed retrospectively over the year 2006 using a standardized self‐administered questionnaire. Overall incidence was not different between girls and boys (1.20 and 1.21 injuries/1000 athlete‐hours, respectively), but in the context of team sport competition girls tended to be at a greater risk (rate ratio 2.05, P=0.053). Girls had a higher proportion of injuries in the ankle/foot region compared with boys (34.8% vs 16.8%). No sex‐related differences were found regarding injury severity. Multivariate logistic regression (controlling for age and practice volume) revealed that girls' team sports were associated with a greater injury risk compared with individual sports [odds ratio (OR) of 4.76], while in boys this was observed for racket sports (OR=3.31). Furthermore, physical or emotional stress tended to be a specific risk factor in girls. There was a tendency for injury outside sports to be coupled to a higher injury risk in girls and boys. Consideration of sex‐specific injury patterns and risk factors could be of importance for effective injury prevention.     

Camel racing injuries among children.

OBJECTIVE: The aim of this study is to determine the frequency and severity of camel racing injuries among children aged 5 to 15 years during the period 1992 to 2003 in the State of Qatar. DESIGN: Case series. SETTING: The study was conducted in the Hamad General Hospital, State of Qatar, from January 1992 to December 2003. PATIENTS AND METHODS: A total of 275 subjects aged 5 to 15 years with camel racing injuries who were seen at the Accident Emergency Department, Critical Care, and Physiotherapy Departments of the Hamad General Hospital were studied. The sociodemographic information and the details of the injury of the studied subjects were collected. The Abbreviated Injury Scale system was used to determine the severity of injury. RESULTS: Overall, 275 camel racing injuries were reported among boys aged 5 to 15 years. The majority of patients were Sudanese (91.3%). The most commonly injured locations were upper limb (23.2%), lower limb (21.1%), and head (20.7%), followed by other injury locations. Seventeen patients were disabled as a result of their injury, and another 3 injuries were fatal. This study revealed that 34% of injuries were considered to be minor, 22.1% moderate, 18.1% serious, 11.6% critical, and 6.4% maximum. CONCLUSIONS: The injury severity caused by the camel racing significantly affected the length of hospital stay. At present, the government is serious about this problem, and there is a draft of proposed legislation intended to prevent the employment of children below the age of 12 as camel jockeys.     

Snow sports injuries in Scotland: a case-control study

OBJECTIVES: To examine the incidence and patterns of snow sports injuries at the three largest commercial ski areas in Scotland and to identify factors associated with injury risk. METHODS: A prospective case-control study of all injured people at Cairngorm, Glenshee, and Nevis Range ski areas during the 1999-2000 winter season. Personal details, snow sports related variables, diagnosis, and treatment were recorded. Control data were collected at random from uninjured people at all three areas. Random counts were performed to analyse the composition of the on slope population. RESULTS: A total of 732 injuries were recorded in 674 people. Control data were collected from 336 people. The injury rate for the study was 3.7 injuries per 1000 skier days. Alpine skiers comprised 67% of the on slope population, snowboarders 26%, skiboarders 4%, and telemark skiers 2%. Lower limb injuries and sprains were the commonest injuries in alpine skiers and skiboarders. Snowboarders sustained more injuries to the upper limb and axial areas. Skiboarders and snowboarders had a higher incidence of fractures. After adjustment for other variables, three factors were all independently associated with injury: snowboarding (odds ratio (OR) 4.07, 95% confidence interval (CI) 1.65 to 10.08), alpine skiing (OR 3.82, CI 1.6 to 9.13), and age <16 years (OR 1.9, CI 1.14 to 3.17). More than five days of experience in the current season and at least one week of experience in total had a protective effect against injury. CONCLUSIONS: Despite a change in the composition of the alpine population at Scottish ski areas, the overall rate and pattern of injury are similar to those reported previously in comparable studies. Several factors are associated with an increased risk of injury and should be targeted in future injury prevention campaigns.     

Sports injuries in a large urban population: occurrence and epidemiological aspects

Most studies reporting on sports injuries have been investigations of specific types and locations in specific sports events and levels. This study aims at outlining the features of sports injuries in general regardless of type, severity, or treatment during 1 year among the adult population of the Greater Helsinki area (pop. 600,000). This study was carried out in cooperation with the Central Statistical Office, which in 1980 performed a nationwide survey aimed at outlining the incidence and features of accidents occurring in Finland. The actual data from this study concerning sports injuries in the Greater Helsinki area was broken down and further analyzed. During the actual time period under investigation, an estimated 40,380 acute sports injuries occurred in the area. Based on this estimate, the calculated occurrence of sports injuries was found to be 670 +/- 121/10,000 inhabitants. Sports injuries were found mainly among young people in their productive working years, though surprisingly low was the occurrence of injuries among women of 20-24 years of age. The majority of the injuries were of mild character, though 9% were classified as severe, and it was estimated on the basis of the data obtained from this study that some 4000 patients attended a casualty department in the area because of an injury sustained in sports, thus placing a considerable burden on these agencies. Distorsions formed with 65% the most common type of injury, and the application of an adhesive bandage was the commonest form of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)     

Injury patterns among female field hockey players

PURPOSE: To examine injury patterns among female field hockey players and to broaden the current base of knowledge by identifying the injury rates of different playing positions. It was hypothesized that goalkeepers would have the highest rate of injury, followed by forwards. METHODS: High school, university, and national level female field hockey players (N = 158) completed an anonymous questionnaire. They reported personal characteristics (age, height, weight); field hockey information (level, years of experience, surface); injury history (type, site, cause, severity); and back pain information. Injury rates were calculated per athlete-year. RESULTS: The most frequently injured site of the body was the lower limb (51%), followed by the head/face (34%), upper limb (14%), and torso (1%). The most prevalent types of injuries were ankle sprains, followed by hand fractures and head/face injuries. Goalkeepers had the highest rate of injury (0.58 injuries/athlete-year), whereas midfielders were the most injured field players (0.36 injuries/athlete-year). Back pain was reported by 59% of the sample, and the lower back was the most common site of this pain. CONCLUSION: There are differences in the rates of injury among playing positions in field hockey and in the types of acute injury sustained at each position. The high number of injuries to the head and face region is also cause for concern. Although most of these injuries are minor, the serious injuries that do occur can be very severe. Now that these patterns have been identified, further examination of the playing situations that lead to injury should be undertaken.