Evidence based prevention of acute injuries during physical exercise in a WHO safe community

OBJECTIVE: To evaluate a community based programme for evidence based prevention of injuries during physical exercise. DESIGN: Quasi-experimental evaluation using an intervention population and a non-random control population. PARTICIPANTS: Study municipality (population 41,000) and control municipality (population 26,000) in Sweden. MAIN OUTCOME MEASURES: Morbidity rate for sports related injuries treated in the health care system; severity classification according to the abbreviated injury scale (AIS). RESULTS: The total morbidity rate for sports related injuries in the study area decreased by 14% from 21 to 18 injuries per 1,000 population years (odds ratio 0.87; 95% confidence interval (CI) 0.79 to 0.96). No tendency towards a decrease was observed in people over 40. The rate of moderately severe injury (AIS 2) decreased to almost half (odds ratio 0.58; 95% CI 0.50 to 0.68), whereas the rate of minor injuries (AIS 1) increased (odds ratio 1.22; 95% CI 1.06 to 1.40). The risk of severe injuries (AIS 3-6) remained constant. The rate of total sports injury in the control area did not change (odds ratio 0.93; 95% CI 0.81 to 1.07), and the trends in the study and control areas were not statistically significantly different. CONCLUSION: An evidence based prevention programme based on local safety rules and educational programmes can reduce the burden of injuries related to physical exercise in a community. Future studies need to look at adjusting the programme to benefit all age groups.