Periodic health evaluation in Para athletes: a position statement based on expert consensus.

Para athletes present a broad range of sports-related injuries and illnesses, frequently encountering barriers when accessing healthcare services. The periodic health evaluation (PHE) is a valuable tool for continuously monitoring athletes' health, screening for health conditions, assisting in the surveillance of health problems by establishing baseline information and identifying barriers to athlete's performance. This position statement aims to guide sports healthcare providers in the PHE for Para athletes across key impairment categories: intellectual, musculoskeletal, neurological and vision.

Rethinking Scale-Up of Rehabilitation for Chronic Disease in Low-Resource Settings: Embracing Complexity for Contextual Impact.

As the burden of chronic disease and multiple long-term conditions is increasing globally, disproportionally affecting those in low-resourced settings, there is an increasing call to action to scale effective models of care that can assist in mitigating the impact of chronic disease on functioning, activity, societal participation, and health-related quality of life. The aim of this paper is to unpack the contextual factors that have been implicitly and explicitly voiced by researchers reporting on rehabilitation interventions used to manage chronic disease in low-resourced settings. We systematically engaged the literature and applied a reflexive qualitative and systems thinking lens to unpack the contextual factors and their interplay.

A high incidence of serious life-threatening cardiovascular medical encounters during a marathon (2014-2019) calls for prevention strategies: SAFER XL.

Objective: The aim of this study was to determine the incidence and nature (severity and type by organ system and specific diagnosis) of all medical encounters (MEs), including serious/life-threatening MEs (SLMEs) during a South African road marathon.

Methods: This descriptive study was a retrospective analysis of data collected over 6 years at the Cape Town Marathon from 2014 to 2019, which included 40 446 starters. All MEs were collected and described as per the consensus statement for mass community-based sporting events.

Incidence of respiratory infections and SARS-CoV-2 is higher during contact phases in student rugby players - Lessons learnt from COVID-19 risk mitigation strategies-AWARE V.

The incidence of acute respiratory infections (ARinf), including SARS-CoV-2, in unvaccinated student rugby players during phases from complete lockdown during the COVID-19 pandemic to returning to competition is unknown. The aim of the study was to determine the incidence of ARinf (including SARS-CoV-2) during non-contact and contact phases during the COVID-19 pandemic to evaluate risk mitigation strategies. In this retrospective cohort study, 319 top tier rugby players from 17 universities completed an online questionnaire.

Ankle, knee and concussion concerns: Unveiling injury patterns in highly trained South African netball players.

Objectives: To describe the rate and type of netball injuries sustained during women's university-level tournament matches in South Africa.

Design: Descriptive epidemiological study.

Setting: Three editions of the women's Varsity Netball tournament (2021-23).

Knee contact forces of individuals with osteoarthritis and those with lower limb amputation: A systematic review.

Objective: Osteoarthritis (OA) is a major cause of impairment. Research has shown that individuals with unilateral lower limb amputation (ULLA) are 17 times more likely to develop OA on their sound side limb. Therefore, this review aimed to describe similarities and differences in the biomechanical loading variables of individuals with OA and those with ULLA.

Evaluation of the SCAT 5 tool in the assessment of concussion in Para athletes: a Delphi study.

Objectives: To investigate if the sport concussion assessment tool version 5 (SCAT5) could be suitable for application to Para athletes with a visual impairment, a spinal cord injury, or a limb deficiency.

Methods: A 16-member expert panel performed a Delphi technique protocol. The first round encompassed an open-ended questionnaire, with round 2 onwards being composed of a series of closed-ended statements requiring each expert's opinion using a five-point Likert scale.

What impact have the IOC medical consensus statements made on athlete health? A survey of medical commissions from National Olympic/Paralympic Committees and International Sports Federations.

Background: The International Olympic Committee (IOC) Medical and Scientific Commission has supported collating and sharing evidence globally by developing sports medicine consensus statements ('Statements''). Publishing the Statements requires substantial resources that must be balanced by use and impact on policy and practice. This study aimed to gain a better understanding of awareness and uptake of the Statements globally through a survey of the National Olympic Committees (NOC), National Paralympic Committees (NPC) and International Federations (IF).

Psychosocial experiences of competitive rugby players on the "long, long journey" to recovery following ACL ruptures and reconstruction.

Anterior Cruciate Ligament (ACL) injuries are serious and potentially career-ending. Reconstruction surgery and extended rehabilitation typically follow, but some athletes never attain the same level of sport performance. The psychosocial experiences of athletes who sustain ACL injuries and their cognitive appraisal, emotional and behavioral responses to the injury, and reconstruction require further attention during the different recovery phases.

The epidemiology of eye illness in Para athletes in the Winter and Summer settings- a systematic review.

The aim of this systematic review was to evaluate eye illnesses in para athletes in the winter and summer settings. A search was conducted using PubMed-Medline, EbscoHost, and Web of Science for full-text original research articles published anytime until November 2022. Studies that reported quantitative data on eye illness in highly active individuals and para athletes, at any level of performance (elite/nonelite/recreational), aged 15-75 yrs were included.

Incidence of injury and illness at the Beijing 2022 Paralympic Winter Games held in a closed-loop environment: a prospective cohort study of 7332 athlete days.

Objective: To describe the epidemiology of injuries and illnesses sustained during the Beijing 2022 Paralympic Winter Games, organised in a closed-loop environment to adhere with COVID-19 restrictions.

Methods: Injuries and illnesses from all teams were recorded on a daily basis by team medical staff on a web-based form and by local organising committee medical (polyclinic) facilities and venue medical support. Duplicates recorded on both systems were removed.

Injury incidence according to athlete impairment type during the 2012 and 2016 Summer Paralympic Games: a combined analysis of 101 108 athlete days.

Objectives: The relationship between sport-related injuries and Para athlete impairment type has not yet been comprehensively studied. This study aimed to describe injury incidence according to athlete impairment type during the London 2012 and Rio 2016 Summer Paralympic Games, by sex, age, Games period, chronicity and anatomical area.

Methods: A combined analysis of 7222 athletes was conducted comprising 101 108 athlete days, using pooled data.

Evaluating workforce needs: an investigation of healthcare professionals' attitudes, beliefs and preparedness towards the management of Para athlete mental health at the Tokyo 2020 and Beijing 2022 Paralympic Games.

Objectives: To examine healthcare professionals (HCPs) attitudes, beliefs and preparedness towards the management of Para athlete mental health during the Tokyo 2020 and Beijing 2022 Paralympic Games.

Methods: A cross-sectional observational study was conducted. National Paralympic Committee's HCPs (n=857) working at the Tokyo 2020 and Beijing 2022 Paralympic Games were invited to respond to an anonymous online survey regarding the management of Para athlete mental health in their team.

Noteworthy Performance of Muscle-Injured Para-Athletes: A Study of Magnetic Resonance Imaging-Detected Muscle Injuries at the Tokyo 2020 Summer Paralympic Games.

Background: To the best of our knowledge, no studies have attempted to correlate athletic performance with muscle injuries sustained during Paralympic Games.

Aim: This study reports the incidence, anatomical location, anatomical site classification, and relationship between competition results and anatomical site classification in athletes who participated in the Paralympic Games.

Methods: All magnetic resonance images collected at the International Paralympic Committee polyclinic at the Tokyo 2020 Paralympic Games were reviewed to identify the presence and anatomical site of muscle injuries.

Tackling the tackle 2: Evaluation of referee and player behavioural change as measures of implementation of a law variation in community-level male amateur rugby union.

Objectives: To evaluate player and referee behaviour during a lower tackle height law variation trial in community rugby union ('rugby').

Design: Prospective observational cohort study.

Methods: In a law variation trial in male amateur community rugby, coded match video surveillance data were analysed.

Tackling the tackle 1: A descriptive analysis of 14,679 tackles and risk factors for high tackles in a community-level male amateur rugby union competition during a lowered tackle height law variation trial.

Objectives: In rugby union (rugby), the tackle is the most frequent cause of concussion and thus a target for intervention to reduce concussion incidence. The aim of this study is to describe tackle characteristics and factors associated with illegal high tackles in amateur community-level rugby during a lowered (armpit level) tackle height law variation trial.

Design: Prospective observational cohort study.

A qualitative study of the perceived benefits of participating in a spinal cord rehabilitation intervention in a low-middle income country.

Purpose: Improving quality of life (QoL) is a major goal of rehabilitation following spinal cord injury (SCI). However, people with disabilities in resource constrained contexts have limited access to rehabilitation and poorer health outcomes, including QoL. There is a paucity of qualitative research on the experiences of persons with SCI involved in rehabilitation programmes in low-middle income countries.

Robotic locomotor training in a low-resource setting: a randomized pilot and feasibility trial.

Purpose: Activity-based Training (ABT) represents the current standard of neurological rehabilitation. Robotic Locomotor Training (RLT), an innovative technique, aims to enhance rehabilitation outcomes. This study aimed to conduct a randomized pilot and feasibility trial of a locomotor training program within South Africa.

Prevalence of health risk behaviours related to non-communicable diseases amongst South African university students: a systematic review.

Background: Engagement in risk behaviours adopted during university continues after graduation, increasing the risk of non-communicable diseases (NCDs). This systematic review aimed to investigate the prevalence of NCD risk behaviours amongst South African university students.

Methods: PubMed and Scopus databases were searched (January 1990-April 2022) for studies investigating alcohol consumption, cigarette smoking, inadequate consumption of fruits and vegetables and physical inactivity.

Promotion of Para Athlete Well-being (PROPEL II): A Cross-sectional Study of Sleep in Para Athletes Across Two Nations.

Objective: Limited research exists on the sleep profiles of South African Para athletes. The aims of this study are to describe sleep quality, day-time sleepiness, and chronotype of South African Para athletes and to compare the relationship between sleep-related outcomes and demographic factors to athletes from a higher-resource country.

Design: A descriptive, cross-sectional survey was conducted.

Female athlete health domains: a supplement to the International Olympic Committee consensus statement on methods for recording and reporting epidemiological data on injury and illness in sport.

The IOC made recommendations for recording and reporting epidemiological data on injuries and illness in sports in 2020, but with little, if any, focus on female athletes. Therefore, the aims of this supplement to the IOC consensus statement are to (i) propose a taxonomy for categorisation of female athlete health problems across the lifespan; (ii) make recommendations for data capture to inform consistent recording and reporting of symptoms, injuries, illnesses and other health outcomes in sports injury epidemiology and (iii) make recommendations for specifications when applying the Strengthening the Reporting of Observational Studies in Epidemiology-Sport Injury and Illness Surveillance (STROBE-SIIS) to female athlete health data.In May 2021, five researchers and clinicians with expertise in sports medicine, epidemiology and female athlete health convened to form a consensus working group, which identified key themes.