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Acute sports injuries in Sweden and their possible prevention: an epidemiological study using insurance data
Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.ORCID iD: 0000-0002-6483-1394
2017 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Physical activity is an essential component of a healthy life, e.g. to prevent obesity, cardiovascular disease and premature death, of which sports can be an important part. Unfortunately, sports activities increase the risk of both overuse and acute injuries. Severe acute injuries may also lead to a permanent medical impairment (PMI), which may influence the ability to be physically active throughout life. However, sports injuries may be prevented, but a profound understanding of the injuries and how to prevent them is needed.

This doctoral thesis examine acute sports injuries reported by licensed athletes of all ages and level of sports nationwide in Sweden, by using national insurance data. Approximately 80% of all the Sports Federations (SF) had their mandatory accident insurance in the insurance company Folksam, and since there is no national sports injury surveillance system in Sweden, this is a unique database, able to be used in epidemiological studies on acute injuries occurring in organized sports in Sweden. The main aim of this thesis was to identify high-risk sports for acute injuries, the most common and the most severe injuries, especially in large sports with numerous licensed athletes, many injuries and injuries resulting in PMI. Based on the results, there will be recommendations regarding sports and body locations where injury prevention efforts should be focused to gain the greatest prevention effect at a national level in Sweden. Another aim was to evaluate the effectiveness of a neuromuscular knee control training program (KCP) that has been implemented nationwide to reduce knee and cruciate ligament injuries, among football players in Sweden.

After evaluating the validity and reliability of the information within the database based on international guidelines, acute injury data were examined and the results presented in four papers. These results showed that there is a need of injury prevention especially in motorcycle sports, team ball sports, and ice hockey. Particularly, knee injuries need to be prevented since they were both the most common injuries and leading to PMI. The severe head- and upper limb injuries also need attention. Sixty-nine percent of the PMI injured athletes, were younger than 25 years. The injury prevention training program, KCP can be considered partially implemented nationwide, since 21 out of 24 district SFs provided KCP educations. The incidence of knee and cruciate ligament injuries has decreased among football players in Sweden. A concerning aspect is that there is no national official policy regarding sports injury and injury prevention in Sweden, nor an official authority that has the explicit responsibility for these issues.

Place, publisher, year, edition, pages
Stockholm: Gymnastik- och idrottshögskolan, GIH , 2017. , p. 87
Series
Avhandlingsserie för Gymnastik- och idrottshögskolan ; 12
Keyword [en]
permanent medical impairment, severe injuries, knee injury, dental, eye injury, football, handball, ice hockey, floorball, basketball, motorcycle, automobile sports, incidence of acute injury
Keyword [sv]
invaliditet, allvarliga skador, idrottsskada, försäkringsdata, knäskada, prevention, fotboll, innebandy, handboll, ishockey, basket, motorcykel, bilsport, tandskada, ögonskada
National Category
Sport and Fitness Sciences
Research subject
Medicine/Technology
Identifiers
URN: urn:nbn:se:gih:diva-5128ISBN: 978-91-983151-3-4 (print)OAI: oai:DiVA.org:gih-5128DiVA, id: diva2:1166071
Public defence
2018-01-12, Sal 1505, Lidingövägen 1, 114 33 Stockholm, 10:30 (Swedish)
Opponent
Supervisors
Note

Avhandlingen (kappan) är korrigerad efter disputationen enligt erratablad.

Available from: 2017-12-14 Created: 2017-12-14 Last updated: 2018-01-24Bibliographically approved
List of papers
1. Insurance claims data: a possible solution for a national sports injury surveillance system? An evaluation of data information against ASIDD and consensus statements on sports injury surveillance.
Open this publication in new window or tab >>Insurance claims data: a possible solution for a national sports injury surveillance system? An evaluation of data information against ASIDD and consensus statements on sports injury surveillance.
2014 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 4, no 6, p. e005056-Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Before preventive actions can be suggested for sports injuries at the national level, a solid surveillance system is required in order to study their epidemiology, risk factors and mechanisms. There are guidelines for sports injury data collection and classifications in the literature for that purpose. In Sweden, 90% of all athletes (57/70 sports federations) are insured with the same insurance company and data from their database could be a foundation for studies on acute sports injuries at the national level.

OBJECTIVE: To evaluate the usefulness of sports injury insurance claims data in sports injury surveillance at the national level.

METHOD: A database with 27 947 injuries was exported to an Excel file. Access to the corresponding text files was also obtained. Data were reviewed on available information, missing information and dropouts. Comparison with ASIDD (Australian Sports Injury Data Dictionary) and existing consensus statements in the literature (football (soccer), rugby union, tennis, cricket and thoroughbred horse racing) was performed in a structured manner.

RESULT: Comparison with ASIDD showed that 93% of the suggested data items were present in the database to at least some extent. Compliance with the consensus statements was generally high (13/18). Almost all claims (83%) contained text information concerning the injury.

CONCLUSIONS: Relatively high-quality sports injury data can be obtained from a specific insurance company at the national level in Sweden. The database has the potential to be a solid base for research on acute sports injuries in different sports at the national level.

National Category
Sport and Fitness Sciences
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-3437 (URN)10.1136/bmjopen-2014-005056 (DOI)24928588 (PubMedID)
Available from: 2014-09-17 Created: 2014-09-17 Last updated: 2017-12-14
2. Incidence and severity of reported acute sports injuries in 35 sports using insurance registry data
Open this publication in new window or tab >>Incidence and severity of reported acute sports injuries in 35 sports using insurance registry data
2016 (English)In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 26, no 4, p. 451-462Article in journal (Refereed) Published
Abstract [en]

Acute injuries in sport are still a problem where limited knowledge of incidence and severity in different sports at national level exists. In Sweden, 80% of the sports federations have their mandatory injury insurance for all athletes in the same insurance company and injury data are systematically kept in a national database. The aim of the study was to identify high-risk sports with respect to incidence of acute and severe injuries in 35 sports reported to the database. The number and incidences of injuries as well as injuries leading to permanent medical impairment (PMI) were calculated during 2008–2011. Each year approximately 12 000 injuries and 1 162 660 licensed athletes were eligible for analysis. Eighty-five percent of the injuries were reported in football, ice hockey, floorball, and handball. The highest injury incidence as well as PMI was in motorcycle, handball, skating, and ice hockey. Females had higher risk of a PMI compared with males in automobile sport, handball, floorball, and football. High-risk sports with numerous injuries and high incidence of PMI injuries were motorcycle, handball, ice hockey, football, floorball, and automobile sports. Thus, these sports ought to be the target of preventive actions at national level.

National Category
Sport and Fitness Sciences
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-3816 (URN)10.1111/sms.12462 (DOI)000373356600010 ()25850826 (PubMedID)
Available from: 2015-05-19 Created: 2015-05-19 Last updated: 2017-12-14Bibliographically approved
3. Incidence and body location of reported acute sport injuries in seven sports using a national insurance database.
Open this publication in new window or tab >>Incidence and body location of reported acute sport injuries in seven sports using a national insurance database.
2018 (English)In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 28, no 3, p. 1147-1158Article in journal (Refereed) Published
Abstract [en]

Sports with high numbers of athletes and acute injuries are an important target for preventive actions at a national level. Both for the health of the athlete and to reduce costs associated with injury. The aim of this study was to identify injuries where injury prevention should focus, in order to have major impact on decreasing acute injury rates at a national level. All athletes in the seven investigated sport federations (automobile sports, basketball, floorball, football (soccer), handball, ice hockey, and motor sports) were insured by the same insurance company. Using this insurance database, the incidence and proportion of acute injuries, and injuries leading to permanent medical impairment (PMI), at each body location, was calculated. Comparisons were made between sports, sex, and age. In total, there were 84 754 registered injuries during the study period (year 2006-2013). Athletes in team sports, except in male ice hockey, had the highest risk to sustain an injury and PMI in the lower limb. Females had higher risk of injury and PMI in the lower limb compared to males, in all sports except in ice hockey. This study recommends that injury prevention at national level should particularly focus on lower limb injuries. In ice hockey and motor sports, head/neck and upper limb injuries also need attention.

Keyword
acute sport injury, epidemiology, national level, permanent medical impairment, severe sport injury, time trend
National Category
Sport and Fitness Sciences
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-5060 (URN)10.1111/sms.12956 (DOI)000426529300041 ()28782303 (PubMedID)
Available from: 2017-11-07 Created: 2017-11-07 Last updated: 2018-03-27Bibliographically approved
4. Acute injuries in floorball, football, handball and ice hockey at a national level and recommended prevention measures
Open this publication in new window or tab >>Acute injuries in floorball, football, handball and ice hockey at a national level and recommended prevention measures
(English)Manuscript (preprint) (Other academic)
National Category
Sport and Fitness Sciences
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-5131 (URN)
Note

At the time of Malin Åman's dissertation this manuscript was submitted.

Available from: 2017-12-14 Created: 2017-12-14 Last updated: 2017-12-14Bibliographically approved
5. A nationwide follow-up survey on the effectiveness of an implemented neuromuscular training program to reduce severe knee injuries in football players
Open this publication in new window or tab >>A nationwide follow-up survey on the effectiveness of an implemented neuromuscular training program to reduce severe knee injuries in football players
Show others...
(English)Manuscript (preprint) (Other academic)
National Category
Sport and Fitness Sciences
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-5132 (URN)
Note

At the time of Malin Åman's dissertation this manuscript was submitted.

Available from: 2017-12-14 Created: 2017-12-14 Last updated: 2017-12-14Bibliographically approved

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