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

Pinheiro, Larissa Santos Pinto; Ocarino, Juliana M.; Madaleno, Fernanda Oliveira; Verhagen, Evert; Mello, Marco Túlio de; Albuquerque, Maicon Rodrigues; Andrade, André Gustavo Pereira de; Mata, Carla Patrícia da; Pinto, Rafael Zambelli; Silva, Andressa; Resende, Renan Alves

doi:10.1136/bjsports-2020-102823

Cited by 28 publications

(18 citation statements)

References 68 publications

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“…The prevalence of urolithiasis was found to be affected by the sample size in this meta-analysis. The larger the screening scale, the lower the prevalence of urolithiasis, which is consistent with screening for many diseases [73]. We suggest that this appearance might be related to small sample studies can achieve refined project management [74] and researchers are more willing to focus on a positive result.…”

Section: Discussionsupporting

confidence: 57%

Prevalence of urolithiasis in China: a systematic review and meta‐analysis

Tan,

Yuan,

et al. 2023

BJU International

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ObjectiveTo estimate the pooled prevalence, as well as the spatial and temporal distribution, of urolithiasis among subjects in China.Materials and MethodsWe conducted a comprehensive search of both Chinese and English databases to retrieve literature pertaining to the prevalence of urolithiasis in the indigenous Chinese population. A random‐effects meta‐analysis model was employed to calculate the pooled prevalence of urolithiasis. Subgroup analyses were conducted based on factors such as time, region, gender, and sample size. Prevalence and spatial distribution maps were created based on provinces and latitude/longitude coordinates.ResultsA total of 46 studies conducted in 22 provinces across China were included in this meta‐analysis and the pooled prevalence of urolithiasis, kidney stones, ureteric calculi, urethral and bladder stones were 8.1% (95% confidence interval [CI] 5.6–11.1%), 7.8% (95% CI 5.8–10.0%), 3.2% (95% CI 0.6–5.7%), 0.5% (95% CI 0.1–0.9%). Most of the urolithiasis prevalence screening in China was concentrated between 100° E and 120° E, with higher rates observed in low latitude areas. Subgroup analysis of kidney stones revealed that Guangdong (12.7%) and Guangxi (10.3%) had the highest prevalence, with the eastern developed area exhibiting higher rates compared to the west. The prevalence in males was higher than in females (odds ratio 1.67, 95% CI 1.46–1.92), although the gender gap has significantly reduced since 2006. Moreover, a greater sample size is associated with a decreased prevalence of urolithiasis.ConclusionsThe prevalence of urolithiasis is increasing in China, and there are noteworthy regional or provincial disparities in occurrence. It is worth noting that the current number of screening studies in some areas is insufficient. Additional investigations with appropriate sample sizes should be supplemented in time.

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Section: Discussionsupporting

confidence: 57%

Prevalence of urolithiasis in China: a systematic review and meta‐analysis

Tan,

Yuan,

et al. 2023

BJU International

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“…Injuries not only pose a limitation on sports performance, but also an additional barrier to activities of daily living for athletes depending on a wheelchair or crutches for mobility. 21 Shoulder, trunk and back injury prevention is of outmost importance and should be implemented in regular training for all athletes with high loads on the upper body. 53,54 Our suggestion for injury prevention training for Para athletes are the freely available resources with the Get Set -Train Smarter application and www.fittoplay.org.…”

Section: Methodological Considerationsmentioning

confidence: 99%

“…1,2 A recent systematic review on the risk of musculoskeletal injuries among Para athletes revealed that the quality of the available evidence is low, and called for larger sample sizes and better quality studies. 21 Longitudinal data will facilitate a more comprehensive understanding of illness and injury patterns overall, enabling better planning of year-round medical services for Para athletes, 22,23 and informing initiatives to protect athlete health.…”

Section: Introductionmentioning

confidence: 99%

Illness and injury among Norwegian Para athletes over five consecutive Paralympic Summer and Winter Games cycles: prevailing high illness burden on the road from 2012 to 2020

Steffen

Clarsen

Gjelsvik³

et al. 2021

Br J Sports Med

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ObjectiveTo describe the illness and injury pattern of Norwegian Para athletes over five consecutive Paralympic Summer and Winter Games cycles and to identify which health problems should be targeted in risk management plans with respect to impairment types.MethodsWe monitored athletes from 12 to 18 months prior to each Game using a weekly online questionnaire (Oslo Sports Trauma Research Center-H2 (OSTRC-H2)). We asked them to report all health problems they had experienced in the preceding 7 days, irrespective of their consequences on their sports participation or performance and whether they had sought medical attention.ResultsBetween 2011 and 2020, 94 candidate athletes were included in this monitoring programme and prepared to represent Norway; of these, 66 (71%) were finally selected for multiple Paralympic Games. The overall response rate to the weekly questionnaires was 87%. At any given time during the five observation cycles, 37% of the athletes (95% CI 36% to 38%) reported having at least one health problem. Athletes with neurological impairments (n=51) lost 10 days per year due to respiratory problems (95% CI 9 to 11) compared with 9 days (8-10) among those with musculoskeletal impairments (n=37). Gastrointestinal problems caused a time loss of on average 4 days per year in athletes with neurological impairments versus 1 day in athletes with musculoskeletal impairments (mean difference 2.7 days, 2.1–3.3). Musculoskeletal injuries generated a high burden for both athlete groups, in particular, to the elbow, shoulder and lumbosacral regions.ConclusionAt any given time, nearly two out of five elite Norwegian Para athletes reported at least one health problem. Respiratory tract and other infections; gastrointestinal problems, injuries to the shoulder, elbow and lumbosacral regions represented the greatest health burden. Our findings can help guide the allocation of clinical resources, which should include a broad network of medical specialists, together with dieticians and physiotherapists, to meet the health challenges in Para athletes.

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“…Each term would be rated as low risk, high risk, and unclear. The Grading of Recommendations Assessment, Development, and Evaluation System (GRADE) ( 32 ) would be used to grade the quality of the evidence for main outcomes, and the quality of the evidence was rated as high, moderate, low, or very low according to the GRADE grading scale. The evaluation was conducted independently by two reviewers (Zhao-bo Yan and Zhi-miao MuRong); any disagreements would be resolved by a third reviewer (Mai-lan Liu).…”

Section: Methodsmentioning

confidence: 99%

Acupuncture as a Complementary Therapy for Cancer-Induced Bone Pain: A Systematic Review and Meta-Analysis

Yan

MuRong²,

Huo³

et al. 2022

Front. Pain Res.

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BackgroundCancer-induced bone pain (CIBP) is a special type of cancer pain and lacks safe and effective treatments. Acupuncture is a potentially valuable treatment for CIBP, studies evaluating the effect of acupuncture on CIBP have increased significantly, but the safety and efficacy of acupuncture to control CIBP remains controversial.ObjectiveTo provide the first meta-analysis to evaluate the safety and efficacy of acupuncture in CIBP management.Data SourcesCNKI, CBM, Wanfang, VIP Database, PubMed, Embase, and Cochrane Library were searched from their inception until 1 June 2022.Study SelectionRCTs with primary bone tumor patients or other types of primary cancer companied by bone metastases as the research subjects and to evaluate the efficacy of acupuncture treatment alone or combined with the control treatment were included. Meanwhile, RCTs should choose the pain score as the primary outcome and pain relief rate, frequency of breakthrough pain, analgesic onset time, analgesia duration, quality of life, and adverse events as reference outcomes.Data Collection and AnalysisWe designed a data-extraction form that was used to extract key information from the articles. Data extraction study evaluation was conducted independently by two reviewers, and a third reviewer would resolve any disagreements. The risk of bias was assessed by the Cochrane Collaboration's tool for assessing the risk bias. The quality of the evidence for main outcomes was evaluated by the GRADE system. Mean differences (MD), relative risk (RR), and 95% confidence intervals (CIs) were calculated. The forest plots were performed using the Review Manager Software (5.3 version). Subgroup analysis was used to investigate the possible sources of potential heterogeneity. Descriptive analysis was performed in case of unacceptable clinical heterogeneity.ResultsThirteen RCTs (with 1,069 patients) were included, and all studies were at high risk of bias owing to lack of blinding or other bias. Eleven studies evaluated the effectiveness of acupuncture as a complementary therapy, and showed that acupuncture plus control treatment (compared with control treatment) was connected with reduced pain intensity (MD = −1.34, 95% CI −1.74 to −0.94; Q < 0.1; I2 = 98%, P < 0.01). Subgroup analyses based on acupoints type partly explain the potential heterogeneity. The results also showed that acupuncture plus control treatment (compared with control treatment) was connected with relieving pain intensity, increasing the pain relief rate, reducing the frequency of breakthrough pain, shortening analgesic onset time, extending the analgesic duration, and improving the quality of life. We have no sufficient evidence to prove the effectiveness of acupuncture alone. Four RCTs reported only adverse events related to opioids' side effects. Evidence was qualified as “very low” because of low methodological quality, considerable heterogeneity, or a low number of included studies.ConclusionAcupuncture has a certain effect as a complementary therapy on pain management of CIBP, which not only mitigates the pain intensity but also improves the quality of life and reduces the incidence of opioids' side effects, although the evidence level was very low. In future, a larger sample size and rigorously designed RCTs are needed to provide sufficient evidence to identify the efficacy and safety of acupuncture as a treatment for CIBP.

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

Cited by 28 publications

References 68 publications

Prevalence of urolithiasis in China: a systematic review and meta‐analysis

Prevalence of urolithiasis in China: a systematic review and meta‐analysis

Illness and injury among Norwegian Para athletes over five consecutive Paralympic Summer and Winter Games cycles: prevailing high illness burden on the road from 2012 to 2020

Acupuncture as a Complementary Therapy for Cancer-Induced Bone Pain: A Systematic Review and Meta-Analysis

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