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Medical

IPC Medical Code

The IPC Medical Code will come into force in 2013 and aims to further improve the safety of athletes participating in the Paralympic Movement.

Developed to ensure that all sport is practiced in a safe manner, the Code make the health of an athlete its leading priority by minimizing and controlling the risks of physical injury and psychological harm.

It also develops measures to protect athletes who suffer injury in their dealings with healthcare professionals.

This is the first initiative of the IPC Medical Committee, formed in November 2009.

The epidemiology of injuries and illnesses at the London 2012 Paralympic Games

Under the IPC Medical Code, the IPC is dedicated to improving the safety of Paralympic sport, and pursues multiple courses of actions to mitigate injury and illness risks. Among these initiatives, the IPC Medical Committee conducted an epidemiological study to monitor injury and illness in athletes competing at the London 2012 Paralympic Games.

All but 4 nations participated in the project by reporting athlete injury and illness on a daily basis in a web-based surveillance system. The period of data collection was 14 days, from 27 August through 9 September 2012 (11 days of the competition period and 3 days of the pre-competition period). The outcomes have recently been published in scientific journals (see references below).

Data have been captured from 3565 athletes from 160 delegations. The main findings can be summarized as follows:

- the incidence rate for injury (injury per 1000 athlete-days) was 12.7. The incidence rate for illness was 13.2. Rates are similar across gender. These rates are slightly higher compared to findings in able-bodied elite sportsmen participating in multisport settings.

- illnesses are at least as prevalent as injuries during Paralympic Games.

- most injuries are acute injuries at the Games, and mostly related to upper limb regions (shoulder, elbow, wrist and hand).

- the sports with the highest incidence rates are football 5-a-side, powerlifting, goalball, wheelchair fencing and wheelchair rugby. Safest sports are shooting, rowing and sailing.

- most illnesses are reported for athletes competing in equestrian, powerlifting, and athletics. Least vulnerable to illness are the athletes in football 7-a-side, shooting and football 5-a-side.

- mainly illnesses of respiratory, skin, digestive, nervous and genitourinary systems are reported.

It is the first time such large scale epidemiological study took place on (elite) athletes with an impairment. These data have direct clinical relevance. e.g., a team physician travelling to a 10-day event with 100 Paralympic athletes can anticipate seeing about 12–13 injuries, about half of which will be new onsets, acute injuries. If the team composition includes athletes participating in the higher risk sports listed above, it is likely that the team will incur more than 12–13 injuries. The team physician should be ready to diagnose and treat a high percentage of upper limb injuries, and anticipate a range of illnesses to deal with.

The IPC will replicate this project in the Sochi 2014 Paralympic Winter Games and beyond, while currently analysing data more in detail by sport and/or impairment type.

Original Publications (available from the IPC upon request):

- Derman, W., Schwellnus, M., Jordaan, E., Blauwet, C., Emery, C., Pit-Grosheide, P., Patino Marques, N.A., Martinez-Ferrer, O., Stomphorst, J., Van de Vliet, P., Webborn, N., & Willick, S. (2013). Illness and injury in athletes during the competition period at the London 2012 Paralympic Games – Development and implementation of a web-based surveillance system (web-IISS) for team medical staff. British Journal of Sports Medicine, 47, 420-425.

- Willick, S., Webborn, N., Emery, C., Blauwet, C., Pit-Grosheide, P., Stomphorst, J., Van de Vliet, P., Patino Marques, N.A., Martinez-Ferrer, O., Jordaan, E., Derman, W., & Schwellnus, M. (2013). The epidemiology of injuries at the London 2012 Paralympic Games. British Journal of Sports Medicine, 47, 426-432.

- Schwellnus, M., Derman, W., Jordaan, E., Blauwet, C., Emery, C., Pit-Grosheide, P., Patino Marques, N.A., Martinez-Ferrer, O., Stomphorst, J., Van de Vliet, P., Webborn, N., & Willick, S. (2013). Factors associated with illness in athletes participating in the London 2012 Paralympic Games – A prospective cohort study involving 49910 athlete days. British Journal of Sports Medicine, 47, 433-440.

FIMS

In 2009, the IPC and the International Federation of Sports Medicine (FIMS) officially signed and put in effect an agreement that aims to improve mutual knowledge on the health, safety, research and performance of athletes with an impairment. Both organisations intend for this collaboration to advance science, professional education and practice, and health and safety relating to Paralympic sports and athletes with an impairment.

To learn more about FIMS, please visit the official website: www.fims.org

NPC Team Physician Conference

The first-ever medical conference was hosted jointly by both the IPC and the Vancouver 2010 Organising Committee (VANOC) on 15 March 2010, with an audience of about 60 attendees, including team physicians, sport representatives, researchers, and general physicians. The conference was a unique opportunity for physicians to share knowledge in the medical area related to Paralympic sport, with speakers that included representatives from the Paralympic Movement.

The IPC plans for similar initiatives at future Paralympic Games.

Presentations from the first NPC Team Physician Conference can now be downloaded:

Paralympic Team Physician Needs and Demands (Davidson)

Paralympic Athletes Competing in Extreme Conditions (O'Connor)

Autonomic Dysreflexia and Boosting (Thompson)

Sport Injury from Salt Lake to Vancouver (Webborn)

Operational Aspects of Paralympic Games Related Medical Services (Wilkinson)

The presentations from the second NPC Team Physician Conference can be found here:

Training OCOG Medical Workforce to serve Paralympic Sports (Pleskov)

Autonomic dysfunctions in Paralympic athletes (Krassioukov)

Team physicians needs and demands on medical care for paralympic athletes (Stinus)

Athlete health and safety issues in Ice Sledge Hockey (Blase)

Safe Sport: The Pre-Participation Examination (Grimm)

The influence of the sit ski position on performance and daily life activity – a case report (Assländer, Albert, Rapp, Rombach)

Safe sport: Anti-doping perspectives (Webb)

Clinical Lessons for Team Physicians: what the IISS tells us (Derman)

Sports participation in extreme (cold) environments (Thompson)

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