KEEPING THE SCORE ON SPORTS: New Trends And Programs Dr. Khaled - PowerPoint PPT Presentation

KEEPING THE SCORE ON SPORTS: New Trends And Programs Dr. Khaled Basiouny Trauma/Acute Care/Surgical Critical Care/Asst. Professor of Surgery George Washington University Karen Liller, Ph.D. Professor and AAAS Fellow University of South Florida Dr. Tad Seifert Director, Norton Healthcare’s Sports Concussion Program University of Kentucky

Sports Injury Surveillance for High School Athletes in West-Central Florida  Karen D. Liller, PhD*  Barbara Morris, DHSc**  Siew Wong, MPH*  Siwon Jang, PhD*** *University of South Florida (USF) College of Public Health, **Florida Hospital • Wesley Chapel, ***USF Center for Urban Transportation Research

ATC TEAM  SMART ATC Team  Sharvettye Frazier Kathryn Hill  Ian Graulich Morgan Williams  Anna Griffiths Manuel Ozoa  Jennifer Stollery Donnie Schaffer  Tara Mendres  Ashley Ahearn  Kevorey Hartwell  Crista Colaneri  Jordan Poole  Kayla Wilhide

SPORTS INJURY IN ADOLESCENTS  The literature shows that there are approximately 1,000,000 sports injuries reported annually to 10-17 year olds.  Sports injuries lead to losses of thousands of dollars each year.  Sports injuries are one of the leading reasons for school-related hospitalizations.

SPORTS INJURY SURVEILLANCE  National data do exist on sports injuries, but are NOT specific to the state of Florida nor include all sports played in high schools.  There is no comprehensive data source that captures injury incidence, prevalence, risk factors, and most importantly exposure information for high school athletes in Florida.

SMART INJURY REGISTRY  To meet the high school sports injury surveillance needs, the SMART Injury Registry was created in 2007.  The Registry was part of the initiatives of the Sports Medicine and Athletic-Related Trauma Institute (SMART) of the University of South Florida College of Medicine.

SMART INJURY REGISTRY  The SMART leaders hired and trained 10 certified athletic trainers (ATCs) who were placed in 10 high schools in west-central Florida to serve the medical needs of athletes and to collect the injury data.  Schools were selected based on willingness to participate and need for a certified athletic trainer in the school.

SMART INJURY REGISTRY  The foundation of the Registry was developed from software (Simtrak™).  Exposure variables were added and were defined as the number of athletes at each practice and/or competition each week.

SMART INJURY REGISTRY  Other added variables (nearly 1,000 changes) included:  Demographics;  Level of Play;  Time and Season of injury;  Equipment and Rules Compliance;  Injury Mechanism, Activity, Environmental Conditions, Field Locations and Positions;  Concussion Information; and  Injury Outcomes.

SMART INJURY REGISTRY  Data were collected and entered electronically by the ATCs and sent by email to the researchers.  Data were sent blinded to the research team.  The collection of data for injury analysis was approved by the University of South Florida Institutional Review Board.

SMART INJURY REGISTRY  Content validity was established by a panel of experts and the accuracy and reliability of ATC data collection procedures was verified before the ATCs collected data in the schools.  This system of data collection was used from 2007-2011.  Different tools were reviewed after 2011 to save costs and the decision was made to join Reporting Information Online or the RIO system for the 2012-2013 academic year until present.

SELECTION OF DATA TOOL  RIO is a sports-injury surveillance system funded by the Centers for Disease Control and Prevention and the National Federation of High School Associations.  Dataset and definitions nearly identical to our original Simtrak system.  Internet-based system where ATCs can submit and update reports when needed.

DEFINITION OF INJURIES  Injuries that occur as a result of participation in an organized high school competition or practice;  requires medical attention by a team physician, certified athletic trainer, personal physician, or emergency department/urgent care facility; and  results in restriction of the high school athlete’s participation for one or more days beyond the day of the injury*  *Any fracture, concussion, or dental injury regardless of restriction status is reported.

SPORTS INJURY REGISTRY  Data were collected on the following sports:  Football  Baseball  Softball  Cheerleading  Volleyball  Swimming (men and women)  Track (men and women)  Cross-country (men and women)  Soccer (men and women)

SPORTS INJURY REGISTRY Sports Included:  Basketball (men and women)  Lacrosse (men and women)  Wrestling  Other sports (largely flag football)

SPORTS INJURY REGISTRY  Athlete and exposure data collected by the ATCs and reported in weekly reports submitted by RIO to investigators monthly.  The 2013-2014 data includes 15 high schools in west- central Florida.  Data were analyzed with SAS 9.3.  All data collection and analyses were approved by the University of South Florida Institutional Review Board.

2013-2014 RESULTS  ATC Participation in Schools  Directly supervised approximately 4,694 athletes from enrolled schools.  Were present at 7,557 practices and 1,492 games  Supervised 24,201 athletes from competing schools

2013-2014 RESULTS Exposure Rates:  Leading rate of injury per 1,000 athletic exposures for practices was for women’s lacrosse at 3.36, followed by other sports at 3.04 and football at 3.00.  Leading rate of injury per 1,000 athletic exposures for competitions was for football at 14.4, followed by other sports at 9.59, and wrestling at 7.72.

2013-2014 RESULTS  Frequencies:  Five-hundred-seventy-four injuries were reported by the ATCs for 2013-2014.  Greatest number of injuries in football (N=270), followed by boys’ wrestling (N=33), girls’ soccer (N=33), and boys’ basketball (N=30).  Most injuries took place during the regular season (75.6%).  Injuries occurred during practices mostly during the first 1-2 hours (58.8%).

2013-2014 RESULTS  Most injured athletes were juniors (26.9%), followed by sophomores (26.0%), seniors (24.7%), and freshmen (22.4%).  Principle body parts injured were the head/face (21.6%), knee (15.7%), and ankle (14.6%).  Leading types of injuries were ligament sprains (26.0%), concussions (19.7%), and muscle strains (13.4%).  Most injuries did not require surgery (93.3%) and were new injuries (85.2%).  Most athletes returned to play in 3-6 days (22.3%) followed by 10-21 days (19.0%).

2013-2014 RESULTS  Injuries were mostly evaluated by the ATCs (94.9%) followed by a general physician (41.1%).  Leading assessment methods were evaluation (95.6%) followed by x-ray (35.5%).

2013-2014 RESULTS  Overall, boys had significantly greater sports injury rates (RR 1.82, CI 1.52-2.19) and in competitions (RR 2.87, CI 2.12-3.91) and practices (RR 1.39, CI 1.10-1.75).  However, in some sports, results differed. For example in girl’s soccer, girls had greater injury rates overall (RR 2.36, CI 1.33-4.19) than boys and greater rates in soccer competitions (RR 2.13, CI 1.05-4.32).

RESULTS Injury Diagnoses by Type of Exposure Study Performance, n=3 Competition, n=247 Practice, n=324 (Cheerleading only) 38 69 15.4% 1 1 24 21.3% 100 33.3% 33.3% 9.7% 138 32 40.5% 42.6% 28 9.9% 11.3% 29 1 57 56 9.0% 33.3% 23.1% 17.3% Sprain/strain Concussion Contusion Fracture Other Note: Other injury type included subluxation, tendonitis, dislocation, torn cartilage, laceration, heat illness/injury, hyperextension, bursitis, Jersey finger, torn ACL ligament, pathology with previous ORIF, syncope, seizure, dehydration, nerve injury, separation, shin splints, avulsion, stress fracture, torn LCL, impingement, shoulder impingement, & skin infection.

RESULTS Time Loss By Type of Exposure Performance, n=3 Competition, n=239 Practice, n=315 (Cheerleading only) 21 8.8% 62 54 62 1 19.7% 17.1% 25.9% 55 1 33.3% 31 23.0% 33.3% 68 9.8% 18 21.6% 54 7.5% 51 32 46 1 17.1% 21.3% 13.4% 14.6% 33.3% 1-2 days 3-6 days 7-9 days 10-21 days >21 days Other Note: Other included season ended before athlete returned to activity, medical disqualification for season, athlete chose not continue (no medical disqualification), unknown due to ATC departure, athlete quit the team without follow up, medical disqualification for career, & returned to activity in <1 day (for fractures, concussions, and/or dental injuries only). Missing data not included in analysis.

RESULTS New and Recurring Injuries by Type of Exposure Surveillance Performance, n=3 Competition, n=247 Practice, n=324 (Cheerleading only ) 3 17 1.2% 5.2% 28 37 11.3% 11.4% 3 100% 216 270 87.4% 83.3% New Recurrence (this academic year) Recurrence (previous academic year)