title: Fit and healthy Paralympians--medical care guidelines for disabled athletes: a study of the injuries and illnesses incurred by the Polish Paralympic team in Beijing 2008 and London 2012.
abstract: BACKGROUND
  Successful performance in Paralympic Games (PGs) requires continuous monitoring of the athletes' health and optimal medical care.
  
  
  OBJECTIVE
  To present the health status and disability category of Polish athletes at the Beijing and London PGs, as well as to compare the injuries and illnesses incurred during both PGs in view of the more stringent healthcare guidelines implemented before London.
  
  
  METHODS
  The preparticipation examination (PPE) involved general medical/orthopaedic examination, ECG, blood and urine tests. The mandatory periodic health evaluation (PHE) introduced before London comprised general medical/orthopaedic/dental examination, anthropometric measurement, ECG, stress test, laryngological and ophthalmological consultations, and blood and urine tests. The incidence rate (IR) for all injuries/illnesses with 95% CI, incidence proportion and exposure data (athlete-days) were calculated.
  
  
  RESULTS
  There were 91 Polish Paralympians in Beijing and 100 in London. Medical consultations decreased from 151 to 74 (injuries: 57 vs 24 and illnesses: 94 vs 50). In both PGs, respiratory tract infections (RTIs) were the most frequent: IR increased from 15.2 in Beijing to 18.1 in London/1000 athlete-days (95% CI 9.7 to 20.7 vs 11.5 to 24.7). In both PGs, most injuries/illnesses concerned Paralympians with spinal cord injuries. The PPE before both PGs confirmed the disability type according to the general medical classification and revealed no health-related contraindications. Only 6.6% of athletes before Beijing but 100% before London had undergone the multispecialist PHE.
  
  
  CONCLUSIONS
  In both PGs, illnesses were more frequent than injuries. RTIs presented a serious problem. Some groups of disabled athletes are at an increased risk of injury/illness. The more stringent medical care guidelines before London may have caused staggeringly better results.
authors.affiliation: Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Kraków, Poland. w.gawronski@medicinasportiva.pl
authors.forename: Wojciech
authors.initials: W
authors.lastname: Gawronski
authors.forename: Joanna
authors.initials: J
authors.lastname: Sobiecka
authors.forename: Jacek
authors.initials: J
authors.lastname: Malesza
mesh_terms: D000328:Adult; D001265:Athletic Injuries / Q000453:epidemiology / Q000628:therapy*; D002681:China / Q000453:epidemiology; D005260:Female; D006304:Health Status; D006801:Humans; D015994:Incidence; D008131:London / Q000453:epidemiology; D008297:Male; D010808:Physical Examination / Q000379:methods; D010809:Physical Fitness / Q000502:physiology; D011044:Poland / Q000208:ethnology; D017410:Practice Guidelines as Topic; D013178:Sports Medicine / Q000706:statistics & numerical data*; D064846:Sports for Persons with Disabilities
keywords: Athletics; Disabled; Evaluation; Olympics; Sporting Injuries