title: Upcoming Paralympic summer games in Rio: what did the German medical team learn from the London Games?
abstract: BACKGROUND
  Musculoskeletal complaints are frequently diagnosed in Paralympic athletes. Despite the increased professionalism in Paralympic Sports, the documentation of injuries and other health complaints during high-level competition is sparse. With respect to the upcoming Paralympic Summer Games in Rio de Janeiro, the aim of this study was the analysis of all musculoskeletal complaints within the German Paralympic Athletes during the London 2012 Paralympic Games.
  
  
  METHODS
  All musculoskeletal complaints (MSC) of the 150 German athletes seeking medical attention, hereby defined as "injury", were recorded during the in-competition period of the London Paralympics Games (22 days), regardless of their severity and consequences. Standardized documentation included the onset of symptoms, the medical diagnoses, the therapeutic measures taken as well as consecutive restrictions in training and competition. Incidence rates and localizations were analyzed by sports discipline.
  
  
  RESULTS
  A total of 201 musculoskeletal complaints were recorded for 140 athletes (93.3%), corresponding to 1.4 musculoskeletal complaints per "injured" athlete. The incidence of musculoskeletal complaints in German athletes was 62.9±15.4/1000 athlete-days. High incidence rates (IR) were observed in wheelchair basketball (IR 72/1000 athlete-days, 1.6 injuries per athlete) and equestrian events (IR 72.7, 1.6). Musculoskeletal complaints were mainly located in the upper extremities (37.6%) and the spine (37.6%). The most frequent diagnoses were myalgia (N.=105, 52%).
  
  
  CONCLUSIONS
  We noted a high rate of musculoskeletal complaints among German Paralympic athletes across sports and body parts, highlighting the need for prevention programs that focus on the upper extremities and spine.
authors.affiliation: Department of Orthopedic and Trauma Surgery, Faculty of Medicine, Albert Ludwigs University of Freiburg, Freiburg, Germany - johanna.kubosch@uniklinik-freiburg.de.
authors.forename: Eva J
authors.initials: EJ
authors.lastname: Kubosch
authors.affiliation: Orthopedic Outpatient Clinic Cologne, German Disabled Athletes Federation, Köln-Lövenich, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Kosel
authors.affiliation: Department of Sports Medicine Oslo, Oslo Sports Trauma Research Center, Norwegian School of Sports Sciences, Oslo, Norway.
authors.forename: Kathrin
authors.initials: K
authors.lastname: Steffen
authors.affiliation: Department of Orthopedic and Trauma Surgery, Faculty of Medicine, Albert Ludwigs University of Freiburg, Freiburg, Germany.
authors.forename: Lukas
authors.initials: L
authors.lastname: Konstantinidis
authors.affiliation: Department of Orthopedic and Trauma Surgery, Faculty of Medicine, Albert Ludwigs University of Freiburg, Freiburg, Germany.
authors.forename: David
authors.initials: D
authors.lastname: Kubosch
authors.affiliation: Department of Orthopedic and Trauma Surgery, Faculty of Medicine, Albert Ludwigs University of Freiburg, Freiburg, Germany.
authors.forename: Norbert P
authors.initials: NP
authors.lastname: Südkamp
authors.affiliation: Department of Orthopedic and Trauma Surgery, Faculty of Medicine, Albert Ludwigs University of Freiburg, Freiburg, Germany.
authors.forename: Anja
authors.initials: A
authors.lastname: Hirschmüller
mesh_terms: D000328:Adult; D001265:Athletic Injuries / Q000453:epidemiology*; D001490:Basketball / Q000293:injuries; D001938:Brazil; D005260:Female; D005858:Germany / Q000208:ethnology; D006801:Humans; D015994:Incidence; D008131:London / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000293:injuries*; D009141:Musculoskeletal System / Q000293:injuries*; D064846:Sports for Persons with Disabilities / Q000706:statistics & numerical data*; D014910:Wheelchairs