Epidemiology of Sports Injuries in Nigeria

EPIDEMIOLOGY OF SPORTS INJURIES IN NIGERIA

By

Dr. Oluwatoyosi Owoeye (Ph.D)Department of Physiotherapy, College of Medicine, UNILAG

Keynote Lecture at the 2014 NOH, Igbobi Annual Scientific Conference/Workshop tagged “Sports Injuries”

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Outline

•Definition of Key Terms•Background•Why is the Present Topic Important?•Injury Risk Management Model•What Exactly are the figures?•General Sports•Specific Sports•Summary•Recommendations•End Notes

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Definition of Key Terms

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Epidemiology

•The study of the determinants of disease events (sports injuries) in populations (Mosby's Medical Dictionary, 2009)

•Science that deals with the study of the causes, distribution, and control of disease (sports injuries) in populations (American Heritage Medical Dictionary, 2004)

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Athletes!

•Recreational/Amateur•Semi-professional

•Professional

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Injury in Sports• Dictionary definition of sport injury…

• Other several definitions!!! For a long time …>>> confusion and complexities in developing sports injury prevention models

• In 2005/2006… Medical Commissions of UEFA, FIFA and IOC published consensus statements on definitions for sports injuries(…..Fuller et al, 2006)

▫ MEDICAL ATTENTION… ▫ TIME-LOSS

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Other Injury Definitions

•Acute Injury vs Overuse Injury•Recurrent Injury•Injury Rate – Prevalence vs Incidence•Injury Mechanism•Injury Severity

Gold standard definitions!

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Applications….!•Studies conducted in different parts of the

world can be justifiably compared with one another, thus enhancing and consolidating a global model for injury prevention

•BUT! …… sports medicine and science researchers in developing countries must follow the gold standard

•Nigeria is doing that… research team at UNILAG

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Why is the Present Topic Important?

•To keep participants in action!- Prevention –

• …..personal, social benefits & economic benefits...

• #exerciseismedicine #sportsforhealth

• …high level of participation…UNILAG Study (Owoeye et al, 2014) Male students 78.4% Female 41.2%

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Background

•Epidemiologic research methods form the cornerstone of public health; and same applies to athletes’ health

•As much as injuries can be prevented in sports, they can not be totally eliminated

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Injury Risk Management Model (Fuller et al, 2012)

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The Nigeria Factor!!

• In Nigeria prevention is our cure…!

• Prevention of injuries should always be a priority and is even more important when treatment possibilities are restricted, as in many parts of Africa (Constantinou, 2010).

• ….documenting injury epidemiology and conducting injury surveillance studies is fundamental and first step in the sequence of prevention…

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•The frequency and characteristics of sports injuries have been shown to vary not only with different styles of play, but also between gender, age groups, levels of play, geographical regions and countries

(Dvorak and Junge, 2000) – Am J Sports Med

…..justifies the need for local epid studies….

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Peculiarity in the Nigerian Cohort…………Nigerian athletes are faced with huge challenges

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(Owoeye et al, 2013)

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We also need to remember…!Participation in a vigorous sports exposes players not only to MS injuries but also to risk of CV events….

- CV Health of PlayersSports Physio unit + Cardiology Unit of the Dept of Physiotherapy & Medicine , UNILAG collaboration … …baseline RFs

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What exactly are the figures???

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QUICK BACKGROUND!

Looking back 5 years…

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…From Popular Scientific Search Engines2009 – 2014 (5-year period)

•Pubmed•Google Scholar•Researchgate

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General Sports…

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Owoeye et al (2009) - Int J Rheum

A Retrospective Study of Sports Injuries Reported at the National Sports Medicine

Centre, Lagos, South-West, Nigeria

• Total of 171 sports injuries in 7 yrs 24injuries/yr

• Male to female ratio of 2:1• Muscle strain followed by sprain• Majority of the injuries affected the LE (mostly

thigh and Knee)

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Distribution of Injuries in Selected Sports

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Owoeye (2010) - Sports Medicine, Arthroscopy, Rehabilitation, Therapy & Technology

Pattern and Management of Sports InjuriesPresented by Lagos State Athletes at the 16thNational Sports Festival (KADA games 2009)

inNigeria

• 655 athletes with age range, 15-38 years• 20.2% injury prevalence • male to female ratio of 2:1 • Mostly “minor” injuries • Muscle strain (31.4%) followed by ligament sprains

(22.9%). • The LE most injured accounting for 50% of all injuries

basketball, cricket, hockey, rugby and baseball… FB?

• Popular rxs - Cryotherapy followed by bandaging

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Severity of Injuries

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Specific Sports

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Basketball

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Owoeye et al (2012) - Sports Medicine, Arthroscopy, Rehabilitation, Therapy & Technology

Incidence and pattern of injuries amongadolescent basketball players in Nigeria

• Study revealed 22.7 injuries per 100 participants; equivalence of 1.0 injury per match

• Injuries mostly affected the LEs and the pattern of injuries was similar in both genders

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Body Parts Injured

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Owoeye et al (2013) – OA Sports Medicine

Musculoskeletal injuries among professional players of the Nigeria female basketball

league: A need for intervention• Age range - 18.2 ± 2.66 years • A total of 108 injuries were sustained by 58

players • I-year injury prevalence of 55.8% (all) and 33.3%

(TL). • Match vs training injuries (P = 0.330) • Sprains and strains mostly diagnosed• LE injuries predominated• Point guards sustained more injuries than

players in other positions- one out of three players suffered a time-loss injury

during a league season

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Injury Distribution by Body Location

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Marathon Athletes

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Ogwumike and Adeniyi (2013) - BMC Sports Science, Medicine, and Rehabilitation

The SPLASH/ICPC integrity marathon in Ibadan, Nigeria: incidence and management of injuries and marathon-related health problems

• Injury prevalence was 16.3% and 17.2% in the maiden and 2nd editions of the said race

• Muscle cramps and heat exhaustion were mostly recorded

• Thigh muscle mostly injured• Cryotherapy was mostly used and by PTs

…Most of the injuries and other health problems were reported by first-time marathon runners

mainly at the finish line

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Boxers

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Oke et al (2012) - Global Advanced Research J of Med and Med Sci

Nature and Incidences of musculoskeletal injuries in Nigeria male amateur boxing engagements

• Age range: 21 – 27years

• 3.9 injuries per athlete …injuries per match ??

• Upper extremities were mostly injured

• Sprains, strains and lacerations were mostly reported

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Injuries by Type and Body Location

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Karate

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Owoeye et al (2012) - Unpublished

Injury Profile in Nigerian Karate Athletes

• A prospective survey• In a total of 300 bouts, 83 injuries were reported

by 64 athletes from a cohort of 270 athletes during a national competition…. 1/4

0.3 injury/bout (0.37 male > 0.16 female)• Head mostly injured; primarily contusions

followed by laceration• Though injuries were mostly mild, 1 of 6 injuries

was severe

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Volleyball

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Owoeye et al (2014) – In view

Injuries in Volleyball Players: Assessment of Nigerian Players at the

20th NSF

Overall prevalence 7.6%0.54 injury per match 1, male; 0.1, femaleLE mostly affected ankle and knee sprains

Injuries mostly medical attention and mild

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Football

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Owoeye et al (2014) – Br J Sports Med

Lower Extremity Injuries among Nigerian Male Youth Football Players

•A total of 227 players sustained 307 time-loss LE injuries (range, 1–6 injuries) with an overall 1-year prevalence rate of 32.5%; equivalent to 1.4 injuries/player per year

•Ankle then knee mostly injured•Match > Training injuries (P<0.001)•About 1 of 2 injuries (48.5%) moderate severity

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Akodu et al (2012) - Afri J of Med & Med Sci

Incidence and Characteristics of Injuries during the 2011 West Africa Football Union (WAFU) Nations’ Cup

•89 injuries/1000 player hours (match) = 9.9 injuries per match

•Injury characteristics similar to previous studies

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Owoeye et al (2014) - J Sports Sci & Med

Efficacy of the FIFA 11+ Warm-up Programme in Male Youth Football: A Cluster Randomised

Controlled TrialExtract

• 0.4 injuries/training & 20.3 injuries/match

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Recreational Athletes

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Owoeye et al (2014) – In View

Sports Participation, Injuries and Risk Factors among UNILAG Students

•Males 58.3% *TL•Females 30.3%

•Sprain…•Knee, ankle, lower leg…

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Conclusion• Epidemiology of sports injuries for prevention is

a continuum

• This review provides information that is imperative for prompt intervention by stakeholders and the government for all athletes...

• Prevention of sports injuries is the most viable option in Nigeria

• Football, basketball and track/field events pose the highest injury risk

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• Injuries mostly range from minimal/mild injuries to moderate injuries

• Injury trend appears to be in congruence with the nature of the different sports however, LE injuries are the most common; majorly characterised by sprains and strains and mostly affecting the knee, ankle and thigh

• The prevalence/incidence of injuries is much higher compared to reports from Europe and other parts of the world; however, the characteristics of injuries are similar

• Sports injuries are equally highly prevalent among recreational athletes

• There is need for more prospective studies… and a need for systematic implementation…

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Recommendations• Government and stakeholders should fund

research relating to prevention of injuries and protection of health in Nigerian athletes to establish a Nigerian Model

• Provision of qualified medical professionals…during competitions… national/states/LGs

• There is a need for a functional and vibrant Sports Science, Medicine & Rehab Conglomerate in Nigeria

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End Note

Not everything that counts can be counted, and not everything that can be counted counts

▫Albert Einstein

That which has been counted should be made to count

▫Oluwatoyosi Owoeye

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THANK YOU FOR YOUR ATTENTION!

@owoeyeobaobowoeye@unilag.edu.ng

07032602437

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References

Available on request…