Epidemiologia de problemas de saúde e avaliação periódica no esporte paralímpico

Abstract

Para athletes have experienced a high risk of health problems due to their increased performance in sports competitions in recent years. The main aim of this thesis was to investigate the epidemiology of health problems in para athletes and describe recommendations and guidance for sports health teams regarding periodic health assessments. The first study investigated the prevalence, incidence and profile of musculoskeletal injuries in this population. A systematic review was conducted in August 2019, with an update in May 2020, in the MEDLINE, EMBASE, AMED, SPORTSDiscus and CINAHL databases; forty-two studies were included. The prevalence of musculoskeletal injuries was 40.8% and the incidence was 14.3 per 1000 athlete-days. Injuries were more prevalent in the shoulder for non-ambulant para athletes and in the lower limbs, for ambulant para athletes. The second study described the characteristics, prevalence, incidence, and burden of health problems in para athletes from the Brazilian Paralympic Reference Center, in Belo Horizonte, during a sports season. It compared the prevalence of health problems among the athletics, powerlifting and swimming sports modalities. From October 2019 to March 2020, 35 para athletes participated in the study. Most injuries occurred in the shoulder, and most illnesses caused respiratory and gastrointestinal symptoms. The average weekly prevalence and incidence rate of health problems were 40.6% and 12.7 health problems per 1000 athlete-hours, respectively. Powerlifting had the highest prevalence of all and substantial health problems, swimming had the lowest prevalence of injuries and athletics had the lowest prevalence of illnesses. Finally, the third study described specific considerations and guidance for sports health teams regarding periodic health evaluation in para athletes from the four major impairment groups (intellectual, musculoskeletal, neurological and visual disabilities). A panel of 16 international experts (epidemiologists, physiotherapists, and sport and exercise physicians) with expertise in para athlete health met by video conference to discuss the position statement’s purpose, methods, and themes. They were divided in working groups and asked to add specific considerations related to clinical, cardiorespiratory, neuromusculoskeletal, and nutritional status, mental and sleep health, concussion, and the particularities of female para athletes health assessments. All authors from the position statement compiled and reviewed the initial drafts. Thus, the studies presented in this thesis contribute to better monitoring para athletes’ health problems and periodic health evaluation conducted by sports health teams.