Recurrent and Subsequent Injuries in Professional and Elite Sport: a Systematic Review

Background Injury surveillance in professional sport categorises injuries as either “new” or “recurrent”. In an attempt to make categorisation more specific, subsequent injury categorisation models have been developed, but it is not known how often these models are used. The aim was to assess how recurrent and subsequent injuries are reported within professional and elite sport. Methods Online databases were searched using a search strategy. Studies needed to prospectively report injury rates within professional or elite sports that have published consensus statements for injury surveillance. Results A total of 1322 titles and abstract were identified and screened. One hundred and ninety-nine studies were screened at full text resulting in 81 eligible studies. Thirty studies did not report recurrent injuries and were excluded from data extraction. Within the studies that reported recurrent injuries, 21 reported the number and percentage; 13 reported only the proportion within all injuries; three reported only the number; five reported the number, percentage and incidence; and two only reported the incidence. Seven studies used subsequent injury terminology, with three reporting subsequent injury following concussion, one using an amended subsequent injury model and three using specific subsequent injury categorisation models. The majority of subsequent injuries (ranging from 51 to 80%) were categorised as different and unrelated to the index injury. The proportion of recurrent injuries (exact same body area and nature related to index injury) ranged from 5 to 21%. Conclusions Reporting recurrent or subsequent injuries remains inconsistent, and few studies have utilised subsequent injury models. There is limited understanding of subsequent injury risk, which may affect the development of injury prevention strategies. Trial Registration CRD42019119264

Dual-Task Gait Stability after Concussion and Subsequent Injury: An Exploratory Investigation

Persistent gait alterations can occur after concussion and may underlie future musculoskeletal injury risk. We compared dual-task gait stability measures among adolescents who did/did not sustain a subsequent injury post-concussion, and uninjured controls. Forty-seven athletes completed a dual-task gait evaluation. One year later, they reported sport-related injuries and sport participation volumes. There were three groups: concussion participants who sustained a sport-related injury (n = 8; age =15.4 ± 3.5 years; 63% female), concussion participants who did not sustain a sport-related injury (n = 24; 14.0 ± 2.6 years; 46% female), and controls (n = 15; 14.2 ± 1.9 years; 53% female). Using cross-recurrence quantification, we quantified dual-task gait stability using diagonal line length, trapping time, percent determinism, and laminarity. The three groups reported similar levels of sports participation (11.8 ± 5.8 vs. 8.6 ± 4.4 vs. 10.9 ± 4.3 hours/week; p = 0.37). The concussion/subsequent injury group walked slower (0.76 ± 0.14 vs. 0.65 ± 0.13 m/s; p = 0.008) and demonstrated higher diagonal line length (0.67 ± 0.08 vs. 0.58 ± 0.05; p = 0.02) and trapping time (5.3 ± 1.5 vs. 3.8 ± 0.6; p = 0.006) than uninjured controls. Dual-task diagonal line length (hazard ratio =1.95, 95% CI = 1.05–3.60), trapping time (hazard ratio = 1.66, 95% CI = 1.09–2.52), and walking speed (hazard ratio = 0.01, 95% CI = 0.00–0.51) were associated with subsequent injury. Dual-task gait stability measures can identify altered movement that persists despite clinical concussion recovery and is associated with future injury risk.

Predictors of subsequent injury at work: findings from a prospective cohort of injured workers in New Zealand

ObjectivesPeople who have experienced a work-related injury can experience further work injuries over time. This study examines predictors of subsequent work-related injuries over 24 months among a cohort of injured workers.MethodsParticipants were those recruited to the earlier Prospective Outcomes of Injury Study (POIS) who had a work-related injury (the ‘sentinel’ injury). Data from POIS participant interviews were combined with administrative data from the Accident Compensation Corporation (New Zealand’s no-fault universal injury insurer) and hospital discharge data. Modified Poisson regression modelling was used to examine whether presentinel injury sociodemographic and health, sentinel injury or presentinel injury work-related factors predicted subsequent work-related injuries.ResultsOver a third of participants (37%) had at least one subsequent work-related injury in 24 months. Factors associated with an increased risk of work-related subsequent injury included being in a job involving carrying or moving heavy loads more than half the time compared with those in jobs that never involved such tasks (RR 1.42, 95% CI 1.01 to 2.01), having an inadequate household income compared with those with an adequate household income (RR 1.33, 95% CI 1.02 1.74) and being aged 50–64 years compared with those aged 30–49 years (RR 1.25, 95% 1.00 to 1.57).ConclusionSubsequent work-related injuries occur frequently, and presenting with a work-related injury indicates a potentially important intervention point for subsequent injury prevention. While the strength of associations were not strong, factors identified in this study that showed an increased risk of subsequent work-related injuries may provide a useful focus for injury prevention or rehabilitation attention.