Paralympic Sports Medicine and Science Descriptive Epidemiology of Paralympic Sports Injuries Nick Webborn, MB, BS FSEM (UK), Carolyn Emery, PT, PhD Abstract: Paralympic sports have seen an exponential increase in participation since 16 patients took part in the first Stoke Mandeville Games on the opening day of the 1948 London Olympic Games. More than 4,000 athletes took part in the London 2012 Para- lympic Games. Few sporting events have seen such rapid evolution. This rapid pace of change also has meant challenges for understanding the injury risks of participation, not only because of the variety of sports, impairment types, the evolution of adapted equip- ment but also because of the inclusion of additional impairment types and development of new sports over time. Early studies were limited in scope but patterns of injuries are slowly emerging within Winter and Summer Paralympic sports. The IPC’s London 2012 study is the largest to date with a prospective cohort study involving 49,910 athlete-days. The results identified large differences across sports and highlighted the need for longitudinal sport specific studies rather than solely games-time studies. This will require collaboration with international sports federations to examine injury patterns and risk factors for injury in this population to appropriately inform injury prevention strategies. Further studies will also need to address the impact of sporting participation, injury, and future health. PM R 2014;6:S18-S22 INTRODUCTION Paralympic sports have seen an exponential increase in participation since 16 patients took part in the first Stoke Mandeville Games on the opening day of the 1948 London Olympic Games. More than 4000 athletes took part in the London 2012 Paralympic Games to packed audiences and worldwide television coverage. Few sporting events have seen such a rapid evolution. This rapid pace of change also has meant challenges for understanding the injury risks of participation because of inclusion of additional impairment types and development of new sports. In 1960, the International Stoke Mandeville Games were held in Rome and since that time, the Games have been held in the country selected for the Olympic Games where possible, save for financial or political reasons. In 1976, in Toronto, the Games included visually impaired and amputee athletes for the first time, and the Games were known as the Olympiad for the Physically Disabled. In 1980, in Arnhem, athletes with physical disabilities not fitting into the historical disability groups (Les Autres; fr. “the others”) or with cerebral palsy also were included. The International Paralympic Committee (IPC) was founded in 1989, and since 1994 the management of the Paralympic Games has been administered byr the IPC. Although athletes with intellectual disabilities have participated in some Paralympic Games, they are not included in this review. The data for this review were primarily published articles and reports from a literature search of PubMed and SPORTDiscus; however, information from Congress proceedings and both published and unpublished articles known to the authors but not identified through these database sources also were evaluated. English-language articles were used primarily, but some German texts were incorporated where translation could be per- formed. Search terms involved permutations and combinations of Paralympic, injury, ce- rebral palsy, visually impaired, wheelchair, disability, and sport. A variety of methodologic limitations, which confound the interpretability of the findings, were evident in the literature, particularly in earlier studies. Factors included a lack of standard definitions for reportable injury and injury details, short study timeframes, N.W. The Centre for Sport and Exercise Sci- ence and Medicine (SESAME), University of Brighton, Eastbourne, UK. Address corre- spondence to: N.W.; e-mail: nickweb- born@sportswise.org.uk Disclosure: nothing to disclose C.E. University of Calgary, Alberta, Canada Disclosure: nothing to disclose Submitted for publication January 31, 2014; accepted June 10, 2014. S18 PM&R 1934-1482/14/$36.00 Printed in U.S.A. ª 2014 by the American Academy of Physical Medicine and Rehabilitation Vol. 6, S18-S22, August 2014 http://dx.doi.org/10.1016/j.pmrj.2014.06.003