Toomas Timpka

• MD PhD
• Professor (Full) at Linköping University

Objective Elite para athletes report a high incidence of sports injuries. Research suggests that athletes’ strategies to manage adversities may influence the sports injury risk, but knowledge about para athletes’ coping behaviours and their association with injuries is limited. The aim was to describe the distribution of coping behaviours in Swedis...

We aimed to use the digital platform maintained by the local health service providers in Southeast Sweden for integrated monitoring of disparities in vaccination and morbidity during the COVID-19 pandemic. The monitoring was performed in the adult population of two counties (n = 657,926) between 1 February 2020 and 15 February 2022. The disparities...

Objective: In Athletics (Track and Field), athletes can be affected by injuries, especially in their quest for top performance. Therefore, we aim to provide an overview of the current knowledge about the problem of injuries in Athletics. Main findings: It is necessary to maintain a clear definition of “injury” when stakeholders in Athletics discuss...

Epidemiological studies suggest that psychiatric disorders are as prevalent among high-performance athletes as in general populations, challenging the myth of invulnerability. Despite efforts of sports organisations to highlight the significance of athletes' mental health, it is still many times tough to combine the sports performance ethos with a...

Background Figure skaters typically jump in only one direction, landing on the same leg. Current prevention programs in figure skating lack knowledge about the importance of jumping direction in injury etiology. Objective To describe lateralisation (handedness, footedness, jumping direction) in female competitive figure skaters and its association...

Background Although it has been established that the risk of musculoskeletal injury is substantial during cross-country running competitions, lack of knowledge regarding causes of performance-limiting issues restricts the possibilities for prevention. Objective To estimate body-systems level and location-specific causal associations between pre-ra...

Background Elite athletes are role models for young sportspersons regarding social media use. Self-objectification, including self-sexualizing, contributes to body dissatisfaction and body shame, especially in young females. For efficient prevention of self-objectification, knowledge is needed about elite athletes’ self-presentation on social media...

Objectives: Despite scientific evidence that confirms their effectiveness, use of vaccines and microbiological mass testing during the COVID-19 pandemic has been associated with social and moral controversies. In this commentary, it is suggested how such conflicts originating from moral/normative imperatives can be managed in infectious disease co...

Objectives To analyse anxiety and depression caseness (defined as a screening condition qualifying for psychiatric examination) and factors associated with anxiety caseness. Methods All competitive figure skaters in the southeastern region of Sweden (N=400) were in April 2019 invited to participate in a cross-sectional study using an online quest...

Objectives: Despite early notions that correct attribution of deaths caused by SARS-CoV-2 infection is critical to the understanding of the COVID-19 pandemic, three years later, the accuracy of COVID-19 death counts is still contested. We aimed to compare official death statistics with cause-of-death assessments made in a clinical audit routine by...

Enabling athletes to achieve peak performances while also maintaining high levels of health is contextually complex. We aim to describe what a ‘health system’ is and apply the essential functions of stewardship, financing, provision of services and resource generation to an Australian high-performance sport context. We introduce a fifth function th...

BAKGRUND Konståkning är en populär sport bland unga tjejer. Trots alla positiva effekter av idrott kan konståkning, liksom andra idrotter, medföra risk för fysisk och psykisk ohälsa. Det finns dessvärre få studier om unga konståkares psykiska hälsa. SYFTE Primärt syfte var att hos deltagare analysera behov för närmare klinisk kartläggning (sk casen...

Objective: Although injury burden prompts elite athletics (track and field) athletes to engage in injury management, little is known about their health literacy. We investigated musculoskeletal (MS) health literacy in world-leading athletics athletes and associations with prechampionship injury acknowledgement by reduction of training load in diff...

BAKGRUND Sociala medier används av idrottsutövare på alla nivåer, även av elitidrottare som är stora förebilder för ungdomar. En omtalad negativ aspekt av publicering av bilder på sig själv och sin kropp i sociala medier är självobjektifiering, dvs. antagande att ens värde bestäms av ens fysiska utseende och den sexuella attraktion man framkallar....

BAKGRUND Konståkning är en populär sport bland unga tjejer. Trots alla positiva effekter av idrott kan konståkning, liksom andra idrotter, medföra risk för fysisk och psykisk ohälsa. Det finns dessvärre få studier om unga konståkares psykiska hälsa. SYFTE Primärt syfte var att hos deltagare analysera behov för närmare klinisk kartläggning (sk case...

Background In preparation of future pandemics, it is important to recognise population-level determinants associated with development of severe illness before efficient vaccines and evidence-based therapeutic measures are available. The aim of this study was to identify pre-pandemic diagnoses recorded in a middle-aged and elderly population that we...

Objectives Little is known about figure skaters’ mental health. This study aimed to describe anxiety and depression caseness (defined as a screening condition qualifying for psychiatric examination) in competitive figure skaters and analyse factors associated with such caseness. Methods A cross-sectional study was performed in April 2019 among all...

Introduction: Little is known about young figure skaters' mental health. This study aimed to analyze anxiety and depression caseness (a screening condition qualifying for psychiatric examination) in a representative Swedish population of licensed competitive figure skaters. Furthermore, factors associated with anxiety caseness were examined. Mate...

Objectives To examine whether universal prevention via a digital health platform can reduce the injury incidence in athletics athletes aged 12–15 years and if club size had an influence on the effect of the intervention. Methods This was a cluster randomised trial where young athletics athletes were randomised through their club following stratifi...

Objectives To analyse the association between pre-participation health status and in-championships injuries in a large dataset from seven international athletics championships, and to determine the health status of athletes during the four weeks before the start of international athletics championships. Design Prospective cohort study Methods We...

The WHO defines mental health as ‘a state of well-being in which an individual realises his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully and is able to make a contribution to his or her community’ (p. 12). According to this definition, mental health is more than a lack of symptoms of mental i...

The term hybrid immunity is used to denote the immunological status of vaccinated individuals with a history of natural infection. Reports of new SARS-CoV-2 variants of concern motivate continuous rethought and renewal of COVID-19 vaccination programs. We used a naturalistic case-control study design to compare the effectiveness of the BNT162b2 mRN...

Computational models for predicting the early course of the COVID-19 pandemic played a central role in policy-making at regional and national levels. We performed a systematic review, data synthesis, and secondary validation of studies that reported on prediction models addressing the early stages of the COVID-19 pandemic in Sweden. A literature se...

This research set out to identify pathways from vulnerability and stressors to depression in a global population of young athletes. Retrospective data were collected at age 18–19 years from Athletics athletes (n = 1322) originating from Africa, Asia, Europe, Oceania, and the Americas. We hypothesised that sports-related and non-sports-related stres...

BACKGROUND With participants engaging in more intense and longer training sessions, the physical loads increase among young figure skaters. Figure skaters jump in one direction, always landing on the same leg. Therefore, asymmetrical load and lateral dominance may play an important role in figure skating injuries, but this has not yet been investig...

The app-based COVID Symptom Study was launched in Sweden in April 2020 to contribute to real-time COVID-19 surveillance. We enrolled 143,531 study participants (≥18 years) who contributed 10.6 million daily symptom reports between April 29, 2020 and February 10, 2021. Here, we include data from 19,161 self-reported PCR tests to create a symptom-bas...

In applied program settings, such as in natural environment control and education, performance evaluation is usually conducted by evaluators considering both self-comparison and comparison with peers. We have developed the performance outcome scoring template (POS-T) for assessments with high face-validity in these settings. POS-T puts achievements...

We report on local nowcasting (short-term forecasting) of coronavirus disease (COVID-19) hospitalizations based on syndromic (symptom) data recorded in regular healthcare routines in Östergötland County (population ≈465,000), Sweden, early in the pandemic, when broad laboratory testing was unavailable. Daily nowcasts were supplied to the local heal...

The present cross-sectional study examined the actor-partner interdependence effect of fear of COVID-19 among Iranian pregnant women and their husbands and its association with their mental health and preventive behaviours during the first wave of the COVID-19 pandemic in 2020. A total of 290 pregnant women and their husbands (N = 580) were randoml...

Vaccination is the most effective way to control the COVID-19 pandemic, but vaccination hesitancy threatens this effort worldwide. Consequently, there is a need to understand what influences individuals’ intention to get a COVID-19 vaccine. Restriction of information gathering on societal developments to social media may influence attitudes towards...

The transmission of COVID-19 is dependent on social mixing, the basic rate of which varies with sociodemographic, cultural, and geographic factors. Alterations in social mixing and subsequent changes in transmission dynamics eventually affect hospital admissions. We employ these observations to model and predict regional hospital admissions in Swed...

The mortality due to stroke is increasing. Accurate prediction of stroke-caused death is very important for healthcare. Data mining methods are novel ways to predict these mortality risks. The aim of this study is to employ popular data mining algorithms to predict the survival of stroke patients and extract decision rules. The data on stroke patie...

Background Physical and sexual abuse victimization have been connected with negative effects on health long after the abuse has stopped. When athletes encounter situations of defeat and entrapment, the likelihood that suicidal ideation will emerge is increased in situations when negative motivational elements are present, for instance, at low level...

Background Competing in international athletics championships bears the risk of injury. Athletics is composed of different disciplines with different physical, mechanical, technical and psychological demands, leading to different injury rates according to disciplines. However, the specific injury characteristics according to disciplines have not b...

Background Although figure skating attracts several hundred thousand participants worldwide, there is little knowledge about physical health and sports injuries among young skaters. Objective To describe the health status of a geographically-defined Swedish population of licensed competitive figure skaters and to examine injury determinants. Desi...

Background Sports-related injuries and illnesses in Paralympic sport is a growing concern, but knowledge about the aetiology and risk factors is limited. Objective To describe the annual incidence of injuries and illnesses among Paralympic athletes and to assess risk factors. Design Prospective cohort study. Setting Paralympic athletes Patients...

In applied program settings, such as in natural environment control and education, performance evaluation is usually conducted by evaluators considering both self-comparison and comparison with peers. We have developed the Performance Outcome Scoring Template (POS-T) for assessments with high face-validity in these settings. POS-T puts achievements...

International outdoor athletics championships are typically hosted during the summer season, frequently in hot and humid climatic conditions. Therefore, we analysed the association between apparent temperature and heat‐related illnesses occurrence during international outdoor athletics championships and compared its incidence rates between athletic...

Little is known about provision of medical services to adolescents prior to participating in international top-level sports. This study aimed to investigate experiences of medical service provision among high-level adolescent athletics (track and field) athletes from three continents. A thematic narrative analysis was applied to data collected from...

The app-based COVID Symptom Study was launched in Sweden in April 2020 to contribute to real-time COVID-19 surveillance. We enrolled 143,531 study participants (≥18 years) who contributed 10.6 million daily symptom reports between April 29, 2020 and February 10, 2021. Data from 19,161 self-reported PCR tests were used to create a symptom-based mode...

Introduction: Although figure skating attracts several hundred thousand participants worldwide, there is little knowledge about physical health and sports injuries among young skaters. The present study aimed to describe the health status of a geographically defined Swedish population of licensed competitive figure skaters and to examine injury det...

The Imperial College COVID-19 Response Team (ICCRT) concluded in a series of high-profile reports that lockdown had been the most effective non-pharmaceutical intervention in 11 European countries during the initial phase of the corona pandemic. As the ICCRT used a transparent modeling framework, we were able to examine assumptions made in the mode...

To examine prevalence of verbal, physical and sexual abuses in young elite athletes, a cross sectional questionnaire-based survey was conducted during the World Athletics under 20 World Championships. This questionnaire aimed at distinguishing between abuses perpetrated in the context of Athletics from those which were unrelated to Athletics. Four...

During public emergencies, a door can open on the fundamental elements upon which a society's social order is built. The Covid-19 pandemic has opened such a door in societies worldwide. We outline in this commentary some of these social elements and how they may have influenced face mask use during the early stages of the pandemic. The purpose is t...

Background Recurrence is a problem for many patients who have episodes of depression. In experimental settings, hyporeactivity in the Electrodermal Orienting Reactivity (EDOR) test has been observed to be more frequent in these patients. The aim of this study was to investigate the clinical value of this test with regard to a prognosis of episode r...

Objectives The aim was to describe levels of subjective Health Literacy (HL), and to examine possible differences in prevalence proportions between sexes, age groups and level of educations among youth athletes and their mentors (coaches, parents/caregivers) in Swedish Athletics Design Cross-sectional. Methods Data on subjective HL were collected...

The transmission of COVID-19 is dependent on social contacts, the rate of which have varied during the pandemic due to mandated and voluntary social distancing. Changes in transmission dynamics eventually affect hospital admissions and we have used this connection in order to model and predict regional hospital admissions in Sweden during the COVID...

The timing of influenza case incidence during epidemics can differ between regions within nations and states. We conducted a prospective 10-year evaluation (January 2008-February 2019) of a local influenza nowcasting (short-term forecasting) method in 3 urban counties in Sweden with independent public health administrations by using routine health...

Objective To investigate how elite track and field athletes with a history of musculoskeletal pain (MSKP) describe their perceptions of clinical treatments based on dry needling guided by a neurological map (neuroanatomical dry needling (naDN)). Design Qualitative study. Methods In-depth interviews were conducted with eight elite Swedish track an...

The role of non-pharmaceutical interventions (NPIs) on the spread of SARS-CoV-2 has drawn significant attention, both scientific and political. Particularly, an article by the Imperial College COVID-19 Response Team (ICCRT), published online in Nature on June 8, 2020, evaluates the efficiency of 5 NPIs. Based on mortality data up to early May, it c...

Introduction: A series of modelling reports that quantify the effect of non pharmaceutical interventions (NPIs) on the spread of the SARS-CoV-2 virus have been made available prior to external scientific peer-review. The aim of this study was to investigate the method used by the Imperial College COVID-19 Research Team (ICCRT) for estimation of NPI...

Introduction Sports‐related injuries and illnesses in Paralympic sport (SRIIPS) is a concern, but knowledge about the aetiology and risk factors is limited. The aim of this study was to describe the annual incidence, type and severity of injuries and illnesses among Swedish Paralympic athletes and to assess risk factors. Methods Swedish Paralympic...

High quality sports injury research can facilitate sports injury prevention and treatment. There is scope to improve how our field applies best practice methods—methods matter (greatly!). The 1st METHODS MATTER Meeting, held in January 2019 in Copenhagen, Denmark, was the forum for an international group of researchers with expertise in research me...

Synopsis: High-quality sports injury research can facilitate sports injury prevention and treatment. There is scope to improve how our field applies best-practice methods-methods matter (greatly!). The first METHODS MATTER meeting, held in January 2019 in Copenhagen, Denmark, was the forum for an international group of researchers with expertise i...

The aim of this study was to develop athletics health guidance (AHG) aimed at supporting coaches and parents involved in organised child athletics by providing practical advice and tools for the management of the most common health problems experienced in athletics by the 12 to 15‐year olds. The study used participatory action research (PAR) and an...

Objective To examine associations between suicidal ideation and sexual and physical abuse among active and recently retired elite athletics (track and field) athletes. Methods The study population consisted of all athletes (n=402) selected for a Swedish Athletics team between 2011 and 2017. Data on suicidal ideation, suicidal events (estimated thr...

The mothers’ nutritional literacy is an important determinant of child malnourishment. We assessed the effect of a smartphone-based maternal nutritional education programme for the complementary feeding of undernourished children under 3 years of age in a food-secure middle-income community. The study used a randomised controlled trial design with...

Injury and illness surveillance, and epidemiological studies, are fundamental elements of concerted efforts to protect the health of the athlete. To encourage consistency in the definitions and methodology used, and to enable data across studies to be compared, research groups have published 11 sport-specific or setting-specific consensus statement...

Background Injury and illness surveillance, and epidemiological studies, are fundamental elements of concerted efforts to protect the health of the athlete. To encourage consistency in the definitions and methodology used, and to enable data across studies to be compared, research groups have published 11 sport- or setting-specific consensus statem...

Objectives: To investigate champion long-distance runners' strategies for managing injury and illness symptoms and staying well. Design: Qualitative research study. Methods: Twelve long-distance runners were interviewed immediately after having competed in World Championships finals. Thematic analysis was used to categorise and structure the d...

There is a need for clinical indicators that can be used to guide the treatment of Achilles tendon complaints in recreational runners. Diagnostic ultrasound has recently been introduced for clinical decision support in tendon pain management. The aim of this study was to determine whether tendon thickness and morphological changes in the Achilles t...

Objective To analyse differences between athletic disciplines in the frequency and characteristics of injuries during international athletics championships. Methods Study design, injury definition and data collection procedures were similar during the 14 international championships (2007–2018). National medical teams and local organising committee...

Objectives: To investigate whether self-reported health complaints and choice of heat stress prevention strategies during the taper predicted peaking at an athletics championship in hot conditions. Design: Cohort study. Methods: Data on health and heat stress prevention were collected before the 2015 World Athletics Championship in Beijing, Ch...

Background Athletes competing in athletics (track and field) at international level may be participating with underlying undiagnosed life-threatening cardiovascular conditions. Our objective was to analyse variations in pre-participation cardiac evaluation prevalence among athletes participating in two International Association of Athletics Federat...

Background Long-distance runners’ understandings of overuse injuries are not well known which decreases the possibilities for prevention. The common sense model (CSM) outlines that runners’ perceptions of a health problem can be described using the categories identity, consequence, timeline, personal control, and cause. The aim of this study was to...

Introduction: Successful team performance has been associated with traits of individual team members that facilitate team interaction and function. Personalities combine different traits and other psychological characteristics as defined by instruments such as the Big Five personality model. In this study we raised the question if there are certain...

Background: With increased participation in Paralympic sport, the burden of sports-related injuries and illnesses may increase. However, there is limited knowledge about the epidemiology of sports-related injuries and illnesses in Paralympic sport [SRIIPS]. Objective: To describe among Swedish Paralympic athletes the 1-yr retrospective period pr...

Objectives: To investigate health-related factors associated with self-rated race performance outcomes among recreational long-distance runners. Design: Panel study. Methods: Data were collected from runners one month before and after a community-level race event including distances from 8 to 42.2 km. The primary outcome measure was self-rated...

This exploratory study aimed to investigate whether data from track and field athletes support a conceptual model where the perception of pain affects self-evaluated health directly, yet is also indirectly mediated through personal factors and external stressors. A cross-sectional study was performed among athletes (n = 278) competing at the highes...

Background Malnutrition is one of the most important reasons for child mortality in developing countries, especially during the first 5 years of life. We set out to systematically review evaluations of interventions that use mobile phone applications to overcome malnutrition among preschoolers. Methods The review was conducted and reported accordi...

Purpose: This review set out to summarise, define, and provide future direction towards the use of performance outcome measures as endpoints in research performed at international benchmark events in athletics. Methods: Scoping review methodology was applied through a search of the PubMed and Sports Discus databases and a systematic article sele...

Illnesses impair athletes’ participation and performance. The epidemiology of illness in athletics is limited. Objective To describe the occurrence and characteristics of illnesses during international athletics championships (indoor and outdoor), and to analyse differences with regards to athletes’ sex and participation in explosive and endurance...

Introduction Sports-related injuries and illnesses in Paralympic sport (SRIIPS) is a growing concern, but knowledge about the etiology of SRIIPS is limited. The aim of this study was to prospectively assess the incidence and risk factors of SRIIPS among Swedish Paralympic athletes during 52 weeks. Materials and methods 107 Paralympic athletes week...

The purpose of this study was to describe among Paralympic athletes the 1-year retrospective period prevalence of severe sports-related injuries and illnesses (SRIIPS) and point prevalence of SRIIPS, and to examine possible differences in prevalence proportions of SRIIPS, between athletes with different demographics, and characteristics related to...

The importance of understanding the prodromal phase of Parkinson’s disease (PD) by systematic recording of prediagnostic symptoms and reductions in body functions has been highlighted. The aim of this study was to investigate whether persons later diagnosed with PD exhibit increased physician-certified sickness absence 1, 2, and 5 years prior to a...

The growing availability of big data in healthcare and public health opens possibilities for infectious disease control in local settings. We prospectively evaluated a method for integrated local detection and prediction (nowcasting) of influenza epidemics over 5 years, using the total population in Östergötland County, Sweden. We used routine heal...

Technical Appendix 2. Programming code used in evaluation of nowcasting for detection and prediction of local influenza epidemics, Sweden, 2009–2014.

Technical Appendix 1. Method design overview of evaluation of nowcasting for detection and prediction of local influenza epidemics, Sweden, 2009–2014.

Value-based purchasing is increasingly discussed in association with efforts to develop modern healthcare systems. These models are the most recent example of models derived from health economics research intended to reform collectively financed healthcare. Previous examples have ranged from creation of pseudo-markets to opening these markets for c...

Objective To examine associations between lifetime sexual and physical abuse, and the likelihood of injury within and outside sport in athletes involved in competitive athletics. Methods A cross sectional study was performed among the top 10 Swedish athletics athletes using 1 year prevalence of sports and non-sports injuries as the primary outcome...

Background: One common model utilized to understand clinical staff and patients' technology adoption is the technology acceptance model (TAM). Objective: This article reviews published research on TAM use in health information systems development and implementation with regard to application areas and model extensions after its initial introductio...

This study set out to identify factors critical for the usability of electronic data collection in association with championships in individual sports. A qualitative analysis of electronic data collection system usability for collection of data on pre-participation health from athletes and in-competition injury and illness from team physicians was...

Background: International middle- and long-distance running competitions attract millions of spectators in association with city races, world championships, and Olympic Games. It is therefore a major concern that ill health and pain, as a result of sports overuse, lead to numerous hours of lost training and decreased performance in competitive run...