Validity of the SPEx sports injury surveillance system for time-loss and medical attention injuries in sports

Abstract

The accurate measurement of sport exposure time and injury occurrence is key to effective injury prevention and management. Current measures are limited by their inability to identify all types of sport-related injury, narrow scope of injury information, or lack the perspective of the injured athlete. The aims of the study were to evaluate the proportion of injuries and the agreement between sport exposures reported by the SMS messaging and follow-up telephone part of the SMS, Phone, and medical staff Examination (SPEx) sports injury surveillance system when compared to measures obtained by trained on-field observers and medical staff (comparison method). We followed 24 elite adolescent handball players over 12 consecutive weeks. Eighty-six injury registrations were obtained by the SPEx and comparison methods. Of them 35 injury registrations (41%) were captured by SPEx only, 10 injury registrations (12%) by the comparison method only, and 41 injury registrations (48%) by both methods. Weekly exposure time differences (95% limits of agreement) between SPEx and the comparison method ranged from -4.2 to 6.3 hours (training) and -1.5 to 1.0 hours (match) with systematic differences being 1.1 hours (95% CI 0.7 to 1.4) and -0.2 (95% CI -0.3 to -0.2), respectively. These results support the ability of the SPEx system to measure training and match play exposures and injury occurrence among young athletes. High weekly response rates (mean 83%) indicate that SMS messaging can be used for player measures of injury consequences beyond time-loss from sport. However, this needs to be further evaluated in large-scale studies. This article is protected by copyright. All rights reserved.

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TABLES AND FIGURES
Table 1. Demographics of participants.
(n=24)
Sex
Boys n (%)
10 (42)
Girls n (%)
14 (58)
Age group
U-16 n (%)
6 (25)
U-18 n (%)
18 (75)
Mean age (sd)
17.0 (0.9)
Player position
Back players n (%)
9 (38)
Wing players n (%)
9 (38)
Line players n (%)
4 (17)
Goal keepers n (%)
2 (8)
Mean years handball experience (sd)
9.7 (3.0)
Mean hours weekly handball training (sd)
9.6 (3.2)

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Table 2. Injury registrations by SPEx and comparison (Observer+medical staff) methods.
Observer + medical staff
SPEx
Injury
No injury
Total
Injury
41
35
76
No injury
7
157
210
Unknown injury status due
to missing responses
3
45
Total
51
237
288

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Table 3. Injury consequenses by the SPEx and comparison (Observer+medical staff method).
Observer + medical staff
SPEx
None
(0 weeks)
Mild
(1 week)
Moderate
(2-4 weeks)
Severe
(>4 weeks)
Total
None (0 weeks)
7
1
0
0
8
Mild (1 week)
2
0
1
0
3
Moderate (2-4 weeks)
1
2
4
0
7
Severe (>4 weeks)
0
1
2
3
6
Total
10
4
7
3
24

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Table 4. Exposure time by the SPEx and comparison (Observer+medical staff) methods
SPEx
Observer +
medical staff
Bias
(95% CI)
Limits of
agreement (95%)
All
players
Mean
(95% CI)
All
players
Mean
(95% CI)
Training*
(hours)
1315
5.6
(5.2 to 6.0)
1269
4.5
(4.1 to 4.8)
1.1
(0.8 to 1.5)
-4.3 to 6.6
Match †
(hours)
119
0.5
(0.4 to 0.6)
216
0.8
(0.7 to 0.9)
-0.3
(-0.3 to -0.2)
-1.5 to 1.0
Total
(hours)
1434
6.1
(5.7 to 6.5)
1484
5.2
(4.8 to 5.6)
0.9
(0.5 to 1.3)
-4.7 to 6.5
* Based on 235 observations due to 53 missing responses in SPEx
† Based on 236 observations due to 52 missing responses in SPEx

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Please also find the figures uploaded separately
Figure 1. SMS message flow in SPEx
*Response modified compared to the original OSTRC overuse questionnaire (Clarsen et al. 2013).

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Figure 2. Injury registrations by the SPEx and reference (Observer) methods during the 12-week study period.
● Previous reported injury or injury before study start by reference (Observer) method ○ Previous reported injury or
injury before study start by SPEx ◆ New injury by reference (Observer) method ◇ New injury by SPEx ・Missing
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ID
12345678910 11 12
Week
Observer
SPEx
New Observer
New SPEx
Missing