An eHealth Application of Self-Reported Sports-Related Injuries and Illnesses in Paralympic Sport: Pilot Feasibility and Usability Study

Background Sport participation is associated with a risk of sports-related injuries and illnesses, and Paralympic athletes’ additional medical issues can be a challenge to health care providers and medical staff. However, few prospective studies have assessed sports-related injuries and illnesses in Paralympic sport (SRIIPS) over time. Advances in mobile phone technology and networking systems offer novel opportunities to develop innovative eHealth applications for collection of athletes’ self-reports. Using eHealth applications for collection of self-reported SRIIPS is an unexplored area, and before initiation of full-scale research of SRIIPS, the feasibility and usability of such an approach needs to be ascertained. Objective The aim of this study was to perform a 4-week pilot study and (1) evaluate the monitoring feasibility and system usability of a novel eHealth application for self-reported SRIIPS and (2) report preliminary data on SRIIPS. Methods An eHealth application for routine collection of data from athletes was developed and adapted to Paralympic athletes. A 4-week pilot study was performed where Paralympic athletes (n=28) were asked to weekly self-report sport exposure, training load, general well-being, pain, sleep, anxiety, and possible SRIIPS. The data collection was followed by a poststudy use assessment survey. Quantitative data related to the system use (eg, completed self-reports, missing responses, and errors) were analyzed using descriptive statistics. The qualitative feasibility and usability data provided by the athletes were condensed and categorized using thematic analysis methods. Results The weekly response rate was 95%. The athletes were of the opinion that the eHealth application was usable and feasible but stated that it was not fully adapted to Paralympic athletes and their impairments. For example, it was difficult to understand how a new injury or illness should be identified when the impairment was involved. More survey items related to the impairments were requested, as the athletes perceived that injuries and illnesses often occurred because of the impairment. Options for description of multifactorial incidents including an injury, an illness, and the impairment were also insufficient. Few technical issues were encountered, but athletes with visual impairment reported usability difficulties with the speech synthesizer. An incidence rate of 1.8 injuries and 1.7 illnesses per 100 hours of athlete exposure were recorded. The weekly pain prevalence was 56% and the impairment contributed to 20% of the reported incidents. Conclusions The novel eHealth-based application for self-reported SRIIPS developed and tested in this pilot study was generally feasible and usable. With some adaptation to accommodate Paralympic athletes’ prerequisites and improved technical support for athletes with visual impairment, this application can be recommended for use in prospective studies of SRIIPS. Trial Registration ClinicalTrials.gov NCT02788500; https://clinicaltrials.gov/ct2/show/NCT02788500 (Archived by WebCite at http://www.webcitation.org/6v56OqTeP)

[1]  Steve Krug,et al.  Don't Make Me Think, Revisited: A Common Sense Approach to Web Usability , 2013 .

[2]  Esme Jordaan,et al.  Illness and injury in athletes during the competition period at the London 2012 Paralympic Games: development and implementation of a web-based surveillance system (WEB-IISS) for team medical staff , 2013, British Journal of Sports Medicine.

[3]  J. J. Caro Sr,et al.  Does electronic implementation of questionnaires used in asthma alter responses compared to paper implementation? , 2004, Quality of Life Research.

[4]  Corinne Peek-Asa,et al.  Sports Injuries to High School Athletes With Disabilities , 2009, Pediatrics.

[5]  Gregg C. Vanderheiden,et al.  Web Content Accessibility Guidelines (WCAG) 2.0 , 2008 .

[6]  Toomas Timpka,et al.  Electronic data capture on athletes’ pre-participation health and in-competition injury and illness at major sports championships: An extended usability study in Athletics , 2018, Health Informatics J..

[7]  Jiri Dvorak,et al.  Towards the reduction of injury and illness in athletes: defining our research priorities , 2016, British Journal of Sports Medicine.

[8]  Nigel Bevan,et al.  Extending Quality in Use to Provide a Framework for Usability Measurement , 2009, HCI.

[9]  M. Schwellnus,et al.  High incidence of injury at the Sochi 2014 Winter Paralympic Games: a prospective cohort study of 6564 athlete days , 2016, British Journal of Sports Medicine.

[10]  Roald Bahr,et al.  The Oslo Sports Trauma Research Center questionnaire on health problems: a new approach to prospective monitoring of illness and injury in elite athletes , 2013, British Journal of Sports Medicine.

[11]  Carolyn Emery,et al.  The epidemiology of injuries at the London 2012 Paralympic Games , 2013, British Journal of Sports Medicine.

[12]  Caroline F Finch,et al.  Sports Injury Surveillance Systems: A Review of Methods and Data Quality , 2015, Sports Medicine.

[13]  Toomas Timpka,et al.  Meta-narrative analysis of sports injury reporting practices based on the Injury Definitions Concept Framework (IDCF): A review of consensus statements and epidemiological studies in athletics (track and field). , 2015, Journal of science and medicine in sport.

[14]  Örjan Dahlström,et al.  The Sports-Related Injuries and Illnesses in Paralympic Sport Study (SRIIPSS): a study protocol for a prospective longitudinal study , 2016, BMC Sports Science, Medicine and Rehabilitation.

[15]  R Bahr,et al.  Recording injuries among World Cup skiers and snowboarders: a methodological study , 2011, Scandinavian journal of medicine & science in sports.

[16]  Michael K Drew,et al.  Performance success or failure is influenced by weeks lost to injury and illness in elite Australian track and field athletes: A 5-year prospective study. , 2016, Journal of science and medicine in sport.

[17]  Toomas Timpka,et al.  Design of a protocol for large-scale epidemiological studies in individual sports: the Swedish Athletics injury study , 2010, British Journal of Sports Medicine.

[18]  Jacob O. Wobbrock,et al.  Slide rule: making mobile touch screens accessible to blind people using multi-touch interaction techniques , 2008, Assets '08.

[19]  R. Bollinger,et al.  Feasibility and Acceptability of Smartphone-Based Ecological Momentary Assessment of Alcohol Use Among African American Men Who Have Sex With Men in Baltimore , 2015, JMIR mHealth and uHealth.

[20]  Jakob Nielsen,et al.  Usability engineering , 1997, The Computer Science and Engineering Handbook.

[21]  Cheryl Cott,et al.  The Electronic Patient Reported Outcome Tool: Testing Usability and Feasibility of a Mobile App and Portal to Support Care for Patients With Complex Chronic Disease and Disability in Primary Care Settings , 2016, JMIR mHealth and uHealth.

[22]  Elske Ammenwerth,et al.  BMC Medical Informatics and Decision Making , 2022 .

[23]  Paul B Gastin,et al.  Monitoring athletes through self-report: factors influencing implementation. , 2015, Journal of sports science & medicine.

[24]  M. Schwellnus,et al.  The incidence and patterns of illness at the Sochi 2014 Winter Paralympic Games: a prospective cohort study of 6564 athlete days , 2016, British Journal of Sports Medicine.

[25]  James R. Lewis,et al.  IBM computer usability satisfaction questionnaires: Psychometric evaluation and instructions for use , 1995, Int. J. Hum. Comput. Interact..

[26]  Luc P de Witte,et al.  User-centered development and testing of a monitoring system that provides feedback regarding physical functioning to elderly people , 2013, Patient preference and adherence.

[27]  Stuart E Willick,et al.  Risk of Injuries in Paralympic Track and Field Differs by Impairment and Event Discipline , 2016, The American journal of sports medicine.

[28]  Peter Van de Vliet,et al.  Paralympic medicine , 2012, The Lancet.

[29]  E. Teijlingen,et al.  The importance of pilot studies. , 2002, Nursing standard (Royal College of Nursing (Great Britain) : 1987).

[30]  B Sheehan,et al.  A comparison of usability factors of four mobile devices for accessing healthcare information by adolescents. , 2012, Applied clinical informatics.

[31]  Caroline Finch,et al.  A new framework for research leading to sports injury prevention. , 2006, Journal of science and medicine in sport.

[32]  Örjan Dahlström,et al.  Paralympic athletes’ perceptions of their experiences of sports-related injuries, risk factors and preventive possibilities , 2016, European journal of sport science.

[33]  Keshia M Pollack,et al.  Developing and Implementing Major League Baseball's Health and Injury Tracking System. , 2016, American journal of epidemiology.

[34]  V. Braun,et al.  Using thematic analysis in psychology , 2006 .

[35]  Bambang Parmanto,et al.  A Persuasive and Social mHealth Application for Physical Activity: A Usability and Feasibility Study , 2014, JMIR mHealth and uHealth.

[36]  Wai Man Chung,et al.  Musculoskeletal Injuries in Elite Able-Bodied and Wheelchair Foil Fencers—A Pilot Study , 2012, Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine.

[37]  K. Steffen,et al.  German translation and content validation of the OSTRC Questionnaire on overuse injuries and health problems , 2016, British Journal of Sports Medicine.

[38]  Evert Verhagen,et al.  Sport Injuries Sustained by Athletes with Disability: A Systematic Review , 2016, Sports Medicine.

[39]  Maria E Fernandez,et al.  How we design feasibility studies. , 2009, American journal of preventive medicine.

[40]  Willem van Meche Incidence, Severity, Aetiology and Prevention of Sports Injuries A Review of Concepts , 1992 .

[41]  J. Lexell,et al.  Sports‐related injuries in athletes with disabilities , 2014, Scandinavian journal of medicine & science in sports.