Toni Graf-Baumann

Summary and agreement statement of the 2nd International Conference on Concussion in Sport, Prague 2004

In November 2001, the 1st International Symposium on Concussion in Sport was held in Vienna, Austria to provide recommendations for the improvement of safety and health of athletes who suffer concussive injuries in ice hockey, football (soccer), and other sports. The 2nd International Symposium on Concussion in Sport was organised by the same group and held in Prague, Czech Republic in November 2004. It resulted in a revision and update of the Vienna consensus recommendations, which are presented here.

Summary and agreement statement of the first International Conference on Concussion in Sport, Vienna 2001

Recommendations for the improvement of safety and health of athletes who may suffer concussive injuriesnnIn November 2001, the first International Symposium on Concussion in Sport was held in Vienna, Austria. This symposium was organised by the International Ice Hockey Federation (IIHF), the Federation Internationale de Football Association Medical Assessment and Research Centre (FIFA, F-MARC), and the International Olympic Committee Medical Commission (IOC).nnThe aim of the symposium was to provide recommendations for the improvement of safety and health of athletes who suffer concussive injuries in ice hockey, football (soccer), and other sports. To this end a range of experts were invited to address specific issues of epidemiology, basic and clinical science, grading systems, cognitive assessment, new research methods, protective equipment, management, prevention, and long term outcome, and to discuss a unitary model for understanding concussive injury. At the conclusion of the conference, a small group of experts were given a mandate by the conference delegates and organising bodies to draft a document describing the agreement position reached by those in attendance at that meeting. For the purpose of this paper, this group will be called the Concussion in Sport Group (CISG).nnThis review seeks to summarise the findings of the Vienna conference and to provide a working document that will be widely applicable to sport related concussion. This document is developed for use by doctors, therapists, health professionals, coaches, and other people involved in the care of injured athletes, whether at the recreational, elite, or professional level.nnDuring the course of the symposium, a persuasive argument was made that a comprehensive systematic approach to concussion would be of potential benefit to aid the injured athlete and direct management decisions.1 This protocol represents a work in progress, and, as with all other guidelines or proposals, it must undergo revision …

Prevention of soccer injuries: a prospective intervention study in youth amateur players.

Background: Risk factors for soccer injuries and possibilities for prevention have been discussed by several authors, but only a few have investigated the effectiveness of preventive interventions. Purpose: The aim of the present study was to evaluate the effects of a prevention program on the incidence of soccer injuries in male youth amateur players. Study Design: Prospective controlled intervention study. Methods: Seven soccer teams took part in a prevention program that focused on education and supervision of coaches and players, while seven other teams were instructed to train and play soccer as usual. Over 1 year all injuries were documented weekly by physicians. Complete weekly injury reports were available for 194 players. Results: The incidence of injury per 1000 hours of training and playing soccer was 6.7 in the intervention group and 8.5 in the control group, which equates to 21% fewer injuries in the intervention group. The greatest effects were observed for mild injuries, overuse injuries, and injuries incurred during training. The prevention program had greater effects in low-skill than in high-skill teams. Conclusions: The incidence of soccer injuries can be reduced by preventive interventions, especially in low skill level youth teams. Coaches and players need better education regarding injury prevention strategies and should include such interventions as part of their regular training.

Summary and agreement statement of the 1st International Symposium on Concussion in Sport, Vienna 2001.

BACKGROUNDIn November 2001, the 1st International Symposium on Concussion in Sport was held in Vienna, Austria. This symposium was organized by the International Ice Hockey Federation (IIHF), the Federation Internationale de Football Association Medical Assessment and Research Centre (FIFA, F-MARC),

Football Injuries during FIFA Tournaments and the Olympic Games, 1998-2001: Development and Implementation of an Injury-Reporting System

Background Standardized assessment of sports injuries provides not only important epidemiological information, but also directions for injury prevention, and the opportunity for monitoring long-term changes in the frequency and characteristics of injury. Purpose Development and implementation of an easy to use injury-reporting system to analyze the incidence, circumstances and characteristics of injury during major international football tournaments. Study Design Prospective survey. Methods A comprehensive injury report form was developed, and implemented during 12 international football tournaments. The physicians of all participating teams were asked to report all injuries after each match. The response rate was 84% on average. Results A total of 901 injuries were reported from 334 matches, which is equivalent to an incidence of 2.7 injuries per match. Approximately one injury per match resulted in a players absence from training or matches. On average 86% of the injuries arose as a result of contact with another player, and approximately half of all injuries were caused by foul play. The number of injuries per match differed substantially between the tournaments for players of different age, sex and skill-level. Conclusion An injury-reporting system has been implemented as matter of routine in FIFA tournaments. The consistent findings in the present study demonstrate the high quality of the data obtained.

Football Injuries During the World Cup 2002

Background The Fédération Internationale de Football Association (FIFA) World Cup is one of the largest, most popular sporting events but is associated with a certain risk of injury for the players. Purpose Analysis of the incidence, circumstances, and characteristics of soccer injury during the World Cup 2002. Study Design Prospective survey. Methods The physicians of all participating teams reported all injuries after each match on a standardized injury report form. The response rate was 100%. Results A total of 171 injuries were reported from the 64 matches, which is equivalent to an incidence of 2.7 injuries per match; approximately 1 to 2 injuries per match resulted in absence from training or match. More than a quarter of all injuries were incurred without contact with another player, and 73% were contact injuries. Half of the contact injuries, or 37% of all injuries, were caused by foul play as rated by the team physician and the injured player. Conclusion The incidence of injuries during the World Cup 2002 was similar to those reported for the World Cup in 1994 and in 1998. Increased awareness of the importance of fair play may assist in the prevention of injury.

Risk Factor Analysis for Injuries in Football Players

Review of the literature shows that information concerning risk factors for football injuries is incomplete and partly contradictory. The aim of this study was to analyze the influence of medical history, physical findings, football skills, and football performance, as well as psychosocial characteristics on the occurrence and severity of football injuries. The prospective outline of the study was as follows: after a baseline examination was performed to ascertain possible predictors of injury, all players were followed up weekly for 1 year to register subsequent injuries and complaints. Two hundred sixty-four of 398 players (67%) had complete weekly follow-ups over 1 year. A majority of the players (N = 216; 82%) were injured during the observation period. In comparing injured and uninjured players, several differences were observed. To create a multidimensional predictor score for football injuries, 17 risk factors were selected. These risk factors covered a wide spectrum, such as previous injuries, acute complaints, inadequate rehabilitation, poor health awareness, high life-event stress, playing characteristics, poor reaction time, poor endurance, and insufficient preparation for games. By summing up the individual risk factors, a predictive sum was calculated for each player. The more risk factors present at the baseline examination, the higher the probability of that player incurring an injury in the ensuing year. Using two risk factors as the cut-off score, more than 80% of the players were correctly classified as to whether they went on to incur an injury. Based on these findings, knowledge from the literature, and practical experience, possibilities for a prevention program are suggested.

Summary and Agreement Statement of the Second International Conference on Concussion in Sport, Prague 2004

In November 2001, the First International Symposium on Concussion in Sport was held in Vienna, Austria. This meeting was organized by the International Ice Hockey Federation (IIHF) in partnership with the Federation Internationale de Football (FIFA) and the International Olympic Committee (IOC) Medical Commission. As part of the resulting mandate for the future, the need for leadership and updates was identified. To meet that mandate, the Second International Symposium on Concussion in Sport was organized by the same group and held in Prague, Czech Republic, in November 2004.

Summary and agreement statement of the first international conference on concussion in sport, vienna 2001

BACKGROUND In November 2001, the First International Symposium on Concussion in Sport was held in Vienna, Austria. This symposium was organized by the International Ice Hockey Federation (IIHF), the Federation Internationale de Football Association Medical Assessment and Research Centre (FIFA, F-MARC), and the International Olympic Committee (IOC) Medical Commission. The aim of the symposium was to provide recommendations addressing this important topic for the improvement of safety and health of athletes who suffer concussive injuries in ice hockey, football (soccer), and other sports. To this end, a range of experts were invited to address specific issues of epidemiology, basic and clinical science, grading systems, cognitive assessment, new research methods, protective equipment, management, prevention, and long-term outcome, and to discuss a unitary model for understanding concussive injury. At the conclusion of the conference, a small group of experts was given a mandate by the conference delegates and organizing bodies to draft a document describing the agreement position reached by those in attendance at that meeting. For the purpose of this paper, this group will be called the Concussion in Sport Group.

FIFA's approach to doping in football

Background and objectives: FIFA’s anti-doping strategy relies on education and prevention. A worldwide network of physicians guarantees doping control procedures that are straightforward and leave no place for cheating. FIFA actively acknowledges its responsibility to protect players from harm and ensure equal chances for all competitors by stringent doping control regulations, data collection of positive samples, support of research, and collaboration with other organisations. This article aims to outline FIFA’s approach to doping in football. Method: Description of FIFA’s doping control regulations and procedures, statistical analysis of FIFA database on doping control, and comparison with data obtained by WADA accredited laboratories as for 2004. Results: Data on positive doping samples per substance and confederation/nation documented at the FIFA medical office from 1994 to 2005 are provided. According to the FIFA database, the incidence of positive cases over the past 11 years was 0.12%, with about 0.42% in 2004 (based on the assumption of 20 750 samples per year) and 0.37% in 2005. Especially important in this regard is the extremely low incidence of the true performance enhancing drugs such as anabolic steroids and stimulants. However, there is a need for more consistent data collection and cross checks among international anti-doping agencies as well as for further studies on specific substances, methods, and procedures. With regard to general health impairments in players, FIFA suggests that principles of occupational medicine should be considered and treatment with banned substances for purely medical reasons should be permitted to enable players to carry out their profession. At the same time, a firm stand has to be taken against suppression of symptoms by medication with the aim of meeting the ever increasing demands on football players. Conclusion: Incidence of doping in football seems to be low, but much closer collaboration and further investigation is needed with regard to banned substances, detection methods, and data collection worldwide.