|Year : 2014 | Volume
| Issue : 2 | Page : 109-114
Prevalence and pattern of sport injuries among college students in Delhi, India
Varun Kumar, Abha Mangal, Geeta Yadav, Deepak K Raut, Saudan Singh
Department of Community Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
|Date of Web Publication||9-Oct-2014|
Department of Community Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi -110 029
Background: While the benefits of sport such as gain of fitness, reducing risk of diseases, or recreation are well-known among policy makers, relatively very little attention is paid to its unwanted side-effect, the injuries. Sports injuries are a burden to both individuals and the society. Therefore, a study was conducted to determine the prevalence and pattern of sport injuries among college students in Delhi, India. Materials and Methods: The study was cross-sectional and pretested, self-administered questionnaire was used. The study was primarily directed towards the members of sports teams (both intra- and intercollege teams) and athletes in selected college in Delhi and complete enumeration of the study subjects was performed. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 21. Results: The prevalence of sport injury was 73.4%. Males suffered more injuries than females. There was a significant statistical difference with age (P = 0.008), students of 20 years and above suffering more injuries than their younger participants. The prevalence of sport injuries was more among those who do not have coaches (P = 0.001, odds ratio (OR) 3.49) and also those who did not receive any formal training (P = 0.000, OR 2.26). Only 68.8% took some form of treatment and very few (26.1%) practiced injury preventive measures. Conclusion: A diligent search for factors contributing to sports injuries is essential for injury management. Attention to preventive measures and appropriate supervision will allow youngsters to continue to enjoy sports in a safer way.
انتشار ونمط الإصابات الرياضية بين طلاب الجامعات في دلهي، الهند
خلفية الدراسة: على الرغم من فوائد الرياضة مثل زيادة اللياقة البدنية, الترفيه عن النفس، أوالحد من مخاطر الأمراض، علما بأن هذه الفوائد معروفة بين واضعي السياسات الصحية, نجد ان القليل من الاهتمام قد وجدته الآثار الجانبية غير المرغوب فيها، وبالتحديد الإصابات الرياضية والتى تشكل عبئا على كل من الأفراد الممارسين للرياضة بشكل خاص والمجتمع بشكل عام. ولذلك، تم إجراء دراسة لتحديد مدى انتشار ونمط الإصابات الرياضية بين طلاب الجامعات في دلهي.
المواد والطرق: وكانت دراسة مستعرضة ، تمت باستخدام الاستبيان الذاتى. وكانت موجها بالدرجة الأولى أعضاء الفرق الرياضية (من داخل وخارج الجامعة) بالاضافة الى رياضيين في كليات مختارة في مدينة دلهي. كل البيانات التى جمعت تم تحليلها باستخدام الحزمة الإحصائية للعلوم الاجتماعية (SPSS) نسخة 21.
النتائج: كان معدل انتشار الإصابات الرياضة 73.4٪. وكانت إصابات الذكور أكثر من الإناث. وكان هناك فروق ذات دلالة إحصائية مع التقدم في العمر (P = 0.008)، والطلاب من 20 سنة وما فوق يعانون إصابات أكثر من الذين هم أصغر سنا. وكان انتشار الإصابات الرياضية أكثر بين أولئك الذين لم يكن لديهم مدربين (P = 0.001، نسبة الأرجحية 3.49) وأيضا أولئك الذين لم يتلقوا أي تدريب رسمي (P = 0.000، أو 2.26) وهناك نسبة 68.8٪ فقط من المشاركين هم الذين تلقوا شكلا من أشكال العلاج وعدد قليل جدا (26.1٪) تمارس التدابير الوقائية من الاصابات.
الخلاصة: هناك حاجة للبحث الدؤوب عن العوامل التي تساهم في احداث الإصابات الرياضية وهذا أمر ضروري للتغلب على الاصابات. وايضا الانتباه إلى التدابير الوقائية والإشراف المناسب والذى يسمح للشباب مواصلة الاستمتاع بالرياضات بطريقة أكثر أمانا.
Keywords: College students, India, sport injury
|How to cite this article:|
Kumar V, Mangal A, Yadav G, Raut DK, Singh S. Prevalence and pattern of sport injuries among college students in Delhi, India
. Saudi J Sports Med 2014;14:109-14
|How to cite this URL:|
Kumar V, Mangal A, Yadav G, Raut DK, Singh S. Prevalence and pattern of sport injuries among college students in Delhi, India
. Saudi J Sports Med [serial online] 2014 [cited 2021 Jun 25];14:109-14. Available from: https://www.sjosm.org/text.asp?2014/14/2/109/142360
| Introduction|| |
Sport is one of the most common and widespread recreational activity and a common cultural element of modern societies. The enthusiasm shown in sport is considered as an identity of an affluent society. Sport plays a significant role in education and socialization, patriotism and community spirit, recreation and health enhancement, and also in well-being and entertainment. There are many advantages of sport on health like decreasing the risk of obesity, cardiovascular disease, hypertension, diabetes, and improving physical fitness to name a few, and the number of people participating in sporting activities is on the rise over last few decades. Sport and exercise contributes both to the physical and mental health of an individual. 
However, participation in sports also entails a risk of injury for all athletes, right from the professional level sport persons down to the amateurs.  Injuries in youth sports account for substantial morbidity and cost.  Sports injuries result from acute trauma or repetitive stress associated with athletic activities. In many cases, these types of injuries are due to overuse of a part of the body when participating in a certain activity. 
It is also suggested, however, that to improve the overall health of people we must increase sports participation and physical exercise. A common assumption is that the health benefits achieved through leisure and sports activities far outweigh the costs of injuries, which are often considered to be an inevitable part of exercise.  Recommendations made for preventing sports injuries are, promotion of using protective equipment and adequate warming up before competition or routine prophylaxis program before the start of training sessions or playing competitive games. Since increasingly many youth are involved in sport programs, health and safety are major issues. Research findings conflict on the exact epidemiology of youth sport injuries. 
While the societal benefits of sport, as gain of fitness, reducing risk of diseases, recreation, educational effects, or integration of marginalized groups are well aware among policy makers, relatively little attention is paid to the unwanted side-effects of injuries. There are preventative steps that can be taken in order to reduce the incidence and severity of youth sport injuries. The most important step is identifying contributing factors and addressing changes in order to prevent injury.
Sports injuries are a burden to both individuals and the society with respect to duration and nature of the treatment, the amount of sports and working time lost, permanent damage and disability, reduced quality of life, and also on economic grounds. Furthermore, there is a paucity of information regarding the profile of sports injuries in developing countries. Therefore, the study was designed with the objectives of determining the prevalence and pattern of sport injuries among college students in Delhi, India.
| Materials and methods|| |
Cross-sectional study was conducted during the months of March and April 2013 among students of a professional college in Delhi. The college was selected by convenience, being near to our hospital. Study participants were students who were involved in some kind of sports. Inclusion criteria were members of sports teams (both intra- and intercollege teams) and athletes. Exclusion criteria were those who were not willing to take part in the study and those not available at the time of administering the questionnaire.
Pretested, self-administered questionnaire was used which consisted of sociodemographic data, types of sports involved, number and type of injury sustained in the last 12 months, time lost due to injury in sports and also in study, availability of trained coaches and formal training, practice of warming up and warming down before and after training or involving in competitive sports, and treatment received for injury and the cost for it. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 21. Chi-square test was used for drawing statistical inferences and P values of < 0.05 were considered significant. Binary logistic regression was also used.
Institutional ethical committee clearance was obtained. Permission for conducting the study was also sought from the college principal. All the members of sports teams were approached in their usual practicing areas. Information was provided about the aims and objectives of the study and the methodology adopted. The study subjects were given assurance about their confidentiality and those who gave written informed consent were included.
For the purpose of our study, we defined sports injury as, "any tissue damage, including even minor bruises caused by sport-related incident during the last 12 months, whether or not it results in any incapacity to the participant".
| Results|| |
Among the 210 students who were involved in some kind of sports, only 192 could be reached within the time period, giving a response rate of 91.4%. Of the 192 study subjects, most of them were males (165, 85.9%) and the most common age was 21 years with 73 (38%) students. Majority were pursuing their 2 nd year of engineering course (81, 42.2%). According to revised Kuppuswamy scale 2012, 104 (54.2%) fall in upper middle (II) socioeconomic class. Regarding their body mass index (BMI), 99 (51.6%) students were having ideal BMI [Table 1].
|Table 1: Distribution of study participants according to sociodemographic profile and body mass index (n=192)|
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Among 192 students, 150 (78.1%) had coach for their sporting activity; whereas, only 115 (59.9%) received formal training in the sports they actively engage. Cricket was the most popular sport with 41 (21.3%) students playing it followed by football, 40 (20.8%).
Prevalence and pattern of sport injuries
The overall prevalence of sports injury in the preceding 1 year was 141 (73.4%, 95 confidence interval (CI): 66.5-79.4). It was more in those playing basketball followed by cricket and least in those playing lawn tennis [Table 2]. Males suffered more (135, 81.8%) sports injuries than females (16, 59.3%) and it was found to be statistically significant (P = 0.008). Study participants of 20 years of age and above suffered more injuries than their younger ages (P = 0.028). But there was no significant difference with year of study (P = 0.293), socioeconomic class (P = 0.370), and BMI (P = 0.071).
|Table 2: Distribution of study participants according to type of sport involved|
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The prevalence of sport injuries was more among those who do not have coaches for their sporting activities (P = 0.001, odds ratio (OR) = 3.49). It was also more among those who did not receive any formal training for the sport they actively engage (P-value = 0.000, OR 2.26). Ankle was the most common region affected (40, 28.4%) and the abrasion was the most common injury type (60, 42.6%) [Table 3].
|Table 3: Distribution of study subjects according to injury pattern (n=141)|
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Treatment for sport injuries
Out of 141 students who suffered injuries, only 97 (68.8%) took some form of treatment. Among them, 45 (46.4%) took self-medication. Only 39 (40.2%) took treatment from a doctor, while 13 (13.4%) were treated by a coach. The treatment cost was borne fully by the individual themselves in 86 (88.7%) instances, while the college sponsored the treatment for 11 (11.3%) cases. There was no help from the government. The median treatment cost was 2, 000 rupees per sports injury.
Recovery time from sports injury
Regarding the recovery time for sport injuries, 18 (12.8%) recovered within 1 week of sustaining injuries. Seventy-six (53.9%) students recovered from 1 week to 1 month, while 47 (33.3%) students took more than a month. The median was 3 days for full recovery. Most of the abrasions (39, 65%) took more than 1 week for full recovery, among sprains (17, 40.5%) and bruise (17, 89.5%) took more than 1 week for full recovery. But among strain (11, 78.6%), fracture 3 (100%) and concussion 2 (100%) took more than a month for full recovery [Table 4].
Knowledge and practice of preventive measures
All the students know about warming up and stretching before playing, but 16 (8.3%) students do not know about warming down. Ignorance about protective aids was found in 46 (23.9%) and assisted exercise in 69 (35.9%). Of these, 133 (69.3%) had received this information from coach, 40 (20.8%) from friend, 17 (8.8%) through internet, and two (1.1%) through books [Figure 1].
|Figure 1: Distribution of study subjects according to practice of sports injury preventive measures|
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Regarding the practice of preventive measures, only 152 (79.2%) students regularly practice warming up. One hundred and nine (56.8%) students do warming down, 129 (67.2) do stretching; whereas, only 50 (26.1%) do assisted exercise and 63 (32.8%) use protective aids. Only 50 (26.1%) regularly practice all forms of preventive measures. Those who regularly practice preventive measures had decreased odds of sustaining sports injuries (P = 0.020, OR 0.42) [Table 5].
|Table 5: Logistic regression analysis for the determinants of sports injury (n=192)|
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There were few positive outcomes, 178 (92.7%) students reported they have first aid facilities in their campus, 173 (90.1%) students reported they have adequate playground facilities, and 158 (82.1%) reported having adequate playing equipments. But physiotherapist was present in only 26 (13.5%) cases and a nutritional expert was available to only 14 (7.3%) students. One hundred and sixty-three (84.9%) students feel that they should have better access to sport health care facilities.
| Discussion|| |
The prevalence of sport injuries in this study was 73.4%. This was higher when compared to a similar study done in West Bengal, India which reported a prevalence of 58.9%  and way higher when compared with studies done in United States,  New Zealand,  and Scotland;  which had a prevalence of around 30%. In this study, males (81.8%) suffered more injuries than the females (59.3%). These results are similar to a study conducted in Singapore. 
The prevalence of sport injuries was more among those who do not have coaches for their sporting activities (P = 0.001) and also who did not receive any formal training for the sport they actively engage (P = 0.000). This shows that lack of proper technical expertise increases the risk of being injured during sports. Injuries were more in those who played basketball (84.2%) followed by cricket (78.5%).
The commonest type of injury was abrasion (42.6%) followed by sprain (29.6%), bruise (13.5%), and strain (9.9%). This is similar to a study done in Scotland, but the strain levels are high.  Extremities (ankle and hand) were the commonest sites to be injured accounting for 28.4 and 27.6%, respectively. This was comparable to a pilot study done on global unintentional injury surveillance in four cities of developing countries,  but a study done in Australia had reported head as the most common site of injury during sports. 
In the present study, out of 141 students who suffered injuries, only 97 (68.8%) took some form of treatment and among those who took treatment majority (46.4%) took self-medication. Eighty-six (88.7%) students spend their own money for receiving treatment, the median being 2, 000 rupees. This highlights the fact that there was no insurance policy in place to cover sport injuries. Most of abrasions and bruise recovered within 1 month; whereas, sprain, strain, fracture, and concussion took more than 1 month for full recovery. This trend was also seen in a study done in Hong Kong. 
About the preventive measures of sport injuries, in the present study 69 (35.9%) students were ignorant about assisted exercises; while 46 (23.9%) students do not know about the protective equipments available for their sports, 16 (8.3%) do not know about warming down, and only 50 (26%) students were regularly practicing these preventive measures. This shows lack of awareness regarding sport injury management among Indian youth.
Although adequate first aid and playground facilities were available, physiotherapist was available to 26 (13.5%) and a nutritional expert to 14 (7.3%) students. One hundred and sixty-three (84.9%) students felt that they should have better access to sport healthcare facilities. This shows lack of technical expertise in this field in India.
Measures like promoting the use of protective equipments and practice of injury preventive techniques like warming up and stretching before the start and of training sessions or playing competitive games will definitely reduce the number of sports injuries at the study site. Physiotherapists and nutritional experts should also be a part of sports teams.
But even with preventive policies, sports injuries happen even in high level athletes. So, in order to reduce its burden, Sports Authority of India (SAI) was setup by government of India in 1984 under Ministry of Youth Affairs and Sports (MYAS) to help promote sport throughout the country by nurturing talent in youth and providing them with requisite infrastructure, equipment, coaching facilities, and competition exposure. But it is catering only to a fraction of those who are in need of these services.  Sports injury center (SIC), the first of its kind in India was established at Safdarjung Hospital, New Delhi in 2010 under Ministry of Health and Family Welfare (MOHFW). It delivers the highest standards of diagnosis, treatment, rehabilitation, and full recovery care for its patients.  But these facilities are available to only a very few people.
The generalization of the study result is limited by the characteristic of the sample, which was recruited from a single college in Delhi. Recall bias for minor sports injuries may also be present. Still this could be a very useful one considering the fact that there were only very few similar studies conducted in developing countries in this background.
| Conclusion|| |
The prevalence of sport injury was high in this study and practice of preventive measures was low. Technical expertise in sports injury management was also low and the injuries are not covered by any form of insurance. A diligent search for factors contributing to injuries is essential for injury management and incorporating these elements into a comprehensive rehabilitation program will give rewarding results. Attention to preventive measures and appropriate supervision will allow youngsters to continue to enjoy sports in a safer way.
Awareness should be made regarding the practice of injury preventive measures like warming up, warming down, stretching, assisted exercises, and protective equipments. Those who are suffering from any form of sport injuries should take appropriate treatment from sport physical therapist and the cost should be covered by some form of sports insurance.
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[Table 1], [Table 2], [Table 3], [Table 4], [Table 5]