Injury and illness surveillance during the 2016 department of defense warrior games: Review of methods and results

Introduction: Surveillance systems have become a valuable tool to capture epidemiological data atmulti-sport events, with findings serving to predict and prevent injury, reduce illness, and guide efficient utilization ofmedical resources. In 2016, the first injury and illness surveillance tool for the Department of Defense (DoD) WarriorGames was established to inform the required medical footprint. The purpose of this paper is to describe the methodsand findings from the 2016 DoD Warrior Games surveillance system, which included a database of injuries and illness.Materials and Methods: A total of 245 wounded warrior (WW) athletes were followed over 19 days, to include trainup and competition periods, as they competed for their respective teams of Army, Navy, Air Force, Marines, SpecialOperations, and United Kingdom. Medical personnel recorded injuries and illnesses treated utilizing a standardized surveillance form and data were entered into a daily tracker to examine patterns or areas for prevention. Reports includedsex, age, event discipline, previous injury or illness, reason for presentation, and treatment provided. Results: FromJune 3 to June 21, 2016, 114 individual encounters were recorded on the standard form and entered into the surveillance database. Athletes accounted for 67% of all encounters. Illness accounted for 30.7% of all visits, while injuriesaccounted for 69.2%. The incident proportion of injuries in athletes was 23.3 injuries per 100 athletes (95% CI 17.6,30.1) and incident rate of 12.2 injuries per 1000 athlete days. Integrative medicine treatments including acupuncture,osteopathic manipulative treatment (OMT), massage therapy, and gua sha accounted for the largest forms of treatment(31%). Conclusions: From the surveillance data, staff levels and treatment supplies can be adjusted. In addition animproved surveillance tool can be created. Continuous surveillance is required to provide information on trends ininjury and illness to support prevention strategies.