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The primary aim is to assess the impact of a multidomain intervention that integrates education, exercise, psychological techniques and machine learning feedback on the duration athletes remain free from injury complaints leading to participation restriction (ICPR) during a 20-week summer competitive athletics season. The secondary aims are to assess the intervention’s effect on reducing (i) the incidence, (ii) the burden, (iii) the period prevalence and (iv) the weekly prevalence of ICPR during the same timeframe. We will perform a two-arm randomised controlled trial. This study will involve an intervention group and a control group of competitive athletes licensed with the French Federation of Athletics, aged between 18 and 45, over an outdoor athletics competitive season lasting 20 weeks (March to July 2025). Data will be collected before the start (demographic, training and injury history) and one time per day (training and competition volume/intensity, perceived physical and psychological state, and illness and injury incidents) for both groups. The intervention group will be required to (i) view a series of 12 educational videos on injury prevention, (ii) engage in discipline-specific exercise programmes, (iii) implement stress and anxiety management techniques and (iv) view daily the injury prognostic feedback generated by the athlete’s collected data based on machine learning. Outcomes will be analysed over the final 14 weeks of follow-up to allow time for the intervention to establish any potential efficacy. The primary outcome will be the time-to-event for each ICPR. Secondary outcomes will include (i) incidence, (ii) burden, (iii) period prevalence and (iv) weekly prevalence of ICPR. The primary outcome will be analysed using a Prentice–Williams–Peterson gap-time model. In contrast, the secondary outcomes will employ Poisson (i, ii), logistic (iii) and generalised estimating equations (iv) regression models, respectively.

Objective To analyse the association between the level of use of injury risk estimation feedback (I-REF) provided to athletes and the injury burden during an athletics season.Method We conducted a prospective cohort study over a 38-week follow-up period on athletes competing at the French Federation of Athletics. Athletes completed daily questionnaires on their athletics activity, psychological state, sleep, self-reported level of I-REF use, and injuries. I-REF provided a daily estimation of the injury risk for the next day, ranging from 0% (no risk of injury) to 100% (maximum risk of injury). The primary outcome was the injury burden during the follow-up, defined as the number of days with injury per 1000 hours of athletics activity. A negative binomial regression model was used to analyse the association between self-reported I-REF use and the injury burden.Results Of the 897 athletes who met the inclusion criteria, 112 (38% women) were included in the analysis. The mean daily response rate of the follow-up was 37%±30%. The primary analysis found no significant association between the self-reported I-REF use and the injury burden (n=112, eβ: 0.992, 95% CI: 0.977 to 1.007; p=0.308). However, when considering athletes’ daily response rate in secondary analysis, for a response rate of at least 9%, we observed a significant association between the self-reported level of I-REF use and the injury burden (n=76, eβ: 0.981, 95% CI: 0.965 to 0.998; p=0.027).Conclusions Daily injury risk estimation feedback using machine learning was not associated with reducing injury burden.

Objective To investigate the feasibility, perceived relevance and usefulness of providing injury and illness prevention information through infographics to athletes and medical teams before and during an international athletics championship, and its potential impact on injury and illness risk during the same championship.Methods We conducted a prospective cohort study during the 2024 European Athletics Championships in Roma with (1) dissemination of infographics, (2) data collection on perceived relevance (yes/no) and perceived usefulness (score from 0 to 100) of infographics among athletes and medical teams using an online questionnaire and (3) data collection by medical teams of newly incurred injuries and illnesses among athletes during the championship.Results Among the 124 athletes who completed the questionnaire, 35.5% had access to the infographics, of which 86.4% found the information relevant, and their perceived usefulness scores to reduce their risk were 51.8±23.9 (range: 2.9–100.0) for injuries and 50.6±23.0 (range: 0.0–100.0) for illnesses. Among the registered physicians and physiotherapists, 44 replied to the survey, 70.5% had access to the infographics, of which 83.9% found it relevant, and their perceived usefulness scores to reduce risk were 55.6±28.0 (range: 6.0–100.0) for injuries and 52.9±28.0 (range: 0.0–100.0) for illnesses. The logistic regression showed that a higher perceived usefulness score was associated with a lower risk of in-championship injury (OR 0.950; 95% CI 0.877 to 0.996).Conclusions Promoting the health protection of athletes through infographics on injury and illness prevention in the context of international athletics championships was feasible and may represent an additional prevention approach.

Objective To describe the incidence and characteristics of the sports injuries and illnesses that occurred during the 2022 European Championships.Methods We conducted a prospective study on newly incurred injuries and illnesses collected by the national medical teams and the local organising committee physicians using a standardised online report form on a daily basis, in all athletes registered at the 2022 European Championships from 11 August 2022 to 21 August 2022 in Munich (Germany).Results In total, 5419 athletes were registered at the 2022 European Championships in 9 sports. A total of 181 in-competition injuries were reported, representing an overall incidence of 33.4 injuries per 1000 registered athletes, with higher values in triathlon, cycling and athletics. More injuries located at the lower limb and involving the muscles and skin were reported in athletics, at the lower limb and involving the skin in triathlon, at the head and trunk and upper limb and involving head and skin in cycling. A total of 65 illnesses were reported, representing an overall incidence of 12.0 illnesses per 1000 registered athletes, with higher values in athletics and rowing. The most affected common system was the cardiovascular system (24.6%), followed by the gastrointestinal (18.5%) and upper respiratory tracts (16.9%). The most frequent causes were exercise (36.9%), infections (30.8%) and ‘others’ (10.8%).Conclusion This was the first injury and illness surveillance during multisports European Championships providing relevant results to help anticipate medical services and athletes’ health protection, and highlighting the need for special attention for triathlon and cycling.

Background Women’s Artistic Gymnastics (WAG) is a sport well known for requiring a heavy and difficult training load from a younger age to reach a high level of performance. This also is associated with an injury risk. Epidemiological studies are thus needed to improve injury prevention strategies.Objective We aimed to determine the injury epidemiology in French high-level WAG.Methods We conducted a retrospective analysis of injury data collected prospectively over six seasons from the 2014–2015 season to the 2019–2020 season among French high-level Women’s Artistic Gymnasts from the France Gymnastics National Centre of Saint-Etienne. We performed descriptive analyses, including the calculation of the 1-year injury prevalence.Results 43 gymnasts were included in this study, representing 111 gymnast-seasons. A total of 285 injuries were collected over the study period, that was, an average of 2.6 injuries per gymnast per season. On average, 91.4% of gymnasts had at least one injury per season. The estimated injury incidence rate was 1.8 injuries per 1000 hours of gymnastics practice. The knee was the most affected joint (16%), followed by the elbow (12%) and the ankle (12%). The most frequent injury type was physis pathologies (16%) and bone injuries (15%). Eighty-eight per cent of injuries required a modification of the gymnastics practice.Conclusions The results of this study allowed a description of the epidemiology of injuries in this population of young and elite gymnasts. This very high injury prevalence supports the need to improve injury risk reduction strategies in WAG.

Objective To investigate if several potential risk factors were associated with time to injury complaints leading to participation restriction in Athletics (ICPR).Methods We performed a secondary analysis of data collected during 39 weeks of the 2017–2018 Athletics season in a cluster-randomised controlled trial (‘PREVATHLE’). Univariate and multivariable analyses using Cox regression models were performed to analyse the association between the time to first ICPR and potential risk factors collected (1) at baseline: sex, age, height, body mass, discipline, the usual duration of Athletics training and non-specific sports training, ICPR in the preceding season (yes/no), ICPR at baseline (yes/no); (2) weekly during the season: duration and intensity of Athletics training and competition, and non-specific sports training, fitness subjective state, sleep duration and illness (yes/no); and (3) combined.Results Data from 320 athletes were included; 138 (43.1%) athletes reported at least one ICPR during the study follow-up. The combined multivariable analyses revealed that the risk of ICPR at any given time was significantly higher in athletes with a pre-existing ICPR (hazard rate ratio, HRR 1.90, 95% CI 1.15 to 3.15; p=0.012) and lower in athletes with a higher fitness subjective state (HRR 0.63, 95% CI 0.55 to 0.73; p

Introduction Two-thirds of athletes (65%) have at least one injury complaint leading to participation restriction (ICPR) in athletics (track and field) during one season. The emerging practice of medicine and public health supported by electronic processes and communication in sports medicine represents an opportunity for developing new injury risk reduction strategies. Modelling and predicting the risk of injury in real-time through artificial intelligence using machine learning techniques might represent an innovative injury risk reduction strategy. Thus, the primary aim of this study will be to analyse the relationship between the level of Injury Risk Estimation Feedback (I-REF) use (average score of athletes’ self-declared level of I-REF consideration for their athletics activity) and the ICPR burden during an athletics season.Method and analysis We will conduct a prospective cohort study, called Injury Prediction with Artificial Intelligence (IPredict-AI), over one 38-week athletics season (from September 2022 to July 2023) involving competitive athletics athletes licensed with the French Federation of Athletics. All athletes will be asked to complete daily questionnaires on their athletics activity, their psychological state, their sleep, the level of I-REF use and any ICPR. I-REF will present a daily estimation of the ICPR risk ranging from 0% (no risk for injury) to 100% (maximal risk for injury) for the following day. All athletes will be free to see I-REF and to adapt their athletics activity according to I-REF. The primary outcome will be the ICPR burden over the follow-up (over an athletics season), defined as the number of days lost from training and/or competition due to ICPR per 1000 hours of athletics activity. The relationship between ICPR burden and the level of I-REF use will be explored by using linear regression models.Ethics and dissemination This prospective cohort study was reviewed and approved by the Saint-Etienne University Hospital Ethical Committee (Institutional Review Board: IORG0007394, IRBN1062022/CHUSTE). Results of the study will be disseminated in peer-reviewed journals and in international scientific congresses, as well as to the included participants.

Objective: The aims of this study were (1) to determine the one-year prevalence of injuries and their characteristics and (2) to analyze potential injury risk factors in high-level/national-level women artistic gymnasts. Methods: Competitive women artistic gymnasts training more than 10 h per week in a national training center and a TOP 12 club in France were invited to participate in a retrospective study through an online questionnaire about their self-reported injuries and potential injury risk factors (e.g., previous injuries, diseases, weight modification) during the 2020/2021 season. Results: A total of 88 gymnasts between 9 and 23 years old, who trained on average 22.0 ± 6.2 h per week, answered the questionnaire. Ninety-five injuries were reported by 62 (70.5%) of the 88 gymnasts. The one-year injury prevalence was 70.5% (95% CI 60.9 to 80.0%). Gymnasts had, on average, 1.1 ± 1.0 injuries per year. The most common reported injury location was the knee (25.3%), and the most common reported injury type was the ligament (26.3%). Having an injury during the previous season (OR = 9.06; CI 95% 2.66 to 36.73; p = 0.0007) and using a prevention program (OR = 3.97; CI 95% 1.46 to 11.15; p = 0.007) were associated with a higher risk of injury in the multivariate analysis. Conclusions: More than 70% of French high-level/national-level gymnasts had at least one injury during the 2020/2021 season. This high injury rate supports the need to promote injury prevention. However, in the present study, using a prevention program was associated with a higher risk of injury. There is thus a need to improve injury prevention strategies to counter the high injury risk and its potential consequences.