Nicola Biasca1, MD. and Yelverton Tegner2, MD, Ph.D.1 Department of Orthopaedics, University Hospital Zurich, Clinic Balgrist, Forchstrasse 340, CH-8008 Zurich, Switzerland, Biasca@swissonline.ch 2 Associate professor in Sports Medicine, Winternet, Institution of Health Sciences, Lule� University of Technology, Hedenbrov�gen, Boden; Timmermansgatan 60, SE-972 33 Lule�, Sweden, email@example.com
There are a lot of steps to be taken to improve the prevention of certain ice hockey injuries, as well as to develop a network of communication between coaches, managers, referees, equipment manufactures and sports physicians in order to improve the performance and the safety of ice hockey players. For this reason we have developed a standardized International Sports Injury System "ISIS" for international comparison. This new system is a development of the earlier presented Injury Report System "IRS", which has earlier been used in several studies and it is generally agreed to be a reliable and valid system for evaluating sport injuries. This new International Sports Injury System is an expanded computerized version of the IRS.
The aims for this new system are multiple. We want to create a reporting system that could help to improve the epidemiological analysis of most sports related injuries, to make available an internationally compatible system for the continuous monitoring of risk factors, to be able to evaluate the different training methods, to evaluate the protective effects of different kinds of equipment and to evaluate the effects of changes in rules.
Dates input are reliable and valid by using a uniform definition of injury (An injury is defined as an event occurring during practice or game that caused the player to stop playing for the rest of the practice or game or to miss the next practice or game) and by using the ICD-10 system for diagnostics. The ICD-10 used in this system is an expanded version in order to have a possibility for more detailed analyses.
The database is an internet-based database system that makes possible to early detect any changes in injury pattern through the years. All teams have the possibility to export their own teams data to the www-based database by guaranteeing the anonymity of their players and their teams. The team physicians always have the possibility to compare the result of their own team with the rest of the teams in the database. By having the same database for all teams makes it possible to detect new injury trends early. Effects of rules changes can also early be detected.
The ISIS protocol can also be used in most sports in order to compare their different injury pattern. At the moment ice hockey, basketball and soccer can use the ISIS system and soon more sports will be added.
All physicians are obliged to keep records of their patients and ISIS makes special medical casebooks unnecessary. It fulfils the criteria of keeping the patient anonymous. The only person who is allowed to read the detailed reports is the registering team physician. By having the input of all data in a standardized fashion it makes scientific statistical analysis easy.
The system can be used for registering different types of training and thus making it possible to evaluate the effects of different training methods on the specific injury pattern. All players participating in the games are also registered here and thus the athletic exposure (AE) can be calculated from these data. This makes it very easy to calculate the injury rate/1000 exposure hours both on training and on game.
The ISIS system gives the possibility to register different season periods: preseason training, ice training, league season, and play off-season.
Through the registration of manufacturers, models, and types of the equipment used by the players at the beginning of the season, as well as the part of the body, which is intended to be protected by this equipment, we have the possibility to relate the injuries to any changes of the equipment as well. This makes it possible to evaluate the true protective effectiveness of different equipment. As most players use the same type of equipment year after year it is very easy to copy data from one season to another.
The registration of the injuries is made easy by the many preset options. The system is so designed that it will be impossible to make illogical inputs. Time away from full training as well as rehabilitative training is documented. It is also possible to register different kinds of treatments and the dynamic system will provide the user a possibility to get new functions as well.
For some diagnoses the system can automatically count all occurrences of a special injury for the player in the same season or in an earlier season as well. This is very important when treating a player for example after an mTBI. When registering a player there is a possibility to register all earlier injuries. If the earlier injuries are registered with the correct ICD-10 number the system will count these injuries as well.
In order to evaluate the aspect of physical fitness and injuries, it is possible to document different test results and to correlate these results with the occurrence of the different injuries. There are no restrictions of either what type of test or how many tests are used. Every team can use their own type of tests. For every player it is possible to document the findings of a physical examination.
This ISIS system is a valid and reliable way of documenting injuries and if used worldwide it can give very important information concerning injuries, epidemiology and treatment.