Advertisement

Epidemiology of injuries in amateur boxing: A systematic review and meta-analysis

Published:September 14, 2022DOI:https://doi.org/10.1016/j.jsams.2022.09.165

      Abstract

      Objectives

      To synthesise competition and training injury data in amateur boxing.

      Design

      Systematic review and meta-analysis. Pooled estimates of competition injury incidence rates per 1000 athlete-exposures (IIRAE) and per 1000 min of exposure (IIRME), and training injury incidence rates per 1000 h of exposure (IIRHE) were obtained by fitting random-effects models.

      Methods

      MEDLINE, Embase, AMED, AUSPORT, and SPORTDiscus databases were searched from inception to 27 May 2022. Cohort studies with prospectively collected injury and exposure data from amateur boxing competition or training published in peer-reviewed journals were eligible for inclusion.

      Results

      Seventeen studies were eligible for inclusion. The competition IIRAE and IIRME summary estimates were 54.7 (95 % CI 33.8–88.4) and 6.8 (95 % CI 4.2–10.9), respectively. The training IIRHE summary estimate was 1.3 (95 % CI 0.2–7.0). The most commonly injured body regions in the competition and training settings were the head and neck (median: 72 %; range: 46 % to 100 %) and upper limb (median: 49 %; range: 40 % to 53 %), respectively. The predominant types of injury were contusions (median: 35 %; range: 5 % to 100 %) and lacerations and abrasions (median: 20 %; range: 0 % to 69 %) in the competition setting, and sprains and strains (median: 60 %; range: 50 % to 81 %) in the training setting.

      Conclusions

      Amateur boxing athletes sustain, on average, 1 injury every 2.5 h of competition and every 772 h of training. There is a need for identifying injury mechanisms and modifiable risk factors that can be targeted by preventive measures to reduce the burden of injury in amateur boxing.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Science and Medicine in Sport
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • World Boxing Organization
        Regulations of World Championship Contests.
        World Boxing Organization, San Juan, Puerto Rico2014
        • International Boxing Association (AIBA)
        Technical & Competition Rules.
        AIBA, Lausanne, Switzerland2019
        • Dawson A.
        Mayweather and McGregor make millions in the ring, but the 3-year-old cage fighting star tops up his earnings trading stocks and buying property.
        Business Insider Australia
        https://www.businessinsider.com.au/mcgregor-mayweather-fight-economics-ufc-mma-bellator-boxing-paul-daley-2017-6
        Date: 2017
        Date accessed: January 14, 2021
        • Finch C.
        • Cassell E.
        The public health impact of injury during sport and active recreation.
        J Sci Med Sport. 2006; 9: 490-497
        • van Mechelen W.
        • Hlobil H.
        • Kemper H.C.
        Incidence, severity, aetiology, and prevention of sports injuries. A review of concepts.
        Sports Med. 1992; 14: 82-99
        • Loosemore M.
        • Knowles C.H.
        • Whyte G.P.
        Amateur boxing and risk of chronic traumatic brain injury: systematic review of observational studies.
        Br Med J. 2007; 335: 809
        • Drury B.T.
        • Lehman T.P.
        • Rayan G.
        Hand and wrist injuries in boxing and the martial arts.
        Hand Clin. 2017; 33: 97-106
        • Loosemore M.
        • Lightfoot J.
        • Beardsle C.
        Boxing injuries by anatomical location: a systematic review.
        Med Sport. 2015; 11: 2583-2590
        • Zazryn T.
        • Mccroy P.
        Boxing.
        in: Caine D.J. Harmer P.A. Schiff M.A. Epidemiology of Injury in Olympic Sports. Wiley-Blackwell, Chichester, United Kingdom2009
        • Moher D.
        • Liberati A.
        • Tetzlaff J.
        • et al.
        PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.
        PLoS Med. 2009; 6: e1000097
        • Ouzzani M.
        • Hammady H.
        • Fedorowicz Z.
        • et al.
        Rayyan—a web and mobile app for systematic reviews.
        Syst Rev. 2016; 5: 210
        • Joanna Briggs Institute
        The Joanna Briggs Institute Critical Appraisal Tools for Use in JBI Systematic Reviews: Checklist for Cohort Studies.
        Joanna Briggs Institute, Adelaide, Australia2017
        • Bahr R.
        • Clarsen B.
        • Derman W.
        • et al.
        International Olympic Committee consensus statement: methods for recording and reporting of epidemiological data on injury and illness in sports 2020 (including the STROBE extension for sports injury and illness surveillance (STROBE-SIIS)).
        Br J Sports Med. 2020; 54: 372-389
        • Orchard J.W.
        • Meeuwisse W.
        • Derman W.
        • et al.
        Sport Medicine Diagnostic Coding System (SMDCS) and the Orchard Sports Injury and Illness Classification System (OSIICS): revised 2020 consensus versions.
        Br J Sports Med. 2020; 54: 397-401
        • Rosychuk R.J.
        • Huston C.
        • Prasad N.G.
        Spatial event cluster detection using a compound Poisson distribution.
        Biometrics. 2006; 62: 465-470
        • Riley R.D.
        • Higgins J.P.
        • Deeks J.J.
        Interpretation of random effects meta-analyses.
        Br Med J. 2011; 342d549
        • Bianco M.
        • Loosemore M.
        • Daniele G.
        • et al.
        Amateur boxing in the last 59 years. Impact of rules changes on the type of verdicts recorded and implications on boxers’ health.
        Br J Sports Med. 2013; 47: 452-457
        • Higgins J.P.
        • Thompson S.G.
        Quantifying heterogeneity in a meta-analysis.
        Stat Med. 2002; 21: 1539-1558
        • Estwanik J.J.
        • Boitano M.
        • Ari N.
        Amateur boxing injuries at the 1981 and 1982 USA/ABF national championships.
        Phys Sports Med. 1984; 12: 123-128
        • Bianco M.
        • Pannozzo A.
        • Fabbricatore C.
        • et al.
        Medical survey of female boxing in Italy in 2002–2003.
        Br J Sports Med. 2005; 39: 532-536
        • Bianco M.
        • Sanna N.
        • Bucari S.
        • et al.
        Female boxing in Italy: 2002–2007 report.
        Br J Sports Med. 2011; 45: 563-570
        • Jensen S.K.
        • Schmidt-Olsen S.
        • Mortensen V.
        Danish amateur boxing during 3 boxing seasons 1983–1986 [Danish].
        Ugeskr Laeger. 1988; 150: 1158-1159
        • Loosemore M.
        • Lightfoot J.
        • Palmer-Green D.
        • et al.
        Boxing injury epidemiology in the Great Britain team: a 5-year surveillance study of medically diagnosed injury incidence and outcome.
        Br J Sports Med. 2015; 49: 1100-1107
        • Lund L.
        • Espersen G.T.
        Pattern of injuries in Danish amateur boxers [Danish].
        Ugeskr Laeger. 1988; 150: 1159-1161
        • Porter M.
        • O’Brien M.
        Incidence and severity of injuries resulting from amateur boxing in Ireland.
        Clin J Sport Med. 1996; 6: 97-101
        • Nagatomi H.
        Sports doctor report: boxing medical jury report of the XXVIII Olympic Games Athens 2004.
        Jpn J Clin Sports Med. 2005; 13: 459-464
        • Zazryn T.
        • Cameron P.
        • McCrory P.
        A prospective cohort study of injury in amateur and professional boxing.
        Br J Sports Med. 2006; 40: 670-674
        • Junge A.
        • Engebretsen L.
        • Mountjoy M.L.
        • et al.
        Sports injuries during the summer Olympic Games 2008.
        Am J Sports Med. 2009; 37: 2165-2172
        • Engebretsen L.
        • Soligard T.
        • Steffen K.
        • et al.
        Sports injuries and illnesses during the London Summer Olympic Games 2012.
        Br J Sports Med. 2013; 47: 407-414
        • Soligard T.
        • Steffen K.
        • Palmer D.
        • et al.
        Sports injury and illness incidence in the Rio de Janeiro 2016 Olympic Summer Games: a prospective study of 11274 athletes from 207 countries.
        Br J Sports Med. 2017; 51: 1265-1271
        • Steffen K.
        • Soligard T.
        • Mountjoy M.
        • et al.
        How do the new Olympic sports compare with the traditional Olympic sports? Injury and illness at the 2018 Youth Olympic Summer Games in Buenos Aires, Argentina.
        Br J Sports Med. 2020; 54: 168-175
        • Lennox S.
        A study of amateur boxing injuries.
        Phys Ther Sport. 1991; 13: 8-9
        • Dande J.
        • Mallick A.
        • Patil A.A.
        • et al.
        Injury surveillance during elite women’s national boxing championship in India.
        Med J Armed Forces India. 2021; ([Published online first 23 June 2021], In press)https://doi.org/10.1016/j.mjafi.2021.03.016
        • Lystad R.P.
        • Alevras A.
        • Rudy I.
        • et al.
        Injury incidence, severity and profile in Olympic combat sports: a comparative analysis of 7712 athlete exposures from three consecutive Olympic Games.
        Br J Sports Med. 2021; 55: 1077-1083
        • Torres E.A.
        Incidence in a pre-Olympic boxing tournament [Spanish].
        Arch Med Deporte. 1997; 14: 55-58
        • Pocecco E.
        • Ruedl G.
        • Stankovic N.
        • et al.
        Injuries in judo: a systematic literature review including suggestions for prevention.
        Br J Sports Med. 2013; 47: 1139-1143
        • Lystad R.P.
        • Pollard H.
        • Graham P.L.
        Epidemiology of injuries in competition taekwondo: a meta-analysis of observational studies.
        J Sci Med Sport. 2009; 12: 614-621
        • Lystad R.P.
        • Augustovičová D.
        • Harris G.
        • et al.
        Epidemiology of injuries in Olympic-style karate competitions: systematic review and meta-analysis.
        Br J Sports Med. 2020; 54: 976-983
        • Lystad R.P.
        • Gregory K.
        • Wilson J.
        The epidemiology of injuries in mixed martial arts: a systematic review and meta-analysis.
        Orthop J Sports Med. 2014; 22325967113518492
        • Williams S.
        • Trewartha G.
        • Kemp S.
        • et al.
        A meta-analysis of injuries in senior men’s professional rugby union.
        Sports Med. 2013; 43: 1043-1455
        • López-Valenciano A.
        • Ruiz-Pérez I.
        • Garcia-Gómez A.
        • et al.
        Epidemiology of injuries in professional football: a systematic review and meta-analysis.
        Br J Sports Med. 2020; 54: 711-718
        • Podlog L.
        • Buhler C.F.
        • Pollack H.
        • et al.
        Time trends for injuries and illness, and their relation to performance in the National Basketball Association.
        J Sci Med Sport. 2015; 18: 278-282
        • Cumps E.
        • Verhagen E.
        • Meeusen R.
        Prospective epidemiological study of basketball injuries during one competitive season: ankle sprains and overuse knee injuries.
        J Sports Sci Med. 2007; 6: 204-211
        • Moller M.
        • Attermann J.
        • Myklebust G.
        • et al.
        Injury risk in Danish youth and senior elite handball using a new SMS text messages approach.
        Br J Sports Med. 2012; 46: 531-537
        • Whitehouse T.
        • Orr R.
        • Fitzgerald E.
        • et al.
        The epidemiology of injuries in Australian professional rugby union 2014 super rugby competition.
        Orthop J Sports Med. 2016; 42325967116634075
        • Hemmings B.J.
        Psychological and Immunological Effects of Training and Massage in Amateur Boxing.
        University of Chichester, Chichester, United Kingdom1998 ([Doctoral dissertation])
        • Davis P.
        • Waldock R.
        • Connorton A.
        • et al.
        Comparison of amateur boxing before and after the 2013 rules change and the impact on boxers’ safety.
        Br J Sports Med. 2018; 52: 741-746
        • Stewart R.
        The Longitudinal Effects of Beta-alanine on Punch Power, Punch Frequency, and Fatigue in Female Amateur Fighters.
        University of Arkansas, Fayetteville, United States2015 ([Doctoral dissertation])
        • Falvey M.
        Because not all blows to the head are the same.
        Br J Sports Med. 2015; 49: 1091-1093
        • Bartsch A.J.
        • Benzel E.C.
        • Miele V.J.
        • et al.
        Boxing and mixed martial arts: preliminary traumatic neuromechanical injury risk analyses from laboratory impact dosage data.
        J Neurosurg. 2012; 116: 1070-1080
        • Jako P.
        Safety measures in amateur boxing.
        Br J Sports Med. 2002; 36: 394-395
        • Loosemore M.P.
        • Butler C.F.
        • Khadri A.
        • et al.
        Use of head guards in AIBA boxing tournaments—a cross-sectional observational study.
        Clin J Sport Med. 2017; 27: 86-88
        • McIntosh P.
        Boxing headguard performance in punch machine tests.
        Br J Sports Med. 2015; 49: 1108-1112
        • Beckwith J.G.
        • Zhao W.
        • Ji S.
        • et al.
        Estimated brain tissue response following impacts associated with and without diagnosed concussion.
        Ann Biomed Eng. 2018; 46: 819-830
        • Campolettano E.T.
        • Gellner R.A.
        • Smith E.P.
        • et al.
        Development of a concussion risk function for a youth population using head linear and rotational acceleration.
        Ann Biomed Eng. 2020; 48: 92-103
        • Swartz E.E.
        • Myers J.L.
        • Cook S.B.
        • et al.
        A helmetless-tackling intervention in American football for decreasing head impact exposure: a randomized controlled trial.
        J Sci Med Sport. 2019; 22: 1102-1107
        • Tjønndal A.
        • Haudenhuyse R.
        • de Geus B.
        • et al.
        Concussions, cuts and cracked bones: a systematic literature review on protective headgear and head injury prevention in Olympic boxing.
        Eur J Sport Sci. 2022; 22: 447-459