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

Abstract

Introduction: Notwithstanding the widespread popularity and public concerns regarding athlete safety in amateur boxing, previous efforts to investigate the epidemiology of injuries in the sport are either limited in scope or outdated. This review aims to systematically review and synthesise the best available epidemiological data on competition and training injuries in amateur boxing, including data on incidence, severity, anatomical location, type of pathology, mode of onset, mechanism of injury, and risk factors. Methods: The protocol for this review was registered on the international prospective register of systematic reviews (CRD42019127770). Five databases (i.e., MEDLINE, Embase, AMED, AusportMed, and SPORTDiscus) were electronically searched from inception to October 2020. Cohort studies that were published in peer-reviewed journals and reported prospectively collected injury and exposure data from amateur boxing athletes were included. Random-effects models were used to obtain pooled summary estimates of competition injury incidence rates per 1000 athlete-exposures (IIRAE) and per 1000 minutes of exposure (IIRME) and training injury incidence rates per 1000 hours of exposure (IIRHE). Results: Fourteen studies (15 cohorts) were eligible for inclusion. The competition IIRAE and IIRME summary estimates were 54.7 (95%CI 32.6–91.9) and 6.9 (95%CI 4.1–11.5), 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 (range: 46% to 100%) and upper limb (40% to 57%), respectively. The predominant types of injury were contusions, concussions, and lacerations in the combined competition and training setting, and sprains and strains in the training setting. Minimal data were available for injury severity, pathology, mode of onset, and mechanism. Discussion: Amateur boxing athletes sustain, on average, 1 injury every 2.4 hours of competition and every 772 hours of training, which is comparable to the injury risk other Olympic combat sports (e.g., judo, karate, taekwondo), but lower than in non-Olympic professional combat sports. While head injuries are common in competition, upper limb sprains and strains predominate in training, which suggests different injury mechanisms are present for each setting. More information about injury severity, mechanisms, and risk factors is needed to guide the development of targeted injury prevention initiatives to mitigate the burden of injury in amateur boxing. Conflict of interest statement: My co-authors and I acknowledge that we have no conflict of interest of relevance to the submission of this abstract.