Objective: To report the epidemiology of injuries in Olympic-style karate competitions. Design: Systematic review and meta-analysis. Pooled estimates of injury incidence rates per 1000 athlete-exposures (IIRAE) and per 1000 min of exposure (IIRME) were obtained by fitting random-effects models. Data sources: MEDLINE, Embase, AMED, SPORTDiscus and AusportMed databases were searched from inception to 21 August 2019. Eligibility criteria Prospective cohort studies published in peer-reviewed journals and reporting injury data (ie, incidence, severity, location, type, mechanism or risk factors) among athletes participating in Olympic-style karate competition. Results: Twenty-eight studies were included. The estimated IIRAE and IIRME were 88.3 (95%CI 66.6 to 117.2) and 39.2 (95%CI 30.6 to 50.2), respectively. The most commonly injured body region was the head and neck (median: 57.9%; range: 33.3% to 96.8%), while contusion (median: 68.3%; range: 54.9% to 95.1%) and laceration (median: 18.6%; range: 0.0% to 29.3%) were the most frequently reported types of injury. Despite inconsistency in classifying injury severity, included studies reported that most injuries were in the least severe category. There was no significant difference in IIRME between male and female karate athletes (rate ratio 1.09; 95%CI 0.88 to 1.36). Conclusion: Karate athletes sustain, on average, 1 injury every 11 exposures (bouts) or approximately 25 min of competition. The large majority of these injuries were minor or mild in severity.
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