Journal of science and medicine in sport最新文献

Objectives: To describe the acute effects of exercise on the morphology, mechanical properties and blood flow of the Achilles tendon, as measured with ultrasound.

Design: Systematic review of cohort studies.

Methods: Seven electronic research databases were systematically searched for exercise intervention-based studies reporting morphology, mechanical properties and blood flow of the Achilles tendon, as measured with ultrasound.

Results: Searches revealed 2460 possible articles and 35 satisfied the inclusion criteria. There is evidence that eccentric heel drops resulted in a reduction in the diameter and cross-sectional area of the tendon whilst running/stretch-shortening cycle activities did not result in a change. The latter did not affect tendon mechanical properties. Tendon blood flow was consistently increased in response to exercise.

Conclusions: The acute response of the Achilles tendon to exercise showed an increase in blood flow and a reduction in diameter following heel drop exercises. Exercise modes were relevant since eccentric and isometric loading resulted in a greater response in the tendon. Activities like running and hopping placing specific demands on the tendon's spring function resulted in a minimal change in tendon morphology and no change in mechanical properties.

Objectives: This study aimed to investigate the impact of acute acetaminophen ingestion on the responses of neuromuscular function, biomarkers of muscle damage, and physical performance during the 72-hour recovery period following simulated soccer match-play.

Design: The study followed a crossover randomized, double-blind, placebo-controlled trial design.

Methods: During the two experimental sessions, thirteen semi-professional male soccer players completed a 90-minute simulated soccer match, 60 min after oral ingestion of 1 g acetaminophen or placebo. Maximal voluntary contraction and twitch responses of the knee extensor muscles, elicited through electrical femoral nerve stimulation, were utilized to evaluate both peripheral fatigue (potentiated twitch force, Q_tw,pot) and central fatigue (voluntary activation). Performance was assessed through countermovement jump and 20 m sprint tests. Creatine kinase and lactate dehydrogenase were also measured.

Results: Smaller reductions were observed in maximal voluntary contraction (-13.3 ± 7.5 % vs. -24.7 ± 11.1 %) and voluntary activation (-3.8 ± 4.4 % vs. -12.9 ± 5.4 %) in the acetaminophen compared to the placebo condition immediately after simulated soccer match-play (p < 0.05). Afterward, these parameters were recovered 24 h earlier in the acetaminophen session compared to the placebo session. Furthermore, the 20 m sprint performance was significantly better throughout the recovery period in the acetaminophen session compared to the placebo session.

Conclusions: The findings of this study showed that acute ingestion of 1 g of acetaminophen (1 h before exercise) attenuated the decrease in maximal voluntary contraction and voluntary activation levels after exercise, as well as improved 20 m sprint performance.

Objectives: Vestibular rehabilitation is a recommended treatment after sport related concussion (SRC), but the optimal timing is not fully understood. This research examined the association between the timing of vestibular rehabilitation initiation and recovery time in adolescent patients with SRC.

Design: Retrospective cross-sectional.

Methods: 112 patients with SRC were referred to vestibular rehabilitation at a specialty concussion clinic. Vestibular rehabilitation initiation was defined as days from date of injury to date of first vestibular rehabilitation assessment. Patients were dichotomized by vestibular rehabilitation initiation: EARLY (8-10 days) and LATE (>10 days). Recovery time was defined as days between injury and medical clearance from the clinic.

Results: 60 (average age 15.22 ± 1.61 years; 51.7 % male) patients were in the EARLY group and 52 (average age 15.37 ± 1.31 years, 28.9 % male) patients were in the LATE group. There were more female patients in the LATE group (p = 0.01) and the LATE group had their first clinic visit later than the EARLY group (p < 0.02). The EARLY group had shorter recovery time (median 26, IQR [21, 32.5] days) compared to the LATE group (median 31, IQR [23.5, 52.5] days; p = 0.02). After controlling for confounding variables, the LATE group had recovery times that were 1.39 times as long as the EARLY group (p < 0.01).

Conclusions: For patients with vestibular issues after SRC, early vestibular rehabilitation initiation is associated with faster recovery time after SRC. The current study provides clarity on the optimal timing of vestibular rehabilitation after SRC.

Objectives: To explore how participation in physical exercise (PE) changes over time after an anterior cruciate ligament (ACL) injury. Additionally, to identify factors associated with participation in PE by analyzing longitudinal data.

Design: An explorative analysis of the NACOX study, a prospective multicenter cohort study.

Methods: Patients with an acute ACL injury aged 15-40 years were followed for three years. The patients regularly reported participation in PE, knee function, new injuries, and surgeries. State sequence analysis and Hierarchical Cluster Analysis were used to analyze participation in PE. Clusters were compared using an analysis of variances, the Chi-square test, and Fischer's exact test.

Results: The study included 275 patients, 52 % female, with a mean age of 25 years. Four clusters were identified, varying from low to high participation in PE after an ACL injury. Clusters differed regarding the number of ACL reconstructions (ACLR) (p = 0.03); time from injury to ACLR (p = 0.03); patient-reported knee function at the follow-ups at 3 months (p = 0.02), 6 months (p = 0.02), and 12 months (p = 0.02) after injury; PE level before injury (p < 0.001); and number of new injuries and surgeries (other than ACLR) (p = 0.001).

Conclusions: Four clusters, varying from low to high participation in PE after an ACL injury were identified. The results provide valuable insight into factors associated with different levels of participation in PE, which can be helpful for healthcare personnel working with ACL rehabilitation.

Long-term memory is important for cognitive health across the lifespan. Previously research has indicated that a bout of exercise improves memory retention for approximately one week; however, its prolonged effects are unknown. This study investigated the effects of acute moderate-intensity exercise on long-term memory for 11 months. Participants engaged in the exercise intervention and seated rest control condition, followed by a word encoding memory task. Word retention in the exercise intervention was better than in the control condition at 6- and 8-weeks post-encoding. These findings suggest that exercise before encoding enhances long-term episodic memory recall for at least eight weeks.

Objectives: To identify descriptors associated with success in apprentice jockeys and to determine optimum numbers of jockeys for safer race riding.

Design: Retrospective cohort study.

Methods: Incidence-rates for jockey falls and success (wins per 1,000 race-starts), time and number of races spent at different apprentice levels were calculated for 807 apprentice and professional jockeys over 19 years of Thoroughbred flat racing in New Zealand (n = 524,551 race-starts). Survival analysis was used to compare career progression for jockeys that fell and those that did not, and individual seasonal fall incidence-rates were modelled.

Results: Apprentices had the highest fall incidence-rate in their first year of race riding (2.4, interquartile range 1.7-3.2 vs 1.1, interquartile range 1.0-1.2, p < 0.05) and a lower success incidence-rate compared to non-apprentice jockeys (71, interquartile range 67-75 vs 97 interquartile range 96-98, p < 0.05). Jockeys who fell during their apprenticeship rode in more race rides to progress towards professional status than those who did not. There was an inverse power relationship between fall incidence-rate and race rides per season for jockeys, with the inflection point at 33 rides per season. Half (48 %) of the jockeys rode fewer than 33 rides per season.

Conclusions: There is a surplus number of jockeys, riding at high fall risk, produced than is required by the number of race riding opportunities. Greater investment into the fitness, education and selection of a smaller cohort of dedicated apprentices, may be beneficial to reduce the risk of early career fall or injury in jockeys and requires further investigation.

Objectives: First, to investigate the medico-socio-professional repercussions of non-fatal cranioencephalic and spinal injuries occurring across all levels of play in male and female Rugby Union in France. Second, to determine whether an association existed between the severity of injuries and the circumstances of their occurrence and/or the profiles of the injured players. Third, to gather new epidemiological data regarding the severity and long-term consequences of these injuries in the sport.

Design: National retrospective observational open cohort study conducted using medical expertise files on all injuries registered by the insurer affiliated to the French Rugby Federation.

Methods: We analysed the medical reports of spinal, craniofacial or radicular trauma occurred from 26/08/2011 to 31/01/2018. Data relating to the severity and the circumstances of the injury, and its medical and socio-professional consequences (e.g., ability of players to continue playing rugby and/or professional/scholastic activity, receiving or not financial compensation) were extracted.

Results: 199 cases were identified. The overall incidence rate of injuries was 10.57/100,000 person-years. The median PMI value after consolidation was 6 %. Five cases had a PMI value equivalent or higher than 50 %. 85 % of players were able to return to work/studies whilst 47 % returned to rugby overall. Injury severity did not differ between age groups, genders, performance levels, training/match-play or according to the game situation.

Conclusions: Although rare, craniofacial and spinal injuries in rugby can leave sequelae with substantial repercussions on personal, professional/scholastic and sporting life. Further research into their potential causes and targeted prevention strategies is warranted.

Objectives: Identify tackle characteristics associated with concussions in male professional rugby league.

Design: Case-control study.

Methods: Tackles resulting in 196 clinically diagnosed concussions and 6592 non-concussive tackles were analysed, from the men's rugby league Super League between 2018 and 2022. Eleven tackle characteristics were coded for each tackle, and Firth penalised logistic regression models were employed to identify influential variables through forward stepwise selection. Three multivariate models were produced; all (i.e., ball-carrier and tackler), tackler, and ball-carrier concussions.

Results: Of the 196 concussions, 70 % occurred to the tackler and 30 % to the ball-carrier. Initial impact location on the ball-carrier was identified as a predictor in all models, specifically the shorts, upper- and lower-leg (OR 9.1-12.3, compared to shoulder) for tacklers and head/neck (OR 66.1, compared to shoulder) for ball-carriers. Tackler head placement in front of the ball-carrier (OR 8.5, compared to away from the body) and a ball-carrier leading arm in any position (OR 4.8-22.1, compared to no leading arm) provided the greatest odds of a tackler concussion. For player's body position the greatest risk of concussion for all players was observed when both players were falling/diving (OR 8.8, compared to both players upright). One (OR 4.9, compared to two) and four (OR 3.7, compared to two) defender tackles provide the greatest odds for all concussions.

Conclusions: Concussion prevention strategies should aim to reduce head impacts by deterring initial contact with the ball-carrier's head/neck. Tackle technique should prioritise making initial impact with the torso and avoid the head being in front of the ball-carrier and any leading arms.

Objectives: To explore the priorities and directions of athlete upper and lower limb pain assessment by facilitating shared understandings of athletes and sport physiotherapists.

Design: Qualitative research using a hermeneutic phenomenological approach.

Methods: We carried out focus groups comprising a deliberate criterion sample using a constructivist perspective. At the end of each focus group, we used the nominal group technique method to generate a list of consensus-based priorities for future pain assessment. Our paper follows the consolidated criteria for reporting qualitative research (COREQ) guidelines.

Results: We completed five focus groups, comprising twelve athletes (female, n = 5, male, n = 7) and four sport physiotherapists (male, n = 4). Two final themes (and six subthemes) were developed; I Enhanced Communication and Pain Descriptions (describing and representing pain, better communication, the role of technology, providing direction and setting the pace), and II Integrating Sport Specific and Multidimensional Assessments (broadening the pain assessment toolkit, the role of technology). We developed a set of thirteen practical priorities for pain assessment that span the subjective, objective, and general aspects of the athlete pain assessment.

Conclusions: We have presented stakeholder-generated perspectives, direction and priorities for athlete pain assessment. Athletes and physiotherapists must continue to work together to achieve a comprehensive sport-specific multidimensional pain assessment experience alongside their wider support networks to ensure optimal representation and communication. We have highlighted some available pain assessment tools and strategies and outlined how novel tools may address certain gaps. Researchers, clinicians, and athletes can consider the practical guidance we have provided to address these priorities.

Objectives: To explore the content (subjective questions, objective tools and outcome measures) and discuss the nature (qualitative elements and wider considerations) of the athlete pain assessment by facilitating shared understandings of athletes and sports physiotherapists.

Design: Qualitative research using a hermeneutic phenomenological approach.

Methods: We carried out focus groups comprising a deliberate criterion sample using a constructivist perspective. We developed a topic guide and used reflexive thematic analysis. We developed codes, candidate themes and finalised themes iteratively, and employed a critical friend to add depth to our analysis. Our paper follows the consolidated criteria for reporting qualitative research guidelines.

Results: We completed five focus groups comprising twelve athletes (five female, seven male) and four sports physiotherapists (four male). Three final themes (and eight subthemes) were created; (i) Measures, Scales and Dimensions (value and limitations of tools and scales, multidimensional methods, making sense and interpreting), (ii) Connect, Listen and Learn (the pain interview and athlete's story, forging the athlete-clinician connection), and (iii) Lighthouse in the Storm: providing direction for athletes in pain (information overload and indecision, a beacon of direction; the role of the physiotherapist, the burden of expectation; challenges for physiotherapists).

Conclusions: We described and explored the phenomenon of pain assessment in sport including current pain assessment strategies. Comprehensive multidimensional assessment methods that preserve the athlete-clinician therapeutic relationship and facilitate optimal communication are priorities for future research and practice.