Journal of science and medicine in sport最新文献

Objectives: Influenza vaccination is a key preventive measure, especially for professional athletes exposed to increased infectious risk due to intense physical activity, frequent travel, and close-contact settings. However, data on vaccine uptake and attitudes in this group are limited. This study examined opinions, behaviors, and determinants of influenza vaccination adherence among male athletes in the Italian Serie A volleyball league during the 2024/25 season to inform targeted immunization strategies.

Design: Cross-sectional observational study.

Methods: A self-administered anonymous questionnaire was distributed to 157 athletes between December 2024 and March 2025. Collected variables included socio-demographic characteristics, vaccination history, perceived influenza risk, vaccination importance, and influencing factors such as medical advice and club policy.

Results: Of 138 respondents (response rate: 87.9 %), 44.9 % intended to vaccinate in the current season, and 63.8 % had been vaccinated previously. Overall, 76.1 % recognized the importance of vaccination. Key motivations were medical recommendations (61.6 %) and club policies (25.4 %). Significant associations were found between perceived influenza risk and vaccination intention (p < 0.001), and between medical recommendation and perceived importance (OR = 3.45, p < 0.01). Age showed no significant association.

Conclusions: Although vaccination is widely regarded as important among professional athletes, adherence is strongly influenced by organizational factors. Medical advice and club support are critical drivers of vaccine acceptance. Tailored communication strategies, integration of vaccination into routine sports medicine, and structured immunization programs are recommended to improve coverage in elite sports and support public health goals.

Objectives: To explore the experiences of people, specifically the acceptability and tolerances of a high and low load-volume (intensity * X sets X repetitions) exercise programme for rotator cuff tendinopathy.

Design: A nested qualitative study with individual in-depth semi-structured interviews.

Methods: Twelve participants (6 high load-volume, 6 low load-volume) were recruited at the conclusion of a pilot and feasibility trial comparing high and low load-volume exercise for rotator cuff tendinopathy. Analysis followed an inductive thematic approach.

Results: Three themes were identified: (1) Intensity: influenced by belief that the treatment will or won't work; (2) adherence: progress reinforced by a positive experience; and (3) education: reassurance and clear instruction regarding pain. Participants expressed initial doubt regarding the rationale behind both the high load-volume intervention and low load-volume intervention (i.e. either too easy or too hard). However, both groups surprised themselves with the improvement they made. Acceptability and tolerance of exercise intensity, either low or high, is are largely influenced by past exercise experience, expectations, attitudes and beliefs regarding the effectiveness of the exercise programme. Findings highlight the acceptability of both approaches for most people with rotator cuff tendinopathy, after some participants were initially apprehensive. Participants expressed the value of practical, informative, condition specific knowledge; the importance of tangible progress with their exercise programme; and appreciation for a low level of burden in adhering to their exercise.

Conclusions: Individualisation of exercise intensity is important, yet needs to consider individual preference, response to the load stimulus and the patients baseline physical capacity.

Objectives: To profile professional rugby union players using longitudinal hip, groin and hamstring strength measures and identify characteristics associated with non-contact lower limb injury and reinjury.

Design: Prospective cohort study.

Methods: 248 players were involved in the study. Over 24 months, injury surveillance data was collected, and a battery of strength tests were conducted at the start of each pre-season and mid-season. The strength tests included: Nordic hamstring exercise (Nordic); hip abduction and adduction at 60° (ABD60, ADD60); and 90° of hip flexion (ABD90 and ADD90).

Results: Strength profiles are presented. For the 55 players who featured at the first and last test of the study; Nordic, ADD90 and ABD90 increased in the forwards only (P = 0.002 to 0.01). Strength changes at the end of the study were correlated with measures obtained at the start (r = -0.38 to -0.49), and amongst the test battery measures (r = 0.42 to r = 0.68). Hamstring, and hip/groin made up 43 % of lower limb non-contact injuries. Those who sustained a hip/groin injury had greater odds (OR = 4.0, P = 0.0016) of also suffering a hamstring injury. For injured players, only ABD60 reduced post-injury (P = 0.0021). Players who reinjured were characterised by lower pre-injury ADD90; and either higher pre-injury Nordic or an ADD90 that did not improve post-index injury. Pre-season strength profiles remained unchanged for uninjured players.

Conclusions: Strength changes were observed overtime, and post-injury. Players who were weaker from the outset improved whilst those who were stronger struggled to maintain strength. Changes from pre-season to in-season are important since most prospective injury studies only measure strength during pre-season. Strong knee flexor strength alone may not protect from reinjury, and further investigations are required to further support the observations that adductor strength is a protective factor in lower limb non-contact reinjury in rugby union players.

Objectives: The long-term effects of high training volumes in young competitive athletes on vascular health are still unclear. The aim of this study was to evaluate the natural course of central systolic blood pressure (cSBP) over time from longitudinal assessment in young athletes.

Design: Prospective longitudinal cohort study.

Methods: 512 children and adolescents (13.4 ± 1.9 years at first measurement, n = 70 girls) were assessed for cSBP between 2012 and 2024. Over a mean follow-up period of 2.2 ± 1.3 years, 1432 follow-up assessments have been conducted. cSBP was noninvasively assessed by oscillometric measurement via Mobil-O-Graph. A linear mixed effect model was performed to examine the course of cSBP over time.

Results: Participants trained on average 8.7 ± 3.5 h per week. cSBP increased significantly over time by 1.90 mmHg per year of age (p < 0.001, 95 % CI 1.64-2.48). The longitudinal increase in cSBP over time remained significant after including sex (β = 1.95, p < 0.001), BMI (β = 1.36, p < 0.001), and sport category (β = 1.92, p < 0.001) into the linear mixed model. The cSBP increase over time was lower in girls compared to boys (β = -0.85, p = 0.025) and in endurance athletes compared to mixed-sport athletes (β = -0.89, p = 0.006).

Conclusions: This study shows a longitudinal increase of cSBP in young athletes. Boys show a steeper cSBP trajectory than girls, while endurance athletes exhibit a slower increase compared with mixed-sport athletes, suggesting sport-specific vascular adaptation. Continuous monitoring of vascular function from childhood into adulthood is recommended for this highly active cohort.

Objectives: To investigate the prevalence of Relative Energy Deficiency in Sport (REDs) in elite adult team ball sport athletes and critically evaluate the methods used to assess prevalence.

Design: Systematic review.

Methods: Six databases were searched in October 2024 for original articles published in English from 2005 onwards. Eligible studies measured prevalence of REDs, low energy availability (LEA), or the Triad in elite team ball sport athletes aged ≥18 years.

Results: Fourteen studies met the eligibility criteria (n = 2 case; n = 2 longitudinal; n = 10 cross-sectional), including 265 athletes representing 12 team ball sports. The 12 included cross-sectional and longitudinal studies used six different methods to identify REDs/LEA prevalence as 0-80 %. Seven studies used energy availability calculations, identifying clinical LEA (<30 kcal·kg FFM^-1·day^-1) in 26.3-63.6 % of athletes. The LEA in Females Questionnaire identified LEA in 29.6-80.0 % of participants across 4 studies. Two studies evaluated REDs via blood/salivary markers, with low total-testosterone in 0-36.4 % of participants. One study found 50 % with low free-testosterone, 9.1 % with low free-T3, and 13.6 % with elevated LDL cholesterol. The REDs Specific Screening Tool identified 33.3 % of athletes in one study at medium risk of REDs. The Exercise Dependence Scale and Eating Disorder Examination Questionnaire were distributed in combination in one study, finding prevalence of REDs in 4.3 % and 25.5 % of participants, respectively.

Conclusions: REDs appears ubiquitous in elite team ball sports, but research remains limited. A criterion approach for evaluating REDs/LEA prevalence is needed for accurate, reliable, and consistent reporting and cross-study comparisons.

Background: This scoping review summarises literature on the prevalence and types of male pelvic floor dysfunction linked to increasing exercise intensity, with a secondary aim of exploring whether a dose-dependent relationship exists between the two.

Methods: A comprehensive search of CINAHL, PEDro, PubMed, Scopus, and Web of Science databases was conducted up to January 2025 using MeSH terms and keywords relating to exercise and PFD.

Results: The search yielded 6031 publications with 1199 duplicates removed prior to screening. After screening 4493 articles, 10 articles were eligible for inclusion. Substantial reporting differences of exercise-related variables were identified. Six studies reported prevalence rates of lower urinary tract symptoms (LUTS), including urinary incontinence, ranging from 3.8 % to 18.8 %. Only one study examined multiple pelvic floor issues, identifying anorectal incontinence in 61.8 % of participants. Studies investigating erectile dysfunction (ED) and chronic prostatitis/pelvic pain (CP/CPPS) reported hazard and odds ratios. When reporting as ratios for ED, CP/CPPS, studies identified that higher weekly MET-minutes of physical activity were slightly more protective than sedentary or lower physical activity levels. The cross-sectional studies reporting LUTS as a sample percentage identified a dose-dependent relationship between weekly MET-minutes and the prevalence of male LUTS, based on both minimum and maximum weighted averages (R = 0.86 vs. R = 0.87).

Conclusions: Athletic males may experience higher rates of LUTS than the general population. A dose-dependent relationship between MET-minutes per week and male LUTS indicates that men who exercise intensely at higher volumes may be at greater risk of symptomology, whereas risk of ED and CP/CPPS may be reduced.

Objective: This study examined the associations of age and running experience with shock attenuation during running, as age and experience may influence passive (body composition) and active (gait) shock attenuation mechanisms.

Design: Cross-sectional study.

Methods: Participants included healthy middle-aged-experienced runners (n = 20, age: 52.95 ± 5.83 years, >1 year of experience, 9-30 mi·week^-1), young-experienced runners (n = 24, age: 22.37 ± 4.09 years, >1 year of experience, 9-30 mi·week^-1), and young-novice runners (n = 14, age: 22.50 ± 3.52 years, <1 year of experience, 3-13 mi·week^-1). Participants ran overground at 3.35 m·s^-1 while triaxial accelerometers measured tibial and low-back impact shock. Frequency-domain axial and resultant shock attenuation was calculated using a transfer function within 3-8 Hz (FB1), 9-20 Hz (FB2), 21-35 Hz (FB3), and 36-50 Hz (FB4) bins. Linear regression tested associations of age among experienced runners and experience among young runners with each dependent variable (α > 0.05).

Results: Middle-aged-experienced runners attenuated less resultant shock within FB1 (p = 0.02, 95 % confidence interval: 1.27-18.71, β = 9.99) and axial shock within FB2 (p = 0.04, confidence interval: 0.40-37.37, β = 28.89) and FB3 (p = 0.005, confidence interval: 17.02-91.71, β = 54.37) than young-experienced runners. Young-novice attenuated less axial shock within FB3 than young-experienced runners (p = 0.02, confidence interval: 6.72-92.13, β = 49.43).

Conclusions: Age and running experience independently influence shock attenuation, suggesting different shock attenuation responses between runner sub-populations.

Objectives: To describe and compare behavioural constructs (BCs) and psychosocial factors related to injury preventive (IP) exercises, training load and pain/injury management in Norwegian youth (aged 12-19) handball and football players and coaches.

Design: Cross-sectional.

Methods: Participants completed a Health Action Process Approach-based questionnaire assessing six BCs: risk perception, outcome expectancies, intention and self-efficacy (task, maintenance, coping), and psychosocial factors: knowledge, attitudes, beliefs, support, and IP facilitators. BC responses were aggregated into scores ranging from 0.14 (lowest) to 1.00 (highest).

Results: In total, 283 football players (131 girls), 245 handball players (194 girls), 193 football coaches (29 women), and 144 handball coaches (69 women) completed the questionnaire. Handball players and coaches had higher intention and self-efficacy compared to their football counterparts (range 0.04-0.09, 0.95 % CI range 0.00-0.12). Compared to players, coaches exhibited higher risk perception (handball: 0.14, 95 % CI 0.07-0.21, football: 0.10, 95 % CI 0.01-0.18), coping self-efficacy (handball: 0.11, 95 % CI 0.02-0.19, football: 0.22, 95 % CI 0.14-0.29), and maintenance self-efficacy (football: 0.12, 95 % CI 0.04-0.18). Players showed greater intention than coaches (handball: 0.10, 95 % CI 0.02-0.19, football: 0.06, 95 % CI 0.01-0.12). BC-scores ≤0.71 were reported for risk perception (players and football coaches), task self-efficacy (players), maintenance self-efficacy (football players and football coaches), and coping self-efficacy (players). Knowledge-building, communication and support were key psychosocial factors.

Conclusions: BC scores, including similar patterns across sports, and coach-player differences suggest that strategies can be consistent across sports and should target risk perception and self-efficacy towards IP exercises, pain/injury, and training load management. Knowledge-building, communication and support should be included.

Objectives: To evaluate the effects of a 12-week low-load blood flow restriction (BFR) training program on physical function, muscle strength, fatigue, physical activity, and manual dexterity in middle-aged individuals with multiple sclerosis (MS).

Design: This study was designed as a randomized controlled clinical trial.

Methods: Sixty-five adults aged 40-65 years with MS (Expanded Disability Status Scale <7) were randomized (32 experimental, 33 control). All participants had not engaged in structured exercise in the past six months and retained sufficient autonomy for training. The experimental group received supervised low-load BFR resistance training twice weekly for 12 weeks (24 sessions), using 30 % of one-repetition maximum. The control group continued with usual care. Exercises targeted the upper and lower limbs with individualized pressure based on estimated arterial occlusion. Primary outcomes included: disease impact (MSIS-29), muscle strength (1RM, handgrip, STS-30), fatigue (Fatigue Severity Scale), physical activity (IPAQ), and manual dexterity (Nine-Hole Peg Test).

Results: Significant improvements (p < 0.05) were found in the BFR group compared to control across all outcome measures. Effect sizes ranged from moderate to large. These included reduced perceived disease impact, enhanced muscle strength, reduced fatigue, increased physical activity, and improved manual dexterity. No adverse events were reported.

Conclusions: Twelve weeks of low-load BFR training is a safe and effective intervention for improving strength, function, and quality of life in middle-aged individuals with MS. It represents a viable alternative to high-intensity training programs in this population.