Scandinavian Journal of Medicine & Science in Sports最新文献

This umbrella review systematically examines pharmacological strategies for exercise-induced bronchospasm (EIB), characterized by a transient airway narrowing post-exercise, often diagnosed by a ≥ 10% reduction in forced expiratory volume in 1 s. EIB is prevalent among elite athletes and individuals exposed to environmental triggers such as cold air and pollutants. Analyzing data from 10 systematic reviews, including 8 meta-analyses, evidence confirms the efficacy of treatments including β₂-adrenoceptor (AR) agonists, muscarinic antagonists, inhaled corticosteroids (ICS), leukotriene receptor antagonists (LTRA), and mast-cell stabilizers. β₂-AR agonists demonstrate significant protective effects despite concerns regarding long-term use, while combination therapies with ICS and LTRA provide additional benefits. A key proposal is the terminological distinction between EIB and "Exercise-Induced Asthma ATtack" (EIAAT), advocating for the use of EIAAT to identify asthma exacerbations during exercise in asthmatics and EIB characterized by bronchospasm in non-asthmatics, thus avoiding misdiagnosis in athletes and guiding appropriate management. The review highlights the promising role of ICS/formoterol in pre-exercise, as-needed, and Single Maintenance and Reliever Therapy (SMART) regimens, emphasizing the need for randomized controlled trials in athletes with EIB and EIAAT. Ensuring appropriate therapy access while maintaining integrity in competitive sports is pivotal, especially with evolving pharmacological options and anti-doping regulations.

This systematic review and meta-analysis (CRD420251006746) investigated the impact of inhaled β₂-adrenoceptor (AR) agonists (IBA) with exemption according to the World Anti-Doping Agency (WADA) 2025 list on athletic performance, respiratory, and cardiovascular outcomes. A key subgroup analysis focused on IBA administered within WADA 2025 permitted dose intervals. Findings indicate that IBA significantly improved sprint time by 0.30 s (95% CI 0.52-0.07) overall, and by 0.27 s (95% CI 0.50-0.05) in healthy subjects, with long-acting β₂-AR agonists yielding a 0.49 s (95% CI 0.81-0.17) improvement. These sprint time enhancements persisted even at WADA-permitted doses. Blood lactate levels significantly increased by 0.67 mmol/L (95% CI 0.19-1.14) overall and by 0.65 mmol/L (95% CI 0.17-1.14) in healthy subjects, though this effect was not significant at WADA-permitted doses. IBA significantly improved forced expiratory volume in 1 s by 0.19 L (95% CI 0.14-0.23) and forced expiratory flow between 25% and 75% by 0.40 L/s (95% CI 0.24-0.56), with lung function improvements confirmed at WADA-permitted doses. Heart rate significantly increased by 1.40 bpm (95% CI 0.32-2.48). IBA did not influence aerobic performance. When administered within WADA 2025 permitted doses, IBA can provide small but relevant gains in anaerobic performance in healthy individuals, while simultaneously offering therapeutic bronchodilation for athletes with asthma or exercise-induced bronchoconstriction. Dose restrictions are critical to minimize the risk of performance enhancement that exceeds therapeutic intent and to mitigate adverse effects. Further research is pivotal to ensure that anti-doping policies align with health standards and ethical considerations for all athletes.

Combined events are an Athletics discipline with specific and particular challenges for performance and health, supporting the interest of focused research on this discipline, despite concerning a small proportion of athletes. The study aim was to summarize and map the available scientific literature on performance and health of combined events to establish the current level of understanding and identify knowledge gaps that require further investigation. A scoping review was conducted searching peer-reviewed articles dealing with performance and/or health in combined events (i.e., pentathlon, heptathlon or decathlon) on the MEDLINE (via PubMed), EMBASE (via Ovid), Web of Science, and Google Scholar databases, from inception to October 13, 2025. In total, 111 articles were included, with 95.5% as primary research, 95.5% using quantitative approach, 22.5% with a level of evidence 1b and 48.6% 2b, and 56.8% with study aim(s) focused on combined events understanding and/or analyzing. 64.0% articles dealt with performance and 59.5% with health, including 23.4% dealing with both. Regarding performance, the majority of articles dealt with performance analysis/tactics/data management (56.3%), followed by physiology (21.1%), and nutrition (11.3%). Regarding health, the majority of articles dealt with injuries (62.1%), followed by physiology (22.7%), illnesses (18.2%), and nutrition (12.1%). These findings (i) can help to suggest some clinical implications for performance enhancement and health protection, and (ii) highlighted the need for continuing research on performance and/or health in combined events, preferably with prospective design, large athletes' sample sizes, focused on underrepresented populations (e.g., women, adolescents, Masters athletes), over one or more Athletics season.

Anabolic androgenic steroid (AAS) use is associated with various health risks, yet its impact on healthcare expenditures remains insufficiently explored. This nationwide register-based study examined direct healthcare costs among 1183 males sanctioned for AAS use in Denmark between 2006 and 2017, compared with 59 150 age- and sex-matched controls from the general population. Healthcare costs were calculated across primary care, hospital services, and prescription drugs, with up to 10 years of follow-up. AAS users had significantly higher total healthcare costs, with a mean excess of 3299 euros (EUR) per person (95% CI: 1857-4742; p < 0.0001) over the follow-up period, corresponding to approximately EUR 537 per AAS user per year. This represents a 45% increase over controls, whose average total costs were EUR 7393 per person. The cost difference was primarily driven by hospital care but was also evident in primary care and prescription medication use. Cumulative cost differences increased steadily over time and remained consistent across most diagnostic categories. AAS users were relatively young and otherwise expected to have low healthcare use, suggesting a notable health burden in this group. These findings add real-world evidence on the healthcare implications of AAS use and highlight a sustained cost difference between AAS users and controls over a prolonged period. Continued follow-up may be necessary to fully capture long-term costs, particularly as some complications may appear years after use.

Low-load blood-flow restriction (BFR) training is a potential alternative to high-load (HL) resistance training, especially when mechanical stress must be minimized. However, its effects on neuromuscular activation remain unclear. This randomized controlled trial compared changes in voluntary activation (VA) and neuromuscular performance following 8 weeks of BFR versus HL knee extensor training and examined the effects of a subsequent 2-week HL phase in both groups. Thirty-seven healthy adults (37-59 years, 22 female) underwent progressive BFR or HL training for 8 weeks (phase 1), followed by 2 weeks of HL training on knee extensor muscles (phase 2). Outcomes included VA, maximal isometric and dynamic leg extension and leg press strength, rate of force development (RFD), and jump performance. Linear mixed models were used to analyze group*time interactions; Cohen's d effect sizes are reported. After both training phases, the BFR group showed smaller improvements than HL in VA (d = -0.31 to -0.37), maximal isometric strength (d = -0.07 to -0.27), dynamic strength (d = -0.18 to -0.75), and RFD (d = -0.48 to -0.54). Jump performance showed trivial between-group differences (d = -0.01 to -0.05). Although a subsequent 2-week HL phase improved outcomes in the BFR group, it did not fully restore neural adaptations to the level of continuous HL training. These findings underscore the essential role of mechanical loading in optimizing neuromuscular function. While BFR may serve as a useful preparatory method in contexts where high loads are initially contraindicated, follow-up HL training is required to maximize neuromuscular adaptation. Trial Registration: This study was preregistered on the Open Science Framework (DOI: 10.17605/OSF.IO/DA6SV).

Children and adolescents with overweight or obesity are less physically active than their lean counterparts. We examined the effects of adding a 3-month high-intensity interval training (HIIT) program to a 12-month lifestyle intervention on physical activity (PA) in children and adolescents with overweight or obesity. Participants were randomized to a 12-month lifestyle intervention (control, N = 83) or a 12-month lifestyle intervention with a 3-month HIIT program (HIIT, N = 90). PA was assessed using accelerometry at baseline, and subsequently at 3 and 12 months. Linear mixed models estimated the mean difference in PA intensity between groups. Associations were explored using Pearson's correlation coefficient. The HIIT group showed a greater increase in moderate-to-vigorous PA (MVPA) after 3 months (p = 0.04), with a mean increase of 8.3 min per day (p < 0.01) compared to 0.9 min per day (p = 0.75) in the control group. At 12 months, there was no difference between the groups (p = 0.64), and MVPA returned to baseline levels. Across randomization, sedentary time increased by 17.5 min per day (p = 0.02) at 3 months and by 29.9 min per day (p < 0.01) at 12 months. Changes from baseline to 12 months in vigorous activity were inversely correlated with changes in BMI z-score (r = -0.26, p = 0.02). Adding a 3-month HIIT program to a 12-month lifestyle intervention in children and adolescents with overweight or obesity increased MVPA at 3 months, but not at 12 months. The inverse correlation between changes in vigorous-intensity PA and changes in BMI z-scores underscores the potential of incorporating vigorous-intensity activities into obesity treatment programs. Trial Registration: ClinicalTrials.gov: NCT05465057.