Sports Medicine - Open最新文献

Current evidence provides both rationale and preliminary support for an association between hip abductor weakness and detrimental running biomechanics. Previous reviews suggest a potential, but inconsistent, role of hip abductor strength in controlling lower limb biomechanics, with conclusions varying depending on the methodology, population, and task. This scoping review aimed to identify and map all available evidence about the influence of hip abductor strength on running biomechanics in healthy runners comparing study designs and methods. Four databases (PubMed, Web of Science, Scopus, and SPORTDiscus) were systematically screened for peer-reviewed articles in English investigating the influence of hip abductor strength on running biomechanics in healthy runners. Running biomechanics were defined as any quantitative kinematic (e.g., joint angles) or kinetic (e.g., joint moments) outcome. Eligible studies were synthesized and presented in a summary table, including general and experimental study characteristics and outcome results. After removing duplicate entries, 1322 records were identified, and 19 articles found to be eligible. These studies examined a wide range of gait cycle characteristics across a diverse set of biomechanical variables. Most studies focused on the hip (n = 16) followed by the knee (n = 8), and pelvis (n = 7). Fewer studies examined the trunk (n = 3), followed by the ankle (n = 2), and tibia (n = 1). Frequently reported outcomes included peak angles, range of motion, angular excursion, and peak velocity. Study designs and methodologies varied considerably. Most studies were cross-sectional (n = 17), while only two were intervention trials, both with notable methodological limitations. Overall, the evidence provides insufficient support for a consistent association between hip abductor or external rotator strength and running biomechanics in healthy runners, and no convincing evidence that strengthening these muscles alone leads to systematic or predictable changes in running kinematics or kinetics. These findings challenge commonly held assumptions regarding the biomechanical effects of hip strengthening and highlight the need for well-controlled intervention studies with greater methodological consistency. Future research should prioritize experimental designs that test hip strengthening under specific conditions, such as fatigue or higher running speeds, to determine whether meaningful biomechanical effects occur.

Background: Portable blood lactate analyzers (PBAs) are increasingly used in sports and clinical contexts to assess physiological responses. Blood lactate is a critical biomarker for evaluating performance and metabolic thresholds. However, variability in device accuracy, sampling procedures, and calibration raises concerns about their validity and reliability.

Objectives: To systematically review peer-reviewed studies assessing the validity and reliability of commercially available PBAs compared to laboratory reference methods and to evaluate the methodological quality and certainty of evidence using the Consensus-based Standards for the selection of health Measurement INstruments (COSMIN) and Grading of Recommendations Assessment, Development and Evaluation (GRADE) frameworks.

Methods: Following PRISMA 2020 guidelines, a systematic search was conducted across PubMed, Web of Science, Scopus, and SPORTDiscus. Of 253 records identified, 25 studies met the inclusion criteria. Validity was assessed using statistical measures such as Pearson's correlation coefficient (r), concordance correlation coefficient (CCC), Bland-Altman limits of agreement (LoA), and mean absolute error (MAE). Reliability was evaluated using intraclass correlation coefficient (ICC), coefficient of variation (CV), and standard error of measurement (SEM). COSMIN and GRADE were used to rate study quality and evidence certainty.

Results: PBAs (e.g., Lactate Pro, Lactate Scout, Accutrend, Lactate Plus) showed strong correlations with reference standards (r = 0.95-0.99) and high reliability (ICC > 0.90; CV < 5%). However, systematic biases at higher lactate concentrations were common. Thirteen studies had high methodological quality.

Conclusions: PBAs demonstrate strong reliability and moderate-to-high validity. Standardized protocols and improved calibration are needed to ensure consistency with laboratory-grade analyzers.

Background: Competitive anxiety is a common psychological challenge among athletes and can negatively affect sports performance. Although several psychological interventions have been shown to reduce competitive anxiety, their relative effectiveness has not been well established. This study aimed to compare the effectiveness of different psychological interventions in reducing competitive anxiety in athletes.

Methods: We searched the Cochrane Library, Embase, PubMed, Scopus, and Web of Science from inception to March 2025, with additional screening of Google Scholar and reference lists. Randomized controlled trials published in English were eligible. Risk of bias was evaluated using the revised Cochrane Risk of Bias Tool. A Bayesian random-effects network meta-analysis was conducted using the 'multinma' package. Subgroup analyses examined anxiety dimensions and competitive level. Effects were expressed as standardized mean differences (SMDs) with 95% credible intervals (CrIs).

Results: A total of 46 trials involving 2,049 participants were included. Mindfulness-Acceptance-Commitment (MAC) showed the largest overall point estimate for reducing competitive anxiety (SMD = - 1.33; 95% CrI: -2.31 to - 0.43). Across anxiety dimensions, relaxation was associated with the largest point estimate for reductions in cognitive anxiety (SMD = - 1.54, 95% CrI: -3.31 to 0.21), while MAC showed the largest estimated effect on somatic anxiety (SMD = - 1.24, 95% CrI: -1.57 to - 0.90). Intervention effects appeared to vary by competitive level: imagery showed the largest point estimate among elite athletes (SMD = - 0.88, 95% CrI: -1.84 to 0.14), MAC among semi-elite athletes (SMD = - 1.37, 95% CrI: -3.11 to - 0.17), and biofeedback among junior athletes (SMD = - 1.07, 95% CrI: -2.26 to 0). Exploratory study-level mediation analyses suggested that reductions in competitive anxiety were associated with improvements in sports performance.

Conclusions: MAC showed the highest estimated effects overall; however, uncertainty remains substantial given the wide credible intervals and limited data for several intervention nodes. Psychological interventions were associated with improved sport performance, and changes in competitive anxiety may be one contributing factor. These findings support the potential value of tailored psychological training approaches for athletes, while underscoring the need for more robust comparative evidence.

Background: Advanced footwear technology (AFT) can enhance long-distance running performance by improving running economy (RE). However, the range of the individual improvements is large. Different intra-individual responses in running biomechanics may account for some of the variation. Thus, this randomized within-subject crossover study aimed to identify biomechanical factors associated with changes in RE when running with different AFT models.

Methods: Twenty-two trained long-distance runners (50% female) ran multiple 5-minute running bouts at their season's best marathon pace (15.0 ± 2.3 km⸱h^- 1) while wearing three standardized AFT models (Nike Air Zoom Alphafly Next% 2, Puma Fast-R Nitro Elite v1, Asics Metaspeed Sky+). During each condition, gas exchange data and three-dimensional kinematics and spatiotemporal variables were acquired. RE was determined as the energetic cost of transport. We used two complementary model selection strategies (Akaike Information Criterion model averaging and least absolute shrinkage and selection operator) to identify biomechanical parameters associated with intra-individual differences in RE, and a repeated measures ANOVA to compare RE between shoes at the group level.

Results: Across shoe conditions, shorter ground contact time was significantly associated with lower energetic cost of transport (β = 0.025, 95% CI [0.010, 0.040], t(42) = 3.33, p = 0.002), reflecting a ~ 1% improvement in RE per 4 ms decrease. We did not find group-level differences in RE between shoe conditions (p = 0.246).

Conclusions: AFT models that reduced runners' individual ground contact time were associated with improved RE. This effect appears to depend on the individual athlete-shoe interaction since no single AFT model stood out as an overall optimum. These findings can help determine optimal footwear for athletes. Future studies should investigate the interaction of AFT properties and individual biomechanics to identify further RE improvements through footwear individualization.

Background: This study aimed to examine differences in external load among professional soccer players during congested weeks across different competition types (League, Cup, and Champions League (UCL)), considering individual match playing time. A retrospective, descriptive, and longitudinal analysis was conducted using external load data from 120 players belonging to the top five teams in the Spanish LaLiga during the 2023/24 season, including 2,671 match observations. Players were categorised by playing time (Starters, Replaced, Fringe, and Non-Starters), and weeks were classified as non-congested (NCON) or congested (CON), with further distinction by competition type. External load metrics were recorded using the Mediacoach^® tracking system and analysed through Linear Mixed Models.

Results: Results indicated that players in NCON weeks covered significantly less distance at very low-speed running (VLSR) and at low-speed running (LSR) compared to CON weeks (both p < .01). Players in CON weeks by League covered significantly higher total distance (TD) compared to UCL congested weeks (p < .001) and NCON weeks (p < .01). In CON weeks by Cup, Non-Starters, who accumulated between 0 and 59 min across two matches, covered significantly higher very high-speed running (VHSR) than CON weeks by UCL (p < .05) and NCON weeks (p < .05).

Conclusions: These findings underscore the relevance of competition context and match playing time when analysing external load during matches. Tailoring training and rotation strategies based on external load data and competition type may help maintain performance and reduce fatigue.

The 24-hour ultra-marathon is a specific race format with a long tradition and high popularity. To date, no comprehensive review has systematically summarized the scientific literature on 24-hour ultra-marathon running. We performed a comprehensive search in the PubMed and Scopus databases, covering studies published until the end of 2025. The participation of runners and finishers in 24-hours has increased in the past decades. Most participants in 24-hours are age group or master runners older than 35 years. 24-hour ultra-runners typically cover distances exceeding 100 km per event, with an average distance ranging from ~ 150-160 km, while the top performers can achieve over 200 km. Men achieve greater distances than women. The best performance is achieved at 40-50 years. The most important predictive variables in 24-hours are training, nutrition, previous experience, and pacing; anthropometric characteristics seemed of no predictive value. During 24-hours, athletes ingest mainly carbohydrates and experience an energy deficit, but rarely exercise-associated hyponatremia. A 24-hour run leads to decrease in body mass, which can be due to dehydration, a loss of skeletal muscle mass, and/or a loss of fat mass. A 24-hour run has effects on the cardiovascular system (i.e., decrease in blood pressure, changes in cardiac biomarkers, and changes in electrocardiogram and echocardiographic findings), the kidneys (i.e. reversible impairment of kidney function), the digestive system (i.e., gastrointestinal discomfort, reversible increase in liver enzymes), the immune system (i.e., increase in immune markers) and the hematological system (i.e., decrease in red blood cells, increase in white blood cells). All negative effects are resolved within 2-3 days. In summary, 24-hour ultra-marathon runners are master athletes with extensive experience, optimal training preparation, and optimal nutrition to complete a 24-hour run successfully. The adverse effects on the heart, kidneys, immune system, and digestive tract generally resolve within a few days after the event. Future studies need to investigate nutrition after the race to enhance recovery and the impact of training and competing in this specific race format on the locomotor system (i.e. skeleton, muscles, tendons, joints). KEY POINTS: The number of runners in 24-hour ultra-marathons has increased globally, with a significant increase among master athletes (35 + years). Training, nutrition, previous experience, and pacing are essential for optimizing performance. Men continue to cover greater distances than women, but this gap has been decreasing over time. The race influences multiple body systems, but most changes resolve within a few days. Further studies should concentrate on post-race recovery and the long-term effects of ultra-marathon running on the musculoskeletal system.

Background: The gut microbiome plays a critical role in metabolism, immunity, and aging. While endurance training has been shown to beneficially modulate the microbiome, the effects of resistance training remain less clear, with some studies reporting minimal changes. This project aims to investigate whether structured resistance training elicits significant changes in gut microbiome composition and diversity in sedentary, healthy adults. 150 participants (85 female, 63 male), between 24 and 61 years of age, completed an 8-week supervised resistance training program between May 2022 and July 2023 in the cities of Tübingen and Rottenburg, Germany. Session-level training data, including weights and repetitions, were recorded alongside metrics like load and compliance. Fecal samples were collected throughout the study period at designated timepoints for 16S rRNA gene amplicon sequencing to assess microbiome composition and for metabolomics analyses to evaluate microbial metabolic activity.

Results: No differences in microbial diversity were observed, and there were no significant changes in microbial community composition or fecal metabolomics across all participants post-training. However, within-individual microbial community changes significantly correlated with strength improvement (Pearson correlation coefficient r = 0.167, p = 0.0004), and significantly stronger shifts in beta diversity were observed in participants with ≥ 33% average strength gains compared to those with ≤ 12.2% gains (Kruskal-Wallis rank sum test, p = 0.08). In these high responders, differential abundance analysis revealed time-dependent microbial changes, with 27 taxa enriched or depleted by week 8 of training (ANCOM-BC2, ≥ 2-fold change, p ≤ 0.05). Notably, Faecalibacterium and Roseburia hominis-both associated with a healthier, anti-inflammatory microbiome-were significantly enriched. Many differentially abundant taxa belonged to the Lachnospiraceae family.

Conclusions: Resistance training drives significant, time-dependent gut microbiome changes, particularly in those demonstrating greater improvements in strength. These shifts mirror endurance training effects and may reflect improved overall health.

Background: The modality of resistance training (e.g., plyometric training [PLYO], traditional resistance training [TRT]) can specifically affect gains in muscle strength and power measures in soccer players. Further, effects of resistance training modality on neuromuscular performance measures (e.g., electromechanical delay [EMD]) are inconsistent in non-athletes.

Objective: To examine the effects of PLYO, TRT, and combined PLYO and TRT (i.e., complex training [CT]) on muscle strength, power, and EMD in highly trained male soccer players (age: 21.7 ± 1.6 years).

Methods: Participants were randomly assigned to eight weeks of CT (n = 30), PLYO (n = 28), and TRT (n = 26) in addition to their regular soccer training, or soccer training control condition (n = 29). Pre- and post-measurements comprised tests for maximal eccentric knee flexor and concentric knee extensor peak torque (PT), their functional ratio (FUNC-H/Q), and the corresponding EMD of the knee flexors at three angular velocities (60, 180, and 300°/s).

Results: Results showed a significant main effect of group for concentric and eccentric PT (p<.001, 1.67 ≤ d ≤ 3.17). Concentric and eccentric PT were larger for CT, PLYO, and TRT groups compared to control group (CG) with the greatest effects for CT across all angular velocities (p<.001, 0.95 ≤ d ≤ 3.57). Additionally, a significant group effect was identified for FUNC-H/Q at 300°/s (p=.002, d = 0.83) with lower ratios in PLYO and TRT groups but not CT compared with CG (p<.001, -0.94 ≤ d≤-0.83). Further, significant and large-sized group effects for EMD were found at 60, 180, and 300°/s (p<.001, 0.96 ≤ d ≤ 2.89). Post-hoc test showed lower EMD values in CT compared with PLYO, TRT, and CG (p<.001, -2.88 ≤ d≤-0.87). Moreover, EMD was lower in PLYO and TRT compared with CG at 60 and 300°/s (p<.001, -1.84 ≤ d≤-1.10).

Conclusions: Complex training, PT, and TRT were effective training modalities in improving neuromuscular performance (i.e., maximal eccentric knee flexor/concentric knee extensor PT, knee flexor EMD) in highly trained soccer players. More specifically, CT appears to be superior in maintaining higher FUNC-H/Q values compared with PLYO and TRT.

Trial registration: This study does not report results related to healthcare interventions using human participants and therefore it was not prospectively registered on a clinical trial registry.

Background: Heart Rate Variability at rest has been recently associated with metabolic outcomes alongside exercise, which in turn have been associated with energy expenditure, muscle power and fat mass. This study aimed to analyse the relationship at rest between autonomic function and metabolic outcomes, in physically active postmenopausal women. We hypothesised that, autonomic function is more strongly associated with Fat oxidation than basal metabolic rate. In sixty-one active postmenopausal women (67.9 ± 5.3 years; 40.3 ± 4.3 kg muscle mass) basal metabolic rate and Heart Rate Variability analysis was recorded simultaneously for 30 min with participants resting supine under standardised activity and diet conditions.

Results: Root Mean Square of Successive Differences of heart beats (RMSSD) and Total power showed a predictive value for resting Fat oxidation (β = 0.46; β = 0.26), explaining 30% of the variance. Including traditional predictors such as energy expenditure increased explained variance to 57.5%. In this model, RMSSD association disappeared, Total power (β = 0.88) became the strongest predictor, and together with energy expenditure (β = 0.53), showed significant associations with FATox. Respiratory exchange ratio only correlated with RMSSD (β = - 0.54) in the isolated Heart Rate Variability model, without basal metabolic rate associations. Box plots of RMSSD quartiles revealed a difference in fat-oxidation between the highest and lowest quartiles, a pattern not seen for Total power.

Conclusion: Baroreflex activity and fat oxidation associate at rest in active postmenopausal women with preserved cardiovascular function. Total power emerges as the strongest Heart Rate Variability predictor of baseline Fat oxidation in the multivariable models. Stratification by RMSSD quartiles revealed graded differences in fat oxidation rates across levels of vagal modulation.

Trial registration: Clinical Trials, NCT06336070. https://clinicaltrials.gov/study/NCT06336070 Registered: 4 April 2024.

Background: Variation in muscle stiffness, reflected by changes in shear modulus (G) measured via shear wave elastography (SWE), is linked to muscle fatigue and athletic performance. Although fatigue recovery varies across populations due to sex and training background, quantitative evidence remains limited. This study aimed to assess changes in passive muscle G during fatigue and recovery and to evaluate the applicability of SWE for monitoring muscle fatigue.

Methods: Thirty-five athletes and 16 non-athletes participated. Muscle fatigue was induced using unilateral eccentric dumbbell elbow flexion at 90% one-repetition maximum (three sets of 10 repetitions plus a final set to exhaustion). G was measured using SWE at baseline, immediately post-exercise, and at 24 and 48 h. Linear mixed-effects models examined the effects of group and time on G, with arm dominance included as a controlled factor.

Results: A significant main effect of time on G was observed (P < 0.001), with no main effects of group or arm dominance and no significant interactions (all P > 0.05). At baseline, non-athlete females showed lower G than athletes in the dominant arm and lower G than male athletes in the non-dominant arm (P < 0.05, effect size [ES] = 1.05-1.39). Immediately, G increased in male athletes, non-athlete males, and non-athlete females (P < 0.05, ES = 0.43-1.34), with non-athlete males showing higher G in the dominant arm than non-athlete females (P < 0.05, ES = 0.95). At 24-hour follow-up, non-athlete females exhibited higher dominant-arm G and lower non-dominant-arm G than non-athlete males and male athletes (P < 0.05, ES = 1.16-1.57). By 48 h, G returned to baseline in male athletes and non-athlete males, while non-athlete females showed a significant decrease in dominant-arm G compared to 24 h measurement (P < 0.05, ES = 1.06). An inter-limb difference occurred only in non-athlete females at 24 h (P < 0.05, ES = 1.14).

Conclusions: Passive muscle modulus G reflects muscle stiffness and can be non-invasively monitored using a portable SWE device. Our findings suggest that passive G is a valid indicator for tracking muscle fatigue and recovery across populations.