Sports Medicine - Open最新文献

Interests in eccentric resistance exercises have been increasing in both research and practice. However, implementing eccentric resistance exercise training is often challenging due to the mechanical limitations of traditional training equipment. To address this, flywheel (FW) devices emerged as a practical alternative. FW devices are commonly considered to provide eccentric-overload training, in which the load is greater in eccentric than concentric phase. However, this is not always the case. In this article, we summarize the mechanical and physiological factors influencing the effectiveness of FW devices in achieving eccentric overload. Then, we discuss a significant limitation of FW resistance exercise in accurately quantifying the load, since eccentric mechanical load is constrained by preceding concentric phase. Lastly, we explore potential practical solutions and improvements in research methods for FW resistance exercises. FW resistance exercises become eccentric-overload exercises only when higher mechanical quantities are achieved and confirmed during the eccentric than in the concentric phase of repetitions. It is important to examine if eccentric overload is actually achieved during training and testing, which can clarify if the eccentric overload is a key factor for the neuromuscular adaptations observed following a FW resistance training.

Background: In response to the COVID-19 pandemic, various measures-including restrictions on children's physical activities, such as national lockdowns (LD)-were implemented to contain its spread. These measures may have compromised motor development, particularly among children from lower socioeconomic backgrounds (SEBs), who are typically less active than peers from higher SEBs. This study examined the impact of COVID-19 restrictions on motor development in relation to SEB.

Methods: Data from 68,996 children in Germany (Age: 8.83 ± 0.56 years, range: 6.4-13.0; 35,270 female, 51.1%) assessed between 2011/2012 and 2022/2023 were analyzed from the longitudinal study 'Berlin hat Talent'. Assessments before and after the pandemic used the German Motor Fitness Test, covering endurance, strength, coordination, and flexibility. Demographic data were collected via questionnaires; SEB was derived from official school-type classifications. Linear mixed-effect models accounted for hierarchical data: test values (level 1), motor domains (2a), participants (2b), and schools (3b). Motor performance was expressed as z-scores based on German reference percentiles. Effects of Time (pre, post LD I, post LD II), Motor Domain, and SEB (continuous, -2 to 2) were estimated, controlling for Age , Gender, and Secular Trends.

Results: The effect of Time was significant (p = .014, η² < .01), with motor performance lower after LD II than pre-pandemic. Time × Motor Domain interaction showed motor domain-specific changes (p = .001, η² < .01): endurance improved, while strength, coordination, and flexibility declined. Time × Motor Domain × SEB interaction was also significant (p < .001, η² = .01), indicating that the effect of Time differed across motor domains depending on SEB. Adjusting for Secular Trends revealed that the pandemic's overall impact (~ -4% across domains) was even stronger (p < .001, η² = .29), with domain-specific changes to -15.47% to + 7.56%. The SEB gap slightly closed, as higher SEB groups declined more strongly (p < .001, η² = .10).

Conclusions: The findings indicate domain-specific and SEB-related differences in motor performance during the pandemic, in particular after accounting for secular trends. Results underscore the need for ongoing monitoring and targeted support measures, particularly for children with lower SEB, during periods of disrupted daily activity.

Background: Most women serving in the military do so during their reproductive life and enter service at a young gynecological age. This review provides an overview of the menstrual cycle and summarizes the evidence for menstrual cycle disturbances in the military and how these disturbances to the menstrual cycle impact health and performance in the military.

Main text: Servicewomen often manage the practical challenges of menstruation and symptoms of the menstrual cycle or menstrual disturbances/dysfunction in an austere environment with no formalized support and/or education, and with unknown stigma and risks. Menstrual health in the military context implies that those who experience a menstrual cycle can access timely information, diagnosis, and support/treatment to achieve "a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity, in relation to the menstrual cycle." Herein we describe how menstrual health is impacted in a multistressor environment, including nutrition (energy balance and energy availability, micronutrients, and microbiome), physical activity, and recovery (occupational tasks, sleep, psychological stress, environment), and how menstrual disturbances can affect occupational performance and the lived experience of the female workforce.

Conclusions: We call for action of militaries worldwide to protect the health of Servicewomen to maximize their potential. Low representation, relatively recent full integration of women into the military workforce, and the exclusion of women from military research have led to policies developed from evidence on men, with the potential to impact the health and performance of Servicewomen.

Background: Esports, defined as competitive video gaming, has grown significantly in popularity, drawing global audiences comparable to traditional sports. However, the sedentary and repetitive nature of esports activities raises concerns about musculoskeletal health. While some studies have examined pain prevalence in esports players, no comprehensive synthesis exists. This systematic review and meta-analysis investigated the overall pain prevalence of esports players, as well as its occurrence in different body regions.

Methods: Following PRISMA guidelines, studies reporting pain prevalence in esports players were identified via PubMed, Web of Science, and Google Scholar. Random-effects meta-analyses were used to calculate one-year and seven-day prevalence rates, as well as pain by body region. Meta-regressions explored potential moderators.

Results: Thirteen studies met the inclusion criteria, with six (553 participants) contributing to the meta-analysis. One-year pain prevalence was 73% ([95% CI: 0.58-0.89], I² = 61%, k = 2), while the seven-day prevalence was 44% ([95% CI: 0.38-0.49], I² = 0%, k = 3). The spine was the most affected region (41%, [95% CI: 0.26, 0.55], I² = 96%, k = 11), with neck pain being particularly prevalent (48%, [95% CI: 0.26, 0.70], I² = 94%, k = 4). Upper extremities were also frequently affected (31%, [95% CI: 0.18, 0.44], I² = 96%, k = 12), with the wrists being notably affected by pain (37%, [95% CI: 0.09, 0.66], I² = 97%, k = 4). Meta-regression suggested higher pain prevalence among mobile players and Asian participants compared to computer players and European participants, though these findings are exploratory due to the limited number of studies.

Conclusions: In this meta-analysis a considerable prevalence of pain among esports players was observed, especially in the spine and upper extremities. However, the results should be interpreted with caution due to methodological heterogeneity and limited study numbers. Nevertheless, they emphasize the need for preventive strategies, such as regular breaks during prolonged sitting, ergonomic interventions and load management programs to optimize training volume and recovery, thereby reducing the risk of musculoskeletal strain. Future research should distinguish between acute and chronic pain, use standardized tools, and explore device-specific pain patterns to inform targeted interventions. Registration number PROSPERO ID: CRD42024599339.

Background: The National Rugby League Women's (NRLW) Premiership, created in 2018 as a professional Australian women's rugby league competition, administers the Sport Concussion Assessment Tool-5th Edition (SCAT5) as part of the game day Head Injury Assessment (HIA). This study aimed to: (i) examine the frequency of video signs of potential concussion in players removed for an HIA, (ii) compare the in-game medical evaluation results between players with concussion and those returned to play, and (iii) report the games missed before returning to match play following concussion in NRLW players.

Methods: Medical personnel and sideline video operators tagged all head impact events requiring medical evaluation via a HIA during three NRLW Premiership seasons (2018-2020). If players were suspected of sustaining a concussion, they were removed from the field for a medical assessment, which included the SCAT5. Two independent reviewers retrospectively coded the video footage of each HIA. Inter-rater reliability of video signs was calculated using Cohen's kappa (κ) and absolute percentage agreement. Video signs and medical evaluation findings were examined descriptively, and results were compared between concussed players and uninjured players who returned to the field.

Results: During the three NRLW Premiership seasons (2018-2020), there were 24 HIAs, with seven players medically diagnosed with concussion. As such, there was one HIA for every 0.88 matches and one medically diagnosed concussion every 3.00 matches. Inter-rater reliability between the two independent video reviewers was high, with the absolute percentage agreement for all concussions signs at 96.3%. On retrospective review, most NRLW players (n = 20, 83.3%) removed for a HIA did not have any consensus video signs, with three players (12.5%) displaying motor incoordination and two players (8.3%) having a blank or vacant look. On the SCAT5, concussed players had lower cognitive scores (M = 21.8 vs. 27.8, p = .01, d = 1.62) and reported more symptoms (M = 4.3 vs.1.0, p = .02, d = 1.09) with greater severity (M = 9.71 vs. 1.41, p = .02, d = 0.96) compared to those who were not diagnosed with a concussion. All players diagnosed with a concussion returned to play within two weeks of their injury.

Conclusion: Fewer than 20% of women removed from play for HIAs showed consensus video signs of possible concussion. Concussed players obtained lower cognitive tests scores and reported more symptoms, with greater severity, compared with uninjured players. Further studies with larger samples are needed to evaluate the video signs of concussion, with in-game SCAT5 scores, to improve the acute identification and management of concussions in the NRLW Premiership.

Background: Esports has gained recognition as an official sport by multiple countries and organizations, featuring in international events like the Asian Games. Despite its growing prominence as a competitive sport, research on esports performance remains limited. Recent studies suggest that physical exercise, particularly high-intensity interval training (HIIT), can enhance cognitive functions and gaming performance. However, these studies have primarily focused on immediate or warm-up effects, leaving a gap in understanding the longer-term impact of such training interventions on esports performance.

Results: This study investigates the effects of a six-week HIIT program on esports performance in first-person shooter (FPS) gamers. Healthy adult FPS gamers aged 18-29 were recruited through various platforms and randomly assigned to either an intervention group, which participated in a six-week HIIT program, or a control group. A total of 83 participants completed the study. The intervention group demonstrated significant improvements in key FPS skills, including flicking, tracking, decision-making, reaction time, and shooting accuracy. Additionally, the HIIT program enhanced VO_2max and sleep quality, with a moderate correlation observed between changes in VO_2max and reaction time over the six-week period. However, no significant enhancements were observed in mental toughness and self-regulation.

Conclusion: A six-week HIIT program can improve gaming performance and overall well-being in esports players. Future research should explore the neurophysiological mechanisms behind these benefits and evaluate other physical training modalities. This study provides insights into how exercise can optimize esports performance and support a balanced lifestyle for gamers. Trial Registration ChiCTR2400083252 (Chinese Clinical Trial Registry).

Background: While the concept of "24-h movement behaviours" has gained attention, and correlational studies have shown its importance for health outcomes among children and adolescents, there is still no comprehensive review summarising the efficacy of such interventions in changing specific behaviour. This systematic review, therefore, aimed to examine the efficacy of interventions targeting 24-h movement behaviours on physical activity, sedentary behaviour/screen time, and sleep duration.

Methods: A systematic search was conducted on February 1, 2024, across six databases (MEDLINE, PsycINFO, EMBASE, PubMed, Web of Science, and SPORTDiscus). Included articles were interventions targeting 24-h movement behaviours simultaneously (physical activity, sedentary behaviour/screen time, and sleep duration) in children and adolescents aged under 18 years. Data were analysed using random effects meta-analysis, and the risk of bias was assessed using the Cochrane risk-of-bias tool.

Results: The literature search identifed 1849 articles, and 20 studies met the inclusion criteria, with 9 of them included in the meta-analysis. A pooled 26-min decrease was observed in screen time (95% CI =  - 48.52, - 3.91, I² = 86%), and an 8-min increase was found in sleep duration (95% CI = 3.52, 12.33, I² = 27%), while no significant changes were observed in physical activity and total sedentary behaviour.

Conclusion: Interventions targeting a combination of 24-h movement behaviours have demonstrated efficacy in decreasing screen time and improving sleep duration, while the efficacy in physical activity and total sedentary behaviour warrants further exploration. The findings from this systematic review on 24-h movement behaviour interventions highlight the potential to leverage the interconnectedness of different movement behaviours, particularly in targeting screen time reduction and sleep duration enhancement. These insights can inform the development of more effective, holistic interventions and policies that promote comprehensive approaches to physical activity, sedentary behaviour, and sleep duration among children and adolescents.