Sports Medicine - Open最新文献

The efficacy of anterior cruciate ligament (ACL) rehabilitation following reconstruction surgery is sub-optimal and the return-to-sport criteria are inconsistent. We examine the hypothesis that the dysfunctional neuroplasticity induced by an ACL injury could be resolved faster when cross-education is combined with innovative paradigms incorporating visual-cognitive tasks to reduce attentional compensation. We posit that the priming effects could be amplified if therapists combined higher force, eccentric based cross-education exercises with visual-cognitive dual-tasking. The overlapping nature of neuroplasticity after an ACL injury and that induced by cross education may provide a pathway to not only address the mechanical muscle strength deficits associated with injury, but the underlying neurological deficits as well. We provide a practical guide to how neuroplasticity-informed ACL rehabilitation that includes cross-education might accelerate recovery from an ACL injury and the subsequent reconstruction surgery.

Background: Cutting-edge dual process health behavior theories propose micro-temporal within-person processes to be critical drivers of physical activity participation. Self-efficacy is the pivotal motivation-oriented correlate of physical activity, a key component across the most prominent health behavior change theories, and has predominantly been researched as stable interpersonal 'trait' factor. However, the micro-temporal within-person 'state' perspective on self-efficacy remains uncharted.

Objectives: To tackle this research gap, we conducted a scoping review and examined (1) time-sensitive (i.e., assessment time span) and (2) theory-conform operationalization of self-efficacy measures as well as (3) within-person variance reports from ecological momentary assessment studies in the physical activity context among healthy adults.

Methods: A scoping review of English articles using PsycINFO, PsycArticles, PSYNDEX, SPORTDiscus and PubMed was conducted up to September 2025. Eligible studies focused on (1) physical activity in (2) healthy adults aged + 18 years and (3) applied multiple within-day, daily or weekly assessments of self-efficacy. Findings were summarized through quantitative analysis of the evidence.

Results: A total of 13 studies was included. Most studies assessed self-efficacy through multiple assessments per day and with a focus on the near future (i.e., next few hours post ecological momentary assessment). The 13 identified self-efficacy items were operationalized according to self-efficacy theory, but varied in semantics, psychometrics, and source. Five studies reported intraclass correlation coefficients that revealed self-efficacy within-person variance to range between 51% and 89%.

Conclusions: Given the pivotal role of self-efficacy across various health-behavior theories and the recent relevance attributed to micro-temporal within-subject processes, thus far surprisingly few studies researched how self-efficacy unfolds within-persons across time. However, the few studies identified provide initial evidence that self-efficacy varies within individuals across time in everyday life, including a tendency towards higher within-person variance for momentary versus day level assessments, and thereby empirically supporting dual process models. Items were assessed dynamically using repeated measures per day and according to theory but differed in conceptual and semantic features. Future research is encouraged to further investigate how self-efficacy unfolds across time, by testing various sampling strategies and applying advanced designs to shed light on the precise timing of effects and to inform adaptive and expedient intervention development.

Sports medicine epidemiology has advanced considerably over the past two decades, with standardized surveillance systems and consensus statements improving the quality of data collection and reporting. Yet the field continues to face structural challenges, including small cohorts, heterogeneous samples, and rare outcomes that undermine reproducibility and limit generalizability. In practice, researchers and clinicians frequently rely on implicit expert judgment to bridge these gaps, but such judgments are often undocumented and irreproducible. Expert elicitation offers a structured, transparent approach to formalizing this knowledge into quantitative priors that can complement empirical data within Bayesian analyses. This commentary introduces expert elicitation to sports medicine epidemiology, drawing on applications of the Sheffield Elicitation Framework (SHELF) in our ongoing work. We highlight three key areas where elicitation can strengthen research and practice: 1) studies involving small, sport-specific cohorts, such as Paralympic athletes; 2) analyses of rare or severe events, including catastrophic injuries and sudden illnesses; and 3) underpowered intervention trials, where structured priors can improve interpretation and guide future prevention and treatment strategies. We also share practical insights from our pilot work, including strategies for framing questions, conducting warm-up and challenge exercises, and using real-time visualization to improve accuracy and engagement. Expert elicitation is not without challenges, requiring careful facilitation and appropriate expertise, but it provides a rigorous, reproducible method for transforming clinical judgment into usable data. Wider adoption of this methodology could accelerate progress in athlete health research by formalizing knowledge that already shapes practice but remains largely untapped.

Objective: The purpose of this study was to examine whether the ACTN3 R577X polymorphism was associated with injury rate and recovery time from non-contact muscle injuries in youth academy players and professional soccer players.

Methods: The ACTN3 rs1815739 genotype was identified in 76 male soccer players (22 professional, 27 U19 and 27 U17) from a top-level French soccer club. Over three consecutive competitive seasons (2020/21 to 2022/23), the players were prospectively monitored. The club's medical staff systematically recorded all injuries sustained during soccer exposure. Injury incidence was calculated based on total soccer exposure, and return-to-play time (RTT) for each injury was determined by the medical staff. A total of 312 injuries were documented, including 144 non-contact muscle injuries. Injury incidence rates (IRs) and rate ratios (RRs) were compared across player genotypes, both overall and within each category, using Poisson or negative binomial regression models with exposure time as an offset. RTT was analyzed by genotype using the Kruskal-Wallis test.

Results: Overall genotype distribution was RR, 52.6%; RX, 30.3%; and XX, 17.1%. Across all players, XX carriers had the highest injury incidence (8.54 [6.54-10.39]/1000 h) followed by RX players (6.65 [5.39-7.91]/1000 h) and RR players (5.15 [4.35-5.95]/1000 h), although these differences did not reach statistical significance. The RRs for XX compared with RR players was 1.66 (95% CI: 0.85-3.23, p = 0.140), indicating a non-significant tendency toward higher incidence in XX players. However, RTT differed significantly among genotypes (p = 0.007), with median [IQR] values of 13 [10, 16] days for RR, 16 [14, 22] days for RX, and 18 [13, 19] days for XX. Subgroup analyses showed that RTT differences were significant in U17 players (p = 0.004), with XX requiring longer recovery (23 days) compared to RR players (11 days). However, these genotype-related differences in RTT were not significant among professional soccer players.

Conclusion: The ACTN3 R577X polymorphism was associated with recovery characteristics following non-contact muscle injuries in soccer players. Specifically, players with the XX genotype required significantly longer return-to-play times, a pattern evident in youth academy players but not in the professional group.

Background: Athlete engagement represents a critical construct for understanding optimal athletic functioning, yet the field lacks comprehensive theoretical models integrating its diverse correlates. While previous research has identified various factors influencing engagement, no systematic synthesis exists mapping all empirical evidence across populations, languages, and sporting contexts. This scoping review addresses this critical gap by providing the first comprehensive, systematic synthesis of all factors associated with athlete engagement, establishing the foundational evidence base necessary for theoretical model development and evidence-based interventions.

Methods: The review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines, Arksey and O'Malley's five stages and the Joanna Briggs Institute methodology for scoping reviews. A comprehensive search was carried out in seven databases and 1428 papers were retrieved. After removing duplicates and applying eligibility criteria, 70 studies were assessed for eligibility. After removing papers of poor quality, unavailable papers and papers investigating other types of engagement, 48 papers published between 2007 and 2024 were selected for analysis.

Results: The majority of these papers were quantitative and cross-sectional, using the Athlete Engagement Questionnaire to measure athlete engagement. The review identified 41 correlates of athlete engagement, categorised as antecedents, consequences, mediators or related variables. Psychological factors, such as burnout, motivation, perfectionism and the coach-athlete relationship, were the most commonly studied.

Conclusions: The results highlight the significant role of burnout, motivation, perfectionism and the coach-athlete relationship in enhancing engagement and emphasise the importance of developing training programmes that address these factors in order to promote athlete engagement.

Registration: The following scoping review was appropriately registered on the Open Science Framework ( https://doi.org/10.17605/OSF.IO/TWNZM ).

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.