Sports Medicine - Open最新文献

Background: The World Health Organization has established recommendations for 24-h movement behaviours in children under 5 years. Building on the successful knowledge translation model of Active Healthy Kids Global Alliance Report Cards, this study aimed to develop a similar framework for the early years.

Methods: Using a three-round twin-panel Delphi survey (conducted via an online survey between 28 November 2024 and 11 March 2025), expert consensus was sought on indicators and benchmarks for the first dedicated report card on 24-h movement behaviours for the early years. The experts were identified through a three-step selection process, which included recognised international projects and networks as well as literature search. In Round 1, participants evaluated the applicability of 15 initial indicators. In Rounds 2 and 3, they rated the importance of each indicator, with results from their own panel (Round 2) and the other panel (Round 3) provided to inform their decisions. Qualitative feedback on definitions and benchmarks was systematically reviewed and incorporated. Consensus was predefined as ≥ 75% agreement, with stability across rounds considered.

Results: Of 175 invited experts, 72 (41.1% recruitment rate) from 15 regions participated in Round 1, with 61 (84.7% response rate) and 56 (77.8% response rate) completing Rounds 2 and 3, respectively. Consensus was achieved for 12 indicators, with definitions and benchmarks refined based on expert inputs. Notably, Weight Status and Motor Proficiency were excluded due to lower agreement.

Conclusions: The finalised set of indicators, definitions, and benchmarks provides a robust foundation for creating a standardised report card for early childhood. The finalised results serve as a critical advocacy instrument to raise awareness, improve surveillance, facilitate cross-jurisdictional comparisons, and inform policy and public health initiatives, ultimately supporting the health and well-being of young children globally.

Background: Currently, there is a paucity of long-term health data for retired athletes. This study describes the prevalence of common morbidities and multimorbidity among retired Great Britain's (GB) Olympic athletes, compared to a general population comparator group.

Methods: A cross-sectional study of retired athletes was undertaken. The English Longitudinal Study of Ageing (ELSA) served as the reference population. Age- and sex-standardized morbidity ratios (SMRs) and odd ratios (ORs) determined where morbidity and multimorbidity prevalence amongst retired athletes exceeded or were inferior to those of the reference population.

Results: Retired athletes (n = 493) were less likely (SMR < 1) than controls (n = 8024) to report diabetes (0.43, 99% CI 0.22, 0.74), stroke (0.39, 99% CI 0.12, 0.90), obesity (0.35, 99% CI 0.23, 0.50), asthma (0.29, 99% CI 0.12, 0.59), lung disease (0.29, 99% CI 0.06, 0.81), angina (0.18, 99% CI 0.05, 0.46), and eye disorders (0.06, 99% CI 0.01, 0.18). In addition, abnormal heart rhythm (0.45, 99% CI 0.40, 0.54) and osteoporosis (0.46, 99% CI 0.42, 0.51) were lower in female athletes. Retired athletes were more likely (SMR > 1) than controls to report melanoma or other skin cancer (5.64, 99% CI 2.80, 10.06) and osteoarthritis (1.44, 99% CI 1.18, 1.75). There were no differences detected in cancers of the breast, prostate, colon, bowel or bladder. Multimorbidity was less prevalent among retired athletes (OR 0.50, 99% CI 0.38, 0.67).

Conclusions: Retired athletes had superior cardiovascular health and a lower risk of multimorbidity, but were more at risk of melanoma or other skin cancer and osteoarthritis.

Background: Knee osteoarthritis is a highly prevalent disease that affects 24-31.8% of patients who undergo total knee replacement (TKR); it impedes their rehabilitation and increases their risk of complications. The aim of this systematic review was to compare the effectiveness of multidisciplinary care intervention with that of conventional physical therapy in mitigating kinesiophobia in patients with knee osteoarthritis undergoing joint replacement.

Methods: This study was registered with the International Prospective Register of Systematic Reviews (registration no. CRD42022366356). Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, two Chinese databases (the National Digital Library of Theses and Dissertations and Airiti Library) and four English databases (CINAHL, Cochrane Library, PubMed, and Embase) were searched from their inception up to January 2023 for randomized controlled trials (RCTs) on multidisciplinary intervention for kinesiophobia following TKR.

Results: Seven RCTs comprising 648 individuals (327 in the experimental group and 321 in the control group) were included in the analysis. Grading of Recommendations, Assessment, Development, and Evaluations revealed moderate evidence quality and strong recommendations for kinesiophobia, pain, and knee joint functional scales. Meta-analysis revealed that multidisciplinary care intervention significantly outperformed conventional physical therapy in terms of reducing kinesiophobia (P < 0.01), with this effect persisting for up to 6 months after the intervention. The overall effect size (standardized mean difference = -2.57, 95% confidence interval [-3.71, -1.44], P < 0.00001) was large, and no risk of publication bias was found.

Conclusions: Multidisciplinary care intervention reduces kinesiophobia in patients with knee osteoarthritis following TKR. It also reduces their pain scores and promotes early postoperative ambulation. Two studies of the seven included RCTs had small sample sizes (fewer than 100 individuals); this may have affected the robustness of the findings.

Background: In the sport sciences, skill development is often (implicitly) explained through two metatheoretical perspectives: interactionism and transactionism. Given certain assumptions, the former adheres to a linear pedagogical approach to learning, while the latter follows a nonlinear pedagogical approach. The aim of this systematic review was to compare the effects of linear and nonlinear pedagogical approaches on the development of technical and tactical skills in team-invasion ball sports.

Methods: A systematic search of six databases (EmBase, PubMed, SPORTDiscus, OVID Medline, CINAHL, and OVID PsychInfo) was undertaken from root to 1st May 2024. Included studies were critically appraised using the ROBINS-I and RoB2 instruments. A narrative and descriptive synthesis approach was utilised.

Results: From 7450 potential records, nine studies were included, which explored the effects of a nonlinear versus linear pedagogy for developing technical and tactical skills in team-invasion ball sports. While, for most outcomes, the results showed there were no significant differences, nonlinear pedagogy did appear more favourable in 34% of technical outcomes. Further, descriptive synthesis of four studies revealed that nonlinear pedagogy was significantly better for developing tactical skills in 66% of outcomes.

Conclusions: While based on limited studies, linear and nonlinear pedagogical approaches appear to achieve similar results with regards to technical skill development. However, nonlinear pedagogy was favoured in some studies. With regards to tactical skill development, nonlinear pedagogical approaches appear better than linear approaches. Further high-quality research is needed to confirm these findings and examine how they may be implicated by the representativeness of the assessment instruments.

Key points: Both linear and nonlinear pedagogical approaches assist with skill development in team-invasion ball sports. Nonlinear pedagogical approaches generally result in greater effects when developing tactical skills, while most literature shows there are no significant differences between approaches when developing technical skills. Further high-quality research exploring the effects of these pedagogical approaches is required to substantiate these findings. Questions remain regarding the representativeness of the assessment instruments used in the studies included in this review.

Registration: This systematic review is registered with Open Science Framework- https://osf.io/za247/.

Background: Rotation of the trunk about its long axis or 'body roll' is essential for maximising front crawl swimming performance yet research on how physical impairment affects body roll is extremely limited. This study quantifies body roll kinematics in swimmers with and without central motor and neuromuscular impairments (CMNI). It was hypothesised that body roll kinematics differ between CMNI and non-disabled swimmers, are associated with sport class (level of impairment) and are influenced by upper and lower-limb functional levels.

Methods: Three-dimensional motion analysis of 27 CMNI (sport classes 2-9) and 13 non-disabled competitive swimmers at 100-200 m race pace provided body roll kinematics, including shoulder and hip roll ranges and torso twist. Health conditions of the CMNI group were cerebral palsy (n = 12), spinal cord injury (n = 10) and neuromuscular disorders (n = 5). CMNI swimmers were divided into three upper-limb [mild (n = 9), moderate (n = 9), severe (n = 9)] and three lower-limb function subgroups [bilateral (n = 2), unilateral (n = 6), without kick (n = 19)] based on their Froude efficiency (a measure of how effectively upper limbs contribute to propulsion) and the number of lower limbs actively kicking during trials, respectively.

Results: The CMNI group exhibited lower shoulder roll range (104 ± 11° vs. 88 ± 21°, p < 0.05) and torso twist (58 ± 13° vs. 48 ± 22°, p < 0.05) but greater hip roll range (62 ± 10° vs. 75 ± 29°, p < 0.05) than the non-disabled group. Statistical non-parametric mapping revealed less shoulder roll from 0 to 28%, less hip roll from 0 to 10%, greater hip roll from 91 to 100%, and less torso twist from 15 to 32% and from 75 to 81% of the cycle, in the CMNI than the non-disabled group (p < 0.05). CMNI body roll patterns varied widely, but discrete and continuous variables did not differ between upper-limb subgroups or between lower-limb subgroups.

Conclusions: CMNI swimmers exhibit different body roll patterns to non-disabled swimmers. The study findings can be used to inform Para swimming coaches and improve the sport-specificity of land-based and water-based assessments currently used to classify CMNI swimmers.

Background: The Sport Concussion Assessment Tool (SCAT) is a multimodal, evidence-based tool designed for repeat administration at baseline, pre-season and/ or for post-injury assessments, following a sport related concussion. Repeat administration of concussion assessment tools requires clinicians to understand the instrument's stability and test-retest reliability. Typically, clinicians compare post-injury scores with baseline test results in order to determine whether a clinically significant change has occurred. The National Rugby League Women's (NRLW) Premiership was created in 2018, with a concussion management process requiring annual pre-season baseline medical assessments of players using the Sport Concussion Assessment Concussion Tool-5th Edition (SCAT5). Although baseline normative data have been published for the SCAT5, reliability data are limited in women. The purpose of this study was to examine the one-year test-retest reliability of the SCAT5 component scores, and to develop reliable change indices, for the women's league.

Results: Participants were 63 NRLW players (mean age = 26.9 years, SD = 5.5) from the 2018-2019 and 2019-2020 seasons. Team medical staff conducted the baseline SCAT5 assessments each year. Test-retest reliability estimates for each of the SCAT5 components were low to moderate (ICCs = 0.28-0.57). The following change scores, reflecting worsening, occurred in 20% or fewer of the sample: +3 symptom number, + 4 symptom severity, and - 2 on the Standardized Assessment of Concussion total score. A change of + 2 total modified Balance Error Scoring System errors occurred in fewer than 10% of the NRLW players between the test and retest.

Conclusion: SCAT5 scores had low to moderate test-retest reliability across a one-year period. Reliable change scores for the SCAT5 were developed in this study for use with professional women rugby league players. When evaluating post-injury SCAT5 scores, it can be helpful to consider both what the score means compared to normative reference values and compared to the athlete's individual baseline scores.

This viewpoint discusses disparities in return-to-play (RTP) policies for athletes with implantable cardioverter defibrillators (ICDs), highlighted by the case of professional football (soccer) player Christian Eriksen. It argues for an international consensus based on shared decision-making to harmonize national policies, balancing athlete autonomy and safety. Current RTP policies vary significantly across countries, creating inconsistencies that impact athletes' careers. Given emerging evidence on the safety of sports participation for athletes with ICDs, the application of an international standardized approach based on shared decision-making is proposed that prioritizes athlete safety without neglecting individual responsibility.

There is a growing body of literature on sex-differences in human performance, particularly in the context of endurance sports. However, several mechanisms (e.g., higher type 1 fibres proportion; lesser neuromuscular fatigue; higher metabolic flexibility etc) have been previously proposed and suggest an advantage to females over ultra-endurance competitions on flat terrain. However, in mountain ultramarathon, the percent sex difference between male and female records appears to be larger than on various road/track running distances on flat terrain, suggesting that additional factors related to the specific mountainous conditions may be at play. In this Current Opinion, we point to three specific factors that are likely to influence and widen sex differences in ultra-distance running events performed in the mountains (i.e., uphill- downhill locomotion, altitude, and changes in extreme ambient temperatures).First, the sex differences in uphill endurance performance are approximately two times larger than those in events primarily performed on flat terrain (i.e., 18-22% vs. 9-12%, respectively), mainly due to the detrimental influence of the lower lean mass to fat mass ratio and lower fast twitch/type II fibre type proportion in females).At altitude, the ventilatory response to exercise emerges as one of the most sex-sensitive factors that may modify reactions to hypoxia. A diffusive mechanism appears to be involved in the larger hypoxemia commonly reported in females.Finally, responses to cold environments are also sex-dependent, with females exhibiting lower muscle mass, which limits thermogenic heat production, a higher body surface area-to-mass ratio, and a greater prevalence of Raynaud's phenomenon.Altogether, these specific factors must be further understood when analyzing sex-differences in mountain ultra-trail performance. Don't forget to look at the scenery!

Background: It is recommended to prescribe sets to volitional muscular failure (e.g., 4 sets) or a fixed repetition scheme of 75 repetitions (1 × 30, 3 × 15) in low-load resistance exercise with blood flow restriction (BFR-RE). While prior studies suggest both protocols may elicit similar muscular adaptations, the extent to which this is explained by matched exercise volume remains unclear.

Objectives: This systematic review and meta-analysis evaluated the number of repetitions performed during four sets of low-load BFR-RE to volitional muscular failure and compared these with the fixed 75-repetition scheme. The goal was to determine whether the two protocols yield similar total and per-set repetition volumes.

Methods: On 10/31/2024, two databases (PubMed^® and Scopus) were used to identify studies that applied a protocol of four sets to volitional muscular failure in BFR-RE with a load of ≤ 50% of one repetition maximum (1RM), regardless of the outcome investigated. Mean repetition data were pooled using a random-effects meta-analysis. One-sample t-tests compared per-set and total volumes to the reference scheme (1 × 30, 3 × 15).

Results: Across 25 studies (47 means; n = 678), the estimated total repetitions performed to failure was 73.1 (95% CI: 61.1 to 85.2). Per-set means were 36.0 (95% CI: 30.5 to 41.4), 14.7 (95% CI: 12.2 to 17.1), 11.5 (95% CI: 9.2 to 13.8), and 10.4 repetitions (95% CI: 8.1 to 12.7) for sets 1 through 4, respectively.

Conclusion: Four sets of BFR-RE to volitional muscular failure produce similar total repetition volume compared to the commonly implemented fixed 75-repetition scheme, though the distribution of repetitions per set differs. These findings provide insight into the mechanical equivalence of two widely used BFR-RE prescriptions.