Sports Medicine - Open最新文献

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.

Introduction: World-wide, endurance races, including road races, trail races, cycling events, and triathlons, attract millions of participants each year. While these events promote health, fitness, and exercise, there exists significant risk for morbidity and mortality. The World Academy of Endurance Medicine (WAEM) created the Race Emergency Medicine Course (REMC) to train and certify race organizers and medical directors regarding planning and response for medical emergencies at endurance events. The course includes asynchronous e-learning modules, in person lectures, hands-on simulation sessions, and race-day observation.

Methods: 599 participants from 20 courses conducted in Europe, Asia, North and South America were surveyed. A 5-point Likert scale was utilized to assess participants' impressions regarding the format, quality and effectiveness of the course. A paired t-test was utilized to evaluate participants' self-assessments of their confidence in managing critical siutations both before and after participating in the course. Descriptive statistics were used to evaluate responses to open-ended questions.

Results: Participants rated the overall REMC 4.7 out of 5. Pre-course e-learning modules were rated 4.4 out of 5 while the lectures, hands-on sessions, and race-day observation activity scored 4.6 out of 5. Overall self-confidence in managing race-related critical situations increased from a mean score of 5.0 to 6.1 on a 7-point scale (p < 0.01). 73% of participants indicated that they plan to modify their practice based on what they learned.

Conclusion: The REMC is a valuable educational tool to promote medical care and safety at endurance events.

Background: Anterior cruciate ligament (ACL) rupture is one of the most severe injuries in professional soccer players, often leading to long absences from competition and career-threatening consequences. Understanding how return to play (RTP) outcomes have evolved over time is essential for optimizing recovery and minimizing re-injury risk. The aim of this systematic review and meta-analysis was to compare RTP rate, level of RTP, time to RTP, and ACL graft re-rupture rate in professional soccer players across three distinct time periods after ACL reconstruction (ACLR).

Methods: Following PRISMA guidelines, MEDLINE (PubMed), Embase (Elsevier), and the Cochrane Library were systematically searched on March 8, 2025, and updated on March 22, 2025. Studies reporting RTP outcomes after ACLR in professional soccer players were included. Methodological quality was assessed using the Methodological Index for Non-Randomized Studies (MINORS). Four primary outcomes-RTP rate, level of RTP, time to RTP, and ACL graft re-rupture rate-were extracted and meta-analyzed across three publication periods (2011-2016, 2017-2021, 2022-2025).

Results: Twenty studies met the inclusion criteria, comprising 1,988 professional soccer players (5 published before 2017, 5 between 2017 and 2021, and 10 after 2021). The mean player age at surgery did not differ across time periods (p > 0.05). Overall, 92.3% of players returned to play, 80.1% regained their pre-injury performance level. The mean time to RTP was 263.2 days, with a significantly slower return observed in 2022-2025 (295.1 days) compared with 2011-2016 (203.5 days; p = 0.006), and the pooled graft re-rupture rate was 8.2%. No significant differences were found among periods for overall RTP, level of RTP, or re-rupture rate (p > 0.05).

Conclusion: More than 92% of professional soccer players successfully RTP after ACLR, and approximately 80% recover their pre-injury level. However, in recent years, RTP has become significantly slower-by over 40%-without a corresponding reduction in graft re-rupture rates. These findings suggest a shift toward more conservative, criteria-based RTP decision-making in professional soccer, reflecting greater emphasis on graft protection and long-term knee health. Level of Evidence Systematic review and meta-analysis of level IV. Trial Registration PROSPERO - CRD420251012143.

Background: Calf strains are common in sports like football, rugby, and tennis, with high recurrence rates during competition. Despite their frequency, there are no universally accepted guidelines for managing these injuries based on grading systems or imaging modalities. This review aims to evaluate the role of imaging and injury grading in predicting return to sport following a calf strain.

Methods: A systematic search was conducted to assess the role of imaging and grading in predicting return to sport in athletes with calf strains. A search of Scopus and PubMed in June 2024 identified relevant studies using terms related to calf strains, imaging, and return to sport. Eligible studies involved human participants, used imaging for diagnosing or grading calf injuries, and assessed return to play outcomes. Studies were excluded if they involved animals, lacked imaging, or did not report relevant outcomes. The screening was done by a team of investigators based on predefined criteria.

Results: The review identified that imaging, particularly ultrasound and MRI, offers valuable information for grading calf strains and predicting recovery timelines. Different grading systems correlated with clinical outcomes, but no single modality or grading system was universally superior. Clinical assessments remained essential in return to play decisions.

Conclusions: Imaging modalities, along with injury grading, provide useful insights into calf strain severity and recovery. However, these tools should complement clinical assessments, which are the gold standard for return to sport decisions. An integrative approach combining imaging and clinical evaluation is recommended to optimize return to sport protocols. Further standardization of grading systems and imaging protocols may improve prediction accuracy and treatment outcomes for calf strains.

Background: Collating evidence on the relationship between training load and physical fitness adaptations in team sport players can help refine training plans.

Objectives: This systematic review and meta-analysis aimed to: (i) identify research designs and methods examining the relationship between training load and physical performance in team sport players, and (ii) synthesize key findings, advancing to meta-analysis where correlations could be established.

Methods: Eligible participants were men and women in team sports at least at the trained or developmental level. Studies included had training loads of at least two weeks with pre-post physical performance evaluations. Searches were conducted in PubMed, Scopus, SPORTDiscus, and Web of Science. Study quality was assessed using the Downs and Black scale, and evidence certainty was evaluated with the GRADE framework.

Results: Of 29,552 records screened, 40 studies with 726 players were included. Significant correlations were evident between heart rate (HR)-based training impulse (TRIMP) and changes in maximal oxygen uptake (r = 0.63, p < 0.05), velocity at a blood lactate concentration of 2 mmol·L⁻¹ (V_LT) (r = 0.47, p < 0.05), and velocity at the onset of blood lactate accumulation (r = 0.43, p < 0.01). A significant correlation between session-rating of perceived exertion (sRPE) and changes in V_LT (r = 0.29, p < 0.05) was found.

Conclusions: HR-based TRIMP methods to quantify internal training load appear to be effective indicators for potential endurance adaptations around training phases in team sport players. In contrast, sRPE and external training load measures demonstrated limited associations with performance adaptations surrounding training.

Background: The emergence of wearable technology offers enhanced real-time health management, including sleep, recovery, and exercise optimization. Despite their potential to monitor load-recovery parameters in elite athletes, the selection, combination, and interpretation or reliance of metrics in relation to perceived impact remain unclear.

Objective: This study assessed data from three wearables measuring sleep, continuous glucose, and exercise, together with the Profile of Mood State (POMS) dimensions alongside subjective ratings via the Readiness Advisor application (RA app) (Silicon Valley Exercise Analytics, svexa, Menlo Park, California, USA) to evaluate their association and value in load-recovery monitoring.

Methods: Twenty national team endurance athletes, competing at the highest international level, were monitored during one year of training, recovery, and competitions. Data collections were made with Global Positioning System (GPS) watches and heart rate monitors, Ōura rings (Ōura Health OY, Oulu, Finland), continuous glucose monitors, POMS questionnaires and subjective ratings in the RA app.

Results: Significant correlations were found between each RA question and its counterpart in a linear mixed model (r values = 0.39-0.81). However, time series analysis through autoregressive integrated moving average (ARIMA analysis) revealed individual variability.

Conclusions: These findings indicate an influence of external aspects and advocate for a multifaceted approach to the assessment of load-recovery balance, well-being and performance. Moreover, personalized analyses proved more accurate than group averages, emphasizing the need for individualized monitoring. Integrating subjective and objective data appears essential for nuanced understanding of the athlete status, advancing high-performance monitoring and athletic health management.