Sports Medicine - Open最新文献

Background: Human Pose Estimation (HPE) has gained increasing attention in sports research due to advancements in Deep Learning (DL) movement skills, which enable precise joint localization in 2D and 3D visual data. DL-based HPE facilitates non-invasive analysis of movement patterns in real-world settings, providing actionable insights for training, performance optimisation, and injury prevention. This systematic review examines the application of DL-based HPE in sports, focusing on the availability and accessibility of training datasets, reproducibility for practitioners, and the influence of human factors. The review also offers recommendations to guide future research and applications.

Methods: A systematic search following PRISMA guidelines was conducted across four databases-Scopus, Web of Science, the Association for Computing Machinery, and SPORTDiscus, yielding 371 articles. Two independent reviewers applied inclusion and exclusion criteria to identify relevant studies, with a third reviewer resolving conflicts. Key aspects analysed included the scope of DL-based HPE applications, dataset characteristics, and algorithmic approaches. A supplementary search was conducted to include contemporary literature published since the initial search date. Data were synthesized descriptively, focusing on trends and limitations in the evidence base.

Results: The identified applications of DL-based HPE in sports were categorized into four domains: movement skill analysis, action recognition, augmented coaching tools, and officiating support. Most studies relied on private datasets for algorithm training and validation, limiting reproducibility and generalizability. Bespoke multi-model algorithms were the most common approach, and single person pose estimation predominated. Despite its potential, the lack of open datasets and standardized practices poses challenges for broader adoption and practical implementation. These findings were echoed in the supplementary search which added no significant findings outside what previous studies had demonstrated.

Conclusions: This review represents the first systematic evaluation of DL-based HPE from a sports science perspective, offering practical guidance for future research and applications. The findings highlight the need for open, standardized datasets and reproducible methodologies to advance the field. Future research should address these limitations while exploring innovative applications to maximize the impact of DL-based HPE in sports science.

Background and aim: The rapid aging of the global population is expected to lead to an increase in the incidence and prevalence of neurodegenerative diseases. Endurance exercise training is considered one of the most effective forms of prevention against neurodegenerative diseases. This study investigated the effects of a 5-year exercise training intervention at varying intensities on cognitive function in healthy older adults.

Methods: 1486 healthy older men (n = 735) and women (n = 751) aged 70-77 years from Trondheim, Norway, were randomly assigned to high-intensity interval training (HIIT, n = 382), moderate-intensity continuous training (MICT, n = 367), or a control group (n = 737) following the national physical activity (PA) guidelines. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) score after 3, 5 and 10 years. A linear mixed model was used to estimate the effect of the exercise intervention between the groups. Measures of physical health, such as cardiorespiratory fitness (CRF), and PA level was also measured.

Results: After 10 years, we observed no significant differences in MoCA scores between the exercise training groups and the control group, despite variations in exercise intensity and good adherence to the exercise interventions. The HIIT group consistently showed higher CRF throughout the study period.

Conclusions: While structured aerobic exercise training over 5 years improved physiological health markers in healthy older adults, its impact on mitigating cognitive decline was limited. Further long-term training studies in different populations are needed to better understand the link between exercise training and cognition in older adults. Trial Registration The Generation 100 Study is registered at ClinicalTrials.gov (Identifier: NCT01666340), registered on 21 August 2012: https://clinicaltrials.gov/study/NCT01666340.

In 2016, a literature review to examine the psychological effects of strength exercises for people who are overweight or obese was conducted, incorporating 17 included studies. Although some positive results were found, the authors concluded that there is a strong need to accumulate more evidence before drawing conclusions. Therefore, the current review aimed to update the overview of existing literature on this topic repeating the same procedures. Additional relevant literature (updated search #1 on 6 April 2022, and #2 on 19 January 2024) was identified by use of the PubMed, PsycINFO, the Psychology and Behavioural Sciences Collection, and SCOPUS databases. Following the original procedures, this review focused on studies with an independent identifiable effect of strength exercises on psychosocial determinants in people with overweight or obesity. Risk of bias was assessed using the Effective Public Health Practice Project Quality Assessment Tool. Effect sizes and corresponding variance estimates were extracted or calculated for the main effects of strength exercises on psychological outcomes. In total, 27 studies (10 additional studies compared to the 2016 review) representing 12,861 participants were included. In addition to the eight broad categories of psychological outcomes (psychological disorders, inhibition, mood, outcome expectations, quality of life, self-efficacy, self-esteem, and stress), two more outcome categories (motivation and executive functions) were identified. No large differences were found between the original and updated literature review: some weak positive effects were found for inhibition, self-efficacy, self-esteem, and psychological disorders but not for the other categories. In conclusion, the literature on the effects of strength exercises on psychological outcomes is - almost 8 years after the original review - still fragmented and more evidence is needed to draw profound conclusions. Future research may consider that the psychological effects of strength exercises might be stronger among people who are overweight or obese when they are in contexts in which they can engage in favorable comparisons with normal-weight counterparts.

Background: 'FUNBALL' is a new multi-component exercise-based injury prevention programme designed specifically for youth football players. Its efficacy in reducing the overall number of injuries has been previously reported. The aim of this study was to investigate the effects of the 'FUNBALL' programme in reducing the incidence of severe injuries (absence from training/match ≥ 28 days) in young male football players.

Methods: 55 football teams from Kosovo, 21 in the Under-15, 22 in the Under-17, and 12 in the Under-19 age groups, were cluster-randomly assigned to the intervention or the control group. The intervention group performed the 'FUNBALL' programme after their usual warm-up at least twice per week. The control group followed their usual training routine. Teams were followed for one football season (August 2021-May 2022). The outcome for the present analysis is severe injuries.

Results: The overall incidence rate (IR) was 0.31/1000 football hours in the intervention group and 0.62/1000 football hours in the control group. Players in the age group of the Under-19s sustained the highest number of severe injuries (IR 0.77/1000 football hours). The overall number of severe injuries was significantly reduced by 49% (incidence rate ratio (IRR) 0.51; 95% CI 0.28-0.91; P = 0.02), with a 63% reduction in those that occurred during training (IRR 0.37; 95% CI 0.15-0.87; P = 0.02). When analyzed by age group, only the Under-17s showed a significant reduction of 76% (IRR 0.24; 95% CI 0.06-0.82; P = 0.02). The low number of subgroup injuries prevented statistical significance. However, a promising protective effect was observed. Severe knee injuries were reduced by 62%. By injury type, sprains or ligament injuries were reduced by 67%, and meniscus or cartilage lesions by 58%. Overuse/growth-related injuries were reduced substantially by 85%.

Conclusion: The 'FUNBALL' programme showed a large efficacy in reducing the incidence of severe injuries in young male football players. Considering that these injuries cause the longest absence from football, it is recommended to implement the programme at least twice per week to exert a preventative effect.

Trail registration number: Clinical trials NCT05137015.

Background: In baseball, batting performance can be measured using game and advanced statistics as well as hitting metrics. To date, the core set of individual characteristics or skills associated with superior batting performance remains to be identified. The aim of this scoping review was to identify and classify the individual characteristics or skills associated with baseball batting performance indicators and describe the methods used to assess these individual characteristics or skills and batting performance indicators.

Methods: A scoping review design was chosen to conduct a systematic literature search. Electronic searches of MEDLINE, SPORTDiscus, and PsycINFO databases were undertaken from inception to August 2024. Cross-sectional studies that investigated the relationship between batting performance indicators and individual characteristics or skills in male or female baseball batters were selected.

Results: Twenty-two cross-sectional studies investigating potential individual characteristics or skills of baseball batting performance met the inclusion criteria. The primary baseball batting performance indicators were grouped into three categories: game statistics, advanced statistics and hitting metrics. Anthropometric measures (height, weight), physical fitness tests (1-RM bench and squat, grip strength, jumps, medicine ball throws, sprint, trunk flexibility, etc.), visual skills (visual acuity, contrast sensitivity, etc.), perceptual skills (anticipation, visual recognition, etc.) and visuomotor skills (eye-hand coordination, reaction time, etc.) were the individual characteristics or skills associated with either game statistics, advanced statistics or hitting metrics.

Conclusions: Based on the studies included in this scoping review, the results show that several anthropometrics, physical, perceptual-cognitive, and visual skills were associated with superior game statistics, advanced statistics or hitting metrics. Greater height, weight, upper- and lower-body muscle strength, power, and speed, as well as oculomotor skills, visual system characteristics, anticipation, visual recognition, and visuomotor skills corresponded to better batting performance.

Background: Upper limb impairment is common among women receiving breast cancer treatment. Although yoga is popular and accessible in cancer support communities, its impact on upper limb function in these women is not well understood. This randomized controlled trial investigated the effects of yoga on shoulder range of motion in women recovering from breast cancer surgery. Eligible participants were Chinese women with early-stage breast cancer who had recently completed surgery and adjuvant treatment. Following the baseline assessment, they were randomly assigned (1:1:1) to a 12-week yoga intervention, a 12-week relaxation intervention (active control), or a postoperative exercise DVD (passive control). Primary outcomes measured shoulder rotation flexibility and range of motion. Secondary outcomes included health-related quality of life, fatigue, pain, sleep quality, anxiety, and depression. All outcomes were assessed at baseline, immediately post-intervention, and at 3, 6, and 12 months post-intervention.

Results: Out of 760 potential participants, 444 were enrolled and randomly assigned to yoga intervention (n = 148), active control (n = 148), or passive control (n = 148). Linear Mixed Modelling indicated that, compared to the Passive control group, the Yoga group showed significant improvement in shoulder rotation flexibility scores (p = 0.004) and right hand up back scratch test scores (p = 0.013) at all time points. There was no significant difference in the back scratch test scores for the left hand up between groups. Secondary outcomes did not significantly differ among the study groups.

Conclusions: Study findings suggest that yoga intervention can improve upper-extremity mobility in women with breast cancer.

Trial registration: HKU Clinical Trials Registry, HKUCTR-1600. Registered 25 May 2013, https://www.hkuctr.com/Study/Show/36d8e3e8d051473b9c2e69bc8ee35dd1 .

Background: Knee injuries, including those requiring surgical intervention, are a leading cause of disability in U.S. Army soldiers. Previous studies investigating the risk of injury after surgery have primarily focused on civilian populations and lack specific information on the timing of new injuries.

Objective: The purpose of this study was to identify the windows of peak injury risk after knee surgery in active-duty soldiers. We hypothesized that injury risk would peak around return to duty and remain elevated beyond completion of post-operative rehabilitation.

Methods: U.S. Army administrative and medical data were extracted from the Soldier Performance, Health, and Readiness database. An accelerated failure time model adjusted for demographic-, surgical-, and military-specific variables was used to identify post-operative injury risk by procedure type.

Results: Of the 7595 soldiers who had knee surgery from 2017 to 2020, 71% (5357) sustained a new musculoskeletal injury within 4 years after surgery. Soldiers with a prior non-knee injury were estimated to sustain re-injury 11% sooner than those without a history of injury, regardless of surgical procedure. Peak hazard for injury occurred around 2.5 months after surgery when physical activity restrictions were lifted. Furthermore, soldiers were more likely to sustain an injury after reaching 14.3 months post-surgery.

Conclusions: These results indicate that both at the end of rehabilitation and 1 year post-surgery may represent critical windows for targeted injury-prevention strategies; however, future studies are needed to confirm these opportunities.

Clinical relevance: These findings suggest potential implications for guiding provider care and informing future policy in military post-operative management, with the goal of improving long-term outcomes.

Background: Individual factors related to performance in age group triathletes competing in different race distances have been explored in scientific literature. However, only a few studies have been conducted using machine learning (ML) predictive models to explore the importance of those individual factors. This study intended to build and analyze machine learning regression models that predict the performance of IRONMAN^® 70.3 age group triathletes, considering sex, age, country of origin, and event location as predictive factors. A total of 823,464 finishers´ records (625,398 men and 198,066 women) of IRONMAN^® 70.3 age group triathletes participating in 197 different events in 183 different locations between 2004 and 2020 were analyzed. The triathletes' sex, age, country of origin, event location and year, and race finish times were thus obtained and considered for the study. Four different ML regression models were built to predict the triathletes' race times from their age, sex, country of origin, and race location. The model with the best performance was then selected and further analyzed using model-agnostic interpretability tools to understand which factors would contribute most to the model predictions.

Results: The Random Forest Regressor model obtained the best predictive score. This model's partial dependence plots indicated that men under 30 years, from Switzerland or Denmark, competing in IRONMAN^®70.3 Austria/St. Polten, IRONMAN^® 70.3 Switzerland, IRONMAN^® 70.3 Sunshine Coast, and IRONMAN^® 70.3 Busselton presented the best performance.

Conclusions: Our results prove that ML models can be used to examine the complex, non-linear interactions between the factors that influence performance and gain insights that can help IRONMAN^® 70.3 age group triathletes better plan their races.

Background: Previous research has demonstrated a relationship between modifiable (e.g. hamstring strength, muscle fascicle length and high-speed running load), non-modifiable factors (e.g. age, previous injury) and hamstring strain injury (HSI) risk. However, these factors have mostly been assessed in isolation and no study to date has investigated the associations between running load, strength and muscle architecture with HSI risk. The study aim was to explore the interactions between modifiable HSI risk factors that are commonly assessed within elite Australian footballers.

Methods: A prospective cohort study design. Eccentric knee flexor strength and biceps femoris long head (BFlh) fascicle lengths were measured in 299 unique elite-level Australian Football players (age 24 ± 4 years, height 188 ± 8 cm, and weight 87 ± 9 kg) during two pre-seasons. Data from wearable micro-sensor units (high-speed running at ≥ 24k/hr and total distance) were collected over two seasons of elite Australian Football.

Results: Across 408 player-seasons there were 67 HSIs (16.4%), which took an average of 17 ± 10 days and 23 ± 12 days to return to full training and competitive matches, respectively. Univariate analysis showed that BFlh pennation angle (OR 1.6, 95% CI 1.2-2.2), fascicle length (OR 0.6, 95% CI 0.5-0.9), weekly high-speed running distance (OR 1.7, 95% CI 1.2-2.4), weekly change in total distance (OR 1.5, 95% CI 1.1-2.2) and weekly change in high-speed running distance (OR 1.6, 1.2-2.2) were significantly different between the injured and uninjured group (P < 0.05). Combining strength and architectural variables of BFlh pennation angle, fascicle length and peak force was able to explain 12% of variance in the risk of sustaining a HSI. The addition of running load exposure variables of weekly distance and change in weekly distance to the multivariate model increased the explained variance to 20%.

Conclusion: Combining measures of running load exposure with hamstring strength and architecture, increases the variance explained by multivariate models for determining HSI risk. Despite this, there was still approximately 80% of unexplained variance in sustaining a HSI in this study.

Background: Intermittent hypoxia (IH) has emerged as a promising strategy to enhance physical performance by eliciting adaptive responses across cardiovascular, respiratory, and muscular systems. Various IH protocols have been applied in both trained and untrained individuals to improve aerobic capacity, strength, and repeated sprint ability. However, the growing number of systematic reviews and meta-analyses (SRs/MAs) has led to heterogeneous conclusions due to variability in populations, protocols, and outcome measures. This umbrella review aimed to synthesize and critically appraise the available SRs/MAs on the effects of IH protocols on physical performance across different fitness levels.

Methods: A systematic search, aligned with the PRIOR (Preferred Reporting Items for Overviews of Reviews) guidelines, was conducted across seven electronic databases (PubMed/MEDLINE, Web of Science, Cochrane Database of Systematic Reviews, Scopus, Embase, PsycINFO, and SciELO) from inception to June 2025. Eligible studies included systematic reviews (SRs) with or without meta-analyses (MAs) or network meta-analyses (NMAs) evaluating the effects of intermittent hypoxia protocols on physical performance. Methodological quality was assessed using the AMSTAR-2 tool.

Results: A total of 22 systematic reviews (14 with meta-analyses, 3 with network meta-analyses) analyzing 487 primary studies and 5,333 participants were included. Intermittent hypoxia (IH) protocols improved both aerobic and anaerobic performance, as well as muscular strength. Live high-train low (LHTL) and live low-train high (LLTH) protocols consistently enhanced V̇O₂max, especially when combined with sea-level training. Anaerobic-focused strategies like repeated sprint training in hypoxia (RSH) and RSH induced by voluntary hypoventilation at low lung volume (RSH-VHL) led to improvements in sprint-fatigue resistance and glycolytic capacity. Intermittent hypoxic interval training (IHIT) and high-intensity interval training (HIIT) under hypoxia showed robust aerobic benefits. However, the magnitude of these effects varied depending on the type of protocol, training status, and hypoxic dose.

Conclusion: IH is an effective and adaptable strategy to improve aerobic and anaerobic performance, as well as to enhance muscle strength and hypertrophy. These benefits often occur without consistent hematological changes. Future studies should focus on individualized approaches, standardization of terminology, and precise quantification of both hypoxic exposure and training load to optimize outcomes and ensure reproducibility.

Review registration: This overview was registered on the International Database of Systematic Review Protocols (PROSPERO ID: CRD42024465481).