Sports Medicine - Open最新文献

Background: An increasing number of studies reveal that concussion rates in male soccer are comparable to other contact sports. Due to their possible negative effects on the neurological health, detecting potential concussion events (PCEs) during a match is essential to account for their medical consequences. The objective of this study was to investigate the incidence and characteristics of the PCEs, as well as the refereeing and medical consequences, and the return-to-play time, of a leading male soccer team of the first division of the Spanish Professional Soccer League throughout a complete season.

Results: A total of 61 PCEs from direct head impacts were identified across the 38 matches played by Real Madrid CF-the 2019-2020 regular season champions and the only team with complete match records, reflecting an incidence of 48.6/1000 h. Most of the PCEs occurred due to "elbow-head" mechanisms or during "aerial heading duels", affecting parietal-occipital and frontonasal areas, with increased incidence in defenses, in the penalty areas, during minutes 45 to 60, and with a tie score. No sanction was given in 54.8% of the PCEs. Medical assistance was requested in only 32.2% of the cases, and only 29.0% of cases resulted in a substitution. The players returned to play after a mean of 9.5 (SD: 11.0) days from the event and 74.2% of the players returned to play in or less than 7 days.

Conclusions: These results are consistent with previous studies in nearby countries and reveal a high incidence and high likelihood of repeated PCEs, with limited impact on refereeing decisions, minimal medical intervention, and short return-to-play periods. Given the potential neurological risks of concussions, greater awareness is needed among professionals, medical teams, the public, and authorities.

Background: Powerlifting is a competitive strength sport focused on achieving the highest possible single-repetition load in three barbell lifts: the back squat, bench press, and deadlift, each testing maximal force output under standardized conditions. Increases in training intensity and the accumulation of fatigue can lead to measurable alterations in kinetic and kinematic variables, with potential implications for both performance and injury risk. Although trained lifters typically exhibit more stable movement patterns than novices, the biomechanical responses to intensity and fatigue remain complex and variable. This systematic review aimed to identify consistent, observable changes in kinetic and kinematic variables in experienced lifters during the back squat, bench press, and deadlift under conditions of increasing intensity and fatigue.

Methods: A keyword search was performed on MEDLINE Complete, SPORTDiscus, and CINAHL Plus up to June 2024. Studies that examined the effects of load and fatigue on the kinetics and kinematics of the back squat, bench press, and deadlift in experienced lifters were included. The quality of studies was rated according to the Quality Assessment of Observational Cohort and Cross-sectional Studies scale. Results were summarized in tables and with a narrative synthesis.

Results: Twenty-two studies, with a total of 293 participants, met the inclusion criteria. Increased intensity was consistently associated with decreases in mean and peak barbell velocity and power, increased force production, longer concentric durations, and greater joint variability, especially in the acceleration and sticking regions. Fatigue led to similar reductions in velocity and power, although findings on force production were inconsistent across studies. Only two studies examined the deadlift, and reporting practices varied between studies.

Conclusion: Increased intensity and fatigue produce predictable kinetic and kinematic changes in the back squat, bench press, and deadlift, particularly during the acceleration and sticking phases. Velocity consistently decreased with intensity and fatigue, while power and joint mechanics showed greater variability across individuals and studies. Coaches and clinicians should monitor these changes to inform programming and technical interventions. However, different lifters may adopt distinct mechanical strategies as intensity increases, especially near the sticking point. Future research should distinguish between- and within-individual variability in kinetic and kinematic expression and address underrepresented movements, particularly the deadlift.

Registration: This systematic review was registered with PROSPERO (CRD42024550339).

Background: There is growing interest in understanding if, and how, the menstrual cycle may affect physical and cognitive performance, particularly in the context of sport and physical activity. While hormonal fluctuations are often assumed to impact cognition, especially during menstruation, empirical evidence remains inconclusive. This study aimed to investigate whether cognitive performance, mood, and symptomology vary across menstrual cycle phases and whether these effects are influenced by athletic participation level.

Results: Fifty-four females (18-40 years) categorised by athletic participation level (i.e., inactive, active, competing, elite) took part. At each key menstrual phase (menstruation / early follicular, late follicular, ovulation and mid-luteal), they completed a cognitive battery (attention, inhibition and spatial anticipation), and reported their mood and symptoms. Faster reaction times and fewer errors were committed during ovulation (p < .01), suggesting better overall performance. In contrast, reaction times were slower during the luteal phase (p < .01), but more errors were committed in the follicular phase (p = .01). Importantly, participants' athletic level had a stronger effect on cognitive performance than phase, where inactive participants scored worse across tasks than their more active counterparts, and elite participants exhibited more significant fluctuations in cognition across phases. Mood and symptoms were worse during menstruation regardless of athletic level. However, while mood varied across phases it did not correlate with cognitive performance. Of note, participants perceived that their symptoms negatively impacted their cognitive performance during menstruation, but there was no evidence of any objective detriment to cognitive performance during this phase neither on reaction times nor errors on any task.

Conclusion: These findings suggest the existence of mild cognitive fluctuations throughout the menstrual cycle, albeit with high individual variability, and which are incongruent with symptomology. Opposing results between perceived and measured performance challenge common assumptions about menstruation-related performance, and highlight the importance of addressing societal biases in female sport and health. The stronger effects of athletic engagement on cognitive performance, rather than phase, reinforce the cognitive benefits of an active lifestyle.

Key points: This study aimed to investigate cognitive fluctuations in eumenorrheic females recruited from a range of activity levels. We demonstrate mild cognitive fluctuations throughout the menstrual cycle, which are incongruent with symptomology. And reinforce the importance of physical activity for supporting cognitive performance.

Background: Advancements in sports materials have led to the creation of innovative fabrics aimed at enhancing athletic performance and reducing the risk of sports-related injuries. Graphene-based composite fibers, with superior far-infrared (FIR) emissivity, are emerging as a promising material in sportswear. This study explores the effects of graphene-based FIR compression garments on aerobic exercise capacity.

Results: A total of 15 healthy, recreationally active male university students (aged 18-25 years) participated in this double-blind, randomized crossover trial. Each participant completed two incremental treadmill tests while wearing either graphene-based FIR compression garments or control garments, with a 7-day washout period between sessions. Results showed significantly longer exercise durations (38.4 s, p < 0.001) and extended time to anaerobic threshold (37.7 s, p < 0.001) in those wearing graphene-based FIR garments compared to those wearing control garments. The maximum heart rate was significantly lower in the graphene group (198.8 ± 7.8 bpm vs. 200.3 ± 7.5 bpm, p < 0.05), with reduced heart rates at the same exercise intensity (176.9 ± 8 bpm vs. 179.8 ± 7.8 bpm, p < 0.05). No significant differences in Maximal Oxygen Uptake (VO2max) were observed between the two groups.

Conclusions: Graphene-based FIR compression garments significantly enhance aerobic performance by improving endurance, likely due to improved peripheral blood circulation and reduced cardiac load. These findings highlight the potential of graphene-based fibers as a disruptive innovation in sportswear. Further research with larger sample sizes is warranted to fully explore their benefits.

Background: The aetiological pathway from societal pressure to meet appearance ideals to disordered eating through appearance-based concerns (e.g., drive for thinness) is well established in the general population; however, its relevance for elite athletes is unclear. This study investigated longitudinal predictors and mediation pathways for disordered eating in athletes, including sports and societal pressures as risk factors, and appearance-based concerns and athlete-specific cognitions as mediators.

Methods: Elite athletes predominantly from Australia and the US completed online surveys at baseline between March-September 2023 (T1, N = 178, 72.4% female, M_age = 23.9, SD_age = 7.0), with follow-ups at 6-months (T2, N = 110) and 12-months (T3, N = 91). The survey assessed disordered eating, weight pressures in sport, societal pressures for appearance, athlete-specific mediators (drive for leanness for performance, athletic identity), and body image concerns. Regression analyses employing multiple imputation were used to examine longitudinal predictors and mediation pathways with disordered eating as the outcome, adjusting for autocorrelations and gender.

Results: Increased disordered eating over 12-months was significantly predicted by higher levels of T1-weight pressures in sport (β = 0.18, p = .046) and T1-drive for leanness for performance (β = 0.21, p = .025). T1-Societal pressures, T1-athletic identity, and T1-body image concerns did not significantly predict increases in disordered eating over time. None of the indirect pathways were significant.

Conclusions: It appears that weight pressures in sport and drive for leanness for performance contribute more to risk of disordered eating in elite athletes than traditional pathways of societal pressures and body image concerns. These findings, together with findings from previous research, were synthesised into a new model of disordered eating in elite athletes, providing targets for future intervention.

Background: While current evidence on injury risk factors remains limited, this study aims to provide insights into how fatigue-induced changes in biomechanical risk factors (BRF) differ between runners, potentially offering a new approach to understanding the development of running-related injuries. Thirty-nine (N = 39) male recreational runners underwent analysis of lower leg angular kinematics, heart rate, blood lactate levels, and perceived effort before and after a 30-minute exhaustive continuous treadmill running test.

Results: Three functional groups (FG) were identified using the K-means algorithm, which grouped participants based on changes in lower limb angular kinematics between pre- and post-fatigue. While FG1 and FG2 exhibited similar behaviours to maintain their usual running dynamics (e.g. no significant changes in hip flexion at touchdown and toe-off, and similar reductions in leg stiffness after fatigue), FG3 showed more pronounced changes, including increased hip flexion (7.4%) and knee flexion (21%) at touch-down, as well as increased knee flexion at maximal knee flexion (6%) and at the toe-off instant (9%) during the running cycle.

Conclusions: Fatigue-induced alterations in the considered biomechanical risk factors allow for the functional grouping of recreational athletes. Changes in FG3 impact running patterns and alter running economy-related variables, which may be associated with an increased injury risk and could guide future research into tailored training and preventive strategies.

Background: Powerlifting is a discipline in which athletes aim to lift the maximum weight in 3 exercises: Squat, Bench Press, and Deadlift. Since the introduction of "Classic" powerlifting by the International Powerlifting Federation (IPF) in 2012, there has been an increase in popularity, athlete participation, and attention from sports science research. Previous studies have examined factors influencing the long-term longitudinal adaptation of upper- and lower-body strength, but no one used this information to develop predictive models of future classic powerlifting performances, especially considering the different age, sex, and weight categories, with the final aim of tailoring the medium- and long-term training goals. This study aims to develop and validate a machine learning-based linear regression model to predict single-lift and overall performance in classic powerlifters. The model considered variables such as sex, age, weight, initial strength levels, and competition history. The study also seeks to provide European normative powerlifting performance data across different categories to assist in talent identification and optimization of training.

Results: The final dataset included 54,064 observations from 8,907 unique lifters. Normative data differed between sex, age categories, and initial strength level (p < 0.001). The predictive model demonstrated high predictive accuracy (Root mean Square of Error 10.41 to 19.4; R² 0.90 to 0.94), with no differences between mean values (p 0.733 to 0.930), extremely large correlations (r 0.95 to 0.97), and no significant bias (z-score - 1.78 to - 0.64) between predicted and actual performance values across all lifts.

Conclusions: The developed machine learning model provides valid and accurate predictions of individual powerlifting performance, by accounting for various individual characteristics. The model can assist coaches and athletes in setting realistic training goals and monitoring progress. Moreover, normative data for each lift and total performance were provided, stratified by sex, age, weight category, and initial strength levels, offering valuable benchmarks for athletes and coaches.

Background: Rock climbing places high loads through the hands, wrists, and fingers, leading to high injury rates, with the highest proportion in the fingers. Until now, there has been no attempt to categorize pain in the forearm to assess readiness to train. The purpose of this study was to create a questionnaire, the VISA-C (Victorian Institute of Sports-like Assessment; C for climbing), to measure forearm pain and determine how pain limits training.

Methods: We asked rock climbers aged 18 to 50 years old, who met the participation criteria and gave consent, to complete a survey containing 8 questions. We analyzed data from climbers who responded to the online questionnaire in the 9-week period between November 5, 2024, and January 8, 2025. We obtained a diverse international sample with English-speaking respondents from 54 countries. We included a supplementary questionnaire to compare the survey results against participant demographics, lifestyle, health, and sport-specific history and habits.

Results: We analyzed data from 1,110 climbers who completed the form. VISA-C scores were significantly different as a function of pain. The mean VISA-C score of the group with no pain was the highest (83.21/100), lower in the group reporting some pain (72.28/100), and lowest in the most severe group with activity-limiting pain (60.05/100), indicating our questionnaire scales with pain severity. We then used the secondary data gathered on our participants to search for associations between pain or skill level and demographic, health, and training habits. Of these, only blood pressure was associated with differences in VISA-C scores.

Conclusions: VISA-C score scaled with pain and can be compared broadly across all major demographics. We observed interesting trends in our secondary analyses. Several variables correlated significantly with either VISA-C score or climbing skill level, but none correlated well with both. Many of the variables we compared agreed with existing literature or pointed to novel associations that warrant more investigation.

Background: While aerobic training is well-established for improving body composition and metabolic health in normoxia, its effectiveness in hypoxia remains unclear.

Objective: This meta-analysis examines whether aerobic training in hypoxia is more effective than in normoxia for improving body composition and metabolic health in overweight and/or obese individuals, and identifies optimal exercise prescription variables.

Methods: A search of five databases was conducted through 10 November 2024. Random-effects meta-analyses evaluated body composition (e.g., body mass and fat mass) and metabolic health markers (e.g., triglycerides and glucose). Subgroup analyses were performed based on hypoxic severity, hypoxic dose, exercise duration, frequency, session length, and age.

Results: Aerobic training in hypoxia resulted in greater reductions in body mass (mean difference [MD] = -0.90, 95% confidence interval [CI]: -1.80 to -0.01), triglycerides (MD = -10.78, 95% CI: -20.68 to -0.88), low-density lipoprotein cholesterol (MD = -3.74, 95% CI: -6.92 to -0.56, p < 0.05), and insulin resistance (MD = -0.22, 95% CI: -0.33 to -0.11) (all p < 0.05), with a trend towards larger fat mass loss (MD = -1.22, 95% CI: -2.59 to 0.15, p = 0.08). These benefits were more prominent in moderate hypoxia (inspired oxygen fraction [FiO₂] ≥ 15%), with hypoxic dose ≥ 55 km·h, in individuals < 40 years, and with protocols involving ≥ 4 days/week, ≥ 60-min sessions, and < 8 weeks of training.

Conclusion: Aerobic training in hypoxia is more effective than in normoxia for reducing body mass, fat mass, triglycerides, low-density lipoprotein cholesterol, and insulin resistance in overweight and/or obese individuals. These findings could help inform obesity management strategies using hypoxic training.