Sports Medicine - Open最新文献

Background: Hot yoga is a collective term used to classify any form of yoga undertaken in warm to hot ambient conditions (≥ 25 °C). This study systematically reviewed the literature concerning hot yoga, with particular focus on acute responses to a single session and identifying prospective health benefits associated with physiological, functional and psychology adaptations following chronic practice.

Methods: The review was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA), with searches performed across two main databases (PubMed and SCOPUS). Studies were included if they met the Population, Intervention, Comparison, and Outcome (PICO) criteria, were of English language, peer-reviewed, full-text original articles, and using human participants.

Results: Forty-three studies investigated the effects of hot yoga (both acute and/or chronic), totalling 942 participants (76% female). The most common method of yoga performed in hot conditions was Bikram (74%), followed by generalised hot yoga (19%), Hatha (5%) and then Vinyasa (2%). Typical session duration ranged 20-90 min and occurred within 30-52 °C and 20-60% relative humidity. Hot yoga training interventions consisted of 6-36 sessions, that were completed 2-6 times per week, over 1-16 weeks. Acute hot yoga increased body temperature and heart rate, but not the energetic demands when compared to other forms of non-heated yoga. Chronic hot yoga appeared to elicit cardiometabolic (e.g. body composition, lipid profiles and macrovascular function) and functional adaptations applicable for health (e.g., bone mineral density, balance and flexibility) as well as physical performance (e.g., submaximal exercise thresholds). Adaptations appear to occur without negatively impacting kidney function or sleep quality across healthy, sedentary and athletic populations. Hot yoga also presents promising, albeit inconclusive findings concerning the alleviation of psychological and affective disorders, and optimising markers of cognitive function. However, caution is advised as case studies report ill-health following hot yoga practice. Some literature lacks rigorous, high-quality experimental designs and sophisticated measurements that allow for mechanistic investigation.

Conclusion: Investigations into hot yoga demonstrate intriguing health and functional benefits. However, claims that hot yoga provides greater health benefits than other forms of yoga or traditional exercise are at present unsubstantiated. Studies describing beneficial effects of hot yoga often do not utilise robust experimental designs or methods that facilitate mechanistic insights. Hot yoga warrants further investigation as a tool to improve health and wellbeing. Researchers should consider the highlighted methodological limitations and recommendations to strengthen experimental work within future re

Background: Whole-body heat exposure, such as sauna bathing or hot water immersion (HWI) has been shown to induce various physiological adaptations that can improve athletic performance. However, the effects of post-exercise heat exposure on acute recovery and promoting training-induced performance adaptations are not well understood. The aim of this systematic review was to summarise the current evidence on the effects of post-exercise heat exposure on physical performance in healthy adults.

Methods: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A systematic search for articles was conducted in December 2023 and updated in June 2025 using the PubMed, SPOLIT, Medline, and SPORTDiscus databases. Eligible studies were randomised or crossover trials comparing whole-body post-exercise heat exposure (≥ 36 °C, e.g., hot water immersion to at least sternum level, or sauna bathing) to passive or placebo recovery. The risk of bias of the included studies was assessed using the Cochrane Collaboration Risk of Bias Tool version 2. Only studies that provided results on maximal physical performance outcomes in healthy adults were included.

Results: Fourteen studies, including a total of 194 participants, met the inclusion criteria. Nine studies investigated acute effects after heat exposure and five were long-term training intervention studies. The acute studies reported uncertain results, with studies showing no effects (n = 4), beneficial (n = 4), or adverse (n = 1) effects of post-exercise heat exposure on performance recovery. The chronic studies suggested that post-exercise heating may improve running performance, at least in hot conditions. However, repeated heat exposures had no effect on cycling performance or VO₂max. The overall quality of the evidence was low to moderate. The heterogeneity of study designs, heating protocols, exercise modes, performance outcomes and recovery times precluded meta-analysis.

Conclusion: Based on the current evidence, it is not possible to draw definitive conclusions about the effects of post-exercise heat exposure on recovery and physical performance development. Additional high-quality studies are needed to determine the optimal heat exposure methods and recovery strategies for different types of training and performance outcomes.

Background: Chronic musculoskeletal pain (CMP) is a prevalent condition associated with significant disability. Emerging evidence suggests that autonomic dysfunction, reflected by heart rate variability (HRV), may play a role in the pathophysiology of CMP and could be responsive to exercise interventions. This systematic review aims to evaluate the effects of exercise on HRV in persons with CMP.

Methods: A comprehensive search was performed in PubMed, Web of Science, and Cochrane databases from database inception until June 15, 2024. Eligible studies included those examining exercise interventions of ≥ four weeks in adults aged 18 to 65 with CMP, where HRV was assessed both before and after the intervention. Non-experimental study designs and studies focusing exclusively on acute exercise effects were excluded. Two independent reviewers performed data extraction and assessed the risk of bias using the Cochrane RoB-2 and ROBINS-I tools. The CERT was used for reporting, and effect sizes for exercise interventions were calculated. Certainty of evidence was assessed using the GRADE framework.

Results: Five randomized and five non-randomized controlled trials were included, involving 277 persons with CMP. There was considerable variability in HRV measurement protocols. The exercise interventions, which included resistance, aerobic, and multi-component training, lasted four to 24 weeks. Significant within-group improvements were found in several HRV measures, especially in linear analyses linked to vagal modulation at rest.

Conclusions: While evidence suggests the positive influence of exercise on autonomic function in CMP, as indicated by HRV changes, the limited number of high-quality studies warrants cautious interpretation. To better understand the impact of different exercise modalities on HRV and address existing data gaps, future research should implement strict protocols for HRV measurements and consistently adhere to established reporting criteria for exercise interventions.

Background: In tackle-collision sports, the tackle has the highest incidence, severity, and burden of injury. Head injuries and concussions during the tackle are a major concern within tackle-collision sports. To reduce concussion and head impact risk, evaluating optimal tackle techniques to inform tackle-related prevention strategies has been recommended. The purpose of this study was to perform a systematic scoping review of player-level tackle training intervention studies in all tackle-collision sports.

Methods: The Arksey and O'Malley's five-stage scoping review process and Levac et al.'s framework were used, along with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) checklist. The main inclusion criteria were that the study included an intervention aimed at improving a player's tackle abilities, and the intervention had to be delivered/implemented at the player-level in a training setting.

Results: Thirteen studies were included in this review, seven studies in American Football (54%), followed by a combined cohort of rugby union and rugby league players (three studies; 23%), rugby union (two studies; 15%), and one study reported on a rugby league cohort (8%). Studies focused primarily on the tackler, with the intervention incorporating a form of instruction or feedback, delivered through video or an expert coach. Other interventions included an 8-week strength and power training programme, designing practice sessions based on baseline data, and helmetless training in American Football. All interventions demonstrated a favourable change in the outcome measured-which included tackler and ball-carrier kinematics based on motion capture video, tackler proficiency scoring, tackling task analysis, head impact frequencies by xPatch head-impact sensor technology, head impact kinematics using head-impact sensors (helmet or skin patches) and football tackle kinematics with motion capture systems or video.

Conclusion: This review shows that a range of studies have been undertaken focusing on player-level training interventions. The quality of studies were rated as 'good', and all studies showed improvements in outcome measures. Coaches and policy makers should ensure tackle technique is profiled alongside other player characteristics, and an evidence-based approach to improving player tackling is adopted, improving both performance and reducing injury risk.

Key points: Only 13 studies tested or implemented interventions at the player level in tackle-collision sports. The focus of the studies was primarily on the tackler, with the interventions incorporating a form of instruction or feedback, which was delivered through video or an expert coach. Other interventions included an 8-week strength and power training programme, designing practice sessions based on baseline data, and

Objectives: This study aimed to investigate the relationship between the relative age effect (RAE) and success in ice hockey during adolescence and adulthood in male Swedish players, as well as potential interactions between relative age (RA) and biological maturation.

Methods: Anthropometric data were collected from high schools with a certified ice hockey programme over 20 years. Birth dates were extracted from public databases to calculate numerical relative age (n = 2211 players). Biological maturity timing was defined as the z-score of the percentage of adult height (z%AH) reached at term 1 (~ 16 years of age). Retrospective longitudinal data on selection to junior national teams (U16, U18, U20) and the National Hockey League (NHL) were retrieved from open databases. Junior and adult success probabilities were modelled using generalised logistic modelling (GLM). Spearman correlation analysis was used to assess the correlation between the anthropometric data, relative age, and biological maturation. In addition, the predictor z%AH was added to the GLMs to characterise interactions.

Results: Individuals with a higher relative age were overrepresented in Swedish ice hockey programmes. Players born between January and March (Q1) were about twice as likely to reach the U16 national team as players born between October and December (Q4). Consequently, in a GLM, relative age was identified as a significant predictor of junior success. The addition of z%AH improved model fit for U16 selection, and an interaction between z%AH and RA was observed (p < 0.05). In contrast, relative age was not a significant predictor of reaching the NHL (p = 0.21). There was no interaction between the RA and z%AH (p = 0.44) for adult success. When cross-tabulated, the players most likely to reach both the NHL and the U16 national team were either born early and matured late or born late and matured early.

Conclusion: Early-born and early-maturing players in certified Swedish high school programmes are more likely to be selected for the U16 national team. In terms of adult success, RA had no significant effect on the likelihood of playing in the NHL. However, in a combined model, regardless of relative age, players with late biological maturity timing were more likely to reach the NHL.

Current Opinion article considers the diverging perspectives of two academics on the trainability and role of perceptual-cognitive abilities in sports performance, specifically applied to agility and sidestepping. This work uses a moderated dialogue approach between these two authors, each representing differing viewpoints: one advocating for the role of perceptual-motor skills through representative learning environments and another emphasising physical resilience. The article explores how fostering scientific discourse through moderated questions posed by a third party can be used to identify convergences and divergences in these perspectives. Both perspectives agree on the complexity of agility, the value of coupling perceptual skills with motor actions in representative environments, and the role of action capabilities in shaping affordances. However, they diverge on the best methods for assessing and training these skills, with contrasting views on the practicality of representative assessments and training transfer to in-game scenarios. The authors propose that the current article forms the first stage for future collaborative research to test hypotheses through adversarial collaboration in order to better understand how perceptual-cognitive skills are integrated with physical training and assessed for practical application in sports settings. By fostering mutual understanding, the article highlights the potential of adversarial debate in advancing scientific practices within the domain of sports performance, as well as how this method can form the basis for joint hypothesis testing between adversaries.

Background: Exercise-based cardiac rehabilitation (CR) shows promise as an adjunctive treatment for patients with atrial fibrillation (AF). Previous evidence has highlighted its beneficial impact in this population. However, studies exhibit significant heterogeneity and often fail to differentiate between AF types. Furthermore, the specific influence of training variables such as exercise modality or intensity on the exercise-induced effects remains unclear. Therefore, the aim of our review was to assess the effect of exercise training (i.e., aerobic, resistance, and combined exercise), on exercise capacity, quality of life (QoL), resting heart rate (HR), AF burden, and symptoms in AF.

Methods: Electronic searches were conducted in PubMed, Embase, and Web of Science up to May 2025. Standardised mean difference (SMD) or mean difference (MD) were estimated in controlled and multi-intervention studies. Effect size indices were pooled using a random-effects model when at least three studies reported a specific outcome. Additionally, subgroup analyses were carried out based on AF type.

Results: Most of the studies used moderate intensity exercise (MIE). Across included studies, peak oxygen uptake (VO₂ peak) (n = 5, N = 1,519), 6-min walk test (6MWT) (n = 5, N = 1,344), QoL (n = 9, N = 1,596), resting HR (n = 6, N = 490), AF burden (n = 5, N = 412), and AF symptoms (n = 4, N = 428) were reported. The results showed that aerobic exercise improves VO₂ peak to a greater extent than usual care, regardless of AF type (MD₊ = 4.24 [95%CI = 0.87; 7.45] ml/kg/min). Compared to usual care, aerobic exercise only diminished resting HR in non-permanent AF (MD₊ = - 12.79 [95%CI = - 15.90: - 9.67] bpm). No differences were found for improving QoL and 6MWT (p > .050). The effect of exercise on AF burden and symptoms has been poorly studied. No pooled analyses were performed by including multi-intervention studies. The findings showed no influence of the aerobic intensity or modality.

Conclusion: Aerobic exercise improves VO₂ peak in patients with permanent and non-permanent AF. MIE reduces resting HR in patients with permanent AF, while no differences were found in non-permanent AF. In contrast, the limited and heterogeneous RCT evidence available is insufficient to demonstrate superior improvements in the 6MWT or QoL compared to usual care. Further research is needed to determine the impact of CR on AF burden and symptoms, and to elucidate how exercise modality and intensity influence outcomes.

Background: Good preoperative quadriceps neuromuscular function is associated with satisfactory functional outcomes post-anterior cruciate ligament reconstruction (ACLR). Whole-body vibration (WBV), which can modulate quadriceps neuromuscular function has not yet been incorporated into ACL prehabilitation. The aim of this study was to determine whether the combination of WBV in a prehabilitation program could achieve a better knee function after ACLR by promoting quadriceps neuromuscular function during the preoperative period.

Methods: A single-blinded randomized controlled clinical trial was conducted. Forty-four participants with a primary, unilateral ACL rupture were randomly assigned to the control (N = 22) or the WBV group (N = 22). The control group underwent prehabilitation twice weekly for five weeks. The WBV group received the same prehabilitation plus WBV. Quadriceps neuromuscular function, including strength (maximal voluntary isometric contraction, MVIC), the early (rate of torque development from 0 to 50ms, RTD_0 - 50), and the late phase (rate of torque development from 100 to 200ms, RTD_{100 - 200}) of rapid contraction and inhibition (central activation ratio, CAR) in the injured limb, were measured at baseline and preoperatively. Knee function was assessed by the International Knee Documentation Committee (IKDC) Score at baseline, preoperatively, and 4 months postoperatively. The linear mixed effect models and multiple linear regression were used for the statistical analyses.

Results: Forty participants completed interventions and 35 finished the postoperative follow-up. Preoperatively, the intervention demonstrated main effects on quadriceps MVIC (p = 0.002), RTD_0 - 50 (p = 0.024), RTD_{100 - 200} (p = 0.005) and CAR (p = 0.043). Furthermore, the effect of time* intervention interaction was significant on quadriceps MVIC (p = 0.011). Postoperatively, the WBV group achieved higher IKDC scores than the control group (p = 0.006). The improvements in preoperative quadriceps MVIC and intervention contributed to better knee function post-ACLR (R² = 0.239, p = 0.007).

Conclusions: Five weeks of WBV in prehabilitation enhanced quadriceps strength pre-ACLR and had potential to enhance knee function post-ACLR. WBV can be considered as an adjunct to prehabilitation protocols.

Trial registration: ClinicalTrials.gov, NCT04988828. Registered 3rd August 2021, https://clinicaltrials.gov/study/NCT04988828?cond=anterior%20cruciate%20ligament&term=WBV&locStr=Hong%20Kong&country=Hong%20Kong&rank=3.

Background: Despite pickleball's rapid growth in the United States, research regarding the patterns and predictors of injuries remain sparse.

Objectives: To describe the prevalence and characteristics of injuries, including time-loss (stopping play for at least a day) and non-time-loss injuries, and evaluate the predictors of injuries in pickleball players.

Methods: A cross-sectional study was conducted. Pickleball players ≥ 18 years of age across the United States, who participated in pickleball at least once a month, were invited to take a pre-validated survey. The primary outcome was self-reported all-complaint injuries, including any physical complaints in the past 12 months.

Results: A total of 1,758 participants (mean age: 62.7 ± 13.0 years) were included in the final analysis. The 12-month prevalence of all-complaint injuries was 68.5% (95% CI: 66.3-70.7%), with time-loss injuries at 40.8% (95% CI: 38.5-43.1%) and non-time-loss injuries at 51.2% (95% CI: 49.4-54.1%). The point prevalence of pain/ongoing injuries was 35.9% (95% CI: 33.1-38.7%). The knee reported the highest injury prevalence (29.1%) followed by combined lower extremity regions of thigh, leg and foot (26.9%), shoulder (22.2%), back (19.9%) and elbow (18.4%). The top "most serious" injury types were overuse/chronic conditions (35.3%), joint/ligament sprains (23.8%), and muscle strains/pulls (20.7%). Based on a multivariable logistic regression, significant predictors of injury included male sex (OR: 1.33, 95%CI: 1.07-1.65, p = 0.011), higher frequency of weekly play (OR: 1.45, 95%CI: 1.15-1.84, p = 0.002), fewer years (< 5 years) of play experience (OR: 1.50, 95%CI: 1.19-1.90, p = 0.001), low/moderate perception of injury prevention importance (OR: 2.02; 95%CI: 1.52-2.67, p < 0.001), and age categories ranging from 33 to 77 years (ORs ranging from 1.83 to 3.11, p ≤ 0.009). Neither increased duration of play nor higher body mass index significantly increased the odds of injury.

Conclusions: Injuries are common among pickleball players, with 69% experiencing at least one all-complaint injury annually, including two in five sustaining injuries that halt play and one in three continuing to play despite pain. These findings underscore the need for tailored injury prevention strategies to optimize the health benefits of pickleball. Identified predictors will inform future injury prevention initiatives in pickleball.