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Bidirectional Relationship Between Mental Health and Sports Injury in Adolescents: A Systematic Review and Meta-analysis. 青少年心理健康与运动损伤的双向关系:系统回顾与meta分析。
IF 9.8 1区 医学 Q1 SPORT SCIENCES Pub Date : 2026-01-13 DOI: 10.1007/s40279-025-02379-z
Athena R W Chow,Mirela Zaneva,Layla Rashid,Catherine Wheatley,Constantin Coussios,Robert Hepach,Lucy Bowes
BACKGROUNDSports injuries are linked to negative impacts on mental health and well-being, including depression, anxiety, stress and lower quality of life. Conversely, poor mental health and well-being have been found to increase the risk of sports injury, injury severity and time taken to recover. Although existing research indicates these associations in athletes broadly, the nature and directionality of these relationships among adolescents are not well characterised. A related limitation is that much of the existing evidence, in both children and adult athletes, is cross-sectional in design, limiting our understanding of causal directionality. Given the high rates of sports participation and the specific risk factors for injury in this demographic, as well as the growing concern about adolescents' mental health and well-being worldwide, this complex relationship warrants greater attention.OBJECTIVEWe aimed to examine the bidirectional relationship between sports injuries and mental health and well-being in adolescents aged 10-24 years, and potential mechanisms of this relationship.METHODSThis systematic review and meta-analysis was registered on PROSPERO (ID: CRD42023374807). Literature searches were performed according to PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines by searching PsycINFO, Web of Science, ERIC, CINAHL, MEDLINE, Embase, Cochrane Library, SPORTDiscus, PEDro, Elicit and Google Scholar. Articles were included if they were quantitative, published in English between 1990 and 2023, focused on young athletes aged 10-24 years, measured mental health/well-being and were an all-complaints sports injury that ranged across all levels of sport.RESULTSOf 397 studies screened, 84 studies were included. The final sample included 221,095 adolescents and young people. A narrative synthesis indicated that sports injuries were associated with worse mental health and well-being in the majority of studies, and vice versa. Meta-analyses revealed that sports injury incidence was significantly associated with worse mental health/well-being (Zr = 0.34, 95% confidence interval 0.17, 0.50), and concussion incidence was significantly associated with worse mental health/well-being (Zr = 0.19, 95% confidence interval 0.08, 0.30), with no evidence of publication bias. Conversely, worse mental health/well-being was associated with a significantly increased risk of sports injury incidence (odds ratio = 1.54, 95% confidence interval 1.13, 2.10). However, after accounting for potential publication bias, the pooled association between mental health/well-being and sports injury risk was no longer statistically significant, highlighting the need for caution in interpreting this relationship. Regarding mechanisms, a small number of studies revealed psychosocial factors (e.g. athletic identity, social support) that could influence this reciprocal relationship.CONCLUSIONSWe found evidence for a bidirectional relationship betwee
运动损伤与心理健康和福祉的负面影响有关,包括抑郁、焦虑、压力和生活质量下降。相反,不良的心理健康和幸福感会增加运动损伤的风险、损伤的严重程度和恢复所需的时间。尽管现有的研究表明这些关联在运动员中广泛存在,但这些关系在青少年中的性质和方向性并没有很好地表征。一个相关的限制是,许多现有的证据,无论是儿童还是成年运动员,都是横断面设计,限制了我们对因果方向的理解。鉴于这一人群的体育参与率高、受伤的具体风险因素多,以及全世界对青少年心理健康和福祉的日益关注,这一复杂关系值得更多关注。目的探讨10-24岁青少年运动损伤与心理健康和幸福感的双向关系及其可能的机制。方法本系统评价和荟萃分析在PROSPERO注册(ID: CRD42023374807)。根据PRISMA (Preferred Reporting Items for Systematic reviews and meta - analysis)指南进行文献检索,检索词包括PsycINFO、Web of Science、ERIC、CINAHL、MEDLINE、Embase、Cochrane Library、SPORTDiscus、PEDro、Elicit和谷歌Scholar。如果文章是量化的,在1990年至2023年期间以英文发表,重点关注10-24岁的年轻运动员,测量心理健康/福祉,并且是涵盖所有体育水平的所有投诉运动损伤。结果在筛选的397项研究中,纳入84项研究。最终的样本包括221,095名青少年和年轻人。一项叙述性综合研究表明,在大多数研究中,运动损伤与较差的心理健康和幸福感有关,反之亦然。荟萃分析显示,运动损伤发生率与较差的心理健康/幸福感显著相关(Zr = 0.34, 95%可信区间0.17,0.50),脑震荡发生率与较差的心理健康/幸福感显著相关(Zr = 0.19, 95%可信区间0.08,0.30),无发表偏倚证据。相反,较差的心理健康/幸福感与运动损伤发生率显著增加相关(优势比= 1.54,95%置信区间1.13,2.10)。然而,在考虑了潜在的发表偏倚后,心理健康/幸福感与运动损伤风险之间的综合关联不再具有统计学意义,这突出了在解释这种关系时需要谨慎。在机制方面,少数研究揭示了可能影响这种相互关系的社会心理因素(如运动员身份、社会支持)。结论青少年运动员运动损伤与心理健康之间存在双向关系。需要进一步的研究来阐明这种关系背后的机制。早期干预措施的重点是支持运动损伤后的心理健康,并解决先前存在的心理健康问题,以减少随后受伤的风险,这些干预措施应针对特别影响青少年运动员的心理社会机制。
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引用次数: 0
Sprint Running Coordination: A Dynamical Systems Perspective. 冲刺跑协调:动态系统视角。
IF 9.8 1区 医学 Q1 SPORT SCIENCES Pub Date : 2026-01-13 DOI: 10.1007/s40279-025-02380-6
Dylan S Hicks,Stuart McMillan,Wolfgang Schöllhorn,Roland van den Tillaar
Sprinting is a complex skill required in many team and individual sports, with practitioners placing an emphasis on enhancing this aspect of performance to improve sporting success. The task of sprinting involves patterns of inter- and intra-limb coordination and control, which emerge as the athlete accelerates to their maximal velocity. Traditionally, practitioners have attempted to modify sprint coordination patterns from a reductionist or cognitive perspective, decomposing performance to individual component parts using knowledge of coaching literature, biomechanics and skill acquisition theory. However, this approach widely neglects the dynamic and complex interactions that shape sprinting more holistically. This perspective article presents sprint coordination within a dynamical systems theory framework, emphasising how sprint performance emerges from constantly varying internal and/or external boundary conditions that regulate patterns of coordination by controlling mechanical, metabolic and neurophysiological degrees of freedom within the limits of the system. Thereby, movement variability is viewed as an essential component of coordination rather than simply 'noise'. We also review classification schemes that identify stable sprint coordination patterns or strategies, with an emphasis on the acceleration and maximal velocity phases. We then examine practices towards "optimal" sprint technique, plus consider coordinative processes including self-organisation, phase transition and shifts in attractor states, alongside skill acquisition approaches used to establish functional sprint coordination patterns. Ultimately, we aim to present an alternative view for sprint practitioners to consider the complexities of sprint coordination and performance through a dynamical systems lens.
短跑是一项复杂的技能,在许多团队和个人运动中都需要,从业者强调提高这方面的表现,以提高运动的成功。短跑的任务涉及肢体间和肢体内的协调和控制模式,这些模式在运动员加速到最大速度时出现。传统上,从业者试图从还原论或认知的角度修改冲刺协调模式,利用教练文献、生物力学和技能习得理论的知识将表现分解为单个组成部分。然而,这种方法普遍忽略了动态和复杂的相互作用,这些相互作用更全面地塑造了冲刺。这篇透视文章在动力系统理论框架内展示了冲刺协调,强调短跑表现如何从不断变化的内部和/或外部边界条件中产生,这些边界条件通过控制系统限制内的机械、代谢和神经生理自由度来调节协调模式。因此,运动可变性被视为协调的重要组成部分,而不仅仅是“噪音”。我们还回顾了确定稳定的冲刺协调模式或策略的分类方案,重点是加速和最大速度阶段。然后,我们研究了“最佳”冲刺技术的实践,并考虑了协调过程,包括自组织、相变和吸引子状态的变化,以及用于建立功能性冲刺协调模式的技能获取方法。最后,我们的目标是为冲刺实践者提供另一种观点,通过动态系统的视角来考虑冲刺协调和表现的复杂性。
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引用次数: 0
The Effects of Occupational and Leisure Time Physical Activity on Health-Related Quality of Life: A Repeated-Measures Longitudinal Study. 职业和休闲时间体力活动对健康相关生活质量的影响:一项重复测量的纵向研究。
IF 9.8 1区 医学 Q1 SPORT SCIENCES Pub Date : 2026-01-10 DOI: 10.1007/s40279-025-02382-4
Stephanie A Prince,Tyler Thomas,Aviroop Biswas
BACKGROUNDHigh leisure time physical activity (LTPA) is consistently linked to health benefits, whereas high occupational physical activity (OPA) has been associated with adverse health outcomes, a phenomenon known as the "physical activity health paradox." This study examined how OPA and LTPA interact to influence health-related quality of life (HRQL), a measure of physical and mental well-being.METHODSA repeated-measures longitudinal study was conducted using data from 7382 Canadian workers (aged 18-75 years) in the National Population Health Survey (1994-2011). Multilevel growth curve models were used to assess associations between self-reported measures of LTPA (active, inactive), OPA (sit, walk/light loads, heavy loads), and OLTPA, a composite variable of their combined effects, with the Health Utility Index score (HRQL), adjusting for sociodemographic and health covariates.RESULTSActive LTPA was associated with better HRQL, whereas OPA was not. Results suggested a curvilinear response between OLTPA and HRQL with age whereby middle-aged workers lifting heavy loads at work and active LTPA have lower HRQL than older workers in the same group. Findings were similar among males, but among older females (60 + years) who lifted heavy loads at work, being inactive rather than active in leisure resulted in higher HRQL.CONCLUSIONThe association between LTPA, OPA, and HRQL is complex, varying across age and sex. These findings highlight the need for physical activity recommendations that are sensitive to occupational demands when promoting health and well-being.
高休闲时间体力活动(LTPA)一直与健康益处有关,而高职业体力活动(OPA)与不良健康结果有关,这种现象被称为“体力活动健康悖论”。本研究考察了OPA和LTPA如何相互作用影响健康相关生活质量(HRQL),这是一种衡量身心健康的指标。方法利用1994-2011年加拿大全国人口健康调查(National Population Health Survey)中7382名18-75岁劳动者的数据进行重复测量的纵向研究。采用多水平生长曲线模型来评估LTPA(运动、不运动)、OPA(坐、走/轻负荷、重负荷)和OLTPA(其综合效应的复合变量)与健康效用指数评分(HRQL)之间的关联,并对社会人口统计学和健康协变量进行了调整。结果active LTPA与较好的HRQL相关,而OPA与较好的HRQL无关。结果表明,OLTPA和HRQL随年龄呈曲线反应,在同一组中,中年工人在工作中搬运重物和活跃的LTPA的HRQL低于老年工人。研究结果在男性中也相似,但在工作中搬运重物的老年女性(60岁以上)中,不运动而不是在休闲时运动导致HRQL更高。结论LTPA、OPA和HRQL之间的关系是复杂的,随年龄和性别而变化。这些发现强调,在促进健康和福祉时,需要对职业需求敏感的体育活动建议。
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引用次数: 0
Goal Setting in Exercise and Physical Activity: An Expert Statement on Behalf of Exercise and Sports Science Australia. 运动和体育活动的目标设定:代表澳大利亚运动和体育科学协会的专家声明。
IF 9.4 1区 医学 Q1 SPORT SCIENCES Pub Date : 2026-01-08 DOI: 10.1007/s40279-025-02373-5
Christian Swann, Jena Buchan, Elizabeth A Calleja, Scott G Goddard, Melanie M Clarke, Rebecca M Hawkins, Patricia C Jackman, Matthew J Schweickle, Stewart A Vella, Simon Rosenbaum

Goal setting is one of the most commonly used strategies for increasing exercise and physical activity, and is a core aspect of the scope of practice for many exercise and health practitioners. Despite its widespread use, recent research has highlighted a need to reconsider traditional practice and re-evaluate the theoretical and empirical basis of goal setting in exercise and physical activity promotion. The issues identified in traditional approaches to goal setting in exercise and physical activity include oversimplification, misapplication of theory and over-reliance on the SMART acronym (e.g., Specific, Measurable, Achievable, Realistic, Time-bound goals) rather than more rigorous evidence-based approaches. Therefore, this expert statement, on behalf of Exercise and Sports Science Australia, reviews theory and empirical evidence on goal setting, and provides practical recommendations for exercise and health practitioners when supporting clients to set goals. To move beyond the issues highlighted in traditional approaches to goal setting, it is necessary to go 'back to basics' and consider the foundations of goal setting. In turn, we outline: the goal-setting process; the structure of goals; moderating factors that determine whether/when certain types of goal should be set; and outcomes of goals, including risks and pitfalls. We provide corresponding practical recommendations to assist exercise and health practitioners in setting goals with clients. This expert statement seeks to help practitioners avoid the issues highlighted in traditional approaches to goal setting in exercise and physical activity, and set more suitable and evidence-based goals with clients instead.

目标设定是增加锻炼和身体活动最常用的策略之一,也是许多锻炼和健康从业者实践范围的核心方面。尽管它被广泛使用,但最近的研究强调需要重新考虑传统实践,重新评估运动和体育活动促进目标设定的理论和实证基础。在传统的运动和体育活动目标设定方法中发现的问题包括过度简化、理论误用和过度依赖SMART首字母缩略词(例如,具体的、可衡量的、可实现的、现实的、有时限的目标),而不是更严格的循证方法。因此,这份专家声明,代表澳大利亚运动和体育科学,回顾了关于目标设定的理论和经验证据,并在支持客户设定目标时为运动和健康从业者提供了实用的建议。为了超越传统目标设定方法中突出的问题,有必要“回到基础”并考虑目标设定的基础。反过来,我们概述:目标设定过程;目标结构;决定是否/何时应该设定某些类型的目标的调节因素;目标的结果,包括风险和陷阱。我们提供相应的实用建议,以帮助运动和健康从业者与客户设定目标。这份专家声明旨在帮助从业者避免在传统方法中强调的锻炼和体育活动目标设定问题,并为客户设定更合适和基于证据的目标。
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引用次数: 0
Correlations Between the Metabolic Costs of Level and Graded Running: A Secondary Analysis of the Literature 分级跑步和分级跑步代谢消耗的相关性:文献的二次分析
IF 9.8 1区 医学 Q1 SPORT SCIENCES Pub Date : 2026-01-06 DOI: 10.1007/s40279-025-02381-5
Loïc Espeit, Thibault Besson, Frederic Sabater-Pastor, Jeanne Tondut, Wouter Hoogkamer, Rodger Kram, Marcel Lemire, Grégoire P. Millet, Aldo Savoldelli, Fabrice Vercruyssen, Gianluca Vernillo, Guillaume Y. Millet
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引用次数: 0
2025 Update to the Female Athlete Triad Coalition Consensus Statement Part 2: Clinical Guidelines for Screening, Diagnosis, Treatment, and Return to Play for Adolescents and Adults. 2025年更新女性运动员三合会联盟共识声明第2部分:青少年和成人筛查、诊断、治疗和重返赛场的临床指南
IF 9.4 1区 医学 Q1 SPORT SCIENCES Pub Date : 2025-12-31 DOI: 10.1007/s40279-025-02332-0
Nancy I Williams, Mary Jane De Souza, Madhusmita Misra, Aurelia Nattiv, Elizabeth Joy, Michelle Barrack, Emily A Ricker, Sasha Gorrell, Kristen J Koltun, Emma O'Donnell, Rebecca J Mallinson, Ana Carla C Salamunes, Kary Woodruff, Michael Fredericson, Franziska Plessow

This is the second of two publications comprising the 2025 update to the 2014 Consensus Statement on treatment and return to play guidelines on the Female Athlete Triad (Triad). This paper pairs with the 2025 Update to the Female Athlete Triad Coalition Consensus Statement Part 1: State of the Science and Introduction of a New Adolescent Model (Sports Medicine, 2025), to focus on evidence-based revisions for screening, diagnosis, treatment, and clearance and return to play. Revised recommendations for managing eating disorders (ED)/disordered eating (DE) and non-pharmacological and pharmacological treatment of bone loss and abnormal menstrual cycles are included, as are the most recent clearance and return to play recommendations, inclusive of adolescent athletes. Recent research supports the adoption of revised criteria for defining and treating energy deficiency, moving away from the concept of an energy-availability threshold. Energy deficiency-induced menstrual disturbances can be reversed with a moderate increase in food intake and modest weight gain, but restoration of menses alone is not associated with high rates of ovulation or increased ovarian steroid levels until multiple consecutive normal length menstrual cycles are achieved. Revised guidelines for the diagnosis and treatment of functional hypothalamic oligo/amenorrhea are included with guidance on the confounding effects of hyperandrogenemia. Gynecological age and psychological stress are factors impacting the individual susceptibility to the Triad. The bone health spectrum of the Triad now includes bone stress injuries. Routes of administration via epidermal patch versus oral for pharmacological treatment of low bone density are discussed. The diagnosis, treatment, and return to play approaches for adolescents with the Triad are unique compared with those employed for adults and require age-appropriate clinical guidelines. The strength of the evidence-based statements is graded using an accepted taxonomy in which randomized controlled trials and observational data are considered the highest level of evidence.

这是两份出版物中的第二份,包括2025年更新的2014年共识声明,关于女性运动员三合症(Triad)的治疗和恢复比赛指南。本文与2025年更新的女性运动员三合会联盟共识声明第1部分:科学现状和新青少年模型的介绍(运动医学,2025)相结合,重点关注基于证据的筛查,诊断,治疗,清除和恢复比赛的修订。修订后的饮食失调(ED)/饮食失调(DE)管理建议,以及骨质流失和月经周期异常的非药物和药物治疗建议,以及最新的清除和恢复运动建议,包括青少年运动员。最近的研究支持采用经修订的标准来定义和治疗能量缺乏,而不是能量可用性阈值的概念。能量不足引起的月经紊乱可以通过适度增加食物摄入和适度增加体重来逆转,但在达到连续多个正常长度的月经周期之前,月经恢复本身与高排卵率或卵巢类固醇水平增加无关。修订版的功能性下丘脑少/闭经的诊断和治疗指南包括高雄激素血症的混杂效应指南。妇科年龄和心理压力是影响个体易感性的因素。三位一体的骨骼健康谱现在包括骨应激损伤。通过表皮贴片给药途径与口服低骨密度的药物治疗进行了讨论。与成年人相比,青少年的诊断、治疗和重返游戏的方法是独特的,需要适合年龄的临床指导。基于证据的陈述的强度使用公认的分类法进行分级,其中随机对照试验和观察数据被认为是最高水平的证据。
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引用次数: 0
2025 Update to the Female Athlete Triad Coalition Consensus Statement Part 1: State of the Science and Introduction of a New Adolescent Model. 2025年更新女运动员三合会联盟共识声明第1部分:科学现状和新青少年模式的引入。
IF 9.4 1区 医学 Q1 SPORT SCIENCES Pub Date : 2025-12-31 DOI: 10.1007/s40279-025-02333-z
Mary Jane De Souza, Nancy I Williams, Madhusmita Misra, Aurelia Nattiv, Elizabeth Joy, Michelle Barrack, Emily A Ricker, Sasha Gorrell, Kristen J Koltun, Emma O'Donnell, Rebecca J Mallinson, Ana Carla C Salamunes, Kary Woodruff, Michael Fredericson, Franziska Plessow

This paper is the first of two publications comprising a 2025 update to the 2014 Consensus Statement on treatment and return-to-play guidelines on the Female Athlete Triad (Triad), defined as three inter-related components including energy status, reproductive function, and bone health. The Triad is initiated by exposure to varying degrees of energy deficiency with or without disordered eating/eating disorders with primary pathological outcomes to the reproductive and skeletal systems. This first paper includes a detailed update on the scientific underpinnings of the Triad and introduces a new Triad model specific to the adolescent female athlete. Energy deficiency and "metabolic compensation" are added to the energy status continuum to describe adaptations that reflect energy conservation. Ovarian steroid hormone exposure and functional hypothalamic oligo-amenorrhea are added to the reproductive function continuum. Bone stress injury is added to the bone health continuum. Rates of change are depicted for the induction and recovery of clinical outcomes within the adult model. Evidence-based statements are presented throughout the paper and supported by a high number of level A and B grades.

这篇论文是两篇出版物中的第一篇,其中包括2014年关于女性运动员三合一(Triad)治疗和重返比赛指南的共识声明的2025年更新,定义为三个相互关联的组成部分,包括能量状态、生殖功能和骨骼健康。三位一体是由于暴露于不同程度的能量缺乏,伴有或不伴有饮食失调/饮食失调,主要病理结果是生殖和骨骼系统。这第一篇论文包括了对三合征的科学基础的详细更新,并介绍了一种针对青少年女运动员的新的三合征模型。能量缺乏和“代谢补偿”被添加到能量状态连续体中,以描述反映能量节约的适应。卵巢类固醇激素暴露和功能性下丘脑少闭经被添加到生殖功能连续体中。骨应激损伤被添加到骨骼健康连续体中。变化率描述了成人模型中临床结果的诱导和恢复。基于证据的陈述贯穿全文,并得到大量a级和B级成绩的支持。
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引用次数: 0
Force and Power Testing During Anterior Cruciate Ligament Reconstruction Rehabilitation: A World-Wide Survey of Current Practices 前交叉韧带重建康复中的力量和力量测试:目前世界范围内的实践调查
IF 9.8 1区 医学 Q1 SPORT SCIENCES Pub Date : 2025-12-27 DOI: 10.1007/s40279-025-02374-4
Alessandro Compagnin, Francesco Della Villa, Giovanni La Rosa, Stephen Patterson, Paul Read, Lee Herrington, Stefano Di Paolo, Eric Hamrin Senorski, Gregory D. Myer, Mike Davison, Mick Hughes, Matthew Buckthorpe
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引用次数: 0
Effects of Exercise on Cytokine Profiles in Breast Cancer Survivors: A Systematic Review. 运动对乳腺癌幸存者细胞因子谱的影响:一项系统综述。
IF 9.8 1区 医学 Q1 SPORT SCIENCES Pub Date : 2025-12-19 DOI: 10.1007/s40279-025-02376-2
Jihen Khalfoun,Abderraouf Ben Abderrahman,Devaraj Loganathan,Amri Hammami,Ayoub Saeidi,Juan Del Coso,Ismail Laher,Hassane Zouhal
BACKGROUNDThe role of exercise in modulating the immune system and cytokines has garnered increasing attention, particularly in the context of breast cancer survivorship. Breast cancer and its treatments often lead to immunosuppression, which can heighten the risk of infections and recurrence. Emerging evidence suggests that various forms of exercise, including aerobic and resistance exercise, can positively influence cytokine profiles in breast cancer patients. However, the specific effects and underlying mechanisms remain underexplored.OBJECTIVEWe aimed to conduct a systematic review of the studies focused on the effects of exercise on cytokine profiles of breast cancer survivors.METHODSThe databases of Cochrane Library, PubMed, Science Direct, Scopus, SPORTDiscus, and Web of Science were searched until 31 December 2024, following PRISMA guidelines. Randomized controlled trials were included if they compared breast cancer survivors participating in a structured exercise program with a non-exercise control group and measured cytokine variables both before and after the intervention. The quality of the included studies was rated with the PEDro scale.RESULTSEleven studies with 481 individuals undergoing exercise interventions were included in the analysis and compared to 240 individuals as controls. Participants in these studies ranged in age from early 40s to late 50s. These studies examined the effects of various exercise interventions, including resistance exercise (n = 2), aerobic exercise (n = 2), concurrent aerobic + resistance exercise (n = 5), tai chi (n = 1), and yoga (n = 1). The training period ranged from 8 to 52 weeks, with most studies lasting 12-15 weeks. The average frequency of training was three sessions per week with a mean session duration of 55 min. The quality of the studies showed a mean PEDro score of 6.5 ± 0.9 points (range 5-8 points). Both aerobic and resistance training alone or in combination impacted several immune indices, including decreases in serum concentrations of interleukin-15 (IL-15), macrophage migration inhibitory factor (MIF), TNF-α expression in NK and NKT cells (NKTNF-α, and NKTTNF-α), and lower IL-10/TNF-α ratio. Other less habitual exercise interventions such as tai chi and yoga also induced positive effects on immune indices.CONCLUSIONBreast cancer survivors enrolled in several forms of exercise training showed improved cytokine parameters compared with counterparts who did not perform exercise. The benefits of exercise training on cytokine profiles of breast cancer survivors were evident with both aerobic and resistance training, whether performed separately or in combination, and with other training regimens such as tai chi and yoga.
运动在调节免疫系统和细胞因子中的作用已引起越来越多的关注,特别是在乳腺癌生存的背景下。乳腺癌及其治疗通常会导致免疫抑制,这可能会增加感染和复发的风险。新出现的证据表明,各种形式的运动,包括有氧运动和阻力运动,可以积极影响乳腺癌患者的细胞因子谱。然而,具体的影响和潜在的机制仍未得到充分探讨。目的:我们旨在对运动对乳腺癌幸存者细胞因子谱影响的研究进行系统回顾。方法按照PRISMA指南,检索Cochrane Library、PubMed、Science Direct、Scopus、SPORTDiscus和Web of Science数据库,检索时间截止到2024年12月31日。如果将参加有组织的锻炼计划的乳腺癌幸存者与不参加锻炼的对照组进行比较,并在干预前后测量细胞因子变量,则包括随机对照试验。纳入研究的质量用PEDro量表评定。结果:有481名接受运动干预的人参与的研究被纳入分析,并与240名作为对照的人进行了比较。这些研究的参与者年龄从40出头到50多岁不等。这些研究考察了各种运动干预的效果,包括阻力运动(n = 2)、有氧运动(n = 2)、有氧+阻力运动(n = 5)、太极(n = 1)和瑜伽(n = 1)。训练时间从8周到52周不等,大多数研究持续12-15周。训练的平均频率为每周三次,平均每次持续时间为55分钟。研究质量的平均PEDro评分为6.5±0.9分(范围5-8分)。有氧和抗阻训练单独或联合训练均影响多项免疫指标,包括血清白细胞介素-15 (IL-15)、巨噬细胞迁移抑制因子(MIF)、NK和NKT细胞中TNF-α表达(NKTNF-α和NKTTNF-α)的降低,以及IL-10/TNF-α比值的降低。其他不太习惯的运动干预,如太极拳和瑜伽,也对免疫指标产生了积极影响。结论:与不进行运动训练的乳腺癌幸存者相比,参加多种形式运动训练的乳腺癌幸存者的细胞因子参数有所改善。无论是单独进行还是联合进行有氧和抗阻训练,以及与太极和瑜伽等其他训练方案一起进行,运动训练对乳腺癌幸存者细胞因子谱的好处都是显而易见的。
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引用次数: 0
The Risks of Misunderstanding the Term "Risk Factor": A Primer with Suggestions to Improve Sports Medicine. 误解“危险因素”的风险:提高运动医学水平的建议。
IF 9.8 1区 医学 Q1 SPORT SCIENCES Pub Date : 2025-12-19 DOI: 10.1007/s40279-025-02378-0
Steven D Stovitz,Franco M Impellizzeri,Ian Shrier
The term "risk factor" is commonly used in research. Although many interpret the term to imply that the risk factor causes the outcome, others use the term to mean a marker for the outcome, which may or may not be a cause of the outcome. How the term risk factor is interpreted can importantly influence the way that study findings are applied in real world settings. For example, if a risk factor is wrongly interpreted to be a cause of an outcome when it is merely associated with the outcome because of noncausal reasons, then wasteful interventions may be developed, recommended, and implemented. The primary aims of this article are (1) to describe how varying definitions of the term risk factor can cause misunderstandings and potentially negatively impact the field of sports medicine, and (2) to propose new, more specific, terminology. We first review some basic concepts on how variables can be associated due to either causal or noncausal reasons and then discuss possible explanations for why the term risk factor continues to be misunderstood. We illustrate how using the term risk factor without further specification creates misunderstandings that can lead to the development and implementation of ineffective interventions. Finally, with the hope of improving communication and avoiding ambiguity in sports medicine, we suggest using "causal risk factor" if the evidence supports causality, "noncausal risk factor" if the evidence does not support causality, and "risk marker" for those not wishing to commit to a causal or noncausal claim.
“风险因素”一词在研究中经常使用。尽管许多人将这个术语解释为暗示风险因素导致了结果,但其他人用这个术语来表示结果的标记,它可能是也可能不是导致结果的原因。如何解释“风险因素”一词会对研究结果在现实世界中的应用产生重要影响。例如,如果一个风险因素被错误地解释为一个结果的原因,而它仅仅是因为非因果原因而与结果相关,那么可能会开发、推荐和实施浪费的干预措施。本文的主要目的是(1)描述术语风险因素的不同定义如何引起误解并潜在地对运动医学领域产生负面影响,以及(2)提出新的,更具体的术语。我们首先回顾一些关于变量如何由于因果或非因果原因而关联的基本概念,然后讨论为什么术语风险因素继续被误解的可能解释。我们说明了在没有进一步说明的情况下使用术语风险因素如何造成误解,从而导致制定和实施无效的干预措施。最后,为了改善沟通和避免运动医学中的歧义,我们建议如果证据支持因果关系,则使用“因果风险因素”,如果证据不支持因果关系,则使用“非因果风险因素”,对于那些不希望承诺因果或非因果主张的人,则使用“风险标记”。
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