Pub Date : 2026-02-07DOI: 10.1007/s40279-025-02391-3
Andrew Watson, Andrew Murray, Alex Ehlert, Jiaqing Xu, Steve Williams, Abbie Spiegelhalter, Daniel Coughlan, Anthony Turner, Chris Bishop
Background: Optimising performance with a driver, fairway woods and long irons is a key focus for many golfers, with the primary goal of hitting the ball as far as possible while maintaining the ball in play. As such, recent years have seen a strong focus in the golf literature on how to maximise performance off the tee by investigating the factors that lead to the increase in clubhead speed (CHS). These factors include: (i) effective use of ground reaction force (GRF) during the swing and (ii) the path followed by the centre of pressure (CoP).
Objectives: The primary purpose of this systematic review was to investigate GRF and CoP within golf research and to identify what associations they have with CHS and skill level.
Methods: This systematic review followed the most recent Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. In total, 129 studies where initially retrieved from SPORTDiscus, Medline and CINAHL databases, with studies meeting the inclusion criteria being subject to Newcastle-Ottawa's quality assessment criteria (with a maximum score of 9 being possible).
Results: A total of 24 studies met the inclusion criteria for this review. Nine empirical investigations showed moderate-to-strong relationships between either: (i) CoP and CHS or (ii) GRF and CHS. In addition, more skilled golfers tended to exhibit higher GRF and superior CHS than less skilled golfers. From a quality assessment standpoint, all 24 studies scored either a 7 or 8.
Conclusions: Changes in both CoP and GRF represent important factors which contribute to superior golf performance, as defined by increases in CHS or reduced handicaps. Clearly defined methods for assessing force during the golf swing and universal terminology regarding GRF and CoP metrics are recommended for further research.
{"title":"Ground Reaction Force and Centre of Pressure During the Golf Swing and Associations with Clubhead Speed and Skill Level: A Systematic Review.","authors":"Andrew Watson, Andrew Murray, Alex Ehlert, Jiaqing Xu, Steve Williams, Abbie Spiegelhalter, Daniel Coughlan, Anthony Turner, Chris Bishop","doi":"10.1007/s40279-025-02391-3","DOIUrl":"https://doi.org/10.1007/s40279-025-02391-3","url":null,"abstract":"<p><strong>Background: </strong>Optimising performance with a driver, fairway woods and long irons is a key focus for many golfers, with the primary goal of hitting the ball as far as possible while maintaining the ball in play. As such, recent years have seen a strong focus in the golf literature on how to maximise performance off the tee by investigating the factors that lead to the increase in clubhead speed (CHS). These factors include: (i) effective use of ground reaction force (GRF) during the swing and (ii) the path followed by the centre of pressure (CoP).</p><p><strong>Objectives: </strong>The primary purpose of this systematic review was to investigate GRF and CoP within golf research and to identify what associations they have with CHS and skill level.</p><p><strong>Methods: </strong>This systematic review followed the most recent Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. In total, 129 studies where initially retrieved from SPORTDiscus, Medline and CINAHL databases, with studies meeting the inclusion criteria being subject to Newcastle-Ottawa's quality assessment criteria (with a maximum score of 9 being possible).</p><p><strong>Results: </strong>A total of 24 studies met the inclusion criteria for this review. Nine empirical investigations showed moderate-to-strong relationships between either: (i) CoP and CHS or (ii) GRF and CHS. In addition, more skilled golfers tended to exhibit higher GRF and superior CHS than less skilled golfers. From a quality assessment standpoint, all 24 studies scored either a 7 or 8.</p><p><strong>Conclusions: </strong>Changes in both CoP and GRF represent important factors which contribute to superior golf performance, as defined by increases in CHS or reduced handicaps. Clearly defined methods for assessing force during the golf swing and universal terminology regarding GRF and CoP metrics are recommended for further research.</p>","PeriodicalId":21969,"journal":{"name":"Sports Medicine","volume":" ","pages":""},"PeriodicalIF":9.4,"publicationDate":"2026-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146132875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-04DOI: 10.1007/s40279-025-02365-5
Jan-Niklas Kreppke, Gavin Brupbacher, Kerstin Rupf, Vivien Hohberg, Robyn Cody, Markus Gerber, Oliver Faude
Background: Physical activity (PA) has positive effects on physical and mental health. Nevertheless, two thirds of individuals with major depressive disorders (MDD) do not meet PA recommendations. Furthermore, MDD is associated with increased cardiovascular risk and autonomic nervous system dysfunction. This depression-related dysfunction is expressed by low heart rate variability (HRV). In contrast, regular PA has been shown to improve autonomic regulation over time as indicated by higher HRV values.
Objective: The overarching aim of this umbrella review is to examine the complex interrelationship and mutual influence between MDD, PA, and HRV. We aim to answer the following questions: (I) How does PA affect depressive symptoms? (II) How are HRV and MDD related? (III) How does PA affect HRV?
Methods: Medline, Embase, PsycINFO, SPORTDiscus, and Epistemonikos were searched for systematic reviews and meta-analyses from their inception until 5 July 2024. Reviews were included if they presented the effects of PA interventions on depression severity in individuals with MDD for part I, if they showed the differences in HRV parameters between healthy individuals and individuals with MDD for part II, and if they presented the effects of PA interventions on HRV parameters in healthy individuals for part III. The quality of the included reviews was assessed by Assessing the Methodological Quality of Systematic Reviews (AMSTAR 2) criteria.
Results: This umbrella review included 90 reviews. Part I shows that various types of PA are effective in reducing symptoms of depression in individuals with MDD. In addition, there is a similar reduction with PA compared with pharmacological treatment. Part II demonstrates that time-based and frequency-based HRV values are lower in individuals with MDD than in healthy individuals. Part III shows that different types of PA can improve time-based, frequency-based and nonlinear HRV parameters in healthy individuals.
Conclusion: This comprehensive umbrella review demonstrates the importance of PA to reduce symptoms of depression and to have a positive impact on autonomic function. Further studies suggest that PA can also improve HRV in individuals with MDD. In the future, randomized controlled trials should be conducted to examine which types and forms of PA are effective in positively affecting HRV in individuals with MDD according to standardized parameters in the area of HRV and depression severity.
Trial registration: The protocol for this umbrella review was a priori registered with PROSPERO: CRD42021278665.
{"title":"Association Between Physical Activity, Heart Rate Variability and Major Depressive Disorders: An Umbrella Review.","authors":"Jan-Niklas Kreppke, Gavin Brupbacher, Kerstin Rupf, Vivien Hohberg, Robyn Cody, Markus Gerber, Oliver Faude","doi":"10.1007/s40279-025-02365-5","DOIUrl":"https://doi.org/10.1007/s40279-025-02365-5","url":null,"abstract":"<p><strong>Background: </strong>Physical activity (PA) has positive effects on physical and mental health. Nevertheless, two thirds of individuals with major depressive disorders (MDD) do not meet PA recommendations. Furthermore, MDD is associated with increased cardiovascular risk and autonomic nervous system dysfunction. This depression-related dysfunction is expressed by low heart rate variability (HRV). In contrast, regular PA has been shown to improve autonomic regulation over time as indicated by higher HRV values.</p><p><strong>Objective: </strong>The overarching aim of this umbrella review is to examine the complex interrelationship and mutual influence between MDD, PA, and HRV. We aim to answer the following questions: (I) How does PA affect depressive symptoms? (II) How are HRV and MDD related? (III) How does PA affect HRV?</p><p><strong>Methods: </strong>Medline, Embase, PsycINFO, SPORTDiscus, and Epistemonikos were searched for systematic reviews and meta-analyses from their inception until 5 July 2024. Reviews were included if they presented the effects of PA interventions on depression severity in individuals with MDD for part I, if they showed the differences in HRV parameters between healthy individuals and individuals with MDD for part II, and if they presented the effects of PA interventions on HRV parameters in healthy individuals for part III. The quality of the included reviews was assessed by Assessing the Methodological Quality of Systematic Reviews (AMSTAR 2) criteria.</p><p><strong>Results: </strong>This umbrella review included 90 reviews. Part I shows that various types of PA are effective in reducing symptoms of depression in individuals with MDD. In addition, there is a similar reduction with PA compared with pharmacological treatment. Part II demonstrates that time-based and frequency-based HRV values are lower in individuals with MDD than in healthy individuals. Part III shows that different types of PA can improve time-based, frequency-based and nonlinear HRV parameters in healthy individuals.</p><p><strong>Conclusion: </strong>This comprehensive umbrella review demonstrates the importance of PA to reduce symptoms of depression and to have a positive impact on autonomic function. Further studies suggest that PA can also improve HRV in individuals with MDD. In the future, randomized controlled trials should be conducted to examine which types and forms of PA are effective in positively affecting HRV in individuals with MDD according to standardized parameters in the area of HRV and depression severity.</p><p><strong>Trial registration: </strong>The protocol for this umbrella review was a priori registered with PROSPERO: CRD42021278665.</p>","PeriodicalId":21969,"journal":{"name":"Sports Medicine","volume":" ","pages":""},"PeriodicalIF":9.4,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146120218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-30DOI: 10.1007/s40279-026-02393-9
Qiao Guan,Yuxiang Du,Jun Zou,Lingli Zhang
The growth period represents a crucial bone mass acquisition and skeletal development phase. During this stage, bone tissues exhibit remarkable resilience and high plasticity, thereby laying a robust foundation for optimal bone strength. Growing bones are highly responsive to external stimuli, particularly exercise and mechanical loading. Appropriate physical activity or mechanical stimulation facilitates the attainment of peak bone mass and offers long-term protection against bone diseases. Therefore, exploring how exercise and mechanical stimuli influence bone development during this critical period and their underlying mechanisms is essential. This study provides a comprehensive review of the effects of exercise and mechanical stimulation on bone development and growth during the growth period. In particular, it focuses on the state of bone cells, such as bone marrow mesenchymal stem cells, osteoblasts, chondrocytes, osteoclasts, and osteocytes, and the molecular mechanisms governing mechanoregulation. Additionally, this study delves into the signaling pathways influenced by exercise and mechanical stimuli, including Wnt/β-catenin, bone morphogenetic protein/SMAD proteins, phosphatidylinositol 3-kinase/protein kinase, receptor activator of nuclear factor κB-receptor activator of nuclear factor κB ligand-osteoprotegerin, and mitogen-activated protein kinase. These pathways are pivotal in regulating bone formation, resorption, and remodeling. This study also analyzes the impact of exercise-modulated signaling pathways on bone development in children and adolescents to provide theoretical insights and practical guidance for designing scientifically sound exercise programs. Ultimately, these findings contribute to optimizing bone health strategies during youth, maintaining long-term bone health, and reducing the risk of bone-related disorders later in life.
{"title":"Mechanical Stimulation Drives Multicellular Synergy and Signaling Pathways in Developing Skeletal Tissues.","authors":"Qiao Guan,Yuxiang Du,Jun Zou,Lingli Zhang","doi":"10.1007/s40279-026-02393-9","DOIUrl":"https://doi.org/10.1007/s40279-026-02393-9","url":null,"abstract":"The growth period represents a crucial bone mass acquisition and skeletal development phase. During this stage, bone tissues exhibit remarkable resilience and high plasticity, thereby laying a robust foundation for optimal bone strength. Growing bones are highly responsive to external stimuli, particularly exercise and mechanical loading. Appropriate physical activity or mechanical stimulation facilitates the attainment of peak bone mass and offers long-term protection against bone diseases. Therefore, exploring how exercise and mechanical stimuli influence bone development during this critical period and their underlying mechanisms is essential. This study provides a comprehensive review of the effects of exercise and mechanical stimulation on bone development and growth during the growth period. In particular, it focuses on the state of bone cells, such as bone marrow mesenchymal stem cells, osteoblasts, chondrocytes, osteoclasts, and osteocytes, and the molecular mechanisms governing mechanoregulation. Additionally, this study delves into the signaling pathways influenced by exercise and mechanical stimuli, including Wnt/β-catenin, bone morphogenetic protein/SMAD proteins, phosphatidylinositol 3-kinase/protein kinase, receptor activator of nuclear factor κB-receptor activator of nuclear factor κB ligand-osteoprotegerin, and mitogen-activated protein kinase. These pathways are pivotal in regulating bone formation, resorption, and remodeling. This study also analyzes the impact of exercise-modulated signaling pathways on bone development in children and adolescents to provide theoretical insights and practical guidance for designing scientifically sound exercise programs. Ultimately, these findings contribute to optimizing bone health strategies during youth, maintaining long-term bone health, and reducing the risk of bone-related disorders later in life.","PeriodicalId":21969,"journal":{"name":"Sports Medicine","volume":"156 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146072981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-27DOI: 10.1007/s40279-025-02387-z
Elie Walsh, Josh Leota, Minh Huynh, Sarah K Liddle, Sean P A Drummond, Elise R Facer-Childs
<p><strong>Background: </strong>Sleep and circadian interventions (e.g. interventions aimed at promoting circadian alignment and supporting stable well-entrained sleep-wake patterns) are predominantly implemented in athletes to improve performance, recovery and adaptation to travel. Emerging evidence from the broader population demonstrates that improving sleep and circadian health can also improve mental health, mood and well-being.</p><p><strong>Objectives: </strong>To evaluate the current evidence on the effectiveness of sleep and circadian interventions for improving mental health, mood and well-being in athlete populations.</p><p><strong>Methods: </strong>Seven databases (CENTRAL, CINAHL, Embase, MEDLINE, PsycINFO, Scopus, SPORTDiscus) were searched from inception to 23 September, 2024 in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eligible studies involved athletes (participating in sport at any level) and evaluated sleep or circadian interventions aimed at improving sleep and/or circadian health, with mental health, mood or well-being outcomes. Sleep interventions directly manipulated sleep through behavioural, environmental or educational approaches. Studies without a comparator/baseline, using indirect methods (e.g. brainwave entrainment) to improve sleep or solely sleep restriction, were excluded. Two reviewers independently screened studies, extracted data, and assessed methodological quality and risk of bias using the Cochrane risk-of-bias tool and Joanna Briggs Institute checklist. Data were synthesised using a multi-level random-effects meta-analysis and pre-specified meta-regression.</p><p><strong>Results: </strong>A total of 21 sleep and circadian interventions have been implemented in sporting environments to improve the mental health of athletes. The interventions that have been investigated are constrained by limited sample sizes, a lack of female representation, a low-quality study design and inconsistent measurement of mental health, making it difficult to draw definitive conclusions of the efficacy of these strategies. The results of the meta-analysis showed that sleep and circadian interventions had a more substantial impact on positive affect compared to negative (β = 0.68, p < 0.001). The interventions were also found to be more effective in improving anxiety, tension and vigour compared to other subjective mood states. The limited interventions with a circadian component (e.g. light exposure) consistently found improvements in outcomes.</p><p><strong>Conclusions: </strong>Sleep and circadian interventions appear to have the strongest effects on positive affect, anxiety, tension and vigour in athletes. Future research should address the limitations of existing studies by focusing on diverse and representative samples, incorporating a longer term follow-up after interventions, using consistent mental health measurements and developing interventions specificall
{"title":"Sleep and Circadian Interventions to Improve Athletes' Mental Health, Mood and Well-Being: A Systematic Review and Meta-Analysis.","authors":"Elie Walsh, Josh Leota, Minh Huynh, Sarah K Liddle, Sean P A Drummond, Elise R Facer-Childs","doi":"10.1007/s40279-025-02387-z","DOIUrl":"https://doi.org/10.1007/s40279-025-02387-z","url":null,"abstract":"<p><strong>Background: </strong>Sleep and circadian interventions (e.g. interventions aimed at promoting circadian alignment and supporting stable well-entrained sleep-wake patterns) are predominantly implemented in athletes to improve performance, recovery and adaptation to travel. Emerging evidence from the broader population demonstrates that improving sleep and circadian health can also improve mental health, mood and well-being.</p><p><strong>Objectives: </strong>To evaluate the current evidence on the effectiveness of sleep and circadian interventions for improving mental health, mood and well-being in athlete populations.</p><p><strong>Methods: </strong>Seven databases (CENTRAL, CINAHL, Embase, MEDLINE, PsycINFO, Scopus, SPORTDiscus) were searched from inception to 23 September, 2024 in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eligible studies involved athletes (participating in sport at any level) and evaluated sleep or circadian interventions aimed at improving sleep and/or circadian health, with mental health, mood or well-being outcomes. Sleep interventions directly manipulated sleep through behavioural, environmental or educational approaches. Studies without a comparator/baseline, using indirect methods (e.g. brainwave entrainment) to improve sleep or solely sleep restriction, were excluded. Two reviewers independently screened studies, extracted data, and assessed methodological quality and risk of bias using the Cochrane risk-of-bias tool and Joanna Briggs Institute checklist. Data were synthesised using a multi-level random-effects meta-analysis and pre-specified meta-regression.</p><p><strong>Results: </strong>A total of 21 sleep and circadian interventions have been implemented in sporting environments to improve the mental health of athletes. The interventions that have been investigated are constrained by limited sample sizes, a lack of female representation, a low-quality study design and inconsistent measurement of mental health, making it difficult to draw definitive conclusions of the efficacy of these strategies. The results of the meta-analysis showed that sleep and circadian interventions had a more substantial impact on positive affect compared to negative (β = 0.68, p < 0.001). The interventions were also found to be more effective in improving anxiety, tension and vigour compared to other subjective mood states. The limited interventions with a circadian component (e.g. light exposure) consistently found improvements in outcomes.</p><p><strong>Conclusions: </strong>Sleep and circadian interventions appear to have the strongest effects on positive affect, anxiety, tension and vigour in athletes. Future research should address the limitations of existing studies by focusing on diverse and representative samples, incorporating a longer term follow-up after interventions, using consistent mental health measurements and developing interventions specificall","PeriodicalId":21969,"journal":{"name":"Sports Medicine","volume":" ","pages":""},"PeriodicalIF":9.4,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146053602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-27DOI: 10.1007/s40279-026-02392-w
Olívia M Ruberti, Guilherme D Telles, Sophie F M Derchain, Rafaela B Araújo, Dhyana Lima, Henrique Bortolozo, Luís Otávio Zanatta Sarian, Eva Zopf, Rodrigo Menezes Jales, Miguel S Conceição
Breast cancer remains one of the leading causes of cancer-related mortality in women worldwide. A key driver of tumor progression and resistance to therapy is abnormal vascularization, which leads to heterogeneous blood flow, hypoxia, impaired drug delivery, and increased malignancy. Emerging clinical evidence suggests that breast tumor Doppler ultrasound parameters can predict pathological response to neoadjuvant chemotherapy, highlighting the potential of tumor blood flow as a prognostic biomarker. In this context, strategies to modulate tumor perfusion-particularly through non-pharmacological approaches-are of growing interest. Exercise has shown promise in promoting vascular remodeling, improving oxygenation, and enhancing treatment efficacy. This narrative review discusses current evidence on the role of tumor blood flow in disease progression and therapeutic response, with special emphasis on the modulatory effects of exercise training. We also explore how tumor blood flow is assessed, briefly outlining key methodologies such as Doppler ultrasound, contrast-enhanced imaging, and perfusion-related biomarkers, and their relevance for interpreting exercise-induced vascular adaptations, its association with tumor aggressiveness, and the interplay between exercise and oncological therapies. Understanding how exercise influences tumor hemodynamics may pave the way for innovative adjuvant strategies in breast cancer management.
{"title":"Breast Tumor Blood Flow, Disease Progression, and Treatment Response: The Role of Exercise.","authors":"Olívia M Ruberti, Guilherme D Telles, Sophie F M Derchain, Rafaela B Araújo, Dhyana Lima, Henrique Bortolozo, Luís Otávio Zanatta Sarian, Eva Zopf, Rodrigo Menezes Jales, Miguel S Conceição","doi":"10.1007/s40279-026-02392-w","DOIUrl":"https://doi.org/10.1007/s40279-026-02392-w","url":null,"abstract":"<p><p>Breast cancer remains one of the leading causes of cancer-related mortality in women worldwide. A key driver of tumor progression and resistance to therapy is abnormal vascularization, which leads to heterogeneous blood flow, hypoxia, impaired drug delivery, and increased malignancy. Emerging clinical evidence suggests that breast tumor Doppler ultrasound parameters can predict pathological response to neoadjuvant chemotherapy, highlighting the potential of tumor blood flow as a prognostic biomarker. In this context, strategies to modulate tumor perfusion-particularly through non-pharmacological approaches-are of growing interest. Exercise has shown promise in promoting vascular remodeling, improving oxygenation, and enhancing treatment efficacy. This narrative review discusses current evidence on the role of tumor blood flow in disease progression and therapeutic response, with special emphasis on the modulatory effects of exercise training. We also explore how tumor blood flow is assessed, briefly outlining key methodologies such as Doppler ultrasound, contrast-enhanced imaging, and perfusion-related biomarkers, and their relevance for interpreting exercise-induced vascular adaptations, its association with tumor aggressiveness, and the interplay between exercise and oncological therapies. Understanding how exercise influences tumor hemodynamics may pave the way for innovative adjuvant strategies in breast cancer management.</p>","PeriodicalId":21969,"journal":{"name":"Sports Medicine","volume":" ","pages":""},"PeriodicalIF":9.4,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146053576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUNDObesity is associated with impaired physical fitness, including physical functional performance and cardiorespiratory fitness, which affect health-related quality of life and mortality.OBJECTIVEWe aimed to investigate the efficacy of a moderate-to-vigorous intensity exercise program and glucagon-like peptide-1 receptor agonist treatment alone or in combination during weight maintenance for physical fitness.METHODSThis is secondary analysis of a randomized controlled trial involving 193 adults with obesity (age 18-65 years, body mass index 32-43 kg/m2) without diabetes mellitus who completed an 8-week low-calorie diet and were subsequently randomized (1:1:1:1 ratio) to: exercise plus placebo; glucagon-like peptide-1 receptor agonist liraglutide 3 mg once-daily plus usual activity; exercise plus liraglutide combined; or placebo plus usual activity. The exercise program was a combination of group sessions (interval-based indoor cycling followed by circuit training) and individual sessions of moderate-to-vigorous intensity, designed to meet the World Health Organization recommendations on physical activity for health. Exercise adherence was measured with sports watches and heart rate monitors. Key secondary endpoints related to physical fitness were changes from randomization to the end of treatment (weeks 0-52) in: (1) physical functional performance (time to ascend and descend an 11-step stairway twice); (2) cardiorespiratory fitness (peak oxygen consumption normalized to fat-free mass); and (3) muscle strength (isometric knee extensor peak torque).RESULTSParticipants randomized to exercise performed a median 2.65 session/week (116 min/week at 79% of maximum heart rate) with no significant difference between those who received placebo or liraglutide. Compared with liraglutide alone, the combined treatment decreased time to complete a stair climb test by 1.2 s [95% confidence interval 0.6-1.9] (corresponding to 8.6%) and improved peak oxygen consumption by 3.0 mL/min/kg fat-free mass [95% confidence interval 0.5-5.5]. Exercise alone led to similar benefits, whereas liraglutide alone did not improve physical fitness. Compared with placebo (- 7.8%), relative muscle strength (strength normalized to body weight) was higher with exercise (- 0.4%), liraglutide (+ 1.0%), and the combined treatment (+ 3.3%) because of lower weight and preserved absolute strength.CONCLUSIONSStructured exercise combined with glucagon-like peptide-1-based obesity pharmacotherapy led to clinically meaningful improvements in physical functional performance and cardiorespiratory fitness, in contrast to pharmacotherapy alone.CLINICAL TRIAL REGISTRATIONEudraCT number, 2015-005585-32; ClinicalTrials.gov number, NCT04122716.
背景：肥胖与身体健康受损有关，包括身体功能表现和心肺健康，影响与健康相关的生活质量和死亡率。目的：研究中强度运动计划和胰高血糖素样肽-1受体激动剂单独或联合治疗在体重维持过程中对身体健康的影响。方法：本研究是对一项随机对照试验的二次分析，该试验涉及193名无糖尿病的肥胖成年人（年龄18-65岁，体重指数32-43 kg/m2），他们完成了8周的低热量饮食，随后随机（1:1:1:1比例）分为：运动加安慰剂；胰高血糖素样肽-1受体激动剂利拉鲁肽3mg每日一次加平时活性；运动加利拉鲁肽联合；或者安慰剂加上常规活动。这项运动计划结合了小组活动（间歇室内骑行，然后是循环训练）和中等到高强度的个人活动，旨在满足世界卫生组织（World Health Organization）关于身体活动有益健康的建议。通过运动手表和心率监测器测量运动坚持度。与身体健康相关的关键次要终点是从随机分配到治疗结束（0-52周）的变化：(1)身体功能表现（两次上下11级楼梯的时间）；(2)心肺适能（耗氧量峰值归一化为无脂量）；(3)肌力（等距膝伸肌峰值扭矩）。结果：随机分配到运动组的参与者平均每周进行2.65次运动（116分钟/周，最大心率79%），安慰剂组和利拉鲁肽组之间无显著差异。与单独使用利拉鲁肽相比，联合治疗使完成爬楼梯试验的时间缩短1.2 s[95%可信区间0.6-1.9]（对应8.6%），使峰值耗氧量提高3.0 mL/min/kg无脂质量[95%可信区间0.5-5.5]。单独运动也能带来类似的益处，而单独利拉鲁肽并不能改善身体健康。与安慰剂组（- 7.8%）相比，运动组（- 0.4%）、利拉鲁肽组（+ 1.0%）和联合治疗组（+ 3.3%）的相对肌肉力量（与体重标准化的力量）更高，因为体重更轻，绝对力量得以保留。结论：与单独药物治疗相比，结构化运动联合胰高血糖素样肽-1肥胖药物治疗可改善身体功能表现和心肺健康，具有临床意义。临床试验注册号：2015-005585-32；ClinicalTrials.gov号码：NCT04122716。
{"title":"Physical Fitness with Exercise and GLP-1 Receptor Agonist Treatment Alone or Combined After Diet-Induced Weight Loss: A Secondary Analysis of a Randomized Controlled Trial in Adults with Obesity.","authors":"Simon Birk Kjær Jensen,Matteo Fiorenza,Christian Rimer Juhl,Rasmus Michael Sandsdal,Emma Jensen,Søren Sonnenborg Seier,Charlotte Janus,Julie Rehné Jørgensen,Martin Bæk Blond,Jens Juul Holst,Bente Merete Stallknecht,Sten Madsbad,Thomas Bandholm,Signe Sørensen Torekov","doi":"10.1007/s40279-025-02386-0","DOIUrl":"https://doi.org/10.1007/s40279-025-02386-0","url":null,"abstract":"BACKGROUNDObesity is associated with impaired physical fitness, including physical functional performance and cardiorespiratory fitness, which affect health-related quality of life and mortality.OBJECTIVEWe aimed to investigate the efficacy of a moderate-to-vigorous intensity exercise program and glucagon-like peptide-1 receptor agonist treatment alone or in combination during weight maintenance for physical fitness.METHODSThis is secondary analysis of a randomized controlled trial involving 193 adults with obesity (age 18-65 years, body mass index 32-43 kg/m2) without diabetes mellitus who completed an 8-week low-calorie diet and were subsequently randomized (1:1:1:1 ratio) to: exercise plus placebo; glucagon-like peptide-1 receptor agonist liraglutide 3 mg once-daily plus usual activity; exercise plus liraglutide combined; or placebo plus usual activity. The exercise program was a combination of group sessions (interval-based indoor cycling followed by circuit training) and individual sessions of moderate-to-vigorous intensity, designed to meet the World Health Organization recommendations on physical activity for health. Exercise adherence was measured with sports watches and heart rate monitors. Key secondary endpoints related to physical fitness were changes from randomization to the end of treatment (weeks 0-52) in: (1) physical functional performance (time to ascend and descend an 11-step stairway twice); (2) cardiorespiratory fitness (peak oxygen consumption normalized to fat-free mass); and (3) muscle strength (isometric knee extensor peak torque).RESULTSParticipants randomized to exercise performed a median 2.65 session/week (116 min/week at 79% of maximum heart rate) with no significant difference between those who received placebo or liraglutide. Compared with liraglutide alone, the combined treatment decreased time to complete a stair climb test by 1.2 s [95% confidence interval 0.6-1.9] (corresponding to 8.6%) and improved peak oxygen consumption by 3.0 mL/min/kg fat-free mass [95% confidence interval 0.5-5.5]. Exercise alone led to similar benefits, whereas liraglutide alone did not improve physical fitness. Compared with placebo (- 7.8%), relative muscle strength (strength normalized to body weight) was higher with exercise (- 0.4%), liraglutide (+ 1.0%), and the combined treatment (+ 3.3%) because of lower weight and preserved absolute strength.CONCLUSIONSStructured exercise combined with glucagon-like peptide-1-based obesity pharmacotherapy led to clinically meaningful improvements in physical functional performance and cardiorespiratory fitness, in contrast to pharmacotherapy alone.CLINICAL TRIAL REGISTRATIONEudraCT number, 2015-005585-32; ClinicalTrials.gov number, NCT04122716.","PeriodicalId":21969,"journal":{"name":"Sports Medicine","volume":"56 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2026-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146033965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUNDSleep is crucial for motor skill learning and cognitive function, affecting performance in various domains, including sports. In offshore sailing, athletes face significant sleep restriction, requiring effective sleep management for safety and performance.OBJECTIVEThis study examines the effects of sleep deprivation on performance in offshore sailing regattas and identifies optimal sleep strategies based on competition characteristics.METHODSA systematic search in PubMed, Web of Science and Scopus, following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, identified 213 articles. After deduplication and screening, 16 articles met the inclusion criteria. Studies were categorised by race length (long/short) and crew size (solo/double/crew).RESULTSThe reviewed literature focused on sleep restriction or deprivation's effects on cognition, reaction speed, fatigue, anxiety, energy expenditure and circadian rhythms. Five studies provided sleep management recommendations, while eight used objective measures such as electroencephalography or actigraphy. Two main results emerge: (1) partial sleep deprivation impairs cognition and reaction speed, increasing technical errors and (2) sleep management strategies vary by crew size and race duration: for short regattas, "banking sleep" beforehand is beneficial, while for long races, 4.5-5.5 h of daily sleep, in 30-min to 1-h episodes, is optimal.CONCLUSIONSSleep management is crucial for performance and safety in offshore sailing. Our findings highlight the need for tailored strategies based on race length and crew size, as no universal approach exists. Insights gained from the present study could inform sleep management practice in other continuous cycle activities, such as maritime work and healthcare. Future research should use objective sleep assessments such as wearables to refine sleep strategies for athletes in extreme conditions.
睡眠对运动技能学习和认知功能至关重要，影响包括运动在内的各个领域的表现。在近海帆船比赛中，运动员面临着严重的睡眠限制，需要有效的睡眠管理来保证安全和表现。目的研究睡眠剥夺对近海帆船赛成绩的影响，并根据比赛特点确定最佳睡眠策略。方法系统检索PubMed、Web of Science和Scopus，遵循系统评价和荟萃分析（PRISMA）指南的首选报告项目，确定了213篇文章。经过重复数据删除和筛选，有16篇文章符合纳入标准。研究按比赛长度（长/短）和船员规模（单人/双人/船员）进行分类。结果综述的文献主要集中在睡眠限制或剥夺对认知、反应速度、疲劳、焦虑、能量消耗和昼夜节律的影响。五项研究提供了睡眠管理建议，而八项研究使用了脑电图或活动描记仪等客观测量方法。主要有两个结果：(1)部分睡眠剥夺会损害认知和反应速度，增加技术错误；(2)睡眠管理策略因船员规模和比赛时间而异：对于短赛艇，事先“储备睡眠”是有益的，而对于长赛艇，每天睡眠4.5-5.5小时，每次30分钟到1小时，是最佳的。结论睡眠管理对近海航行运动员的成绩和安全至关重要。我们的研究结果强调了基于比赛长度和船员规模的量身定制策略的必要性，因为不存在通用的方法。从本研究中获得的见解可以为其他连续周期活动（如海上工作和医疗保健）的睡眠管理实践提供信息。未来的研究应该使用客观的睡眠评估，比如可穿戴设备，来完善运动员在极端条件下的睡眠策略。
{"title":"Sleep Management and Performance in Offshore Sailing Regattas: A Systematic Review.","authors":"Serena Ceccanti,Simone Bruno,Andrea Bazzani,Federico Bianchi,Ugo Faraguna","doi":"10.1007/s40279-025-02389-x","DOIUrl":"https://doi.org/10.1007/s40279-025-02389-x","url":null,"abstract":"BACKGROUNDSleep is crucial for motor skill learning and cognitive function, affecting performance in various domains, including sports. In offshore sailing, athletes face significant sleep restriction, requiring effective sleep management for safety and performance.OBJECTIVEThis study examines the effects of sleep deprivation on performance in offshore sailing regattas and identifies optimal sleep strategies based on competition characteristics.METHODSA systematic search in PubMed, Web of Science and Scopus, following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, identified 213 articles. After deduplication and screening, 16 articles met the inclusion criteria. Studies were categorised by race length (long/short) and crew size (solo/double/crew).RESULTSThe reviewed literature focused on sleep restriction or deprivation's effects on cognition, reaction speed, fatigue, anxiety, energy expenditure and circadian rhythms. Five studies provided sleep management recommendations, while eight used objective measures such as electroencephalography or actigraphy. Two main results emerge: (1) partial sleep deprivation impairs cognition and reaction speed, increasing technical errors and (2) sleep management strategies vary by crew size and race duration: for short regattas, \"banking sleep\" beforehand is beneficial, while for long races, 4.5-5.5 h of daily sleep, in 30-min to 1-h episodes, is optimal.CONCLUSIONSSleep management is crucial for performance and safety in offshore sailing. Our findings highlight the need for tailored strategies based on race length and crew size, as no universal approach exists. Insights gained from the present study could inform sleep management practice in other continuous cycle activities, such as maritime work and healthcare. Future research should use objective sleep assessments such as wearables to refine sleep strategies for athletes in extreme conditions.","PeriodicalId":21969,"journal":{"name":"Sports Medicine","volume":"58 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146033561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-22DOI: 10.1007/s40279-025-02345-9
Aaron Miralles-Iborra,Francisco J Vera-Garcia,Jose L L Elvira,Juan Del Coso,Matthew Buckthorpe,Manuel Manchón-Davó,Heidy Rondón-Espinosa,Javier De Los Ríos-Calonge,Víctor Moreno-Pérez
BACKGROUNDTo date, several studies have characterised the mechanisms, injury patterns and biomechanical factors leading to anterior cruciate ligament (ACL) injuries in football (soccer). However, varying methodologies have resulted in differing findings and outcomes.OBJECTIVEWe aimed to provide a clearer understanding of the mechanisms, injury patterns and biomechanical factors that may pose a higher risk of ACL injury in football players, we conducted a meta-analysis of studies that used video analysis as their primary research tool.METHODSFive databases (PubMed, Web of Science, Embase, Scopus and SPORTDiscus) were searched from inception to September 2024 according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The population, exposure and outcome framework were used to formulate eligibility criteria. Cohort studies of male and female football players reporting mechanisms, injury patterns and/or biomechanical factors of ACL injury examined by video analysis were included. A subsequent meta-analysis was performed to calculate odds ratios (ORs) and frequencies for the different patterns leading to ACL injury.RESULTSThirteen studies published between 2015 and 2024 were included with a total of 709 participants. Ten studies focused on male players, two on female players and one study included both. Regarding mechanisms, non-contact ACL injuries were more likely than direct contact (OR = 5.75, 95% confidence interval [CI] 2.28-14.53, p < 0.001, I2 = 88%) and indirect contact (OR = 3.32, 95% CI 1.88-5.86, p < 0.001, I2 = 74%). Anterior cruciate ligament injuries were more common during defending actions compared with attacking actions (OR = 2.51, 95% CI = 1.23-5.08, p < 0.001, I2 = 88%) and without ball possession than with ball possession (OR = 2.31, 95% CI 1.01-5.29, p = 0.05, I2 = 75%). Particularly, the frequency of ACL injuries while pressing/tackling was significantly higher than the rest of the actions (p < 0.001). Regarding biomechanical factors, ACL injuries were more common when players were on single-leg support compared with double-leg support (OR = 9.66, 95% CI 6.97-13.39, p < 0.001, I2 = 0%). Anterior cruciate ligament injuries often involved complex multiplanar interactions, with a predominance of knee flexion (range from 26° ± 10° at initial contact to 39 ± 11° at the injury frame) along with a consistent knee valgus pattern at the injury frame (79% of the cases; χ2 = 33.32, p < 0.001).CONCLUSIONSA comprehensive review of video-analysis studies on ACL injuries in football reveals that the most common injury pattern involves a defending action performed on single-leg support, without ball possession, and occurring through a non-contact mechanism. Still, the review reflects that the mechanism of ACL injury in football is complex and should be interpreted holistically rather than in isolation.CLINICAL TRIAL REGISTRATIONThe protocol for this systematic review was registered a priori in the I
迄今为止，一些研究已经描述了导致足球运动员前交叉韧带（ACL）损伤的机制、损伤模式和生物力学因素。然而，不同的方法导致了不同的发现和结果。目的：为了更清楚地了解足球运动员ACL损伤的机制、损伤模式和生物力学因素，我们对使用视频分析作为主要研究工具的研究进行了meta分析。方法根据PRISMA （Preferred Reporting Items for Systematic Reviews and Meta-Analysis）指南，检索自成立至2024年9月的5个数据库（PubMed、Web of Science、Embase、Scopus和SPORTDiscus）。使用人群、暴露和结果框架来制定合格标准。通过视频分析对男女足球运动员报告前交叉韧带损伤的机制、损伤模式和/或生物力学因素进行队列研究。随后进行了荟萃分析，以计算导致ACL损伤的不同模式的优势比（ORs）和频率。结果纳入2015年至2024年间发表的13项研究，共有709名参与者。10项研究关注男性玩家，2项研究关注女性玩家，还有一项研究将男女玩家都包括在内。就机制而言，非接触性ACL损伤比直接接触（OR = 5.75, 95%可信区间[CI] 2.28-14.53, p < 0.001, I2 = 88%）和间接接触（OR = 3.32, 95% CI 1.88-5.86, p < 0.001, I2 = 74%）更容易发生。前十字韧带损伤主要发生在防守时（OR = 2.51, 95% CI = 1.23 ~ 5.08, p < 0.001, I2 = 88%），无球时较有球时（OR = 2.31, 95% CI 1.01 ~ 5.29, p = 0.05, I2 = 75%）。特别是，压迫/抢断时ACL损伤的频率明显高于其他动作（p < 0.001）。在生物力学因素方面，运动员单腿支撑时ACL损伤比双腿支撑时更常见（OR = 9.66, 95% CI 6.97-13.39, p < 0.001, I2 = 0%）。前交叉韧带损伤通常涉及复杂的多平面相互作用，以膝关节屈曲为主（从初次接触时的26°±10°到受伤时的39±11°），同时在受伤时膝关节外翻模式一致（79%的病例；χ2 = 33.32, p < 0.001）。结论：对足球前交叉韧带损伤的视频分析研究的全面回顾表明，最常见的损伤模式包括单腿支撑下的防守动作，没有控球，并且通过非接触机制发生。尽管如此，该综述反映了足球前交叉韧带损伤的机制是复杂的，应该从整体上解释而不是孤立的。临床试验注册本系统评价的方案在INPLASY数据库中先验注册（注册号INPLASY202420026）。
{"title":"Mechanisms, Injury Patterns and Biomechanical Factors of Anterior Cruciate Ligament Injuries in Football (Soccer): A Systematic Review and Meta-Analysis of Video-Analysis Studies.","authors":"Aaron Miralles-Iborra,Francisco J Vera-Garcia,Jose L L Elvira,Juan Del Coso,Matthew Buckthorpe,Manuel Manchón-Davó,Heidy Rondón-Espinosa,Javier De Los Ríos-Calonge,Víctor Moreno-Pérez","doi":"10.1007/s40279-025-02345-9","DOIUrl":"https://doi.org/10.1007/s40279-025-02345-9","url":null,"abstract":"BACKGROUNDTo date, several studies have characterised the mechanisms, injury patterns and biomechanical factors leading to anterior cruciate ligament (ACL) injuries in football (soccer). However, varying methodologies have resulted in differing findings and outcomes.OBJECTIVEWe aimed to provide a clearer understanding of the mechanisms, injury patterns and biomechanical factors that may pose a higher risk of ACL injury in football players, we conducted a meta-analysis of studies that used video analysis as their primary research tool.METHODSFive databases (PubMed, Web of Science, Embase, Scopus and SPORTDiscus) were searched from inception to September 2024 according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The population, exposure and outcome framework were used to formulate eligibility criteria. Cohort studies of male and female football players reporting mechanisms, injury patterns and/or biomechanical factors of ACL injury examined by video analysis were included. A subsequent meta-analysis was performed to calculate odds ratios (ORs) and frequencies for the different patterns leading to ACL injury.RESULTSThirteen studies published between 2015 and 2024 were included with a total of 709 participants. Ten studies focused on male players, two on female players and one study included both. Regarding mechanisms, non-contact ACL injuries were more likely than direct contact (OR = 5.75, 95% confidence interval [CI] 2.28-14.53, p < 0.001, I2 = 88%) and indirect contact (OR = 3.32, 95% CI 1.88-5.86, p < 0.001, I2 = 74%). Anterior cruciate ligament injuries were more common during defending actions compared with attacking actions (OR = 2.51, 95% CI = 1.23-5.08, p < 0.001, I2 = 88%) and without ball possession than with ball possession (OR = 2.31, 95% CI 1.01-5.29, p = 0.05, I2 = 75%). Particularly, the frequency of ACL injuries while pressing/tackling was significantly higher than the rest of the actions (p < 0.001). Regarding biomechanical factors, ACL injuries were more common when players were on single-leg support compared with double-leg support (OR = 9.66, 95% CI 6.97-13.39, p < 0.001, I2 = 0%). Anterior cruciate ligament injuries often involved complex multiplanar interactions, with a predominance of knee flexion (range from 26° ± 10° at initial contact to 39 ± 11° at the injury frame) along with a consistent knee valgus pattern at the injury frame (79% of the cases; χ2 = 33.32, p < 0.001).CONCLUSIONSA comprehensive review of video-analysis studies on ACL injuries in football reveals that the most common injury pattern involves a defending action performed on single-leg support, without ball possession, and occurring through a non-contact mechanism. Still, the review reflects that the mechanism of ACL injury in football is complex and should be interpreted holistically rather than in isolation.CLINICAL TRIAL REGISTRATIONThe protocol for this systematic review was registered a priori in the I","PeriodicalId":21969,"journal":{"name":"Sports Medicine","volume":"31 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146015353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-17DOI: 10.1007/s40279-025-02388-y
Eline de Jager,Brian Caulfield,Evgenia Angelidi,Brian MacNamee,Sinead Holden
BACKGROUNDHeart rate variability (HRV) reflects autonomic nervous system function and can now be continuously monitored in real-world settings using wearable technology. However, the influence of ovarian hormones on HRV remains unclear, underscoring the need to synthesize evidence across the female lifespan.OBJECTIVETo examine the association between ovarian hormone profiles and HRV measured by wearable/mobile devices.DESIGNLiving systematic review.DATA SOURCESA comprehensive search was conducted in PubMed, Web of Science, IEEE Xplore, SPORTDiscus, and Embase from inception to December 2025. The search followed the Participant (females of any age), Exposure (ovarian hormone profiles), and Outcomes (HRV measured by wearable devices) framework, using a combination of MeSH terms and keyword adaptations. Quality was assessed for cohort studies using the Newcastle-Ottawa Scale.ELIGIBILITY CRITERIAAll studies were independently double screened by title, abstract, and full text. Studies were eligible if they examined differences in HRV measured by a wearable device, across the menstrual cycle in naturally menstruating females, in response to exogenous ovarian hormones, or across another ovarian hormone state such as menopause or pregnancy.RESULTSFrom 299 identified records, 16 studies were included. In naturally menstruating females, HRV was higher at the beginning of the cycle and lower toward the end, with differences in time-domain HRV ranging from 3 to 9%. Hormonal contraceptive users exhibited lower HRV, particularly in the late cycle. Additionally, HRV tended to decline after menopause with increasing age. The quality of evidence in this review was moderate (7/9). Variability in how menstrual cycle phases and menopausal status were classified across studies limited comparability and the ability to synthesize findings quantitatively.CONCLUSIONSWearable-derived HRV is associated with differences across the menstrual cycle, oral contraceptive use, and reproductive life stages. This should be considered when presenting HRV metrics to female users. This may improve the interpretation of data for female athletes, patients, or women who track their HRV.OSF REGISTRATIONDOI https://doi.org/10.17605/OSF.IO/S4RYW .
心率变异性（HRV）反映了自主神经系统的功能，现在可以使用可穿戴技术在现实环境中连续监测。然而，卵巢激素对HRV的影响仍不清楚，强调需要综合整个女性生命周期的证据。目的探讨可穿戴/移动设备测量卵巢激素谱与HRV的关系。DESIGNLiving系统回顾。数据来源从成立到2025年12月，在PubMed、Web of Science、IEEE explore、SPORTDiscus和Embase中进行了全面的检索。搜索遵循参与者（任何年龄的女性），暴露（卵巢激素谱）和结果（可穿戴设备测量的HRV）框架，使用MeSH术语和关键字适应的组合。采用纽卡斯尔-渥太华量表评估队列研究的质量。入选标准：所有研究均通过标题、摘要和全文进行独立的双重筛选。如果研究通过可穿戴设备测量HRV的差异，在自然月经的女性的整个月经周期中，对外源性卵巢激素的反应，或在其他卵巢激素状态（如更年期或怀孕）中，研究都是合格的。结果299份鉴定记录中纳入16项研究。在自然月经的女性中，HRV在周期开始时较高，在周期结束时较低，时域HRV的差异在3%至9%之间。激素避孕药使用者表现出较低的HRV，特别是在月经后期。此外，随着年龄的增长，HRV在绝经后趋于下降。本综述的证据质量为中等（7/9）。不同研究中对月经周期阶段和绝经状态分类的差异限制了可比性和定量综合研究结果的能力。结论可穿戴性HRV与月经周期、口服避孕药使用和生殖生命阶段的差异有关。在向女性用户呈现HRV指标时，应该考虑到这一点。这可能会改善对女性运动员、患者或跟踪HRV的女性数据的解释。OSF REGISTRATIONDOI https://doi.org/10.17605/OSF.IO/S4RYW。
{"title":"Wearable-Derived Heart Rate Variability Across the Menstrual Cycle, Hormonal Contraceptive Use, and Reproductive Life Stages in Females: A Living Systematic Review.","authors":"Eline de Jager,Brian Caulfield,Evgenia Angelidi,Brian MacNamee,Sinead Holden","doi":"10.1007/s40279-025-02388-y","DOIUrl":"https://doi.org/10.1007/s40279-025-02388-y","url":null,"abstract":"BACKGROUNDHeart rate variability (HRV) reflects autonomic nervous system function and can now be continuously monitored in real-world settings using wearable technology. However, the influence of ovarian hormones on HRV remains unclear, underscoring the need to synthesize evidence across the female lifespan.OBJECTIVETo examine the association between ovarian hormone profiles and HRV measured by wearable/mobile devices.DESIGNLiving systematic review.DATA SOURCESA comprehensive search was conducted in PubMed, Web of Science, IEEE Xplore, SPORTDiscus, and Embase from inception to December 2025. The search followed the Participant (females of any age), Exposure (ovarian hormone profiles), and Outcomes (HRV measured by wearable devices) framework, using a combination of MeSH terms and keyword adaptations. Quality was assessed for cohort studies using the Newcastle-Ottawa Scale.ELIGIBILITY CRITERIAAll studies were independently double screened by title, abstract, and full text. Studies were eligible if they examined differences in HRV measured by a wearable device, across the menstrual cycle in naturally menstruating females, in response to exogenous ovarian hormones, or across another ovarian hormone state such as menopause or pregnancy.RESULTSFrom 299 identified records, 16 studies were included. In naturally menstruating females, HRV was higher at the beginning of the cycle and lower toward the end, with differences in time-domain HRV ranging from 3 to 9%. Hormonal contraceptive users exhibited lower HRV, particularly in the late cycle. Additionally, HRV tended to decline after menopause with increasing age. The quality of evidence in this review was moderate (7/9). Variability in how menstrual cycle phases and menopausal status were classified across studies limited comparability and the ability to synthesize findings quantitatively.CONCLUSIONSWearable-derived HRV is associated with differences across the menstrual cycle, oral contraceptive use, and reproductive life stages. This should be considered when presenting HRV metrics to female users. This may improve the interpretation of data for female athletes, patients, or women who track their HRV.OSF REGISTRATIONDOI https://doi.org/10.17605/OSF.IO/S4RYW .","PeriodicalId":21969,"journal":{"name":"Sports Medicine","volume":"19 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2026-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145986398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-13DOI: 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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