Sports Medicine最新文献

Background: Motor competence and executive functions co-develop throughout childhood and adolescence, and there is emerging evidence that improvements in motor competence may have cognitive benefits in these populations. There is a need to provide a quantitative synthesis of the cross-sectional, longitudinal and experimental studies that have examined the association between motor competence and executive functions in school-aged youth.

Objectives: The primary aim of our systematic review was to synthesise evidence of the association between motor competence and executive functions in school-aged children and adolescents (5-18 years). Our secondary aim was to examine key moderators of this association.

Methods: We searched the PubMed, PsycINFO, Scopus, Ovid MEDLINE, SPORTDiscus and EMBASE databases from inception up to 27 June 2023. We included cross-sectional, longitudinal and experimental studies that assessed the association between motor competence (e.g., general motor competence, locomotor skills, object control skills and stability skills) and executive functions (e.g., general executive functions, inhibition, working memory and cognitive flexibility) in children and adolescents aged 5-18 years.

Results: In total, 12,117 records were screened for eligibility, and 44 studies were included. From the 44 included studies, we meta-analysed 37 studies with 251 effect sizes using a structural equation modelling approach in the statistical program R. We found a small positive association (r = 0.18, [95% confidence interval (CI) 0.13-0.22]) between motor competence and executive functions. The positive associations were observed in cross-sectional (r = 0.17, [95% CI 0.13-0.22]), longitudinal (r = 0.15, [95% CI 0.03-0.28]) and experimental studies (r = 0.25, [95% CI 0.01-0.45]). We also found that general motor competence (r = 0.25, [95% CI 0.18-0.33]), locomotor (r = 0.15, [95% CI 0.09-0.21]), object control (r = 0.14, [95% CI 0.08-0.20]) and stability (r = 0.14, [95% CI 0.08-0.20]) skills were associated with executive functions. We did not find any moderating effects for participants' age on the associations between motor competence and executive functions.

Conclusions: Our findings suggest a small-to-moderate positive association between motor competence and executive functions in children and adolescents. The small number of experimental studies included in this review support the assertion that interventions targeting children's motor competence may be a promising strategy to improve their executive functions; however, more research is needed to confirm these findings. Future studies should explore the underlying mechanisms linking motor competence and executive functions as their comprehension may be used to optimise future intervention design and delivery.

Prospero registration: CRD42021285134.

Background: Polarized training intensity distribution (POL) was recently suggested to be superior to other training intensity distribution (TID) regimens for endurance performance improvement.

Objective: We aimed to systematically review and meta-analyze evidence comparing POL to other TIDs on endurance performance.

Methods: PRISMA guidelines were followed. The protocol was registered at PROSPERO (CRD42022365117). PubMed, Scopus, and Web of Science were searched up to 20 October 2022 for studies in adults and young adults for ≥ 4 weeks comparing POL with other TID interventions regarding VO₂peak, time-trial (TT), time to exhaustion (TTE) or speed or power at the second ventilatory or lactate threshold (V/P at VT₂/LT₂). Risk of bias was assessed with RoB-2 and ROBINS-I. Certainty of evidence was assessed with GRADE. Results were analyzed by random effects meta-analysis using standardized mean differences.

Results: Seventeen studies met the inclusion criteria (n = 437 subjects). Pooled effect estimates suggest POL superiority for improving VO₂peak (SMD = 0.24 [95% CI 0.01, 0.48]; z = 2.02 (p = 0.040); 11 studies, n = 284; I² = 0%; high certainty of evidence). Superiority, however, only occurred in shorter interventions (< 12 weeks) (SMD = 0.40 [95% CI 0.08, 0.71; z = 2.49 (p = 0.01); n = 163; I² = 0%) and for highly trained athletes (SMD = 0.46 [95% CI 0.10, 0.82]; z = 2.51 (p = 0.01); n = 125; I² = 0%). The remaining endurance performance surrogates were similarly affected by POL and other TIDs: TT (SMD = - 0.01 [95% CI -0.28, 0.25]; z =  - 0.10 (p = 0.92); n = 221; I² = 0%), TTE (SMD = 0.30 [95% CI - 0.20, 0.79]; z = 1.18 (p = 0.24); n = 66; I² = 0%) and V/P VT₂/LT₂ (SMD = 0.04 [95% CI -0.21, 0.29]; z = 0.32 (p = 0.75); n = 253; I² = 0%). Risk of bias for randomized controlled trials was rated as of some concern and for non-randomized controlled trials as low risk of bias (two studies) and some concerns (one study).

Conclusions: POL is superior to other TIDs for improving VO₂peak, particularly in shorter duration interventions and highly trained athletes. However, the effect of POL was similar to that of other TIDs on the remaining surrogates of endurance performance. The results suggest that POL more effectively improves aerobic power but is similar to other TIDs for improving aerobic capacity.

Effort and the perception of effort (PE) have been extensively studied across disciplines, resulting in multiple definitions. These inconsistencies block scientific progress by impeding effective communication between and within fields. Here, we present an integrated perspective of effort and PE that is applicable to both physical and cognitive activities. We define effort as the energy utilized to perform an action. This definition can be applied to biological entities performing various voluntary or involuntary activities, irrespective of whether the effort contributes to goal achievement. Then, we define PE as the instantaneous experience of utilizing energy to perform an action. This definition builds on that of effort without conflating it with other subjective experiences. We explore the nature of effort and PE as constructs and variables and highlight key considerations in their measurement. Our integrated perspective aims to facilitate a deeper understanding of these constructs, refine research methodologies, and promote interdisciplinary collaborations.

Background: Musculoskeletal pain while running is a concern to women during pregnancy and can lead to running cessation. To support women who wish to run during pregnancy, it is essential to understand the sites, severities and personal risk factors associated with musculoskeletal pain.

Objective: The aim was to investigate prevalence and risk factors for musculoskeletal pain when running during pregnancy.

Methods: An online survey was completed by women who had a child in the past 5 years and ran prior to and during pregnancy. Pain frequency informed prevalence rates by body site, and logistic regression odds ratios (ORs) and 95% confidence intervals were calculated.

Results: A total of 3102 women of 23 ethnicities from 25 countries completed the survey. Women were 22-52 years old when they gave birth and ran 2-129 km/week during the 0.5-35 years before the birth of their youngest child. Women ran significantly less distance and less often during pregnancy than before pregnancy. Most women (86%) experienced pain while running during pregnancy (59% pelvis/sacroiliac joint, 52% lower back, 51% abdomen, 44% breast, 40% hip). The highest prevalence of severe-to-worst pain was at the pelvis/sacroiliac joint (9%). Women at greatest risk of pain while running during pregnancy had a previous injury (OR = 3.44) or were older (OR = 1.04). Women with a previous child were less likely to experience breast pain (OR = 0.76) than those running during their first pregnancy.

Conclusion: Healthcare practices to reduce pain should focus on regions of greatest musculoskeletal change during pregnancy, specifically the pelvis, lower back and abdomen. Efforts to support women to run for longer throughout pregnancy should focus on pain at the pelvis and breasts.

Factors influencing sport injury risk, rehabilitation outcomes, and return to sport processes have been the focus in various research disciplines (sports medicine, psychology and sociology). One discipline, with over 50 years of scholarship, is the psychology of sport injury. Despite the research in this field, there is no evidence-based consensus to inform professional practice. The aim of this original and timely consensus statement is to summarise psychological sport injury research and provide consensus recommendations for sport practitioners seeking to implement psychological principles into clinical practice. A total of seven experts with extensive experience outlined the consensus objectives and identified three psychology of sport injury sub-domains: risk, rehabilitation and return to sport. The researchers, grouped in pairs, prepared initial drafts of assigned sub-domains. The group met in Stockholm, and the three texts were merged into a draft and revised in an iterative process. Stress responses are the strongest psychological risk factor for acute injuries. Intra- and interpersonal factors, as well as sociocultural factors, are demonstrated psychosocial risk factors for overuse injuries. Stress management and mindfulness interventions to prevent injuries have been successfully implemented. The rehabilitation process may influence athlete's cognitive, emotional, and behavioural responses. Social support, mindfulness, acceptance-based practices, and cognitive-behavioural based intervention programs reduce negative reactions. Return to sport includes various stages and different trajectories. Returning athletes typically experience concerns regarding competence, autonomy, and relatedness. It is recommended that athletes focus on the physical, technical, and psychological demands of their sport as they progress to increasingly intense activities. Interdisciplinary collaboration (e.g., sports medicine and psychology) would be beneficial in enhancing clinical practice and improving athlete outcomes.

The mechanisms underlying range of motion enhancements via flexibility training discussed in the literature show high heterogeneity in research methodology and study findings. In addition, scientific conclusions are mostly based on functional observations while studies considering the underlying physiology are less common. However, understanding the underlying mechanisms that contribute to an improved range of motion through stretching is crucial for conducting comparable studies with sound designs, optimising training routines and accurately interpreting resulting outcomes. While there seems to be no evidence to attribute acute range of motion increases as well as changes in muscle and tendon stiffness and pain perception specifically to stretching or foam rolling, the role of general warm-up effects is discussed in this paper. Additionally, the role of mechanical tension applied to greater muscle lengths for range of motion improvement will be discussed. Thus, it is suggested that physical training stressors can be seen as external stimuli that control gene expression via the targeted stimulation of transcription factors, leading to structural adaptations due to enhanced protein synthesis. Hence, the possible role of serial sarcomerogenesis in altering pain perception, reducing muscle stiffness and passive torque, or changes in the optimal joint angle for force development is considered as well as alternative interventions with a potential impact on anabolic pathways. As there are limited possibilities to directly measure serial sarcomere number, longitudinal muscle hypertrophy remains without direct evidence. The available literature does not demonstrate the necessity of only using specific flexibility training routines such as stretching to enhance acute or chronic range of motion.

Background

Despite widespread use of intensity zones to quantify external load variables in basketball research, the consistency in identifying zones and accompanying intensity thresholds using predominant monitoring approaches in training and games remains unclear.

Objectives

The purpose of this work was to examine the external load intensity zones and thresholds adopted across basketball studies using video-based time-motion analysis (TMA), microsensors, and local positioning systems (LPS).

Methods

PubMed, MEDLINE, and SPORTDiscus databases were searched from inception until 31 January 2023 for studies using intensity zones to quantify external load during basketball training sessions or games. Studies were excluded if they examined players participating in recreational or wheelchair basketball, were reviews or meta-analyses, or utilized monitoring approaches other than video-based TMA, microsensors, or LPS.

Results

Following screening, 86 studies were included. Video-based TMA studies consistently classified jogging, running, sprinting, and jumping as intensity zones, but demonstrated considerable variation in classifying low-intensity (standing and walking) and basketball-specific activities. Microsensor studies mostly utilized a single, and rather consistent, threshold to identify only high-intensity activities (> 3.5 m·s⁻² for accelerations, decelerations, and changes-in-direction or > 40 cm for jumps), not separately quantifying lower intensity zones. Similarly, LPS studies predominantly quantified only high-intensity activities in a relatively consistent manner for speed (> 18.0 m·s⁻¹) and acceleration/deceleration zones (> 2.0 m·s⁻²); however, the thresholds adopted for various intensity zones differed greatly to those used in TMA and microsensor research.

Conclusions

Notable inconsistencies were mostly evident for low-intensity activities, basketball-specific activities, and between the different monitoring approaches. Accordingly, we recommend further research to inform the development of consensus guidelines outlining suitable approaches when setting external load intensity zones and accompanying thresholds in research and practice.