Sports Medicine最新文献

In this opinion piece I reiterate the concepts of near and far transfer as previously described in the psychological literature. I show that despite very limited evidence, many technologies, tools and methods make questionable claims of eliciting far transfer from generic perceptual and/or cognitive training to sports performance. Specifically, this commentary illustrates with studies on stroboscopic vision, neurofeedback training and executive functions that the claims made for the beneficial effects of these training methods are currently unsubstantiated. I conclude that greater scrutiny by researchers is needed in order to assist practitioners to make better-informed decisions about tools, methods and technologies that may aid sports performance.

Introduction

Low energy availability (LEA) occurs when energy expenditure from athletic training and bodily functions exceeds caloric intake. This imbalance results in declines in athletic performance and increases the risk of injury. Relative energy deficiency in sport (REDs) is a condition that occurs when the energy deficit is severe enough to cause alterations to metabolic rate, menstrual function, immune function, bone health, protein synthesis, and cardiovascular function. Many athletes, particularly those competing in endurance, aesthetic, or weight-class sports, are adversely impacted by this condition.

Objectives

This study aims to determine the prevalence of LEA and REDs among athletes and present the first secondary analysis of the impacts of these phenomena on sports performance and risk of injury.

Methods

This systematic review was registered on PROSPERO (CRD42023469253). Literature searches were performed following PRISMA guidelines using PubMed, Embase, and Cochrane online databases. Inclusion criteria were articles discussing the prevalence of LEA or REDs, the impact of LEA or REDs on athletic performance, or the impact of LEA or REDs EA on injury.

Results

A total of 59 studies met the inclusion criteria for this meta-analysis, and 2737 of 6118 athletes (44.7%) in 46 different studies were determined to have LEA, including 44.2% of female athletes and 49.4% of male athletes. In addition, 460 of 730 athletes (63.0%) in eight different studies were determined to be at risk of REDs. Athletes with LEA were found to have decreased run performance, training response, endurance performance, coordination, concentration, judgment, explosive power, and agility relative to athletes with normal energy availability, as well as an increased likelihood of absence from training due to illness. Studies had mixed results as to whether LEA increased the risk of injury in general. However, most studies concluded that athletes with LEA have impaired bone health and a higher risk of bone stress injuries.

Discussion

To our knowledge, this is the first systematic review analyzing the impacts of LEA and REDs on athletic performance and risk of injury. Due to the high estimated prevalence of LEA among athletes, coaches may want to consider employing surveys such as the low energy availability in females questionnaire (LEAF-Q) to identify athletes at risk for LEA, as early identification and correction of LEA can prevent the development of symptoms of REDs, reduce the risk of impaired bone health and bone stress injuries, and help athletes optimize the performance benefits from their training.

The increasing legalization of Cannabis sativa plant products has sparked growing interest in their therapeutic applications. Prohibition laws established in 1937 hindered formal research on cannabis, a plant with cultural and medicinal roots dating back to 2700 BC in Chinese history. Despite regulatory hurdles, published research on cannabis has emerged; yet elite athletes remain an underrepresented population in these studies. Athletes, known for exploring diverse substances to optimize performance, are drawn to the potential benefits of cannabinoid therapy, with anecdotal reports suggesting positive effects on issues ranging from anxiety to brain injuries. This review aims to evaluate empirical published cannabis research with a specific focus on its potential applications in athletics. The changing legal landscape, especially the removal of cannabis from drug testing programs in leagues such as the National Basketball Association (NBA), and endorsements by Major League Baseball (MLB) for cannabinoid products and the National Football League (NFL) for cannabis research, reflects a shift in the acceptability of such substances in sports. However, stigma, confusion, and a lack of education persist, hindering a cohesive understanding among sports organizations, including business professionals, policymakers, coaches, and medical/training staff, in addition to athletes themselves. Adding to the confusion is the lack of consistency with cannabinoid regulations from sport to sport, within or out of competition, and with cannabis bioactive compounds. The need for this review is underscored by the evolving attitudes toward cannabinoids in professional sports and the potential therapeutic benefits or harms they may offer. By synthesizing current cannabis research, this review aims to provide a comprehensive understanding of the applications and implications of cannabinoid use in the realm of athletics.

Objective: To describe sex differences in concussion characteristics in US Service Academy cadets.

Design: Descriptive epidemiology study.

Setting: Four US service academies.

Participants: 2209 cadets (n = 867 females, n = 1342 males).

Independent variable: Sex.

Outcome measures: Injury proportion ratios (IPR) compared the proportion of injuries by sex (females referent) for injury situation, certainty of diagnosis, prolonged recovery, recurrent injuries, mental status alterations, loss of consciousness (LOC), posttraumatic amnesia (PTA), retrograde amnesia (RGA), motor impairments, delayed symptom presentation, and immediate reporting.

Main results: Concussions from varsity/intercollegiate sports [IPR of 1.73, 95% confidence interval (CI) 1.43-2.10] and intramurals (IPR of 1.53, 95% CI 1.02-2.32) accounted for a larger proportion in males, whereas concussions outside of sport and military activities accounted for a smaller proportion among males (IPR of 0.70, 95% CI 0.58-0.85). The proportion of concussions with prolonged recovery was lower among males (IPR of 0.69, 95% CI 0.60-0.78), while concussions with altered mental status (IPR of 1.23, 95% CI 1.09-1.38), LOC (IPR of 1.67, 95% CI 1.17-2.37), PTA (IPR of 1.94, 95% CI 1.43-2.62), and RGA (IPR of 2.14, 95% CI 1.38-3.31) accounted for a larger proportion among males. A larger proportion of concussions that were immediately reported was observed in males (IPR of 1.15, 95% CI 1.00-2.31). Proportions of other characteristics (e.g., recurrent injuries) were not different between sexes.

Conclusions: A higher proportion of concussions occurred outside of sport and military training for female cadets, who also displayed proportionally longer recovery times than males, despite males demonstrating a higher proportion of LOC, PTA, and RGA. Possible factors may include different mechanisms of injury outside of sport and military training, different biopsychosocial states associated with sex or injury context, and delayed injury reporting when outside of an observed environment, possibly secondary to perceived stigma about reporting injuries.