Pub Date : 2025-09-30DOI: 10.1007/s40279-025-02324-0
Richard A J Mercer,Jennifer L Russell,Donald S Strack,Aaron J Coutts,Blake D McLean
BACKGROUNDUnderstanding the work demands and psychobiological responses of high-performance sport practitioners is important for informing strategies that support and improve staff health, well-being, and performance. Although research in this area has grown, previous reviews have focused on specific aspects of well-being and particular practitioner populations. Currently, no comprehensive reviews summarize all research relating to high-performance sport practitioners. A broad overview could help clarify the work demands and responses of staff in this field.OBJECTIVESThis scoping review aims to provide an overview of the literature on staff working in high-performance sport with roles and responsibilities related to athlete operations and/or performance. Using theoretical frameworks to operationally define key concepts, the review maps relevant studies and summarizes findings on work demands, resources, coping strategies, and responses in high-performance sport.METHODSA scoping review was conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Searches were performed across three electronic databases, PubMed, PsycINFO, and SPORTDiscus, to identify relevant studies published up to 1 August 2024. The search strategy employed terms related to working in high-performance sport and was structured using the population, exposure, and outcome framework. Studies examining staff working full-time in high-performance sport and assessing work demands, responses, resources, or coping strategies were included. This review was registered with the Open Science Framework ( osf.io/br9hm/ ).RESULTSElectronic and manual searches identified 124 studies meeting the inclusion criteria. These studies spanned various levels of sport: collegiate (n = 53), professional (n = 24), national/international (n = 13), Olympic/Paralympic (n = 10), mixed levels (n = 14), and "high-performance" or "elite" sport (n = 10). The studies examined coaches (n = 79), medical and performance staff (n = 41), and mixed practitioners (n = 4). Data on countries, competitions, study designs, measurement tools, and theoretical frameworks were reported for each study. Outcomes assessed included responses (n = 24), demands (n = 12), resources and coping (n = 12), and mixed combinations (n = 76), with the most common combinations being "demands, responses, and resources and coping" (n = 23) and "demands and resources and coping" (n = 21).CONCLUSIONSPractitioners in high-performance sport encounter a diverse array of demands, including workload challenges, organizational and structural factors, athlete- and performance-related pressures, and sociocultural factors. These challenges often elicit a range of emotional, psychological, physical, and physiological responses, contributing to persistent issues such as burnout and difficulties in achieving work-life balance. To navigate these challenges, practit
{"title":"Work Demands, Responses, and Coping Strategies for Staff in High-Performance Sport: A Scoping Review.","authors":"Richard A J Mercer,Jennifer L Russell,Donald S Strack,Aaron J Coutts,Blake D McLean","doi":"10.1007/s40279-025-02324-0","DOIUrl":"https://doi.org/10.1007/s40279-025-02324-0","url":null,"abstract":"BACKGROUNDUnderstanding the work demands and psychobiological responses of high-performance sport practitioners is important for informing strategies that support and improve staff health, well-being, and performance. Although research in this area has grown, previous reviews have focused on specific aspects of well-being and particular practitioner populations. Currently, no comprehensive reviews summarize all research relating to high-performance sport practitioners. A broad overview could help clarify the work demands and responses of staff in this field.OBJECTIVESThis scoping review aims to provide an overview of the literature on staff working in high-performance sport with roles and responsibilities related to athlete operations and/or performance. Using theoretical frameworks to operationally define key concepts, the review maps relevant studies and summarizes findings on work demands, resources, coping strategies, and responses in high-performance sport.METHODSA scoping review was conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Searches were performed across three electronic databases, PubMed, PsycINFO, and SPORTDiscus, to identify relevant studies published up to 1 August 2024. The search strategy employed terms related to working in high-performance sport and was structured using the population, exposure, and outcome framework. Studies examining staff working full-time in high-performance sport and assessing work demands, responses, resources, or coping strategies were included. This review was registered with the Open Science Framework ( osf.io/br9hm/ ).RESULTSElectronic and manual searches identified 124 studies meeting the inclusion criteria. These studies spanned various levels of sport: collegiate (n = 53), professional (n = 24), national/international (n = 13), Olympic/Paralympic (n = 10), mixed levels (n = 14), and \"high-performance\" or \"elite\" sport (n = 10). The studies examined coaches (n = 79), medical and performance staff (n = 41), and mixed practitioners (n = 4). Data on countries, competitions, study designs, measurement tools, and theoretical frameworks were reported for each study. Outcomes assessed included responses (n = 24), demands (n = 12), resources and coping (n = 12), and mixed combinations (n = 76), with the most common combinations being \"demands, responses, and resources and coping\" (n = 23) and \"demands and resources and coping\" (n = 21).CONCLUSIONSPractitioners in high-performance sport encounter a diverse array of demands, including workload challenges, organizational and structural factors, athlete- and performance-related pressures, and sociocultural factors. These challenges often elicit a range of emotional, psychological, physical, and physiological responses, contributing to persistent issues such as burnout and difficulties in achieving work-life balance. To navigate these challenges, practit","PeriodicalId":21969,"journal":{"name":"Sports Medicine","volume":"69 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194697","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 : 2025-09-29DOI: 10.1007/s40279-025-02326-y
Mohammad Alimoradi,Mohammad Alghosi,Mojtaba Iranmanesh,Mohammed Moinuddin,Nicola Relph
BACKGROUNDThe epidemiology of injury in soccer has traditionally focused on soccer players, rather than match officials. Although injury data on referees exist, no comprehensive review has summarized injury profiles in this population.OBJECTIVETo conduct a systematic review and meta-analysis of injury epidemiology in elite and amateur soccer referees, focusing on injury rates, types, locations, severity, and causes.METHODSPubMed (Medline), Web of Science, Scopus, CINAHL, and SPORTDiscus, covering their entire history up to 19 April 2025 were searched. This review included prospective and retrospective studies reporting injury incidence or prevalence among football match officials, with a study period of at least one season. Studies needed to specify injury definitions and include data on injury location, type, mechanism, or severity. Both male and female officials were eligible. Systematic reviews, commentaries, and letters were excluded. Study quality and risk of bias were evaluated using the STROBE-SIIS, in addition to the Newcastle-Ottawa Scale and funnel plots. Injury incidence rates were estimated using a random effects Poisson regression, accounting for heterogeneity and moderators. Heterogeneity was assessed with the I2 statistic.RESULTSA total of 17 studies were included, encompassing 3621 referees. The most frequent injuries were strains and sprains in the knee and ankle. The overall injury incidence was 2.19 injuries per 1000 h of exposure (95% CI 1.30-3.69). On-field referees experienced an incidence rate of 1.46 injuries per 1000 h of exposure (95% CI 0.76-2.81), while assistant referees had a lower rate of 0.84 per 1 h of exposure (95% CI 0.36-1.97). During matches, the injury incidence was 2.24 per 1000 h of exposure (95% CI 1.38-3.64), compared with 0.67 injuries per 1000 h of exposure during training sessions (95% CI 0.36-1.24). However, despite sensitivity analysis, there were still high levels of heterogeneity across included studies.CONCLUSIONSFindings noted higher injury incidence during matches compared with training, and on-field referees compared with assistants. The variation in injury profiles highlights the importance of implementing targeted preventive strategies tailored to the unique demands of refereeing. However, there is still a lack of research in this population, especially in female referees.PROSPERO REGISTRATION NUMBERCRD42024497970.
足球受伤的流行病学传统上关注的是足球运动员，而不是比赛官员。尽管存在裁判的损伤数据，但没有全面的综述总结了这一人群的损伤概况。目的对精英和业余足球裁判的损伤流行病学进行系统回顾和荟萃分析，重点关注损伤率、类型、部位、严重程度和原因。方法检索spubmed （Medline）、Web of Science、Scopus、CINAHL和SPORTDiscus截至2025年4月19日的全部历史数据库。本综述包括前瞻性和回顾性研究，报告了足球比赛官员受伤发生率或患病率，研究周期至少为一个赛季。研究需要明确损伤定义，并包括损伤部位、类型、机制或严重程度的数据。男女官员都有资格。系统评论、评论和信件被排除在外。除使用纽卡斯尔-渥太华量表和漏斗图外，还使用STROBE-SIIS评估研究质量和偏倚风险。使用随机效应泊松回归估计伤害发生率，考虑异质性和调节因子。采用I2统计量评估异质性。结果共纳入17项研究，涉及3621名评审。最常见的损伤是膝盖和脚踝的拉伤和扭伤。总损伤发生率为每1000小时暴露2.19例损伤（95% CI 1.30-3.69）。现场裁判每1000小时暴露的伤害发生率为1.46 (95% CI 0.76-2.81)，而助理裁判每1小时暴露的伤害发生率较低，为0.84 （95% CI 0.36-1.97）。在比赛期间，受伤发生率为2.24 / 1000小时（95% CI 1.38-3.64），而在训练期间，受伤发生率为0.67 / 1000小时（95% CI 0.36-1.24）。然而，尽管进行了敏感性分析，但在所纳入的研究中仍存在很高的异质性。研究结果表明，比赛期间的受伤发生率高于训练期间，而现场裁判的受伤发生率高于助理裁判。损伤概况的变化突出了针对裁判的独特要求实施有针对性的预防策略的重要性。然而，对这一人群的研究仍然缺乏，尤其是对女性裁判的研究。普洛斯彼罗注册号crd42024497970。
{"title":"Epidemiology of Injury in Elite and Amateur Soccer Referees: A Systematic Review and Meta-analysis.","authors":"Mohammad Alimoradi,Mohammad Alghosi,Mojtaba Iranmanesh,Mohammed Moinuddin,Nicola Relph","doi":"10.1007/s40279-025-02326-y","DOIUrl":"https://doi.org/10.1007/s40279-025-02326-y","url":null,"abstract":"BACKGROUNDThe epidemiology of injury in soccer has traditionally focused on soccer players, rather than match officials. Although injury data on referees exist, no comprehensive review has summarized injury profiles in this population.OBJECTIVETo conduct a systematic review and meta-analysis of injury epidemiology in elite and amateur soccer referees, focusing on injury rates, types, locations, severity, and causes.METHODSPubMed (Medline), Web of Science, Scopus, CINAHL, and SPORTDiscus, covering their entire history up to 19 April 2025 were searched. This review included prospective and retrospective studies reporting injury incidence or prevalence among football match officials, with a study period of at least one season. Studies needed to specify injury definitions and include data on injury location, type, mechanism, or severity. Both male and female officials were eligible. Systematic reviews, commentaries, and letters were excluded. Study quality and risk of bias were evaluated using the STROBE-SIIS, in addition to the Newcastle-Ottawa Scale and funnel plots. Injury incidence rates were estimated using a random effects Poisson regression, accounting for heterogeneity and moderators. Heterogeneity was assessed with the I2 statistic.RESULTSA total of 17 studies were included, encompassing 3621 referees. The most frequent injuries were strains and sprains in the knee and ankle. The overall injury incidence was 2.19 injuries per 1000 h of exposure (95% CI 1.30-3.69). On-field referees experienced an incidence rate of 1.46 injuries per 1000 h of exposure (95% CI 0.76-2.81), while assistant referees had a lower rate of 0.84 per 1 h of exposure (95% CI 0.36-1.97). During matches, the injury incidence was 2.24 per 1000 h of exposure (95% CI 1.38-3.64), compared with 0.67 injuries per 1000 h of exposure during training sessions (95% CI 0.36-1.24). However, despite sensitivity analysis, there were still high levels of heterogeneity across included studies.CONCLUSIONSFindings noted higher injury incidence during matches compared with training, and on-field referees compared with assistants. The variation in injury profiles highlights the importance of implementing targeted preventive strategies tailored to the unique demands of refereeing. However, there is still a lack of research in this population, especially in female referees.PROSPERO REGISTRATION NUMBERCRD42024497970.","PeriodicalId":21969,"journal":{"name":"Sports Medicine","volume":"96 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182556","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}
BACKGROUNDHead acceleration events (HAEs) are an increasing concern in rugby union due to their association with brain injury and long-term neurological health.OBJECTIVESThis original research study aimed to establish essential baseline data on HAEs in under-21 professional rugby using instrumented mouthguards (iMGs) and to determine whether a higher competition level (professional club versus international) is associated with elevated magnitude and incidence rate of HAEs.METHODSA prospective observational cohort design was used with 32 under-21 club academy players and 38 under-20 international players. Players underwent 3D dental scans and were provided with custom-fit iMGs. The iMGs contained an accelerometer and gyroscope that sampled at 3200 Hz with measured ranges of ± 200 g and ± 35 rad/s. The iMGs recorded peak linear acceleration (PLA), peak angular acceleration (PAA) and peak angular velocity (PAV). Data were collected from academy matches (254 player-matches; 241 h of exposure) and international matches (114 player-matches; 118.2 h of exposure). Descriptive statistics (median, interquartile range [IQR], 95th percentile and peak values) were calculated to characterise HAE magnitude across positions and competition levels. Negative binomial regressions assessed incidence rates across teams, positions and thresholds, adjusting for exposure time.RESULTSA total of 6508 HAEs were recorded across 368 player matches from club U21 and national U20 rugby players. Median and peak values for linear acceleration, angular acceleration and change in angular velocity were generally higher in club players, particularly in the front row and outside backs. Club outside backs demonstrated the highest PLA (72.8 g) and PAA (5740 rad/s2), while the club front row reached the highest PLA (81.8 g) and PAA (8034 rad/s2) overall. The national team back row reported the highest ΔPAV with 38.3 rad/s. Incidence rate analyses revealed significantly higher rates of severe HAEs (> 30 g, > 2000 rad/s2, > 15 rad/s) in club outside backs and the club front row compared with their national counterparts. Conversely, the club halves exhibited significantly lower rates of low-magnitude events across all metrics.CONCLUSIONThis study compared HAEs in U21 professional club and U20 international rugby players using iMGs. Contrary to expectations, international players did not consistently exhibit higher HAE magnitude or incidence. Notably, club outside backs and front row players experienced the highest severe HAE rates. These findings highlight the need to consider playing style, position-specific demands and technique in strategies to mitigate concussion risk in developing elite rugby players.
{"title":"Head Acceleration Event Magnitude and Incidence Rate in Academy Rugby Union: A Comparison Across Club and International Competition.","authors":"Jonathan Ward,Damien Bonnet,Mickael Roumeau,Loic Louit,Olivier Chaplain,Bertrand Mathieu,Marie-Aurelie Castel,Patrice Halimi,Jean-Jacques Raymond,Julien Piscione,Olivier Gavarry","doi":"10.1007/s40279-025-02327-x","DOIUrl":"https://doi.org/10.1007/s40279-025-02327-x","url":null,"abstract":"BACKGROUNDHead acceleration events (HAEs) are an increasing concern in rugby union due to their association with brain injury and long-term neurological health.OBJECTIVESThis original research study aimed to establish essential baseline data on HAEs in under-21 professional rugby using instrumented mouthguards (iMGs) and to determine whether a higher competition level (professional club versus international) is associated with elevated magnitude and incidence rate of HAEs.METHODSA prospective observational cohort design was used with 32 under-21 club academy players and 38 under-20 international players. Players underwent 3D dental scans and were provided with custom-fit iMGs. The iMGs contained an accelerometer and gyroscope that sampled at 3200 Hz with measured ranges of ± 200 g and ± 35 rad/s. The iMGs recorded peak linear acceleration (PLA), peak angular acceleration (PAA) and peak angular velocity (PAV). Data were collected from academy matches (254 player-matches; 241 h of exposure) and international matches (114 player-matches; 118.2 h of exposure). Descriptive statistics (median, interquartile range [IQR], 95th percentile and peak values) were calculated to characterise HAE magnitude across positions and competition levels. Negative binomial regressions assessed incidence rates across teams, positions and thresholds, adjusting for exposure time.RESULTSA total of 6508 HAEs were recorded across 368 player matches from club U21 and national U20 rugby players. Median and peak values for linear acceleration, angular acceleration and change in angular velocity were generally higher in club players, particularly in the front row and outside backs. Club outside backs demonstrated the highest PLA (72.8 g) and PAA (5740 rad/s2), while the club front row reached the highest PLA (81.8 g) and PAA (8034 rad/s2) overall. The national team back row reported the highest ΔPAV with 38.3 rad/s. Incidence rate analyses revealed significantly higher rates of severe HAEs (> 30 g, > 2000 rad/s2, > 15 rad/s) in club outside backs and the club front row compared with their national counterparts. Conversely, the club halves exhibited significantly lower rates of low-magnitude events across all metrics.CONCLUSIONThis study compared HAEs in U21 professional club and U20 international rugby players using iMGs. Contrary to expectations, international players did not consistently exhibit higher HAE magnitude or incidence. Notably, club outside backs and front row players experienced the highest severe HAE rates. These findings highlight the need to consider playing style, position-specific demands and technique in strategies to mitigate concussion risk in developing elite rugby players.","PeriodicalId":21969,"journal":{"name":"Sports Medicine","volume":"18 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182554","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 : 2025-09-27DOI: 10.1007/s40279-025-02315-1
Riki Lindsay,Courtney C Walton,Aden Kittel,Dominic G McNeil,Paul Larkin,Michael Spittle,Suzanne M Cosh
BACKGROUNDThe mental health of participants in sport has attracted increasing focus within research, practice, and policy. While mental health in sports has received increased attention, the mental health of sporting officials-such as judges, referees, and umpires-remains significantly under-researched compared with athletes. To our knowledge, there are no systematic reviews and meta-analyses that have synthesised available prevalence data of mental health symptoms and disorders in sporting officials. In addition, while previous reviews have provided a broad overview of risk and protective factors in relation to overall mental health, links between identified factors and specific mental health and well-being outcomes have not been explored. Therefore, this study aimed to systematically review and analyse the prevalence rates of mental health symptoms and disorders (e.g., depression and anxiety) among sporting officials and identify specific risk and protective factors influencing sporting officials' mental health and/or psychological well-being.METHODSRelevant studies were retrieved from SCOPUS, Web of Science, SPORTDiscus and PsycINFO up until July 2025. Prevalence rates of specific mental health outcomes (i.e. anxiety and depressive symptoms) were meta-analysed.RESULTSA total of 26 studies were included. Meta-analyses comprising 2797 sporting officials showed that the pooled proportion of elevated anxiety symptoms was 19.1% (95% CI 13.4-27, I2 = 94.1%) and 20.6% (95% CI 12.4-32.3, I2 = 97.3%) for elevated symptoms of depression. Sport-environmental risk factors were identified in 70% of the studies (k = 19) (e.g., levels of professional experience, environment around matches, experiences of abuse), while 48% of studies (k = 13) examined personal risk factors (e.g., age, sex, injury). A total of 37% of studies (k = 10) examined sport-environmental protective factors (e.g., years of officiating experience, level of officiating, hours and frequency of officiating), while 33% of studies (k = 9) investigated personal protective factors (e.g., emotional intelligence, feelings of competence, age, sex).CONCLUSIONSThe results suggest that targeting change at various levels of the sport ecosystem may help foster and promote positive mental health outcomes among sporting officials. The findings of this review suggest that strategies tailored to officials could include age/level of experience-specific support interventions and creating organisational cultures that prioritise mental health outcomes.
体育运动参与者的心理健康在研究、实践和政策中引起了越来越多的关注。虽然体育运动中的心理健康受到越来越多的关注，但与运动员相比，体育官员（如裁判员、裁判员和裁判员）的心理健康研究仍显不足。据我们所知，目前还没有系统的综述和荟萃分析，综合了体育官员心理健康症状和障碍的现有流行数据。此外，虽然以前的审查提供了与总体心理健康有关的风险和保护因素的广泛概述，但尚未探讨已确定因素与具体心理健康和福祉结果之间的联系。因此，本研究旨在系统地回顾和分析体育官员心理健康症状和障碍（如抑郁和焦虑）的患病率，并确定影响体育官员心理健康和/或心理健康的具体风险和保护因素。方法检索截至2025年7月的SCOPUS、Web of Science、SPORTDiscus和PsycINFO等相关文献。对特定心理健康结果（即焦虑和抑郁症状）的患病率进行meta分析。结果共纳入26项研究。包含2797名体育官员的荟萃分析显示，焦虑症状升高的总比例为19.1% (95% CI 13.4-27, I2 = 94.1%)，抑郁症状升高的总比例为20.6% （95% CI 12.4-32.3, I2 = 97.3%）。70%的研究（k = 19）确定了运动环境风险因素（例如，专业经验水平，比赛周围环境，虐待经历），而48%的研究（k = 13）检查了个人风险因素（例如，年龄，性别，受伤）。总共有37%的研究（k = 10）调查了运动环境保护因素（例如，执法经验的年数、执法水平、执法时间和频率），而33%的研究（k = 9）调查了个人保护因素（例如，情商、能力感、年龄、性别）。结论在体育生态系统的各个层面进行针对性的改变可能有助于培养和促进体育官员的积极心理健康结果。这项审查的结果表明，为官员量身定制的策略可以包括针对年龄/经验水平的支持干预措施，并创建优先考虑心理健康结果的组织文化。
{"title":"The Mental Health of Sporting Officials: A Systematic Review and Meta-analysis.","authors":"Riki Lindsay,Courtney C Walton,Aden Kittel,Dominic G McNeil,Paul Larkin,Michael Spittle,Suzanne M Cosh","doi":"10.1007/s40279-025-02315-1","DOIUrl":"https://doi.org/10.1007/s40279-025-02315-1","url":null,"abstract":"BACKGROUNDThe mental health of participants in sport has attracted increasing focus within research, practice, and policy. While mental health in sports has received increased attention, the mental health of sporting officials-such as judges, referees, and umpires-remains significantly under-researched compared with athletes. To our knowledge, there are no systematic reviews and meta-analyses that have synthesised available prevalence data of mental health symptoms and disorders in sporting officials. In addition, while previous reviews have provided a broad overview of risk and protective factors in relation to overall mental health, links between identified factors and specific mental health and well-being outcomes have not been explored. Therefore, this study aimed to systematically review and analyse the prevalence rates of mental health symptoms and disorders (e.g., depression and anxiety) among sporting officials and identify specific risk and protective factors influencing sporting officials' mental health and/or psychological well-being.METHODSRelevant studies were retrieved from SCOPUS, Web of Science, SPORTDiscus and PsycINFO up until July 2025. Prevalence rates of specific mental health outcomes (i.e. anxiety and depressive symptoms) were meta-analysed.RESULTSA total of 26 studies were included. Meta-analyses comprising 2797 sporting officials showed that the pooled proportion of elevated anxiety symptoms was 19.1% (95% CI 13.4-27, I2 = 94.1%) and 20.6% (95% CI 12.4-32.3, I2 = 97.3%) for elevated symptoms of depression. Sport-environmental risk factors were identified in 70% of the studies (k = 19) (e.g., levels of professional experience, environment around matches, experiences of abuse), while 48% of studies (k = 13) examined personal risk factors (e.g., age, sex, injury). A total of 37% of studies (k = 10) examined sport-environmental protective factors (e.g., years of officiating experience, level of officiating, hours and frequency of officiating), while 33% of studies (k = 9) investigated personal protective factors (e.g., emotional intelligence, feelings of competence, age, sex).CONCLUSIONSThe results suggest that targeting change at various levels of the sport ecosystem may help foster and promote positive mental health outcomes among sporting officials. The findings of this review suggest that strategies tailored to officials could include age/level of experience-specific support interventions and creating organisational cultures that prioritise mental health outcomes.","PeriodicalId":21969,"journal":{"name":"Sports Medicine","volume":"17 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145153390","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 : 2025-09-22DOI: 10.1007/s40279-025-02300-8
Yohan Rousse,Benoit Sautillet,Guillaume Costalat,Franck Brocherie,Grégoire P Millet
The optimisation of muscle recovery from exercise-induced muscle damage (EIMD) is a major issue in sports medicine. This comprehensive review examines the effects of four environmental stressors, including cold (cold therapy), heat (heat therapy), hot-cold alternation (contrast therapy) and reduced oxygen availability (hypoxia therapy), on muscle recovery following EIMD. The analysis of related randomised controlled trials assessed the influences of these stressors on five markers of recovery (muscular performance, joint amplitude, muscle pain, swelling and blood biomarkers). Although cold therapy has been widely studied, the lack of consensus on its application modalities leads to controversial debates regarding its effectiveness for muscle recovery. Heat therapy, particularly hot water immersion, appears to be the most effective method for restoring muscle function. However, the use of local heating techniques is less well understood. Moreover, contrast therapy seems to be promising for reducing swelling post-EIMD; however, the lack of studies and the variety of utilised techniques involving contrast therapy limit conclusions. Finally, local hypoxia, which is elicited by intermittent blood flow restriction, demonstrates potential for reducing inflammation and improving the recovery of muscle function, based on the appropriate application of protocols. By synthesising existing data, this comprehensive review shows that most environmental stress-based therapies can be effective, if the modalities of application-such as dose or frequency-are appropriate. It offers practical recommendations for optimising muscle recovery. This review also highlights the need for further research to refine protocols and better understand the potential synergistic effects of these environmental stress-based interventions.
{"title":"Isolated and Combined Effects of Cold, Heat and Hypoxia Therapies on Muscle Recovery Following Exercise-Induced Muscle Damage.","authors":"Yohan Rousse,Benoit Sautillet,Guillaume Costalat,Franck Brocherie,Grégoire P Millet","doi":"10.1007/s40279-025-02300-8","DOIUrl":"https://doi.org/10.1007/s40279-025-02300-8","url":null,"abstract":"The optimisation of muscle recovery from exercise-induced muscle damage (EIMD) is a major issue in sports medicine. This comprehensive review examines the effects of four environmental stressors, including cold (cold therapy), heat (heat therapy), hot-cold alternation (contrast therapy) and reduced oxygen availability (hypoxia therapy), on muscle recovery following EIMD. The analysis of related randomised controlled trials assessed the influences of these stressors on five markers of recovery (muscular performance, joint amplitude, muscle pain, swelling and blood biomarkers). Although cold therapy has been widely studied, the lack of consensus on its application modalities leads to controversial debates regarding its effectiveness for muscle recovery. Heat therapy, particularly hot water immersion, appears to be the most effective method for restoring muscle function. However, the use of local heating techniques is less well understood. Moreover, contrast therapy seems to be promising for reducing swelling post-EIMD; however, the lack of studies and the variety of utilised techniques involving contrast therapy limit conclusions. Finally, local hypoxia, which is elicited by intermittent blood flow restriction, demonstrates potential for reducing inflammation and improving the recovery of muscle function, based on the appropriate application of protocols. By synthesising existing data, this comprehensive review shows that most environmental stress-based therapies can be effective, if the modalities of application-such as dose or frequency-are appropriate. It offers practical recommendations for optimising muscle recovery. This review also highlights the need for further research to refine protocols and better understand the potential synergistic effects of these environmental stress-based interventions.","PeriodicalId":21969,"journal":{"name":"Sports Medicine","volume":"41 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145116796","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 : 2025-09-19DOI: 10.1007/s40279-025-02308-0
Gregory Tierney, Ross Tucker, James Tooby, Lindsay Starling, Éanna Falvey, Danielle Salmon, James Brown, Sam Hudson, Keith Stokes, Ben Jones, Simon Kemp, Patrick O'Halloran, Matt Cross, Melanie Bussey, David Allan
Objectives: In elite rugby union, suspected concussions lead to immediate removal from play for either permanent exclusion or a temporary 12-min assessment as part of the Head Injury Assessment 1 (HIA1) protocol. The study aims to retrospectively identify a head acceleration event (HAE) severity measure associated with HIA1 removals in elite rugby union using instrumented mouthguards (iMGs).
Methods: HAEs were recorded from 215 men and 325 women, with 30 and 28 HIA1 removals from men and women, respectively. Logistical regression was calculated to identify whether peak power, maximum principal strain (MPS) and/or the Head Acceleration Response Metric (HARM) were associated with HIA1 events compared to non-cases. Optimal threshold values were determined using the Youden Index. Area under the curve (AUC) was compared using a paired-sample approach. Significant differences were set at p < 0.05.
Results: All three severity measures (peak power, HARM, MPS) were associated with HIA1 removals in both the men's and women's game. Peak power performed most consistent of the three severity measures for HIA1 removals based on paired-sample AUC comparisons in the men's and women's games. The HARM and MPS were found to perform lower than peak linear acceleration in the women's game based on AUC comparisons (p = 0.006 and 0.001, respectively), with MPS performing lower than peak angular acceleration (p = 0.001).
Conclusion: Peak power, a measure based on fundamental mechanics and commonly communicated in sports performance, was the most effective metric associated with HIA1 removals in elite rugby. The study bridges the gap by identifying a consistent HAE severity measure applicable across sexes.
{"title":"Peak Power: A Severity Measure for Head Acceleration Events Associated with Suspected Concussions.","authors":"Gregory Tierney, Ross Tucker, James Tooby, Lindsay Starling, Éanna Falvey, Danielle Salmon, James Brown, Sam Hudson, Keith Stokes, Ben Jones, Simon Kemp, Patrick O'Halloran, Matt Cross, Melanie Bussey, David Allan","doi":"10.1007/s40279-025-02308-0","DOIUrl":"https://doi.org/10.1007/s40279-025-02308-0","url":null,"abstract":"<p><strong>Objectives: </strong>In elite rugby union, suspected concussions lead to immediate removal from play for either permanent exclusion or a temporary 12-min assessment as part of the Head Injury Assessment 1 (HIA1) protocol. The study aims to retrospectively identify a head acceleration event (HAE) severity measure associated with HIA1 removals in elite rugby union using instrumented mouthguards (iMGs).</p><p><strong>Methods: </strong>HAEs were recorded from 215 men and 325 women, with 30 and 28 HIA1 removals from men and women, respectively. Logistical regression was calculated to identify whether peak power, maximum principal strain (MPS) and/or the Head Acceleration Response Metric (HARM) were associated with HIA1 events compared to non-cases. Optimal threshold values were determined using the Youden Index. Area under the curve (AUC) was compared using a paired-sample approach. Significant differences were set at p < 0.05.</p><p><strong>Results: </strong>All three severity measures (peak power, HARM, MPS) were associated with HIA1 removals in both the men's and women's game. Peak power performed most consistent of the three severity measures for HIA1 removals based on paired-sample AUC comparisons in the men's and women's games. The HARM and MPS were found to perform lower than peak linear acceleration in the women's game based on AUC comparisons (p = 0.006 and 0.001, respectively), with MPS performing lower than peak angular acceleration (p = 0.001).</p><p><strong>Conclusion: </strong>Peak power, a measure based on fundamental mechanics and commonly communicated in sports performance, was the most effective metric associated with HIA1 removals in elite rugby. The study bridges the gap by identifying a consistent HAE severity measure applicable across sexes.</p>","PeriodicalId":21969,"journal":{"name":"Sports Medicine","volume":" ","pages":""},"PeriodicalIF":9.4,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087277","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 : 2025-09-17DOI: 10.1007/s40279-025-02314-2
Melanie D Bussey,Danielle Salmon,Bridie Nanai,Janelle Romanchuk,Raul M Gomez,Darryl Tong,Gisela Sole,Ross Tucker,Éanna Falvey
BACKGROUNDRugby Union has attracted increased scrutiny because of concerns over head acceleration events (HAEs), particularly regarding their frequency, severity and potential long-term health implications. While substantial efforts by governing bodies have focused on reducing head impact risks through education, regulatory changes and the introduction of instrumented mouthguards, limited data exist for the community rugby context, especially across different age grades and playing positions.OBJECTIVEWe aimed to quantify HAE across playing positions, age grades and contact phases in community rugby and to identify match scenarios associated with high-magnitude head loading.METHODSA prospective observational cohort study included 259 male players across U13, U15, U19, and Premier senior men's grades. Players were fitted with instrumented mouthguards, and match play was video recorded for verification. Head acceleration events were identified from instrumented mouthguard-triggered sensor acceleration events > 5 g and coded for match context, player position and contact event characteristics. Statistical models evaluated differences in HAE frequency, incidence rates and head kinematics (peak linear acceleration, peak angular acceleration, rotational velocity change index) across grades, positions and contact scenarios.RESULTSA total of 7358 HAEs were verified from 8593 sensor acceleration events across 72 matches. Tackles and rucks accounted for ~ 60% of all HAEs. High tackles significantly increased head loading in ball carriers (peak linear acceleration: + 4.16 g, p = 0.02; peak angular acceleration: + 443 rad/s2, p = 0.002; rotational velocity change index: + 1.87 rad/s, p = 0.04), while low tackles elevated head loading in tacklers (peak linear acceleration: + 4.9 g, p = 0.004). Upright tacklers were more likely to produce high tackles (p < 0.001) and head-to-head contacts (p = 0.019). U13 ball carriers showed higher rotational loading than tacklers (rotational velocity change index: + 5.01 rad/s, p = 0.008), likely reflecting frequent secondary mechanisms such as head-to-ground and body-to-ground. Defensive rucks carried a greater HAE risk than attacking rucks (all p < 0.05), particularly for U19 jacklers (incidence rate ratio = 2.27, p < 0.0001).CONCLUSIONSTackles and rucks are primary sources of HAEs, with risk shaped by posture, tackle height and player role. Lower tackle heights reduce ball carrier load but increase tackler exposure, indicating a potential safety trade-off. Younger players, particularly U13s, were more susceptible to secondary impacts (e.g. head-to-ground), potentially because of limited task-specific experience and underdeveloped control during the tackled phase. Position- and age-specific strategies may be required to optimise safety and reduce HAE risk across all levels of community rugby.
由于对头部加速事件（HAEs）的关注，特别是其频率、严重程度和潜在的长期健康影响，drugby Union吸引了越来越多的审查。虽然管理机构已经做出了大量努力，通过教育、监管改革和引入带器械的护齿器来减少头部撞击风险，但社区橄榄球环境的数据有限，特别是不同年龄等级和比赛位置的数据。目的：我们旨在量化社区橄榄球比赛中不同位置、年龄等级和接触阶段的HAE，并确定与高强度头部负荷相关的比赛场景。方法前瞻性观察队列研究包括259名U13、U15、U19和Premier高年级男子运动员。球员配备了仪器护齿器，并录制了比赛视频以进行验证。头部加速事件从牙套触发的传感器加速事件> 5 g中识别出来，并根据比赛背景、球员位置和接触事件特征进行编码。统计模型评估了不同等级、位置和接触情况下HAE频率、发病率和头部运动学（峰值线加速度、峰值角加速度、旋转速度变化指数）的差异。结果72场比赛中8593个传感器加速度事件共验证了7358个HAEs。抢断和抢球占所有HAEs的约60%。高铲球显著增加了持球者的头部负荷（峰值线加速度：+ 4.16 g, p = 0.02；峰值角加速度：+ 443 rad/s2， p = 0.002；转速变化指数：+ 1.87 rad/s, p = 0.04），而低铲球增加了铲球者的头部负荷（峰值线加速度：+ 4.9 g, p = 0.004）。直立铲球者更有可能产生高铲球（p < 0.001）和头与头接触（p = 0.019）。U13持球者的旋转载荷高于抢手（旋转速度变化指数：+ 5.01 rad/s, p = 0.008），这可能反映了频繁的二次机制，如头对地和身体对地。防守队员发生HAE的风险高于进攻队员（均p < 0.05），特别是U19劫机者（发病率比= 2.27,p < 0.0001）。结论铲球和铲球是HAEs的主要来源，其危险性受铲球姿势、铲球高度和球员角色的影响。较低的铲球高度减少了球载体的负荷，但增加了铲球者的暴露，表明了潜在的安全权衡。年轻球员，特别是u13球员，更容易受到二次撞击（例如头着地），这可能是因为他们在处理阶段的特定任务经验有限，控制能力不发达。在所有级别的社区橄榄球运动中，可能需要针对位置和年龄的策略来优化安全性并降低HAE风险。
{"title":"Contact Role and Tackle Characteristics Shape Head Acceleration Exposure in Male Community Rugby: A Cohort Study Utilising Instrumented Mouthguards.","authors":"Melanie D Bussey,Danielle Salmon,Bridie Nanai,Janelle Romanchuk,Raul M Gomez,Darryl Tong,Gisela Sole,Ross Tucker,Éanna Falvey","doi":"10.1007/s40279-025-02314-2","DOIUrl":"https://doi.org/10.1007/s40279-025-02314-2","url":null,"abstract":"BACKGROUNDRugby Union has attracted increased scrutiny because of concerns over head acceleration events (HAEs), particularly regarding their frequency, severity and potential long-term health implications. While substantial efforts by governing bodies have focused on reducing head impact risks through education, regulatory changes and the introduction of instrumented mouthguards, limited data exist for the community rugby context, especially across different age grades and playing positions.OBJECTIVEWe aimed to quantify HAE across playing positions, age grades and contact phases in community rugby and to identify match scenarios associated with high-magnitude head loading.METHODSA prospective observational cohort study included 259 male players across U13, U15, U19, and Premier senior men's grades. Players were fitted with instrumented mouthguards, and match play was video recorded for verification. Head acceleration events were identified from instrumented mouthguard-triggered sensor acceleration events > 5 g and coded for match context, player position and contact event characteristics. Statistical models evaluated differences in HAE frequency, incidence rates and head kinematics (peak linear acceleration, peak angular acceleration, rotational velocity change index) across grades, positions and contact scenarios.RESULTSA total of 7358 HAEs were verified from 8593 sensor acceleration events across 72 matches. Tackles and rucks accounted for ~ 60% of all HAEs. High tackles significantly increased head loading in ball carriers (peak linear acceleration: + 4.16 g, p = 0.02; peak angular acceleration: + 443 rad/s2, p = 0.002; rotational velocity change index: + 1.87 rad/s, p = 0.04), while low tackles elevated head loading in tacklers (peak linear acceleration: + 4.9 g, p = 0.004). Upright tacklers were more likely to produce high tackles (p < 0.001) and head-to-head contacts (p = 0.019). U13 ball carriers showed higher rotational loading than tacklers (rotational velocity change index: + 5.01 rad/s, p = 0.008), likely reflecting frequent secondary mechanisms such as head-to-ground and body-to-ground. Defensive rucks carried a greater HAE risk than attacking rucks (all p < 0.05), particularly for U19 jacklers (incidence rate ratio = 2.27, p < 0.0001).CONCLUSIONSTackles and rucks are primary sources of HAEs, with risk shaped by posture, tackle height and player role. Lower tackle heights reduce ball carrier load but increase tackler exposure, indicating a potential safety trade-off. Younger players, particularly U13s, were more susceptible to secondary impacts (e.g. head-to-ground), potentially because of limited task-specific experience and underdeveloped control during the tackled phase. Position- and age-specific strategies may be required to optimise safety and reduce HAE risk across all levels of community rugby.","PeriodicalId":21969,"journal":{"name":"Sports Medicine","volume":"171 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071730","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 : 2025-09-17DOI: 10.1007/s40279-025-02313-3
Kevin Till,Sergio Lara-Bercial,Joseph Baker,David Morley
There are current global concerns surrounding the lifestyle behaviours and future health and well-being of youth. One concept that has gained traction to address these concerns is physical literacy (PL). Organised youth sport is one context that can promote PL, offering multiple benefits coupled with a range of challenges. This Leading Article aims to provide a balanced overview of the key challenges associated with supporting PL within youth sport and offers solutions to overcome these challenges. The first challenge focuses upon attracting youth (and parents) to sport through increasing recruitment against social constraints (e.g., socioeconomic), popular entertainment (e.g., streaming) and family issues (e.g., scheduling). The second centres on retaining children in sport to maximise participation through the appropriate design, organisation and delivery of training and competition opportunities. The final challenge relates to the talent pathway and how sports can structure (e.g., [de]selection) and deliver (e.g., training intensification) a pathway to ensure that all youth athletes flourish along their PL journey. Our solutions focus on organisations (e.g., national governing bodies, clubs) understanding and considering, (1) PL as an individual's relationship with movement and physical activity throughout life, (2) children's rights (e.g., interests, opportunities, expression of views), and (3) sport policies and practices when designing and delivering sport experiences. Whilst these challenges and solutions are wide ranging and complex, our belief is that the adoption of a PL approach by stakeholders when designing, delivering and enacting sport programs can enhance the experiences of youth involved in sport and ultimately support their lifelong PL journey.
{"title":"Challenges and Solutions to Supporting Physical Literacy within Youth Sport.","authors":"Kevin Till,Sergio Lara-Bercial,Joseph Baker,David Morley","doi":"10.1007/s40279-025-02313-3","DOIUrl":"https://doi.org/10.1007/s40279-025-02313-3","url":null,"abstract":"There are current global concerns surrounding the lifestyle behaviours and future health and well-being of youth. One concept that has gained traction to address these concerns is physical literacy (PL). Organised youth sport is one context that can promote PL, offering multiple benefits coupled with a range of challenges. This Leading Article aims to provide a balanced overview of the key challenges associated with supporting PL within youth sport and offers solutions to overcome these challenges. The first challenge focuses upon attracting youth (and parents) to sport through increasing recruitment against social constraints (e.g., socioeconomic), popular entertainment (e.g., streaming) and family issues (e.g., scheduling). The second centres on retaining children in sport to maximise participation through the appropriate design, organisation and delivery of training and competition opportunities. The final challenge relates to the talent pathway and how sports can structure (e.g., [de]selection) and deliver (e.g., training intensification) a pathway to ensure that all youth athletes flourish along their PL journey. Our solutions focus on organisations (e.g., national governing bodies, clubs) understanding and considering, (1) PL as an individual's relationship with movement and physical activity throughout life, (2) children's rights (e.g., interests, opportunities, expression of views), and (3) sport policies and practices when designing and delivering sport experiences. Whilst these challenges and solutions are wide ranging and complex, our belief is that the adoption of a PL approach by stakeholders when designing, delivering and enacting sport programs can enhance the experiences of youth involved in sport and ultimately support their lifelong PL journey.","PeriodicalId":21969,"journal":{"name":"Sports Medicine","volume":"17 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071727","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 : 2025-09-13DOI: 10.1007/s40279-025-02318-y
Gustavo R Mota
{"title":"Comment on \"Optimizing Post‑Activation Performance Enhancement in Athletic Tasks: A Systematic Review with Meta‑analysis for Prescription Variables and Research Methods\".","authors":"Gustavo R Mota","doi":"10.1007/s40279-025-02318-y","DOIUrl":"10.1007/s40279-025-02318-y","url":null,"abstract":"","PeriodicalId":21969,"journal":{"name":"Sports Medicine","volume":" ","pages":""},"PeriodicalIF":9.4,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058644","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 : 2025-09-13DOI: 10.1007/s40279-025-02319-x
Kai Xu,Anthony J Blazevich,Daniel Boullosa,Rodrigo Ramirez-Campillo,MingYue Yin,YuMing Zhong,YuHang Tian,Mitchell Finlay,Paul J Byrne,Francisco Cuenca-Fernández,Ran Wang
{"title":"Response to Comment on \"Optimizing Post-Activation Performance Enhancement in Athletic Tasks: A Systematic Review with Meta-Analysis for Prescription Variables and Research Methods\".","authors":"Kai Xu,Anthony J Blazevich,Daniel Boullosa,Rodrigo Ramirez-Campillo,MingYue Yin,YuMing Zhong,YuHang Tian,Mitchell Finlay,Paul J Byrne,Francisco Cuenca-Fernández,Ran Wang","doi":"10.1007/s40279-025-02319-x","DOIUrl":"https://doi.org/10.1007/s40279-025-02319-x","url":null,"abstract":"","PeriodicalId":21969,"journal":{"name":"Sports Medicine","volume":"53 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056638","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}
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