Sports Medicine最新文献

Background

Injury risk in professional football (soccer) is increased in the weeks following return-to-play (RTP). However, the time course of injury risk after RTP (the hazard curve) as well as its influencing factors are largely unknown. This knowledge gap, which is arguably due to the volatility of instantaneous risk when calculated for short time intervals, impedes on informed RTP decision making and post-RTP player management.

Objectives

This study aimed to characterize the hazard curve for non-contact time-loss injuries after RTP in male professional football and to investigate the influence of the severity of the index injury and playing position.

Methods

Media-based injury records from the first German football league were collected over four seasons as previously published. Time-to-event analysis was employed for non-contact time-loss injury after RTP. The Kaplan–Meier survival function was used to calculate the cumulative hazard function, from which the continuous hazard function was retrieved by derivation.

Results

There were 1623 observed and 1520 censored events from 646 players analyzed. The overall shape of the hazard curve was compatible with an exponential decline of injury risk, from an approximately two-fold level shortly after RTP towards baseline, with a half-time of about 4 weeks. Interestingly, the peak of the hazard curve was slightly delayed for moderate and more clearly for severe index injuries.

Conclusions

The time course of injury risk after RTP (the hazard curve) can be characterized based on the Kaplan–Meier model. The shape of the hazard curve and its influencing factors are of practical as well as methodological relevance and warrant further investigation.

Background

Flow limitations in the iliac arteries (FLIA) is a sport-related vascular condition increasingly recognised as an occupational risk for professional cyclists and other endurance athletes. Surgical reconstruction is the definitive treatment for athletes wishing to continue competition. However, less information has been published regarding conservative management options and return-to-sport (RTS) guidelines.

Objective

Our aim was to review the existing literature on conservative treatment of FLIA, identify knowledge gaps and propose an RTS framework for athletes returning to competition.

Methods

A comprehensive literature review was performed using the Ovid-MEDLINE, PubMed, Embase and PEDro databases for publications relevant to conservative management of FLIA. A scoping review was conducted following PRISMA-ScR guidelines. Original, peer-reviewed publications in English describing conservative or postoperative management for athletes with FLIA were included. Additional grey literature and clinical expertise were consulted to inform RTS guidelines.

Results

Overall, 62 studies were included in this review. In total, 11 categories of conservative modalities were extracted and presented qualitatively in terms of the information source (discussion or results statements) and perspective of the authors (positive, negative or mixed). We have proposed RTS guidelines covering pre-operative preparation and postoperative rehabilitation based on the available literature, clinical experience, and drawing from other areas of sports medicine research.

Conclusion

There is insufficient literature evaluating the effectiveness of conservative management options for FLIA to establish best practices. Considering the importance of RTS for competitive athletes, we proposed practical guidelines to help with clinician and patient decision making. Future consensus should be sought for RTS best practices.

Background and Objective

Competitive alpine skiing, snowboarding and freestyle skiing, all different in nature and risks, are known for their high injury and illness burden. Testing measures and training methods may be considered for athletes’ preparation to support performance enhancement while safeguarding their health. We explored the perspectives and perceptions of competitive alpine skiing, snowboarding and freestyle skiing stakeholders regarding testing and training practices in their competitive snow sports.

Methods

We conducted an exploratory qualitative study based on grounded theory principles through 13 semi-structured interviews about testing and training practices with athletes, on-snow and off-snow coaches, managers and healthcare providers from different national teams. The interviews were inductively analysed through a constant comparative data analysis.

Results

Participants described winning as the end goal of testing and training practices, which requires athletes to perform in their best condition. To do so, they mentioned two main targets: performance enhancement and health protection. Participants acknowledged health as a premise to perform optimally, considering testing and monitoring approaches, goal setting, and training to support and protect athlete performance. This continuous cyclic process is driven by communication and shared decision making among all stakeholders, using testing and monitoring outputs to inform goal setting, training (e.g. on-snow and off-snow) and injury prevention. Such an approach helps athletes achieve their goal of winning while being fit and healthy throughout their short-term and long-term athletic career development.

Conclusions

The ultimate goal of testing measures and training methods in such competitive snow sports is winning. Performance enhancement and health protection act as pillars in systematic, tailored and flexible processes to guarantee athletes’ best preparation to perform. Moreover, athletes’ assessments, goal setting, monitoring tools, open communication and shared decision making strongly guide this cyclic process.

Background

There has been an increase in studies examining the demands of soccer relative to each playing position in recent years. Understanding the physical, physiological, and technical demands on soccer players according to their positional role during competitive matches is necessary to understand match requirements and develop position-specific training practices. Thereby, there is a clear need to synthesize the information on the different profiles of each playing position.

Objective

This review aimed to organize the literature investigating physical, physiological, and technical demands according to playing positions and provide a framework to identify gaps and suggestions for future studies.

Methods

A systematic search was conducted in October 2023 using four electronic databases: Web of Science, SPORTDiscus, PubMed and Scopus. The review followed PRISMA 2020 guidelines and the PRISMA-ScR extension for Scoping Reviews. The studies were included if the sample comprised adult male soccer players categorized from Tier 3 to Tier 5 (i.e., highly trained/national level, elite/international level, or world class) and compared the physical, physiological, or technical parameters across playing positions.

Results

A total of 178 studies met the inclusion criteria and were included in the review. The number of teams, players, and matches analyzed per study varied considerably. Although a range of classifications were reported across studies, 59% of studies classified players as central defenders, full-backs, central midfielders, wide midfielders, and forwards. The findings suggests that central and external midfielders, and external defenders cover greater total and high-speed distance than forwards or central defenders. Sprint distance was higher in external midfielders versus all other positions. Defenders and central midfielders perform more passes than external midfielders and forwards. Heart rate was the most commonly reported physiological variable across playing positions. When expressed as a percentage of maximal heart rate, midfielders presented higher mean values than all other playing positions.

Conclusion

This scoping review demonstrates that there are differences in the demands on players across playing positions in soccer. Training practices in soccer should be based on the specific requirements of each positional role to ensure players can fulfill their tactical responsibilities during the game.

Background

Cognitive and mental health problems are highly prevalent in adolescence. While higher levels of physical fitness may mitigate these problems, there is a lack of long-term follow-up studies on the associations of physical fitness from childhood with cognition and mental health in adolescence.

Objective

We investigated the associations of physical fitness from childhood to adolescence over an 8-year follow-up with cognition and mental health in adolescence.

Methods

The participants were 241 adolescents (112 girls), who were 6–9 years at baseline and 15–17 years at 8-year follow-up. Average and change scores for cardiorespiratory fitness (maximal power output [W_max]; peak oxygen uptake [VO_2peak]), motor fitness (10 × 5-m shuttle run), and muscular fitness (standing long jump; hand grip strength) were calculated. Global cognition score was computed from six individual cognitive tasks, and perceived stress and depressive symptoms were assessed at the 8-year follow-up. The data were analysed using linear regression models adjusted for age, sex, and parental education.

Results

Average motor fitness was positively associated with global cognition score (standardised regression coefficient [β] − 0.164, 95% confidence interval [CI] − 0.318 to − 0.010) and inversely with perceived stress (β = 0.182, 95% CI 0.032–0.333) and depressive symptoms (β = 0.181, 95% CI 0.028–0.333). Average cardiorespiratory fitness was inversely associated with perceived stress (W_max: β = − 0.166, 95% CI − 0.296 to − 0.036; VO_2peak: β = − 0.149, 95% CI − 0.295 to − 0.002) and depressive symptoms (W_max: β = − 0.276, 95% CI − 0.405 to − 0.147; VO_2peak: β = − 0.247, 95% CI − 0.393 to − 0.102). A larger increase in cardiorespiratory fitness was associated with lower perceived stress (W_max: β = − 0.158, 95% CI − 0.312 to − 0.003; VO_2peak: β = − 0.220, 95% CI − 0.395 to − 0.044) and depressive symptoms (W_max: β = − 0.216, 95% CI − 0.371 to − 0.061; VO_2peak: β = − 0.257, 95% CI − 0.433 to − 0.080).

Conclusions

Higher levels of motor fitness in childhood and adolescence were associated with better cognition in adolescence. Higher levels of and larger increases in cardiorespiratory fitness from childhood to adolescence were associated with better mental health in adolescence.

Background: Different types of sedentary behavior are associated with several health outcomes, but the causality of these associations remains unclear.

Objectives: To conduct a systematic review and meta-analysis of Mendelian randomization (MR) studies investigating the associations between sedentary behaviors and health outcomes.

Methods: A systematic search on PubMed, Embase, Web of Science, Scopus, and PsycINFO up to August 2023 was conducted to identify eligible MR studies. We selected studies that assessed associations of genetically determined sedentary behaviors and health outcomes. A meta-analysis was conducted to examine the causal associations when two or more MR studies were available. We graded the evidence level of each MR association based on the results of the main method and sensitivity analyses in MR studies.

Results: A total of 31 studies with 168 MR associations between six types of sedentary behavior and 47 health outcomes were included. Results from meta-analyses suggested a total of 47 significant causal associations between sedentary behaviors and health outcomes. Notably, more leisure TV watching is robustly correlated with increased risks of myocardial infarction, coronary artery disease, all-cause ischemic stroke, and type 2 diabetes. Conversely, robust inverse associations were observed between leisure computer use and risks of rheumatoid arthritis, Alzheimer's disease, and gastroesophageal reflux disease.

Conclusion: These findings suggest that different types of sedentary behavior have distinct causal effects on health outcomes. Therefore, interventions should focus not only on reducing sedentary time but also on promoting healthier types of sedentary behavior.

Prospero registration: CRD42023453828.

Coverage of problems relating to mental health and well-being is gaining ground in the sports sector today, both in the media and in the scientific literature. Despite exposure to numerous stressors and suffering from poor mental health, coaches have in general been largely overlooked in the scientific literature. Previous studies have mainly focused upon athlete populations. The absence of research means that there are real shortcomings in both understanding the mechanisms involved in the deterioration of coaches' mental health and well-being and in the lack of specific support systems available. This paper first describes findings from the recent, albeit quite scarce, research investigating mental health and well-being in coaches. It then proposes a number of avenues for research and support protocols, both of which are currently ongoing at the French Football Federation Research Centre. The aim is to help support these key participants in the sports sector who arguably have not been given sufficient consideration until now.

Background: Currently, most studies on the health benefits of traditional Chinese exercises on type 2 diabetes mellitus have explored the effects of a single type of traditional Chinese exercise on type 2 diabetes. Although a previous study evaluated the combined clinical effects of traditional Chinese exercises on type 2 diabetes, the studies included in that review were deficient in their study design. In addition, previous studies have not explored the ideal exercise dose that should be taken by patients with type 2 diabetes when performing traditional Chinese exercises.

Objective: To understand whether the findings of previous systematic reviews and meta-analyses are still applicable and to try to address the deficiencies in the previous review, this review conducted a meta-analysis of existing randomized controlled trials to investigate the impact of traditional Chinese exercises on glycemic control with type 2 diabetes.

Methods: The literature was searched in seven Chinese and English databases. Randomized controlled trials published in English and Chinese, from database inception to March 2023, were included in this review. Two reviewers independently reviewed the search results, extracted the data, and assessed the risk of bias. A meta-analysis of the included studies was conducted using Rev Man 5.4 and Stata 15.1 software. Heterogeneity was investigated using a sensitivity analysis, a subgroup analysis, and a meta-regression analysis. Pre-determined subgroups included the duration of the intervention, frequency of exercise, and duration of the single exercise session.

Results: A total of 31 randomized controlled trials (2077 subjects) were selected in this review. The meta-analysis revealed that traditional Chinese exercises were more effective than control groups in lowering glycated hemoglobin (Z = 6.06; mean difference [MD] =  - 0.64, 95% confidence interval [CI] - 0.85, - 0.44; P < 0.00001), fasting blood glucose (Z = 7.81; MD =  - 0.82, 95% CI - 1.03, - 0.62; P < 0.00001), 2-h plasma glucose (Z = 5.61; MD =  - 1.03, 95% CI - 1.39, - 0.67; P < 0.00001), total cholesterol (Z = 4.23; MD =  - 0.37, 95% CI - 0.54, - 0.20; P < 0.0001), high-density lipoprotein cholesterol (Z = 5.94; MD = 0.12, 95% CI 0.08, 0.16; P < 0.00001), low-density lipoprotein cholesterol (Z = 6.20; MD =  - 0.34, 95% CI - 0.44, - 0.23; P < 0.00001), and triglyceride levels (Z = 3.74; MD =  - 0.44, 95% CI - 0.67, - 0.21; P = 0.0002) among patients with type 2 diabetes.

Conclusions: Traditional Chinese exercises can significantly improve blood glucose and lipid levels in patients with type 2 diabetes. When performing traditional Chinese exercise interventions for type 2 diabetes, it is recommended that exercise programs are designed for 30-50 min/session, 4-5 sessions/week for at least 3 months.

Background: Nutrition guidance for athletes must consider a range of variables to effectively support individuals in meeting energy and nutrient needs. Resistance exercise is a widely adopted training method in athlete preparation and rehabilitation and therefore is one such variable that will influence nutrition guidance. Given its prominence, the capacity to meaningfully quantify resistance exercise energy expenditure will assist practitioners and researchers in providing nutrition guidance. However, the significant contribution of anaerobic metabolism makes quantifying energy expenditure of resistance exercise challenging.

Objective: The aim of this scoping review was to investigate the methods used to assess resistance exercise energy expenditure.

Methods: A literature search of Medline, SPORTDiscus, CINAHL and Web of Science identified studies that included an assessment of resistance exercise energy expenditure. Quality appraisal of included studies was performed using the Rosendal Scale.

Results: A total of 19,867 studies were identified, with 166 included after screening. Methods to assess energy expenditure included indirect calorimetry (n = 136), blood lactate analysis (n = 25), wearable monitors (n = 31) and metabolic equivalents (n = 4). Post-exercise energy expenditure was measured in 76 studies. The reported energy expenditure values varied widely between studies.

Conclusions: Indirect calorimetry is widely used to estimate energy expenditure. However, given its limitations in quantifying glycolytic contribution, indirect calorimetry during and immediately following exercise combined with measures of blood lactate are likely required to better quantify total energy expenditure. Due to the cumbersome equipment and technical expertise required, though, along with the physical restrictions the equipment places on participants performing particular resistance exercises, indirect calorimetry is likely impractical for use outside of the laboratory setting, where metabolic equivalents may be a more appropriate method.