BMJ Open Sport & Exercise Medicine最新文献

The HEALTHYBACK trial is based on a multimodal intervention to determine the effectiveness of a supervised physical exercise, mindfulness, behaviour change and pain neuroscience education programme on several health variables in individuals with chronic primary low back pain (CPLBP). The study will be a randomised controlled trial among 70 individuals diagnosed with CPLBP (aged 18-65 years). The intervention will be conducted in person within a hospital setting for 16 weeks and comprises a first phase (16 sessions supervised physical exercise (2 days/week, 45 min/session), mindfulness (1 day/week, 2.5 hours/session), behaviour change (daily/24 hours via a wrist-worn activity prompting device) and pain neuroscience education (1 day/biweekly, 2 hours/session)) and a second phase (16 sessions functional full-body muscle strengthening exercise, 3 days/week, 50 min/session). The primary outcomes will include perceived acute pain, pain pressure threshold, conditioned pain modulation, temporal summation of pain and disability due to pain. Secondary measures will include physical fitness, body composition, gait parameters, device-measured physical activity and sedentary behaviour, haematological profile, self-reported sedentary behaviour, quality of life, pain catastrophising, mental health, sleep duration and quality, and symptoms related to central sensitisation. The groups will undergo pretest (before the intervention), post-test (after each phase of the intervention) and retest (at a 6-week detraining period after the intervention) measurements. The results will determine the effectiveness of multidimensional interventions on several health parameters in individuals with CPLBP. They will provide knowledge for pain management and functioning in affected individuals, which might diminish the need for primary healthcare services. Trial registration number: NCT06114264.

Abstract:

Objective: To determine the epidemiology and clinical characteristics of match and training injuries among football players at an academy in Ghana.

Methods: In this prospective observational study, we followed 80 youth and adult football players at a Ghanaian academy over a season of 39 weeks. Medical attention and time-loss injuries, as well as exposure times of players, were recorded by resident physiotherapists using a standardised injury surveillance form. The average weekly injury prevalence was calculated. Injury incidence rates were calculated per 1000 exposure hours, with significance indicated as 95% CIs.

Results: 126 injuries were recorded during the season, with an average weekly injury prevalence of 4.1%. The overall injury incidence was 4.5 (95% CI 3.8 to 5.4) injuries per 1000 hours with under 14 (5.8 (3.3 to 10.2)/1000 hours) and under 18 players (5.7 (4.4 to 7.4)/1000 hours) recording a higher incidence than under 16 (5.1 (3.5 to 7.4)/1000 hours) and senior players (2.7 (1.9 to 3.9)/1000 hours). Match injury incidence was 13 times higher than training injury incidence (27.4 (21.5 to 34.9) vs 2.3 (1.8 to 3.0) injuries/1000 hours). Injuries to the lower extremities had the highest incidence (3.9 (2.1 to 7.2) injuries/1000 hours), with the knee being the most commonly injured site (n=30, 23.8%). The most common type of injury was a joint sprain (1.9 (1.5 to 2.5) injuries/1000 hours), and the most common injury mechanism was direct contact with another player (1.5 (1.1 to 2.0) injuries/1000 hours). Most injuries were moderately severe (2.0 (1.5 to 2.6) injuries/1000 hours).

Conclusion: Ghanaian academy football players have a substantial risk of sustaining injuries, especially among younger players. Further studies should focus on developing specific injury prevention programmes in under-researched football-playing populations.

Objectives: We aimed to determine the effectiveness of exercise training during pregnancy on peak oxygen uptake (V̇O₂peak), cardiac function and flow-mediated dilatation (FMD) of the brachial artery throughout pregnancy and post partum in individuals with a prepregnancy body mass index (BMI) ≥28 kg/m².

Trial design: Parallel-group randomised controlled trial (RCT).

Methods: The exercise group in the Exercise Training in Pregnancy (ETIP) RCT was offered 3 weekly supervised exercise sessions comprising 35 min of moderate-intensity treadmill walking followed by 25 min of strength exercises. The intervention started in gestational weeks 12-18 and continued throughout pregnancy. We measured V̇O₂peak and FMD at baseline, in gestational weeks 34-37 and 3 months post partum and offered echocardiography in gestational weeks 14, 20, and 32, and 6-8 weeks postpartum.

Results: Of the 91 participants included in ETIP, 87 participants (age: 31.3±4.2 years, BMI: 34.6±4.3 kg/m²) provided data on V̇O₂peak, cardiac function and/or FMD. There was no statistically significant effect of exercise training on V̇O₂peak in gestational weeks 34-37, with an estimated effect of 1.7 mL/min/kg (95% CI -0.4 to 3.7, p=0.112) or post partum (1.6 mL/min/kg, 95% CI -0.2 to 3.4, p=0.079), compared with the control group. There were no statistically significant between-group differences in either FMD or any of the echocardiographic outcomes. Only 50% of the participants in the exercise group fulfilled our prespecified adherence criteria.

Conclusion: Offering pregnant individuals with BMI ≥28 kg/m², a supervised exercise intervention did not improve cardiorespiratory fitness, cardiac function or FMD.

Trial registration number: NCT01243554.

Patient-reported outcome measurements (PROMs) are important to evaluate the impact of clinical practice in athletes with Achilles tendinopathy (AT). The TENDINopathy Severity assessment-Achilles (TENDINS-A) is a PROM that measures the pain, symptoms and physical function associated with AT. This study aims to translate, cross-culturally adapt and measure the properties of the Persian language version of the TENDINS-A (Persian-TENDINS-A) in athletes with AT. According to the COnsensus-based Standards for selecting health Measurement INstruments guidelines, 100 athletes with AT will be required for test-retest reliability, construct validity and internal consistency. Analyses will include confirmatory factor analysis, internal consistency, construct validity, SE of measurement, agreement, smallest detectable change, and floor and ceiling effects. Test-retest reliability of the Persian-TENDINS-A will be evaluated within 2-3 days for the Persian-TENDINS-A. Hypothesis testing of the Persian-TENDINS-A will be determined using a Pearson correlation of a single point in time between Persian-TENDINS-A scores with the Victorian Institute of Sports Assessment-Achilles and Pain Self-Efficacy Questionnaires. The study protocol was approved by the Ethics Committee of the University of Zabol (approval ID: IR.UOZ. REC.1403.004) based on the Declaration of Helsinki. Findings from this study will be disseminated to the athletes, clinicians and researchers through peer-reviewed journals and national and international conferences.

Objectives: There is a lack of data on salivary sex hormones across the menstrual cycle (MC) or hormonal contraceptive (HC) cycle of elite athletes. We aimed to provide original data on salivary sex hormones (17β-estradiol, progesterone and free testosterone) in naturally menstruating female athletes with a regular cycle or irregular cycle and using combined HC. A secondary purpose was to compare these data with published data from the general population according to the menstrual status (MC or HC or irregularly menstruating).

Methods: 367 saliva tests were performed on 44 elite athletes during 6 months of follow-up to certify for cycle regularity. Athletes were grouped into regular MC, n=13; irregular MC, n=5; and HC, n=26. We compared salivary data of regular MC across six cycle phases (menses, mid-follicular, late follicular, early luteal, mid-luteal and late luteal phases) with published data from women with a similar MC or HC status from the general population.

Results: We provided salivary original data according to six sub-phases among elite athletes with regular MC. HC athletes showed lower salivary sex hormonal levels, markedly after the first week of active HC compared with regular MC. Athletes with irregular cycles do not show a progesterone rise from the first half to the second half of the cycle (Δirregular=0.38 (1.90), a rise detectable within regular MC group ΔregularMC=2.86 (2.88)).

Conclusions: We provided original data for salivary sex hormone levels in elite female athletes. These references may be valuable for research investigating MC or combined HC data, particularly in longitudinal follow-ups requiring repeated measurements.

The incidence of breast cancer has increased from 900 000 to 2.3 million new annual cases over the last 25 years. The 5-year survival rate has markedly risen to over 90% worldwide due to significant therapeutic advancements. Longer survival in patients with breast cancer means more patients may experience long-term effects of their treatments, including cancer therapy-related cardiac dysfunction (CTRCD). To date, there is no established primary prevention to minimise CTRCD. The Cardiac Health in Breast Cancer study is a two-arm, single-centre, randomised controlled trial investigating the impact of an exercise programme on cardiac changes in patients with breast cancer undergoing cardiotoxic cancer therapy. 48 females with breast cancer will be randomised to either a 12-month intervention group (IG) or a control group (CG). The IG will receive a combination of supervised high-intensity interval training (HIIT) and high-intensity resistance training (HIRT) for 6 months, while the CG will follow WHO guidelines for physical activity independently. All participants will undergo transthoracic echocardiography, cardiac magnetic resonance (CMR) imaging and cardiopulmonary exercise testing at baseline, after 6 months and after 12 months. The primary endpoint is the occurrence of symptomatic or asymptomatic CTRCD at the time points of examination, detected by cardiac imaging, which may be mitigated by structured physical exercise. Secondary endpoints include assessments of cardiac inflammation as detected by CMR, mitochondrial dysfunction, health-related quality of life, the occurrence of fatigue, depression and anxiety, as well as exercise capacity, average heart rate, heart rate variability and daily physical activity.

In recent years, organised and competitive video gaming, esports, has gained enormous popularity in many parts of the world, contributing to the growing professionalisation of this sports branch. To become or remain a professional esports player, individuals practice video gaming for several hours a day while remaining in a sitting posture which may not only lead to a decrease in training quality in the short term (eg, due to cognitive fatigue) but also put them at a higher risk for negative health events in the long-term (eg, overuse injuries). Thus, interrupting periods of prolonged video gaming in a sitting posture with acute physical exercise is strongly recommended for esports players even though the optimal dosage of acute physical exercise breaks remains unclear. To address this gap, we propose in this viewpoint that traditional concepts of exercise prescription and dosage determination using the variables frequency, intensity, time (also referred to as duration) and type of physical exercise (ie, abbreviated with the acronym FITT) should be complemented by the variable density which characterises the timing of consecutive bouts of acute physical exercise during an esports session.

The 24-hour Movement Behaviour (24-h MovBeh) paradigm, encompassing physical activity (PA), sedentary behaviour (SB) and sleep patterns, is recognised as a holistic approach to adolescent health. It emphasises promoting PA, reducing SB and ensuring sufficient sleep, especially in school environments. Understanding the links between lifestyle factors and health outcomes is crucial for clinical and public health, informing interventions for lifestyle changes among adolescents. This study aims to assess adherence to 24-h MovBeh among Lithuanian adolescents, examining the patterns, inter-relationships and impacts on socio-demographic status, 24-h MovBeh, health-related fitness, blood pressure, body composition, dietary patterns, health-related quality of life, mental health, physical and exercise motivation, other lifestyles and health indicators, and academic performance. The 24-h MovBeh study is a prospective cohort study beginning in 2025 with baseline data collected in schools. It will recruit 500 primary and secondary school adolescents (11-14 years old) from Klaipeda and Kaunas, Lithuania. The study will evaluate 11 main categories: Socio-demographic status, 24-h MovBeh, health-related fitness, blood pressure, body composition, dietary patterns, health-related quality of life, mental health, physical and exercise motivation, other lifestyles and health indicators, and academic performance. Statistical analysis will estimate adherence to 24-h MovBeh and its inter-relationships with individual and environmental factors and health outcomes. The 24-h MovBeh study will be a crucial step towards establishing a monitoring system for health and lifestyle outcomes, benefiting researchers, policymakers, adolescents, and parents, while laying the groundwork for future intervention studies.

Objective: Shoulder pain, primarily due to rotator cuff tendinopathy, significantly impacts function and quality of life, with considerable socioeconomic implications. Physiotherapy myofascial trigger point therapy (MPT) is traditionally used, but therapeutic exercise (TE) has gained attention for its potential administrative and implementation benefits. The aim of this study was to evaluate the efficacy of TE compared with MPT in treating shoulder tendinopathies.

Methods: A single-blind randomised controlled trial was conducted comparing TE and MPT. Outcome measures included pain intensity with the Numerical Rating Scale, pressure pain threshold (PPT) and range of motion (ROM), assessed before and after 10 treatment sessions. A total number of 72 participants (TE group n=36 age 49.22±15.29/MTP group n=36 age 49.03±19.12) participated in the study.

Interventions: Participants in both groups were evaluated before treatment and after 10 sessions. A total of 10 sessions were conducted over 5 weeks of intervention.

Results: Both interventions showed improvements in pain intensity and ROM, with no significant differences between the groups in most measures except PPT, where TE demonstrated a greater decrease in pressure-induced pain.

Conclusion: TE could serve as an alternative to manual therapy, offering cost-benefit advantages, especially in administration via telecare and group sessions, highlighting its broader application in physiotherapy.

Trial registration number: NCT06241404.

[This corrects the article DOI: 10.1136/bmjsem-2024-002066.].