BMJ Open Sport & Exercise Medicine最新文献

Objectives: Lateral ankle sprains (LAS) are among the most common injuries in professional football (soccer). Despite this, the severity and possible long-term consequences of LAS remain trivialised. This multicentre observational study in German elite football provides insights into time-loss and recurrence rates after LAS. Time-loss and recurrence rates are outcome measures vital for the future evaluation of rehabilitation protocols.

Methods: 798 male football players representing 34 teams from 13 professional German football clubs participated in this study during the 2021-2022 season, followed by a 12-month follow-up period. Data collection and reporting were carried out in accordance with the UEFA recommendations for the standardised collection of data on football injuries. Time-loss, recurrence rate and standardised severity grades (I-III) after LAS were recorded for professionals, U23, U19 and U17, respectively.

Results: A total of 187 ankle injuries were reported, with 115 out of the total being analysed. The overall time-loss was 29.89 days, with significant differences between youth elite players and professionals (32.96 vs 15.53 days lost; p<0.001). Professional players demonstrated the shortest time-loss in all LAS injury grades. Time-loss decreased with advancing age (R ²=0.03, F(1, 106)=3.16, p=0.078). Grade I LAS's time-loss differs significantly from grades II and III (p<0.001). A recurrent LAS was recorded in 34 players. The overall LAS recurrence rate was 25.6%.

Conclusion: This study provides data on time-loss and recurrence, which serve as reference values for future evaluation of rehabilitation concepts after LAS in elite football players.

Background: The Aspetar Sports Injury and Illness Prevention Programme introduced the Aspetar IP² NetWork, a customizable injury prevention programme for professional football clubs in Qatar during the 2020/2021 season. It includes 23 focus areas selected by stakeholders to prevent sports-related health issues.

Objective: To assess the real world implementation of the IP² NetWork preventive focus areas during the first season after introduction, focusing on team adoption and player compliance.

Methods: A survey was conducted among team physicians, physiotherapists and fitness coaches from the 18 professional football clubs in Qatar. The survey examined the implementation of the IP² NetWork focus areas and the roles of the different professionals in managing these areas.

Results: 17 out of 18 clubs reported using IP² focus areas, applying an average of 11.4 areas (range 4-21). The most commonly used strategies were the Nordic hamstring exercise, cold water immersion, taping and concussion prevention. Team physicians led 38% of the focus areas, followed by physiotherapists (25%) and fitness coaches (24%), with 11% managed collaboratively. Fitness coaches primarily handled exercise-based areas like warm-ups and load monitoring. Preventive measures were applied to the full squad in 81% of cases, with 19% targeting at-risk players. Player compliance was high, with 86% of focus areas adopted by all or most players, rising to 97% for players identified to be at greater risk of injury or illness.

Conclusion: Implementing the IP² focus areas was widespread among teams in Qatar, with strong collaboration between medical staff. Player compliance, especially among at-risk players, was excellent, demonstrating the programme's feasibility and effectiveness in real-world settings.

Objective: This study aims to prospectively analyse current demographics, distribution and severity of climbing injuries in adolescents. We hypothesised that the injury distribution of adolescent climbers would differ from adults, as presented in the literature and that primary periphyseal stress injuries of the finger (PPSI) will be very common and correlate with training hours and climbing level.

Methods: We performed a prospective single-centre injury surveillance of all adolescent (<18 years of age) climbers who presented between 2017 and 2020. A standard questionnaire, including questions for medical history, injury and training data and an examination protocol, was conducted in all patients. Injuries were graded, and risk factors, anthropometric specifics and stages of development were analysed. Injury epidemiology of adolescents was then compared with adults as presented in the literature.

Results: 137 independent climbing-related injuries were found in 95 patients. Injury onset was acute in 67 (48.9%) and chronic in 70 (51.8%). Forty-one injuries (29.9%) occurred during bouldering, 18 (13.1%) during lead climbing, 2 (1.5%) in speed climbing and 1 (0.7%) while training on the campus board. Average International Climbing and Mountaineering Federation injury score was 1.5±0.5 (range 0-3). Females had more training hours (p=0.004), more campus board use (p=0.004) and more acute injuries than males (p<0.001). 82% of the injuries affected the upper extremity and the most frequent injury was PPSI (45.3% of all injuries). Finger injuries were significantly more common in males than in females (p<0.05). The injury distribution in adolescent climbers differed significantly from adults (p<0.001).

Conclusions: Injured adolescent climbers had mostly chronic injuries affecting the upper extremity, with almost half of the injuries being PPSIs of the fingers. Further preventive measures targeting this type of injury need to be identified. Reducing the use of the finger crimp grip, monitoring the load, ensuring adequate recovery and targeted education appear to be crucial.

The primary aim is to assess the impact of a multidomain intervention that integrates education, exercise, psychological techniques and machine learning feedback on the duration athletes remain free from injury complaints leading to participation restriction (ICPR) during a 20-week summer competitive athletics season. The secondary aims are to assess the intervention's effect on reducing (i) the incidence, (ii) the burden, (iii) the period prevalence and (iv) the weekly prevalence of ICPR during the same timeframe. We will perform a two-arm randomised controlled trial. This study will involve an intervention group and a control group of competitive athletes licensed with the French Federation of Athletics, aged between 18 and 45, over an outdoor athletics competitive season lasting 20 weeks (March to July 2025). Data will be collected before the start (demographic, training and injury history) and one time per day (training and competition volume/intensity, perceived physical and psychological state, and illness and injury incidents) for both groups. The intervention group will be required to (i) view a series of 12 educational videos on injury prevention, (ii) engage in discipline-specific exercise programmes, (iii) implement stress and anxiety management techniques and (iv) view daily the injury prognostic feedback generated by the athlete's collected data based on machine learning. Outcomes will be analysed over the final 14 weeks of follow-up to allow time for the intervention to establish any potential efficacy. The primary outcome will be the time-to-event for each ICPR. Secondary outcomes will include (i) incidence, (ii) burden, (iii) period prevalence and (iv) weekly prevalence of ICPR. The primary outcome will be analysed using a Prentice-Williams-Peterson gap-time model. In contrast, the secondary outcomes will employ Poisson (i, ii), logistic (iii) and generalised estimating equations (iv) regression models, respectively.

The symptoms of active systemic lupus erythematosus (SLE) potentially lead to inactivity, muscle loss and social isolation. In addition to medical treatment, the current EULAR recommendations describe the relevance of physical activity, exercise and training as a non-pharmacological management option in patients with SLE. A positive interaction between fatigue and the basic health-promoting effects of exercise is well established. Still unclear is what kind of training, setting, and intensity show optimal objective and subjective outcomes. The study will include 40 adult SLE patients with moderate to severe fatigue. The study lasts 28 weeks and is divided into a 12-week "real-world" monitoring phase before rehabilitation, a 4-week inpatient rehabilitation phase, and a 12-week maintenance activity and training phase after the rehabilitation. The parameters consisted of physical performance parameters, laboratory parameters, physician and patient-related questionnaires and activity data based on a fitness watch. During rehabilitation, patients receive individual high-intensity interval training (HIIT), basic endurance training and functional interval training. This proof-of-concept trial aims to investigate if high-intensity interval training is feasible and how VO2peak is increased. Additionally, the effect of the severity of fatigue measured by patient-related outcomes and the number of anti-NR2 antibodies is focussed. This study was approved by the Ethics Committee of the Medical Association of Rhineland-Palatinate and complies with the standards of the Declaration of Helsinki. All participants will sign a written informed consent. Trial registration number: DRKS00022933.

Healthcare workers (HCWs) actively involved in patient care at tertiary care hospitals face significant stress and workload, which may adversely impact their sympatho-vagal balance (SVB). Research has extensively investigated SVB using various techniques, such as heart rate variability (HRV). With its multifaceted approach, yoga has been suggested to influence autonomic nervous system function and, consequently, SVB. Thus, this study aims to investigate the efficacy of a 4-week yoga module on SVB among HCWs. This randomised controlled trial will involve 108 HCWs aged 19-60 years. Participants will be randomised to either (1) a yoga intervention group or (2) a medium-paced walking control group. The primary outcome is a change in HRV after 4 weeks of intervention. Secondary outcomes comprise immediate change in state anxiety, selective attention and HRV compared pre- and post-intervention on days 1, 14 and 28. Intention-to-treat and per-protocol analysis will be performed to gain a comprehensive understanding of the effects of intervention. Multivariate linear model will adjust covariates in baseline HRV data in both groups. Independent t-test will compare pre- and postdata on all outcomes between groups. Paired t-test will be used to compare pre- and postdata on all outcomes within the group. The study protocol is registered on the Clinical Trials Registry - India (CTRI) (CTRI/2024/09/074132).

Individuals who were active before and during pregnancy face significant barriers to return postpartum, and participation in exercise and sport often decreases significantly during this period. Evidence is beginning to emerge regarding elite athletes' experiences with returning to sport postpartum. Understanding the experiences of recreational participants is essential to improve wider participation postpartum. This qualitative study aimed to describe the experiences of those returning to recreational exercise or sport postpartum, and to identify actions to support such a return. 14 mothers from the UK and Ireland, participated in one-to-one interviews. Interviews were transcribed verbatim and analysed using contemporary reflexive thematic analysis. Six themes were generated: (1) The challenging transition to motherhood, (2) Regaining, reclaiming and role modelling: motivators for returning, (3) Changed bodies and reframed minds: the experience and benefits of returning, (4) The mental load: adaptation, priorities, judgement and guilt, (5) Lack of appropriate knowledge and professional support and (6) Support, environment, culture and provision. Participants gave detailed accounts of the experience of returning to recreational exercise or sport postpartum. A list of actionable steps to support the return to recreational exercise and sport postpartum was generated from the data. These include the training of relevant professionals, the delivery of guidance during antenatal and postpartum care, the provision of opportunities to return postpartum and the embedding of policy to support such a return. The study provides actionable recommendations and future research directions to support postpartum mothers in resuming recreational exercise and sport.

Objectives: Physical activity is associated with positive health effects and improved cognitive function in children. However, these data are primarily based on cross-sectional studies. We investigated changes in cognitive function, physical fitness and physical activity in children following a school-based intervention.

Methods: The 'fit4future' study is a prospective, interventional, long-term study conducted in Germany to evaluate the impact of a comprehensive school-based health promotion programme in children. The aims of the programme have been to increase the amount of physical activity, to support a healthy diet and to improve attention and concentration performance as well as coping strategies. Schools received equipment to support physical activity, for example, action cards, brochures as well as online materials containing information regarding physical activity, nutrition, cognitive function and stress management. Teachers were trained in six workshops to enable them to promote a systematic health promotion process at schools. Parents received brochures about healthy lifestyles with practical advice for everyday family life. Additional information was provided on the programme's homepage. At the beginning of the second and the end of the third grade, children completed a differential performance test (Concentrated Task) for the assessment of concentration and attention in which they had to cross predetermined pictorial symbols on preprinted test sheets (average marked signs). Changes in the average marked signs were investigated and compared with age-specific and sex-specific norms. Physical fitness and activity were assessed using a six-item fitness test and questionnaire.

Results: A total of 839 children (mean age 7.5±0.6 years, 48% girls) from 32 schools participated in this study. Over 2 years, average marked signs increased from 91.6±20.7 to 138.0±27.6 (p<0.001) (n=553 children, mean age 7.5±0.6 years, 51% girls). This improvement was greater than expected compared with the age-specific and sex-specific norms. The children showed significant improvements in all fitness test items and a significant increase in physical activity (p<0.001). Age, baseline average marked signs and changes in the jump-and-reach test were associated with changes in cognitive function (regression coefficient β=0.95, SE=0.23, p<0.001).

Conclusion: A school-based health promotion programme improved cognitive function, physical activity and physical fitness beyond the age-related improvements expected over 2 years in a large cohort of primary school children.

Trial registration number: German Clinical Trials Register (DRKS-ID: DRKS00020894, Date of registration: 2020-02-26).

Background: The interest in elite athletes' mental health has increased over the past decade. However, there is still a paucity in the literature concerning elite Para athletes' mental health and its association with injuries and illnesses affecting athletes' participation in sports.

Objective: To assess the weekly prevalence of mental distress and its association with injury, illness, sleep duration, hours of participation in sports and perceived exertion over a 44-week period in a cohort of Swedish elite Para athletes. A secondary aim was to describe the period prevalence of mental distress.

Methods: This was a prospective longitudinal study including 59 Swedish elite Para athletes with physical, visual and intellectual impairments. Each week athletes reported mental distress according to 'The four-item Patient Health Questionnaire for Anxiety and Depression' (PHQ-4), sleep duration, hours of sports participation, perceived exertion as well as any new injury or illness. Descriptive statistics and multilevel regression analyses were used to analyse data.

Results: The weekly prevalence was 15% for symptoms of anxiety, and 21% for depressive symptoms. The 44-week period prevalence was 58% for anxiety, and 42% for depressive symptoms. Multilevel logistic regression analyses revealed significant associations between reporting symptoms of mental distress with an ongoing injury, illness, and low sleep duration.

Conclusion: Elite Para athletes report a moderate rate of symptoms of anxiety and depression, and there were associations between reporting mental distress and experiencing an injury or illness affecting athletes' participation in sports. The findings highlight the importance of longitudinal mental health monitoring and multidisciplinary support systems targeting those athletes reporting mental distress, injury or illness.

This study explored professional Judokas' experiences of the anterior cruciate ligament (ACL) injury process, the consequences of the injury, and their perceptions of underlying factors contributing to the injury. Eleven professional Judokas treated with ACL reconstruction were interviewed using semi-structured interviews. Qualitative content analysis of the transcripts revealed two main themes: 'from the mat to mastery: a Judoka's quest in the wake of injury' and 'beyond the physical: the silent struggle for psychological victory.' Judokas described judo as a lifestyle, with their injuries impacting both physical performance and mental health. Fatigue, high training intensity, and bad luck were identified as contributing factors to their injuries. While the injury posed significant physical and mental challenges, Judokas emphasized the role of the discipline and structure learned through judo to navigate the recovery process. Judokas attributed their ACL injuries to a mix of preparation and unpredictable elements, and reported both positive and negative consequences of their experiences.