BMJ Open Sport & Exercise Medicine最新文献

Objective: To determine if paediatric athletes exhibit differences in positive screenings on the Sport Mental Health Assessment Tool (SMHAT-1) compared with adults.

Methods: Team USA Olympic and Paralympic paediatric athletes ≤21 years (n=589; 58.8% female; age=19.5±1.7 years) completed the SMHAT-1 between January 2021 and September 2024. A comparative sample of Team USA adult athletes (n=493, 54.2% female; age=27.3±4.9 years) matched for sex and sport was randomly sampled, and the percentage of athletes with a positive screening on each questionnaire was calculated. χ² analysis compared the proportion of positive screenings between paediatric and adult samples. Piecewise linear regression assessed the association between age and total questionnaire scores.

Results: The proportion of positive screenings was lower for paediatric athletes for the Alcohol Use Disorders Identification Test Consumption (AUDIT-C) (χ²(1)=21.2, p<0.001) and Athlete Psychological Strain Questionnaire (APSQ) (χ²(1)=4.47, p=0.034). Increasing age of paediatric athletes was associated with higher AUDIT-C (β=0.41, p<0.001) and APSQ scores (β=0.35, p<0.001); however, a negative deviation was observed in AUDIT-C (β=-0.44, p<0.001) and APSQ scores (β=-0.38, p=0.002) among adults. Further, increasing age of paediatric athletes was associated with increased General Anxiety Disorder-7 (β=0.14, p=0.045) and ASSQ (β=0.12, p=0.029) scores; however, there was no significant deviation from this age trend in adults for either score (p>0.05).

Conclusion: Paediatric athletes produce a similar proportion of positive screenings to adults on subcomponents of the SMHAT-1, but they show a lower proportion of positive screenings for alcohol misuse and psychological strain. The changes in SMHAT-1 subcomponent scores among paediatric athletes warrant continued exploration to determine how the interaction of psychosocial development and elite sport may impact mental health.

Objectives: This review aimed to provide a pooled estimate of injury incidence and epidemiology in women's ice hockey.

Methods: A systematic review and meta-analysis were conducted by searching PubMed and Scopus in August 2024, including only reports published in English. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, and the PRISMA checklist was used. Observational studies reporting injury incidence in women's ice hockey based on exposure time were included. Reviews, editorials and commentaries were excluded. A random-effects model calculated pooled injury incidences per 1000 athlete exposures (AEs), with separate analyses for games, practices, injury locations and types. The risk of bias was evaluated using the Joanna Briggs Institute Critical Appraisal Checklist for Prevalence Studies.

Results: Of 510 records screened, 18 reports conducted in North America were included, with six reports contributing to the analysis. These reports reported a total of 3365 injuries and 719 010 AEs, yielding an overall injury incidence of 5.21 injuries per 1000 AEs. Injury rates were higher during games (10.10 per 1000 AEs) compared with practices (3.11 per 1000 AEs). Lower limb injuries were the most frequent (0.57 per 1000 AEs), while concussions or traumatic brain injuries were the most common injury types (0.54 per 1000 AEs).

Conclusion: The overall injury incidence in collegiate-level women's ice hockey is considerable, with lower limb injuries being the most common injury location and concussions the most frequent injury type. This review establishes a baseline for injury patterns in women's collegiate ice hockey prior to the potential legalisation of body checking in all levels of women's ice hockey, offering valuable insights for future research and the development of targeted injury prevention strategies.

Prospero: https://www.crd.york.ac.uk/PROSPERO/view/CRD42024590497.

Heart failure (HF) is a chronic and progressive cardiovascular condition associated with significant morbidity, mortality and healthcare burden. Increasing evidence points to a critical role of gut dysbiosis and the gut-heart-brain axis in HF pathophysiology. Altered gut microbiota may influence systemic inflammation, neurohormonal activity and cardiac function through gut-derived metabolites such as trimethylamine N-oxide (TMAO) and short-chain fatty acids (SCFAs). Yoga-based cardiac rehabilitation (Yoga-CaRe) is a cost-effective intervention that has been shown to improve quality of life, exercise capacity and cardiovascular outcomes in cardiac patients. However, the mechanism underlying its benefits remains unclear. Furthermore, its effect on gut microbiota diversity and the downstream impact on the gut-heart-brain axis in HF remains largely unexplored. This study outlines a prospective, randomised, open-label, blinded-endpoint trial investigating the effects of a 12-week Yoga-CaRe intervention versus enhanced standard care in 60 HF patients with reduced ejection fraction. Participants will be randomly assigned in a 1:1 ratio to either the Yoga-CaRe or the control group. The Yoga-CaRe group will participate in 20 supervised yoga sessions, complemented by guided daily home practice, while the control group will receive enhanced standard care. The trial will assess changes in gut microbiota composition, levels of gut-derived metabolites (TMAO and SCFAs), inflammatory biomarkers (TNF-α and high-sensitivity C reactive protein), heart rate variability, 6 min walk test (6MWT) and echocardiography. Biological samples and clinical data will be analysed using integrated bioinformatics and statistical approaches to evaluate intervention efficacy and identify potential mechanistic pathways. The YoGH-Biome study has received ethical clearance from the Institutional Ethics Committee of the SDM College of Medical Sciences and Hospital, India (SDMIEC/2025/1073). It is registered with the Clinical Trials Registry of India. Study results will be disseminated via scientific publications, conferences and stakeholder forums to inform integrative strategies for HF management. Trial registration number: CTRI/2023/12/060757.

Insufficient physical activity (PA) among children has become a major global public health concern. The family environment plays a crucial role in shaping children's weekend PA, yet evidence-based interventions in this context remain scarce This study will conduct a three-arm cluster randomised controlled trial, 'WeekendGo!' guided by an integrated theoretical framework that encompasses the Social Cognitive Theory, Health Action Process Approach and Family Functioning Theory, aimed at promoting children's weekend PA. Approximately 555 children and their parents will be recruited and randomised into three groups: a staged intervention group (intervention I), a general intervention group (intervention II) and a control group, for 12 months. The primary outcome will be the children's weekend moderate-to-vigorous PA. Secondary outcomes will include children's cognitive factors such as self-efficacy, perceived barriers and resources, motivation and behavioural intention. Generalised linear mixed-effects models will be used for analysis, adhering to the intention-to-treat principle, with missing data handled through multiple imputation. Trial registration number: ChiCTR2500095942.

Objectives: To develop a sustainable and accessible educational programme on biopsychosocial female-specific topics, for young female athletes in organised sport, their parents and coaches for future testing and evaluation in a full-scale intervention study.

Methods: A digital educational programme, along with its methodology, was developed in four steps: First, content validity of female-specific topics was identified through (a) literature reviews by an interdisciplinary research team and (b) an online survey of 1323 female athletes (aged 16-24 years) assessing perceived knowledge and knowledge needs regarding biopsychosocial topics. Second, film scripts based on identified topics were written, internally reviewed and evaluated by a pilot group of six 13-16-year-old female athletes. Third, online surveys assessing main and secondary outcomes were developed and tested in the pilot group. Finally, digital format and production were developed collaboratively with a film scholar and film technicians.

Results: The intervention development yielded 12 videos of 5-7 min, featuring sports science researchers and female elite athletes sharing their perspectives on biopsychosocial topics specific to women. The protocol development produced a quasi-experimental, modified staircase cluster trial design, including bi-weekly assessment of main (ie, well-being and sporting experiences) and secondary outcomes (eg, perceived support) at baseline, pre-, post-intervention and post-post follow-up.

Conclusion: This study outlines the development of a digital educational intervention for young female athletes, their parents and coaches, emphasising that interdisciplinary collaboration and user engagement are key to identifying intervention components and relevant outcomes.

Objective: To analyse the causes of death and factors associated with mortality among NBA players using verifiable open-source data and a time-to-event approach accounting for competing risks.

Methods: This retrospective cohort study included all 4374 former and active NBA players from 1946 to July 2019. Players who exclusively played in the American Basketball Association were excluded. The main exposure was participation in the NBA. The primary outcome was cause-specific death, categorised into: neoplasms, cardiovascular diseases, external causes and idiopathic. Ethnicity and height were assessed as predictors using cause-specific adjusted Cox models.

Results: By July 2019, 864 players (19.8%) had died, 855 of them identified as African ancestry or European ancestry. Among these, 47.6% of deaths were idiopathic, 20.1% due to neoplasms, 17.6% due to cardiovascular diseases, 8.1% due to external causes and 6.5% due to other specified causes. From age 60 years onwards, neoplasms and cardiovascular diseases were the leading causes of death. At age 85 years, the estimated cardiovascular disease-related mortality was higher in African ancestry players (27%) than in European ancestry players (20%). African ancestry ethnicity was associated with increased risk of cardiovascular death (adjusted HR 1.32; 95% CI 1.06 to 1.65), and height was positively associated with mortality from both neoplasms and cardiovascular diseases.

Conclusions: In this cohort of NBA players, neoplasms and cardiovascular diseases emerged as the primary causes of death, particularly among African ancestry athletes and taller individuals. These findings underscore the need to view the long-term health of elite athletes as a public health priority.

Mild traumatic brain injury (mTBI) remains a significant health concern for the US Military Health System and a threat to warfighter readiness. Although most service members (SMs) recover following an initial period of rest and a progressive return-to-activity protocol, a subset experience persistent cognitive, psychological and physical symptoms lasting months to years post-injury. Sub-symptomatic exercise has demonstrated efficacy in reducing exercise intolerance and expediting recovery in athletes with mTBI. Given differences in injury mechanisms between athletes and SMs, including blast exposure, it is unclear whether similar benefits extend to military populations with chronic post-concussive symptoms. This prospective, randomised controlled trial will evaluate the efficacy of an adaptable, sub-symptomatic exercise treatment (ASSET) programme compared with a mobility active control (MAC) intervention in SMs with chronic mTBI symptoms. A total of 140 active-duty SMs with a history of mTBI per Department of Defense criteria and persistently elevated neurobehavioural symptoms more than 1 month post-injury will be enrolled. Following screening and informed consent, participants will be randomised to ASSET or MAC and undergo baseline assessment. Outcomes will be assessed immediately postintervention (approximately 8 weeks) and at 3 months post-treatment. The primary outcome is neurobehavioural symptom resolution. Secondary and exploratory outcomes include cognitive performance, physiological adaptation, locomotion and military-relevant functional performance. Statistical analyses will examine group differences over time to determine treatment effects.

Background: Anxiety disorders are persistent, functionally impairing conditions with high societal burden. In contrast, anxiety symptoms are elevated anxiety meeting scale thresholds (not formal diagnoses). While exercise is recognised as a complementary intervention for anxiety, the most effective mode of exercise for anxiety disorders remains unclear.

Objective: To evaluate the effectiveness and acceptability of exercise treatments for adults with anxiety disorders via network meta-analysis.

Methods: Systematic review and frequentist network meta-analysis were conducted, searching five databases (MEDLINE, EMBASE, PsycINFO, CENTRAL, SPORTDiscus) up to 1 March 2025. Treatments assessed included aerobic exercise, mind-body exercise (MBE), resistance training (RT), stretching, multicomponent exercise, cognitive-behavioral therapy, psychoeducation, waitlist control, usual care and placebo. Risk of bias was assessed using the Cochrane Risk of Bias Tool 2.0 (RoB 2.0). Outcomes included anxiety severity reduction (for effectiveness) and all-cause discontinuation rates (for acceptability).

Results: 30 RCTs (1421 participants) were included: four had low risk, 19 some concerns and seven high risk. For combined anxiety conditions (anxiety disorders and symptoms), RT was most effective (standardised mean difference (SMD) -0.80, 95% CI -1.24 to -0.36, SUCRA 78.7%), followed by MBE (SMD -0.78, 95% CI -1.12 to -0.44, SUCRA 77.8%). For anxiety disorders, RT was most effective (SMD -0.79, 95% CI -1.18 to -0.40, SUCRA 78.5%) and MBE for anxiety symptoms (SMD -0.84, 95% CI -1.48 to -0.20, SUCRA 77.9%). No acceptability differences across treatments; network meta-regression showed diagnosis status did not alter effects.

Conclusions: Both resistance exercise and MBE may be effective for anxiety disorders, with moderate certainty evidence. Acceptability remains unclear.

Prospero registration number: CRD42024561238.

The differentiation between training load and match load is an important consideration in applied practice, with the match load construct being used in athlete monitoring to inform training prescription and return to play decision-making post-rehabilitation. The term 'match load' lacks a clear definition, and its complexity requires greater recognition. We propose a practical, conceptual framework for match load and influential contextual factors to consider within professional football that may impact a player's match load. The aim of the article is to provide practitioners with definitions of match load categories and to guide future research that may help enhance the measurement and management of load to inform training and rehabilitation processes.