BMJ Open Sport & Exercise Medicine最新文献

Although horse riding is hazardous and injuries are common, young riders regularly engage in horse-related activities. To our knowledge, there have been no syntheses on youth horse-related injuries published during the past decade that employ a multi- and interdisciplinary research agenda (M-IDR) and that incorporate both quantitative and qualitative methods. Therefore, this scoping review aimed to (1) review studies on horse-related injuries among children and adolescents and (2) identify methodological and paradigmatic trends according to M-IDR. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews Checklist, we searched six databases (PubMed, SportDiscus, Scopus, PsycInfo, Sociological Abstracts and Web of Science) for studies on horse-related injuries among youth riders published between 1 January 2014 and 1 December 2024. The total sample included 1400 participants aged 0-17 years, of which 78.7% were girls. The main results present data on acute injuries in general and traumatic brain injury in particular. In terms of disciplinary insights, the study design and paradigmatic views predominantly reflect a positivistic worldview, employ quantitative methods and are consistent with previous literature reviews on equestrian sport injuries. Further studies are needed on the injuries that occur among young riders in equestrian sports. They should use an interpretivist approach to explore norms and attitudes towards injuries and risk-taking within the equestrian community, for example, how cultural predisposition influences safety equipment use among young equestrians in private stables.

Futsal, a high-intensity sport, places considerable demands on the hip adductors and core musculature, often resulting in strength deficits and reduced agility. Optimising training strategies to prevent injury and enhance performance is a growing area of interest. This study aims to compare the effectiveness of the modified progressive Copenhagen exercise versus sliding hip exercise in adjuncts to conventional physiotherapy in improving strength, core stability and agility in futsal athletes. A parallel, three-arm, randomised controlled trial was conducted over a period of 8 weeks. Participants will be enrolled from four centres. 39 futsal athletes were randomly allocated into three groups via a 1:1:1 allocation. Primary outcome measures included isometric hip adductor strength via handheld dynamometer, core stability assessed via sphygmomanometer and agility performance measured using the agility t-test and secondary outcome measures included isometric hip abductor strength measured by the single-leg squat test. Assessments were conducted pre- and postintervention. The final analysis will include dropouts and treatment side effects. Ethical clearance was obtained from the Institutional Ethical Committee, Ref. No. DMIHER(DU)/ie,C/2025/610. The findings will be published in peer-reviewed journals and disseminated at international conferences. Trial registration number: CTRI/2025/04/084525.

Objectives: To evaluate the onset, frequency and time loss impact of recurrent calf muscle strain injuries in elite male Australian football players over a decade. To explore how outcomes are affected by alternative recurrence definitions.

Method: Calf muscle strain injuries were reported to the Soft Tissue Injury Registry of the Australian Football League (2014-2023). Cases were categorised as index versus recurrent injuries. Alternate recurrence definitions varied based on: (1) timing (ie, subsequent injuries occurring before or after full recovery (a return to full training) and (2) location (ie, subsequent injuries involving the same side but not necessarily same muscle vs only those confirmed to involve the same muscle).

Results: 563 injuries in 359 players were evaluated. Recurrences resulted in ≥2153 total days lost over 10 years and ≥35.6 days lost on average per injury. Recurrence frequencies within 2 years (13%-21.3%), within the same season (7.5%-13.9%) and within 2 months (2.9%-7.3%) varied depending on the definition. 20% of all subsequent injuries occurred before full recovery, and these injuries took on average 46.7±25.6 days to return to play.

Conclusions: Recurrent calf muscle strain injuries in elite male Australian football players commonly have prolonged time loss, irrespective of timing or location. A 2-year recurrence susceptibility is consistent across onsets, and cases that fail early can have a large impact when accounted for. We need to 'talk the same language' in research and practice to better understand and prevent recurrences for a given type of injury across different sports and sporting levels.

Physical activity (PA) is a cornerstone of both disease prevention and long-term condition management, yet it remains absent from many treatment plans, particularly in primary care. Despite clinicians recognising the value of PA, systemic barriers such as time constraints and limited training hinder its integration into everyday consultations. For this reason, there has been a call for further resources to improve clinician confidence in initiating these conversations. This viewpoint presents a practical, five-step framework to help primary care clinicians support inactive patients to become more active. It does this by integrating core principles of PA counselling, including motivational interviewing, risk screening and the frequency, intensity, time and type (FITT) principle into a practical, accessible framework. It simplifies the often fragmented guidance on PA prescription, offering clinicians a clear, time-efficient tool to support behaviour change in routine practice. A visual infographic translates the five steps into an accessible aid for busy consultations. This viewpoint aims to equip primary care clinicians with the clarity and confidence needed to embed PA advice into their routine care. In doing so, it supports the shift towards proactive, personalised and preventive healthcare.

Objectives: To explore the acute effects of a heavy-load resistance protocol and exercise in the supine position on fetal heart rate (FHR) and uteroplacental blood flow.

Method: In this experimental laboratory study, 48 healthy pregnant athletes (elite: n=7; recreational: n=41) completed 3×8 repetitions with one repetition in reserve in sumo deadlift, bench press and incline bench press. FHR and umbilical and uterine artery pulsatility index (PI) were assessed before and after exercise. Symptoms of vena cava syndrome were recorded following the supine exercise.

Results: Pre- and post-exercise FHR remained within the normal range (110-160 bpm), but there were statistically significant increases after sumo deadlifts (p=0.002) and incline bench press (p=0.008), with no significant change after bench press (p=0.122). Umbilical artery PI did not change, while uterine artery PI significantly decreased after the sumo deadlift (p=0.005), bench press (p<0.001) and incline bench press (p<0.001). No fetal bradycardia was observed after the sumo deadlift or incline bench press, but one case occurred after bench press, resolving shortly after 3 min. Fetal tachycardia (>160 bpm) occurred in four cases after sumo deadlift, five after bench press and three after incline bench press, though none exceeded pathological levels (>180 bpm). One recreational athlete experienced symptoms of vena cava syndrome after the supine exercise, coinciding with a slight decrease in umbilical artery PI, but with stable FHR.

Conclusion: The results indicate that highly active women, especially those with resistance training experience, can safely engage in a heavy-load resistance protocol, including supine exercise, without jeopardising fetal well-being.

Background: The prevalence of obesity has tripled over the past 35 years. Although caloric restriction reduces body fat, lean tissue is also lost. Resistance exercise may mitigate these effects. This review assesses the effects of resistance exercise on body composition and cardiometabolic health in adults with overweight or obesity undergoing dietary weight loss.

Methods: A search was performed in PubMed, Embase, CINAHL, Scopus, Web of Science and CENTRAL. Systematic searches yielded N=6934 studies of which n=25 were relevant for inclusion after screening for eligibility. We included randomised controlled trials of adults (18-65 years) (body mass index ≥25 kg/m²) comparing dietary weight-loss interventions with resistance exercise to diet-only weight-loss interventions. The Cochrane Collaboration's risk of bias and GRADE (Grades of Recommendations Assessment, Development and Evaluation) assessment tools were used. A meta-analysis was performed, including those studies that compared dietary weight-loss plus resistance exercise interventions to diet-only weight-loss interventions.

Results: Overall, resistance exercise during diet-induced weight loss had no effect on body mass (mean difference between groups: -0.32 kg, p=0.35), with weight loss ranging from -2.5 kg to -20.9 kg in diet plus resistance exercise groups and from -0.7 kg to -20.4 kg in diet-only groups. However, resistance exercise protected against the loss of fat-free mass (between-group standardised mean difference (SMD): 0.40, p=0.0003, moderate certainty) and increased loss of fat mass (SMD: -0.36, p<0.00001, high certainty). Muscular strength was also significantly greater (SMD 2.36, p=0.00001) following the inclusion of resistance exercise (low certainty). No effects of resistance were seen in any of the other cardiometabolic markers studied.

Conclusion: In people living with obesity and overweight, the addition of resistance exercise to dietary restriction may enhance its beneficial effects. Current evidence, therefore, supports the implementation of resistance exercise during weight loss to attenuate the loss of fat-free mass (moderate certainty), increase loss of fat mass (high certainty) and improve muscle strength (low certainty).

Prospero registration number: CRD 42021266482.

Objectives: To compare injury incidences between the 2022/23 season and the preceding five seasons, and between World Cup players and non-World Cup players during the 2022/23 season.

Methods: During the 2022/23 season, 29 teams participated in the Union of European Football Associations Elite Club Injury Study and reported football exposures and injuries prospectively. Injury incidence was compared with that of the five preceding seasons for the full season and for periods before and after the Fédération Internationale de Football Association World Cup 2022. In addition, World Cup players were compared with non-World Cup players. Incidences were compared using rate ratio (RR) with 95% CI.

Results: Injury incidences during the 2022/23 season were similar to previous seasons except for training incidence which, due to a significantly lower incidence in the 2017/18 season compared with all other seasons, was higher during the full season (RR 1.10, 95% CI 1.00 to 1.21) and in the period before the World Cup (RR 1.17, 95% CI 1.02 to 1.35). World Cup players had similar injury incidences before and after the tournament (training incidence; RR 0.95, 95% CI 0.65 to 1.38, match incidence; RR 1.15, 95% CI 0.87 to 1.52) but a significantly lower match incidence than non-World Cup players before the tournament (RR 0.84, 95% CI 0.71 to 1.00).

Conclusions: No major changes in injury incidences were observed during the 2022/23 season compared with previous seasons. World Cup players experienced similar injury incidences before and after the tournament, and had a lower match injury incidence before the tournament compared with non-World Cup players.

Background: The use of continuous glucose monitors (CGM) in scuba diving for patients with type 1 diabetes (T1DM) shows potential but faces challenges related to accuracy. Previous research has highlighted the poor accuracy of the Dexcom G7 (DG7) in repetitive diving contexts. This study investigates the impact of calibration on the accuracy of DG7, providing valuable insights for patients and clinicians.

Materials and methods: In August 2024, 'Diabete Sommerso' organised a 4-day diving cruise around Elba Island (Italy) with 15 participants, including individuals with T1DM. Each participant with diabetes wore two DG7 sensors (one on the arm and one on the abdomen), calibrated daily and compared the results to capillary glucose (Beurer GL50Evo as the reference). Accuracy was assessed using mean absolute relative difference (MARD)/median ARD, Food and Drug Administration (FDA) integrated continuous glucose monitoring (iCGM) criteria and Surveillance Error Grid (SEG) analysis. Hypoglycaemia detection and trends were also evaluated.

Results: Eight participants with T1DM completed the study using 16 DG7 sensors with no detachments or skin reactions. Analysis of 765 sensor-capillary glucose pairs during 68 dives showed an overall MARD of 13.7%, with arm sensors (11% MARD) outperforming abdomen sensors (16%, p=0.0001). SEG analysis revealed that more than 97% of readings fell within the no-risk zone; however, the FDA's iCGM criteria for non-adjunctive use were not met.

Conclusions: Calibration improved the accuracy of DG7 in repetitive diving for patients with T1DM. However, capillary glucose checks remain essential, as non-adjunctive criteria were not met.

Background: Relative energy deficiency in sport (REDs) is a condition caused by chronic and/or severe low energy availability. Endurance athletes are at risk of REDs, which are characterised by negative effects on health and performance. Disturbed cholesterol metabolism is a suggested indicator of REDs and could affect the future cardiovascular health of athletes. We investigated the association between the REDs risk and cholesterol levels in endurance athletes.

Methods: Finnish endurance athletes (n=87; female 44, male 43) were recruited as part of the Athletic Performance and Nutrition study. The participants were examined at the beginning (T1) and end (T2) of the training season. The REDs risk was assessed using the REDs Clinical Assessment Tool version 2.

Results: At T1, 37 (77%) female and 31 (72%) male athletes were at medium-to-high REDs risk. The REDs risk was not associated with cholesterol levels in a cross-sectional analysis, and no overall change in the REDs risk or the cholesterol levels was observed between T1 and T2. In female athletes, an increase in REDs risk status from low to medium-to-high between T1 and T2 was associated with a decrease in low-density lipoprotein (LDL) cholesterol (beta adjusted for age -0.62, 95% CI -0.94 to -0.30) and total cholesterol (beta adjusted for age -0.85, -1.42 to -0.28)).

Conclusions: REDs risk was not associated with cholesterol levels at T1 or T2. However, in female athletes, an increase in the REDs risk across time points was associated with a decrease in LDL and total cholesterol levels.

Objectives: To describe training loads and injury incidences, and explore their relationship in senior schoolboy rugby players in Leinster, Ireland.

Methods: Prospective cohort study conducted during the 2019-2020 season. Methods aligned with consensus statements for rugby injury surveillance research. Injuries were coded using the Orchard Sports Injury Classification System (OSICS) version 10.1 and recorded using the World Rugby Injury Surveillance System. Training load measures (session type, duration and rate of perceived exertion) were recorded by the players using The Sports Office smartphone application.

Results: In total, 463 participants (mean age 17, (SD=0.9 years)) in 16 schools provided data over 20 weeks. Injury incidence per 1000 player hours was 19.9 (95% CI: 15.2 to 25.6) match injuries and 0.7 (95% CI: 0.4 to 1.0) training injuries. Median injury severity was 22 days (95% CI: 17 to 28) lost for match injuries and 14 days (95% CI: 5 to 41) lost for training injuries. Frequent injury sites included shoulder (n=23, 27%), head (n=22, 26%), wrist/hand (n=9, 11%), ankle (n=8, 10%) and knee (n=5, 6%). Tackle accounted for 49% of injuries. Players' recording of individual training load showed 11.5% compliance. Exposure was calculated as 31 141 training hours and 3063 match hours. Training sessions included conditioning weights (31%), rugby skills: non-contact (28%) and semicontact (24%), with variation in proportion of sessions across schools.

Conclusion: Match activity and tackle events accounted for most injuries. Training exposure and type varied widely across schools. Low compliance in recorded individual training load limited analysis of association with injury risk, highlighting the challenge in identifying injury risk factors in an adolescent cohort.