BMJ Open Sport & Exercise Medicine最新文献

Objectives: To date, consistent evidence for consequences of heading in football (soccer) on the structure and function of the brain is lacking, but first studies indicate a potential effect of specific high-magnitude headers. The purpose of this longitudinal, prospective study was to investigate whether potential structural and/or functional alterations within the brain were associated with (high-magnitude) heading.

Methods: 3T MRI sequences were obtained from active high-level male players before and after an observation period of 17.2 months (median). Cortical thickness and grey matter (GM) volume were investigated on a whole-brain level. Functional connectivity (FC) was analysed in the default mode network (DMN) and salience network (SN). During the observation period, each training and each match was videotaped and evaluated regarding the heading exposure. Significant structural and functional findings were subsequently correlated with specific header characteristics.

Results: 14 included participants (mean age: 20.36±3.34 years) played 5822 headers. GM volume remained unchanged, whereas cortical thickness decreased minimally from pre-measurement to post-measurement in a left precentral region (mean change: 0.048±0.128 mm; clusterwise p=0.0416). Within the SN, FC increased in one cluster (false discovery rate corrected p=0.026). FC remained stable within the DMN and between DMN and SN. Change from pre-measurement to post-measurement for the significant results did not correlate with heading variables.

Conclusion: Our findings may indicate no cumulative effect of heading during the observation period. As these results contrast with cross-sectional findings, more longitudinal, prospective studies with a greater sample size are urgently needed to understand potential heading effects.

Objectives: Although photobiomodulation therapy combined with static magnetic field (PBMT-sMF) has demonstrated benefits for enhancing performance and recovery when applied before or after exercise sessions, its effects on adaptations during periods without training after strength training protocols remain unexplored. Therefore, we aimed to evaluate the effects of PBMT-sMF on the maintenance of muscle strength and structural properties of the quadriceps during a 4-week detraining period following a 12-week resistance strength training programme.

Methods: In this triple-blind, randomised, placebo-controlled trial, 48 healthy men were randomised to one of four groups: PBMT-sMF during both training and detraining, PBMT-sMF during training and placebo during detraining, placebo during training and PBMT-sMF during detraining or placebo throughout. All participants completed 12 weeks of unilateral resistance training (leg press and leg extension, twice weekly), followed by 4 weeks of detraining. PBMT-sMF or placebo was applied bilaterally to the anterior thigh prior to each session of exercise and two times per week during detraining. Outcomes included maximal voluntary contraction (MVC, primary outcome), as well as one-repetition maximum (1RM), muscle volume and anatomical cross-sectional area, measured at baseline and weeks 4, 8, 12 and 16.

Results: PBMT-sMF significantly preserved muscle strength (MVC and 1RM) and structural features (volume and anatomical cross-sectional area) during detraining compared with placebo (p<0.05). The group that received PBMT-sMF during both the training and detraining phases demonstrated the greatest preservation across all outcomes.

Conclusion: PBMT-sMF significantly attenuated strength loss and structural muscle changes during the detraining period after a resistance training programme.

Trial registration number: NCT03858179.

Objectives: Para athletes may face unique challenges in the anti-doping system, including issues of privacy, implementation, comprehension and accessibility. While previous studies have examined non-disabled athletes' views, little is known about how international elite Para athletes perceive anti-doping procedures. The aim of this study was to increase the understanding of elite Para athletes' experiences and perceptions of anti-doping procedures.

Methods: Using a cross-sectional observational study design, data were collected via an online questionnaire distributed during major international Para competitions. A total of 109 elite Para athletes from 25 countries, representing three impairment groups-physical, visual and intellectual impairments-participated in the study. Data were analysed using descriptive statistics and non-parametric analytical tests.

Results: Among elite Para athletes, 27% had never received anti-doping education during their sports careers, while those who had received such education felt more confident in staying updated on the prohibited list. Over half had never undergone doping testing, and over 70% had never submitted whereabouts information. Most athletes who had been tested found the procedure respectful and adapted to their impairment. However, 25% could not provide a urine sample without assistance from a doping control officer or another person. Furthermore, 40% of those who had submitted whereabouts information said updating it reduced their enjoyment of being an elite athlete.

Conclusions: This study shows that many Para athletes, even at the elite level, have limited experience with key anti-doping procedures, highlighting a need for more inclusive, prioritised and accessible anti-doping efforts tailored to the needs of Para athletes.

Objectives: To examine the existing literature on the impact of outdoor, non-electric mountain biking on adolescent well-being, focusing on behavioural, emotional and social outcomes.

Design: Scoping review conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (2020 update) and the framework by Arksey and O'Malley, with methodological guidance from the Joanna Briggs Institute.

Data sources: Six databases, Medline, EMBASE, PsycINFO, CINAHL, SPORTDiscus and SCOPUS, were systematically searched in November 2024 and July 2025, supplemented by citation tracking and grey literature review. The protocol was registered on the Open Science Framework (DOI: 10.17605/OSF.IO/7CVWD).

Eligibility criteria for selecting studies: Included studies focused on adolescents aged 10-18 years, examined outdoor, non-electric mountain biking as the primary intervention, reported at least one well-being outcome and published in the last decade. Both qualitative and quantitative designs were eligible. Excluded were adult populations, e-biking, indoor cycling and studies without relevant well-being outcomes.

Results: Five studies met inclusion criteria. Programmes were associated with improved self-esteem, resilience, emotional regulation and social connection. Mentorship, peer engagement and nature exposure emerged as key facilitators. Quality appraisal using the Mixed Methods Appraisal Tool indicated moderate to high methodological rigour.

Conclusion: Preliminary evidence suggests mountain biking may contribute to adolescent well-being, particularly in self-confidence, social connection and resilience. Its combination of physical challenge, social support and green exercise makes it a potentially valuable youth mental health strategy. Further research should examine long-term impacts and comparative effectiveness.

Collecting an account of practitioners' lived experiences of on-pitch concussion management in football provides real-world insight into areas for improvement, and future research direction. Previous research suggests that healthcare professionals (HCPs) in football are confident with on-pitch concussion recognition; however, some players are still returned to the field to later be removed with a concussion.

Objectives: The aim of this study is to understand the on-pitch assessment procedure of HCPs and factors that may influence whether or not a player is removed following a suspected head injury in football based on semistructured interviews.

Methods: 10 elite-level pitch-side HCPs participated in a semistructured interview. Recorded interview transcripts were analysed via reflexive thematic analysis. This process generated four key themes: time, formalised procedure for identifying concussion, interpretation of behaviour and stakeholder actions.

Results: This study provides evidence that HCPs in football feel that they do not have enough time to conduct a thorough concussion assessment. Assessments are currently subjective and rely on the sideline healthcare staff's relationship with the player to determine if they are acting normally. The HCPs value seeing the mechanism of injury and advocate the use of video replays. Temporary concussion substitutes would allow more time for assessment and for the use of assessment tools such as the Sport Concussion Assessment Tool.

Conclusions: Based on the current findings, research should focus on developing multimodal testing batteries to detect concussion on-pitch, while football should consider implementing video analysis at all levels and temporary concussion substitutes.

Short set configurations attenuate cardiovascular responses, reduce perceived exertion and allow for greater mechanical performance compared with longer sets. Mid-term to long-term adaptations to resistance training across set configurations remain unexplored in postmenopausal women. This study will explore cardiovascular, metabolic, neuromuscular and perceptual adaptations to 12-week resistance training programmes differing in set configuration. Forty physically active postmenopausal women will participate. After medical screening, they will complete four pretest assessments measuring cardiovascular, metabolic, neuromuscular and body composition variables. Participants will then be randomly assigned to a control group or one of two experimental groups. Each session, experimental groups will complete 36 repetitions per exercise (leg press, bench press, leg curl and lat pull-down) with a 12-repetition maximum load. The 4S group will complete nine sets of 4 reps with 45 s of rest, while the 9S group will do four sets of 9 reps with 120 s of rest. The intervention will span 12 weeks with 24 training sessions. Afterwards, all participants will repeat the initial assessments. Experimental groups will return 3 months later for follow-up evaluations of cardiovascular, metabolic and body composition outcomes. A 3×3 repeated-measures analysis of variance will be used to analyse the effects of set configuration (4S, 9S, control) over time (pretest, post-test, follow-up). The study was approved by the Galician Regional Government Ethical Committee. All participants will receive detailed oral and written information before providing informed consent. Results will be widely disseminated, including through outreach events to promote knowledge transfer. Trial registration number: NCT05544357; registration date: 7 December 2022.

Time-to-event is a powerful statistical approach increasingly used in sports science and medicine to examine time-to-event outcomes such as time to sports injury occurrence, career duration and recovery processes. This scoping review aims to systematically assess the methodological quality and reporting practices of studies published within the sports science and medicine domain using time-to-event techniques (eg, Cox regression). We conducted a scoping review of 138 original studies published between 2013 and 2023. Studies were identified from PubMed and Web of Science, and methodological reporting was evaluated using the Statistical Analyses and Methods in the Published Literature guidelines, focusing on statistical methods, model assumptions, censoring and reporting of survival measures. Reporting deficiencies were widespread. Over 90% of studies did not report the number of individuals at risk at each time point, 75% did not adequately address assumptions underlying survival models and 62% did not clearly define the purpose of the analysis. Only 20% reported median survival times when pertinent, and reporting of HRs and reasons for censoring was often incomplete. Slight improvements were observed in studies published after 2020, but major gaps remain. These findings highlight the need for improved methodological transparency, adherence to reporting standards and comprehensive statistical education. Enhancing these aspects will strengthen the reproducibility, interpretability and practical relevance of time-to-event studies in sports science and medicine.

Women with clinically severe obesity are at risk of poor physical and mental health. Lifestyle interventions must be developed to support exercise participation for this group. The factors influencing the involvement of women with clinically severe obesity in such programmes require investigation. This study aimed to identify barriers and facilitators to the initiation and maintenance of exercise training for women with severe obesity before, during and after participation in a weight loss study. Women with obesity were recruited for participation in a randomised controlled trial (n=60) investigating the effects of energy restriction (ER) with (energy restriction plus exercise (EXER): n=30) and without (ER: n=30) the addition of exercise. Following the 12-month intervention, n=11 (all from the EXER group) women agreed to participate and were interviewed to retrospectively explore their experiences of exercise engagement before, during and after the programme. Participants also provided their own suggestions for improving future exercise and weight loss programmes. Data were then transcribed verbatim, and reflective thematic analysis was used. Five themes related to intrapersonal and social components of the social ecological model were constructed and included: 'weight', 'concerns about physical limitations' and 'exercise confidence and enjoyment'. Social themes were 'work and family commitments' and 'accountability and support'. Women with clinically severe obesity most commonly reported intrapersonal and social influences of exercise participation. This study's results may help inform the exercise programme development of practitioners and further intervention development at a population level.

Decision-making for the optimal management of traumatic knee injuries can be challenging. Clinical trials reveal only small differences between surgical and non-surgical approaches, while patient and clinician biases, as well as healthcare access issues, may also influence management. Little is known about the real-world healthcare pathways for patients with a knee injury, as well as the person- and/or healthcare-related factors that influence management strategies and outcomes. The Australian Knee Injury Inception Cohort Study (KIICS) aims to: (1) describe healthcare pathways following acute knee injury (including the timing and type of healthcare consultations); (2) identify patient- and/or healthcare-related predictors of management strategy (ie, surgical vs non-surgical); and (3) examine the long-term outcome of different injury types, healthcare pathways and management strategies. KIICS is a nationwide prospective longitudinal inception cohort study recruiting Australians who have sustained an acute knee injury within the previous 6 months that disrupted daily activities or sports and led to a healthcare consultation. Participants will complete online questionnaires at enrolment and at 6 months, 1, 2, 5 and 10 years post-injury. The data to be collected will include sociodemographic characteristics, knee injury history, the sequence of healthcare consultations and referral patterns, and management strategies (ie, surgical vs non-surgical). Patient-reported outcomes will include knee pain and instability, knee-related quality of life, patient-acceptable symptom state, health-related quality of life, mental health, fear of reinjury, return-to-sport status and activity level. Detailed statistical analysis plans will be developed to address the study's key research questions, informing clinical practice, shared decision-making and healthcare policy.