BMJ Open Sport & Exercise Medicine最新文献

Effective injury prevention programmes (IPPs) hold promise for mitigating ACL injuries in female handball players, yet adherence remains a challenge. This mixed methods study explores the relationship between programme usability characteristics and the potential effectiveness of a newly developed ACL IPP through survey and interview data from 23 female handball players aged 15-18 and their four coaches. Players' knee abduction moment (KAM) was measured during a cutting task and used to measure potential effectiveness. Findings reveal significant correlations between reductions in KAM and players' perceived effectiveness of the programme in reducing ACL injury risk and their intention to use it (Spearman's rho (r_s) -0.52, 95% CI -0.78 to -0.1, p=0.02 and r_s -0.46, 95% CI -0.75 to -0.03, p=0.04, respectively). Coaches and players identified efficiency and perceived effectiveness as key factors influencing programme adoption. Concerns regarding programme length and doubts about exercise efficacy and transferability emerged as barriers, while perceived effectiveness, efficiency and enjoyability were facilitators for programme use. Players' suggestions for programme improvement included shortening the duration and incorporating playful elements. Design thinking sessions yielded strategies to optimise time efficiency and integrate IPPs into existing training routines. The study reaffirms the importance of balancing programme effectiveness with practicality and clear communication about its purpose and benefits to facilitate programme adoption. Enhancing programme usability and involving all end-users in the design process are crucial steps toward promoting the acceptance and adoption of IPPs among target populations.

Aim: In the clinical setting of acute myocarditis, existing guidelines recommend refraining from moderate-intensity to high-intensity sports for 3-6 months, yet the extent to which these recommendations are implemented by clinicians and followed by patients remains unclear.

Methods: From January 2020 to December 2023, consecutive patients with myocarditis according to European Society of Cardiology criteria were prospectively enrolled. Myocarditis was categorised into acute, subacute and non-acute myocarditis. Patients completed a sports questionnaire and sports behaviour was categorised into no sports (NSP), recreational (REC) or competitive sports (COMP).

Results: A total of 165 patients with myocarditis (mean age 50±17 years, 35% women) completed the questionnaire. Overall 73 (44%) patients received sports counselling. A total of 44 (72%) patients engaged in sports (REC+COMP) with acute or subacute myocarditis, received sports counselling with 38 (87%) adhering. Overall COMP patients (all male) received more counselling (11/11; 100%) compared with REC (53/105; 50%) and NSP (9/49; 18%). Of 39 women in the REC group, 14 (36%) received recommendations, whereas of 66 men 39 (59%) received recommendations (p<0.001). Of all patients engaged in sports, 55% received recommendations. Self-reported adherence to recommendations was significantly lower in COMP (73%) compared with REC (92%, p<0.001).

Conclusion: Although only half of the myocarditis patients received counselling regarding sports activity, adherence to these recommendations was generally high but varied by activity level. Women received fewer recommendations overall compared with men. While competitive athletes were counselled more frequently than recreational athletes, they were less likely to adhere to the recommendations.

Objectives: Rugby Union has a relatively high risk of injury. Early evidence suggests a benefit of lowering tackle height to reduce head and neck injuries, although concerns persist among stakeholders regarding implementation challenges. This study aimed to understand whether referees can reach the same conclusion regarding tackle height in a controlled environment (ie, video) and whether priming influenced these decisions.

Methods: Forty-eight active referees completed a questionnaire based on high-tackle decision-making guidelines after watching tackles. Participants were randomly assigned one of two instructional videos containing a high or legal tackle to investigate the impact of priming on law interpretation.

Results: The percent agreement regarding tackle height was 78.1% between participants, 62.7% between participants and an experienced analyst, and 74.0% between participants and a gold-standard referee. Mean intra-rater reliability when determining whether a tackle was high was substantial (percent agreement: 91.2%). For high tackles, 83% of participants agreed on the danger level, 57% on the contact location and 71% on the presence of mitigating factors. No significant effects of priming were observed. Inter-rater agreement among participants and the gold-standard referee was moderate for all items except danger and height, which showed strong agreement.

Conclusion: These results suggest a need for improved referee training to support changes to the legal tackle height.

Understanding and predicting individual responses to common stressors is essential for optimising performance in high-stress environments. This article outlines a protocol for a study to identify biomarkers that predict performance under heat, musculoskeletal, psychosocial and sleep stress, for future integration into a wearable sensor system. In Phase I, healthy adults aged between 18 and 45 years (n=104) will be recruited for an intervention trial that involves exposure to one of the four stressors: heat, musculoskeletal, psychosocial or sleep deprivation. Biomarkers will be identified from molecular markers in biological samples (eg, blood, saliva, sweat and stool), physiological measures and psychological assessments to predict cognitive and physical performance under stress. A within-subjects design will determine changes in molecular and non-molecular markers before and after stress exposure. In Phase II, we will use the biomarkers identified in Phase I to develop a wearable sensor to predict and monitor human performance under stress.

Objectives: To explore the effects of two different types of exercise (individual vs group) on physical activity (PA) among Croatian university students.

Methods: A total of 976 university students between the ages of 19 and 20 years (age 19.4±1.1 years, body mass index 21.9±2.9 kg/m²) were randomly assigned to either the control group (individual exercise) (n=504) or the intervention group, which received group exercise (n=472). Pre- and postintervention measures included: self-rated health, parents' occupation, psychological distress, nutritional status and PA levels. The overall intervention effect was estimated using linear regression method, and heterogeneity in intervention effect was assessed by modelling complex variance.

Results: Group-based exercise intervention significantly increased total PA time by more than 10 metabolic equivalents (METS) hours per week compared with individual-based exercise control group. When considering different types of activities, the intervention effect was stronger for vigorous activity (increase by almost 6 METS hours per week) than walking activity (2.5 METS hours per week). The change in moderate activity level was not significant after covariate adjustment. In addition, intervention was also effective in reducing sedentary hours. Finally, when complex level-1 heterogeneity was modelled by intervention status, we found substantially larger variance in the intervention group compared with the controls, indicating presence of heterogeneous treatment effect.

Conclusions: This study discusses major implications of different ways of exercising among youths from a health, educational and sport perspective. Intervention and policies that leverage school social capital might serve as an avenue for health promotion in youth.

Abstract:

Objective: While emergency care for sudden cardiac arrest (SCA) is strictly regulated in professional football, the situation in amateur football is unclear. This study investigated the emergency readiness for SCA in German amateur football clubs.

Methods: A cross-sectional survey of 253 German amateur football clubs (fifth division and lower) was conducted between January and August 2023. Club representatives participated in a 30-point questionnaire on automated external defibrillator (AED) availability, visibility, purchase, usage, frequency of staff trained in cardiopulmonary resuscitation (CPR) and AED usage, regular CPR and AED training, and the existence of an emergency action plan (EAP).

Results: 161 of 253 eligible clubs (64% response rate) participated. An AED was available in 48/161 (30%) clubs. 46 of 161 clubs (29%) had no CPR-trained staff. A high availability of CPR- and AED-trained staff (>75% likelihood of being present at the pitch) was more likely during a match (61% and 84%) than training (40% and 51%), respectively. Retrospectively, over 7 years, five clubs reported that CPR-trained staff used an AED, resulting in a survival rate of 80%. 16 clubs (10%) had an EAP in the event of an SCA.

Conclusion: German amateur football clubs show low emergency readiness for SCA despite a promising survival rate when an AED is used by CPR-trained staff on-site. Regular CPR and AED training for club members, increased availability of AEDs, and the development of EAPs might be beneficial in responding adequately to an SCA during football training and matches.

Objective: To describe the incidence and characteristics of match and training injuries in the UK Vitality Netball Superleague (VNSL).

Methods: Ninety players were observed over one 14-month VNSL season (2021), including pre-, in- and post-season periods. Team physiotherapists recorded injuries using an online surveillance system, classifying them by location, type, mode, mechanism and impact, including severity (time-loss days, TL) and medical attention days (MA). Injury incidence (I) and TL/MA injury burden were calculated per 1000 player hours. χ² analysis compared match and training differences.

Results: Thirty-nine players sustained 70 injuries (n=35 match, 35 training). Match incidence exceeded training (I=41.12 vs 1.10 injuries). Acute injuries were higher in matches (27 vs 17), while overuse injuries were higher in training (18 vs 3; p=0.001). Contact injuries were higher in matches (21 vs 7), and non-contact injuries were higher in training (10 vs 6; p=0.028). Acute ankle ligament injuries in matches caused substantial TL burden (411.7 days lost), while overuse lower leg injuries in training led to high MA burden (13.8). Anterior cruciate ligament (ACL) injuries were infrequent but burdensome (TL 496). The centre position sustained the most injuries (41%).

Conclusion: This study underpinned implementing the first injury surveillance system in the elite UK netball competition, revealing match injury rates ~40 times higher than in training, with distinct injury characteristics. Findings suggest that prevention should target acute lower limb injuries and overuse conditions. Further research should assess the impact of playing with overuse injuries.

Objectives: As a high-intensity intermittent sport with short and repeated rapid accelerations, decelerations and changes of direction, badminton involves high joint and muscle loads. This review aims to identify relevant injury risk characteristics and factors that facilitate developing and implementing badminton-specific injury prevention programmes.

Design: This systematic review of badminton injuries assessed the risk of bias, injury incidence, mechanism, location, type, severity, and risk factors.

Data sources: PubMed, WoS, SURF, EBSCO, Ovid and SPORTDiscus.

Eligibility criteria: Only English or German peer-reviewed articles presenting epidemiological data. All age groups, genders and levels of play were represented.

Results: Examination of 19 studies with male (60%) and female players (41%) at different player levels (age: 10-50 years). The mean injury incidence was between 1 and 4 injuries/1000 hours, whereby the incidence in the studies that were only carried out with elite players tended to be at the upper end. Lower body injuries occurred most frequently (41%-92%), including strains (11%-64%), sprains (10%-61%), tendinopathy (6%-14%) and stress fractures (5%-11%). There was a high proportion of overuse injuries (25%-74%) and a predominance of mild and moderate injuries (73%-100%). The following risk factors can only be cautiously emphasised due to the heterogeneous results: The risk of injury increases with increasing level of play and a history of injury.

Conclusion: Young players with a history of injury quickly moving to higher competition classes must be targeted with the highest injury prevention priority. Future studies should focus on improving the quality of studies by using comparable data collection methods.