BMJ Open Sport & Exercise Medicine最新文献

Sports concussion is a common and costly injury, and increased public injury awareness could help reduce costs. Many factors, including public messages about sports concussion by the sports media, shape public injury awareness. Empirical analyses show that this messaging can be poor. The proposed solutions include providing media guidance, but little is known about this topic. This scoping review will enable a systematic search and synthesis of guidance materials for improved health messaging of sports concussion by the mass media. The five review stages are (1) determining the research question, (2) identifying relevant materials, (3) selecting relevant information, (4) data extraction and (5) analysis and presentation of the results. A brief protocol will be registered on a recommended platform (Open Science Framework). The search strategy will access 20 databases, as well as Google and Google Scholar, and include hand searching. Selected materials must describe or provide mass media guidance for sports concussion by a health-affiliated authority. Eligibility will be confirmed via a two-stage screening process, including independent assessment. Data from eligible materials will be extracted and collated in tables. If sufficient or appropriate materials are identified, the synthesis will draw on key evaluative resources related to injury management and guideline development methodologies. The knowledge synthesis will use descriptive and narrative methods to determine what is known on this topic, including documenting existing guidance (content and properties) and using the extracted data to inform recommendations for future guidance.

The incidence of injuries reported in artistic gymnastics varies greatly. This is partly due to inconsistencies in defining and reporting injuries in artistic gymnastics. The objective was to develop consistent definitions and methodology for reporting injuries in artistic gymnastics. A group of medical practitioners working with international-level artistic gymnasts from America, Asia, Australia and Europe came to a consensus on recommendations for defining and reporting injuries in artistic gymnastics. Development of the consensus statement was achieved through in-person and online discussions, online surveys and post meeting electronic discussions. This consensus statement is meant to serve as an extension to the recommendations made by the IOC on injury surveillance. The statement includes specific recommendations of injury definitions, characterising activity at the time of injury, and describing injury burden in artistic gymnastics. The following consensus statement has been developed to encourage consistency of injury surveillance in artistic gymnastics. Reporting injury in a consistent manner will help understand the true burden of injury in artistic gymnastics and help guide future work in injury prevention.

Following a mild traumatic brain injury (mTBI; also known as concussion), physiotherapists may be involved in injury identification, assessment and rehabilitation. However, how people perceive and experience the physiotherapist's role is not well understood. Semistructured interviews were undertaken with patients who saw a physiotherapist individually or as part of a multidisciplinary team following mTBI in New Zealand. Interviews were recorded, transcribed verbatim and analysed using the interpretive descriptive approach. A total of 12 interviews were held with participants aged 19-67 (50% female; mean age 37 (SD=14.8) years) who had a mTBI on average 9 (SD=8) months ago. Thematic coding of interviews generated four themes, each supported by three to five categories representing their experiences: (1) 'How physiotherapy could help me'-representing how the interventions were delivered; (2) 'Empower me to manage my mTBI'-representing participants learnings to self-manage; (3) 'Set me up to get the most out of treatment'-representing considerations needed before, during and after practice to maximise engagement and (4) 'Get to know me and what's important to me'-representing the importance of considering the person as a whole, and preferences for assessment, intervention, communication and culture throughout service delivery. Overall, participants reported variable mTBI care experiences yet perceived the physiotherapist as having a key role in supporting self-management and treating headaches, neck pain and balance issues. mTBI physiotherapy care needs to be more attuned to patients' preferences and circumstances and delivered in a way that maximises rehabilitation outcomes. Building effective therapeutic connections with patients may be key to addressing these concerns simultaneously in practice.

A high incidence of injuries has been reported in young athletes. Several factors have been associated with athletes' sports injuries. However, scientific evidence is lacking, particularly for adolescent athletes. Hence, the Healthy Injury-Free Adolescent Athletes (HIFAA) was designed to evaluate sports injuries and examine associations with risk factors related to physical load and mental health. Secondary aims are to evaluate differences between sex, age, high school year and sports and examine injuries and the athletic situation 5 to 10 years after graduation. Adolescent athletes aged 15-19 years enrolled in high school and competing in sports to reach a national or international level of sports will be included. At inclusion, athletes will sign an informed consent form and fill out a baseline questionnaire addressing potential risk factors (eg, sports, training and competing health and injuries, and psychosocial status). Athletes will then prospectively be monitored weekly regarding injuries, physical (training/match/competing, perceived exertion) and psychological (fatigue, sleep, mental stress, recovery) load until graduation. A shortened version of the baseline questionnaire will be filled out every year, and a follow-up questionnaire regarding injuries, sporting situations and mental health will be filled out 5-10 years after graduation. Injuries are frequent among adolescent athletes, with consequences ranging from shorter interruptions in sports performance to mental health problems and early termination of sports. A reduction of these injuries is warranted. This study will provide a detailed understanding of risk factors, a prerequisite to introducing appropriate preventive measures.

Objective: A few video analysis studies have been published in recent years, but none specifically on Spanish football. We aimed to describe the mechanisms, situational patterns, biomechanics and neurocognitive errors related to anterior cruciate ligament (ACL) injuries in professional Spanish football matches.

Methods: We identified 167 consecutive ACL injuries across 12 seasons of the top two leagues in Spanish football. 115 (69%) injury videos were analysed for mechanism and situational pattern, while biomechanical analysis was possible in 81 cases. Neurocognitive errors were investigated for all non-contact injuries. Three independent reviewers evaluated each video. ACL injury epidemiology-month, timing within the match and pitch location at the time of injury was also documented.

Results: More injuries occurred in defensive (n=68, 59%) than offensive (n=48, 41%) (p<0.01) playing situations. 16 (14%) injuries were direct contact, 49 (43%) indirect contact and 50 (43%) non-contact. Most injuries (89%) occurred during four main situational patterns: (1) pressing/tackling (n=47, 47%); (2) tackled (n=23, 23%); (3) landing from a jump (n=12, 12%) and regaining balance after kicking (n=6, 6%). Injuries generally involved a knee-dominant loading strategy in the sagittal plane with abducted hip and knee valgus. Of the non-contact injuries, 39 (78%) were deemed to involve a neurocognitive error. More (58%) injuries occurred in the first half of matches (p<0.01).

Conclusions: ACL injuries in Spanish football occurred similarly with non-contact and indirect contact mechanisms (44%). Four in five non-contact injuries involved a neurocognitive error. Most injuries occurred during four previously identified situational patterns, with more injuries earlier in the match.

Objective: To determine whether vitamin D supplementation influences grip strength, explosive leg power, cardiorespiratory fitness and risk of exercise-induced bronchoconstriction (EIB) in South African schoolchildren.

Methods: Substudy (n=450) in Cape Town schoolchildren aged 8-11 years nested within a phase 3 randomised placebo-controlled trial (ViDiKids). The intervention was weekly oral doses of 10 000 IU vitamin D₃ (n=228) or placebo (n=222) for 3 years. Outcome measures were serum 25-hydroxyvitamin D₃ (25(OH)D₃) concentrations, grip strength, standing long jump distance, peak oxygen uptake (VO_2peak, determined using 20 m multistage shuttle run tests) and the proportion of children with EIB, measured at end-study.

Results: 64.7% of participants had serum 25(OH)D₃concentrations <75 nmol/L at baseline. At 3-year follow-up, children randomised to vitamin D versus placebo had higher mean serum 25(OH)D₃ concentrations (97.6 vs 58.8 nmol/L, respectively; adjusted mean difference 39.9 nmol/L, 95% CI 36.1 to 43.6). However, this was not associated with end-study differences in grip strength, standing long jump distance, VO_2peak or risk of EIB.

Conclusion: A 3-year course of weekly oral supplementation with 10 000 IU vitamin D₃ elevated serum 25(OH)D₃ concentrations in South African schoolchildren but did not influence muscle strength, exercise capacity or risk of EIB.

Objective: To determine whether weekly oral vitamin D supplementation influences grip strength, explosive leg power, cardiorespiratory fitness or spirometric lung volumes in Mongolian schoolchildren.

Methods: Multicentre, randomised, placebo-controlled clinical trial conducted in children aged 6-13 years at baseline attending 18 schools in Ulaanbaatar. The intervention was weekly oral doses of 14 000 IU vitamin D₃ (n=4418) or placebo (n=4433) for 3 years. Outcome measures were grip strength, standing long jump distance and serum 25-hydroxyvitamin D (25(OH)D) concentrations (determined in all participants), peak oxygen uptake (VO_2peak, determined in a subset of 632 participants using 20 m multistage shuttle run tests) and spirometric outcomes (determined in a subset of 1343 participants).

Results: 99.8% of participants had serum 25(OH)D concentrations <75 nmol/L at baseline, and mean end-study 25(OH)D concentrations in children randomised to vitamin D versus placebo were 77.4 vs 26.7 nmol/L (mean difference 50.7 nmol/L, 95% CI 49.7 to 51.4). However, vitamin D supplementation did not influence mean grip strength, standing long jump distance, VO_2peak, spirometric lung volumes or peak expiratory flow rate, either overall or within subgroups defined by sex, baseline 25(OH)D concentration <25 vs ≥25 nmol/L or calcium intake <500 vs ≥500 mg/day.

Conclusion: A 3-year course of weekly oral supplementation with 14 000 IU vitamin D₃ elevated serum 25(OH)D concentrations in Mongolian schoolchildren with a high baseline prevalence of vitamin D deficiency. However, this intervention did not influence grip strength, explosive leg power, peak oxygen uptake or spirometric lung volumes, either overall or in subgroup analyses.

Trial registration number: NCT02276755.

Our objective was to explore athlete's and sports physiotherapists' experiences of sports-related pain in the upper and lower limb. Using a constructivist and pragmatic perspective, we carried out focus groups comprising a deliberate criterion sample of athletes and sports physiotherapists. We used a topic guide that moved from open exploratory questions to questions focusing on the phenomena of sports-related pain in athletes. We coded, developed candidate themes and refined finalised themes using reflexive thematic analysis. A member of our research team acted as a critical friend adding additional perspectives. We followed the Consolidated Criteria for Reporting Qualitative Research (COREQ). We completed five focus groups comprising 12 athletes (n=5 female, n=7 male) and four sports physiotherapists (n=4 male) including one initial pilot (two athletes). We developed four final themes (1-4) and nine subthemes (1.1-4.3): (1) Athlete Pain Lens (1.1-pain is part of being an athlete and 1.2-pain shapes the life of an athlete), (2) Exploring And Navigating Pain (2.1-the sports-related pain spectrum and 2.2-making sense of pain), (3) The Emotional Toll of Pain (3.1-challenging emotions and 3.2-the impact of time) and (4) Coping, Community and Communication (4.1-coping with pain, 4.2-influence of community and support network and 4.3-communication, the broken key). We highlighted the distinct and challenging phenomenon of sports-related pain experienced by athletes and physiotherapists. Through effective communication, members of the athlete's community may recognise, and adjust to these challenges.

Photobiomodulation therapy (PBMT), as an adjunct therapy to exercise, can reduce pain in musculoskeletal disorders. In addition, PBMT associated with exercise decreases fatigue, accelerates muscle recovery and enhances performance and gain through different training protocols. Although it has not been investigated, the association of PBMT and exercise therapy could be an alternative to improve the positive effects of exercise in patients with non-specific low back pain (LBP). Therefore, we aim to evaluate the effects of PBMT associated with motor control exercise (MCE) versus placebo associated with MCE in patients with chronic non-specific LBP. This is a prospectively registered, two-arm, randomised, placebo-controlled, triple-blind trial. A total of 148 patients with chronic non-specific LBP will be randomised to either active PBMT associated with MCE or placebo PBMT associated with MCE. Treatment sessions will be provided twice a week for 6 weeks. The primary outcomes will be pain intensity and general disability measured at the end of the treatment. The secondary outcomes will be pain intensity and general disability measured 1 month after the end of the treatment, 3, 6 and 12 months after randomisation, in addition to levels of prostaglandin E2 measured at the end of the treatment. Medication intake, cointerventions and adverse events will be measured at all time points. This study was approved by the Research Ethics Committee of Irmandade de Santa Casa de Misericórdia de Porto Alegre. The results will be disseminated through scientific publications and presentations at scientific meetings. Trial registration number: NCT05487118.