BMJ Open Sport & Exercise Medicine最新文献

Objectives: Physical function is often a main focus of knee injury rehabilitation, but recent recommendations include increasing attention to psychological factors. We have developed the MOTor Imagery to Facilitate Sensorimotor re-learning (MOTIFS) training model which integrates dynamic motor imagery into physical rehabilitation. The objective is to report interim analysis results of an adaptive randomised controlled trial regarding the pre-defined continuation criteria.

Methods: Following a 12-week intervention in which participants were randomised to either MOTIFS or Care-as-Usual training, n=42 people undergoing rehabilitation for a traumatic knee injury were assessed for change from baseline to follow-up in psychological readiness to return to activity, using the ACL Return to Sport after Injury Scale (ACL-RSI), and side hop limb symmetry index. Continuation criteria included differences of ≥5 points in ACL-RSI and ≥8 points in side hop limb symmetry index in favour of the MOTIFS group. If these were not met, ≥5 points change in enjoyment was acceptable.

Results: Pre-defined continuation criteria were not met for ACL-RSI (mean difference -8.1 (SE 4.1)), side hop limb symmetry index (mean difference 4.4 (SE 7.8)), nor enjoyment (mean difference 3.9 (SE 4.5)), indicating that major modifications are required for continuation of the MOTIFS trial.

Conclusion: While results of this interim analysis did not show differences in psychological readiness to return to activity or side hop performance, previous research shows that the MOTIFS model is positive and enjoyable. Further research is warranted to evaluate more appropriate outcomes related to the holistic nature of physical and psychological readiness to return to activity.

Trial registration number: NCT03473821.

Objectives: This study aimed to evaluate the effects of a novel, low-volume combined high-intensity interval training (HIIT) and progressive resistance training (PRT) in overweight/obese adults.

Methods: This randomised control trial compared the effect of regular supervised HIIT combined with PRT (Exercise) with an unsupervised stretching intervention (Control), in previously inactive adults with either normal glucose (NG), pre-diabetes or type 2 diabetes (T2DM) with body mass index of >25 kg/m². Participants were randomly allocated (1:1) to receive low-volume exercise or control by an online randomisation tool. The primary outcome was the difference in change of hepatic steatosis between Exercise and Control. A prespecified sensitivity analysis was undertaken for weight stable participants (<5% change in bodyweight from baseline). Secondary outcomes were change in hepatic steatosis within the glucose groups, glycaemic control, cardiorespiratory fitness, muscle strength and body composition.

Results: Between June 2018 and May 2021, 162 participants were randomly assigned (NG: 76, pre-diabetes: 60, T2DM: 26) and 144 were included in the final analysis. Mean absolute change in hepatic steatosis was -1.4% (4.9) in Exercise (n=73) and -0.1% (7.2) in Control (n=71)(p=0.25). By preplanned sensitivity analysis, the mean change in hepatic steatosis with Exercise (n=70) was -1.5% (5) compared with 0.7% (4.6) with Control (n=61) (p=0.017). Subgroup analysis within the glucose groups showed that exercise reduced hepatic steatosis in those with pre-diabetes but not NG or T2DM (pre-diabetes: -1.2% (4.4) in Exercise and 1.75% (5.7) in Control, p=0.019).

Conclusion: These findings show that low-volume HIIT with PRT yields improvements in muscle strength and cardiorespiratory fitness and may have a small effect on hepatic steatosis.

Trial registration number: The trial was prospectively registered with the ANZCTR (ACTRN12617000552381).

Background: There is a research gap in the survey of injuries and illnesses in the sport of luge.

Objective: To analyse the type, frequency and burden of injuries and illnesses that occurred over a preparation period and a competition period in elite luge athletes.

Methods: In total 40 elite luge athletes, who were all part of a national team and competed internationally, self-reported acute injuries, overuse injuries and illnesses weekly using the Oslo Sports Trauma Research Centre Questionnaire on Health Problems.

Results: The most frequently stated health problems were illnesses with 41.9% (n=75), followed by acute injuries at 31.9% (n=57). Overuse injuries accounted for 24.0% (n=43). Illnesses represented the greatest burden with a median severity score of 60.0 (IQR: 23.63), followed by acute injuries with 42.0 (IQR: 26.83) and overuse injuries with 35.0 (IQR: 23.95). In the case of acute injuries, the anatomical regions most affected were the hand (n=8, 14.0 %), foot (n=8, 14.0 %), head (n=7, 12.3 %) and neck (n=6, 10.5 %). In the case of overuse injuries, the shoulder (n=9, 20.9 %) and lumbar spine (n=7, 16.3 %) were most frequently reported. Strains (n=15, 26.3 %) and contusions (n=14, 24.6 %) were the predominant types of acute injuries. Four concussions were recorded, with none of the athletes taking a break from normal training of more than 3 days. This stands in contrast to the current recommendations for the return to sport after concussion.

Conclusion: The results of this study represent the current incidence rates and health burden of acute and chronic injuries in this constantly evolving sport. 95% of all athletes reported at least one health problem during the observation period. These findings support the need for specific prevention programmes. The establishment of a concussion protocol should be considered.

The long-term health effects of football (soccer) have received significant attention in recent years. While brain health is currently the focus of this interest, potential long-term risks or benefits related to cardiovascular and metabolic diseases and cancer are also of interest to sports medicine professionals. However, studies assessing the overall health risks for professional football players remain scarce. We introduce 'SoccHealth', a satellite project to the German National Cohort (NAKO), Germany's largest population-based cohort study. SoccHealth examined 348 former professional football players aged 40-69 using the infrastructure and comprehensive examination programme of NAKO. The German Statutory Accidental Insurance for Professional Athletes identified and invited male players, while female players were recruited among former national team members. Details of the examination programme and the sociodemographic and career-related characteristics of the participants are described. The identical examination programme for the NAKO participants provides the opportunity to draw general population controls according to various definitions and focus on the respective research question to be analysed. This report delineates one approach to evaluate the long-term health effects of football across a broad range of diseases.

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.

Abstract:

Background: Low energy availability (LEA) occurs when athletes' energy intake fails to match the energy expended during exercise, resulting in insufficient energy to support essential functions for optimal health, a condition known as relative energy deficiency in sports (REDs).

Objective: This study aims to explore the prevalence of LEA among Malaysian national athletes and its associations with health-related outcomes.

Methods: A total of 43 athletes (51.2% males, aged 18-40) identified previously as having moderate or high risk of REDs through a questionnaire underwent comprehensive clinical assessments. Resting metabolic rate (RMR) was measured using indirect calorimetry, with an RMR ratio of <0.90 indicating LEA. Weight and height were measured, and fasting blood samples were analysed for ferritin, free triiodothyronine (fT3), follicle-stimulating hormone (FSH), luteinising hormone (LH), estradiol (female athletes) and testosterone (male athletes). Bone mineral density (BMD) of the lumbar spine and total left hip, as well as body composition, were measured using dual-energy X-ray absorptiometry (DXA).

Results: Out of the 43 athletes, 12 showed evidence of LEA, exhibiting at least one of the following characteristics: low estradiol levels (87.5%), low testosterone (75.0%), low fT3 (66.7%), low LH (58.3%), low FSH (58.3%), low ferritin (25.0%) and low BMD (8.3%). Notably, fT3, estradiol and testosterone were significant predictors for LEA.

Conclusions: A low but noteworthy incidence of LEA among Malaysian national athletes was associated with hormone imbalances. Awareness about LEA among athletes and sports personnel is essential for early detection and appropriate intervention.

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.