BMJ Open Sport & Exercise Medicine最新文献

Regular physical activity (PA) reduces morbidity and mortality in prostate cancer. Prescribing PA in cancer is a necessary awareness but is a real challenge in the case of prostate cancer. Motivational peer support seems to be an innovative strategy for lifestyle change. Therefore, we developed the Acti-Pair programme and demonstrated its feasibility. We want to evaluate its effectiveness in promoting PA in patients with prostate cancer. The Acti-Pair 2 study is an interventional, comparative, multicentre, randomised, stepped-wedge cluster study. The control group will consist of patients being followed for prostate cancer and receiving advice and recommendations for PA during consultations to make patients more active in their daily lives (=usual practice, PA to be performed independently at home). The intervention group will consist of patients being followed up for prostate cancer and benefiting from the Acti-Pair programme, which combines three interventions: (1) motivational support from a peer; (2) construction of a personalised and realistic project and (3) support from health and adapted PA professionals. This study will assess the effectiveness, implementation and efficiency of the Acti-Pair programme. It will allow the identification of key success factors for implementing the Acti-Pair programme to prepare for its transferability. Trial registration number: Clinical trial, NCT05739565, registered on 20 February 2023, https://clinicaltrials.gov/study/NCT05739565..

Abstract:

Background: Physical inactivity and tobacco smoking remain the leading causes of morbidity and mortality worldwide. In Germany, smoking prevalence is high at around 30%, and only 45% achieve the WHO recommendation for physical activity (PA). Understanding how smoking and physical inactivity co-occur can inform interventions targeting these behaviours.

Methods: We analysed data from 4073 adults (≥18 years) participating in a national household survey between April and July 2022. We tested the association between PA level (not=reference/low/medium/very active) and smoking status (never=reference/ex/current smoker). Among current smokers, we tested associations between PA level and cigarettes smoked per day, time spent with and strength of urges to smoke and motivation to stop smoking.

Results: Overall, 29.9% (95% CI=28.5; 31.4) reported no leisure-time PA; among current smokers, it was 39.8% (95% CI=37.3; 42.4). Higher PA levels were associated with lower odds of being a current versus never smoker (OR=0.74, 95% CI=0.69; 0.79). Among current smokers, higher PA levels were associated with smoking fewer cigarettes per day (β=-0.98, 95% CI=-1.39; -0.56), weaker urges to smoke (OR=0.81, 95% CI=0.74; 0.89) and higher motivation to stop smoking (OR=1.13, 95% CI=1.02; 1.24). The association between PA and time spent with urges to smoke was not statistically significant (OR=0.93, 95% CI=0.85; 1.02).

Conclusion: People who are more physically active are less likely to smoke. Current smokers with higher PA levels smoke less, are less dependent and are more motivated to quit. Further research is required to determine whether these associations are causal and, if so, whether interventions to increase PA could help people to quit smoking.

The use of network meta-analysis (NMA) in sport and exercise medicine (SEM) research continues to rise as it enables the comparison of multiple interventions that may not have been assessed in a single randomised controlled trial. NMA can then inform clinicians on potentially better interventions. Despite the increased use of NMA, we have observed that in the SEM field, a key challenge for author groups can be the assessment and reporting of key assumptions, in particular transitivity and consistency. This paper provides SEM researchers with a practical guide on how to approach the transitivity and consistency assumptions of NMA. Using a previously published NMA in the SEM field, we provide the statistical code, source data and worked examples to facilitate understanding and best practice of NMA in the particular field. We hope these resources result in improved conduct and reporting of NMA that ultimately leads to advances in the SEM field.

Objective: Lateral ankle sprains (LASs) are prevalent in soccer and can affect long-term performance, injury recurrence and risk for chronic ankle instability. This case-control study examined functional impairments associated with LAS in professional soccer players aged 17-21.

Methods: 40 players were divided into 2 groups: 21 with a history of LAS and 19 healthy matched controls. Functional assessments included the Foot and Ankle Ability Measure (FAAM), Y Balance Test (YBT), Weight Bearing Lunge Test, Heel Rise Test, Side Hop Test, and ankle and hip isometric strength measurements.

Results: Soccer players with a history of LAS exhibited significant deficits in dynamic balance, particularly in the anterior and composite YBT scores, with moderate effect sizes (p<0.05). FAAM scores also revealed functional limitations in daily activities and sports performance for the LAS group. No significant differences were observed in strength or mobility measures, including the Heel Rise, Side Hop and isometric tests. There were also no differences between injured and non-injured legs in the LAS group in the performance tests.

Conclusions: These findings highlight the persistent deficits in dynamic balance following LAS, emphasising the need for targeted rehabilitation to mitigate the risk of reinjury and enhance performance in soccer players.

Physical activity guidelines targeting different populations with and without chronic diseases or disabilities are required to meet the diverse functional and physiological needs experienced by different subgroups of people to achieve optimal health benefits. As the importance of physical activity guidelines in promoting optimal health and well-being becomes increasingly recognised, there is a critical need for their systematic evaluation to ensure they remain effective, applicable and aligned with evolving health needs and scientific insights. This study aims to systematically review, critically evaluate, and compare global physical activity and sedentary behaviour guidelines on frequency, intensity, time, and type of exercise for adults, pregnant and postpartum women, and people living with chronic conditions and/or disabilities. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols checklist. We will search the Allied and Complementary Medicine Database, APA PsycInfo, Cumulative Index of Nursing and Allied Health Literature, Cochrane Library, Education Resources Information Center, Google Scholar, MEDLINE, PubMed, Scopus, SPORTDiscus, Web of Science and grey literature databases from 2010 to October 2024. Two reviewers will independently select guidelines, extract data and assess methodological quality using the Appraisal of Guidelines for Research and Evaluation II Instrument . Key recommendations will be summarised and classified as 'strong' and 'conditional' based on established criteria. A comprehensive evaluation of current guidelines will identify their differences and similarities and reveal their relevance in practical settings. The findings will guide healthcare professionals, researchers and policymakers in implementing evidence-based recommendations for managing physical activity and sedentary behaviour in targeted populations. Additionally, we will highlight current knowledge gaps and potential shortcomings in existing guidelines. PROSPERO registration number: CRD42023491339.

Objectives: This study aimed to evaluate the effectiveness of a telehealth-based therapeutic exercise (TTE) programme with real-time video conference supervision for young adult females with patellofemoral pain (PFP).

Methods: The study design was a randomised controlled trial. Forty-two participants with PFP were allocated to either the TTE group or the control (C) group. The TTE group received a 4-week telehealth-based exercise programme supervised through real-time video conferencing, while the C group followed a self-guided stretching exercise. Pain intensity was assessed using the Visual Analogue Scale, while functional performance was evaluated with hop tests and the step-down test. Dynamic knee valgus was measured by the frontal plane projection angle during a single-leg squat. In addition, the study used a specific health questionnaire which evaluated knee pain and function, including the self-administered Kujala Patellofemoral Questionnaire (KPQ). All outcomes were assessed both before and after the intervention.

Results: After the 4-week interventions, the results showed a significant interaction between the group and the time of pain intensity, functional performance and dynamic knee valgus (p<0.001). The TTE group demonstrated significant pain reduction (p<0.001) and improved KPQ score (p<0.001), while the C group showed no significant changes. TTE participants also exhibited improved functional performance in the hop and step-down tests. Additionally, dynamic knee valgus was significantly decreased in the TTE group.

Conclusion: The telehealth-based exercise programmes offer a convenient and effective alternative for managing PFP symptoms, providing remotely accessible and specialised care.

Objectives: To summarise the evidence regarding the prevalence of anxiety and depression in former elite athletes compared with the general population.

Design: Systematic review and meta-analysis.CRD42022347359.

Data sources: Five electronic databases (Web of Science, PubMed, MEDLINE, Scopus and SPORTDiscus) were searched from 1970 to 2023.

Eligibility criteria: Studies were included in the meta-analysis if they: (1) were written in English; (2) included male or female elite athletes that had been retired ≥1 year; (3) included a control group or population reference values; (4) reported the time-point prevalence of anxiety and/or depression; and (5) were of a retrospective, longitudinal or prospective, methodological design. A modified version of the Downs and Black tool was used to determine risk of bias.

Results: 37 unique studies including 24 732 former athletes (2% female) were included in the meta-analysis. The time-point prevalence of anxiety (prevalence ratio (PR): 2.08 (95% CI 1.57 to 2.60)) and depression (PR: 2.58 (95% CI 2.04 to 3.12)) in former athletes was over twice that of the general population. Subgroup analyses revealed former American football players and jockeys had the highest time-point prevalence of both anxiety and depression (PR: 2.24-2.88), whereas the time-point prevalence of depression and anxiety was not significantly different to the general population for former rugby players (PR: 1.13-1.30).

Conclusion: Our meta-analyses demonstrated the time-point prevalence of anxiety and depression in former elite athletes could be over twice that of the general population, with sport-specific differences evident.

Prospero registration number: CRD42022347359.

Many football injury prevention programmes (IPPs) have been developed to target various injuries and populations. There was no specific IPP for youth players in place before. However, several existing IPPs designed for adults were also assessed in the youth population. All the existing ones face the challenge of long-term adherence even though efficacy has been demonstrated for many weeks to seasons. The main barriers to a successful long-term implementation of IPPs are time constraints and the lack of attractiveness for the players as they do not contain football-specific and motivating exercises. Increasing its attractiveness was the main aspect of designing the programme. To achieve this, a new approach was used. The 'FUNBALL' programme includes competitive, pair-based exercises and frequent ball use. It offers more flexibility as there is a choice between two different exercises for each category. It was developed through close collaboration between the research community, closely involved in real-life football, and the end-users. Tailoring IPPs to the preferences of end-users could mean a significant advancement on long-term adherence compared with previous programmes. However, further research is needed to assess this assumption.

Objectives: To examine sex differences in psychological readiness to return to sport following anterior cruciate ligament (ACL) reconstruction as well as to determine whether males and females separately fulfilled cut-off values (≥65) of psychological readiness necessary to return to sport.

Information sources: Web of Science, Scopus and PubMed were comprehensively searched from inception to January 2024 to identify relevant studies.

Eligibility criteria: Observational investigations that compared males and females with a history of ACL reconstruction concerning psychological readiness to return to sport.

Risk of bias: Studies were rated using the Methodological Index for Non-Randomised Studies.

Included studies: Only 11 reports fulfilled the eligibility criteria and were included in the quantitative analysis. A total of 2618 participants were subjected to the primary ACL reconstruction, out of 1631 males and 987 females. Psychological readiness to return to sport was evaluated approximately 9±2.9 months following surgery.

Synthesis of results: The main findings demonstrated that males had slightly higher psychological readiness to return to the sport than females (standardised mean difference 0.33; 95% CI 0.14 to 0.52; p=0.0007; I²=77%) after ACL surgery. In addition, the mean psychological readiness to return to the sport of males was 70.1±8.8 points and of females 65.1±8.8 points, indicating that both sexes exceeded recommendations necessary to return to sport.

Conclusion: Males had slightly higher psychological readiness to return to sport than females approximately 9±2.9 months after ACL reconstruction and both sexes exceeded the highlighted recommendations necessary to return to sport.

Prospero registration number: CRD42024497769: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024497769.

Objectives: This study aimed to investigate the short-term effects of a 1-hour floatation-resting environmental therapy (FLO) versus conventional napping (NAP) on heart rate variability (HRV) in highly trained individuals.

Methods: 20 non-fatigued participants underwent a prospective randomised interventional study comparing the impacts of FLO and NAP on both supine and standing HRV. Measurements were taken before and after each intervention under controlled conditions, and subjective experiences were assessed through questionnaires.

Results: FLO and NAP were associated with changes in HRV parameters but did so differently. NAP significantly enhanced supine parasympathetic activity, as evidenced by increased log-transformed root mean square of successive differences (p=0.02) and power spectral density (p=0.03) relative to heart rate (HR) values, confirming its effectiveness in promoting autonomic recovery. In contrast, despite being better perceived regarding subjective well-being (p=0.04), FLO conferred no significant changes in supine root mean square of successive differences and decreased power spectral density relative to HR (p=0.02). However, post-intervention comparisons were not statistically different. While supine HR decreased significantly following both interventions, standing HR measurements showed a non-significant increase for FLO compared with NAP (p=0.056).

Conclusion: In highly trained individuals, FLO and NAP demonstrated minimal impact on acute autonomic function. NAP appears more effective for enhancing short-term parasympathetic activity, while FLO provides a more enjoyable experience. These findings underscore the importance of personalised recovery strategies and emphasise the need for further research into individual responses and the long-term effects of these interventions.