BMJ Open Sport & Exercise Medicine最新文献

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 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.

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.

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.

Objective: To investigate the feasibility, perceived relevance and usefulness of providing injury and illness prevention information through infographics to athletes and medical teams before and during an international athletics championship, and its potential impact on injury and illness risk during the same championship.

Methods: We conducted a prospective cohort study during the 2024 European Athletics Championships in Roma with (1) dissemination of infographics, (2) data collection on perceived relevance (yes/no) and perceived usefulness (score from 0 to 100) of infographics among athletes and medical teams using an online questionnaire and (3) data collection by medical teams of newly incurred injuries and illnesses among athletes during the championship.

Results: Among the 124 athletes who completed the questionnaire, 35.5% had access to the infographics, of which 86.4% found the information relevant, and their perceived usefulness scores to reduce their risk were 51.8±23.9 (range: 2.9-100.0) for injuries and 50.6±23.0 (range: 0.0-100.0) for illnesses. Among the registered physicians and physiotherapists, 44 replied to the survey, 70.5% had access to the infographics, of which 83.9% found it relevant, and their perceived usefulness scores to reduce risk were 55.6±28.0 (range: 6.0-100.0) for injuries and 52.9±28.0 (range: 0.0-100.0) for illnesses. The logistic regression showed that a higher perceived usefulness score was associated with a lower risk of in-championship injury (OR 0.950; 95% CI 0.877 to 0.996).

Conclusions: Promoting the health protection of athletes through infographics on injury and illness prevention in the context of international athletics championships was feasible and may represent an additional prevention approach.

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.

Objective: The aim of this study was twofold: first, to examine the association between perceived barriers to physical activity (PA) practice and depression, anxiety and stress in a sample of Spanish adolescents; and second, to determine which barriers are specifically associated with depression, anxiety and stress.

Methods: This cross-sectional study was conducted with 765 adolescents aged 12-17 (55.6% girls) in the Valle of Ricote, Murcia, Spain. Depression, anxiety and stress symptoms were assessed using the Depression, Anxiety and Stress Scale (DASS-21), with validated cut points employed to determine the presence of each of these mental conditions. The perception of barriers to PA was assessed using a validated questionnaire for the Spanish adolescent population.

Results: The barrier 'Because I feel that my physical appearance is worse than that of others' was related to a higher likelihood of having depression (OR=2.41; 95% CI 1.35 to 4.28; p=0.003), anxiety (OR=2.65; 95% CI 1.51 to 4.71; p=0.001) and stress (OR=2.82; 95% CI 1.59 to 5.07; p<0.001). Similarly, the barrier 'Because nobody encourages me to engage in physical activity' was related to a higher likelihood of having depression (OR=1.92; 95% CI 1.08 to 3.43; p=0.026), anxiety (OR=1.97; 95% CI 1.11 to 3.50; p=0.021) and stress (OR=1.99; 95% CI 1.12 to 3.59; p=0.021).

Conclusion: Perceived barriers to PA related to physical appearance and social support seem to be associated with a greater likelihood of depression, anxiety and stress among Spanish adolescents.

This study protocol describes a systematic method to identify, collect and rank sports science and medicine interventions most associated with optimising team performance in elite football in observational studies. While numerous interventions, such as conditioning or injury prevention programmes, protective equipment, training periodisation, tactical decision-making, supplements, medication and hydration administration, have been associated with football players and team performance enhancement, there is a need to prioritise them to save resources and increase the efficiency of applications. Nevertheless, previous literature has shown that systematic reviews in elite football often need more protocol registration and have limited procedures, synthesis and practical implications directly applicable to the field. Therefore, this protocol outlines a comprehensive process developed following the Cochrane Collaboration and Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement comprising the following stages: (1) research question formulation and preliminary study, (2) eligibility criteria, (3) search strategy, (4) study selection, (5) data collection, (6) data assessment and (7) data synthesis and statistical analysis. It also presents a data quality standard process incorporating human and large language models reviewers and a detailed flow diagram for selecting suitable quantitative synthesis and ranking techniques. It includes meta-regression, pairwise, network, Bayesian or hierarchical meta-analysis options. The project associated and pre-registration of the protocol is available on the Open Science Framework (https://osf.io/tzcxq/).

Objective: Low energy availability (LEA) is common in athletes. Disturbances in sex hormone levels due to insufficient energy availability have been suggested to influence cholesterol metabolism and impact the overall risk for cardiovascular disease. We assessed the relationship between Low Energy Availability in Females Questionnaire (LEAF-Q) and Eating Disorder Examination Questionnaire Short (EDE-QS) scores with cholesterol levels in a cross-sectional study of female athletes.

Method: Finnish national- to international-level female athletes self-reported physiological symptoms of LEA, including menstrual disturbances, using the LEAF-Q (n=176) and eating disorder symptoms using the EDE-QS (n=294). Serum cholesterol concentrations (mmol/L) were determined from venous blood samples. We analysed the relationship between the different variables using Pearson's r and linear regression. We also studied separately participants representing lean sports, that is, sports that emphasise leanness (LEAF-Q, n=60; EDE-QS, n=80).

Results: LEA symptoms were common; 72 (41%) of 176 participants scored ≥8 points in the LEAF-Q, which is indicative of a high risk of problematic LEA. A one-point increase in LEAF-Q score was associated with a small, non-significant increase in low-density lipoprotein (LDL) cholesterol level (beta=0.024, 95% CI -0.0011 to 0.049, p=0.061). Higher EDE-QS scores were associated with higher LDL cholesterol levels (beta=0.028, 95% CI 0.0098 to 0.046, p=0.0029). These associations were somewhat stronger among athletes representing lean sports (LEAF-Q and LDL: beta=0.043, 95% CI 0.0041 to 0.08, p=0.031; EDE-QS and LDL: beta=0.036, 95% CI 0.0041 to 0.068, p=0.028).

Conclusion: In this study, LEAF-Q and EDE-QS were associated with higher LDL cholesterol levels among athletes representing lean sports.