BMJ Open Sport & Exercise Medicine最新文献

Objectives: Our aim was to describe the absence days caused by the 30 most frequent injury diagnoses in elite European women's club football.

Methods: Members of the medical staff in football clubs participating in the Union of European Football Associations (UEFA) Women's Elite Club Injury Study (WECIS) reported injury occurrences from a total of 72 team-seasons. Injury absence was defined as the number of days between injury occurrence and when the injured player was allowed to return to full participation by the medical team.

Results: In total, 2 390 injuries were registered and included in the study. Sixty-six per cent of these injuries were included among the 30 most common injury diagnoses. Most of the injuries included among the 30 most common were mild leading to a median absence of 7 days or less in 397 cases (23%) or moderate leading to a median absence of 7-28 days in 1177 cases (69%). Severe injuries accounted for a median absence of ≥28 days in 140 cases (8%) were less common and included only four diagnoses, all related to knee injuries. These four diagnoses, however, caused 35% of all absence during the study period.

Conclusion: Most of the time lost due to injuries in elite European women's football teams results from moderate and severe injuries. This article provides guidelines for expected time-loss for the most common injury types in women's professional football and will aid clinicians to make more accurate estimations of when players can be expected to return to participation following injuries.

Objectives: To describe injury epidemiology in British basketball, assess sex-based differences and injury risk factors.

Methods: 122 athletes from British basketball leagues and national teams completed an online questionnaire collecting demographic, sporting and injury data from the 2021/2022 season. A medical-attention and 24-hour time-loss injury definition was used. Injury incidence rate (IIR) (injuries/1000 athlete-exposure (AE) hours) was calculated as (number of injuries/season AE-hours)×1000. Mann-Whitney tests assessed sex differences in IIRs. Χ² tests assessed sex differences in injury proportions. Linear regression assessed relationships between IIR and reported risk factors.

Results: 46 men and 76 women (median age (IQR): 23.0 years (19.0-26.0)) reported 140 injuries. Median IIR was 2.1 injuries/1000 AE-hours (IQR: 0.0-3.5). Lower limb injuries were most common (70.7%), specifically ankle (32.9%) and knee (25.7%). No significant sex differences were noted in injury site, type, mechanism, timing or severity. Higher IIR was associated with advancing age (B=0.182, 95% CI: 0.038 to 0.325, p=0.014), increased weight (B=0.140, 95% CI: 0.071 to 0.210, p≤0.001), female sex (B=2.214, 95% CI: 0.424 to 4.003, p=0.016), comorbidities (B=2.782, 95% CI: 0.967 to 4.598, p=0.003) and 1-3 years of elite experience (B=2.950, 95% CI: 1.561 to 4.340, p≤0.001 vs 3-8 years). Guards (B=4.996, 95% CI: 3.603 to 6.389, p≤0.001) and forwards (B=3.180, 95% CI: 1.627 to 4.732, p≤0.001) were associated with higher IIR than centres.

Conclusion: Lower limb injuries were most common. IIR was positively associated with age, weight, female sex, comorbidities and 1-3 years of elite experience. Guards and forwards had the strongest associations compared with centres. Findings may inform targeted injury prevention strategies. Future research should prospectively assess injury risk.

Objectives: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a global health issue due to its high prevalence, yet the impact of accelerometer-measured physical activity on clinical outcomes remains unclear. This study aims to examine the associations of physical activity with the risk of liver cirrhosis, cancer, cardiovascular disease (CVD) incidence and mortality.

Methods: 32 681 MASLD participants with accelerometer-derived physical activity data from the UK Biobank were analysed. Physical activity intensity was categorised into light (LPA), moderate (MPA) and vigorous (VPA) intensity. Cox proportional hazard and acceleration failure models were employed to assess associations between physical activity duration and outcomes.

Results: During a median follow-up of 7.5-7.9 years, 1883 deaths, 151 liver cirrhosis, 3312 cancers and 6657 CVD events were recorded. Physical activity, regardless of intensity, was consistently associated with a reduced risk of liver cirrhosis, CVD and all-cause mortality. Compared with non-MASLD individuals, our analysis indicates that longer duration of physical activity, specifically >1945 min/week of LPA or >383 min/week of MPA may theoretically eliminate the excess risk of mortality associated with MASLD.

Conclusions: Among MASLD individuals, longer physical activity duration, regardless of intensity, was associated with reduced risks of liver cirrhosis and mortality. MPA and VPA were associated with lower CVD risk, while VPA was associated with reduced cancer risk, highlighting the potential benefits of increasing the intensity and duration of physical activity in MASLD management.

Objectives: To assess the mental health status of referees in Cameroonian professional football and identify associated risk factors.

Methods: A cross-sectional analytical study was conducted among referees from the Cameroon Elite One, Elite Two and Female Super League during the 2024-2025 season. The Depression Anxiety Stress Scale-21 was used to assess mental health status after officiating a match, classifying scores as normal, mild, moderate, severe or extremely severe for depression, anxiety and stress symptoms. Data were analysed using R Studio (V.4.2.2). Logistic regression identified associations with statistical significance set at p<0.05.

Results: Out of 179 professional referees in Cameroon, 150 (83.8%) participated. Ages ranged from 18 to 45 years (mean=30±5.86 years). Depression symptoms were observed in 28%, with higher rates in assistant referees (32.4%) than in central referees (23.7%). Anxiety symptoms were present in 42.7% of participants, while 12% exhibited stress symptoms. Lower level referees had higher levels of all symptoms. Notably, 90.5% of referees with symptoms of depression had at least one additional mental health symptom. Severe symptoms of depression co-occurred with severe anxiety and stress symptoms. Having another profession significantly increased risks of depression symptoms (p=0.007, OR 7.7) and anxiety (p=0.003, OR 4.2). Performance concerns were the main psychological stressor (74.0%).

Conclusion: Cameroonian referees experience high levels of depression, anxiety and stress symptoms, with assistant referees more affected. Holding another profession increases mental health risks. Targeted interventions are needed to address psychological stressors and improve referees' well-being.

Background: This systematic review aimed to summarise worldwide levels of fundamental movement skills (FMS) mastery in children and adolescents according to their age and sex.

Methods: Studies were identified by searching three electronic databases (Medline, Scopus and Web of Science). The final search included literature up to 28 December 2023. Only studies assessing FMS mastery in typically developing children or adolescents using process-oriented tools were included. The risk of bias was evaluated using the Joanna Briggs Institute critical appraisal checklists. The results of studies were quantitatively summarised, and weighted means of mastery levels were calculated based on age and sex.

Results: 31 studies met the inclusion criteria, comprising data from 22 595 subjects across 10 different countries. FMS mastery generally increases with age, although different FMS develop at different rates. In terms of sex, males demonstrated higher mastery in most object-control skills, while females outperformed males in all stability skills and certain locomotor skills.

Discussion: These findings provide valuable insights into age-related trends and sex differences in FMS development among children and adolescents. It seems that many children worldwide do not achieve mastery in most FMS during childhood. Regular FMS assessments are crucial to identify development delays and to design appropriate interventions. Moreover, there appear to be specific ages at which developing targeted interventions for certain FMS is more critical, as mastery of these skills is more readily attainable.

Prospero registration number: CRD42023404061.

Objectives: The purpose of this study was to (1) establish the agreement of multiple expert reviewers' identification of hamstring strain injury (HSI) scenarios and related body postures among National Football League (NFL) players and (2) determine the prevalence of each HSI scenario and associated body posture in the NFL between 2018 and 2022.

Methods: Videos from 305 HSIs in the NFL were reviewed in a blinded fashion by two expert reviewers, who classified the injuries into seven predefined injury scenarios developed by a separate committee of experts. Lower extremity body postures were also identified. Cohen's Kappa coefficients were calculated to determine inter-rater agreement and used to select the subset of injuries to be described via injury scenario and body posture with the intent of minimising bias or ambiguity in reporting.

Results: 137/305 (45%) injury videos met the criteria for inclusion in the final dataset based on assessment of classification agreement. Agreement in injury scenario and body posture ranged from poor to moderate. Sprinting injuries were the most common scenario (59/137, 43%). Unique scenarios specific to American football demonstrated the importance of excessive trunk flexion during contact, or during acceleration and change of direction (54/137, 39%).

Conclusions: Using a systematic approach involving multiple expert reviewers, sprint-related injury scenarios were highlighted as the most common injury scenario for HSIs. Specific to American football; however, excessive trunk flexion during contact plays or during acceleration and change of direction may be important to consider for injury prevention or rehabilitation from HSIs.

Objective: To determine the most important barriers, facilitators and resources identified by rheumatology healthcare providers (HCPs) to supporting physical activity (PA) among individuals with rheumatoid arthritis (RA).

Methods: Nominal group technique (NGT) sessions were conducted with rheumatology HCPs following a structured process of idea generation, discussion and independent rating. Determinants and resources were grouped into themes and mapped to the Behaviour Change Wheel.

Results: A total of 14 rheumatology HCPs participated in four NGT sessions. RA HCPs identified 14 facilitators and 14 barriers to PA promotion, along with 12 helpful resources and 13 additional resource needs. The most important facilitators were patient-centred PA discussions, reassurance around movement safety and delegating PA counselling to exercise professionals. Key barriers included limited time, patient information overload and ineffective handouts. Six overarching themes were emphasised after grouping and theoretical mapping: patient-provider conversations, interdisciplinary teamwork, counselling skills, monitoring and feedback, time and capacity and resource quality. The six categories of key resources were tailored programmes, educational handouts, referral tools, exercise professionals, online tools and professional development.

Conclusion: This study identified key barriers and facilitators influencing how rheumatology HCPs support PA among RA patients, highlighting the importance of tailored discussions, interdisciplinary teamwork, counselling skills and supportive resources. HCPs emphasised the need for high-quality, RA-specific resources such as allied health networks and RA-specific programmes. Theoretical mapping pinpointed targets within capability, opportunity and motivation to enhance PA promotion. Ongoing work is underway to codevelop evidence-based tools addressing these determinants to improve PA support for individuals with RA.

Objectives: Contact breast injury (CBI) and exercise-induced breast pain (EIBP) are common in adult female contact sports; however, incidence in adolescent players is unknown. The present study investigated the occurrence, mechanism and reporting behaviours of CBI and EIBP in under-18 international female rugby union.

Methods: A cross-sectional survey was distributed to players (n=110, 17.0±0.7 years) participating in the Women's U18 Six Nations.

Results: Incidence of CBI and EIBP was 39% and 43%, respectively. Seventy-seven percent of players affected by CBI had experienced multiple incidents in the previous year. Activities associated with the highest severity of EIBP were running, jumping and tackling, with 27% reporting that breast pain inhibited their performance. Concerningly, 64% of players did not report CBI, and no injuries were reported to coaching/medical personnel. Notably, over half of players did not consciously adopt strategies to prevent CBI, which may be attributed to various bio-psycho-social mechanisms.

Conclusion: While there is a worryingly high incidence of CBI and EIBP in adolescent female international rugby players, reporting remains low, and there is a lack of uptake of support/protective strategies. Further research is warranted to investigate the effectiveness of female-specific protective equipment and educational programmes, aiming to improve breast health.

Introduction: The Sport Mental Health Assessment Tool-1 (SMHAT-1) was developed to screen elite athletes for mental health concerns. Previous work demonstrated high false negative rates (FNRs) for the initial triage step of the tool, but given the novelty of the deployment of the SMHAT-1 during large multisport, multinational competitions, replication of these findings was justified and required. This study, therefore, aimed to recalculate classification performance metrics at the triage step and investigate potential reasons for the high FNRs observed.

Methods: All athletes (n=847) completed steps 1 and 2, including an additional Posttraumatic Stress Disorder questionnaire, and FNRs were calculated. Exploratory analysis, including an exploratory factor analysis (EFA), was used to investigate the latent constructs being captured.

Results: Classification performance metrics indicated FNRs ranging from 0% (Patient Health Questionnaire-9 (PHQ9) and PHQ9 Item 9) to 63.16% (Brief Eating Disorder in Athletes Questionnaire (BEDAQ)), consistent with previous findings. The EFA identified nine latent factors in step 2, with each instrument appearing to mostly favour its own independent factor, highlighting a range of distinct latent constructs. An exploratory mixed graphical model revealed some step 2 clusters that were not closely linked with the Athlete Psychological Strain Questionnaire (APSQ) items.

Conclusions: These findings confirm previous concerns regarding the APSQ's sensitivity and underscore the challenge of using a single triage tool to capture the broad spectrum of mental health issues assessed by the SMHAT-1. Future work should consider a bespoke triage tool to better capture the diverse mental health needs of elite athletes.

Sports-related concussions (SRCs) typically occur when the brain is hyperthermic. Acute head-and-neck cooling should, therefore, reduce the brain's metabolic demands, with the potential to improve recovery following an SRC. Elite ice hockey players who underwent head-and-neck cooling after sustaining a concussion (SRC) showed reduced return-to-play times, although further investigation is warranted. This paper aims to describe the methods proposed for investigating the clinical effects and feasibility of acute head-and-neck cooling in elite male rugby union players. A quasi-experimental study will be conducted in two professional male rugby competitions (clusters): the United Rugby Championship 'intervention group' and the PREM Rugby 'standard care group'. Both groups will follow World Rugby's standardised, graduated return-to-play concussion management protocols. In addition to this, within 30 min of the SRC, the intervention group will be offered head-and-neck cooling for 45 min. The quantitative phase of the study will collect return-to-play times and clinical outcomes in both groups (sample size calculated: 100 concussions per cohort). The qualitative phase will explore the experiences of players and medical teams with the intervention. Intention-to-treat and per-protocol analyses, using appropriate regression modelling techniques, will adjust for possible confounders between the two groups, and thematic content analysis will be employed in the analysis of the respective phases. The Clinical Observed Outcomes with Local HEad-neck cooling After Diagnosed concussions study will provide evidence regarding acute head-and-neck cooling as a potential adjunct treatment to current concussion management in elite male rugby union.