BMJ Open Sport & Exercise Medicine最新文献

Objectives: To evaluate the association between tackle characteristics and suspected concussion among Canadian high school girls' rugby union players.

Methods: A case-control video-analysis study was used to examine the association between a priori tackle characteristics (eg, type, height, head position) and suspected concussion. For every concussive tackle event, six non-concussive tackle events were matched for game and team. Penalised logistic regression was used to estimate ORs with 95% CIs for concussion given tackle characteristics.

Results: 33 concussive tackle events, including 38 concussions, were identified. 20 were ball carrier concussions (53%). 261 (228 non-concussive, 33 concussive) tackle events, including 632 individual tackler and ball carrier instances, were coded. All ball carrier head contact intensity types were associated with concussion compared with no head contact. A trip tackle type (OR: 4.41, 95% CI 1.25 to 15.61), illegal tackle type (OR: 4.41, 95% CI 2.67 to 7.29), deceleration (OR: 14.03, 95% CI 4.65 to 42.30) and no change of speed (OR: 18.81, 95% CI 10.04 to 35.24) increased concussion odds for ball carriers. A tap (OR: 10.64, 95% CI 2.00 to 56.62) and trip tackle type (OR: 5.91, 95% CI 3.18 to 10.99), two (OR: 3.38, 95% CI 1.13 to 10.07) or three (OR: 13.91, 95% CI 1.74 to 111.53) tacklers within the event, and a head-down position (OR: 40.54, 95% CI 27.78 to 59.18) increased concussion odds for tacklers. Higher tackler contact on ball carrier (tackle height) increased concussion odds for ball carrier (reference: knee-to-upper-leg; waist-to-sternum OR: 2.27, 95% CI 1.08 to 4.80; sternum-to-armpit OR: 5.65, 95% CI 1.40 to 22.87) and tacklers (sternum-to-armpit OR: 4.20, 95% CI 1.26 to 14.03).

Conclusion: Numerous tackle characteristics were associated with ball carrier and tackler concussion. This is the first study to identify tackle height on ball carrier as a risk factor for concussion in girls' rugby. Future directions should consider tackle training programmes and lower tackle height as potential concussion prevention solutions.

Objectives: To identify how exercise adherence is reported in research which focuses on enhancing cardiorespiratory and muscular fitness in stroke survivors.

Design: Systematic scoping review.

Data sources: Scopus, PubMED/MEDLINE, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, PsycINFO/PsycARTICLES and Web of Science.

Eligibility criteria for selecting studies: The review sought published reports involving a cardiorespiratory or resistance training exercise intervention for people who experienced a stroke ≥6 months prior to participation. Reports were screened by two reviewers and were assessed for methodological quality using the Mixed Methods Appraisal Tool.

Results: 37 reports (randomised trials=30, interventions without control=5, non-randomised trial=1, dose escalation trial=1; total n=1347 participants) out of 6732 records met the inclusion criteria. 29 reports (78%) documented intervention adherence by describing participant completion rates, indicating 65-100% adherence. Exercise session adherence within intervention was identifiable in 16 reports (43%), 12 of which recorded session attendance, signifying 61-100% adherence. There were also measures of the intensity or duration participants sustained during sessions in 14 studies. Only one study measured postintervention (ie, at least 3 months after intervention completion) exercise adherence, and two studies actively supported participants' exercise motivation.

Conclusion: Adherence is commonly measured by intervention completion rates. Despite its importance for intervention effectiveness, less than half of studies measured exercise session adherence within interventions. Future research should address this limitation to better understand how stroke survivors engage with exercise.

Objectives: Hamstring strain injury (HSI) is the most common time-loss injury in football and is prone to recurrence. This exploratory study aimed to describe the relationship between short-term external training load (TL) and HSI occurrence in male senior football players at the professional level.

Methods: TL data in terms of global positioning system (GPS) variables and HSI incidence were collected over four seasons from 25 senior professional football players. GPS variables included total distance (TD), very intense accelerations (>3.00 m/s²), very intense decelerations (<-3.00 m/s²), high-speed running distance (>19.8 km/hour), maximal sprint distance (>29.8 km/hour) and maximal velocity. For each injury case, TL during the 7 and 14 days preceding the injury was compared with matched control periods from the same player.

Results: 25 hamstring injuries were included for analysis. Large interindividual variation in TL patterns was observed, with some players exhibiting higher and others lower TL in the periods preceding injury compared with control periods. No consistent group-level trends were identified between injured and control periods.

Conclusion: This exploratory study found considerable individual variability in TL prior to HSI and no clear group-level patterns. These findings suggest that short-term TL metrics alone may have limited utility in predicting HSI risk at the group level in professional football players.

Background: Injury surveillance is fundamental for understanding and managing risks in elite football. The simultaneous organisation of Union of European Football Associations (UEFA) EURO 2024 and Confederación Sudamericana de Fútbol (CONMEBOL) Copa America 2024 created a unique chance to use a standardised method across two major men's tournaments, providing descriptive insights into injury rates and patterns in various competitive settings.

Objective: To analyse the incidence, severity and burden of time-loss injuries across both tournaments.

Methods: A prospective injury surveillance study was conducted using standardised methodologies from UEFA's Elite Club Injury Study and International Olympic Committee reporting guidelines. Injury incidence rates (IRs) were calculated per 1000 hours of exposure, and injury burden was measured in tournament days lost per 1000 hours.

Results: A total of 85 injuries were recorded, resulting in an overall IR of 4.0 per 1000 hours (95% CI: 3.1 to 4.8). Match injury rates (16.3 per 1000 hours; 95% CI: 11.9 to 20.7) were significantly higher than training rates (1.8 per 1000 hours; 95% CI: 1.2 to 2.4). Injury rates were comparable between UEFA EURO (3.9 per 1000 hours; 95% CI: 2.9 to 4.9) and CONMEBOL Copa America (4.2 per 1000 hours; 95% CI: 2.6 to 5.7). The injury burden was higher in UEFA EURO (30.0 vs 18.3 days lost per 1000 hours). Muscle injuries (58%) and lower extremity injuries (86%) were the most common.

Conclusions: Injury patterns were broadly similar across tournaments, with lower extremity injuries, particularly muscle injuries, being the most common. The study highlights the presence and impact of pre-existing injuries on player availability and underscores the practical value of harmonised injury surveillance, even in small sample contexts, to enhance international data comparability and support future multi-tournament analyses.

Although horse riding is hazardous and injuries are common, young riders regularly engage in horse-related activities. To our knowledge, there have been no syntheses on youth horse-related injuries published during the past decade that employ a multi- and interdisciplinary research agenda (M-IDR) and that incorporate both quantitative and qualitative methods. Therefore, this scoping review aimed to (1) review studies on horse-related injuries among children and adolescents and (2) identify methodological and paradigmatic trends according to M-IDR. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews Checklist, we searched six databases (PubMed, SportDiscus, Scopus, PsycInfo, Sociological Abstracts and Web of Science) for studies on horse-related injuries among youth riders published between 1 January 2014 and 1 December 2024. The total sample included 1400 participants aged 0-17 years, of which 78.7% were girls. The main results present data on acute injuries in general and traumatic brain injury in particular. In terms of disciplinary insights, the study design and paradigmatic views predominantly reflect a positivistic worldview, employ quantitative methods and are consistent with previous literature reviews on equestrian sport injuries. Further studies are needed on the injuries that occur among young riders in equestrian sports. They should use an interpretivist approach to explore norms and attitudes towards injuries and risk-taking within the equestrian community, for example, how cultural predisposition influences safety equipment use among young equestrians in private stables.

Futsal, a high-intensity sport, places considerable demands on the hip adductors and core musculature, often resulting in strength deficits and reduced agility. Optimising training strategies to prevent injury and enhance performance is a growing area of interest. This study aims to compare the effectiveness of the modified progressive Copenhagen exercise versus sliding hip exercise in adjuncts to conventional physiotherapy in improving strength, core stability and agility in futsal athletes. A parallel, three-arm, randomised controlled trial was conducted over a period of 8 weeks. Participants will be enrolled from four centres. 39 futsal athletes were randomly allocated into three groups via a 1:1:1 allocation. Primary outcome measures included isometric hip adductor strength via handheld dynamometer, core stability assessed via sphygmomanometer and agility performance measured using the agility t-test and secondary outcome measures included isometric hip abductor strength measured by the single-leg squat test. Assessments were conducted pre- and postintervention. The final analysis will include dropouts and treatment side effects. Ethical clearance was obtained from the Institutional Ethical Committee, Ref. No. DMIHER(DU)/ie,C/2025/610. The findings will be published in peer-reviewed journals and disseminated at international conferences. Trial registration number: CTRI/2025/04/084525.

Objectives: To evaluate the onset, frequency and time loss impact of recurrent calf muscle strain injuries in elite male Australian football players over a decade. To explore how outcomes are affected by alternative recurrence definitions.

Method: Calf muscle strain injuries were reported to the Soft Tissue Injury Registry of the Australian Football League (2014-2023). Cases were categorised as index versus recurrent injuries. Alternate recurrence definitions varied based on: (1) timing (ie, subsequent injuries occurring before or after full recovery (a return to full training) and (2) location (ie, subsequent injuries involving the same side but not necessarily same muscle vs only those confirmed to involve the same muscle).

Results: 563 injuries in 359 players were evaluated. Recurrences resulted in ≥2153 total days lost over 10 years and ≥35.6 days lost on average per injury. Recurrence frequencies within 2 years (13%-21.3%), within the same season (7.5%-13.9%) and within 2 months (2.9%-7.3%) varied depending on the definition. 20% of all subsequent injuries occurred before full recovery, and these injuries took on average 46.7±25.6 days to return to play.

Conclusions: Recurrent calf muscle strain injuries in elite male Australian football players commonly have prolonged time loss, irrespective of timing or location. A 2-year recurrence susceptibility is consistent across onsets, and cases that fail early can have a large impact when accounted for. We need to 'talk the same language' in research and practice to better understand and prevent recurrences for a given type of injury across different sports and sporting levels.

Physical activity (PA) is a cornerstone of both disease prevention and long-term condition management, yet it remains absent from many treatment plans, particularly in primary care. Despite clinicians recognising the value of PA, systemic barriers such as time constraints and limited training hinder its integration into everyday consultations. For this reason, there has been a call for further resources to improve clinician confidence in initiating these conversations. This viewpoint presents a practical, five-step framework to help primary care clinicians support inactive patients to become more active. It does this by integrating core principles of PA counselling, including motivational interviewing, risk screening and the frequency, intensity, time and type (FITT) principle into a practical, accessible framework. It simplifies the often fragmented guidance on PA prescription, offering clinicians a clear, time-efficient tool to support behaviour change in routine practice. A visual infographic translates the five steps into an accessible aid for busy consultations. This viewpoint aims to equip primary care clinicians with the clarity and confidence needed to embed PA advice into their routine care. In doing so, it supports the shift towards proactive, personalised and preventive healthcare.

Objectives: To explore the acute effects of a heavy-load resistance protocol and exercise in the supine position on fetal heart rate (FHR) and uteroplacental blood flow.

Method: In this experimental laboratory study, 48 healthy pregnant athletes (elite: n=7; recreational: n=41) completed 3×8 repetitions with one repetition in reserve in sumo deadlift, bench press and incline bench press. FHR and umbilical and uterine artery pulsatility index (PI) were assessed before and after exercise. Symptoms of vena cava syndrome were recorded following the supine exercise.

Results: Pre- and post-exercise FHR remained within the normal range (110-160 bpm), but there were statistically significant increases after sumo deadlifts (p=0.002) and incline bench press (p=0.008), with no significant change after bench press (p=0.122). Umbilical artery PI did not change, while uterine artery PI significantly decreased after the sumo deadlift (p=0.005), bench press (p<0.001) and incline bench press (p<0.001). No fetal bradycardia was observed after the sumo deadlift or incline bench press, but one case occurred after bench press, resolving shortly after 3 min. Fetal tachycardia (>160 bpm) occurred in four cases after sumo deadlift, five after bench press and three after incline bench press, though none exceeded pathological levels (>180 bpm). One recreational athlete experienced symptoms of vena cava syndrome after the supine exercise, coinciding with a slight decrease in umbilical artery PI, but with stable FHR.

Conclusion: The results indicate that highly active women, especially those with resistance training experience, can safely engage in a heavy-load resistance protocol, including supine exercise, without jeopardising fetal well-being.

Background: The prevalence of obesity has tripled over the past 35 years. Although caloric restriction reduces body fat, lean tissue is also lost. Resistance exercise may mitigate these effects. This review assesses the effects of resistance exercise on body composition and cardiometabolic health in adults with overweight or obesity undergoing dietary weight loss.

Methods: A search was performed in PubMed, Embase, CINAHL, Scopus, Web of Science and CENTRAL. Systematic searches yielded N=6934 studies of which n=25 were relevant for inclusion after screening for eligibility. We included randomised controlled trials of adults (18-65 years) (body mass index ≥25 kg/m²) comparing dietary weight-loss interventions with resistance exercise to diet-only weight-loss interventions. The Cochrane Collaboration's risk of bias and GRADE (Grades of Recommendations Assessment, Development and Evaluation) assessment tools were used. A meta-analysis was performed, including those studies that compared dietary weight-loss plus resistance exercise interventions to diet-only weight-loss interventions.

Results: Overall, resistance exercise during diet-induced weight loss had no effect on body mass (mean difference between groups: -0.32 kg, p=0.35), with weight loss ranging from -2.5 kg to -20.9 kg in diet plus resistance exercise groups and from -0.7 kg to -20.4 kg in diet-only groups. However, resistance exercise protected against the loss of fat-free mass (between-group standardised mean difference (SMD): 0.40, p=0.0003, moderate certainty) and increased loss of fat mass (SMD: -0.36, p<0.00001, high certainty). Muscular strength was also significantly greater (SMD 2.36, p=0.00001) following the inclusion of resistance exercise (low certainty). No effects of resistance were seen in any of the other cardiometabolic markers studied.

Conclusion: In people living with obesity and overweight, the addition of resistance exercise to dietary restriction may enhance its beneficial effects. Current evidence, therefore, supports the implementation of resistance exercise during weight loss to attenuate the loss of fat-free mass (moderate certainty), increase loss of fat mass (high certainty) and improve muscle strength (low certainty).

Prospero registration number: CRD 42021266482.