BMJ Open Sport & Exercise Medicine最新文献

Objectives: To compare injury incidences between the 2022/23 season and the preceding five seasons, and between World Cup players and non-World Cup players during the 2022/23 season.

Methods: During the 2022/23 season, 29 teams participated in the Union of European Football Associations Elite Club Injury Study and reported football exposures and injuries prospectively. Injury incidence was compared with that of the five preceding seasons for the full season and for periods before and after the Fédération Internationale de Football Association World Cup 2022. In addition, World Cup players were compared with non-World Cup players. Incidences were compared using rate ratio (RR) with 95% CI.

Results: Injury incidences during the 2022/23 season were similar to previous seasons except for training incidence which, due to a significantly lower incidence in the 2017/18 season compared with all other seasons, was higher during the full season (RR 1.10, 95% CI 1.00 to 1.21) and in the period before the World Cup (RR 1.17, 95% CI 1.02 to 1.35). World Cup players had similar injury incidences before and after the tournament (training incidence; RR 0.95, 95% CI 0.65 to 1.38, match incidence; RR 1.15, 95% CI 0.87 to 1.52) but a significantly lower match incidence than non-World Cup players before the tournament (RR 0.84, 95% CI 0.71 to 1.00).

Conclusions: No major changes in injury incidences were observed during the 2022/23 season compared with previous seasons. World Cup players experienced similar injury incidences before and after the tournament, and had a lower match injury incidence before the tournament compared with non-World Cup players.

Background: The use of continuous glucose monitors (CGM) in scuba diving for patients with type 1 diabetes (T1DM) shows potential but faces challenges related to accuracy. Previous research has highlighted the poor accuracy of the Dexcom G7 (DG7) in repetitive diving contexts. This study investigates the impact of calibration on the accuracy of DG7, providing valuable insights for patients and clinicians.

Materials and methods: In August 2024, 'Diabete Sommerso' organised a 4-day diving cruise around Elba Island (Italy) with 15 participants, including individuals with T1DM. Each participant with diabetes wore two DG7 sensors (one on the arm and one on the abdomen), calibrated daily and compared the results to capillary glucose (Beurer GL50Evo as the reference). Accuracy was assessed using mean absolute relative difference (MARD)/median ARD, Food and Drug Administration (FDA) integrated continuous glucose monitoring (iCGM) criteria and Surveillance Error Grid (SEG) analysis. Hypoglycaemia detection and trends were also evaluated.

Results: Eight participants with T1DM completed the study using 16 DG7 sensors with no detachments or skin reactions. Analysis of 765 sensor-capillary glucose pairs during 68 dives showed an overall MARD of 13.7%, with arm sensors (11% MARD) outperforming abdomen sensors (16%, p=0.0001). SEG analysis revealed that more than 97% of readings fell within the no-risk zone; however, the FDA's iCGM criteria for non-adjunctive use were not met.

Conclusions: Calibration improved the accuracy of DG7 in repetitive diving for patients with T1DM. However, capillary glucose checks remain essential, as non-adjunctive criteria were not met.

Background: Relative energy deficiency in sport (REDs) is a condition caused by chronic and/or severe low energy availability. Endurance athletes are at risk of REDs, which are characterised by negative effects on health and performance. Disturbed cholesterol metabolism is a suggested indicator of REDs and could affect the future cardiovascular health of athletes. We investigated the association between the REDs risk and cholesterol levels in endurance athletes.

Methods: Finnish endurance athletes (n=87; female 44, male 43) were recruited as part of the Athletic Performance and Nutrition study. The participants were examined at the beginning (T1) and end (T2) of the training season. The REDs risk was assessed using the REDs Clinical Assessment Tool version 2.

Results: At T1, 37 (77%) female and 31 (72%) male athletes were at medium-to-high REDs risk. The REDs risk was not associated with cholesterol levels in a cross-sectional analysis, and no overall change in the REDs risk or the cholesterol levels was observed between T1 and T2. In female athletes, an increase in REDs risk status from low to medium-to-high between T1 and T2 was associated with a decrease in low-density lipoprotein (LDL) cholesterol (beta adjusted for age -0.62, 95% CI -0.94 to -0.30) and total cholesterol (beta adjusted for age -0.85, -1.42 to -0.28)).

Conclusions: REDs risk was not associated with cholesterol levels at T1 or T2. However, in female athletes, an increase in the REDs risk across time points was associated with a decrease in LDL and total cholesterol levels.

Objectives: To describe training loads and injury incidences, and explore their relationship in senior schoolboy rugby players in Leinster, Ireland.

Methods: Prospective cohort study conducted during the 2019-2020 season. Methods aligned with consensus statements for rugby injury surveillance research. Injuries were coded using the Orchard Sports Injury Classification System (OSICS) version 10.1 and recorded using the World Rugby Injury Surveillance System. Training load measures (session type, duration and rate of perceived exertion) were recorded by the players using The Sports Office smartphone application.

Results: In total, 463 participants (mean age 17, (SD=0.9 years)) in 16 schools provided data over 20 weeks. Injury incidence per 1000 player hours was 19.9 (95% CI: 15.2 to 25.6) match injuries and 0.7 (95% CI: 0.4 to 1.0) training injuries. Median injury severity was 22 days (95% CI: 17 to 28) lost for match injuries and 14 days (95% CI: 5 to 41) lost for training injuries. Frequent injury sites included shoulder (n=23, 27%), head (n=22, 26%), wrist/hand (n=9, 11%), ankle (n=8, 10%) and knee (n=5, 6%). Tackle accounted for 49% of injuries. Players' recording of individual training load showed 11.5% compliance. Exposure was calculated as 31 141 training hours and 3063 match hours. Training sessions included conditioning weights (31%), rugby skills: non-contact (28%) and semicontact (24%), with variation in proportion of sessions across schools.

Conclusion: Match activity and tackle events accounted for most injuries. Training exposure and type varied widely across schools. Low compliance in recorded individual training load limited analysis of association with injury risk, highlighting the challenge in identifying injury risk factors in an adolescent cohort.

To enhance performance, increase resilience and prevent injuries, training and testing (T&T) are the most important strategies for preparing athletes for the demands of their sport. However, for competitive snow sports such as alpine skiing, freestyle skiing and snowboarding, there is little evidence and a lack of international harmonisation of current best practices. This consensus statement, commissioned by the International Ski and Snowboard Federation (FIS), aims to provide recommendations for the physical and psychological T&T of competitive alpine and freestyle skiers and snowboarders within National Ski and Snowboard Associations. A diverse international consensus panel was selected to represent the subject matter regarding gender, nationality, expertise/background, level of competition and skiing and snowboarding discipline. Researchers, officials, physicians, physiotherapists, coaches and former athletes with extensive experience in the field were among the experts. However, the panel had a limited gender balance (seven women and 13 men) and was over-represented by European members (65%) and North American members (20%), whereas there was limited representation of perspectives from South American (5%), Australasian (5%) and African (5%) experts and a lack of experts from Asia. In the first step, the panel established an overarching structure of topics and questions to be addressed by the consensus statement. Following the RAND-UCLA appropriateness method, the consensus process subsequently included panellist ratings, discussions and revisions informed by statements derived from the literature or expert/panellist opinions. These two outcomes served as the basis for manuscript writing, which was finalised through two iterative rounds of manuscript feedback and revision. This consensus statement aims to help athletes, coaches and medical staff of international and national federations plan and implement effective T&T activities for competitive alpine and freestyle skiers and snowboarders.

Gender disparity persists in sports and exercise medicine (SEM), with women comprising only 27% of the faculty of SEM (FSEM) membership. While existing literature explores the barriers women face in progressing within SEM, less attention has been given to when and why female medical students disengage from the specialty pathway. This viewpoint article analyses data from the National Undergraduate SEM Society (USEMS), University SEM Committees and National Health Service England to track gender differences at various career stages. FSEM membership data was also reviewed to assess representation at the consultant level. Over the past 5 years, 46.8% of USEMS members and 48.6% of University SEM Committee members have been women. In contrast, at the Foundation doctor level, female USEMS membership figures drop to 24% and only 20.1% of SEM training applications submitted between 2021 and 2023 were by women. Despite strong engagement at the undergraduate level, few women pursue specialty SEM training, indicating that external barriers may be discouraging them from continuing. More research is needed to understand the specific factors leading to this disengagement so that appropriate steps can be taken to prevent it.

Injury in elite (professional/competitive/collegiate) dance is commonplace and pernicious. Return-to-dance after extended time-loss injury requires careful consideration to ensure dancers are ready to safely resume practice (return to class/rehearsal/competition/performance). The available assessment tools in dance consider predominantly physical domains (eg, flexibility/balance) and refer to specific dance genres only (eg, ballet). This scoping review aims to explore biopsychosocial domains (eg, fear/confidence) identified in dance and sport literature, informing safe return to dance post injury. The scoping review will conform to Joanna Briggs Institute (JBI) Evidence Synthesis guidelines. Nine databases (in health, medicine, kinesiology, sport and dance) will be searched for studies of return-to-dance/sport protocols, in dancers, athletes and aesthetic performers. Two independent reviewers will conduct title, abstract and full-text screening using Covidence review management software. Data charting will be completed using a modified standardised JBI extraction form. The scoping review will be disseminated to stakeholders in the world of elite dance in performance (troupes/companies), educational (academies/universities) settings and sports medicine clinicians will also be targeted in dissemination. Findings will be shared via both peer-reviewed and non-peer-reviewed publications (eg, blog posts/academic publications/conference presentations). An infographic of key findings will be developed and shared on social media. This scoping review will inform a subsequent e-Delphi project involving dancers, teachers and clinicians to develop a dance-specific tool informing safe return to dance post injury. This novel tool will extend beyond currently available tools focusing on physical factors to consider holistic dancer wellness, with application across multiple dance genres.

This viewpoint aims to characterise the evolution of peak oxygen uptake (V̇O₂peak) in chronic kidney disease (CKD), describe its impact on patients' ability to engage in physical activities of daily living and frame the meaningfulness of exercise training in this respect. Analysis of literature data from 4889 patients shows that per cent-predicted V̇O₂peak decreases from 69%±10% at CKD stage 2 to 51%±9% at CKD stage 5, before partially recovering to 60%±12% beyond 12 months post-transplant. Similarly, V̇O₂peak expressed as oxygen uptake relative to body weight decreases from 24.7±4.1 to 18.0±3.4 mL/kg/min across CKD stage 2-5, with a partial recovery to 21.6±4.9 mL/kg/min beyond 12 months post-transplant. Considerable variability exists in reported V̇O₂peak levels at each of the different disease stages. In a substantial proportion of patients, impaired cardiorespiratory fitness contributes to limitations in performing common physical activities such as brisk walking, carrying groceries upstairs, mowing the lawn or engaging in vigorous play with (grand-)children. Tailored exercise training can improve cardiorespiratory fitness and enable a meaningful increase in the ability to participate in a wider range of physical activities of daily living; a powerful message to incentivise patients.

Non-specific neck pain (NSNP) is a common musculoskeletal disorder causing functional limitations and reduced quality of life. Conventional physiotherapy provides symptomatic relief but often yields inconsistent improvements in cervical kinematics. Osteopathic manipulation has shown promise in addressing biomechanical dysfunctions and restoring normal neck mobility. This randomised controlled trial aims to evaluate the effect of osteopathic manipulation combined with standard physiotherapy on neck kinematics in individuals with NSNP using X-Sens motion capture analysis. After obtaining written informed consent from the patient, eligible inpatients and outpatients from the Musculoskeletal Physiotherapy and Orthopaedics department will be recruited. Participants who meet the inclusion and exclusion criteria will be randomly assigned (1:1) to either Group A (osteopathic manipulation + standard treatment) or Group B (standard treatment alone) using computer-generated random numbers and sealed opaque envelopes. Both groups will receive 30-minute treatment sessions, 5 days per week for 4 weeks. Follow-ups will be conducted at the second and fourth weeks post-treatment.Baseline neck kinematics and functional outcomes will be assessed using the X-Sens motion capture system. Data will be analysed on an intention-to-treat basis. Descriptive statistics will summarise demographic data. Between-group differences will be analysed using appropriate parametric or non-parametric tests. Repeated measures ANOVA will assess changes over time within and between groups for primary and secondary outcomes.

Objective: This study aimed to describe and compare the epidemiological injury patterns at the World Taekwondo Championships (WTC) in 2017 Muju, 2019 Manchester and 2022 Guadalajara, with consideration of changes in the competition rules.

Methods: A retrospective cohort study design using a modified injury surveillance system (ISS) was applied across three WTC events. Injury incidence proportion was computed and calculated both per 1000 athlete exposures and per 1000 minutes of exposure.

Results: Across the three events, 2663 athlete registrations and 4712 exposures were recorded. Injury incidence rates decreased from 13.49 (95% CI 11.18 to 15.80) per 100 athlete exposures in 2017 to 6.41 (95% CI 4.79 to 8.03) in 2019, before increasing to 8.60 (95% CI 6.51 to 10.69) in 2022. Injury patterns shifted, with fewer head and neck injuries and more upper extremity injuries. Severe injuries declined, with changes linked to revised rules, scoring systems and match formats. Male and heavyweight athletes consistently showed higher injury rates across all WTCs.

Conclusion: Our study revealed significant changes in injury profile across the three WTCs, coinciding with major competition rule modifications. Despite the overall decrease in injury incidence rates, variations in injury distribution associated with rule modifications were observed. The observed reduction in severe injuries and overall injury rates suggests enhanced athlete safety. However, these findings highlight the importance of ongoing assessment and refinement of competition rules, athlete preparation protocols and ISS to further confirm and improve the safety of taekwondo athletes.