BMJ Open Sport & Exercise Medicine最新文献_第9页

Acute Achilles tendon ruptures between 2002–2021: sustained increased incidence, surgical decline and prolonged delay to surgery—a nationwide study of 53 688 ruptures in Sweden 2002-2021 年间急性跟腱断裂：发病率持续上升、手术率下降和手术延迟时间延长--对瑞典 53 688 例跟腱断裂进行的全国性研究

IF 4.8 Q1 SPORT SCIENCES

BMJ Open Sport & Exercise Medicine

Pub Date : 2024-07-01 DOI: 10.1136/bmjsem-2024-001960

Simon Svedman, Alejandro Marcano, Paul W Ackermann, Li Felländer-Tsai, Hans Erik Berg

Introduction Given the lack of consensus on optimal treatment strategies for acute Achilles tendon rupture (ATR), understanding temporal trends, treatment choice and demographic characteristics is important. Previous research suggests increasing incidence with declining surgical treatment. Current trends in Sweden are not known. Hypothesis/purpose To assess how incidence rates, treatment trends and time from injury to surgery (TTS) of ATR have changed between 2002 and 2021 in Sweden, with particular attention to changes since 2012. Study design Descriptive epidemiology study. Methods We conducted a nationwide register-based study including all inpatients and outpatients ≥18 years of age with an ATR between 2002 and 2021 in Sweden. Results 53 688 ATRs (78.5% men) were identified during the study period. 15 045 patients (81.5% men) were surgically treated within 30 days. The long-term incidence rate for ATR injury increased by 45%, from 28.8 in 2002 to 41.7 in 2021 per 100 000 person-years (p<0.0001). In the last 5 years of the study, there was a significant, continuing increase in ATR incidence by 21%, from 34.4 in 2017 to 41.7 in 2021 per 100 000 person-years (p<0.0001). The surgical incidence rates decreased from 13.4 to 6.0 per 100 000 person-years (p<0.0001). TTS increased from 0.6 days in 2002 to 5.1 in 2021 (p<0.0001). Conclusion The observed increase in incidence rates and decrease in surgical treatment of ATR emphasise the need for evidence-based treatment and rehabilitation protocols for non-operated patients of all ages. A significant increase in time from injury to surgery was observed throughout the study period. Data may be obtained from a third party and are not publicly available. The data analysed in this study were extracted from the Swedish national patient register and are not publicly available but can be acquired via a third party. To obtain permission to access data, specific requirements must be met per Swedish law, including only reporting aggregated data in scientific articles as a precaution to safeguard the anonymity of the individuals in the dataset. For these reasons, data cannot be made generally available.

导言：由于对急性跟腱断裂（ATR）的最佳治疗策略缺乏共识，因此了解其时间趋势、治疗选择和人口特征非常重要。以往的研究表明，随着手术治疗的减少，发病率也在增加。瑞典目前的趋势尚不清楚。假设/目的评估 2002 年至 2021 年间瑞典 ATR 的发病率、治疗趋势和从受伤到手术的时间（TTS）发生了哪些变化，尤其关注 2012 年以来的变化。研究设计描述性流行病学研究。方法我们在全国范围内开展了一项登记研究，研究对象包括 2002 年至 2021 年期间瑞典所有年龄≥18 岁的 ATR 住院和门诊患者。结果在研究期间发现了 53 688 例 ATR（78.5% 为男性）。15 045 名患者（81.5% 为男性）在 30 天内接受了手术治疗。ATR 损伤的长期发病率增加了 45%，从 2002 年的每 10 万人年 28.8 例增加到 2021 年的 41.7 例（p<0.0001）。在研究的最后5年中，ATR发病率持续显著增加了21%，从2017年的每10万人年34.4例增加到2021年的41.7例（p<0.0001）。手术发病率从每 10 万人年 13.4 例降至 6.0 例（p<0.0001）。TTS从2002年的0.6天增加到2021年的5.1天（p<0.0001）。结论所观察到的 ATR 发病率的增加和手术治疗的减少强调了对所有年龄段的非手术患者进行循证治疗和康复方案的必要性。在整个研究期间，从受伤到手术的时间明显延长。数据可能来自第三方，不对外公开。本研究分析的数据摘自瑞典全国患者登记册，不对外公开，但可通过第三方获取。要获得访问数据的许可，必须满足瑞典法律规定的特定要求，包括在科学文章中仅报告汇总数据，以保护数据集中个人的匿名性。由于这些原因，数据不能普遍提供。

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引用次数: 0

Self-reported reproductive health of retired elite women’s footballers: a cross-sectional study 退役精英女子足球运动员自我报告的生殖健康状况：横断面研究

IF 4.8 Q1 SPORT SCIENCES

BMJ Open Sport & Exercise Medicine

Pub Date : 2024-07-01 DOI: 10.1136/bmjsem-2024-002028

Sean Carmody, Steve den Hollander, Kirsty Elliott-Sale, Margo Lynn Mountjoy, Jane S Thornton, Andrew Massey, Gino Kerkhoffs, Vincent Gouttebarge

Objectives The primary objective of this study was to describe the self-reported reproductive health of retired elite women’s footballers with specific reference to menstrual function, pregnancy and motherhood, contraceptive use and pelvic floor function. Methods An electronic survey was disseminated to women’s footballers (18 years or older) who had retired from elite football within 10 years of completing the survey. Results 69 respondents completed the survey (mean age 35.8 years, mean age at retirement 30.3 years). One-third of participants self-reported experiencing at least one episode of amenorrhoea (>3 months without menstruation) for reasons other than hormonal contraceptive use or pregnancy. Three participants (mean age of 41 years, range 30–54) reported having reached menopause at the time of the study. 54 (78.3%) participants were not using any form of contraception. 17 (24.6%) of the participants are mothers (range 1–3 children). 51 of the participants (73.9%) had never been pregnant, and the majority of those who had been pregnant (86.7%) became pregnant in less than 2 years following the onset of desire for pregnancy. Four of the retired players gave birth during their playing career, and the mean time to return to competitive matches following delivery was 22 weeks. The mean Pelvic Floor Distress Inventory-20 score for participants was 72. Conclusion These insights can be used to inform future efforts to promote positive reproductive health outcomes for current, former and future women’s footballers. Research efforts should focus on improving the understanding of how to effectively support women’s footballers in the perinatal period. Best practice guidelines on the use of menstrual cycle monitoring and pelvic health support would improve standards of care for women’s footballers. Stakeholders should consider gender-specific postretirement care for women’s footballers. Data are available on reasonable request.

目的本研究的主要目的是描述退役精英女足运动员自我报告的生殖健康状况，特别是月经功能、怀孕和生育、避孕药具使用和盆底功能。方法向 10 年内从精英足球退役的女足运动员（18 岁或以上）发放电子调查问卷。结果 69 名受访者完成了调查（平均年龄 35.8 岁，平均退役年龄 30.3 岁）。三分之一的参与者自述至少有一次闭经（超过 3 个月没有月经来潮），原因不包括使用激素避孕药或怀孕。有 3 名参与者（平均年龄 41 岁，30-54 岁不等）表示在研究期间已进入更年期。54名参与者（78.3%）未采取任何避孕措施。17 名参与者（24.6%）是母亲（1-3 个孩子不等）。51 名参与者（73.9%）从未怀孕过，其中大多数人（86.7%）是在有怀孕意愿后不到两年的时间内怀孕的。其中有四名退役运动员在比赛期间分娩，产后恢复比赛的平均时间为 22 周。参与者的盆底压力量表-20 平均分为 72 分。结论这些见解可为今后促进现役、退役和未来女足运动员取得积极的生殖健康成果提供参考。研究工作应侧重于提高对如何在围产期为女足运动员提供有效支持的认识。关于使用月经周期监测和骨盆健康支持的最佳实践指南将提高女足运动员的护理标准。利益相关者应考虑为女足运动员提供针对不同性别的退役后护理。如有合理要求，可提供相关数据。

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引用次数: 0

Target trial framework for determining the effect of changes in training load on injury risk using observational data: a methodological commentary 利用观察数据确定训练负荷变化对受伤风险影响的目标试验框架：方法论评述

IF 4.8 Q1 SPORT SCIENCES

BMJ Open Sport & Exercise Medicine

Pub Date : 2024-07-01 DOI: 10.1136/bmjsem-2024-002037

Chinchin Wang, Jay S Kaufman, Russell J Steele, Ian Shrier

In recent years, a large focus has been placed on managing training load for injury prevention. To minimise injuries, training recommendations should be based on research that examines causal relationships between load and injury risk. While observational studies can be used to estimate causal effects, conventional methods to study the relationship between load and injury are prone to bias. The target trial framework is a valuable tool that requires researchers to emulate a hypothetical randomised trial using observational data. This framework helps to explicitly define research questions and design studies in a way that estimates causal effects. This article provides an overview of the components of the target trial framework as applied to studies on load and injury and describes various considerations that should be made in study design and analyses to minimise bias.

近年来，管理训练负荷以预防损伤已成为一大重点。为了最大限度地减少损伤，训练建议应建立在研究负荷与损伤风险之间因果关系的基础上。虽然观察研究可用于估计因果效应，但研究负荷与损伤之间关系的传统方法容易产生偏差。目标试验框架是一种有价值的工具，它要求研究人员利用观察数据模拟假设的随机试验。该框架有助于明确界定研究问题，并以估计因果效应的方式设计研究。本文概述了目标试验框架在负荷和伤害研究中的应用，并介绍了在研究设计和分析中应考虑的各种因素，以尽量减少偏差。

引用次数: 0

Profile of Sport and Exercise Physician trainee’s clinical practice within Australasia in 2019: a cross-sectional study 2019 年澳大拉西亚运动与锻炼医师学员临床实践概况：横断面研究

IF 4.8 Q1 SPORT SCIENCES

BMJ Open Sport & Exercise Medicine

Pub Date : 2024-07-01 DOI: 10.1136/bmjsem-2024-001930

Christopher Lim, Brett Vaughan, Kylie Fitzgerald, Jane Fitzpatrick

Objective To identify the patient population profile and the spectrum of training activities and influencing factors of Australasian College of Sport and Exercise Physician (ACSEP) trainees. Design Retrospective cross-sectional design. Setting Training settings for ACSEP trainees. Participants Twenty ACSEP trainees undertaking full-time training in training period 2 of the 2019 training year (1 August 2019–31 January 2020). Exclusion criteria were trainees undertaking part time study and new fellows who completed their fellowship exams in 2019. Independent variables Patient and practitioner demographics Method Retrospective cross-sectional design. Main outcome measurements Patient data recorded in ACSEP trainees’ logbook. Short questionnaire capturing pertinent trainee demographics. Results Most ACSEP trainee patients are adults aged 18–65 years of age (78.2%), presenting with knee (18.7%), ankle (17%) and spinal complaints (13.1%) in clinical practice or sporting team environments. Youths 10–17 make up 13.1% of presentations and older adults 66 years and older make up 8%. Only Australian trainees are engaging in additional training activities, such as surgical assisting outside of the clinic or sporting team environment. Conclusion Australasian Sport and Exercise Physician trainees appear to consult primarily musculoskeletal complaints, including providing broader care to paediatric and older populations, and work with sporting teams. There are differences between Australia and New Zealand trainee employment conditions, which appear to be affecting training experiences. These differences warrant consideration to ensure equitable training experiences and financial stability for trainees. Data may be obtained from a third party and are not publicly available. Our data set comprises deidentified participant data from the Australasian College of Sport & Exercise Physicians. ACSEP may be contacted to request access to the de-identified data (nationaloffice@acsep.org.au) . Reuse of data may only be approved by the ACSEP Training and Research Committees.

目的确定澳大利亚运动与锻炼医师学院（ACSEP）受训者的患者群体概况、培训活动范围和影响因素。设计采用回顾性横断面设计。环境 ACSEP 受训人员的培训环境。参与者在2019培训年第2培训期（2019年8月1日至2020年1月31日）接受全日制培训的20名ACSEP学员。排除标准是进行非全日制学习的学员和在 2019 年完成研究员考试的新研究员。自变量患者和从业人员人口统计学方法回顾性横断面设计。主要结果测量 ACSEP 学员日志中记录的患者数据。简短问卷调查，收集相关的学员人口统计数据。结果大多数 ACSEP 受训人员的患者是 18-65 岁的成年人（78.2%），在临床实践或运动队环境中出现膝关节（18.7%）、踝关节（17%）和脊柱不适（13.1%）。10-17 岁的青少年占 13.1%，66 岁及以上的老年人占 8%。只有澳大利亚学员参加了额外的培训活动，如在诊所或运动队环境之外进行手术辅助。结论澳大拉西亚的运动与锻炼医师学员似乎主要咨询肌肉骨骼方面的主诉，包括为儿科和老年人群提供更广泛的护理，并与运动队合作。澳大利亚和新西兰受训人员的就业条件存在差异，这似乎影响了培训体验。这些差异值得考虑，以确保受训人员获得公平的培训经历和稳定的经济收入。数据可能来自第三方，不对外公开。我们的数据集包括澳大利亚运动与锻炼医师学院（Australasian College of Sport & Exercise Physicians）提供的去身份化学员数据。如需访问去标识化数据，请联系 ACSEP (nationaloffice@acsep.org.au)。数据的再利用只能由 ACSEP 培训和研究委员会批准。

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引用次数: 0

A prospective study of injuries and illnesses among 910 amateur golfers during one season 对 910 名业余高尔夫球手在一个赛季中的伤病情况进行前瞻性研究

IF 4.8 Q1 SPORT SCIENCES

BMJ Open Sport & Exercise Medicine

Pub Date : 2024-07-01 DOI: 10.1136/bmjsem-2023-001844

Patrick Gordon Robinson, Benjamin Clarsen, Andrew Murray, Astrid Junge, Margo Lynn Mountjoy, Tomas Drobny, Lance Gill, Francois Gazzano, Mike Voight, Jiri Dvorak

Objectives Our aims were (a) to describe the prevalence and incidence of self-reported injuries and illnesses of amateur golfers over a 5-month period and (b) to investigate potential risk factors for injury. Methods We recruited 910 amateur golfers (733 males [81%] and 177 females [19%]) from golf clubs in the USA and Switzerland. The median age was 60 (IQR: 47–67) and the median golfing handicap was 12 (IQR: 6–18). Participants’ health was monitored weekly for 5 months using the Oslo Sports Trauma Research Centre Questionnaire on Health Problems. Players also completed a baseline questionnaire on personal and golf-specific characteristics and their medical history. Results We distributed 19 406 questionnaires and received 11 180 responses (57.6%). The prevalence of injuries was 11.3% (95% CI: 9.8 to 12.8) and of illnesses was 2% (95% CI 1.7 to 2.2). The incidence of injuries and illnesses was 3.79 (95% CI 3.54 to 4.06) and 0.94 (95% CI 0.81 to 1.07) per golfer per year, respectively. The injury regions with the highest burden of injury (time-loss days per player per year) were lumbosacral spine (5.93), shoulder (3.47) and knee (2.08). Injury risk was higher with increased age, osteoarthritis and previous injury. Conclusion The prevalence and incidence of injury and illness in amateur golf were low compared with many other sports. To further reduce the burden of injury, future research attention should be directed towards the lumbosacral spine, knee and shoulder. Data are available upon reasonable request.

目的我们的目标是：(a) 描述业余高尔夫球手在 5 个月内自我报告的伤病发生率和发病率；(b) 调查潜在的受伤风险因素。方法我们从美国和瑞士的高尔夫俱乐部招募了 910 名业余高尔夫球手（733 名男性 [81%]，177 名女性 [19%]）。年龄中位数为 60 岁（IQR：47-67），高尔夫差点中位数为 12（IQR：6-18）。在为期 5 个月的时间里，每周都会使用奥斯陆运动创伤研究中心的健康问题问卷对参与者的健康状况进行监测。参与者还填写了一份基线调查问卷，内容包括个人特征、高尔夫运动特征和病史。结果我们发放了 19 406 份问卷，收到 11 180 份回复（57.6%）。受伤率为 11.3%（95% CI：9.8 至 12.8），患病率为 2%（95% CI：1.7 至 2.2）。每名高尔夫球手每年的伤病发生率分别为 3.79（95% CI 3.54 至 4.06）和 0.94（95% CI 0.81 至 1.07）。受伤负担（每名球手每年损失的时间天数）最高的受伤部位是腰骶部（5.93）、肩部（3.47）和膝部（2.08）。年龄越大、患有骨关节炎和曾受过伤的球员受伤风险越高。结论与许多其他运动相比，业余高尔夫球运动的伤病流行率和发病率较低。为进一步减轻受伤的负担，今后的研究应关注腰骶部、膝关节和肩关节。如有合理要求，可提供相关数据。

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引用次数: 0

Cross-validation of the Canadian Assessment of Physical Literacy second edition (CAPL-2) for Spanish children 针对西班牙儿童的加拿大体育素养评估第二版（CAPL-2）的交叉验证

IF 4.8 Q1 SPORT SCIENCES

BMJ Open Sport & Exercise Medicine

Pub Date : 2024-07-01 DOI: 10.1136/bmjsem-2024-001971

Maria Mendoza Muñoz, José Francisco López-Gil, Raquel Pastor-Cisneros, Antonio Castillo Paredes, Javier Urbano Mairena, Mark Tremblay, Jorge Carlos Vivas

Background/objective This study aimed to explore physical literacy (PL) using the Canadian Assessment of Physical Literacy, second edition (CAPL-2), adapt it to the Spanish context and provide evidence of its validity for use in Spanish children aged 8–12. Methods A total of 280 students (150 girls, mean age 10.5±0.9 years) from Extremadura (Spain) completed the CAPL-2. Means and SDs were used to present CAPL-2 scores according to age and sex, as well as frequencies to place participants at different PL levels. Confirmatory factor analysis (CFA) was conducted to establish the best model fit for the data. Results The median PL of Spanish children was progressing, and girls had a lower PL than boys for all ages except 12 years. The results supported a four-domain model for the CAPL-2 Spanish version and reported good fit indices after CFA (χ2 per df ratio=1.118; P (χ2)=0.256; root mean square error of approximation=0.021; comparative fit index=0.987; Tuker-Lewis index=0.991; normed fit index=0.895). Conclusion The CAPL-2 model is a valid and reliable instrument for Spanish children aged 8–12. It represents the first tool that assesses PL in Spanish children, covering the domains of motivation and confidence, physical competence, knowledge and understanding, and daily behaviour. It may be relevant for all professionals related to physical activity, education and the health field. The datasets used during the current study are available from the corresponding author on reasonable request.

背景/目的本研究旨在使用加拿大体育素养评估第二版（CAPL-2）来探讨体育素养（PL），使其适应西班牙的情况，并为其在西班牙 8-12 岁儿童中使用的有效性提供证据。方法来自埃斯特雷马杜拉（西班牙）的 280 名学生（150 名女生，平均年龄（10.5±0.9）岁）完成了 CAPL-2。根据年龄和性别的不同，CAPL-2 的得分以均值和标度表示，并以频率将参与者归入不同的 PL 水平。为了建立最适合数据的模型，我们进行了确认性因素分析（CFA）。结果西班牙儿童的 PL 中位数在不断进步，除 12 岁外，其他年龄段的女孩 PL 均低于男孩。结果支持 CAPL-2 西班牙语版的四域模型，CFA 后的拟合指数良好（χ2 每 df 比=1.118；P (χ2)=0.256；均方根近似误差=0.021；比较拟合指数=0.987；Tuker-Lewis 指数=0.991；规范拟合指数=0.895）。结论 CAPL-2 模型对于 8-12 岁的西班牙儿童来说是一个有效且可靠的工具。它是第一个评估西班牙儿童 PL 的工具，涵盖了动机和信心、身体能力、知识和理解以及日常行为等领域。所有与体育活动、教育和健康领域相关的专业人员都可以使用该工具。本研究中使用的数据集可向通讯作者索取。

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引用次数: 0

Perspectives on reasons why football and handball players sustain acute and severe knee injuries: a mixed-methods concept mapping study 足球和手球运动员膝关节急性严重损伤原因透视：混合方法概念图研究

IF 4.8 Q1 SPORT SCIENCES

BMJ Open Sport & Exercise Medicine

Pub Date : 2024-07-01 DOI: 10.1136/bmjsem-2024-002048

Tine Alkjær, Elisabeth Bandak, Marius Henriksen, Robin Christensen, Kristian Thorborg, Mette K Zebis, Jesper Bencke, Pætur M Holm, Eva E Wæhrens

Background The high incidence of knee injuries in football/handball challenges effective prevention. Identifying tangible and modifiable factors associated with a knee injury may innovate preventive actions. Engaging key stakeholders can reveal crucial insights that could improve knee injury prevention in football/handball. Objective To investigate football/handball stakeholders’ perspectives on reasons for acute and severe knee injuries to generate a conceptual model on important factors associated with knee injuries in football/handball. Methods Mixed-method participatory Group Concept Mapping was applied to collect statements from football/handball stakeholders (players/coaches/healthcare staff/researchers) on the question, ‘ What may explain why some players sustain a knee injury?’ . Participants rated the importance and feasibility of screening for each statement. Multidimensional scaling and hierarchical cluster analysis produced a cluster map, forming the basis for developing a final conceptual model. Results Stakeholders (n=37) generated and sorted 100 statements. Cluster analysis followed by cluster map validation yielded seven themes: (1) the player’s physical and motor skill profile, (2) preparation and training, (3) footwear and playing surface, (4) the sport’s impact on the risk of injury, (5) mental and physical fatigue, (6) history of injury and 7) genetics and context. A final conceptual model illustrating factors associated with knee injuries in football/handball was developed. Forty-six statements were identified as both important and feasible to screen for. Conclusions Stakeholders’ perspectives on knee injuries in football/handball revealed a complex interplay of factors. We developed a conceptual model fostering stakeholder dialogue for enhanced prevention. Key among its themes is ‘preparation and training’. All data relevant to the study are included in the article or uploaded as supplementary information.

背景足球/手球运动中膝关节损伤的高发率给有效预防带来了挑战。确定与膝关节损伤相关的有形和可改变的因素可以创新预防措施。让主要利益相关者参与进来，可以揭示改善足球/手球运动中膝关节损伤预防的重要见解。目标调查足球/手球运动利益相关者对急性和严重膝关节损伤原因的看法，以生成一个与足球/手球运动中膝关节损伤相关重要因素的概念模型。方法采用混合方法的参与式小组概念图法，收集足球/手球利益相关者（球员/教练/医护人员/研究人员）对 "某些球员膝盖受伤的原因是什么？参与者对每项陈述的重要性和筛查可行性进行评分。多维缩放和分层聚类分析绘制了聚类图，为建立最终概念模型奠定了基础。结果利益相关者（n=37）生成并整理了 100 条陈述。聚类分析和聚类图验证产生了七个主题：(1) 运动员的体能和运动技能状况，(2) 准备和训练，(3) 鞋类和比赛场地，(4) 运动对受伤风险的影响，(5) 精神和身体疲劳，(6) 受伤史，以及 (7) 遗传和环境。最终形成的概念模型说明了与足球/手球运动中膝关节损伤相关的因素。最终确定了 46 项既重要又可行的筛查指标。结论利益相关者对足球/手球运动中膝关节损伤的看法揭示了各种因素之间复杂的相互作用。我们开发了一个概念模型，促进利益相关者对话，以加强预防。其中的关键主题是 "准备和训练"。与该研究相关的所有数据均包含在文章中或作为补充信息上传。

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引用次数: 0

To play or not to play, that is the question: an interview study with amateur football coaches on perceptions of pain during sports participation 踢还是不踢，这是一个问题：对业余足球教练关于运动过程中疼痛感的访谈研究

IF 4.8 Q1 SPORT SCIENCES

BMJ Open Sport & Exercise Medicine

Pub Date : 2024-07-01 DOI: 10.1136/bmjsem-2024-001941

Sofi Sonesson, Hanna Lindblom, Martin Hägglund

Amateur football coaches play a key role in preventing, assessing and treating pain among their players, as they are often the first point of contact and may be the main source of advice and guidance. The objective of this study was to explore amateur football coaches’ perceptions of pain during sports participation and their approach to pain management. We conducted a qualitative interview study with 20 amateur football coaches from a strategically selected sample of male and female, and junior and senior teams. A semistructured interview guide and conventional qualitative content analysis were used. One overall theme emerged: To play or not to play—coaches navigating difficult terrain with limited resources . The theme included four main categories: How can pain be understood?; Can pain be avoided?; How to manage players with pain?; What resources do we need? Different ways of understanding pain emerged, and coaches described that players have different pain thresholds. Pain was seen as a part of the game that cannot be completely avoided. In general, there was a restrictive attitude regarding pain medication, though actual consumption was not known. Coaches emphasised shared responsibility with players to achieve adequate training loads, a positive communication climate surrounding pain, and a need for education and competence. In conclusion, coaches expressed various interpretations of pain during sports participation and pain management, where they need to take on great responsibility despite limited medical competence. Coaches believed that adequate pain management is important, and their keys to reducing the risk of pain included structured and customised training, a well-balanced training load and recovery, and a positive communication climate in the team. Coaches often decide whether players experiencing pain can participate in team training and match play, emphasising the need for education support and access to medical competence. All data relevant to the study are included in the article or uploaded as supplemental information.

业余足球教练在预防、评估和治疗球员疼痛方面发挥着关键作用，因为他们往往是第一接触点，也可能是建议和指导的主要来源。本研究旨在探讨业余足球教练对运动过程中疼痛的看法及其疼痛治疗方法。我们对 20 名业余足球教练进行了定性访谈研究，这些教练分别来自男女业余足球队、青少年足球队和成年足球队。我们采用了半结构化访谈指南和传统的定性内容分析方法。得出了一个总体主题：踢球还是不踢球--教练在资源有限的情况下艰难前行。该主题包括四个主要类别：如何理解疼痛？可以避免疼痛吗？如何管理有疼痛的球员？出现了不同的理解疼痛的方式，教练员描述说，球员有不同的疼痛阈值。疼痛被视为比赛的一部分，无法完全避免。一般来说，对止痛药物持限制态度，但实际用药量不得而知。教练们强调要与球员共同承担责任，以达到足够的训练负荷，围绕疼痛营造积极的沟通氛围，并需要教育和能力。总之，教练们对运动过程中的疼痛和疼痛管理表达了不同的理解，尽管他们的医疗能力有限，但他们需要承担很大的责任。教练们认为，充分的疼痛管理非常重要，而他们降低疼痛风险的关键在于结构化和定制化的训练、均衡的训练负荷和恢复，以及团队中积极的沟通氛围。教练通常会决定出现疼痛的球员能否参加球队训练和比赛，这就强调了教育支持和医疗能力的必要性。所有与研究相关的数据均包含在文章中或作为补充信息上传。

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引用次数: 0

A narrative review of inherited arrhythmogenic syndromes in young population: role of genetic diagnosis in exercise recommendations 年轻人遗传性心律失常综合征综述：基因诊断在运动建议中的作用

IF 4.8 Q1 SPORT SCIENCES

BMJ Open Sport & Exercise Medicine

Pub Date : 2024-07-01 DOI: 10.1136/bmjsem-2023-001852

Georgia Sarquella-Brugada, Estefanía Martínez-Barrios, Sergi Cesar, Rocío Toro, José Cruzalegui, Andrea Greco, Nuria Díez-Escuté, Patricia Cerralbo, Fredy Chipa, Elena Arbelo, Carles Diez-López, Gonzalo Grazioli, Norma Balderrábano, Oscar Campuzano

Sudden cardiac death is a rare but socially devastating event, especially if occurs in young people. Usually, this unexpected lethal event occurs during or just after exercise. One of the leading causes of sudden cardiac death is inherited arrhythmogenic syndromes, a group of genetic entities characterised by incomplete penetrance and variable expressivity. Exercise can be the trigger for malignant arrhythmias and even syncope in population with a genetic predisposition, being sudden cardiac death as the first symptom. Due to genetic origin, family members must be clinically assessed and genetically analysed after diagnosis or suspected diagnosis of a cardiac channelopathy. Early identification and adoption of personalised preventive measures is crucial to reduce risk of arrhythmias and avoid new lethal episodes. Despite exercise being recommended by the global population due to its beneficial effects on health, particular recommendations for these patients should be adopted considering the sport practised, level of demand, age, gender, arrhythmogenic syndrome diagnosed but also genetic diagnosis. Our review focuses on the role of genetic background in sudden cardiac death during exercise in child and young population.

心脏性猝死是一种罕见但对社会极具破坏性的事件，尤其是发生在年轻人身上。通常，这种意想不到的致命事件发生在运动中或运动后不久。遗传性心律失常综合征是导致心脏性猝死的主要原因之一。在有遗传倾向的人群中，运动可能会引发恶性心律失常，甚至晕厥，而心脏性猝死则是首发症状。由于遗传原因，在诊断或疑似诊断出心脏通道病后，必须对家庭成员进行临床评估和基因分析。早期识别和采取个性化预防措施对于降低心律失常风险和避免新的致命发作至关重要。尽管运动因其对健康的有益影响而受到全球民众的推荐，但针对这些患者的特别建议应考虑到所从事的运动、需求水平、年龄、性别、诊断出的心律失常综合征以及基因诊断。我们的综述侧重于遗传背景在儿童和青少年运动时心脏性猝死中的作用。

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引用次数: 0

Association between profiles of accelerometer-measured daily movement behaviour and mortality risk: a prospective cohort study of British older adults. 加速度计测量的日常运动行为特征与死亡风险之间的关系：英国老年人前瞻性队列研究。

IF 3.9 Q1 SPORT SCIENCES

BMJ Open Sport & Exercise Medicine

Pub Date : 2024-06-27 eCollection Date: 2024-01-01 DOI: 10.1136/bmjsem-2023-001873

Manasa Shanta Yerramalla, Mathilde Chen, Aline Dugravot, Vincent T van Hees, Severine Sabia

Objectives: We identified profiles of wake-time movement behaviours (sedentary behaviours, light intensity physical activity and moderate-to-vigorous physical activity) based on accelerometer-derived features among older adults and then examined their association with all-cause mortality.

Methods: Data were drawn from a prospective cohort of 3991 Whitehall II accelerometer substudy participants aged 60-83 years in 2012-2013. Daily movement behaviour profiles were identified using k-means cluster analysis based on 13 accelerometer-assessed features characterising total duration, frequency, bout duration, timing and activity intensity distribution of movement behaviour. Cox regression models were used to assess the association between derived profiles and mortality risk.

Results: Over a mean follow-up of 8.1 (SD 1.3) years, a total of 410 deaths were recorded. Five distinct profiles were identified and labelled as 'active' (healthiest), 'active sitters', 'light movers', 'prolonged sitters', and 'most sedentary' (most deleterious). In model adjusted for sociodemographic, lifestyle, and health-related factors, compared with the 'active' profile, 'active sitters' (HR 1.57, 95% CI 1.01 to 2.44), 'light movers' (HR 1.75, 95% CI 1.17 to 2.63), 'prolonged sitters' (HR 1.67, 95% CI 1.11 to 2.51), 'most sedentary' (HR 3.25, 95% CI 2.10 to 5.02) profiles were all associated with a higher risk of mortality.

Conclusion: Given the threefold higher mortality risk among those with a 'most sedentary' profile, public health interventions may target this group wherein any improvement in physical activity and sedentary behaviour might be beneficial.

研究目的我们根据加速度计得出的特征，确定了老年人唤醒时间运动行为（久坐行为、轻度体力活动和中度至剧烈体力活动）的特征，然后研究了它们与全因死亡率的关系：数据取自 2012 年至 2013 年期间 3991 名年龄在 60-83 岁之间的怀特霍尔 II 加速计子系统研究参与者的前瞻性队列。根据加速度计评估的 13 个特征，即运动行为的总持续时间、频率、回合持续时间、时间和活动强度分布，采用 K-均值聚类分析确定了日常运动行为特征。采用 Cox 回归模型评估得出的特征与死亡风险之间的关系：在平均 8.1 年（SD 1.3）的随访期间，共记录了 410 例死亡。结果：在平均 8.1 年（SD 1.3 年）的随访中，共记录了 410 例死亡，其中有五种不同的特征，分别为 "活跃"（最健康）、"活跃坐姿"、"轻度运动"、"长期坐姿 "和 "最久坐"（最有害）。在对社会人口、生活方式和健康相关因素进行调整后的模型中，与 "活跃 "特征相比，"活跃坐姿"（HR 1.57，95% CI 1.01 至 2.44）、"轻度移动"（HR 1.75，95% CI 1.17 至 2.63）、"长期坐姿"（HR 1.67，95% CI 1.11 至 2.51）和 "最久坐"（HR 3.25，95% CI 2.10 至 5.02）特征都与较高的死亡风险相关：鉴于 "最爱久坐 "人群的死亡风险比其他人群高出三倍，公共卫生干预措施可以针对这一人群，因为在这一人群中，体育锻炼和久坐行为的任何改善都可能是有益的。

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引用次数: 0