BMJ Open Sport & Exercise Medicine最新文献

Objective: To identify characteristics of tackling, of being tackled and interactions between tackle characteristics that are associated with concussion.

Methods: A case-control study in male professional rugby union players in England over five seasons (2016/2017 to 2020/2021) analysed characteristics of tackles that led to a clinically diagnosed concussion (cases), and a control group of tackles that did not result in a concussion. ORs were plotted against the overall frequency of each tackle characteristic.

Results: 231 tackles resulting in concussions (tackler 178, 77%; ball-carrier 53, 23%), alongside 9963 control tackles, were analysed. For tacklers, 'head to torso' (_{Lower CI} OR _{Upper CI; 4.0} 6.5 _10.7) had relatively low odds of concussion compared with 'no head contact'. 'Head to knee' had the highest odds of concussion (_75.3 155.8 _322.4), but 'head to hip' occurred more frequently and had the highest number of concussions per 1000 tackles (3.1/1000 tackles). For ball-carriers, 'head to head' contact had the highest odds of concussion (_56.7 104.3 _192.0). When 'tackler body position' was 'upright', the odds of concussion to the tackler were significantly higher when contacting the ball-carrier's 'head and neck' versus their 'torso' (_3.0 23.7 _206.7).

Conclusions: Lower tackles reduce the chances of concussion to ball-carriers. The influence of tackle height on concussion to tacklers is more nuanced, but the chances are relatively low when contact is made with the ball-carrier's torso. These findings support ongoing implementation of strategies to reduce concussion risk by lowering tackle height to target the torso.

Introduction: Physical activity is important for personal growth and development among students. About two million deaths are reported yearly, arising from inactivity. 81% of students do not meet the recommendations; hence they are exposed to unhealthy behaviour.

Objective: To determine the knowledge of secondary school students on physical activity in Kakamega County.

Methods: A descriptive survey design was used with a questionnaire developed with two sections; on knowledge and physical activity participation. A sample size of 422 students aged 14-18 years was used. Self-reporting questionnaires were administered. The data were collected within a week and analysed through descriptive and comparative statistical analyses. We used Pearson correlation to test the relationship between knowledge and physical activity participation, and independent t-test to check gender differences in physical activity and knowledge. Findings were considered significant at p<0.05.

Results: Male students were 194 (47.1%) while 218 (52.9%) were female students, with the majority being 17 years of age with a mean of 16 and SD of 1.4. Kakamega High School (31.0%) formed the majority of the students. There was a positive and significant relationship (r=0.159, p<0.001) between knowledge and physical activity. There were no significant differences (t (438)=-0.738, p=0.434) in the scores of males (M=2.07, SD=0.690) and females (M=2.13, SD=0.738). With a mean difference of=-0.054, 95% CI: -0.188 to 0.081). From the findings, 59.4% of students had adequate knowledge of physical activity.

Conclusions: The study highlights the need for more emphasis on educating students about the negative and positive health impacts of inactivity and actively engaging in physical activity both at school and at home. This will improve knowledge levels.

Objective: This cross-sectional study aimed to investigate subjective and objective deficits of neurocognitive function, balance and vestibulo-ocular performance in athletes with sport-related concussion (SRC) compared with healthy control athletes.

Methods: 72 patients with SRC and 72 matched healthy controls were included. All participants performed computerised testing of neurocognitive function, device-assisted balance testing and objective evaluation of vestibulo-ocular function (video head impulse and dynamic visual acuity test). Clinical symptom clusters (headache/migraine, anxiety/mood, fatigue, cognitive, vestibular, ocular) were determined for each patient using the Sport Concussion Assessment Tool, 5th edition symptom evaluation. Independent t-tests or Mann-Whitney U tests were calculated to test for group differences in the whole cohort and according to clinical symptom clusters.

Results: When investigating the whole cohort, significant differences between patients with SRC and control subjects were found in one parameter of balance testing (sway velocity double-firm), with lower performance in the SRC group (p<0.001, r=0.345). The number of symptom clusters assigned to the SRC patients ranged from 0 (no definite cluster) to 6 (all clusters), and all clusters were frequent in the investigated cohort. Patients with vestibular, cognitive and fatigue symptom clusters demonstrated significantly lower performance in balance testing compared with SRC patients without those clusters (p<0.001 to p=0.005, r=0.368-0.439). Additionally, SRC patients presenting with symptoms of the fatigue cluster demonstrated significantly worse performance in vestibulo-ocular testing compared with SRC patients without the fatigue cluster (p=0.006, d=0.781).

Conclusion: SRC patients presented with variable numbers and qualities of clinical symptom clusters. Some subjective clusters were associated with abnormal objective tests of other clusters (vestibular, cognitive and fatigue with abnormal balance; and fatigue with abnormal vestibulo-ocular performance). Clinical symptom clusters and their overlap should be considered when examining patients with SRC.

Background: The use of analgesic and anti-inflammatory (AAI) medications is prevalent among athletes, particularly in contact sports like football. Understanding the perceptions and practices of AAI medication use is crucial for protecting athlete health and enhancing performance.

Objectives: To investigate the prevalence and patterns of AAI medication use and the perception towards sports pharmacy and medication use from players in the Egyptian men's national football team.

Methods: A questionnaire-based cross-sectional study was conducted across training camps in 2024 for the Egyptian men's national football team.

Results: Results from the survey indicated a high usage of AAI medication among the participants, with 64% of footballers reporting usage. The survey revealed a lack of awareness among footballers regarding the potential adverse side effects of these medications (including non-steroidal anti-inflammatory drugs) and that footballers felt sports pharmacists have a crucial role in managing and educating athletes. Notably, 76% of footballers (n=19) expressed a desire to have a sports pharmacist as part of their medical team.

Conclusion: Our study demonstrated the widespread use of AAI medication among these elite international footballers, accompanied by a perceived need for pharmacists to be integrated into the medical team at the international level. It is hoped that such integration will ensure that footballers receive the necessary guidance and support to use AAI medications responsibly.

Objective: This study examines the relationship between the risk of exercise addiction and psychological factors like anxiety, depression, self-esteem and sleep quality in athletes.

Methods: This cross-sectional study was conducted in Lahore between August and November 2023, involving 282 athletes from five gyms engaged in bodybuilding, powerlifting or strength training. The study explored the relationship between exercise addiction risk and psychological factors, including anxiety, depression, body image distress, self-esteem, stress, obsessive-compulsive symptoms and sleep quality. Participants met specific inclusion criteria related to training frequency, duration and mental health status. Standardised questionnaires, including the Exercise Addiction Inventory, Hospital Anxiety and Depression Scale, Body Shape Questionnaire, Rosenberg Self-Esteem Scale, Obsessive-Compulsive Inventory-Revised, Pittsburgh Sleep Quality Index and Perceived Stress Scale, were used for data collection. Data were analysed using SPSS (V.24) with descriptive statistics, t-tests, analysis of variance (ANOVA), Pearson correlations and hierarchical multiple regression.

Results: 267 completed the study. The majority were male (85.4%), with bodybuilding (50.2%) being the most common type of training. Participants reported high levels of psychological distress, including anxiety, body image concerns and stress. Exercise addiction risk was significantly associated with body image distress (r=0.45), anxiety (r=0.42) and stress (r=0.40), while self-esteem showed a negative correlation (r= -0.36). Hierarchical regression showed psychological factors accounted for 51% of the variance in addiction risk, with body image distress and anxiety being the strongest predictors. Bodybuilders and males reported significantly higher addiction risk scores compared with other groups.

Conclusion: Body image dissatisfaction, anxiety and stress are significant risk factors for exercise addiction, often reflecting emotional coping over performance goals.

Objectives: Pelvic floor dysfunction (PFD) symptoms are common among athletes but remain underexplored in youth of both sexes competing in track and field. The primary objective was to assess the prevalence of PFD. Secondary objectives evaluated symptoms impact, awareness of pelvic floor health, related behaviours and gynaecological health in females.

Methods: This observational, cross-sectional study was conducted during the Lima 2024 World Athletics U20 Championships. All athletes were eligible and invited to complete a multilingual, anonymous web-based survey assessing pelvic floor health.

Results: Of the 325 athletes who participated (59.1% females, 40.9% males), 43.7% (n=142) reported PFD symptoms. Prevalence was similar across daily life and athletics activities. Overactive bladder and pelvic pain were the most common conditions. Females had higher PFD rates (n=103, 53.7%) compared with males (n=39, 29.3%). Athletes with athletics-related urinary incontinence (n=42; 12.9%) reported frustration and reduced concentration during performance. Symptomatic athletes had low body mass index and reported more maladaptive pelvic floor-related behaviours than asymptomatic athletes (p<0.05). Menstrual issues and contraceptive use were more frequent among females with PFD (p<0.05). Fewer than 30% (n=95) were aware of pelvic floor health, and 88% (n=286) had never undergone screening. Most did not disclose symptoms (n=111; 78.2%) or seek specialised care (n=135; 95.1%).

Conclusions: PFD was prevalent among elite youth athletes, particularly females. These findings highlight the need for proactive strategies, including education, embedding pelvic floor health in medical evaluations and addressing sex-specific needs to optimise athletes' health throughout their careers.

Resistance training (RT) reduces the cardiovascular risk in patients with hypertension, especially blood pressure (BP). Current guidelines suggest an intensity between 50% and 80% of the load for 1-repetition maximum (1RM) for the training prescription for this population. However, there is an absence of chronic studies designed to test the effect of different intensities on cardiovascular parameters. This study will investigate RT acutely and a 10-week intervention on BP, heart rate (HR), heart rate variability (HRV), endothelial function (EF), feeling responses and rate of perceived exertion (RPE) in postmenopausal women. Salivary samples will be collected to analyse stable metabolites of nitric oxide. The study will adopt two sequential phases: crossover (acute) and randomised controlled trial (10 weeks). 20 postmenopausal women (50-65 years old) diagnosed with hypertension will be enrolled to perform baseline assessments. In the acute test (phase 1), the participants will perform one RT session with 60%1RM (18-20 repetitions per set) and 80%1RM (8-10 repetitions per set) in a random order. BP, HR and HRV will be measured before and for 1 hour after the session. The feeling will be measured before each RT session and at the end, along with RPE. For the 10-week intervention (phase 2), participants will be randomly allocated to train for 10 weeks at 60%1RM or 80%1RM. BP, HR, HRV, feeling responses, RPE, EF and salivary samples will be measured at baseline, during and after all experiments. Intention-to-treat analysis will be adopted using the linear mixed model.

Introduction: The Union Cycliste Internationale, the world cycling governing body, has highlighted its mission to promote and support research in cycling epidemiology and medicine, especially for the benefit of lesser-known disciplines within its 2030 Agenda. This systematic review aimed to comprehensively analyse and synthesise the existing literature about cycling-related injuries and illnesses across all competitive disciplines.

Design: Systematic review and meta-analysis of epidemiological studies.

Data sources: PubMed (Medline), Embase and SPORTDiscus were searched in August 2024.

Eligibility criteria: All epidemiological studies including information on injuries and/or illness in competitive cycling from inception to August 2024.

Results: Forty-four studies were included across the competitive cycling disciplines of Mountain Bike (MTB), road, track, bicycle motocross (BMX) and para cycling. No studies were found for cyclocross, gravel, indoor, trials and esports cycling disciplines. BMX had the highest injury incidence overall, with 4.59 injuries per 365 days (95% CI 4.34 to 4.85), while para-cyclists had the highest illness prevalence at 3.89 illnesses per 365 days (95% CI 3.42 to 4.36). The most common injuries were upper limb injuries, particularly in BMX (65.21% (95% CI 54.50 to 74.65)), followed by road cycling (48.32% (95% CI 46.51 to 50.14)) and track cycling (44.18% (95% CI 43.28 to 45.09)). In road cycling, 14.36% (95% CI 13.12 to 15.69) of injuries were head, neck or face-related. Skin lacerations, abrasions and lesions were the most common injury types across disciplines, with bone fractures being the second most common. Despite a higher prevalence of head, neck and face injuries, road cycling had the lowest incidence of concussions (4.68% (95% CI 4.04 to 5.42)). Gastrointestinal illness had the highest prevalence overall in road cycling (17.90% (95% CI 14.4 to 22.0)), while respiratory illness was most prevalent in Track (31.82% (95% CI 22.29 to 42.61)) and MTB (31.82% (95% CI 22.29 to 42.61)).

Conclusion: This systematic review highlights the high prevalence of upper limb injuries across competitive cycling disciplines, particularly in BMX, road and track cycling. Skin lacerations, abrasions and bone fractures were the most common injury types. These findings help inform future injury and illness surveillance studies in cycling disciplines where high-quality epidemiological data are currently lacking and support the development of future injury and illness prevention strategies.

Prospero registration number: CRD42024502703.

Over the past few decades, we have seen an increase in the popularity of organised sports among youth, especially gymnastics. Along with this increase in the popularity of organised sports, sports specialisation is also on the rise. Some argue that specialising as early as possible is essential for better performance and skill development. However, it has been associated with negative mental health effects in children and adolescents, as well as a higher risk of overuse injuries in young athletes. Although sports specialisation has been a popular research topic in recent years, many questions regarding its underlying factors and its impacts (positive or negative) on injuries, psychosocial health and performance remain unanswered. The purpose of this study is to present the protocol for a study that aims to describe sports specialisation in young gymnasts and to understand the association between sports specialisation, injury, psychological health and physical performance. This study will use a convergent mixed methods design. There will be a qualitative phase where we will conduct interviews and focus group discussions with athletes and different actors in the field. This will be conducted alongside a prospective cohort study over an entire sports season. Athletes will be assessed at the start, middle and end of the season for skill acquisition (core strength and endurance, power and dynamic postural control), psychosocial variables (stress, personality traits, anxiety and quality of life) and sports participation. They will be followed throughout the season using online weekly surveys to monitor training load and injuries.

Objectives: To determine whether the structures and processes of an English Championship football club's performance and healthcare team (PHCT) were associated with player availability (PA) during periods of match congestion (≤3 days between matches).

Methods: This sequential explanatory mixed-method case study included 10 practitioners from the PHCT. Participants completed team process/structure questionnaires two times per month during the 2017-2018 season. PA and match frequency data were provided by the PHCT, who also participated in a postseason focus group. Associations between PA and team structures/processes were assessed using Pearson correlations. Framework analysis was used to explore PHCT perceptions of teamwork effectiveness. Results synthesis was guided by the Integrated Team Effectiveness Model.

Results: Mean PA during match congestion was 78.1% (95% bias-corrected and accelerated bootstrap CI (BCa): 76.2%, 80.4%) compared with 84.2% (95% BCa: 80.6%, 87.3%) during uncongested periods. There were significant associations between match frequency and PA (r= -0.68; 95% BCa: 0.32, 0.93; p=0.008) and PHCT processes and PA (r=0.53; 95% BCa: 0.09, 0.89; p=0.035). Having more PHCT meetings (r=0.46; BCa 95%: 0.22, 0.82; p=0.048) and greater satisfaction with those meetings (r=0.41; BCa 95%: 0.04, 0.07; p=0.043) were associated with higher PA, irrespective of match frequency. During match congestion, the PHCT reported that resource and task coordination issues negatively impacted their processes.

Conclusions: Match congestion was associated with disruptions to PHCT processes and structure, with negative implications for PA.