BMC Sports Science Medicine and Rehabilitation最新文献

Background: Integrative neuromuscular training (INT) is proposed to enhance static and dynamic balance in team athletes by improving sensorimotor control. This systematic review and meta-analysis evaluated INT effects across these two domains.

Methods: We searched PubMed/MEDLINE, Scopus, SPORTDiscus (EBSCOhost), and the Web of Science Core Collection from database inception through 3 March 2025. Random-effects and multilevel meta-analyses were conducted in R (meta, metafor). Standardized mean differences (Hedges' g) were pooled using inverse-variance weighting. For datasets with multiple effects per study, we fitted multilevel random-effects models (metafor::rma.mv) with random intercepts for study and within-study effects, estimating variance components (τ²) via REML. We report 95% confidence intervals, I², τ², and 95% prediction intervals. Risk of bias was assessed with RoB 2 and certainty of evidence with GRADE; small-study effects were examined using Egger's regression (k ≥ 10) and bubble plots.

Results: Fifteen randomized controlled trials (n = 609 athletes) were included. Overall risk of bias (RoB 2) was judged as some concerns across studies. INT improved dynamic balance (SMD = 1.48, 95% CI 0.97-1.99; I² = 86.8) and static balance (SMD = 0.89, 95% CI 0.32-1.47; I² = 51.2). Dynamic balance improved more with ≥ 3 sessions/week (SMD = 2.01, 95% CI 1.23-2.80; I² = 91.2%), whereas static balance benefited more from programs ≤ 8 weeks (SMD = 1.16, 95% CI 0.77-1.54).

Conclusions: INT improves balance in team athletes, with larger gains for dynamic tasks. Dynamic balance was preferentially enhanced by ≥ 3 sessions/week, while static balance gains were optimal at ≤ 8 weeks. Evidence certainty was moderate for dynamic balance and low for static balance.

Background: Lumbar spinal stenosis (LSS) affects a considerable portion of global population and is one of the main reasons for lumbar spine surgery in individuals over the age of 65. Diagnosing LSS remains challenging due to a lack of universally accepted criteria and a weak correlation between imaging severity and symptoms. Functional assessment, including standardized treadmill or walking tests, is recommended. While self-reported questionnaires are commonly used, objective exertion tests are also important for assessing symptom severity and treatment outcomes. This study aims to evaluate and map the scientific knowledge on objective physical performance and exercise tests for patients with LSS.

Method: This scoping review followed the Joanna Briggs Institute methodology and is reported in accordance with the PRISMA-ScR guidelines. A protocol was registered on open science framework (OSF). The review question was informed by the Population-Concept-Context framework. A systematic search of CINAHL (Cumulative Index to Nursing and Allied Health Literature), MEDLINE, Cochrane, Embase, Web of Science, and Scopus was conducted from inception to December, 2025. Two reviewers independently screened studies against predefined eligibility criteria and extracted data using a standardized charting form. Findings were synthesized narratively and presented in tabular and graphical formats.

Results: 57 studies met the inclusion criteria. In most studies, the diagnosis of LSS was made using a combination of clinical assessments, such as the patient's history and/or physical examination, along with MRI findings. After reviewing the literature on exertional tests for patients with lumbar spinal stenosis and extracting the relevant data, the tests were grouped into six categories: walking tests, treadmill tests, cycling tests, standing lumbar extension tests, accelerometer testing, and other functional mobility and balance tests.

Conclusion: Exertional tests in patients with LSS have diagnostic, evaluative, and rehabilitative value, supporting both clinical decision-making and outcome assessment. Among available methods, walking tests, particularly those quantifying neurogenic claudication, are the most valid and reliable objective measures. Accelerometer-based assessments effectively capture ambulation capacity, while treadmill and standing lumbar extension tests show promise but require further validation. Additional research is needed to standardize protocols and determine how disability severity influences test selection and performance outcomes.

Level of evidence: III.

Background: The rise in youth karate competition participation correlates with elevated injury risk. This study investigated injury incidence and patterns among Iranian junior athletes at the 2023 National Karate Championships (Tehran, April-May 2023), the official selection event for the national team, considering differences by age, sex, weight, and bout characteristics.

Methods: A prospective cohort design was employed, analyzing data from 1391 athletes across 1544 bouts. Injury data were systematically collected by qualified medical personnel using standardized forms. Injury incidence rates (IIRs) were rigorously calculated per 1000 athlete-exposures (AEs) and per 1000 min of exposure (MEs) to account for varying exposure durations.

Results: A total of 527 injuries were recorded during the competition. The overall IIR was determined to be 18.94 per 1000 AEs and 9.02 per 1000 MEs. The face was identified as the most commonly injured anatomical site, accounting for 46% of all injuries, while contusions were the most frequent injury type, comprising 48%. Athletes in the Under-21 (U21) male category exhibited the highest injury rates. Furthermore, more than half (52%) of all recorded injuries occurred within the first minute of a bout, and losing athletes sustained a disproportionately high 59% of the total injuries.

Conclusion: In conclusion, this study identified a high injury incidence among Iranian junior karate athletes, with the face being the most commonly affected region and contusions the predominant injury type. Male and U21 athletes showed notably higher injury rates, particularly early in bouts and among those who lost. These findings highlight the need for targeted preventive strategies and serve as a national benchmark for future injury surveillance in youth karate.

Objective: HIIT is a time-efficient aerobic exercise with potential for obesity prevention and control, as it achieves comparable or superior effects to traditional exercise in a shorter duration. This meta-analysis examines the differential effects of HIIT and MICT on body fat composition and cardiorespiratory fitness in adults, providing evidence for optimized exercise prescriptions.

Methods: Searched PubMed, Embase, Cochrane Library, and Web of Science for RCTs assessing HIIT cycling's effects on fat reduction and cardiorespiratory fitness. Data were pooled using SMD in Review Manager 5.4 and Stata 18. Heterogeneity was evaluated via the I² statistic, with subgroup analyses stratified by population (disease, obese, sedentary).

Results: Nineteen RCTs were included. Compared to MICT, HIIT significantly reduced BMI in obese populations (SMD = -0.59 kg/m², 95% CI: -0.84 to -0.34, P < 0.001), but slightly increased BMI in disease populations (SMD = 0.40 kg/m², 95% CI: 0.03 to 0.77, P = 0.042). For cardiorespiratory fitness, HIIT outperformed MICT in improving VO₂peak in obese populations (SMD = 0.23 ml·kg⁻¹·min⁻¹, 95% CI: 0.01 to 0.45, P = 0.041) and sedentary populations (SMD = 6.21 ml·kg⁻¹·min⁻¹, 95% CI: 4.68 to 7.74, P < 0.001).

Conclusion: HIIT cycling demonstrates comparable efficacy to MICT for improving body composition, including body fat percentage, fat mass, and lean body mass in adults, while outperforming MICT in reducing BMI among obese individuals and enhancing cardiorespiratory fitness VO₂peak across obese and sedentary populations.

Background: Percentile-based thresholds in the International Tennis Federation (ITF) junior ranking system are widely used to gauge competitive standing, yet little is known about their long-term dynamics, systemic biases, and predictive validity. Total Ranking Points (TRP) reflect cumulative achievement but are affected by tournament volume and access. Points per Event (PPE) have therefore been proposed as a complementary efficiency-based metric. The age at which thresholds are reached and the geographic distribution of top performers are critical for understanding developmental timing and equity of access.

Objectives: This study aimed to (1) quantify and forecast cut-off thresholds (P₉₀, P₇₅, P₅₀) categories using TRP and PPE; (2) examine the age of players achieving these benchmarks; (3) assess geographic representation at P₉₀; and (4) test whether trajectories display linear stability or accelerating progression.

Methods: A longitudinal dataset of 8,413 junior female players ranked in ITF year-end lists (2004-2024) was analysed. TRP were obtained from ITF records, while PPE were calculated as TRP divided by sanctioned tournament entries. Annual percentile cut-offs were derived using binary logistic regression. Geographic equity was assessed via country counts, Shannon diversity, and a sensitivity criterion (≥ 2 players per country). Player ages were calculated from birth year and tested with regression and Kendall's τ. Bayesian Prophet models forecast 2025-2029 thresholds, configured for changepoint detection.

Results: TRP thresholds rose exponentially, while PPE trajectories were more variable. P₉₀ age remained stable at 16 years, whereas P₇₅ and P₅₀ trended older. Geographic access at P₉₀ was stable but concentrated, with only 5-10 countries represented annually and repeated multi-player presence limited to a few nations (e.g., USA, Russia, Czechia). Forecasts indicated TRP cut-offs will continue to rise through 2029, with P₉₀ exceeding 1,400 points, while PPE trends remained less stable.

Conclusions: The ITF junior girls' ranking system shows accelerating cumulative thresholds (TRP) alongside less predictable efficiency-based patterns (PPE). Elite entry age remains consistently young, broader tiers are ageing, and access to P₉₀ is dominated by a small group of nations. Percentile thresholds therefore capture systemic competitiveness more than intrinsic ability, offering valuable but context-dependent insights for planning and equity in talent development.

Background: Squash is a high-intensity sport requiring rapid directional changes and explosive strokes, placing high demands on neuromuscular coordination. The forehand stroke is a key offensive action, yet its neuromuscular control mechanisms remain underexplored. Post-activation potentiation (PAP) has been shown to acutely enhance explosive performance, but its role in optimizing complex skills such as the squash forehand stroke is still unclear.

Methods: This study investigated the effects of three intervention modalities-deep squat training, elastic band training, and neuromuscular electrical stimulation (NMES)-on the neuromuscular control patterns during squash forehand strokes. Fourteen muscles of the lower limbs, trunk, and upper limbs were recorded using surface electromyography (EMG). Muscle synergies were extracted using non-negative matrix factorization, while intermuscular coherence was calculated with short-time Fourier transform. The number of synergies, synergy weights, activation duration, and coherence area across α, β, and γ frequency bands were analyzed using repeated-measures ANOVA tests.

Results: No significant differences were found in the number of synergies (VAF > 0.9) or in activation duration across conditions (p > 0.05). However, significant differences in synergy weights were observed among groups. Squat training increased pectoralis major activation compared to band training (p = 0.040), while NMES selectively enhanced activation in deltoid, gluteus maximus, and gastrocnemius medialis. Coherence analysis showed that NMES significantly increased α- and β-band coherence in several muscle pairs, whereas squat and band training enhanced γ-band coherence between trunk-lower limb muscles.

Conclusions: These findings suggest that while the overall modular structure of squash forehand strokes remains stable, different interventions induce distinct neuromuscular adaptations. NMES enhances central-peripheral coupling through selective muscle activation, whereas squat and band training primarily improve kinetic chain coordination and dynamic stability. This study provides novel insights into the neural control mechanisms of squash strokes and practical guidance for training strategies.