Journal of Sport and Health Science最新文献

Background: Due to its high relevance in sports and rehabilitation, the exploration of interventions to further optimize flexibility becomes paramount. While stretching might be the most common way to enhance range of motion, these increases could be optimized by imposing an additional activation of the muscle, such as mechanical vibratory stimulation. While several original articles provide promising findings, contradictory results on flexibility and underlying mechanisms (e.g., stiffness), reasonable effect size (ES) pooling remains scarce. With this work we systematically reviewed the available literature to explore the possibility of potentiating flexibility, stiffness, and passive torque adaptations by superimposing mechanical vibration stimulation.

Methods: A systematic search of 4 databases (Web of Science, MEDLINE, Scopus, and Cochrane Public Library) was conducted until December 2023 to identify studies comparing mechanical vibratory interventions with passive controls or the same intervention without vibration (sham) on range of motion and passive muscle stiffness in acute (immediate effects after single session) and chronic conditions (multiple sessions over a period of time). ES pooling was conducted using robust variance estimation via R to account for multiple study outcomes. Potential moderators of effects were analyzed using meta regression.

Results: Overall, 65 studies (acute: 1162 participants, chronic: 788 participants) were included. There was moderate certainty of evidence for acute flexibility (ES = 0.71, p < 0.001) and stiffness (ES = -0.89, p = 0.006) effects of mechanical vibration treatments vs. passive controls without meaningful results against the sham condition (flexibility: ES = 0.20, p < 0.001; stiffness: ES = -0.19, p = 0.076). Similarly, moderate certainty of evidence was found for chronic vibration effects on flexibility (control: ES = 0.64, p = 0.043; sham: ES = 0.65, p < 0.001). Lack of studies and large outcome heterogeneity prevented ES pooling for underlying mechanisms.

Conclusion: Vibration improved flexibility in acute and chronic interventions compared to the stand-alone intervention, which can possibly be attributed to an accumulated mechanical stimulus through vibration. However, studies on biological mechanisms are needed to explain flexibility and stiffness effects in response to specific vibration modalities and timing.

Background: The potential of exercise as a concurrent therapy for actively treated primary tumors has been suggested by emerging preclinical and observational studies. However, clinical trials regarding this question are scarce. Therefore, we conducted a randomized controlled trial investigating the effects of aerobic or resistance exercise concomitant to neoadjuvant chemotherapy (NACT) on tumor size.

Methods: In the BENEFIT study (German title: Bewegung bei neoadjuvanter chemotherapie zur verbesserung der fitness), patients with breast cancer scheduled for NACT were randomly assigned to supervised resistance training (RT, n = 60) or aerobic training (AT, n = 60) twice weekly during NACT or to a waitlist control group (WCG, n = 60). The primary outcome, "change in tumor size", as well as the secondary clinical outcomes pathologic complete response (pCR), type of surgery (breast conserving/mastectomy), axillary lymph node dissection (ALND, yes/no), premature discontinuation of chemotherapy (yes/no), and relative dose intensity (RDI) were derived from clinical records. Due to the highly skewed distribution, the primary outcome was categorized. Multiple (ordinal) logistic regression analyses were performed.

Results: Overall, there was no significant difference in post-intervention tumor size between RT or AT and WCG. However, there was a significant effect modification by hormone receptor (HR) status (p_interaction = 0.030). Among patients with HR+ tumors, results suggest a beneficial effect of AT on tumor shrinkage (odds ratio (OR) = 2.37, 95% confidence interval (95%CI): 0.97‒5.78), on pCR (OR = 3.21, 95%CI: 0.97‒10.61); and on ALND (OR = 3.76, 95%CI: 0.78‒18.06) compared to WCG. The effects of RT were slightly less pronounced. For HR-subtypes, beneficial effects on RDI were found for AT (OR = 3.71, 95%CI: 1.20‒11.50) and similarly for RT (OR = 2.58, 95%CI: 0.88‒7.59). Both AT and RT had favorable effects on premature discontinuation of chemotherapy (OR (no vs. yes) = 2.34, 95%CI: 1.10‒5.06), irrespective of tumor receptor status.

Conclusion: While there was no significant effect on the primary outcome in the overall group, aerobic and resistance exercise concomitant to NACT seem to beneficially affect tumor shrinkage and pCR, reduce the need for ALND among patients with HR+ breast cancers, and prevent low RDI among patients with HR- breast cancers. These results warrant confirmation in further trials.

Purpose: This study aimed to assess the influence of older vs. younger age and previous anterior cruciate ligament (ACL) injury on resting serum cartilage oligomeric matrix protein (sCOMP(t_pre)) concentration, on immediate load-induced sCOMP kinetics after a 30-min treadmill walking stress (∆_sCOMP(t_post)), and on the dose-response relationship between ambulatory load magnitude and ∆_sCOMP(t_post).

Methods: A total of 85 participants were recruited in 4 groups (20-30 years: 24 healthy, 23 ACL-injured; 40-60 years: 23 healthy, 15 ACL-injured). Blood samples were collected immediately before and after a walking stress at 80%, 100%, or 120% bodyweight (BW) on 3 test days and analyzed for sCOMP concentration. Linear models were used to estimate the effect of age, knee status (unilateral ACL injury, 2-10 years prior), and sex on sCOMP(t_pre), ∆_sCOMP(t_post), and the dose-response between ambulatory load magnitude and ∆_sCOMP(t_post).

Results: We found that sCOMP(t_pre) was 21% higher in older than younger participants (p < 0.001) but did not differ between ACL-injured and healthy participants (p = 0.632). Also, ∆_sCOMP(t_post) was 19% lower in older than younger participants (p = 0.030) and increased with body mass index (p < 0.001), sCOMP(t_pre) (p = 0.008), and with 120%BW (p < 0.001), independent of age, ACL injury, or sex.

Conclusion: Age but not prior ACL injury influences resting sCOMP and load-induced sCOMP. The dose-response relationship between ambulatory load magnitude and load-induced sCOMP changes is not affected by age, ACL injury, or sex. A better understanding of systemic sCOMP and the role of its mechanoresponse for the understanding of osteoarthritis pathophysiology and monitoring intervention efficacy may require knowledge of individual cartilage composition and tissue-level loading parameters.

Background: Preparticipation examinations (PPEs) are unstandardized screening tools routinely used to collect an athlete's baseline health information prior to the start of a new competitive season. However, many PPEs include minimal and often nonspecific questions related to the health concerns of female athletes. A lack of female athlete specific health questions could result in missed red flags and subsequent injury or illness. As such, the objectives of this scoping review were to (a) determine what female athlete specific health questions currently exist in PPEs in the scientific literature to prevent injury and illness, and (b) map the results against the health domains outlined in the International Olympic Committee (IOC) consensus statement supplement on the female athlete.

Methods: We searched Embase, Scopus, CINAHL, Medline Ovid, and SPORTDiscus from inception to December 2022. Any study with female athlete specific health PPE questions or recommendations for questions (i.e., menstrual health, eating habits, musculoskeletal health, etc.) was included. Three reviewers independently screened titles and abstracts, followed by full text articles for eligibility and data extraction, with conflicts resolved by a third-party reviewer. Extracted data were summarized into 3 determined groupings.

Results: Of the 1356 studies screened, 41 were included in this study. Forty studies (98%) included questions/recommendations related to menstrual health. Thirty-one studies (76%) had questions/recommendations concerning disordered eating/eating habits. Twenty-four studies (59%) referred to body weight/image, and 16 studies (39%) referred to musculoskeletal health. No studies included questions on all IOC female athlete health domains.

Conclusion: There is currently a gap in female athlete specific health content included in PPEs. A more comprehensive, standardized PPE with a focus on inclusion of female athlete specific health questions and considerations should be developed to improve health and optimal participation of female athletes around the world.

Purpose: The purpose of this umbrella review was to synthesize the evidence from systematic reviews on the benefits and harms of exercise therapy and physical activity (PA) for the secondary prevention and management of low back pain (LBP).

Methods: An umbrella review was conducted to evaluate the effectiveness of exercise therapy and PA in the management and secondary prevention of LBP. A systematic search was performed in MEDLINE, CINAHL, Scopus, Web of Science, Cochrane Database of Systematic Reviews, and Physiotherapy Evidence Database (PEDro), including reference lists of relevant reviews, covering studies published between January 1, 2010 and May 20, 2024. Eligible studies were systematic reviews of randomized controlled trials and observational studies, with or without meta-analyses. The primary outcome for secondary prevention was LBP recurrence, while for management, primary outcomes included pain intensity and disability, with adverse events as secondary outcomes. Data were extracted across immediate, short-term, intermediate, and long-term follow-up periods. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework was used to assess the certainty of evidence, and the Assessment of Multiple Systematic Reviews tool (AMSTAR) tool was applied by 2 independent reviewers (JC, QL, and/or DXMW) to evaluate the quality of the included reviews. The study was prospectively registered on the Open Science Framework (OSF).

Results: A total of 70 systematic reviews were included, 43 with meta-analyses, 7 with network meta-analyses, and 20 without meta-analyses. Six (out of 10) reviews with meta-analyses for secondary prevention indicated a small benefit from general exercises and leisure-time PA (low-to-moderate certainty). For LBP management, 35 (out of 36) reviews reported that exercise therapies such as Pilates, motor control, mixed exercise, Tai Chi, water-based exercises, and yoga showed small beneficial effects on pain and disability compared to minimal intervention mainly in the short-term (low-to-moderate certainty). Seven network meta-analyses favored motor control and Pilates over other forms of exercise to reduce pain (low certainty). Adverse events were reported in less than 31% of the reviews, predominantly involving post-exercise soreness and temporary increases in pain, mainly in yoga-related studies. Adverse events were considered minor, and no serious adverse events were reported.

Conclusion: There is low-to-moderate certainty that exercise therapy and leisure-time PA are beneficial for improving pain and preventing the recurrence of LBP. However, evidence on the potential harms of these interventions is limited, and adverse events related to exercise and PA remain under-investigated.

Background: Higher accelerometer-assessed volume and intensity of physical activity (PA) have been associated with a longer life expectancy but can be difficult to translate into recommended doses of PA. We aimed to: (a) improve interpretability by producing UK Biobank age-referenced centiles for PA volume and intensity; (b) inform public-health messaging by examining how adding recommended quantities of moderate and vigorous PA affect PA volume and intensity.

Methods: 92,480 UK Biobank participants aged 43-80 years with wrist-worn accelerometer data were included. Average acceleration and intensity gradient were derived as proxies for PA volume and intensity. We generated sex-specific centile curves using Generalized Additive Models for Location Scale and Shape (GAMLSS) and modeled the effect of adding moderate (walking) or vigorous (running) activity on the combined change in the volume and intensity centiles (change in PA profile).

Results: In men, volume was lower as age increased while intensity was lower after age 55; in women, both volume and intensity were lower as age increased. Adding 150 min of moderate PA weekly (5 × 30 min walking) increased the PA profile by 4 percentage points. Defining moderate PA as brisk walking approximately doubled the increase (9 percentage points) while 75 min of vigorous PA weekly (5 × 15 min running) trebled the increase (13 percentage points).

Conclusion: These UK Biobank reference centiles provide a benchmark for interpretation of accelerometer data. Application of our translational methods demonstrate that meeting PA guidelines through shorter duration vigorous activity is more beneficial to the PA profile (volume and intensity) than longer duration moderate activity.

Background: There is a lack of research examining the interplay between objectively measured physical activity volume and intensity with life expectancy. The purpose of the study was to investigate the interplay between objectively measured PA volume and intensity profiles with modeled life expectancy in women and men within the UK Biobank cohort study and interpret findings in relation to brisk walking.

Methods: Individuals from UK Biobank with wrist-worn accelerometer data were included. The average acceleration and intensity gradient were extracted to describe the physical activity volume and intensity profile. Mortality data were obtained from national registries. Adjusted life expectancies were estimated using parametric flexible survival models.

Results: 40,953 (57.1%) women (median age = 61.9 years) and 30,820 (42.9%) men (63.1 years) were included. Over a median follow-up of 6.9 years, there were 1719 (2.4%) deaths (733 in women; 986 in men). At 60 years, life expectancy was progressively longer for higher physical activity volume and intensity profiles, reaching 95.6 years in women and 94.5 years in men at the 90th centile for both volume and intensity, corresponding to 3.4 additional years (95% confidence interval (95%CI): 2.4-4.4) in women and 4.6 additional years (95%CI: 3.6-5.6) in men compared to those at the 10th centiles. An additional 10-min or 30-min daily brisk walk was associated with 0.9 (95%CI: 0.5-1.3) and 1.4 years (95%CI: 0.9-1.9) longer life expectancy, respectively, in inactive women; and 1.4 years (95%CI: 1.0-1.8) and 2.5 (95%CI: 1.9-3.1) in inactive men.

Conclusion: Higher physical activity volumes were associated with longer life expectancy, with a higher physical activity intensity profile further adding to a longer life. Adding as little as a 10-min brisk walk to daily activity patterns may result in a meaningful benefit to life expectancy.