Physician and Sportsmedicine最新文献

Introduction: The purpose of this scoping review was to determine if there is an association between sleep patterns, as measured by sleep actigraphy, and athletic injuries and performance.

Methods: Studies were included from Pubmed, Embase, and SPORTDiscus, if they measured sleep using actigraphy, evaluated sports injuries and athletic performance. Systematic reviews, narrative reviews, and those not using actigraphy or which focused on concussions instead of other sports injuries were excluded.

Results: A total of 17 studies met inclusion criteria, examining athletes from 10 different sports. Of the seven studies evaluating the relationship between sleep metrics (sleep latency, efficiency, duration, wake after sleep onset) and injury occurrence, four studies (57%) found that decreased sleep correlated with increased injury occurrence in elite soccer, paralympic, and adolescent track and field athletes. Eight studies (47%) evaluated the relationship between sleep metrics and performance (reaction time, sports specific tasks, aerobic, and anaerobic capacity), finding that decreased sleep metrics correlated with decreased aerobic and anaerobic performance in rugby athletes, cyclists, triathletes, mixed martial arts (MMA), and Dutch elite youth athletes.

Conclusion: Findings of this study show that there is no consensus on the relationship between the amount or quality of sleep and rates of sports-related injuries in adult athletes. Poor sleep metrics (total sleep time/duration, latency, and efficiency) were correlated with a decrease in response time in cyclists and Dutch elite youth athletes. Worsened sleep metrics were also found to decrease aerobic performance in physically active males, MMA fighters, rugby players, triathletes, and cyclists. In summary, these findings suggest that there is an association between poor sleep and worsened athletic performance, but the evidence for injury risk is inconclusive.

Background: Branched-chain amino acids (BCAAs) - leucine, isoleucine, and valine - are widely used in sports nutrition, yet their effects on endurance performance remain uncertain. Most studies emphasize biochemical markers without linking them to functional outcomes. This is the first systematic review to evaluate whether biochemical alterations induced by BCAA or leucine supplementation are associated with actual performance or recovery benefits in endurance athletes.

Methods: A systematic review was conducted in accordance with PRISMA 2020, the Cochrane Handbook for Systematic Reviews of Interventions, and the GRADE approach. Searches were performed in PubMed, Embase, and Web of Science up to 11 July 2024. Eligible studies included endurance runners or athletes, used BCAA or leucine supplementation, and reported outcomes related to performance, recovery, or adverse effects. Risk of bias was assessed using the ROBINS-I tool.

Results: From 152 records, 15 studies met inclusion criteria. No consistent improvement was observed in performance, fatigue, or recovery. Only two studies reported statistically significant differences. One trial found a 42% reduction in muscle soreness (p < 0.05), though with inadequate control for protein intake and confounders. Biochemical changes included: increase 140% valine (p < 0.01), low plasma glucose (p < 0.01), increase free fatty acids (p < 0.001), and raise 25% protein synthesis post-exercise (95% CI: 20-30%, p = 0.01). Mental performance improved after 12 km and 30 km runs (p < 0.05), but no functional performance gains were consistently observed.

Conclusion: BCAA and leucine supplementation do not result in meaningful improvements in endurance performance or muscle recovery. Despite biochemical alterations, current evidence - limited by low methodological quality, surrogate outcomes, and risk of bias - does not support the use of BCAA as an effective strategy for endurance athletes.

Background: Musculoskeletal injuries are common in youth football and can impact athletes' development and performance. Understanding their incidence and characteristics is essential for prevention and management.

Objective: To analyze the incidence and characteristics of musculoskeletal injuries in youth categories of a Brazilian football club over one competitive season and assess associations with age group, playing position and training load.

Design: Prospective cohort study.

Methods: We included 180 male athletes from four youth categories (U-11/13, U-15, U-17, U-20) monitored during the 2022 season. Data were collected from medical records, including injury diagnosis and severity, training load metrics (sRPE, TRIMP, ACWR, GPS).Injuries were defined as any condition causing at least one day of absence. Statistical analyses included correlations and group comparisons.

Results: A total of 181 injuries were recorded; 64.4% of athletes sustained at least one. Muscle injuries were most frequent (59%), followed by joint injuries (19.8%). The U-20 group had the highest incidence (33%), and forwards were most affected (34.2%). Bone injuries caused the longest absences (p < 0.0001). No significant associations were found between training load and injury outcomes.

Conclusion: Injury patterns varied by age and position. Muscle injuries predominated, highlighting the importance of integrated monitoring of injury characteristics, athlete profile, and physical demands to support injury prevention and early management in youth football.

Objective: The primary objective of this study was to describe the musculoskeletal health of retired elite women's footballers, with a particular emphasis on hip, knee, and ankle pain and function.

Methods: Retired elite women's footballers (18 years or older) were surveyed on their history of severe hip, knee, and ankle injuries, and previous joint surgery. Validated questionnaires (e.g. Knee Injury and Osteoarthritis Outcome Score Physical Function Short Form (KOOS-PS)) were used to assess health outcomes, such as level of function and pain.

Results: Sixty-two respondents completed the survey (mean age 35.5 years, mean age at retirement 30.5 years). Nineteen (30.6%) retired players reported experiencing hip pain at least once per month. Forty-four (71%) participants had at least one severe knee injury during their career, with nearly a third (n = 20, 32.3%) experiencing knee pain on a weekly basis. The majority (n = 48, 77.4%) of participants had experienced at least one severe ankle injury during their career. Hip, knee and ankle pain was associated with a history of severe hip, knee, or ankle injury during a playing career. A history of ankle surgery was associated with ankle pain. Mean KOOS-PS score (84.7) was lower than that seen in the general population, while hip/ankle outcome measures were comparable to the general population.

Conclusion: Musculoskeletal complaints, especially knee-related issues, are common among retired elite women's footballers, and are associated with severe injuries during a player's career. Collaborative injury prevention efforts are likely to lead to positive health benefits for current, future and former elite women's footballers.

Objectives: To describe the profile of sports-related musculoskeletal complaints treated by physiotherapy during a multi-sport university competition, identify associated factors (training load, strengthening frequency, and previous complaint history), and evaluate the immediate effect of physiotherapy interventions on pain.

Methods: gThis cross-sectional descriptive epidemiological study analyzed physiotherapy records from a University Games (2022-2025), involving 5100 student-athletes. All athletes who sought physiotherapy for a musculoskeletal complaint during the events were included. A standardized assessment form recorded demographics, sport modality, training characteristics, strengthening frequency, previous complaints in the same region, anatomical location, mechanism, physiotherapy interventions, and pain intensity (Numeric Pain Rating Scale, NPRS) before and after treatment. Incidence rates were calculated as physiotherapy-treated complaints per 1000 athlete exposure hours.

Results: A total of 1803 physiotherapy treatment encounters were registered. Most complaints involved the lower limbs (64.7%) and were classified as traumatic (50.3%) or atraumatic/overuse (25.0%). Five team sports - futsal, 7-a-side soccer, volleyball, handball, and basketball - accounted for 93.6% of sport-specific cases. The overall incidence of physiotherapy-treated complaints was 29.62 per 1000 athlete exposure hours. Baseline pain showed no significant difference between encounters with and without a previous complaint in the same region (p = 0.060), was weakly correlated with weekly sport-training hours (ρ = 0.101, p = 0.014), and was not associated with strengthening frequency (ρ = 0.038, p = 0.192). In 1020 encounters with pre- and post-treatment data, a mean reduction of -2.69 NPRS points was observed (p < 0.001; Cohen's d = 1.58).

Conclusion: Musculoskeletal complaints during multi-sport university competitions predominantly affect the lower limbs and are mainly traumatic in nature, particularly in high-intensity team sports. Immediate, on-site physiotherapy provides substantial pain relief, underscoring its role in acute athlete care and as a foundation for targeted injury prevention strategies.

Objectives: Youth weight and resistance training are growing in popularity, offering benefits like improved performance and injury prevention. However, improper technique and lack of supervision can lead to injuries - many of which are preventable with proper training and guidance. This study examined weightlifting-related injury trends and causes among youth in U.S. emergency departments. It was hypothesized that injuries would increase from 2014 to 2023, teens would have the highest injury rates, and crush injuries to fingers and toes would be the most common.

Methods: The National Electronic Injury Surveillance System (NEISS), a publicly available database representing approximately 100 US EDs, was used to identify fractures related to weightlifting in patients 0-18 years old. Fractures were included in this study if caused by improper use of equipment, dropped weights, crush injuries, or falls due to misplaced equipment. Queries were restricted to fractures from 2014 to 2023.

Results: From 2014 to 2023, an estimated 32,955 fractures related to weightlifting were identified, out of which, 28,647 were due to improper use. The mean age was 11.4 ± 5.9 years. Across the study period, the highest number of fractures from improper use in a year was in 2023 (NEISS cases = 114, NE = 3639, 12.7%). Most fractures occurred in males (NEISS cases = 679, NE = 20380, 71.1%). Adolescents (15-18) were the most injured age group (NEISS cases = 376, NE = 12646, 44.1%), with fractures occurring most frequently at home (29.6%) and at places of recreation or sports (21.1%). The most fractured body parts were the finger (38.9%) and toe (38%). There was a significant increase in finger fractures across time (p < .01).

Conclusion: Weight training-related fractures due to improper use display an observed increasing trend among male youth in the US, with an actual case count of 1386 in 2014 increasing to 2815 in 2023. Additionally, there was a significant increase in finger injuries. Future research should be focused on implementing more stringent safety guidelines, increased supervision, as well as proper equipment use, and education for youth in the US, especially in homes and places of recreation.

Objectives: Using a repeated-measures design, we investigated reported symptoms, oculomotor, and neurophysiological responses for up to 26 days following a sports-related concussion.

Methods: Over the course of one season, 115 athletes (mean age 26.2 ± 5.4 years) from one football team (f = 28, m = 37) and one ice hockey team (f = 21, m = 29) were assessed for self-reported symptoms and severity of symptoms, cognitive testing for 10-word recall and digit backwards. Oculomotor performance was assessed using eye-pursuits. Neurophysiology was assessed using transcranial magnetic stimulation. Baseline data were collected during pre-season for all athletes and, when a concussion was identified during the season, additional data were collected at 2-, 12-, 19-, and 26-days post-injury.

Results: Twenty-two players suffered concussion injuries (f = 9, m = 13). Significant increases in symptoms were reported at 2 days (p < 0.001) and 12 days (p = 0.017). Severity of symptoms was significantly increased at 48 hours only (p = 0.002). Significant decrements in performance for 10-word recall (p = 0.003), digit backwards (p = 0.011), and eye-pursuit (p = 0.009) were observed at 48 hours in comparison to baseline. Transcranial magnetic stimulation revealed significantly increased cortical inhibition at 48 hours (p = 0.024), 12 days (p = 0.009), and 19 days (p = 0.028) compared to baseline. No differences were seen between females and males for any variables or timepoints.

Conclusion: Players with SRC show acute changes in cortical inhibition, resolving by 26 days after injury, which follows a longer time-course for recovery compared to symptoms, cognitive tests, and oculomotor eye-pursuits. These results suggest that measuring the recovery of athletes with SRC warrants further investigation using physiological testing to accompany clinical measures in the determination of a player's readiness to return to play.

Background: Cyclocross is a growing discipline in competitive cycling, yet there is a lack of epidemiological data on injury patterns within the discipline. This study aimed to describe the incidence, type, location and mechanisms of injuries sustained during a national-level cyclocross event, using standardized injury surveillance methodology.

Methods: A prospective observational study was conducted at the 2025 British National Cyclocross Championships. Medical staff recorded injuries using the IOC consensus statement on injury and illness reporting, with adaptations from the UCI cycling-specific injury surveillance framework. Injury incidence was calculated per 1000 athlete-hours, and injury characteristics were analyzed by sex, mechanism, and severity.

Results: Overall, 6.7% of 534 cyclists sustained an injury during the event. The overall injury incidence was 98.62 injuries per 1,000 athlete-hours (95% CI: 69.07-136.53). Most injuries (91.9%) were acute. Lacerations (38%) and joint sprains (17%) were the most common diagnoses, with the knee (43%) being the most frequently affected body part. The mean injury severity was 6.83 ± 15.44 days. The primary mechanism of injury was contact with the ground or course features (56.8%). While males sustained more injuries, females experienced significantly longer time-loss per injury (mean 22.5 days vs. 4.88 days; p < 0.05).

Conclusions: Cyclocross is associated with a high rate of predominantly moderate acute injuries, differing from injury patterns seen in road or mountain biking. These findings highlight the need for discipline-specific injury prevention strategies and further research, particularly into sex-based differences and risk mitigation during technical sections of races.

Objective: To establish match injury rates, characteristics, severity, burden, and associated risk factors in South African provincial women's rugby players.

Method: A secondary data analysis of injury data collected prospectively during the 2023 Women's Premier Division competition in South Africa. Match injuries were analyzed, and a modified version of the rugby consensus injury definition was used. The injury incidence rate was calculated as injuries/1000 player match hours. Univariate analysis was used, and injury incidence risk was calculated where applicable. Statistical significance was set at p < 0.05.

Results: The injury incidence rate for all injuries was 207.1/1000 player match hours (95% CIs 153.8 to 260.5), and for time-loss injuries 25.0/1000 player match hours (95% CIs 6.5 to 43.5). The mean severity was 22.3 days. The lower limb and muscle/tendon injuries were the most commonly injured anatomical regions and injury types. Contact injuries had a significantly higher injury incidence rate than non-contact injuries (p < 0.001). The injury incidence risk was significantly higher for forwards compared to backs (p = 0.019).

Conclusion: The overall match injury incidence rate was comparable to other studies on women's rugby. Contact injuries, lower limb, and muscle/tendon injuries are associated with a significantly higher injury incidence rate.

Background: The prevalence of low bone mineral density (BMD) among female athletes is higher than that among their male counterparts up to 40%. Low BMD increases the risk of stress fractures.

Purpose: To examine factors associated with low BMD in female athletes, and to develop, test, and evaluate a Pre-screening Tool for Early Detection of Low BMD in Female Athletes (PreST-LBMD).

Method: The development and validation groups (381 and 233 subjects, respectively) underwent a medical interview and a BMD test at the lumbar spine using dual-energy X-ray absorptiometry (DXA). A Z-score < -1 was classified as low BMD. After extracting factors associated with low BMD from univariate logistic regression and multivariate least absolute shrinkage and selection operator (LASSO) regression analyses, each variable was scored based on the β coefficients from LASSO regression to create the PreST-LBMD. The development model was validated using receiver operating characteristic (ROC) curves. Furthermore, using external validation data, sensitivity, negative predictive value (NPV), and area under the curve (AUC) were calculated to evaluate the performance of PreST-LBMD.

Result: Factors associated with low BMD included age at menarche, amenorrhea for more than 1 year during the teenage years, current duration of amenorrhea, body mass index, history of stress fractures, and exercise load. The calculated cutoff value for a high likelihood of low BMD was 3 points, with a sensitivity of 0.83 (0.79-0.88), a negative predictive value of 0.85 (0.81-0.90), and an area under the curve of 0.74 (0.67-0.81).

Conclusion:  We successfully developed the PreST-LBMD, which showed promising results identifying female athletes with low BMD. Those scoring ≥3 should be assessed by DXA and evaluated for the likelihood of low BMD by the athlete's health and performance team.