Sports Health-A Multidisciplinary Approach最新文献

Background: Artistic roller skating is a sport that involves high physical demands, particularly in the free skating discipline, where jumps are critical. Managing training loads is essential for optimizing performance and preventing injuries.

Hypothesis: To investigate the internal and external training loads of female artistic roller skating athletes and to analyze the relationships between these loads components.

Study design: Cohort study.

Level of evidence: Level 3.

Methods: A total of 15 female artistic roller skating athletes were monitored over a 4-week mesocycle leading up to the National Championship. Internal training load (ITL) was measured using the session rating of perceived exertion (sRPE), whereas external training load (ETL) was assessed with an inertial measurement unit capturing jumps and energy. Repeated measures analysis of variance (RMANOVA) and correlation analysis were conducted.

Results: The RMANOVA revealed significant differences in monotony and strain of ITL, as well as in the monotony of jumps and energy. Significant correlations were found between ITL and ETL metrics, with higher sRPE and daily ITL associated with increased jumps and energy.

Conclusion: The findings highlight the interrelationships between internal and external load metrics, with higher perceived exertion and daily training loads associated with increased external workload, particularly in jump frequency and energy. In addition, training monotony and strain fluctuated across microcycles, with notable increases observed as the competition approached. These results emphasize the importance of systematically monitoring both internal and external training loads, including monotony and strain, to better understand workload dynamics and guide training adjustments.

Clinical relevance: The findings provide practical insights for coaches on how to balance training intensity and volume to enhance performance and prevent overtraining and injuries.

Background: Few studies have explored relationships between low back pain (LBP) and physical characteristics (physique, muscle strength, tightness, and flexibility) in female rhythmic gymnasts (RGs).

Hypothesis: Due to their extreme flexibility, modifiable physical factors for LBP in RGs are not related to muscle tightness.

Study design: Cross-sectional study.

Level of evidence: Level 4.

Methods: College female RGs (n = 95) were categorized into LBP and non-LBP groups based on questionnaires and orthopaedic surgeon interview. Physical assessments included whole-body bone mineral content and density, trunk lean body mass, and scoliosis presence by dual-energy X-ray absorptiometry scans, presence of abnormal findings and spine alignment by magnetic resonance imaging scans, hip muscle strength testing (flexion, extension, and abduction), range of motion (ROM), and flexibility testing. LBP and non-LBP groups were compared, and multivariate regression analysis performed.

Results: RGs with LBP exhibited significantly longer practice time, lower hip flexion muscle strength on the nondominant side versus dominant side, lower active straight leg raise on the nondominant side versus dominant side, and lower hip external rotation (ER) ROM on the nondominant side versus dominant side. A history of LBP was also associated with current LBP. Multivariate logistic regression analysis revealed that a history of LBP (odds ratio [OR], 6.33; 95% CI, 1.56-25.62), differences in hip flexion strength (OR, 0.96; 95% CI, 1.00-1.08), and differences in hip ER ROM (OR, 1.12; 95% CI, 1.03-1.19) were factors associated with LBP.

Conclusion: LBP was experienced by 27.3% RGs and associated not only with a history of LBP and a deficit in hip flexor strength on the nondominant side but also a deficit in hip ER ROM on the nondominant side.

Clinical relevance: Focusing on hip flexor strength and hip ER ROM on the nondominant side may be of value for LBP rehabilitation and prevention in RGs.

Background: Previous studies have identified demographic, radiographic, and intraoperative predictors of outcomes after hip arthroscopy for femoroacetabular impingement syndrome, yet few studies have identified whether preoperative gait metrics can predict outcomes.

Hypothesis: Increased preoperative step count, walking speed, step length, and gait symmetry will be associated with better outcomes after surgery.

Study design: Retrospective cohort study.

Level of evidence: Level 4.

Methods: Patients who underwent hip arthroscopy between 2019 and 2022 and downloaded the smartphone app rHip, allowing for retroactive access of gait metric data, were identified. Preoperative gait metrics, age, sex, body mass index (BMI), and exercise participation were analyzed via multivariate stepwise linear regression for a relationship with 1-year postoperative patient-reported outcomes (PROs), including Hip Outcome Scale-Activities of Daily Living (HOS-ADL); HOS-Sports Subscale (HOS-SS), and 12-item international Hip Outcome Tool (iHOT-12). Thresholds for preoperative gait metrics were analyzed via receiver operator characteristic curve. A subgroup analysis was performed to compare those who did and did not reach this threshold.

Results: A total of 43 patients (86% female; age, 33.1 ± 13.7 years; BMI, 23.9 ± 4.4 kg/m²) met inclusion criteria. Multivariate regression found that preoperative walking speed was significantly associated with postoperative HOS-ADL, HOS-SS, and iHOT-12 (P ≤ .01). A preoperative walking speed threshold of 1.065 m/s was predictive of outcome achievement. Those who failed to achieve this threshold were significantly older, of greater BMI, and less active (P ≤ .04). They also showed significantly worse 1-year postoperative scores (P ≤ .02) and lower PASS achievement for HOS-ADL, HOS-SS, and iHOT-12 (P ≤ .04).

Conclusion: Preoperative walking speed is significantly associated with 1-year outcomes after hip arthroscopy. Patients who averaged <1.065 m/s show significantly worse outcomes after surgery.

Clinical relevance: Assessment of preoperative walking speed may allow physicians to better counsel patients regarding expected outcomes after hip arthroscopy.

Context: Flag football is a rapidly growing sport with injuries frequently presenting to emergency departments (EDs). Current literature on flag football lacks mechanisms of injury and any information pertaining to female athletes. The purpose of this study was to examine demographic-specific injury trends in those playing flag football.

Evidence acquisition: The National Electronic Injury Surveillance System (NEISS) was queried for flag football injuries presenting to United States EDs from January 1, 2013 to December 31, 2022. Patient demographics, injury site, diagnosis, and disposition were recorded. NEISS narratives were used to identify mechanisms of injury. National estimates (NEs) were calculated using the NEISS statistical sample weight. Annual injury trends were evaluated by linear regression.

Study design: Descriptive epidemiology study.

Level of evidence: Level 3.

Results: There were 2508 flag football injuries (NE, 86,443) analyzed from 2013 to 2022; 78.2% were sustained by male athletes. Linear regression analysis revealed no significant trend in annual injuries (P = 0.16) from 2013 to 2022. The most common mechanism of injury was player-player collision (35.7%). The 2 age groups most affected by flag football injuries were middle school-aged (11-13 years) (20.8%) and high school-aged (14-18 years) (23.7%). The area of the body most affected for pediatric (<18 years) groups was the head, while adults most frequently injured their fingers. In addition, the most common mechanism for the pediatric age group was fracture (21.3%), whereas adult age groups most frequently suffered from strain/sprain injuries.

Conclusion: The number of injuries from flag football identified in this study has not decreased throughout the last decade, aside from 2020 - potentially due to the prevalence of COVID-19. Collisions were the most frequent mechanism of injury across all age groups. Whereas younger athletes frequently sustained head injuries and fractures, older athletes typically sustained strain/sprain injuries and finger injuries.

Background: Maximum repetitions to failure (RTF) and repetitions in reserve (RIR) can be estimated through fastest mean velocity (MV_fastest) and mean velocity (MV), respectively. However, the impact of inter-repetition intervals (IRI) on these relationships in free-weight back squat and bench press exercises is unclear.

Hypothesis: The IRI would affect RTF-MV_fastest and RIR-MV relationships, with a higher goodness-of-fit using self-selected IRI (SSIRI) compared with 0 seconds (IRI0) and 3 seconds (IRI3).

Study design: Crossover study design.

Level of evidence: Level 3.

Methods: Eighteen male participants completed 1 session per IRI configuration, consisting of 3 single sets of RTF (65%-75%-85% of the 1-repetition maximum) during the free-weight back squat and bench press exercises.

Results: Individualized RTF-MV_fastest and RIR-MV relationships were stronger than generalized (median R² = 0.98 vs 0.65 and 0.84 vs 0.40, respectively). The goodness-of-fit of the relationships was stronger for SSIRI than for IRI0 during back squat (P < .01) and comparable between IRIs during bench press (P ≥ .28). During back squat, MV_fastest values were higher for IRI0 than for IRI3 and SSIRI (eighth-fifteenth repetitions; P ≤ .07), whereas during the bench press, they were higher for IRI0 than for IRI3 (eleventh-fifteenth repetitions; P ≥ .28). Overall, MV values associated with each RIR were higher for IRI0 than for SSIRI (10 out of 18 comparisons) during back squat, and for IRI0 than for IRI3 and SSIRI (16 and 14 out of 18 comparisons) during bench press.

Conclusion: These results highlight the importance of standardizing the IRI during set-to-failure to establish RTF-MV_fastest and RIR-MV relationships, with SSIRI recommended as a more accurate and effective procedure.

Clinical relevance: This information may provide practitioners with a valuable tool to objectively quantify the level of effort being exerted during resistance training sets by measuring movement velocity in free-weight exercises.

Context: Small-sided soccer games (SSSG) have been proposed as a strategy to promote the health of children and adolescents. Understanding training loads has a strong influence on program effectiveness.

Objective: This systematic review aimed to describe the training load and perception of enjoyment during SSSG in untrained children and adolescents.

Data sources: A systematic search on PubMed, Web of Science, Scopus, and Scielo databases was performed.

Study selection: Experimental or observational studies conducted in untrained children or adolescents (6 to 18 years) that analyzed internal loads, external loads, or perceived enjoyment during 1 or more SSSG were included.

Study design: Systematic review following PRISMA guidelines.

Level of evidence: Level 3.

Data extraction: Information on publication type, participants, SSSG characteristics, and main results of the internal and external load and perceived enjoyment was extracted.

Results: A total of 15 articles (n = 539 participants, aged 8-18 years) were included. Twenty-one SSSG designs were identified, and the format used most was 3v3. Heartrate (HR) (range 71%-88% of maximum HR) and rate of perceived exertion (range 3-7 of 10 or 12-15 of 20) were the primary measures of internal load, while distance traveled, average speed, and number of accelerations were used to assess external load. Perceived enjoyment was reported using mainly the 16-item PACES or 18-item PACES scale (59.14 or 88.67, respectively). The structural aspects of the game were evaluated in 6 studies, suggesting that the number of players, pitch size, man-marking, and restricting the type of locomotion may affect workload. Contextual factors, such as verbal motivation or sex, can also influence workload.

Conclusion: SSSG is associated with moderate-to-vigorous intensity exercise and high enjoyment perception. Workload can be affected by structural (number of players, pitch size, man-marking) and contextual factors (verbal encouragement, sex composition), although evidence is still limited.

Context: Adolescence is a critical period for bone development, and physical exercise has been recognized as a key factor in promoting bone health. Whole-body bone mineral density (BMD) serves as a vital indicator of bone strength and future fracture risk.

Objective: To systematically review and perform a meta-analysis of the effects of physical exercise on whole-body BMD in adolescents, identifying types of exercise beneficial for bone health.

Data sources: A comprehensive search was conducted across databases including Web of Science, PubMed, Embase, EBSCOhost, Cochrane, and Scopus to identify relevant studies published between 1991 and 2025.

Study selection: Studies were selected based on predefined inclusion criteria that focused on adolescents, physical exercise, and whole-body BMD outcomes. A total of 12 studies involving 1845 participants met the criteria for inclusion.

Study design: Systematic review and meta-analysis.

Level of evidence: Level 1.

Data extraction: Data were extracted using the Cochrane Handbook guidelines, and meta-analysis was conducted using Review Manager software. Publication bias was assessed using a funnel plot.

Results: Physical exercise increased whole-body BMD significantly in adolescents (pooled effect size of mean difference, 0.06; 95% CI, 0.04, 0.09; P < 0.001). Physical exercise significantly improved whole-body BMD in both male and female adolescents, but the effect was more pronounced in boys (P < 0.001) compared with girls (P = 0.002). High-impact and weightbearing exercises, such as basketball, soccer, ice hockey, and boxing, significantly enhanced whole-body BMD in adolescents, whereas nonweightbearing exercises, such as swimming, had a weaker effect on BMD improvement. Judo showed no significant effect.

Conclusion: Physical exercise, particularly high-impact sports, significantly enhances whole-body BMD in adolescents, especially in boys. These findings highlight the importance of incorporating effective physical activities into adolescent physical education to promote optimal bone health.

Context: The use of photobiomodulation therapy (PBMT) as an adjunct to improve muscle performance and accelerate recovery in high-level volleyball and football players remains controversial.

Objective: To determine whether PBMT improves skeletal muscle performance in ball sports athletes, and whether there are differences in the improvement of skeletal muscle performance by PBMT between volleyballers and footballers.

Data sources: A comprehensive search of the Web of Science, Medline, Scopus, and PubMed databases was conducted through April 10, 2025.

Study selection: Eligible studies included those explicitly categorized as randomized controlled trials (RCT) of PBMT interventions for high-level volleyballers and/or footballers; 14 studies met the inclusion criteria.

Study design: Meta-analysis.

Level of evidence: Level 2.

Data extraction: The primary outcome measures included maximal voluntary contraction force (MVC), number of repetitions, and creatine kinase (CK) levels. Means and standard deviations for each variable of interest were used to calculate standardized mean differences (SMDs).

Results: The active laser had no significant effect on MVC (mean difference [MD], 19.67; 95% CI, 7.36 to 31.72; P = 0.31)]; however, it significantly increased the number of repetitions (SMD, 0.58; 95% CI, -0.05 to 1.21; P = 0.04) and significantly decreased CK levels (MD, -45.37; 95% CI, -55.52 to -35.22; P < 0.001).

Conclusion: PBMT can delay muscle fatigue onset and reduce CK levels in ball sports athletes. The improvement in skeletal muscle performance induced by PBMT showed differences between volleyballers and footballers, as there was a significant increase the number of repetitions in volleyball players, whereas a significant decrease in CK levels was noted in footballers.

Background: Previous research shows that injuries are prevalent in ladies Gaelic football. However, little is known about how these injuries occur (ie, the mechanism of injury). In addition, there are limited data on injuries sustained during elite-level matches. Concussions are also a key concern, yet research has examined solely self-reported suspected concussions, and it remains unclear how potential concussions are identified and managed during matches.

Objective: To establish the incidence, characteristics, and management of suspected injuries and concussions in elite ladies Gaelic football matches.

Design: Cross-sectional video analysis study.

Level of evidence: Level 3.

Methods: A video coding framework was developed based on similar published studies and validated by 5 Gaelic football-specific raters. One research assistant coded all matches from the 2022 season, and an experienced referee also reviewed foul play events.

Results: There were 829 suspected injuries (suspected injury rate [IR], 229.0 per 1000 hours; 95% CI, 214.0-245.2; 6.9 suspected injuries per match) and 162 suspected concussions (IR, 44.8 per 1000 hours; 95% CI, 38.4-52.2; 1.4 per match) recorded in 120 matches. Most suspected injuries received onfield medical attention (84.0%); however, just 13.6% of suspected concussions were removed from play. The tackle accounted for the most suspected injuries (40.2%), player-to-player contact (68.2%) was the most common mechanism, and the head/neck (38.1%) was the body location injured most frequently. Foul play concerned 53.2% of suspected injuries, with 76.7% of fouls concerning the tackle.

Conclusion: The nonremoval of suspected concussions and the frequency of tackle-related suspected injuries and foul play warrants attention.

Clinical relevance: Developing and implementing injury prevention programs, concussion management strategies, and education for all knowledge users may contribute to a safer playing environment.