Sports Health-A Multidisciplinary Approach最新文献

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.

Background: Sports concussion receives heavy attention from researchers. Conversely, research devoted to performing arts concussion is scant, despite a variety of head injury opportunities in artistic endeavors and environments. Circus is a high-energy, high-velocity performing art for which minimal concussion research is available.

Purpose: Assess via medical records the 10-year concussion incidence in Cirque du Soleil (CdS) performers and the variables surrounding their concussions.

Study design: Descriptive epidemiology.

Level of evidence: Level 5.

Methods: Data were extracted from CdS performers' medical records for 2010 to 2019: sex, age at injury, performance type, artistic discipline, mechanism of injury, performance context, and time-loss from full participation. Yearly artist-exposures for all CdS artists were identified. Data were analyzed for both resident and touring shows.

Results: Over 10 years there were 2,733,073 exposures, with 354 concussions sustained among 296 performers. Acrobats were the most commonly concussed (82.8% of all concussions). There were 1.30 concussions per 10,000 artist-exposures. Repeat concussions accounted for 58 concussions (16.4%). Full return to performance occurred at a mean of 35.5 ± 100.3 days. The highest rate of concussions was in 2019 (1.93 per 10,000 artist-exposures); 2010 had the lowest (0.86 per 10,000 artist-exposures). More concussions occurred during performances than training sessions; nearly half (170 of 354) occurred during the first of 2 shows presented nightly. There was no significant difference in overall incidence between resident and touring performers. The most frequent concussion mechanisms were impact with apparatus/equipment (113 of 354) or with another artist (106 of 354).

Conclusion: The concussion incidence of CdS artists is noteworthy compared with sports concussions. Acrobats sustained the most concussions. Concussions occurred more frequently during performances than during training.

Clinical relevance: These new data on performing arts concussions highlight the prevalence and incidence of concussions in circus performers for healthcare professionals who care for them.

Background: Deep gluteal muscles play an important role in femoral rotation and hip stability, but are often neglected in clinical research. We quantified and compared activation changes of superficial and deep gluteal muscles across 4 common therapeutic exercises: single-leg bridge (BRIDGE), side-lying clamshell (CLAM), side-lying reverse clamshell (R-CLAM), and side-lying hip abduction with external rotation (ABD-ER).

Hypothesis: ABD-ER activates both superficial and deep gluteal muscles more effectively than other exercises.

Study design: Controlled laboratory study.

Level of evidence: Level 2.

Methods: Ten healthy, physically active people (5 women and 5 men; age, 27.2 ± 1.9 years; Tegner activity scale, 6.4 ± 0.5) participated. Muscle functional magnetic resonance imaging was conducted before and after 1 set of 40 repetitions of each exercise type. Percent changes in T2 relaxation time in superficial and deep gluteal muscle activation were assessed before and after each exercise using repeated-measures analysis of variance or Friedman test.

Results: All muscles showed increased activation after exercise. BRIDGE (11.6%) and ABD-ER (13.2%) activated the gluteus medius more than CLAM (4.5%). ABD-ER activated the tensor fasciae latae (17.8%) and gluteus minimus (18.1%) more than other exercises (2.7% to 7.2%). BRIDGE (13.1%), CLAM (14.5%), and ABD-ER (23.8%) activated the piriformis more than R-CLAM (5.3%). CLAM (24.2%) and ABD-ER (19.5%) activated the obturator internus more than BRIDGE (5.3%) and R-CLAM (7.3%). CLAM and ABD-ER activated the gemellus superior (18.7% and 21.4%, respectively) and gemellus inferior (6.7% and 9.2%, respectively) more than R-CLAM (7.7% and 3.4%, respectively).

Conclusion: Of the exercises studied, ABD-ER was most effective in activating both superficial and deep gluteal muscles. BRIDGE and CLAM demonstrated selective activation advantages for specific muscles, supporting an individualized approach to exercise selection.

Clinical relevance: These insights into gluteal muscle activation changes before and after therapeutic exercises will aid clinical decision-making for exercise prescriptions.

Background: Studies of National Collegiate Athletic Association (NCAA) athletes have been concerning for rates of athletes reporting playing while symptomatic with a concussion and of athlete nondisclosure of concussion symptoms.

Purpose/hypothesis: This study's primary aim was to determine whether application of a brief and validated scale for concussion reporting expectation (CR-E) is an effective screening tool for collegiate athletes. It was hypothesized that 20% of athletes would be considered high risk for nondisclosure of concussion symptoms using this screening tool.

Study design: Cross-sectional.

Level of evidence: Level 2B.

Methods: NCAA Division I athletes (n = 358) from 18 teams who presented for preparticipation physical examinations (PPEs) in the 2023 fall season were queried with the CR-E and concussion history questions. The time to complete the CR-E was recorded, and providers recorded whether the screening results warranted additional concussion counseling or education. We report survey responses for all athletes stratified by sex and sport. Power analysis study population was based on NCAA collegiate athletes.

Results: The CR-E required an average of 2 minutes for athletes to complete during their PPE. Of 238 of 358 athletes who completed the CR-E questionnaire, 2 in 3 were determined to benefit from concussion education. Overall, athletes felt "neutral" about their agreement on a Likert scale to report concussion symptoms in 4 scenarios described on the CR-E. Water polo, volleyball, women's soccer, gymnastics, and football represented sports with higher rates of counseling, below average agreement to report concussion symptoms for 4 scenarios queried, and most frequent nonreporting histories.

Conclusion: The CR-E questionnaire represents an impactful screening tool with high utility and feasibility for collegiate athletes.

Clinical relevance: Our study supports a brief screening tool to guide concussion counseling for athletes. Based on our data, there appears to be room for improvement in athlete concussion education overall.

Background: Softball pitchers accrue high rates of injury. Research suggests certain mechanics at discrete pitch events are related with pain. Here, we examine relationships between peak throwing shoulder kinetics and trunk/pelvis kinematics and compare trunk/pelvis kinematics between pitchers who were healthy and those currently experiencing pain.

Hypothesis: (1) Peak shoulder kinetics would be positively related to greater trunk and pelvis flexion, lateral flexion, and rotation; and (2) pitchers in pain would exhibit greater trunk and pelvis flexion, lateral flexion, and rotation during the pitch than those who were pain-free.

Study design: Cross-sectional study.

Methods: A total of 42 high school pitchers (height, 1.71 ± 0.06 m; weight, 75.0 ± 15.9 kg; age, 16 ± 2 years) were separated into 2 groups based on presence or absence of pain. Peak kinetic data from 3 pitches per pitcher were averaged and used as dependent variables. Kinematic data were averaged across 3 trials, and time normalized to 101 datapoints between foot contact and follow-through of the pitch. Statistical parametric mapping regressions were used to assess the relationships between peak shoulder kinetics and waveform of trunk and pelvis kinematics.

Results: Pelvic lateral tilt significantly predicted peak throwing shoulder superior (P = 0.05) and lateral (P = 0.04) force. Pelvis rotation predicted peak superior force (P = 0.02). Waveform analyses revealed no waveform differences between healthy pitchers and those currently experiencing pain.

Conclusion: Peak shoulder kinetic variables are related with pelvic positioning during the pitch; however, trunk and pelvis kinematics do not differ according to presence of pain.

Clinical relevance: Pitchers in pain do not adopt specific trunk and pelvic alterations during the pitch, potentially concealing the effects of pain from visual identification. Coaches and clinicians need to discuss health status with pitchers versus relying on visual observations to understand pain and injury risk.