British Journal of Sports Medicine最新文献

Objective: To quantify the extent of musculoskeletal injuries in Olympic Athletics (track and field) disciplines by synthesising the current evidence on the prevalence of injured athletes, injury event incidence rates and injury characteristics.

Design: Systematic review and meta-analysis.

Data sources: MEDLINE, Web of Science, EMBASE, SPORTDiscus, CINAHL and Cochrane were searched from inception to 28 January 2025.

Eligibility criteria: Studies reporting athletics-related musculoskeletal injuries in Olympic Athletics disciplines.

Results: From 18 319 identified references, 216 studies were included; 38% of these studies were classified as having low study quality. Data synthesis was performed on 88 studies reporting on all injuries across all Athletics disciplines (21.6% with high study quality). The synthesised prevalence of injured athletes was 11.7% (95% CI 2.0% to 26.9%) for prospective studies only including championship/competition data, and 69.7% (95% CI 52.4% to 84.5%) for prospective studies combining training and competition data. The synthesised injury event incidence rates were 68.8 injuries per 1000 registered athletes (95% CI 39.4 to 120.2) for prospective studies only including championship/competition data, and 4.2 injuries per 1000 athlete-exposures (95% CI 2.1 to 7.7) and 3.8 injuries per 1000 hours of Athletics (95% CI 1.7 to 8.3) for prospective studies combining training and competition data. The Grading of Recommendations, Assessment, Development and Evaluation certainty of evidence was 'very low' for all outcomes, and 'low' for the injury event incidence rate per 1000 registered athletes for prospective studies conducted in championship/competition settings. Injuries were mainly located at the thigh, followed by the lower leg, foot and ankle. The main tissue type affected was the muscle, followed by tendon, ligament, skin, bone and joint.

Conclusions: This systematic review with meta-analysis quantified the extent of musculoskeletal injuries in Athletics. Our findings inform future research and healthcare service planning and support targeted injury risk reduction strategies at all levels in Athletics.

Objective: To compare body composition and physical fitness between transgender and cisgender individuals.

Design: Systematic review with meta-analysis.

Data sources: PubMed, Web of Science, Embase and SportDiscus.

Eligibility criteria: Inclusion criteria comprised studies of transgender individuals comparing body composition or physical fitness pre-to-post gender-affirming hormone therapy (GAHT) or versus cisgender controls.

Results: 52 studies (n=6485) were included. Transgender women had similar relative fat mass (standardised mean difference (SMD) -0.33, 95% CI -0.72 to 0.05, Grading of Recommendations Assessment, Development and Evaluation (GRADE): very low), relative lean mass (SMD 0.19, 95% CI -0.14 to 0.53, GRADE: low), upper-body strength (SMD 0.54, 95% CI -0.95 to 2.02, GRADE: very low), lower-body strength (SMD 0.05, 95% CI -1.31 to 1.40, GRADE: very low) and maximal oxygen consumption (SMD -0.28, 95% CI -0.81 to 0.25, GRADE: very low) in comparison to cisgender women. Transgender men exhibited higher relative fat mass (SMD 0.96, 95% CI 0.28 to 1.64, GRADE: moderate), lower relative lean mass (SMD -6.42, 95% CI -12.26 to -0.58, GRADE: moderate) and lower upper-body strength (SMD -1.46, 95% CI -2.52 to -0.40, GRADE: moderate) than cisgender men. In transgender women, GAHT was associated with increased fat mass and reduced lean mass and upper-body strength over 1-3 years. Transgender men demonstrated reduced fat mass and increased lean mass and strength following GAHT.

Conclusion: While transgender women exhibited higher lean mass than cisgender women, their physical fitness was comparable. Current evidence is mostly low certainty and has heterogenous quality but does not support theories of inherent athletic advantages for transgender women over cisgender.

Prospero registration number: CRD42024562210.

Objective: To investigate the relationship between active commuting and atherosclerosis in middle age using state-of-the-art coronary CT angiography (CCTA).

Methods: This cross-sectional study used data from the Swedish CArdioPulmonary bioImage Study (SCAPIS) and included 23 722 randomly recruited individuals aged 50-64 years from six different regions in Sweden. The exposure was commuting mode, assessed using self-reported questionnaires and categorised as year-round walking and/or cycling (active commuting), commuting by bus/train, commuting by car or mixed commuting patterns. The outcome was atherosclerosis, evaluated using CCTA for coronary stenosis and coronary artery calcium (CAC) score and ultrasound for carotid plaques. Associations were analysed using multivariate binomial logistic regression models.

Results: After adjusting for confounders (age, sex, SCAPIS site, education, occupational physical activity and leisure time exercise habits, sleep, diet and smoking habits), active commuting was associated with lower odds of coronary stenosis (OR 0.87; 95% CI 0.80 to 0.94) and a CAC score ≥1 Agatston units (OR 0.93; 95% CI 0.86 to 1.00), as compared with car commuting. No associations were observed between active commuting and the presence of carotid plaques (OR 0.97; 95% CI 0.90 to 1.03). When stratified, the inverse association with coronary stenosis appeared to be somewhat stronger for cycling (OR 0.86; 95% CI 0.78 to 0.95) than for walking (OR 0.89; 95% CI 0.79 to 1.01).

Conclusion: Using advanced CCTA imaging in a large, randomly selected sample of middle-aged adults, we show for the first time that coronary atherosclerosis is less common in active commuters, particularly those cycling, compared with car commuters. While this indicates that active commuting might be a potential preventive measure to reduce atherosclerosis and subsequent cardiovascular disease, further causal analyses are needed to confirm our findings.