British Journal of Sports Medicine最新文献

Objective: The inclusion of transgender athletes in competitive sports has promoted significant dialogue and controversy among exercise-related professionals. The objective of this study was to investigate body composition, exercise-related performance parameters and associated health-related factors of transgender women (TW), cisgender women (CW) and cisgender men (CM) amateur volleyball players.

Methods: This was a cross-sectional study comprising TW, CW and CM amateur volleyball players eligible with the following characteristics: 'gender incongruent' (for TW only); age between 18 and 35 years; body mass index (BMI) between 18.0 and 29.9 kg/m²; 'very active' according to the International Physical Activity Questionnaire, and engaged in regular volleyball training for at least 1 year. All participants were assessed for body composition, blood biomarkers, handgrip strength, countermovement jump height (CMJ), squat jump height (SQJ) and maximum oxygen consumption (V̇O_2max).

Results: 69 amateur volleyball players were initially evaluated, but only 23 met the inclusion criteria and were included in the study (7 TW, 8 CW and 8 CM). Age (p=0.07) and BMI (p=0.26) were similar between groups. Estradiol (p=0.47), total testosterone (p=1.00) and haemoglobin (p=1.00) levels did not differ between TW and CW. However, analysis not adjusted by confounding variables showed that CM presented higher testosterone levels (p<0.001), haemoglobin levels (p=0.03), lean body mass (p=0.03), handgrip strength (p<0.001), CMJ (p<0.001), SQJ (p=0.012) and V̇O_2max (mL/min) (p=0.001) compared with TW. When adjusted by confounding variables, all p values were <0.05, except for SQJ (p=0.062).

Conclusion: TW athletes displayed similar exercise performance and biomarkers compared with CW but lower results compared with CM.

Knee cartilage lesions are frequent in football players, but evidence for surgical treatment is lacking. The aim of this International Cartilage Regeneration & Joint Preservation Society, Fédération Internationale de Football Association, and Aspetar (ICRS-FIFA-Aspetar) consensus was to develop specific expert-based, patient-specific practical recommendations on the appropriateness of non-surgical or surgical treatments for symptomatic knee cartilage lesions in competitive football players. The RAND/UCLA appropriateness method was used, and 17 voting experts provided recommendations on the appropriateness of surgical treatment in 96 different clinical scenarios defined on 6 variables: cartilage injury onset, lesion location, defect size, bone involvement, player symptom level and preference towards higher priority of a quick return to play or long-term results. Surgical treatment of a cartilage lesion was considered appropriate in 32% of the scenarios, in 21% inappropriate, while in 47% of the scenarios, the appropriateness was considered uncertain. The parameters with the highest appropriateness for the surgical treatment of a cartilage lesion in a football player were the inability to play (75.0% of appropriate scenarios), a lesion sized 2 cm² or bigger (47.9% of appropriate scenarios) and the preference of the player for long-term results (41.7% of appropriate scenarios). In this ICRS-FIFA-Aspetar expert consensus, surgical treatment for cartilage injuries in competitive football players was considered appropriate only in one-third of the clinical scenarios, and the choice was mainly driven by the level of symptoms. Surgical preference was also influenced by larger lesions, lesions of the condyles and trochlea with subchondral bone involvement and player's preference towards long-term results.

Objective: To examine the impact of exercise on musculoskeletal pain (low back pain (LBP), pelvic girdle pain (PGP), lumbopelvic pain (LBPP) and bodily pain) and kinesiophobia during the postpartum period.

Design: Systematic review with random effects meta-analysis.

Study eligibility criteria: Online databases were searched from database inception to 12 January 2024. Studies of all designs (except case studies) of any publication date or language were included if they contained information on the population (women and people in the first year postpartum), intervention (subjective or objective measures of frequency, intensity, duration, volume or type of exercise, alone ('exercise-only') or in combination with other interventions (eg, electrotherapy, infrared irradiation, ultrasound; 'exercise+cointervention')), comparator (no exercise or different exercise measures) and outcome (symptom severity of LBP/PGP/LBPP, related disability, bodily pain and kinesiophobia).

Results: 37 studies (N=3769 participants) from 15 countries were included. Moderate certainty evidence showed that exercise-only interventions, including various strengthening exercises targeting the trunk muscles, were associated with a greater reduction in LBPP symptom severity (4 randomised controlled trials (RCTs), n=210; mean difference -2.21 points (on a 0-10 Visual Analogue Scale) 95% CI -3.33 to -1.08) and related disability (6 RCTs, n=296; standardised mean difference -1.17, 95% CI -1.92 to -0.43; large effect size) as compared with no exercise. Similar results were found for bodily pain (2 RCTs, n=318). Evidence was limited and inconclusive regarding the impact of exercise interventions on kinesiophobia.

Conclusion: Postnatal exercises, including a variety of muscular strengthening exercises targeting the trunk muscles, decrease the symptom severity of LBPP and related disability.

Lacrosse has experienced significant growth in popularity worldwide and will return to the Summer Olympic Games in 2028. While there are published consensus recommendations for prehospital care of athletes with suspected spine injuries, there are currently no recommendations specific to lacrosse athletes with and without circulation, airway, or breathing (CAB) compromise. The document aims to determine evidence- and consensus-based best practices and provide implementation recommendations to guide healthcare professionals in the prehospital care of suspected spine-injured lacrosse athletes. We comprised a consensus group of 15 individuals with diverse clinical, research, and administrative experiences to ensure broad representation across lacrosse competition levels. Peer-reviewed scientific and medical research literature was systematically searched for articles on spine injury in lacrosse participants to derive evidence-based recommendations. Following a modified Delphi approach with three rounds of voting, the author panel developed ten consensus-based best practices and implementation recommendations related to the care of potentially spine-injured lacrosse athletes with and without CAB compromise. In addition, recommendations are provided to guide the implementation of key preparations before lacrosse participation, such as developing and distributing an emergency action plan, lacrosse-specific policies and procedures, and cardiopulmonary resuscitation and automated external defibrillator requirements. All recommendations obtained acceptable levels of agreeability, feasibility, and clarity from at least 80% of the panel. The recommendations provide prehospital care guidance for healthcare professionals and event organisers aimed at improving patient outcomes following suspected spine injury.

With the WHO stating that nearly 99% of the global population is exposed to air pollution levels that increase the risk of chronic diseases, the question of exercising in polluted environments is relevant to the health of athletes. Major sporting events held under conditions of poor air quality (AQ) have highlighted the lack of answers to concerns raised by organisers and athletes about the associated health risks. This evidence-based narrative review compiles current knowledge and identifies gaps regarding the relationship between AQ and sport. It is a summary of a more comprehensive report prepared for the International Olympic Committee (IOC) Medical and Scientific Commission. This article discusses the various sources of air pollutants encountered during exercise, summarises current AQ guidelines and provides insights into AQ conditions during the Paris 2024 Olympic and Paralympic Games (OPG) as well as in Los Angeles over the past four summers, in preparation for the 2028 OPG. It also summarises the effects of air pollution on the respiratory health and performance of athletes, while proposing mitigation strategies, with a particular emphasis on AQ education.