Pub Date : 2025-03-21DOI: 10.1136/bjsports-2024-108449
Matthew J Gervais, Stephanie-May Ruchat, Muhammad Usman Ali, Talia Sjwed, Brittany A Matenchuk, Sarah Meyer, Michelle F Mottola, Kristi B Adamo, Allison Sivak, Margie H Davenport
Objective This systematic review and meta-analysis examined the relationship between postpartum exercise and maternal postpartum anthropometrics. Design Systematic review with random-effects meta-analysis and meta-regression. Study eligibility criteria Online databases were searched from database inception until 12 January 2024. Randomised controlled trials (RCTs) written in any language were eligible if they contained information on the population (postpartum women and people); intervention (frequency, intensity, duration, volume or type of exercise, alone (‘exercise-only’) or in combination with other interventions (eg, dietary; ‘exercise+cointervention’)); comparator (no exercise) and outcomes (anthropometric measures including weight, postpartum weight retention (PPWR), body mass index (BMI), fat mass, lean body mass (LBM), body fat percentage, waist circumference, hip circumference or waist–hip ratio). Results 64 RCTs (n=12 684 participants) from 20 countries were included. Moderate to high certainty of evidence showed that exercise-only interventions reduced weight by 1.34 kg (18 studies, n=771; 95% CI −2.06 to –0.61, I2 0%), BMI by 0.73 kg/m2 (14 studies, n=662; 95% CI −1.21 to –0.25, I2 60%) and fat mass by 1.55 kg (5 studies, n=135; 95% CI −3.01 to –0.09, I2 0%) compared with no exercise. The duration of the exercise interventions ranged from 3 months to 3 years. Dose–response analysis found 560 MET-min/week of exercise (eg, 120 min/week of brisk walking) was associated with 1 kg/m2 reduction in BMI. Low certainty of evidence showed that exercise-only interventions had no effect on LBM (5 RCTs, n=135; standardised mean difference −0.13; 95% CI −0.48, 0.21, I2 0%) compared with no exercise. Conclusions These findings highlight physical activity as an effective intervention to improve postpartum anthropometrics and reduce PPWR. PROSPERO registration number CRD42022359282. All data relevant to the study are included in the article or uploaded as supplementary information.
{"title":"Impact of postpartum physical activity on maternal anthropometrics: a systematic review and meta-analysis","authors":"Matthew J Gervais, Stephanie-May Ruchat, Muhammad Usman Ali, Talia Sjwed, Brittany A Matenchuk, Sarah Meyer, Michelle F Mottola, Kristi B Adamo, Allison Sivak, Margie H Davenport","doi":"10.1136/bjsports-2024-108449","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108449","url":null,"abstract":"Objective This systematic review and meta-analysis examined the relationship between postpartum exercise and maternal postpartum anthropometrics. Design Systematic review with random-effects meta-analysis and meta-regression. Study eligibility criteria Online databases were searched from database inception until 12 January 2024. Randomised controlled trials (RCTs) written in any language were eligible if they contained information on the population (postpartum women and people); intervention (frequency, intensity, duration, volume or type of exercise, alone (‘exercise-only’) or in combination with other interventions (eg, dietary; ‘exercise+cointervention’)); comparator (no exercise) and outcomes (anthropometric measures including weight, postpartum weight retention (PPWR), body mass index (BMI), fat mass, lean body mass (LBM), body fat percentage, waist circumference, hip circumference or waist–hip ratio). Results 64 RCTs (n=12 684 participants) from 20 countries were included. Moderate to high certainty of evidence showed that exercise-only interventions reduced weight by 1.34 kg (18 studies, n=771; 95% CI −2.06 to –0.61, I2 0%), BMI by 0.73 kg/m2 (14 studies, n=662; 95% CI −1.21 to –0.25, I2 60%) and fat mass by 1.55 kg (5 studies, n=135; 95% CI −3.01 to –0.09, I2 0%) compared with no exercise. The duration of the exercise interventions ranged from 3 months to 3 years. Dose–response analysis found 560 MET-min/week of exercise (eg, 120 min/week of brisk walking) was associated with 1 kg/m2 reduction in BMI. Low certainty of evidence showed that exercise-only interventions had no effect on LBM (5 RCTs, n=135; standardised mean difference −0.13; 95% CI −0.48, 0.21, I2 0%) compared with no exercise. Conclusions These findings highlight physical activity as an effective intervention to improve postpartum anthropometrics and reduce PPWR. PROSPERO registration number CRD42022359282. All data relevant to the study are included in the article or uploaded as supplementary information.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"7 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143672343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-20DOI: 10.1136/bjsports-2024-109183
Emily Kroshus-Havril, Carey Wheelhouse, James Houle, Jessica Bartley, Darcy Gruttadaro, Casey Pick, Ashwin L Rao, Alicia Fine, Jean Merrill, Deena Casiero, Brian Hainline
We sought to generate consensus-based recommendations to inform updates to the National Collegiate Athletic Association (NCAA) Mental Health Best Practices. A two-phase modified Delphi consensus process was used to identify foundational premises and actionable recommendations for NCAA member schools. Participants were members of the NCAA’s Mental Health Advisory Group (n=31), including student-athletes, representatives from leading national organisations involved in college student or athlete mental health and higher education, and licensed mental health providers who work with student-athletes. The consensus process produced 11 foundational premises and 36 recommendation statements that were considered useful and feasible for NCAA member schools. Foundational premises addressed multiple levels of risk factors that may adversely impact student-athlete mental health. Recommendations for member schools were broadly grouped into (1) creating healthy environments that support mental health and promote well-being; (2) developing procedures for identifying student-athletes with mental health symptoms and disorders, including the use of validated mental health screening tools; (3) establishing mental health action plans that outline referral pathways of student-athletes to licensed mental health providers; and (4) ensuring licensure of providers who oversee and manage student-athlete mental healthcare. These premises and recommendations provide guidance for understanding and supporting student-athlete mental health needs.
{"title":"Consensus recommendations to inform an update of the NCAA Mental Health Best Practices","authors":"Emily Kroshus-Havril, Carey Wheelhouse, James Houle, Jessica Bartley, Darcy Gruttadaro, Casey Pick, Ashwin L Rao, Alicia Fine, Jean Merrill, Deena Casiero, Brian Hainline","doi":"10.1136/bjsports-2024-109183","DOIUrl":"https://doi.org/10.1136/bjsports-2024-109183","url":null,"abstract":"We sought to generate consensus-based recommendations to inform updates to the National Collegiate Athletic Association (NCAA) Mental Health Best Practices. A two-phase modified Delphi consensus process was used to identify foundational premises and actionable recommendations for NCAA member schools. Participants were members of the NCAA’s Mental Health Advisory Group (n=31), including student-athletes, representatives from leading national organisations involved in college student or athlete mental health and higher education, and licensed mental health providers who work with student-athletes. The consensus process produced 11 foundational premises and 36 recommendation statements that were considered useful and feasible for NCAA member schools. Foundational premises addressed multiple levels of risk factors that may adversely impact student-athlete mental health. Recommendations for member schools were broadly grouped into (1) creating healthy environments that support mental health and promote well-being; (2) developing procedures for identifying student-athletes with mental health symptoms and disorders, including the use of validated mental health screening tools; (3) establishing mental health action plans that outline referral pathways of student-athletes to licensed mental health providers; and (4) ensuring licensure of providers who oversee and manage student-athlete mental healthcare. These premises and recommendations provide guidance for understanding and supporting student-athlete mental health needs.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"15 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-18DOI: 10.1136/bjsports-2024-109184
Iryna Demchenko, Stephanie A Prince, Katherine Merucci, Cristina Cadenas-Sanchez, Jean-Philippe Chaput, Brooklyn J Fraser, Taru Manyanga, Ryan McGrath, Francisco B Ortega, Ben Singh, Grant R Tomkinson, Justin J Lang
Objective To synthesise data on the associations between cardiorespiratory fitness (CRF) and health in children and adolescents, evaluate the certainty of evidence and identify knowledge gaps. Design An overview of systematic reviews with meta-analyses. Results were pooled using forest plots and certainty of evidence evaluated with GRADE. Data sources Medline, Embase, Scopus, CINAHL and SPORTDiscus were searched from January 2002 to March 2024. Eligibility criteria for selected studies Systematic reviews with meta-analyses exploring CRF and health in children and adolescents aged <18 years. Results From the 9062 records identified, 14 reviews were included. Meta-analysed data from 125 164 observations covering 33 health outcomes were compiled, showing favourable (n=26) or null (n=7) associations with CRF. Among general populations, the associations were weak-to-moderate, with favourable links between CRF and indicators of anthropometry and adiposity, cardiometabolic and vascular health, and mental health and well-being. Among clinical populations, CRF was lower in participants with a condition compared with healthy controls, with the largest difference for newly diagnosed cancer (mean difference=−19.6 mL/kg/min; 95%CI: −21.4,–17.8). Patients with cystic fibrosis had a greater risk for all-cause mortality when comparing low CRF vs. high (relative risk=4.9; 95%CI: 1.1, 22.1). The certainty of evidence ranged from very low to moderate. Conclusion CRF shows promising links to numerous health outcomes in paediatric populations, though the low certainty of evidence calls for further research. High-quality longitudinal evidence is warranted to confirm the findings and investigate a predictive role of childhood CRF for future health. Data are available upon reasonable request.
{"title":"Cardiorespiratory fitness and health in children and adolescents: an overview of systematic reviews with meta-analyses representing over 125 000 observations covering 33 health-related outcomes","authors":"Iryna Demchenko, Stephanie A Prince, Katherine Merucci, Cristina Cadenas-Sanchez, Jean-Philippe Chaput, Brooklyn J Fraser, Taru Manyanga, Ryan McGrath, Francisco B Ortega, Ben Singh, Grant R Tomkinson, Justin J Lang","doi":"10.1136/bjsports-2024-109184","DOIUrl":"https://doi.org/10.1136/bjsports-2024-109184","url":null,"abstract":"Objective To synthesise data on the associations between cardiorespiratory fitness (CRF) and health in children and adolescents, evaluate the certainty of evidence and identify knowledge gaps. Design An overview of systematic reviews with meta-analyses. Results were pooled using forest plots and certainty of evidence evaluated with GRADE. Data sources Medline, Embase, Scopus, CINAHL and SPORTDiscus were searched from January 2002 to March 2024. Eligibility criteria for selected studies Systematic reviews with meta-analyses exploring CRF and health in children and adolescents aged <18 years. Results From the 9062 records identified, 14 reviews were included. Meta-analysed data from 125 164 observations covering 33 health outcomes were compiled, showing favourable (n=26) or null (n=7) associations with CRF. Among general populations, the associations were weak-to-moderate, with favourable links between CRF and indicators of anthropometry and adiposity, cardiometabolic and vascular health, and mental health and well-being. Among clinical populations, CRF was lower in participants with a condition compared with healthy controls, with the largest difference for newly diagnosed cancer (mean difference=−19.6 mL/kg/min; 95%CI: −21.4,–17.8). Patients with cystic fibrosis had a greater risk for all-cause mortality when comparing low CRF vs. high (relative risk=4.9; 95%CI: 1.1, 22.1). The certainty of evidence ranged from very low to moderate. Conclusion CRF shows promising links to numerous health outcomes in paediatric populations, though the low certainty of evidence calls for further research. High-quality longitudinal evidence is warranted to confirm the findings and investigate a predictive role of childhood CRF for future health. Data are available upon reasonable request.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"20 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143653390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-18DOI: 10.1136/bjsports-2024-108732
Kristoffer W Barfod, Lars Blønd, Rasmus Kramer Mikkelsen, Jasmin Bagge, Lisbet Rosenkrantz Hölmich, Thomas Kallemose, Anders Troelsen, Per Hölmich
Objective To investigate if treatment with a single injection of autologous micro-fragmented adipose tissue improved patient-reported health compared with a placebo saline injection in patients suffering from pain and functional impairment due to knee osteoarthritis. Methods We conducted a randomised controlled trial with patients blinded to the treatment and allocated in a 1:1 ratio to one of two parallel groups. Patients aged 18–70 years with Kellgren-Lawrence grades 2–3 in the tibiofemoral joint and suffering from pain and functional impairment of the knee were eligible for inclusion. Abdominal adipose tissue was harvested by liposuction in all patients. The active treatment group was treated with an intra-articular injection of autologous micro-fragmented adipose tissue, and the placebo group with isotonic saline. The primary outcome was the Knee injury and Osteoarthritis Outcome Score (KOOS4) evaluated at 6 months. Results 238 patients were assessed for eligibility and 120 (mean age 52.2, 58% female) included from January 2019 to February 2022. There were no statistically significant differences between the active treatment and the placebo group at any time point. Both groups showed statistically significant and clinically relevant improvements from baseline to 6, 12 and 24 months. Mean KOOS4 at 6 months was 55.5 (95% CI 51.4 to 59.6) for the active treatment group and 51.5 (95% CI 47.4 to 55.6) for the placebo group. Conclusion This study did not show superiority of micro-fragmented adipose tissue compared with a placebo saline injection for the treatment of knee osteoarthritis. Trial registration number [NCT03771989][1]. Data are available upon reasonable request. Individual deidentified participant data that underlie the results reported in this paper (text, tables, figures and appendices) and the study protocol will be shared if requested and approved by the Danish Data Regulation Authority. Data will be available beginning 1 month and ending 5 years after publication of this paper. Data will be available for researchers who provide a methodologically sound scientific proposal, which has been approved by an ethical committee. Proof of the latter should be provided. Analyses should achieve the aims reported in the approved proposal. Proposals for data should be directed to the corresponding author (Kristoffer.barfod@regionh.dk). [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT03771989&atom=%2Fbjsports%2Fearly%2F2025%2F03%2F18%2Fbjsports-2024-108732.atom
{"title":"Treatment of knee osteoarthritis with a single injection of autologous micro-fragmented adipose tissue is not superior to a placebo saline injection: a blinded randomised controlled trial with 2-year follow-up","authors":"Kristoffer W Barfod, Lars Blønd, Rasmus Kramer Mikkelsen, Jasmin Bagge, Lisbet Rosenkrantz Hölmich, Thomas Kallemose, Anders Troelsen, Per Hölmich","doi":"10.1136/bjsports-2024-108732","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108732","url":null,"abstract":"Objective To investigate if treatment with a single injection of autologous micro-fragmented adipose tissue improved patient-reported health compared with a placebo saline injection in patients suffering from pain and functional impairment due to knee osteoarthritis. Methods We conducted a randomised controlled trial with patients blinded to the treatment and allocated in a 1:1 ratio to one of two parallel groups. Patients aged 18–70 years with Kellgren-Lawrence grades 2–3 in the tibiofemoral joint and suffering from pain and functional impairment of the knee were eligible for inclusion. Abdominal adipose tissue was harvested by liposuction in all patients. The active treatment group was treated with an intra-articular injection of autologous micro-fragmented adipose tissue, and the placebo group with isotonic saline. The primary outcome was the Knee injury and Osteoarthritis Outcome Score (KOOS4) evaluated at 6 months. Results 238 patients were assessed for eligibility and 120 (mean age 52.2, 58% female) included from January 2019 to February 2022. There were no statistically significant differences between the active treatment and the placebo group at any time point. Both groups showed statistically significant and clinically relevant improvements from baseline to 6, 12 and 24 months. Mean KOOS4 at 6 months was 55.5 (95% CI 51.4 to 59.6) for the active treatment group and 51.5 (95% CI 47.4 to 55.6) for the placebo group. Conclusion This study did not show superiority of micro-fragmented adipose tissue compared with a placebo saline injection for the treatment of knee osteoarthritis. Trial registration number [NCT03771989][1]. Data are available upon reasonable request. Individual deidentified participant data that underlie the results reported in this paper (text, tables, figures and appendices) and the study protocol will be shared if requested and approved by the Danish Data Regulation Authority. Data will be available beginning 1 month and ending 5 years after publication of this paper. Data will be available for researchers who provide a methodologically sound scientific proposal, which has been approved by an ethical committee. Proof of the latter should be provided. Analyses should achieve the aims reported in the approved proposal. Proposals for data should be directed to the corresponding author (Kristoffer.barfod@regionh.dk). [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT03771989&atom=%2Fbjsports%2Fearly%2F2025%2F03%2F18%2Fbjsports-2024-108732.atom","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"214 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143653392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-17DOI: 10.1136/bjsports-2024-108777
Michael JM O’Brien, Andrew K Wallis, Joshua J Heerey, Tønning Lisa Urup, Inger Mechlenburg, Julie Sandell Sandell Jacobsen, Jitendra Balakumar, Joanne L Kemp
Hip dysplasia is a developmental condition that can be congenital or occur throughout childhood and increases the risk of hip osteoarthritis. It is associated with pain and impairments in young adults and can be career-ending for professional athletes. Rehabilitation often involves high-level goals and expectations, and there is no guarantee that interventions (both surgical and non-surgical) can always achieve these. Existing research in adults with hip dysplasia has focused on non-athletes undergoing surgery, with minimal studies in athletes. To guide future research, it is important to appreciate current knowledge and recognise gaps in the literature. The aim of this editorial is to outline what is known about athletes with hip dysplasia and offer considerations for management and future studies. ### Hip dysplasia prevalence Hip dysplasia is a condition of insufficient acetabular coverage of the femoral head. The prevalence of hip dysplasia among athletes has a large variation in the reported data, potentially due to differences in diagnostic criteria. In elite ballet dancers, dysplasia rates of up to 89% have been reported1 with different imaging methods used across studies. The lateral centre-edge angle (LCEA) indicates lateral coverage of the femoral head by the acetabulum and is the traditional radiographic measure used to diagnose hip dysplasia. In a cohort of female football players, hip dysplasia was identified in 16% when using an LCEA cut-off of <20°; this increased to 66% when using an LCEA of <25°.2 More uniform diagnostic …
{"title":"Athletes with hip dysplasia: current understanding, management and future directions","authors":"Michael JM O’Brien, Andrew K Wallis, Joshua J Heerey, Tønning Lisa Urup, Inger Mechlenburg, Julie Sandell Sandell Jacobsen, Jitendra Balakumar, Joanne L Kemp","doi":"10.1136/bjsports-2024-108777","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108777","url":null,"abstract":"Hip dysplasia is a developmental condition that can be congenital or occur throughout childhood and increases the risk of hip osteoarthritis. It is associated with pain and impairments in young adults and can be career-ending for professional athletes. Rehabilitation often involves high-level goals and expectations, and there is no guarantee that interventions (both surgical and non-surgical) can always achieve these. Existing research in adults with hip dysplasia has focused on non-athletes undergoing surgery, with minimal studies in athletes. To guide future research, it is important to appreciate current knowledge and recognise gaps in the literature. The aim of this editorial is to outline what is known about athletes with hip dysplasia and offer considerations for management and future studies. ### Hip dysplasia prevalence Hip dysplasia is a condition of insufficient acetabular coverage of the femoral head. The prevalence of hip dysplasia among athletes has a large variation in the reported data, potentially due to differences in diagnostic criteria. In elite ballet dancers, dysplasia rates of up to 89% have been reported1 with different imaging methods used across studies. The lateral centre-edge angle (LCEA) indicates lateral coverage of the femoral head by the acetabulum and is the traditional radiographic measure used to diagnose hip dysplasia. In a cohort of female football players, hip dysplasia was identified in 16% when using an LCEA cut-off of <20°; this increased to 66% when using an LCEA of <25°.2 More uniform diagnostic …","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"18 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143640148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective To prospectively examine the prevalence of diagnosed eating disorders (ED-diagnosis), ED-symptoms and factors predicting ED-symptoms in three male and female high school student groups: elite athletes, trained athletes and a non-athlete reference group at baseline (T1) and 1-year follow-up (T2). Methods A survey was administered at baseline (T1) (n=1186) and 1-year follow-up (T2) (n=1144) (step-one). Participants classified with ED-symptoms by the Eating Disorder Examination Questionnaire (EDEQ 6.0) at T2 were invited to a diagnostic interview (step-two). Results Prevalence of ED-diagnosis for males and females were 6.9% and 9.3% in elite athletes, 5.9% and 11.2% in trained athletes and 3.0% and 11.9% in references, respectively. No group differences were statistically significant. Male references had more ED-symptoms compared with elite and trained male athletes (EDEQ-global score 0.81 vs <0.55), while elite female athletes had fewer ED-symptoms compared with trained female athletes and female references (EDEQ-global score 1.14 vs >1.59). Trained female athletes increased ED-symptoms over time, whereas elite female athletes consistently had fewer ED-symptoms in comparison. High ED-symptom presentation was predicted by high body mass index and more psychological distress in males, whereas for females, ED-symptoms were predicted by lower resilience, more psychological distress and being a non-athlete reference. Conclusion No statistically significant group differences in the prevalence of ED-diagnosis were observed between elite athletes, trained athletes and a non-athlete reference group. Female elite athletes had fewer ED-symptoms compared with other female groups, and male references had more ED-symptoms compared with male athlete groups. Preventive measures that address psychological resilience and distress should be considered. Trial registration number [NCT04003675][1]. Data are available upon reasonable request. The data set analysed during the current study is available from the corresponding author on reasonable request. [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT04003675&atom=%2Fbjsports%2Fearly%2F2025%2F03%2F17%2Fbjsports-2024-108808.atom
{"title":"Factors predicting disordered eating and the prevalence of eating disorders in adolescent elite athletes, trained athletes and a reference group: a prospective controlled two-step study","authors":"Christine Sundgot-Borgen, Jorunn Sundgot-Borgen, Nina Sølvberg, Monica Klungland Torstveit, Margo Mountjoy, Therese Fostervold Mathisen","doi":"10.1136/bjsports-2024-108808","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108808","url":null,"abstract":"Objective To prospectively examine the prevalence of diagnosed eating disorders (ED-diagnosis), ED-symptoms and factors predicting ED-symptoms in three male and female high school student groups: elite athletes, trained athletes and a non-athlete reference group at baseline (T1) and 1-year follow-up (T2). Methods A survey was administered at baseline (T1) (n=1186) and 1-year follow-up (T2) (n=1144) (step-one). Participants classified with ED-symptoms by the Eating Disorder Examination Questionnaire (EDEQ 6.0) at T2 were invited to a diagnostic interview (step-two). Results Prevalence of ED-diagnosis for males and females were 6.9% and 9.3% in elite athletes, 5.9% and 11.2% in trained athletes and 3.0% and 11.9% in references, respectively. No group differences were statistically significant. Male references had more ED-symptoms compared with elite and trained male athletes (EDEQ-global score 0.81 vs <0.55), while elite female athletes had fewer ED-symptoms compared with trained female athletes and female references (EDEQ-global score 1.14 vs >1.59). Trained female athletes increased ED-symptoms over time, whereas elite female athletes consistently had fewer ED-symptoms in comparison. High ED-symptom presentation was predicted by high body mass index and more psychological distress in males, whereas for females, ED-symptoms were predicted by lower resilience, more psychological distress and being a non-athlete reference. Conclusion No statistically significant group differences in the prevalence of ED-diagnosis were observed between elite athletes, trained athletes and a non-athlete reference group. Female elite athletes had fewer ED-symptoms compared with other female groups, and male references had more ED-symptoms compared with male athlete groups. Preventive measures that address psychological resilience and distress should be considered. Trial registration number [NCT04003675][1]. Data are available upon reasonable request. The data set analysed during the current study is available from the corresponding author on reasonable request. [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT04003675&atom=%2Fbjsports%2Fearly%2F2025%2F03%2F17%2Fbjsports-2024-108808.atom","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"183 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143640464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-11DOI: 10.1136/bjsports-2024-108734
Chengqing Jiang, Ziang Li, Bo Guo, Lin Chen, Liang Zhu, Yu Liang, Yinghan Shen, Tianxin Long, Ming Zhai, Jiayun Shi, Haiyan Xu, Yongjian Wu
Objective To explore the association of wearable device-measured moderate-to-vigorous intensity physical activity (MVPA) with cardiovascular disease (CVD) risk in long-term cancer survivors. Methods This retrospective analysis involved a prospective cohort of 6109 cancer survivors without CVD from the UK Biobank accelerometry subsample. The MVPA volume is categorised into four groups based on guideline recommendations (0–75 min/week, 75–150 min/week, 150–300 min/week, ≥300 min/week). Cox proportional hazard models are used to investigate the association of MVPA with incident CVD. Results Over a median follow-up of 7.88 years, there were 539 incident CVD events (361 incident coronary artery disease (CAD) events, 155 incident heart failure (HF) events, and 109 incident stroke events). Adjusted CVD incidence rates (95% CIs) across MVPA groups (0–75 min/week, 75–150 min/week, 150–300 min/week, ≥300 min/week) were 15.30 (12.90, 18.10), 13.50 (11.00, 16.40), 12.00 (10.20, 14.10) and 9.86 (8.35, 11.60) per 1000 person-years, respectively. Adjusted HRs (95% CI) for CVD, CAD, HF and stroke in the highest MVPA group (≥300 min/week) compared with those in the lowest MVPA group (0–75 min/week) were 0.63 (0.49, 0.80), 0.68 (0.51, 0.91), 0.66 (0.42,1.06) and 0.72 (0.42, 1.23), respectively. For obesity-related cancers, the beneficial effect on CVD was observed when exceeding 300 MVPA min/week (HR 0.54 (0.37–0.81)) compared with the lowest MVPA group. Conclusions Findings from the UK Biobank study suggest that longer MVPA durations are associated with reduced CVD risk in cancer survivors, underscoring the potential for physical activity to serve as a key component in cardio-oncology care. This study was conducted based on the UK Biobank cohort study under application number 91035.
{"title":"Wearable device-measured physical activity and incident cardiovascular disease in cancer survivors","authors":"Chengqing Jiang, Ziang Li, Bo Guo, Lin Chen, Liang Zhu, Yu Liang, Yinghan Shen, Tianxin Long, Ming Zhai, Jiayun Shi, Haiyan Xu, Yongjian Wu","doi":"10.1136/bjsports-2024-108734","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108734","url":null,"abstract":"Objective To explore the association of wearable device-measured moderate-to-vigorous intensity physical activity (MVPA) with cardiovascular disease (CVD) risk in long-term cancer survivors. Methods This retrospective analysis involved a prospective cohort of 6109 cancer survivors without CVD from the UK Biobank accelerometry subsample. The MVPA volume is categorised into four groups based on guideline recommendations (0–75 min/week, 75–150 min/week, 150–300 min/week, ≥300 min/week). Cox proportional hazard models are used to investigate the association of MVPA with incident CVD. Results Over a median follow-up of 7.88 years, there were 539 incident CVD events (361 incident coronary artery disease (CAD) events, 155 incident heart failure (HF) events, and 109 incident stroke events). Adjusted CVD incidence rates (95% CIs) across MVPA groups (0–75 min/week, 75–150 min/week, 150–300 min/week, ≥300 min/week) were 15.30 (12.90, 18.10), 13.50 (11.00, 16.40), 12.00 (10.20, 14.10) and 9.86 (8.35, 11.60) per 1000 person-years, respectively. Adjusted HRs (95% CI) for CVD, CAD, HF and stroke in the highest MVPA group (≥300 min/week) compared with those in the lowest MVPA group (0–75 min/week) were 0.63 (0.49, 0.80), 0.68 (0.51, 0.91), 0.66 (0.42,1.06) and 0.72 (0.42, 1.23), respectively. For obesity-related cancers, the beneficial effect on CVD was observed when exceeding 300 MVPA min/week (HR 0.54 (0.37–0.81)) compared with the lowest MVPA group. Conclusions Findings from the UK Biobank study suggest that longer MVPA durations are associated with reduced CVD risk in cancer survivors, underscoring the potential for physical activity to serve as a key component in cardio-oncology care. This study was conducted based on the UK Biobank cohort study under application number 91035.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"20 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143599489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-07DOI: 10.1136/bjsports-2024-109104
Margie H Davenport, Shefali Christopher, Rita E Deering, Christina Prevett, Sinead Dufour, Milena Forte, Nicole Beamish, Kristi Adamo, Kari Bo, Emma Brockwell, Émilie Brunet-Pagé, Radha Chari, Marlize De Vivo, Karen Fleming, Amal Hassan, Melanie Hayman, Kirstin N Lane, Michelle F Mottola, Sarah E Neil-Sztramko, Rita A Santos-Rocha, Anna Szumilewicz, Stephanie-May Ruchat
Objective To establish expert consensus on prescreening and contraindications to moderate-to-vigorous intensity physical activity (MVPA) during the first year postpartum. Methods A Delphi survey of clinical and exercise professionals working with postpartum women and people was conducted until consensus was reached (≥75% agreement). Round I consisted of questions about relative and absolute contraindications to MVPA. Rounds II and III included additional questions based on the thematic coding of open-ended responses from the previous rounds. The results were used to develop a postpartum MVPA preparticipation screening tool. Results 120 participants completed round I, 105 completed round II and 95 completed round III. Consensus was reached in 46/49 (94%) statements. Twenty-four relative contraindications to MVPA were identified: (loss of consciousness; neurological symptoms; kidney disease; calf pain or swelling suggestive of deep vein thrombosis; severe abdominal pain; vaginal bleeding not associated with menses; postpartum cardiomyopathy; caesarean section with symptoms that worsen with MVPA; unstable hypertension; eating disorder; malnutrition; anaemia; excessive fatigue; fractures or other significant musculoskeletal injuries; haemodynamic instability; breathing difficulties; acute systemic infection accompanied by fever, body aches, or swollen lymph glands; the new onset of chest pain, discomfort, and other angina-like symptoms with exertion; dizziness or lightheadedness during MVPA; new symptoms of heart disease, stroke; and other medical or physical conditions that may affect the ability to be physically active. Key biopsychosocial barriers to MVPA were identified. Conclusion This Delphi study recommends relative contraindications to MVPA for the first year postpartum that were incorporated into a postpartum MVPA pre-participation screening tool the Get Active Questionnaire for Postpartum. Data are available upon reasonable request. Data is available upon request.
{"title":"International Delphi study of clinical and exercise professionals’ opinion of physical activity prescreening and contraindications for participating in postpartum physical activity","authors":"Margie H Davenport, Shefali Christopher, Rita E Deering, Christina Prevett, Sinead Dufour, Milena Forte, Nicole Beamish, Kristi Adamo, Kari Bo, Emma Brockwell, Émilie Brunet-Pagé, Radha Chari, Marlize De Vivo, Karen Fleming, Amal Hassan, Melanie Hayman, Kirstin N Lane, Michelle F Mottola, Sarah E Neil-Sztramko, Rita A Santos-Rocha, Anna Szumilewicz, Stephanie-May Ruchat","doi":"10.1136/bjsports-2024-109104","DOIUrl":"https://doi.org/10.1136/bjsports-2024-109104","url":null,"abstract":"Objective To establish expert consensus on prescreening and contraindications to moderate-to-vigorous intensity physical activity (MVPA) during the first year postpartum. Methods A Delphi survey of clinical and exercise professionals working with postpartum women and people was conducted until consensus was reached (≥75% agreement). Round I consisted of questions about relative and absolute contraindications to MVPA. Rounds II and III included additional questions based on the thematic coding of open-ended responses from the previous rounds. The results were used to develop a postpartum MVPA preparticipation screening tool. Results 120 participants completed round I, 105 completed round II and 95 completed round III. Consensus was reached in 46/49 (94%) statements. Twenty-four relative contraindications to MVPA were identified: (loss of consciousness; neurological symptoms; kidney disease; calf pain or swelling suggestive of deep vein thrombosis; severe abdominal pain; vaginal bleeding not associated with menses; postpartum cardiomyopathy; caesarean section with symptoms that worsen with MVPA; unstable hypertension; eating disorder; malnutrition; anaemia; excessive fatigue; fractures or other significant musculoskeletal injuries; haemodynamic instability; breathing difficulties; acute systemic infection accompanied by fever, body aches, or swollen lymph glands; the new onset of chest pain, discomfort, and other angina-like symptoms with exertion; dizziness or lightheadedness during MVPA; new symptoms of heart disease, stroke; and other medical or physical conditions that may affect the ability to be physically active. Key biopsychosocial barriers to MVPA were identified. Conclusion This Delphi study recommends relative contraindications to MVPA for the first year postpartum that were incorporated into a postpartum MVPA pre-participation screening tool the Get Active Questionnaire for Postpartum. Data are available upon reasonable request. Data is available upon request.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"21 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143582591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-07DOI: 10.1136/bjsports-2024-109237
Ajay Shah, Cari Whyne, Alex Kiss, Hans Kreder, Dawit Gulta, Stephen Chen, Harman Chaudhry
Objectives Total hip replacement (THR) is one of the most common elective orthopaedic surgeries performed, with increasing demand among younger individuals. Few evidence-based guidelines exist on safe activity participation following THR, including whether high-intensity sport participation is safe for individuals. The purpose of this study was to identify if increased intensity of physical activity following THR was associated with increased activity-related pain and increased revision rates. Methods Two groups undergoing THR were recruited: preoperative (cohort 1) and 5–7 years postsurgery (cohort 2); both followed for 5 years. Activity was self-reported through validated questionnaires and grouped into categories from ‘A’ (low intensity, eg, aquafit) to ‘F’ (high intensity, eg, tennis). The primary outcome was the presence of hip pain during activity (binary variable, Y/N), measured by the association between hip pain and intensity of activity (categories A–F). Secondary outcomes included activity duration, revision rate or a change in patient-reported outcome measures (PROMs). Results 1098 individuals were included in this study (cohort 1: n=588, cohort 2: n=510). Regression analysis showed no significant interaction between activity intensity and hip pain across all time points. Approximately 20.6% of all activity (11.0% of participants) occurred in the highest intensity categories (E and F); these subjects showed no decrease in activity duration, worsening PROMs or increased revision rates compared with lower intensity activity groups (all p>0.05). When analysing by individual activities, certain activities (eg, snowboarding, squash, tennis and backpacking) were more correlated with hip pain (r>0.60), while others (eg, snorkelling, swimming, home weights, aquafit, cross-country skiing and sledding) were less likely to have hip pain (r<−0.60). Conclusions This study showed that higher-intensity activities do not lead to decreased activity duration, worsening patient-reported outcomes or increased revision rates following THR, although certain activities may be associated with increased pain. These findings can inform patient counselling after THR. Data are available on reasonable request. We request investigators to contact us directly to discuss data sharing.
{"title":"Safe Activity participation Following Elective Total hip replacement: the SAFE-T investigation","authors":"Ajay Shah, Cari Whyne, Alex Kiss, Hans Kreder, Dawit Gulta, Stephen Chen, Harman Chaudhry","doi":"10.1136/bjsports-2024-109237","DOIUrl":"https://doi.org/10.1136/bjsports-2024-109237","url":null,"abstract":"Objectives Total hip replacement (THR) is one of the most common elective orthopaedic surgeries performed, with increasing demand among younger individuals. Few evidence-based guidelines exist on safe activity participation following THR, including whether high-intensity sport participation is safe for individuals. The purpose of this study was to identify if increased intensity of physical activity following THR was associated with increased activity-related pain and increased revision rates. Methods Two groups undergoing THR were recruited: preoperative (cohort 1) and 5–7 years postsurgery (cohort 2); both followed for 5 years. Activity was self-reported through validated questionnaires and grouped into categories from ‘A’ (low intensity, eg, aquafit) to ‘F’ (high intensity, eg, tennis). The primary outcome was the presence of hip pain during activity (binary variable, Y/N), measured by the association between hip pain and intensity of activity (categories A–F). Secondary outcomes included activity duration, revision rate or a change in patient-reported outcome measures (PROMs). Results 1098 individuals were included in this study (cohort 1: n=588, cohort 2: n=510). Regression analysis showed no significant interaction between activity intensity and hip pain across all time points. Approximately 20.6% of all activity (11.0% of participants) occurred in the highest intensity categories (E and F); these subjects showed no decrease in activity duration, worsening PROMs or increased revision rates compared with lower intensity activity groups (all p>0.05). When analysing by individual activities, certain activities (eg, snowboarding, squash, tennis and backpacking) were more correlated with hip pain (r>0.60), while others (eg, snorkelling, swimming, home weights, aquafit, cross-country skiing and sledding) were less likely to have hip pain (r<−0.60). Conclusions This study showed that higher-intensity activities do not lead to decreased activity duration, worsening patient-reported outcomes or increased revision rates following THR, although certain activities may be associated with increased pain. These findings can inform patient counselling after THR. Data are available on reasonable request. We request investigators to contact us directly to discuss data sharing.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"2 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143582593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-06DOI: 10.1136/bjsports-2024-109012
Mariana Romano de Lira, Ney Meziat-Filho, Gabriela Zuelli Martins Silva, Julia Castro, Jessica Fernandez, Rinaldo Roberto de Jesus Guirro, Roger Berg, Thais Cristina Chaves
Objective This study investigated the efficacy of cognitive functional therapy (CFT) versus a sham procedure for pain intensity and disability for patients with non-specific chronic low back pain (CLBP). Methods This is a randomised sham-controlled trial conducted in a primary care public health service. A total of 152 participants were randomly assigned to the CFT group (n=76) and the sham group (n=76). The CFT group received six 1 hour individualised sessions; the sham procedure group received six individual sessions of neutral talking+detuned photobiomodulation (low-level laser therapy) equipment. Both groups received an education booklet with information on strategies for CLBP self-management. Primary outcomes were pain intensity and disability at 6 weeks. Participants were assessed preintervention, postintervention (at 6 weeks), and 3 and 6 months after randomisation. Results We obtained primary outcome data from 97.4% (n=74) of participants in the CFT group and 98.7% (n=75) from the sham group. The CFT group showed greater effects in pain intensity (mean difference (MD)=−1.8; 95% CI −2.5 to −1.1) and disability (MD=−9.9; 95% CI −13.2 to −6.5) postintervention compared with the sham group. The effect remained at the 3-month and 6-month follow-ups. Conclusions CFT showed sustained clinical efficacy compared with a sham procedure for treating pain intensity and disability in patients with CLBP. Trial registration number This trial was registered in ClinicalTrials.gov, [NCT04518891][1] and was previously published . Data are available upon reasonable request. The study protocol, participant consent and information forms, de-identified individual participant data, the data dictionary and statistical code can be made available by request to the corresponding author. [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT04518891&atom=%2Fbjsports%2Fearly%2F2025%2F03%2F05%2Fbjsports-2024-109012.atom
{"title":"Efficacy of cognitive functional therapy for pain intensity and disability in patients with non-specific chronic low back pain: a randomised sham-controlled trial","authors":"Mariana Romano de Lira, Ney Meziat-Filho, Gabriela Zuelli Martins Silva, Julia Castro, Jessica Fernandez, Rinaldo Roberto de Jesus Guirro, Roger Berg, Thais Cristina Chaves","doi":"10.1136/bjsports-2024-109012","DOIUrl":"https://doi.org/10.1136/bjsports-2024-109012","url":null,"abstract":"Objective This study investigated the efficacy of cognitive functional therapy (CFT) versus a sham procedure for pain intensity and disability for patients with non-specific chronic low back pain (CLBP). Methods This is a randomised sham-controlled trial conducted in a primary care public health service. A total of 152 participants were randomly assigned to the CFT group (n=76) and the sham group (n=76). The CFT group received six 1 hour individualised sessions; the sham procedure group received six individual sessions of neutral talking+detuned photobiomodulation (low-level laser therapy) equipment. Both groups received an education booklet with information on strategies for CLBP self-management. Primary outcomes were pain intensity and disability at 6 weeks. Participants were assessed preintervention, postintervention (at 6 weeks), and 3 and 6 months after randomisation. Results We obtained primary outcome data from 97.4% (n=74) of participants in the CFT group and 98.7% (n=75) from the sham group. The CFT group showed greater effects in pain intensity (mean difference (MD)=−1.8; 95% CI −2.5 to −1.1) and disability (MD=−9.9; 95% CI −13.2 to −6.5) postintervention compared with the sham group. The effect remained at the 3-month and 6-month follow-ups. Conclusions CFT showed sustained clinical efficacy compared with a sham procedure for treating pain intensity and disability in patients with CLBP. Trial registration number This trial was registered in ClinicalTrials.gov, [NCT04518891][1] and was previously published <https://pubmed.ncbi.nlm.nih.gov/35788240/>. Data are available upon reasonable request. The study protocol, participant consent and information forms, de-identified individual participant data, the data dictionary and statistical code can be made available by request to the corresponding author. [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT04518891&atom=%2Fbjsports%2Fearly%2F2025%2F03%2F05%2Fbjsports-2024-109012.atom","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"58 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143570400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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