British Journal of Sports Medicine最新文献

Objective: Low back pain (LBP) impacts the performance and quality of life of elite athletes during and beyond their career. Our aim was to explore the lived experiences of elite athletes with persistent LBP (pLBP) with a focus on understanding the biopsychosocial factors that influence their recovery.

Methods: Australian elite athletes with pLBP (>3 months) participated in semistructured interviews which focused on their pLBP experience. Recordings were transcribed verbatim, and data were analysed using Braun and Clarke's reflexive thematic analysis. We partnered with athletes throughout the research process, including study design and data analysis.

Results: 17 elite national and international athletes who competed in 10 Summer Olympic sports were included (mean symptom duration 18 months and current pain of 3.5/10 (SD+/-2.1)). Four themes were generated to represent participants' experiences: (1) the burden of pLBP, (2) validation, agency and feeling empowered to manage pain, (3) perceived barriers and coping strategies in recovery and (4) culture and interpersonal relationships for managing persisting low back pain.

Conclusions: Elite athletes with pLBP report disruption to identity, self-confidence and perceived worth. The culture of elite sport magnifies psychosocial determinants of pain and recovery. Agency was fostered through validation of their pain experience, enhanced by education, diagnostic labelling and a culture of openness. Recovery was influenced by mental health and relationships within and beyond sport. Clinicians play a key role in facilitating athlete agency, contextualising pain and supporting psychological and social well-being.

Objective: To evaluate the effectiveness of interventions on physical activity promotion in low-income and middle-income countries (LMICs).

Design: Systematic review and meta-analysis.

Data sources: PubMed, EMBASE, CINAHL and Cochrane CENTRAL.

Eligibility criteria: Randomised controlled trials and quasi-experimental studies published between January 2010 and September 2024. Primary outcomes included standardised mean difference (SMD) in physical activity outcomes reported mainly in metabolic equivalent to task (MET) minutes, physical activity minutes and sedentary behaviour. Data were synthesised using random-effects meta-analysis to calculate the SMD reported in a 95% CI, and the risk of bias was assessed using Cochrane Risk of Bias 2 (RoB 2) and Risk of Bias in Non-Randomised Studies of Interventions tools (ROBINS-I). SMDs of 0.2, 0.5 and 0.8 were interpreted as small, medium and large effects as per Cohen's threshold.

Results: 23 studies involving 12 689 participants from LMICs were included in the meta-analysis. Results indicated a small but statistically significant overall effect on physical activity (SMD=0.29, 95% CI 0.13 to 0.46, I²=96%). Significant improvements were observed for MET minutes (SMD=0.42, 95% CI 0.21 to 0.64, I²=94%) and physical activity scores (SMD=0.86, 95% CI 0.38 to 1.35, I²=91%), but not in total physical activity minutes, sedentary time or energy expenditure, indicating interventions mainly enhanced activity intensity. Interventions via apps and interactive calls were most effective, though overall evidence certainty was low to very low because of heterogeneity and imprecision.

Conclusions: Interventions, primarily delivered through mobile apps or interactive calls, led to small improvements in physical activity intensity and could have significant public health benefits in LMICs. Future interventions should be context-specific and backed by robust trials to increase their impact and inform sustainable policy.

Prospero registration number: CRD42023412477.