British Journal of Sports Medicine最新文献_第3页

Stepping into Play: a FIFA decision aid for football participation after childbirth. 步入比赛：产后参加足球比赛的国际足联决策援助。

IF 16.2 1区医学 Q1 SPORT SCIENCES

British Journal of Sports Medicine

Pub Date : 2026-03-17 DOI: 10.1136/bjsports-2025-110228

Emma Brockwell, Sinéad Dufour, Ivi Casagrande, Margie H Davenport

Objective: To create a decision aid to support football participation after childbirth.

Methods: The creation of the decision aid was based on the knowledge-to-action cycle, using the intervention mapping knowledge and transfer framework. Five phases were used in the development process: (1) evaluation of scientific literature, (2) identifying barriers and enablers to sport participation after childbirth, (3) creating and refining the objective and approach of the decision aid, (4) ascertaining the key health screening components for the decision aid and (5) administering a preliminary assessment of the practicality and criterion validity of the decision aid for amateur to elite-level football players to support quality decision-making about football participation after childbirth.

Results: Following an evaluation of scientific literature to identify essential considerations for return-to-football after childbirth, the working group developed the Fédération Internationale de Football Association Stepping into Play decision aid that: (1) prioritises the athlete's voice, (2) facilitates the resumption of participation in team training when and where possible, (3) considers postpartum symptoms and dysfunction, (4) reflects that football participation requires a cognitive stimulus approach and (5) uses currently available questionnaires validated for the postpartum period whenever possible to enhance global internal methodological rigour. The resources underwent a thorough external review by experts (physicians, physiotherapists and performance coaches working in football). After combining their feedback, a broader consultation took place with 32 respondents from 12 countries. This consultation confirmed the high utility of these resources for postpartum football players and their multidisciplinary teams at all levels. The decision aid itself (97% approval), a seven-stage approach (100% approval), and the Postpartum Medical and Performance Debrief Form (100% approval) all received strong support. In an applied case study, 93% of respondents demonstrated competency in using the decision aid by accurately guiding the player through each successive step. The qualitative feedback from the respondents allowed for further refinement and enhancement of the decision aid.

Conclusion: This newly developed decision aid is designed to empower postpartum players and their multidisciplinary teams to make quality decisions about football participation after childbirth.

目的：为产后参与足球运动提供决策辅助。方法：基于知识-行动循环，采用干预映射知识和迁移框架，构建决策辅助工具。在开发过程中使用了五个阶段：(1)评估科学文献；(2)确定分娩后参加体育运动的障碍和促进因素；(3)创建和完善决策援助的目标和方法；(4)确定决策辅助的关键健康筛查成分；(5)初步评估决策辅助对业余至精英水平足球运动员产后参与足球质量决策的实用性和标准效度。结果：在对科学文献进行评估以确定分娩后重返足球的基本考虑因素后，工作组制定了国际足球协会进入比赛决策援助：(1)优先考虑运动员的声音，(2)在可能的时间和地点促进恢复参与团队训练，(3)考虑产后症状和功能障碍，(4)反映足球参与需要认知刺激方法，(5)使用目前可用的问卷，在产后期间验证，尽可能增强全球内部方法的严严性。这些资源经过了专家（从事足球工作的医生、物理治疗师和表现教练）的彻底外部审查。在综合了他们的反馈后，对来自12个国家的32名受访者进行了更广泛的咨询。这次咨询证实了这些资源对产后足球运动员及其各级多学科团队的高效用。决策辅助本身（97%赞成）、七阶段方法（100%赞成）、产后医疗和绩效汇报表（100%赞成）都得到了大力支持。在一个应用案例研究中，93%的受访者通过准确地引导玩家完成每个连续的步骤，展示了使用决策辅助的能力。答复者提供的定性反馈有助于进一步改进和加强决策援助。结论：这种新开发的决策辅助工具旨在使产后球员及其多学科团队能够在分娩后对足球参与做出高质量的决策。

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引用次数: 0

Effects of percutaneous platelet-rich plasma injection on return-to-play after acute hamstring muscle injury: a systematic review and meta-analysis. 经皮富血小板血浆注射对急性腘绳肌损伤后恢复的影响：系统回顾和荟萃分析。

IF 16.2 1区医学 Q1 SPORT SCIENCES

British Journal of Sports Medicine

Pub Date : 2026-03-12 DOI: 10.1136/bjsports-2025-110683

Hirotaka Nakagawa, Patrick Krochmal, Ian Thomas, Judy B Rabinowitz, Ryan C Kruse, Robert Bowers, Walter I Sussman

Objective: To evaluate the effectiveness and safety of platelet-rich plasma (PRP) for acute hamstring injuries, with attention to return-to-play (RTP) time, reinjury rates and adverse events.

Design: Systematic review and meta-analysis of randomised controlled trials (RCTs). Risk of bias was assessed using the Cochrane tool; certainty of evidence was evaluated using GRADE (Grading of Recommendations Assessment, Development and Evaluation).

Data sources: Databases included Embase, MEDLINE, Web of Science, Elsevier and Cochrane Central searched through March 2025.

Eligibility criteria: RCTs comparing PRP to control treatments for acute hamstring injuries were included. Non-randomised and chronic tendinopathy studies were excluded.

Results: Six RCTs (n=277) were included. PRP reduced RTP time versus control (mean difference -8.6 days; 21.4 vs 30.0 days; 95% CI -3.04 to -0.03; p=0.045), though heterogeneity was high (I²=94.1%). Reinjury (15% vs 16%; p=0.722) and adverse event rates (1% vs 0%; p=0.687) did not differ. Certainty of evidence was rated as low to moderate due to risk of bias and imprecision.

Conclusion: PRP may shorten RTP in acute hamstring injuries, especially when image-guided. Reinjury risk appears unchanged. Further trials are needed to confirm these findings and standardise biological use in muscle injuries.

Prospero registration number: CRD420251109346.

目的：评价富血小板血浆（PRP）治疗急性腘绳肌损伤的有效性和安全性，并关注其恢复时间、再损伤率和不良事件。设计：随机对照试验（rct）的系统评价和荟萃分析。使用Cochrane工具评估偏倚风险；使用GRADE（建议评估、发展和评价分级）评估证据的确定性。数据来源：检索截止到2025年3月的数据库包括Embase、MEDLINE、Web of Science、Elsevier和Cochrane Central。入选标准：纳入比较PRP与对照治疗急性腿筋损伤的随机对照试验。非随机和慢性肌腱病变研究被排除在外。结果：纳入6项rct （n=277）。与对照组相比，PRP缩短了RTP时间（平均差异为8.6天；21.4天对30.0天；95% CI为-3.04至-0.03;p=0.045），尽管异质性很高（I²=94.1%）。再损伤（15% vs 16%, p=0.722）和不良事件发生率（1% vs 0%, p=0.687）无差异。由于存在偏倚和不精确的风险，证据的确定性被评为低至中等。结论：PRP可缩短急性腘绳肌损伤的RTP，尤其是在图像引导下。再次受伤的风险似乎没有变化。需要进一步的试验来证实这些发现，并使肌肉损伤的生物学应用标准化。普洛斯彼罗注册号：CRD420251109346。

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引用次数: 0

Sports medicine in the Transfer Portal and Name, Image and Likeness era. 传送门户和名称、形象和相似时代的运动医学。

IF 18.4 1区医学 Q1 SPORT SCIENCES

British Journal of Sports Medicine

Pub Date : 2026-03-12 DOI: 10.1136/bjsports-2025-110766

James L Moeller,Jon G Divine

引用次数: 0

Dr Calvin Spellmon: service and mentorship in Birmingham city schools. Dr Calvin Spellmon：伯明翰城市学校的服务和辅导。

IF 18.4 1区医学 Q1 SPORT SCIENCES

British Journal of Sports Medicine

Pub Date : 2026-03-12 DOI: 10.1136/bjsports-2025-110934

Allison N Schroeder,James L Moeller

引用次数: 0

Dual-energy X-ray absorptiometry per cent fat Z-score as a predictor of menstrual status in adolescent and young adult female athletes. 双能x线吸收仪百分比脂肪z分数作为青春期和年轻成年女运动员月经状况的预测因子。

IF 18.4 1区医学 Q1 SPORT SCIENCES

British Journal of Sports Medicine

Pub Date : 2026-03-10 DOI: 10.1136/bjsports-2025-110243

Meghan Keating,Grace H Saville,Lauren McCall,Kristin L Sainani,Kathryn E Ackerman

OBJECTIVEWeight/fat mass gain to support resumption of normal menses can be an important treatment goal for female athletes with amenorrhoea (AMEN) or oligomenorrhoea (OLIGO) related to relative energy deficiency in sport (REDs). However, targets based on body mass index (BMI) or per cent expected body weight (%EBW) may be less applicable in athletes, who typically have greater lean mass compared with the general population. Our aim was to determine if dual-energy X-ray absorptiometry (DXA)-derived %fat Z-score can detect menstrual status in female athletes and if a %fat Z-score cut-off of <-1.0 is a better indicator than standard BMI (in those >20 years) or %EBW (in those ≤20 years) thresholds.METHODS388 female athletes (age 15-30 years, Tier ≥2) with DXA scans were classified as AMEN (n=159), OLIGO (n=84) or naturally menstruating (NM, n=145) using clinical records. We compared %fat Z-score and BMI or %EBW values across menstrual groups and calculated sensitivity and specificity for predicting AMEN and the combined OLIGO and AMEN groups (OLIGO/AMEN) using traditional BMI or %EBW risk cut-offs versus a risk cut-off of <-1.0 for %fat Z-score.RESULTS%fat Z-score was superior to traditional BMI or %EBW thresholds in discriminating between menstrual status groups. Using a %fat Z-score cut-off <-1.0 improved sensitivity (p<0.0001) for predicting AMEN (68.9%) and OLIGO/AMEN (57.7%) compared with the sensitivity of traditional BMI or %EBW cut-offs for AMEN (29.3%) and OLIGO/AMEN (25.9%). However, %fat Z-score <-1.0 did not improve specificity for predicting AMEN (75.4%) nor OLIGO/AMEN (79.9%) compared with the specificity of traditional BMI or %EBW cut-offs for AMEN (83.9%; p=0.0078) and OLIGO/AMEN (85.2%; p=0.14).CONCLUSIONSWhen attempting to resume normal menstruation, achieving a %fat Z-score ≥-1.0, rather than using BMI or %EBW targets, may be a better goal for athletes with REDs-related amenorrhoea or oligomenorrhoea.

目的增加体重/脂肪量以支持恢复正常月经可能是与运动中相对能量缺乏（red）相关的闭经（AMEN）或少经（OLIGO）女运动员的重要治疗目标。然而，基于身体质量指数（BMI）或预期体重百分比（%EBW）的目标可能不太适用于运动员，因为与一般人群相比，运动员通常拥有更大的瘦质量。我们的目的是确定双能x线吸收仪（DXA）衍生的%脂肪z评分是否可以检测女运动员的月经状况，以及%脂肪z评分截止时间为20年或%EBW（≤20年）阈值。方法根据临床记录，将388名DXA扫描的女性运动员（15-30岁，Tier≥2）分为AMEN （n=159）、OLIGO （n=84）和自然月经（NM, n=145）。我们比较了月经组的%fat Z-score和BMI或%EBW值，并计算了使用传统BMI或%EBW风险临界值与%fat Z-score <-1.0的风险临界值相比，预测AMEN和OLIGO和AMEN联合组（OLIGO/AMEN）的敏感性和特异性。结果：在区分月经状态组时，%脂肪z评分优于传统BMI或%EBW阈值。与传统BMI或%EBW临界值预测AMEN（29.3%）和OLIGO/AMEN（25.9%）的敏感性相比，使用%fat z评分临界值<-1.0提高了预测AMEN（68.9%）和OLIGO/AMEN（57.7%）的敏感性（p<0.0001）。然而，与传统BMI或%EBW临界值预测AMEN的特异性（83.9%,p=0.0078）和OLIGO/AMEN的特异性（85.2%,p=0.14）相比，%fat Z-score <-1.0并未提高预测AMEN的特异性（75.4%）和OLIGO/AMEN的特异性（79.9%）。结论在尝试恢复正常月经时，实现%fat Z-score≥-1.0，而不是使用BMI或%EBW指标，可能是red相关性闭经或少经运动员更好的目标。

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引用次数: 0

Rehabilitation and outcomes following revision total hip replacement: patients' experiences, optimised rehabilitation interventions and opioid use (PhD Academy Award). 翻修全髋关节置换术后的康复和结果：患者经历、优化的康复干预和阿片类药物使用（博士学院奖）。

IF 18.4 1区医学 Q1 SPORT SCIENCES

British Journal of Sports Medicine

Pub Date : 2026-03-10 DOI: 10.1136/bjsports-2026-111665

Martin Gade Stisen

引用次数: 0

Harmful anachronism: World Athletics reinstates gene testing to participate in women's competitions. 有害的时代错误：世界田联恢复了参加女子比赛的基因检测。

IF 18.4 1区医学 Q1 SPORT SCIENCES

British Journal of Sports Medicine

Pub Date : 2026-03-04 DOI: 10.1136/bjsports-2025-110787

Silvia Camporesi,Shane M Heffernan,Pascal Borry,Jensen Brehaut,Tim Cable,Jonathan Cooper,Luke Cox,Antoine Duval,Niall Fife,Sasha Gollish,Fergus M Guppy,Blair R Hamilton,Vanessa Heggie,Adam Herbert,Richard Holt,Jörg Krieger,Sigmund Loland,Fernanda Malinsky,Marcus Mazzucco,Mike J McNamee,Jonathan Ospina-Betancurt,Madeleine Pape,Lyndsay P Pieper,María José Martínez Patiño,Roger Pielke,Yannis P Pitsiladis,Francisco J Sánchez,Jaime Schultz,Alexandra L Shaw,Andrew Sinclair,Sarah Teetzel,Eric Vilain,Georgina K Stebbings,Alun G Williams

引用次数: 0

Pre-participation cardiovascular screening among NCAA athletes: a systematic review and meta-analysis of 27 891 athletes. NCAA运动员赛前心血管筛查：27891名运动员的系统回顾和荟萃分析

IF 18.4 1区医学 Q1 SPORT SCIENCES

British Journal of Sports Medicine

Pub Date : 2026-03-03 DOI: 10.1136/bjsports-2025-110791

Justin J Conway,Dylan Bennett,Irfan M Asif,Masaru Teramoto,Brett G Toresdahl

OBJECTIVETo evaluate the outcomes of pre-participation cardiovascular screening among National Collegiate Athletic Association (NCAA) athletes and quantify the added value of history and physical exam (H&P) when combined with a screening ECG.DESIGNSystematic review and meta-analysis following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.DATA SOURCESMEDLINE (1946-present), EMBASE (1947-present), PubMed (1966-present) and Cochrane Library (1991-present).ELIGIBILITY CRITERIA FOR SELECTING STUDIESPeer-reviewed research articles published in English reporting original findings on pre-participation cardiovascular screening outcomes in NCAA athletes.RESULTS18 studies, representing 27 891 NCAA athletes (44.2% female), were included. A total of 66 (0.24%) athletes were diagnosed with a cardiovascular condition associated with serious morbidity or sudden cardiac arrest/death (SCA/D). Wolff-Parkinson-White was the most common diagnosis (n=39, 59.1%), followed by hypertrophic cardiomyopathy (n=11, 16.7%). Among the eight studies (16 609 athletes) for which the screening performance of ECG and H&P could be extracted separately, ECG screening resulted in a 3.5-fold higher detection rate of true positive cases (number needed to screen (NNS) =475) compared with H&P alone (NNS=1661). The false positive rate for H&P was 17% versus 5% for ECG (p<0.001). The added value of H&P in athletes with a negative ECG was low (NNS=3003).CONCLUSIONECG screening significantly increases the detection of conditions associated with serious morbidity or SCA/D compared with H&P alone, with H&P providing minimal added value in athletes with a normal ECG. Our findings support the utility of ECG in preparticipation screening for NCAA athletes.PROSPERO REGISTRATION NUMBERCRD42020188308.

目的评价全国大学生体育协会（NCAA）运动员参加前心血管筛查的结果，并量化病史和体格检查（H&P）与筛查心电图相结合的附加价值。按照系统评价和元分析指南的首选报告项目设计系统评价和元分析。数据来源：medline（1946年至今），EMBASE（1947年至今），PubMed（1966年至今）和Cochrane图书馆（1991年至今）。选择研究的资格标准发表在英文的同行评议的研究文章，报告了NCAA运动员参加前心血管筛查结果的原始发现。结果纳入18项研究，共27 891名NCAA运动员（女性44.2%）。共有66名（0.24%）运动员被诊断患有与严重发病率或心脏骤停/死亡（SCA/D）相关的心血管疾病。Wolff-Parkinson-White是最常见的诊断（n=39, 59.1%），其次是肥厚性心肌病（n=11, 16.7%）。在分别提取心电图和H&P筛查表现的8项研究（16 609名运动员）中，心电图筛查的真阳性检出率（需要筛查的人数(NNS) =475）比单独进行H&P筛查（NNS=1661）高3.5倍。H&P的假阳性率为17%，而ECG为5% （p<0.001）。心电图阴性运动员H&P的附加值较低（NNS=3003）。结论：与单纯H&P相比，心电图筛查显著增加了严重发病率或SCA/D相关疾病的检出率，而H&P对心电图正常的运动员的附加价值极小。我们的研究结果支持心电图在NCAA运动员赛前筛查中的效用。普洛斯彼罗注册号crd42020188308。

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引用次数: 0

Adolescent maturation and injury risk in an elite ballet school: a 7-year cohort study of 506 students. 一所精英芭蕾舞学校的青少年成熟和伤害风险：一项对506名学生的7年队列研究。

IF 18.4 1区医学 Q1 SPORT SCIENCES

British Journal of Sports Medicine

Pub Date : 2026-03-02 DOI: 10.1136/bjsports-2025-110306

Niall MacSweeney,Karen Sheriff,Christopher Fitzpatrick,Daniel Dylan Cohen,Phil D B Price,Ryan Mahaffey,Charles Pedlar,Joseph William Shaw

OBJECTIVESThis study investigates how growth and maturation-related factors are associated with growth and bone injury risk in elite-level ballet students.METHODS506 full-time dance students (preprofessional) were included in the study across a 7-year time period. A causal framework was outlined using a directed acyclic graph (DAG) to outline the investigatory approach. This was then used to inform a model-building process, which used a combination of generalised linear and polynomial mixed-effects models to identify relationships between growth-related and bone-related injury occurrence and percentage of adult height, growth rate, body mass index (BMI) percentile and change BMI, while controlling for year group.RESULTSA significant positive relationship (p=0.0006) was observed between growth rate and growth injury occurrence, while a significant (quadratic p value=0.0019) inverted U-shaped relationship was observed between percentage of adult height and growth injury occurrence. Growth rate and percentage of adult height demonstrated similar associations with bone injury; however, substantially greater error was observed when analysing bone injury compared with growth-related injury. No relationships were observed between age-specific and sex-specific BMI percentile or change in BMI and either injury type.CONCLUSIONBoth growth rate and maturation stage (85%-95% of adult height) were associated with the risk of growth-related injury in dancers. The combination of these factors can be used to implement proactive injury-reduction strategies targeting growth-related injuries.

目的探讨芭蕾精英学生生长和成熟相关因素与生长和骨损伤风险的关系。方法506名全日制舞蹈学生（专业前）在7年的时间里被纳入研究。使用有向无环图（DAG）概述了因果框架，以概述调查方法。然后将其用于模型构建过程，该过程使用广义线性和多项式混合效应模型的组合来确定生长相关和骨相关损伤发生率与成人身高、增长率、体重指数（BMI）百分位数和变化BMI之间的关系，同时控制年龄组。结果生长速率与生长损伤发生率呈显著正相关（p=0.0006），成人身高百分比与生长损伤发生率呈显著的倒u型相关（二次p值=0.0019）。成人身高的生长速率和百分比与骨损伤有相似的相关性；然而，与生长相关损伤相比，在分析骨损伤时观察到更大的误差。没有观察到年龄特异性和性别特异性BMI百分位数或BMI变化与任一损伤类型之间的关系。结论舞者的生长速率和成熟阶段（成人身高的85% ~ 95%）与生长相关损伤的发生风险相关。这些因素的结合可以用来实施针对生长相关损伤的主动伤害减少策略。

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引用次数: 0

Developing a sexual assault emergency action plan: modified Delphi consensus recommendations from the American Medical Society for Sports Medicine. 制定性侵犯紧急行动计划：修改德尔福共识建议从美国医学会运动医学。

IF 18.4 1区医学 Q1 SPORT SCIENCES

British Journal of Sports Medicine

Pub Date : 2026-03-02 DOI: 10.1136/bjsports-2025-110966

Sherilyn DeStefano,Megan Agnew,Stephanie Deccy,Katherine F Wainwright,Jason Matuszak, ,Stephanie A Kliethermes

Sexual assault affects an estimated 0.5-12% of athletes and can seriously affect athlete health. Concerted efforts are needed to support survivors in receiving timely and appropriate care. Despite recognition from leading sports organisations about the need to prevent and respond effectively to sexual assault, many sports medicine physicians feel inadequately prepared to handle sexual assault disclosures. Emergency action plans (EAPs) offer a promising strategy to support adequate responses and ensure competent and consistent care. This modified Delphi study aimed to identify consensus-based components of a sexual assault EAP designed for sports medicine clinicians responding to sexual assault disclosures. A diverse panel of 24 individuals with lived and practical experience related to sexual violence in sport participated in one anonymous open-ended round and three anonymous voting rounds. The open-ended round generated important components in eight key domains: General Guidance; Mandatory Reporting, Confidentiality and Consent; Initial Evaluation; Follow-up Planning; Athlete Safety and Trauma-Informed Care; Legal Considerations; Established Contacts and Resources and Implementation. Overall, 90/130 proposed items (69%) achieved consensus (≥80% agreement for non-ranking items). The sexual assault EAP framework may improve clinician competency and support adequate responses, addressing common barriers such as low disclosure rates, personnel turnover and confidentiality concerns. Adoption of such plans has the potential to increase athlete trust in reporting mechanisms and foster more comprehensive care for athlete-survivors of sexual violence in sport. Example EAP templates are provided to assist sports organisations in implementing protocols that enhance self-efficacy among clinicians and support survivors throughout the reporting and recovery process.

性侵犯影响了大约0.5-12%的运动员，并会严重影响运动员的健康。需要齐心协力，支持幸存者获得及时和适当的护理。尽管领先的体育组织认识到预防和有效应对性侵犯的必要性，但许多运动医学医生觉得在处理性侵犯信息方面准备不足。紧急行动计划提供了一种有希望的战略，以支持适当的应对措施，并确保有能力和持续的护理。本改进的德尔菲研究旨在确定为运动医学临床医生应对性侵犯披露而设计的性侵犯EAP中基于共识的组成部分。一个由24名具有与体育中的性暴力有关的生活和实践经验的个人组成的多元化小组参加了一轮匿名开放式投票和三轮匿名投票。不限成员名额的回合在八个关键领域产生了重要组成部分：一般指南；强制性报告、保密和同意；初步评估;后续规划;运动员安全和创伤知情护理；法律因素;已建立的联系、资源和实施。总体而言，130个建议项目中有90个（69%）达成了共识（非排名项目的一致性≥80%）。性侵犯EAP框架可以提高临床医生的能力，支持适当的反应，解决常见的障碍，如低披露率，人员流动和保密问题。采用这些计划有可能增加运动员对报告机制的信任，并促进对体育界性暴力幸存者的更全面的照顾。提供了示例EAP模板，以帮助体育组织实施提高临床医生自我效能的协议，并在整个报告和恢复过程中支持幸存者。

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引用次数: 0