Pub Date : 2024-11-01DOI: 10.1136/bjsports-2024-109345
Wes O Zimmermann, Fred Hartgens
The summer of 2024 was dominated by spectacular sporting events, first and foremost by the Paris Olympic and Paralympic Games. The Netherlands achieved a credible sixth place in the medal ranking of nations in the Olympic Games and a fourth place in the Paralympic Games. How does a small country (18 million inhabitants) achieve such success? The answer may be focus and collaboration. The Netherlands Olympic Committee has been focusing for at least 30 years on supporting those athletes who have a good chance of reaching the finals and preferably winning a medal at the highest international level. Tough choices are not avoided. If an athlete cannot meet the performance requirements, support is no longer provided. A multidisciplinary group of experts is placed around an individual athlete or team, all of whom must collaborate in support of the athletes and contribute to optimise performance. Sports medicine physicians are an integral part of the support teams, managing and preventing injuries and (legally!) facilitating improved performance. Sports medical education is an important component of the support programme. Athletes learn to register their own injuries and illnesses so that they gain insight into which circumstances contribute to overload and injury. In the Netherlands, para-athletes can access the same support as their non-impaired colleagues. A report by the Dutch Sports Council, an independent advisory body that focuses on highlighting the significance of sports and exercise for society, has made an important contribution to further improve the supporting facilities for para-athletes. The name of the 2022 report is ‘Equal and inclusive, advice on …
{"title":"Sports medicine in the Netherlands – focus and collaboration bring success","authors":"Wes O Zimmermann, Fred Hartgens","doi":"10.1136/bjsports-2024-109345","DOIUrl":"https://doi.org/10.1136/bjsports-2024-109345","url":null,"abstract":"The summer of 2024 was dominated by spectacular sporting events, first and foremost by the Paris Olympic and Paralympic Games. The Netherlands achieved a credible sixth place in the medal ranking of nations in the Olympic Games and a fourth place in the Paralympic Games. How does a small country (18 million inhabitants) achieve such success? The answer may be focus and collaboration. The Netherlands Olympic Committee has been focusing for at least 30 years on supporting those athletes who have a good chance of reaching the finals and preferably winning a medal at the highest international level. Tough choices are not avoided. If an athlete cannot meet the performance requirements, support is no longer provided. A multidisciplinary group of experts is placed around an individual athlete or team, all of whom must collaborate in support of the athletes and contribute to optimise performance. Sports medicine physicians are an integral part of the support teams, managing and preventing injuries and (legally!) facilitating improved performance. Sports medical education is an important component of the support programme. Athletes learn to register their own injuries and illnesses so that they gain insight into which circumstances contribute to overload and injury. In the Netherlands, para-athletes can access the same support as their non-impaired colleagues. A report by the Dutch Sports Council, an independent advisory body that focuses on highlighting the significance of sports and exercise for society, has made an important contribution to further improve the supporting facilities for para-athletes. The name of the 2022 report is ‘Equal and inclusive, advice on …","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"1 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142599311","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 : 2024-10-29DOI: 10.1136/bjsports-2024-108264
Kye-Yeung Park, Youn Huh, Ga Eun Nam, Kyungdo Han, Jin-Hyung Jung, Yoon Jeong Cho, Seon Mee Kim, Hwan-Sik Hwang, Yong-Moon Mark Park
Objective To examine associations between the amount and changes in regular physical activity (PA) before and after diagnosis of dementia and all-cause mortality risk, and whether these associations differ by PA intensity (light, moderate or vigorous). Methods This retrospective cohort study used data from the Korean National Health Insurance Service Database, including 60 252 individuals newly diagnosed with dementia between 2010 and 2016 who underwent health examinations both before and after diagnosis. PA was assessed using the International Physical Activity Questionnaire–Short Form. Multivariable Cox proportional hazards regression models were used to analyse the associations between PA (amount and changes) and all-cause mortality risk. Results During a mean follow-up of 3.7 years, 16 431 (27.3%) deaths occurred. Higher PA levels after dementia diagnosis were associated with a dose-dependent decrease in mortality risk (p for trend <0.001). Maintaining regular PA, compared with remaining inactive, was associated with the lowest mortality risk (HR=0.71, 95% CI 0.65 to 0.79). Sustained engagement in PA of any intensity was associated with decreased mortality risk: light (HR=0.70, 95% CI 0.67 to 0.75), moderate (HR=0.74, 95% CI 0.64 to 0.86) and vigorous PA (HR=0.70, 95% CI 0.61 to 0.79). Initiating any PA intensity after dementia diagnosis was associated with at least 20% reduced mortality risk. These associations were consistent in Alzheimer’s disease. Conclusions Maintaining or initiating regular PA, regardless of intensity, after dementia diagnosis was associated with a reduced risk of all-cause mortality. Lifestyle modifications promoting PA might offer survival benefits for individuals with dementia. No data are available. This study was performed using the National Health Insurance System database in Korea, and the results do not necessarily represent the opinions of the National Health Insurance Corporation. Restrictions apply to the availability of these data, which were used under the licence for this study.
目的 研究痴呆症确诊前后定期体育锻炼（PA）的数量和变化与全因死亡风险之间的关系，以及这些关系是否因体育锻炼强度（轻度、中度或重度）而有所不同。方法 这项回顾性队列研究使用了韩国国民健康保险服务数据库中的数据，其中包括 60 252 名在 2010 年至 2016 年间新确诊为痴呆症的患者，他们在确诊前后都接受了健康检查。研究人员使用国际体力活动调查问卷-简表对患者的体力活动进行了评估。采用多变量 Cox 比例危险回归模型分析了 PA（数量和变化）与全因死亡风险之间的关系。结果 在平均 3.7 年的随访期间，共有 16 431 人（27.3%）死亡。痴呆症确诊后，较高的 PA 水平与死亡风险的下降呈剂量依赖关系（趋势 p <0.001）。与保持不运动相比，保持定期的体育锻炼与最低的死亡风险相关（HR=0.71，95% CI 0.65 至 0.79）。持续参与任何强度的体育锻炼都与死亡风险的降低有关：轻度（HR=0.70，95% CI 0.67-0.75）、中度（HR=0.74，95% CI 0.64-0.86）和强度（HR=0.70，95% CI 0.61-0.79）。痴呆症确诊后开始任何强度的体育锻炼都会使死亡风险降低至少 20%。这些关联在阿尔茨海默病中是一致的。结论 痴呆症确诊后，无论强度如何，保持或开始有规律的体育锻炼都与全因死亡风险的降低有关。调整生活方式，促进体育锻炼，可能会为痴呆症患者的生存带来益处。暂无数据。本研究使用韩国国民健康保险系统数据库进行，研究结果不代表国民健康保险公团的观点。这些数据的可用性受到限制，本研究使用这些数据需获得许可。
{"title":"Changes in physical activity and all-cause mortality among individuals with dementia: a cohort study using the National Health Insurance Service Database in Korea","authors":"Kye-Yeung Park, Youn Huh, Ga Eun Nam, Kyungdo Han, Jin-Hyung Jung, Yoon Jeong Cho, Seon Mee Kim, Hwan-Sik Hwang, Yong-Moon Mark Park","doi":"10.1136/bjsports-2024-108264","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108264","url":null,"abstract":"Objective To examine associations between the amount and changes in regular physical activity (PA) before and after diagnosis of dementia and all-cause mortality risk, and whether these associations differ by PA intensity (light, moderate or vigorous). Methods This retrospective cohort study used data from the Korean National Health Insurance Service Database, including 60 252 individuals newly diagnosed with dementia between 2010 and 2016 who underwent health examinations both before and after diagnosis. PA was assessed using the International Physical Activity Questionnaire–Short Form. Multivariable Cox proportional hazards regression models were used to analyse the associations between PA (amount and changes) and all-cause mortality risk. Results During a mean follow-up of 3.7 years, 16 431 (27.3%) deaths occurred. Higher PA levels after dementia diagnosis were associated with a dose-dependent decrease in mortality risk (p for trend <0.001). Maintaining regular PA, compared with remaining inactive, was associated with the lowest mortality risk (HR=0.71, 95% CI 0.65 to 0.79). Sustained engagement in PA of any intensity was associated with decreased mortality risk: light (HR=0.70, 95% CI 0.67 to 0.75), moderate (HR=0.74, 95% CI 0.64 to 0.86) and vigorous PA (HR=0.70, 95% CI 0.61 to 0.79). Initiating any PA intensity after dementia diagnosis was associated with at least 20% reduced mortality risk. These associations were consistent in Alzheimer’s disease. Conclusions Maintaining or initiating regular PA, regardless of intensity, after dementia diagnosis was associated with a reduced risk of all-cause mortality. Lifestyle modifications promoting PA might offer survival benefits for individuals with dementia. No data are available. This study was performed using the National Health Insurance System database in Korea, and the results do not necessarily represent the opinions of the National Health Insurance Corporation. Restrictions apply to the availability of these data, which were used under the licence for this study.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"41 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142541246","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 : 2024-10-29DOI: 10.1136/bjsports-2024-108697
Viktor H Ahlqvist, Marcel Ballin
Polygenic risk scores (PRSs), designed to capture genetic predisposition to specific traits,1 are becoming increasingly accessible at scale and are being used in physical activity research. PRSs are typically calculated by aggregating the effect sizes of single-nucleotide polymorphisms (SNPs) associated with a particular trait or disease, usually derived from genome-wide association studies (GWASs), into a score for each individual to reflect their genetic liability to that trait or disease. Various methodologies exist for constructing PRSs, ranging from simple to more complex.1 The simplest approach often involves selecting a subset of SNPs based on their associated p values from the GWAS, while more sophisticated methods may incorporate additional data, such as linkage disequilibrium patterns or functional genomic information.1 Regardless of the approach, the appeal of PRSs lies in their simplicity and versatility, especially as they can be readily computed in cohorts with existing genetic data. This makes PRSs valuable both for controlling confounding and as a research focus in their own right. This editorial aims to discuss some key challenges in using PRSs for analysing physical activity and health, focusing on the difficulty of distinguishing mechanisms behind associations and the limited clinical interpretability of effect estimates. We also offer some practical recommendations for future research. Recent studies have employed PRSs related to physical activity to investigate various outcomes, finding that high scores are associated with lower risk of cardiometabolic risk factors, coronary heart disease, stroke, hypertension, type 2 diabetes, obesity and all-cause mortality.2–4 However, the interpretation of these results is hampered by several challenges. A fundamental challenge is that several potential explanations exist for why a PRS for physical activity might be associated with health outcomes. These include a true causal effect of physical activity on health outcomes and the influence of shared genetics. Unfortunately, …
{"title":"Polygenic risk analysis in physical activity and health: why are the same results interpreted differently?","authors":"Viktor H Ahlqvist, Marcel Ballin","doi":"10.1136/bjsports-2024-108697","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108697","url":null,"abstract":"Polygenic risk scores (PRSs), designed to capture genetic predisposition to specific traits,1 are becoming increasingly accessible at scale and are being used in physical activity research. PRSs are typically calculated by aggregating the effect sizes of single-nucleotide polymorphisms (SNPs) associated with a particular trait or disease, usually derived from genome-wide association studies (GWASs), into a score for each individual to reflect their genetic liability to that trait or disease. Various methodologies exist for constructing PRSs, ranging from simple to more complex.1 The simplest approach often involves selecting a subset of SNPs based on their associated p values from the GWAS, while more sophisticated methods may incorporate additional data, such as linkage disequilibrium patterns or functional genomic information.1 Regardless of the approach, the appeal of PRSs lies in their simplicity and versatility, especially as they can be readily computed in cohorts with existing genetic data. This makes PRSs valuable both for controlling confounding and as a research focus in their own right. This editorial aims to discuss some key challenges in using PRSs for analysing physical activity and health, focusing on the difficulty of distinguishing mechanisms behind associations and the limited clinical interpretability of effect estimates. We also offer some practical recommendations for future research. Recent studies have employed PRSs related to physical activity to investigate various outcomes, finding that high scores are associated with lower risk of cardiometabolic risk factors, coronary heart disease, stroke, hypertension, type 2 diabetes, obesity and all-cause mortality.2–4 However, the interpretation of these results is hampered by several challenges. A fundamental challenge is that several potential explanations exist for why a PRS for physical activity might be associated with health outcomes. These include a true causal effect of physical activity on health outcomes and the influence of shared genetics. Unfortunately, …","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"40 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142541146","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}
Objectives To assess (1) the 1-year prevalence of previous shoulder, knee and ankle injuries; (2) the in-season prevalence proportion (prevalence) of injuries and illnesses, injury incidence rate (ir) and injury burden (product of ir and weeks with injuries); (3) initial injury management strategies. Methods We conducted a cohort study of 679 highest-division Danish handball players aged 14–18. Players self-reported past-year shoulder, knee and ankle injuries at baseline, and weekly information on any handball-related injuries (irrespective of time loss and medical attention), illnesses, exposure hours and injury management over 31 weeks. Results At baseline, 46% (95% CI 42% to 49%) of the players reported a past-year shoulder, knee or ankle injury. The weekly average injury and illness prevalence was 21% (95% CI 19% to 23%) and 2% (95% CI 1.7% to 2.3%), respectively, and the ir was 9.4 (95% CI 8.7 to 10.2)/1000 hours. Females experienced the highest injury burden from knee injuries (ir: 1.7 (95% CI 1.3 to 2.2) × 6.7 (95% CI 4.7 to 8.7) weeks with injury/1000 hours), while males experienced the highest injury burden from shoulder injuries (ir: 1.3 (95% CI 1.0 to 1.7) × 5.7 (95% CI 3.6 to 7.8) weeks with injury/1000 hours). Health professionals were consulted in 58% (95% CI 54% to 62%) of injuries, players independently made the return to sport decision in 44% (95% CI 37% to 51%) of injury recurrences, and used analgesics, mainly (91% (95% CI 85% to 95%)) sourced from home, in 24% (95% CI 21% to 28%) of injuries. Conclusion Almost half of highest-division adolescent Danish handball players reported a previous past-year shoulder, knee or ankle injury. Any time during the season, 21% reported an injury and 2% an illness. The highest injury burdens were from knee injuries in females and shoulder injuries in males. Health professionals often managed injuries, but players frequently made return to sport decisions independently and commonly used analgesics sourced from home. Data are available upon reasonable request. All data are available on reasonable request. All personally identifiable information will be deleted or anonymised before data transfer.
目的 评估(1)肩部、膝部和踝部受伤的 1 年发生率；(2)赛季中伤病发生率、受伤发生率和受伤负担（受伤发生率与受伤周数的乘积）；(3)最初的伤病处理策略。方法 我们对 679 名年龄在 14-18 岁的丹麦最高级别手球运动员进行了一项队列研究。球员在基线时自我报告了过去一年的肩伤、膝伤和踝伤情况，并在 31 周内每周报告与手球有关的任何伤病（不考虑时间损失和就医情况）、疾病、接触时间和伤病处理情况。结果 在基线时，46%（95% CI 42% 至 49%）的球员报告在过去一年中肩部、膝盖或脚踝受过伤。每周平均受伤率和患病率分别为 21% (95% CI 19% 至 23%) 和 2% (95% CI 1.7% 至 2.3%)，虹吸指数为 9.4 (95% CI 8.7 至 10.2)/1000小时。女性因膝关节受伤而承受的伤害负担最高（ir：1.7（95% CI 1.3 至 2.2）×6.7（95% CI 4.7 至 8.7）周/1000 小时），而男性因肩关节受伤而承受的伤害负担最高（ir：1.3（95% CI 1.0 至 1.7）×5.7（95% CI 3.6 至 7.8）周/1000 小时）。58%（95% CI 54%至 62%）的受伤者咨询了卫生专业人员，44%（95% CI 37%至 51%）的受伤复发者独立做出了重返运动场的决定，24%（95% CI 21%至 28%）的受伤者使用了镇痛剂，主要（91%（95% CI 85%至 95%））是从家里购买的。结论 丹麦最高级别青少年手球运动员中，近一半的人表示在过去一年中曾受过肩伤、膝伤或脚踝伤。在赛季中的任何时间，21%的球员都曾受伤，2%的球员曾生病。女性受伤最严重的是膝盖，男性受伤最严重的是肩膀。医护人员通常会对伤病进行处理，但球员经常会独立做出重返运动场的决定，并且通常会使用从家中购买的止痛药。如有合理要求，可提供相关数据。如有合理要求，可提供所有数据。在数据传输之前，所有可识别个人身份的信息都将被删除或匿名化。
{"title":"Health problems and injury management in adolescent handball: the Safeplay one-season cohort study of 679 players","authors":"Merete Møller, Stian Isaksen Johansen, Grethe Myklebust, Rasmus Oestergaard Nielsen, Sören Möller, Ulla Mikkelsen, Niels Wedderkopp, Martin Lind","doi":"10.1136/bjsports-2024-108493","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108493","url":null,"abstract":"Objectives To assess (1) the 1-year prevalence of previous shoulder, knee and ankle injuries; (2) the in-season prevalence proportion (prevalence) of injuries and illnesses, injury incidence rate (ir) and injury burden (product of ir and weeks with injuries); (3) initial injury management strategies. Methods We conducted a cohort study of 679 highest-division Danish handball players aged 14–18. Players self-reported past-year shoulder, knee and ankle injuries at baseline, and weekly information on any handball-related injuries (irrespective of time loss and medical attention), illnesses, exposure hours and injury management over 31 weeks. Results At baseline, 46% (95% CI 42% to 49%) of the players reported a past-year shoulder, knee or ankle injury. The weekly average injury and illness prevalence was 21% (95% CI 19% to 23%) and 2% (95% CI 1.7% to 2.3%), respectively, and the ir was 9.4 (95% CI 8.7 to 10.2)/1000 hours. Females experienced the highest injury burden from knee injuries (ir: 1.7 (95% CI 1.3 to 2.2) × 6.7 (95% CI 4.7 to 8.7) weeks with injury/1000 hours), while males experienced the highest injury burden from shoulder injuries (ir: 1.3 (95% CI 1.0 to 1.7) × 5.7 (95% CI 3.6 to 7.8) weeks with injury/1000 hours). Health professionals were consulted in 58% (95% CI 54% to 62%) of injuries, players independently made the return to sport decision in 44% (95% CI 37% to 51%) of injury recurrences, and used analgesics, mainly (91% (95% CI 85% to 95%)) sourced from home, in 24% (95% CI 21% to 28%) of injuries. Conclusion Almost half of highest-division adolescent Danish handball players reported a previous past-year shoulder, knee or ankle injury. Any time during the season, 21% reported an injury and 2% an illness. The highest injury burdens were from knee injuries in females and shoulder injuries in males. Health professionals often managed injuries, but players frequently made return to sport decisions independently and commonly used analgesics sourced from home. Data are available upon reasonable request. All data are available on reasonable request. All personally identifiable information will be deleted or anonymised before data transfer.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"126 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142541162","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 : 2024-10-29DOI: 10.1136/bjsports-2024-108460
Gary O'Donovan, Fanny Petermann-Rocha, Gerson Ferrari, Catalina Medina, Carolina Ochoa-Rosales, Olga L L Sarmiento, Agustín Ibáñez
Objectives To investigate associations of the ‘weekend warrior’ physical activity pattern with mild dementia. Methods Participants in the Mexico City Prospective Study were surveyed from 1998 to 2004 and re-surveyed from 2015 to 2019. Participants were asked about leisure time physical activity at baseline. Those who exercised up to once or twice per week were termed ‘weekend warriors’ and those who exercised more often were termed ‘regularly active’. A Mini Mental State Examination (MMSE) was used to assess mild dementia at re-survey. Cox models were adjusted for age, sex, education, income, blood pressure, smoking, body mass index, civil status, sleep, diet and alcohol at baseline. The attributable fraction was defined as the proportion of cases that would not exist if all adults were to exercise once or twice per week or more often. Results The analysis included 10 033 adults of mean (SD) age 51 (10) years followed for 16 (2) years. There were 2400 cases when mild dementia was defined as a score of ≤22 on the MMSE. Compared with the group that reported no sport or exercise, the hazard ratio was 0.75 (95% CI 0.61 to 0.91) in the weekend warrior group, 0.89 (95% CI 0.78 to 1.02) in the regularly active group and 0.84 (95% CI 0.75 to 0.95) in the combined group. The attributable fraction was 13% (95% CI 5% to 21%). Similar results were observed when mild dementia was defined as a score of ≤23 on the MMSE. Conclusions This longitudinal analysis suggests that the weekend warrior physical activity pattern is associated with a reduced risk of mild dementia. Data are available upon reasonable request. Mexico City Prospective Study data are available for open-access data requests. The data access policy is described online: .
目的 研究 "周末战士 "体育锻炼模式与轻度痴呆症的关系。方法 1998年至2004年对墨西哥城前瞻性研究的参与者进行了调查，并于2015年至2019年进行了再次调查。调查询问了参与者在基线时的业余体育活动情况。每周运动最多一到两次的人被称为 "周末战士"，而更经常运动的人被称为 "经常运动者"。在再次调查时，使用迷你精神状态检查（MMSE）来评估轻度痴呆。Cox模型对基线时的年龄、性别、教育程度、收入、血压、吸烟、体重指数、婚姻状况、睡眠、饮食和饮酒等因素进行了调整。可归因部分的定义是，如果所有成年人每周锻炼一到两次或更频繁，则不存在病例的比例。结果 分析对象包括 10 033 名成年人，平均（标清）年龄为 51（10）岁，随访时间为 16（2）年。如果轻度痴呆的定义是 MMSE 评分≤22 分，则有 2400 例。与未报告运动或锻炼情况的组别相比，周末战士组的危险比为0.75（95% CI 0.61至0.91），经常锻炼组的危险比为0.89（95% CI 0.78至1.02），综合组的危险比为0.84（95% CI 0.75至0.95）。可归因比例为 13% (95% CI 5% 至 21%)。将轻度痴呆定义为 MMSE 评分≤23 分时，也观察到了类似的结果。结论 这项纵向分析表明，周末战士体育锻炼模式与轻度痴呆症风险降低有关。如有合理要求，可提供相关数据。墨西哥城前瞻性研究的数据可申请开放获取。数据访问政策在线说明：.
{"title":"Associations of the ‘weekend warrior’ physical activity pattern with mild dementia: findings from the Mexico City Prospective Study","authors":"Gary O'Donovan, Fanny Petermann-Rocha, Gerson Ferrari, Catalina Medina, Carolina Ochoa-Rosales, Olga L L Sarmiento, Agustín Ibáñez","doi":"10.1136/bjsports-2024-108460","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108460","url":null,"abstract":"Objectives To investigate associations of the ‘weekend warrior’ physical activity pattern with mild dementia. Methods Participants in the Mexico City Prospective Study were surveyed from 1998 to 2004 and re-surveyed from 2015 to 2019. Participants were asked about leisure time physical activity at baseline. Those who exercised up to once or twice per week were termed ‘weekend warriors’ and those who exercised more often were termed ‘regularly active’. A Mini Mental State Examination (MMSE) was used to assess mild dementia at re-survey. Cox models were adjusted for age, sex, education, income, blood pressure, smoking, body mass index, civil status, sleep, diet and alcohol at baseline. The attributable fraction was defined as the proportion of cases that would not exist if all adults were to exercise once or twice per week or more often. Results The analysis included 10 033 adults of mean (SD) age 51 (10) years followed for 16 (2) years. There were 2400 cases when mild dementia was defined as a score of ≤22 on the MMSE. Compared with the group that reported no sport or exercise, the hazard ratio was 0.75 (95% CI 0.61 to 0.91) in the weekend warrior group, 0.89 (95% CI 0.78 to 1.02) in the regularly active group and 0.84 (95% CI 0.75 to 0.95) in the combined group. The attributable fraction was 13% (95% CI 5% to 21%). Similar results were observed when mild dementia was defined as a score of ≤23 on the MMSE. Conclusions This longitudinal analysis suggests that the weekend warrior physical activity pattern is associated with a reduced risk of mild dementia. Data are available upon reasonable request. Mexico City Prospective Study data are available for open-access data requests. The data access policy is described online: <http://www.ctsu.ox.ac.uk/research/mcps>.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"15 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142541155","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 : 2024-10-28DOI: 10.1136/bjsports-2023-107852
Sasha Bailey, Benjamin Trevitt, Sav Zwickl, Beau Newell, Emma Staples, Ryan Storr, Ada S Cheung
Objectives This study aimed to assess participation rates of transgender and gender diverse (trans) people in sport/fitness activities, compare mental health outcomes for trans people participating in sport/fitness with those who do not and explore internal/external barriers and bullying experiences faced by trans people in sport/fitness contexts. Methods A cross-sectional online survey open to trans people aged ≥16 years living in Australia was conducted between February and April 2023 and it assessed rates of sport/fitness participation, barriers to participation and bullying experiences through multiple-choice questions. Mental health measures comprised the Kessler Psychological Distress Scale (K10) and self-reported history of self-harm and suicidality. Covariate-adjusted binary logistic regression models tested associations between interpersonal factors, sport/fitness variables and mental health outcomes. Results Of 664 respondents (median age 32 years), around one-third (32.8%) regularly participated in sport/fitness. Common internal barriers to participation included anxiety about others’ reactions (63.9%), body dissatisfaction/dysphoria (56.5%) and fears about feeling accepted/affirmed by others (54.7%). Respondents commonly reported experiencing inadequate bathroom/changing facilities (44.4%), exclusionary rules and regulations surrounding gender (36.7%), and invasive or uncomfortable policies or procedures (23.3%). Over one-third (34.4%) of trans people had experienced gender-based bullying or exclusion. Regular sport/fitness participation was associated with significantly lower K10 scores (mean difference=−4.4, 95% CI−5.8, –2.9, p<0.001) and a 40% reduction in odds of recent thoughts of self-harm and suicide (aOR 0.6, 95% CI 0.5, 0.9, p=0.01; aOR 0.6, 95%CI 0.4, 0.9, p=0.02). Conclusion Trans people face significant barriers to sport/fitness despite experiencing significant mental health and personal benefits from participation. Affirming and including trans people in sport and fitness should be a key priority for sport and fitness federations, organisations and policy-makers.
{"title":"Participation, barriers, facilitators and bullying experiences of trans people in sport and fitness: findings from a national community survey of trans people in Australia","authors":"Sasha Bailey, Benjamin Trevitt, Sav Zwickl, Beau Newell, Emma Staples, Ryan Storr, Ada S Cheung","doi":"10.1136/bjsports-2023-107852","DOIUrl":"https://doi.org/10.1136/bjsports-2023-107852","url":null,"abstract":"Objectives This study aimed to assess participation rates of transgender and gender diverse (trans) people in sport/fitness activities, compare mental health outcomes for trans people participating in sport/fitness with those who do not and explore internal/external barriers and bullying experiences faced by trans people in sport/fitness contexts. Methods A cross-sectional online survey open to trans people aged ≥16 years living in Australia was conducted between February and April 2023 and it assessed rates of sport/fitness participation, barriers to participation and bullying experiences through multiple-choice questions. Mental health measures comprised the Kessler Psychological Distress Scale (K10) and self-reported history of self-harm and suicidality. Covariate-adjusted binary logistic regression models tested associations between interpersonal factors, sport/fitness variables and mental health outcomes. Results Of 664 respondents (median age 32 years), around one-third (32.8%) regularly participated in sport/fitness. Common internal barriers to participation included anxiety about others’ reactions (63.9%), body dissatisfaction/dysphoria (56.5%) and fears about feeling accepted/affirmed by others (54.7%). Respondents commonly reported experiencing inadequate bathroom/changing facilities (44.4%), exclusionary rules and regulations surrounding gender (36.7%), and invasive or uncomfortable policies or procedures (23.3%). Over one-third (34.4%) of trans people had experienced gender-based bullying or exclusion. Regular sport/fitness participation was associated with significantly lower K10 scores (mean difference=−4.4, 95% CI−5.8, –2.9, p<0.001) and a 40% reduction in odds of recent thoughts of self-harm and suicide (aOR 0.6, 95% CI 0.5, 0.9, p=0.01; aOR 0.6, 95%CI 0.4, 0.9, p=0.02). Conclusion Trans people face significant barriers to sport/fitness despite experiencing significant mental health and personal benefits from participation. Affirming and including trans people in sport and fitness should be a key priority for sport and fitness federations, organisations and policy-makers.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"26 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142519446","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 : 2024-10-28DOI: 10.1136/bjsports-2024-108313
Elisabeth Kilcourse, Charlotte Taylor, Neil Heron
{"title":"Critical incidents and traumatic events in elite sport: proposing the 5Cs approach for how sport medicine teams should care for the affected individual, team and the wider community in the post-traumatic period.","authors":"Elisabeth Kilcourse, Charlotte Taylor, Neil Heron","doi":"10.1136/bjsports-2024-108313","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108313","url":null,"abstract":"","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521056","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 : 2024-10-28DOI: 10.1136/bjsports-2024-108484
Emmanuel Stamatakis, Matthew Ahmadi, Raaj Kishore Biswas, Borja del Pozo Cruz, Cecilie Thøgersen-Ntoumani, Marie H Murphy, Angelo Sabag, Scott Lear, Clara Chow, Jason M R Gill, Mark Hamer
Background Vigorous intermittent lifestyle physical activity (VILPA) refers to brief bouts of intense physical activity embedded into daily life. Objective To examine sex differences in the dose–response association of VILPA with major adverse cardiovascular events (MACE) and its subtypes. Methods Using multivariable-adjusted cubic splines, we examined the associations of daily VILPA duration with overall MACE and its subtypes (incident myocardial infarction, heart failure and stroke) among non-exercisers (individuals self-reporting no leisure-time exercise and no more than one recreational walk per week) in the UK Biobank. We also undertook analogous analyses for vigorous physical activity among exercisers (individuals self-reporting participation in leisure-time exercise and/or recreational walking more than once a week). Results Among 13 018 women and 9350 men, there were 331 and 488 all MACE, respectively, over a 7.9-year follow-up. In women, daily VILPA duration exhibited a near-linear dose–response association with all MACE, myocardial infarction and heart failure. In men, dose-reponse curves were less clear with less evidence of statistical signifigance. Compared with women with no VILPA, women’s median daily VILPA duration of 3.4 min was associated with hazard ratios (HRs; 95% confidence intervals) of 0.55 (0.41 to 0.75) for all MACE and 0.33 (0.18 to 0.59) for heart failure. Women’s minimum doses of 1.2–1.6 min of VILPA per day were associated with HRs of 0.70 (0.58 to 0.86) for all MACE, 0.67 (0.50 to 0.91) for myocardial infarction, and 0.60 (0.45 to 0.81) for heart failure. The equivalent analyses in UK Biobank’s accelerometry sub-study exercisers suggested no appreciable sex differences in dose–response. Conclusions Among non-exercising women, small amounts of VILPA were associated with a substantially lower risk of all MACE, myocardial infarction and heart failure. VILPA may be a promising physical activity target for cardiovascular disease prevention, particularly in women unable or not willing to engage in formal exercise. The data that support the findings of this study are available from the UK Biobank, but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Data are, however, available from the authors upon reasonable request and with permission of the UK Biobank. ES and MA had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. The statistical code used in the analyses of this manuscript is available upon request. The authors have archived the statistical code of multiple similar manuscripts, e.g. .
{"title":"Device-measured vigorous intermittent lifestyle physical activity (VILPA) and major adverse cardiovascular events: evidence of sex differences","authors":"Emmanuel Stamatakis, Matthew Ahmadi, Raaj Kishore Biswas, Borja del Pozo Cruz, Cecilie Thøgersen-Ntoumani, Marie H Murphy, Angelo Sabag, Scott Lear, Clara Chow, Jason M R Gill, Mark Hamer","doi":"10.1136/bjsports-2024-108484","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108484","url":null,"abstract":"Background Vigorous intermittent lifestyle physical activity (VILPA) refers to brief bouts of intense physical activity embedded into daily life. Objective To examine sex differences in the dose–response association of VILPA with major adverse cardiovascular events (MACE) and its subtypes. Methods Using multivariable-adjusted cubic splines, we examined the associations of daily VILPA duration with overall MACE and its subtypes (incident myocardial infarction, heart failure and stroke) among non-exercisers (individuals self-reporting no leisure-time exercise and no more than one recreational walk per week) in the UK Biobank. We also undertook analogous analyses for vigorous physical activity among exercisers (individuals self-reporting participation in leisure-time exercise and/or recreational walking more than once a week). Results Among 13 018 women and 9350 men, there were 331 and 488 all MACE, respectively, over a 7.9-year follow-up. In women, daily VILPA duration exhibited a near-linear dose–response association with all MACE, myocardial infarction and heart failure. In men, dose-reponse curves were less clear with less evidence of statistical signifigance. Compared with women with no VILPA, women’s median daily VILPA duration of 3.4 min was associated with hazard ratios (HRs; 95% confidence intervals) of 0.55 (0.41 to 0.75) for all MACE and 0.33 (0.18 to 0.59) for heart failure. Women’s minimum doses of 1.2–1.6 min of VILPA per day were associated with HRs of 0.70 (0.58 to 0.86) for all MACE, 0.67 (0.50 to 0.91) for myocardial infarction, and 0.60 (0.45 to 0.81) for heart failure. The equivalent analyses in UK Biobank’s accelerometry sub-study exercisers suggested no appreciable sex differences in dose–response. Conclusions Among non-exercising women, small amounts of VILPA were associated with a substantially lower risk of all MACE, myocardial infarction and heart failure. VILPA may be a promising physical activity target for cardiovascular disease prevention, particularly in women unable or not willing to engage in formal exercise. The data that support the findings of this study are available from the UK Biobank, but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Data are, however, available from the authors upon reasonable request and with permission of the UK Biobank. ES and MA had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. The statistical code used in the analyses of this manuscript is available upon request. The authors have archived the statistical code of multiple similar manuscripts, e.g. <https://zenodo.org/record/7187927%23.Y0ZfoHZBy3A>.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"61 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142519438","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 : 2024-10-26DOI: 10.1136/bjsports-2024-109165
Bryan Holtzman, Rose K Kelly, Grace H Saville, Lauren McCall, Kaya A Adelzedah, Samantha R Sarafin, Prakruthi Nikam, Isabella Meneguzzi, Abby McIntyre, Emily K Kraus, Kathryn E Ackerman
Objectives To determine the association between surrogates of low energy availability (EA) and proposed health and performance outcomes of Relative Energy Deficiency in Sport (REDs) in a clinical sample of adolescent and young adult male athletes. Methods Male athletes ages 15–30 years presenting to a sports medicine clinic at two tertiary care centres were invited to complete a survey about athlete health and well-being. Participants were divided into low EA and adequate EA groups based on survey responses. The associations between low EA and REDs outcomes were evaluated using χ2 tests and ORs were calculated using binomial logistic regression (significance: p<0.05). Results Low EA was associated with increased frequency of self-reported immunological, metabolic, psychological, cardiovascular and gastrointestinal dysfunction; reduced endurance performance, response to training, judgement, coordination and muscle strength; and increased irritability and depression. Low EA athletes were more likely to have self-reported cardiovascular dysfunction (OR 2.87, 95% CI 1.56 to 5.26) and psychological illness (OR 3.23, 95% CI 1.91 to 5.41), decreased training response (OR 2.64, 95% CI 1.38 to 5.03) and endurance performance (OR 2.26, 95% CI 1.13 to 4.52) and were less likely to have self-reported gonadal dysfunction (OR 0.49, 95% CI 0.30 to 0.81), than adequate EA athletes (p<0.05). Conclusions Low EA surrogates are associated with many adverse health outcomes and performance effects of REDs in male athletes. More prospective REDs research in males is needed to improve various aspects of REDs screening in young male athletes. No data are available.
目的 在青少年和年轻成年男性运动员的临床样本中，确定低能量可用性（EA）替代物与运动中相对能量缺乏（REDs）的健康和表现结果之间的关联。方法 邀请在两个三级医疗中心的运动医学诊所就诊的 15-30 岁男性运动员填写一份有关运动员健康和福祉的调查问卷。根据调查回答将参与者分为低 EA 组和适当 EA 组。采用χ2检验评估低EA与REDs结果之间的关联，并采用二项逻辑回归计算ORs（显著性：P<0.05）。结果 低 EA 与以下因素有关：自我报告的免疫、代谢、心理、心血管和胃肠道功能障碍的频率增加；耐力表现、对训练的反应、判断力、协调性和肌肉力量下降；易怒和抑郁增加。低 EA 运动员更有可能出现自我报告的心血管功能障碍（OR 2.87，95% CI 1.56 至 5.26）和心理疾病（OR 3.23，95% CI 1.91 至 5.41）、训练反应下降（OR 2.64，95% CI 1.38 至 5.03）和耐力表现（OR 2.26，95% CI 1.13 至 4.52），与充足 EA 运动员相比，自我报告性腺功能障碍（OR 0.49，95% CI 0.30 至 0.81）的可能性更小（P<0.05）。结论 低 EA 代用指标与男性运动员的许多不良健康后果和 REDs 对成绩的影响有关。需要对男性进行更多的前瞻性 REDs 研究，以改进年轻男性运动员 REDs 筛查的各个方面。暂无数据。
{"title":"Low energy availability surrogates are associated with Relative Energy Deficiency in Sport outcomes in male athletes","authors":"Bryan Holtzman, Rose K Kelly, Grace H Saville, Lauren McCall, Kaya A Adelzedah, Samantha R Sarafin, Prakruthi Nikam, Isabella Meneguzzi, Abby McIntyre, Emily K Kraus, Kathryn E Ackerman","doi":"10.1136/bjsports-2024-109165","DOIUrl":"https://doi.org/10.1136/bjsports-2024-109165","url":null,"abstract":"Objectives To determine the association between surrogates of low energy availability (EA) and proposed health and performance outcomes of Relative Energy Deficiency in Sport (REDs) in a clinical sample of adolescent and young adult male athletes. Methods Male athletes ages 15–30 years presenting to a sports medicine clinic at two tertiary care centres were invited to complete a survey about athlete health and well-being. Participants were divided into low EA and adequate EA groups based on survey responses. The associations between low EA and REDs outcomes were evaluated using χ2 tests and ORs were calculated using binomial logistic regression (significance: p<0.05). Results Low EA was associated with increased frequency of self-reported immunological, metabolic, psychological, cardiovascular and gastrointestinal dysfunction; reduced endurance performance, response to training, judgement, coordination and muscle strength; and increased irritability and depression. Low EA athletes were more likely to have self-reported cardiovascular dysfunction (OR 2.87, 95% CI 1.56 to 5.26) and psychological illness (OR 3.23, 95% CI 1.91 to 5.41), decreased training response (OR 2.64, 95% CI 1.38 to 5.03) and endurance performance (OR 2.26, 95% CI 1.13 to 4.52) and were less likely to have self-reported gonadal dysfunction (OR 0.49, 95% CI 0.30 to 0.81), than adequate EA athletes (p<0.05). Conclusions Low EA surrogates are associated with many adverse health outcomes and performance effects of REDs in male athletes. More prospective REDs research in males is needed to improve various aspects of REDs screening in young male athletes. No data are available.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"59 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142490362","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}
Knowledge of relative energy deficiency in sport (REDs) has grown significantly between 2018 and 2022 with over 170 original publications in this period. The latest International Olympic Committee (IOC) consensus statement on REDs was published in 2023 in the British Journal of Sports Medicine in a dedicated edition with 10 accompanying narrative reviews and editorials.1 The 2023 IOC REDs consensus statement includes the following: Figure 1 REDs health conceptual model. The effects of LEA exist on a continuum. While some exposure to LEA is mild and transient termed adaptable LEA (arrow depicted in white), problematic LEA is associated with a variety of adverse REDs outcomes (arrow depicted in red). *Mental health issues can either precede REDs or be the result of REDs. LEA, low energy availability; REDs, relative energy deficiency in sport. As recommended in the consensus statement, a multidisciplinary approach is essential when managing REDs. This includes the creation of a safe and trusting therapeutic relationship, which includes active listening and the prioritisation of holistic care.1 Members of the multidisciplinary athlete health and performance team should be knowledgeable in REDs-related science and have clinical competence in the recognition and treatment of REDs. Gillbanks et al identified a lack of vigilance for the signs or symptoms of REDs among physiotherapists, as well …
{"title":"Relative energy deficiency in sport (REDs): the role of the physiotherapist","authors":"Manon Dauvergne, Marie-Elaine Grant, Margo Mountjoy","doi":"10.1136/bjsports-2024-108751","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108751","url":null,"abstract":"Knowledge of relative energy deficiency in sport (REDs) has grown significantly between 2018 and 2022 with over 170 original publications in this period. The latest International Olympic Committee (IOC) consensus statement on REDs was published in 2023 in the British Journal of Sports Medicine in a dedicated edition with 10 accompanying narrative reviews and editorials.1 The 2023 IOC REDs consensus statement includes the following: Figure 1 REDs health conceptual model. The effects of LEA exist on a continuum. While some exposure to LEA is mild and transient termed adaptable LEA (arrow depicted in white), problematic LEA is associated with a variety of adverse REDs outcomes (arrow depicted in red). *Mental health issues can either precede REDs or be the result of REDs. LEA, low energy availability; REDs, relative energy deficiency in sport. As recommended in the consensus statement, a multidisciplinary approach is essential when managing REDs. This includes the creation of a safe and trusting therapeutic relationship, which includes active listening and the prioritisation of holistic care.1 Members of the multidisciplinary athlete health and performance team should be knowledgeable in REDs-related science and have clinical competence in the recognition and treatment of REDs. Gillbanks et al identified a lack of vigilance for the signs or symptoms of REDs among physiotherapists, as well …","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"14 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142490440","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：