British Journal of Sports Medicine最新文献

Objective: Leisure-time physical activity (LTPA) has been linked to better work ability in cross-sectional and short-term follow-up studies. Less is known about the effects of long-term habitual LTPA on work ability. We investigated whether differences in lifetime LTPA from adolescence to late adulthood affect work ability at the end of working life.

Methods: In this 45-year observational cohort study involving a nationally representative Finnish sample, we created a latent lifetime LTPA factor from three self-report PA measurements at ages 10-19, 35-44 and 55-64 years. The association between the lifetime LTPA factor and validated Work Ability Index at the end of working life (age 55-64 years) was explored with structural equation modelling-based linear regression analysis.

Results: Higher lifetime LTPA was associated with higher work ability at the end of working life (N=2385, 45% males; ß=0.22, SE=0.05, p<0.001) while all three LTPA measurements contributed to the latent LTPA factor (adolescence ß=0.29, SE=0.05; mid-adulthood ß=0.40, SE=0.06; late adulthood LTPA ß=0.59, SE=0.09). In late adulthood (N=815), meeting the 2020 WHO PA guidelines was dose-responsively associated with excellent work ability: OR very active (>2.38 metabolic equivalent of task (MET)-hour/day (>300 min moderate-to-vigorous PA (MVPA) or >150 min vigorous PA (VPA)/week) vs inactive (<1.19 MET-hour/day (<150 min MVPA or <75 min of VPA/week)) = 2.18, 95% CI 1.44 to 3.30; OR active (1.19-2.38 MET-hour/day (150-300 min MVPA or 75-150 min VPA/week)) vs inactive=1.67, 95% CI 1.04 to 2.68. The results remained unchanged after adjustment for covariates sex, educational level and work-related physical strain.

Conclusions: An inactive lifestyle adopted in youth and maintained throughout life may present a significant risk for impaired work ability up to the end of working life. To support workforce productivity, it is essential to implement robust strategies that promote PA, particularly among children and adolescents, but also among working age adults.

Objective: To synthesise all qualitative studies investigating patients' (and parents of paediatric patients) perspectives on their anterior cruciate ligament (ACL) injury and the care they received.

Design: Systematic review and qualitative evidence synthesis, with certainty of evidence evaluated using GRADE-CERQual.

Data sources: MEDLINE, The Cochrane Central Register of Controlled Trials, EMBASE, CINAHL, SPORTDiscus and PsycINFO.

Eligibility criteria: Qualitative studies investigating the perspectives of patients with lived experience of ACL injury.

Results: We included 56 studies of 806 participants (52% female). Five main themes were identified of mostly moderate-certainty evidence, consistent across different geographical locations and time since injury. Theme 1 (34 studies, 500 participants) 'ACL - wow, this is bad': knowledge and beliefs around injury are shaped by external messages both preinjury and postinjury. Theme 2 (40 studies, 562 participants) 'Who am I now?': coping with disrupted self-identity. Theme 3 (39 studies, 534 participants) 'It is easier when you feel supported': access to individual, interpersonal and community level support can facilitate physical and psychological recovery. Theme 4 (51 studies, 740 participants) 'Nobody tells you about the head game': bracing for the psychological roller coaster, including fear of reinjury and despair. Theme 5 (38 studies, 572 participants) 'I'm not just another statistic': highlighting the importance of patient-centred care.

Conclusions: An ACL injury can have significant and lasting impacts on physical, emotional, social and athletic identities. Being cognisant of the impact of external messages and social ecological factors on patients' perspectives, including their beliefs, preferences, expectations and experiences, may enhance patient outcomes.

There is a need to better understand the specific demands and characteristics of Formula 1 (eg, high accelerations/decelerations, environmental stress) to optimise driver performance and health; however, data are scarce and much of the knowledge is held within the sport by the teams, drivers and the drivers' Performance Coaches. This review combined all relevant published research data available for motor car drivers (considering what is known regarding the neuromuscular and strength characteristics (6 articles), and the metabolic, cardiovascular and thermoregulatory responses (19 articles)) with novel data collected using structured interviews with three elite Formula 1 Performance Coaches. The limited data suggest that Formula 1 drivers are not especially exceptional when it comes to aerobic fitness, stature or body mass, but there are some sport-specific adaptations, most notably augmented neck strength. Short-term and long-term interventions are routinely undertaken to minimise the risks associated with the g-forces (eg, neck strength straining) and thermal stress (eg, heat acclimation, precooling and per-cooling) experienced, but much of these strategies are based on experience and anecdotal evidence rather than data. The Performance Coaches highlighted discrepancies between the published data and their applied practice and provided insight on several aspects related to driver health and performance, including the greatest stressors and how drivers prepare for g-forces, heat, jetlag, travel and nutritional constraints. The Performance Coaches also identified key areas that should be further addressed in future studies related to maintaining driver health (eg, the unknown impact of porpoising on lower back injury risk).