Pub Date : 2024-09-27DOI: 10.1136/bjsports-2024-108247
Mark P Ranasinghe, Harrison Andersen, Ruby K Dempsey, Noah Wexler, Rochelle Davis, Monique Francois, Stephen Gilbert, Anthony David Okely, Catherine Sherrington, Paddy C Dempsey
Objectives Physical activity guidelines inform policy and practice in promoting healthier lifestyles. The WHO advocates for distinct recommendations for each country to address variation in needs, resources and context. Specific regional recommendations for three underactive populations facing unique barriers to movement are lacking—people with chronic conditions, disability and advanced age. We review which countries/regions provide specific physical activity guidelines for these populations to identify deficiencies in meeting WHO recommendations and inform future directions for guideline development. Design Scoping review. Data sources OVID Medline, PubMed, Scopus, Embase, Web of Science, Google Scholar, ProQuest, CINAHL, Google searches, targeted websites. Eligibility criteria Data sources were searched from database inception to September 2023 to identify community-facing physical activity guidelines at the national/international level for these populations. We recorded, summarised and analysed physical activity guideline recommendations extracted from published guideline documents, organised by population and country/region. Results 66 articles were identified, addressing 28 distinct countries/regions, including four international guidelines, published from 2009 to 2023. The WHO guidelines were adopted by 19 countries and the European Union. Across all regions, a lack of specific advice was identified for individuals with chronic conditions (46%), disability (46%) and advanced age (11%). Advice for chronic conditions and disability commonly replicated general adult population advice. Conclusion Many countries/regions do not produce physical activity guidelines specific to populations with chronic conditions and disability. As such, a large proportion of countries/regions failed to meet WHO recommendations, highlighting a lack of customised advice to address unique barriers faced by vulnerable populations. No data are available. Not applicable.
{"title":"Contemporary national and international guidelines on physical activity and sedentary behaviour for people living with chronic conditions, disability and advanced age: a scoping review","authors":"Mark P Ranasinghe, Harrison Andersen, Ruby K Dempsey, Noah Wexler, Rochelle Davis, Monique Francois, Stephen Gilbert, Anthony David Okely, Catherine Sherrington, Paddy C Dempsey","doi":"10.1136/bjsports-2024-108247","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108247","url":null,"abstract":"Objectives Physical activity guidelines inform policy and practice in promoting healthier lifestyles. The WHO advocates for distinct recommendations for each country to address variation in needs, resources and context. Specific regional recommendations for three underactive populations facing unique barriers to movement are lacking—people with chronic conditions, disability and advanced age. We review which countries/regions provide specific physical activity guidelines for these populations to identify deficiencies in meeting WHO recommendations and inform future directions for guideline development. Design Scoping review. Data sources OVID Medline, PubMed, Scopus, Embase, Web of Science, Google Scholar, ProQuest, CINAHL, Google searches, targeted websites. Eligibility criteria Data sources were searched from database inception to September 2023 to identify community-facing physical activity guidelines at the national/international level for these populations. We recorded, summarised and analysed physical activity guideline recommendations extracted from published guideline documents, organised by population and country/region. Results 66 articles were identified, addressing 28 distinct countries/regions, including four international guidelines, published from 2009 to 2023. The WHO guidelines were adopted by 19 countries and the European Union. Across all regions, a lack of specific advice was identified for individuals with chronic conditions (46%), disability (46%) and advanced age (11%). Advice for chronic conditions and disability commonly replicated general adult population advice. Conclusion Many countries/regions do not produce physical activity guidelines specific to populations with chronic conditions and disability. As such, a large proportion of countries/regions failed to meet WHO recommendations, highlighting a lack of customised advice to address unique barriers faced by vulnerable populations. No data are available. Not applicable.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":null,"pages":null},"PeriodicalIF":18.4,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142328608","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 : 2024-09-26DOI: 10.1136/bjsports-2024-108644
Bjørnar Berg, Ewa M Roos, Martin Englund, Nina Jullum Kise, Lars Engebretsen, Cathrine Nørstad Eftang, May Arna Risberg
Objective To evaluate radiographic knee osteoarthritis (OA) progression, development of knee OA, patient-reported outcomes and knee muscle strength at 10-year follow-up after arthroscopic partial meniscectomy (APM) or exercise therapy for degenerative meniscal tears. Methods Randomised controlled trial including 140 participants, with a degenerative meniscal tear and no or minimal radiographic OA changes. Participants were randomised to either APM or 12 weeks of exercise therapy (1:1 ratio). The primary outcome was knee OA progression assessed by the Osteoarthritis Research Society International (OARSI) atlas sum score (sum of medial and lateral compartment joint space narrowing and osteophyte score). Secondary outcomes included incidence of radiographic and symptomatic knee OA, patient-reported pain and knee function and isokinetic knee muscle strength. Results The adjusted mean difference in change in the OARSI sum score was 0.39 (95% CI −0.19 to 0.97), with more progression in the APM group. The incidence of radiographic knee OA was 23% in the APM group and 20% in the exercise group (adjusted risk difference 3% (95% CI −13% to 19%)). No clinically relevant differences were found in patient-reported outcomes or isokinetic knee muscle strength. Conclusion No differences in radiographic knee OA progression and comparable rates of knee OA development were observed 10 years following APM and exercise therapy for degenerative meniscal tears. Both treatments were associated with improved patient-reported pain and knee function. Trial registration number [NCT01002794][1]. Data are available on reasonable request. [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT01002794&atom=%2Fbjsports%2Fearly%2F2024%2F09%2F26%2Fbjsports-2024-108644.atom
目的 评估关节镜下半月板部分切除术(APM)或运动疗法治疗退行性半月板撕裂后,10 年随访期间膝关节骨关节炎(OA)的影像学进展、膝关节 OA 的发展、患者报告的结果以及膝关节肌肉力量。方法 随机对照试验,包括140名半月板退行性撕裂且无或仅有轻微放射学OA变化的参与者。参与者被随机分配接受半月板切除术或12周的运动疗法(1:1的比例)。主要结果是通过国际骨关节炎研究学会(OARSI)的 Atlas 总分(内侧和外侧室关节间隙狭窄和骨质增生评分之和)评估膝关节 OA 的进展情况。次要结果包括影像学和无症状膝关节OA的发生率、患者报告的疼痛和膝关节功能以及等速膝关节肌力。结果 OARSI总分变化的调整后平均差异为0.39(95% CI -0.19至0.97),APM组的变化更大。膝关节放射学 OA 的发生率在 APM 组为 23%,在锻炼组为 20%(调整后风险差异为 3%(95% CI -13%-19%))。在患者报告的结果或膝关节等动肌力方面未发现临床相关差异。结论 对退行性半月板撕裂进行 APM 和运动疗法治疗 10 年后,膝关节 OA 的影像学进展无差异,膝关节 OA 的发生率相当。两种疗法都能改善患者报告的疼痛和膝关节功能。试验注册号[NCT01002794][1]。如有合理要求,可提供相关数据。[1]:/lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT01002794&atom=%2Fbjsports%2Fearly%2F2024%2F09%2F26%2Fbjsports-2024-108644.atom
{"title":"Arthroscopic partial meniscectomy versus exercise therapy for degenerative meniscal tears: 10-year follow-up of the OMEX randomised controlled trial","authors":"Bjørnar Berg, Ewa M Roos, Martin Englund, Nina Jullum Kise, Lars Engebretsen, Cathrine Nørstad Eftang, May Arna Risberg","doi":"10.1136/bjsports-2024-108644","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108644","url":null,"abstract":"Objective To evaluate radiographic knee osteoarthritis (OA) progression, development of knee OA, patient-reported outcomes and knee muscle strength at 10-year follow-up after arthroscopic partial meniscectomy (APM) or exercise therapy for degenerative meniscal tears. Methods Randomised controlled trial including 140 participants, with a degenerative meniscal tear and no or minimal radiographic OA changes. Participants were randomised to either APM or 12 weeks of exercise therapy (1:1 ratio). The primary outcome was knee OA progression assessed by the Osteoarthritis Research Society International (OARSI) atlas sum score (sum of medial and lateral compartment joint space narrowing and osteophyte score). Secondary outcomes included incidence of radiographic and symptomatic knee OA, patient-reported pain and knee function and isokinetic knee muscle strength. Results The adjusted mean difference in change in the OARSI sum score was 0.39 (95% CI −0.19 to 0.97), with more progression in the APM group. The incidence of radiographic knee OA was 23% in the APM group and 20% in the exercise group (adjusted risk difference 3% (95% CI −13% to 19%)). No clinically relevant differences were found in patient-reported outcomes or isokinetic knee muscle strength. Conclusion No differences in radiographic knee OA progression and comparable rates of knee OA development were observed 10 years following APM and exercise therapy for degenerative meniscal tears. Both treatments were associated with improved patient-reported pain and knee function. Trial registration number [NCT01002794][1]. Data are available on reasonable request. [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT01002794&atom=%2Fbjsports%2Fearly%2F2024%2F09%2F26%2Fbjsports-2024-108644.atom","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":null,"pages":null},"PeriodicalIF":18.4,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142325141","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 : 2024-09-24DOI: 10.1136/bjsports-2024-108364
Leticia Amaral Corrêa, Mark Hancock, Stephanie Mathieson, Arianne Verhagen, Ben Darlow, Paul William Hodges, Simon French
Objective To develop and evaluate a new patient-reported outcome measure (PROM) to assess people’s knowledge and beliefs about low back pain. Methods This study followed the COnsensus-based Standards for the selection of health Measurement INstruments guidelines. An 18-item preliminary version of the Back pain Knowledge and beliefs Survey (BacKS) was generated based on evidence-based key messages and current clinical guidelines for low back pain. Four items were added following input from three consumers and seven experts. Focus groups (n=9) confirmed content validity. The 22-item version was completed by 258 Australian-based adults (>18 years) with self-reported low back pain. A follow-up survey was sent 1 week later. The following measurement properties were evaluated to produce, and then assess the final version of BacKS: structural validity (exploratory factor analysis); internal consistency (Cronbach’s alpha); test–retest reliability (intraclass correlation coefficient); measurement error (Smallest Detectable Change); construct validity (hypothesis tested: moderate positive Pearson correlation between BacKS and Back Beliefs Questionnaire); plus, interpretability and feasibility. Results The final BacKS comprised 20 items with a 2-factor structure (biomedical factor: 9 items, score ranging from 9 to 45, and self-care factor: 11 items, score ranging from 11 to 55). Internal consistency and reliability were adequate (>0.70) for each factor. Smallest detectable change was 4.4 (biomedical factor) and 7.0 (self-care factor). Our construct validity hypothesis was confirmed (Pearson correlation=0.53). No floor or ceiling effects were detected. Conclusion The BacKS is a valid, reliable and feasible PROM to measure knowledge and beliefs about low back pain in clinical practice and research settings. Data are available on reasonable request.
{"title":"Back pain Knowledge and beliefs Survey (BacKS): development and assessment of measurement properties","authors":"Leticia Amaral Corrêa, Mark Hancock, Stephanie Mathieson, Arianne Verhagen, Ben Darlow, Paul William Hodges, Simon French","doi":"10.1136/bjsports-2024-108364","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108364","url":null,"abstract":"Objective To develop and evaluate a new patient-reported outcome measure (PROM) to assess people’s knowledge and beliefs about low back pain. Methods This study followed the COnsensus-based Standards for the selection of health Measurement INstruments guidelines. An 18-item preliminary version of the Back pain Knowledge and beliefs Survey (BacKS) was generated based on evidence-based key messages and current clinical guidelines for low back pain. Four items were added following input from three consumers and seven experts. Focus groups (n=9) confirmed content validity. The 22-item version was completed by 258 Australian-based adults (>18 years) with self-reported low back pain. A follow-up survey was sent 1 week later. The following measurement properties were evaluated to produce, and then assess the final version of BacKS: structural validity (exploratory factor analysis); internal consistency (Cronbach’s alpha); test–retest reliability (intraclass correlation coefficient); measurement error (Smallest Detectable Change); construct validity (hypothesis tested: moderate positive Pearson correlation between BacKS and Back Beliefs Questionnaire); plus, interpretability and feasibility. Results The final BacKS comprised 20 items with a 2-factor structure (biomedical factor: 9 items, score ranging from 9 to 45, and self-care factor: 11 items, score ranging from 11 to 55). Internal consistency and reliability were adequate (>0.70) for each factor. Smallest detectable change was 4.4 (biomedical factor) and 7.0 (self-care factor). Our construct validity hypothesis was confirmed (Pearson correlation=0.53). No floor or ceiling effects were detected. Conclusion The BacKS is a valid, reliable and feasible PROM to measure knowledge and beliefs about low back pain in clinical practice and research settings. Data are available on reasonable request.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":null,"pages":null},"PeriodicalIF":18.4,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142317618","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 : 2024-09-19DOI: 10.1136/bjsports-2024-108587
Sean Tweedy,Iain Mayank Dutia,John Cairney,Emma Beckman
{"title":"Single case experimental design: a rigorous method for addressing inequity and enhancing precision within Para sport and exercise medicine research.","authors":"Sean Tweedy,Iain Mayank Dutia,John Cairney,Emma Beckman","doi":"10.1136/bjsports-2024-108587","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108587","url":null,"abstract":"","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":null,"pages":null},"PeriodicalIF":18.4,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142275170","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 : 2024-09-13DOI: 10.1136/bjsports-2024-108263
Robert-Jan de Vos, Karin Gravare Silbernagel, Peter Malliaras, Tjerk Sleeswijk Visser, Hakan Alfredson, Inge van den Akker-Scheek, Mathijs van Ark, Annelie Brorsson, Ruth Chimenti, Sean Docking, Pernilla Eliasson, Kenneth Farnqvist, Zubair Haleem, Shawn L Hanlon, Jean-Francois Kaux, Rebecca Samantha Kearney, Paul D Kirwan, Kornelia Kulig, Bhavesh Kumar, Trevor Lewis, Umile Giuseppe Longo, Tun Hing Lui, Nicola Maffulli, Adrian James Mallows, Lorenzo Masci, Dennis McGonagle, Dylan Morrissey, Myles Calder Murphy, Richard Newsham-West, Katarina Maria Nilsson-Helander, Richard Norris, Francesco Oliva, Seth O’Neill, Koen Peers, Ebonie Kendra Rio, Igor Sancho, Alex Scott, Kayla D Seymore, Sze-Ee Soh, Patrick Vallance, Jan A N Verhaar, Arco C van der Vlist, Adam Weir, Jennifer Ann Zellers, Bill Vicenzino
To develop a core outcome set for Achilles tendinopathy (COS-AT) for use in clinical trials we performed a five-step process including (1) a systematic review of available outcome measurement instruments, (2) an online survey on truth and feasibility of the available measurement instruments, (3) an assessment of the methodological quality of the selected outcome measurement instruments, (4) an online survey on the outcome measurement instruments as COS and (5) a consensus in-person meeting. Both surveys were completed by healthcare professionals and patients. The Outcome Measures in Rheumatology guidelines with a 70% threshold for consensus were followed. We identified 233 different outcome measurement instruments from 307 included studies; 177 were mapped within the International Scientific Tendinopathy Symposium Consensus core domains. 31 participants (12 patients) completed the first online survey (response rate 94%). 22/177 (12%) outcome measurement instruments were deemed truthful and feasible and their measurement properties were evaluated. 29 participants (12 patients) completed the second online survey (response rate 88%) and three outcome measurement instruments were endorsed: the Victorian Institute of Sports Assessment-Achilles questionnaire, the single-leg heel rise test and evaluating pain after activity using a Visual Analogue Scale (VAS, 0–10). 12 participants (1 patient) attended the final consensus meeting, and 1 additional outcome measurement instrument was endorsed: evaluating pain during activity/loading using a VAS (0–10). It is recommended that the identified COS-AT will be used in future clinical trials evaluating the effectiveness of an intervention. This will facilitate comparing outcomes of intervention strategies, data pooling and further progression of knowledge about AT. As COS-AT is implemented, further evidence on measurement properties of included measures and new outcome measurement instruments should lead to its review and refinement.
{"title":"ICON 2023: International Scientific Tendinopathy Symposium Consensus – the core outcome set for Achilles tendinopathy (COS-AT) using a systematic review and a Delphi study of professional participants and patients","authors":"Robert-Jan de Vos, Karin Gravare Silbernagel, Peter Malliaras, Tjerk Sleeswijk Visser, Hakan Alfredson, Inge van den Akker-Scheek, Mathijs van Ark, Annelie Brorsson, Ruth Chimenti, Sean Docking, Pernilla Eliasson, Kenneth Farnqvist, Zubair Haleem, Shawn L Hanlon, Jean-Francois Kaux, Rebecca Samantha Kearney, Paul D Kirwan, Kornelia Kulig, Bhavesh Kumar, Trevor Lewis, Umile Giuseppe Longo, Tun Hing Lui, Nicola Maffulli, Adrian James Mallows, Lorenzo Masci, Dennis McGonagle, Dylan Morrissey, Myles Calder Murphy, Richard Newsham-West, Katarina Maria Nilsson-Helander, Richard Norris, Francesco Oliva, Seth O’Neill, Koen Peers, Ebonie Kendra Rio, Igor Sancho, Alex Scott, Kayla D Seymore, Sze-Ee Soh, Patrick Vallance, Jan A N Verhaar, Arco C van der Vlist, Adam Weir, Jennifer Ann Zellers, Bill Vicenzino","doi":"10.1136/bjsports-2024-108263","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108263","url":null,"abstract":"To develop a core outcome set for Achilles tendinopathy (COS-AT) for use in clinical trials we performed a five-step process including (1) a systematic review of available outcome measurement instruments, (2) an online survey on truth and feasibility of the available measurement instruments, (3) an assessment of the methodological quality of the selected outcome measurement instruments, (4) an online survey on the outcome measurement instruments as COS and (5) a consensus in-person meeting. Both surveys were completed by healthcare professionals and patients. The Outcome Measures in Rheumatology guidelines with a 70% threshold for consensus were followed. We identified 233 different outcome measurement instruments from 307 included studies; 177 were mapped within the International Scientific Tendinopathy Symposium Consensus core domains. 31 participants (12 patients) completed the first online survey (response rate 94%). 22/177 (12%) outcome measurement instruments were deemed truthful and feasible and their measurement properties were evaluated. 29 participants (12 patients) completed the second online survey (response rate 88%) and three outcome measurement instruments were endorsed: the Victorian Institute of Sports Assessment-Achilles questionnaire, the single-leg heel rise test and evaluating pain after activity using a Visual Analogue Scale (VAS, 0–10). 12 participants (1 patient) attended the final consensus meeting, and 1 additional outcome measurement instrument was endorsed: evaluating pain during activity/loading using a VAS (0–10). It is recommended that the identified COS-AT will be used in future clinical trials evaluating the effectiveness of an intervention. This will facilitate comparing outcomes of intervention strategies, data pooling and further progression of knowledge about AT. As COS-AT is implemented, further evidence on measurement properties of included measures and new outcome measurement instruments should lead to its review and refinement.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":null,"pages":null},"PeriodicalIF":18.4,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142231289","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 : 2024-09-10DOI: 10.1136/bjsports-2024-108117
Pieter Coenen, Maaike A Huysmans, Andreas Holtermann, Richard P Troiano, Paul Jarle Mork, Steinar Krokstad, Els Clays, Bart Cillekens, Dirk De Bacquer, Mette Aadahl, Line Lund Kårhus, Anette Sjøl, Lars Bo Andersen, Jussi Kauhanen, Ari Voutilainen, Richard M Pulsford, Emmanuel Stamatakis, Uri Goldbourt, Annette Peters, Barbara Thorand, Annika Rosengren, Lena Björck, Kyle Sprow, Kristin Franzon, Miguel Rodriguez-Barranco, Leila Luján-Barroso, Anders Knutsson, Lars Alfredsson, Martin Bahls, Till Ittermann, Alexander Kluttig, Lamiaa Hassan, Miriam Wanner, Matthias Bopp, Jacob Louis Marott, Peter Schnohr, Børge Grønne Nordestgaard, Knut Eirik Dalene, Ulf Ekelund, Johan Clausen, Magnus Thorsten Jensen, Christina Bjørk Petersen, Niklas Krause, Jos Twisk, Willem van Mechelen, Allard J van der Beek
Objective Health effects of different physical activity domains (ie, during leisure time, work and transport) are generally considered positive. Using Active Worker consortium data, we assessed independent associations of occupational and leisure-time physical activity (OPA and LTPA) with all-cause mortality. Design Two-stage individual participant data meta-analysis. Data source Published and unpublished cohort study data. Eligibility criteria Working participants aged 18–65 years. Methods After data harmonisation, we assessed associations of OPA and LTPA with all-cause mortality. In stage 1, we analysed data from each study separately using Cox survival regression, and in stage 2, we pooled individual study findings with random-effects modelling. Results In 22 studies with up to 590 497 participants from 11 countries, during a mean follow-up of 23.1 (SD: 6.8) years, 99 743 (16%) participants died. Adjusted for LTPA, body mass index, age, smoking and education level, summary (ie, stage 2) hazard ration (HRs) and 95% confidence interval (95% CI) for low, moderate and high OPA among men (n=2 96 134) were 1.01 (0.99 to 1.03), 1.05 (1.01 to 1.10) and 1.12 (1.03 to 1.23), respectively. For women (n=2 94 364), HRs (95% CI) were 0.98 (0.92 to 1.04), 0.96 (0.92 to 1.00) and 0.97 (0.86 to 1.10), respectively. In contrast, higher levels of LTPA were inversely associated with mortality for both genders. For example, for women HR for low, moderate and high compared with sedentary LTPA were 0.85 (0.81 to 0.89), 0.78 (0.74 to 0.81) and 0.75 (0.65 to 0.88), respectively. Effects were attenuated when adjusting for income (although data on income were available from only 9 and 6 studies, for men and women, respectively). Conclusion Our findings indicate that OPA may not result in the same beneficial health effects as LTPA. Data may be obtained from a third party and are not publicly available. All aggregated data are provided in this manuscript, including the supplementary files. Part of the individual participant are available on request, while other parts may be obtained from a third party and are not publicly available.
{"title":"Associations of occupational and leisure-time physical activity with all-cause mortality: an individual participant data meta-analysis","authors":"Pieter Coenen, Maaike A Huysmans, Andreas Holtermann, Richard P Troiano, Paul Jarle Mork, Steinar Krokstad, Els Clays, Bart Cillekens, Dirk De Bacquer, Mette Aadahl, Line Lund Kårhus, Anette Sjøl, Lars Bo Andersen, Jussi Kauhanen, Ari Voutilainen, Richard M Pulsford, Emmanuel Stamatakis, Uri Goldbourt, Annette Peters, Barbara Thorand, Annika Rosengren, Lena Björck, Kyle Sprow, Kristin Franzon, Miguel Rodriguez-Barranco, Leila Luján-Barroso, Anders Knutsson, Lars Alfredsson, Martin Bahls, Till Ittermann, Alexander Kluttig, Lamiaa Hassan, Miriam Wanner, Matthias Bopp, Jacob Louis Marott, Peter Schnohr, Børge Grønne Nordestgaard, Knut Eirik Dalene, Ulf Ekelund, Johan Clausen, Magnus Thorsten Jensen, Christina Bjørk Petersen, Niklas Krause, Jos Twisk, Willem van Mechelen, Allard J van der Beek","doi":"10.1136/bjsports-2024-108117","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108117","url":null,"abstract":"Objective Health effects of different physical activity domains (ie, during leisure time, work and transport) are generally considered positive. Using Active Worker consortium data, we assessed independent associations of occupational and leisure-time physical activity (OPA and LTPA) with all-cause mortality. Design Two-stage individual participant data meta-analysis. Data source Published and unpublished cohort study data. Eligibility criteria Working participants aged 18–65 years. Methods After data harmonisation, we assessed associations of OPA and LTPA with all-cause mortality. In stage 1, we analysed data from each study separately using Cox survival regression, and in stage 2, we pooled individual study findings with random-effects modelling. Results In 22 studies with up to 590 497 participants from 11 countries, during a mean follow-up of 23.1 (SD: 6.8) years, 99 743 (16%) participants died. Adjusted for LTPA, body mass index, age, smoking and education level, summary (ie, stage 2) hazard ration (HRs) and 95% confidence interval (95% CI) for low, moderate and high OPA among men (n=2 96 134) were 1.01 (0.99 to 1.03), 1.05 (1.01 to 1.10) and 1.12 (1.03 to 1.23), respectively. For women (n=2 94 364), HRs (95% CI) were 0.98 (0.92 to 1.04), 0.96 (0.92 to 1.00) and 0.97 (0.86 to 1.10), respectively. In contrast, higher levels of LTPA were inversely associated with mortality for both genders. For example, for women HR for low, moderate and high compared with sedentary LTPA were 0.85 (0.81 to 0.89), 0.78 (0.74 to 0.81) and 0.75 (0.65 to 0.88), respectively. Effects were attenuated when adjusting for income (although data on income were available from only 9 and 6 studies, for men and women, respectively). Conclusion Our findings indicate that OPA may not result in the same beneficial health effects as LTPA. Data may be obtained from a third party and are not publicly available. All aggregated data are provided in this manuscript, including the supplementary files. Part of the individual participant are available on request, while other parts may be obtained from a third party and are not publicly available.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":null,"pages":null},"PeriodicalIF":18.4,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142166131","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 investigate the physical activity (PA) intensity associated with cardiometabolic health when considering the mediating role of cardiorespiratory fitness (CRF).
Methods: A subsample of males and females aged 50-64 years from the cross-sectional Swedish CArdioPulmonary bioImage Study was investigated. PA was measured by accelerometry and CRF by a submaximal cycle test. Cardiometabolic risk factors, including waist circumference, systolic blood pressure, high-density lipoprotein, triglycerides and glycated haemoglobin, were combined to a composite score. A mediation model by partial least squares structural equation modelling was used to analyse the role of CRF in the association between PA and the composite score.
Results: The cohort included 4185 persons (51.9% female) with a mean age of 57.2 years. CRF mediated 82% of the association between PA and the composite score. The analysis of PA patterns revealed that moderate intensity PA explained most of the variation in the composite score, while vigorous intensity PA explained most of the variation in CRF. When including both PA and CRF as predictors of the composite score, the importance of vigorous intensity increased.
Conclusion: The highly interconnected role of CRF in the association between PA and cardiometabolic health suggests limited direct effects of PA on cardiometabolic health beyond its impact on CRF. The findings highlight the importance of sufficient PA intensity for the association with CRF, which in turn is linked to better cardiometabolic health.
目的考虑到心肺功能(CRF)的中介作用,研究与心脏代谢健康相关的体力活动(PA)强度:方法:调查了瑞典CArdio-Pulmonary bioImage横断面研究中 50-64 岁男性和女性的子样本。加速度测量法测量了PA,亚极限循环测试测量了CRF。包括腰围、收缩压、高密度脂蛋白、甘油三酯和糖化血红蛋白在内的心脏代谢风险因素被合并为一个综合评分。通过偏最小二乘法结构方程模型建立的中介模型,分析了CRF在PA与综合得分之间的关联中的作用:结果:该队列包括 4185 人(51.9% 为女性),平均年龄为 57.2 岁。82%的CRF介导了PA与综合评分之间的关系。PA 模式分析显示,中等强度的 PA 可解释综合评分的大部分变化,而剧烈强度的 PA 则可解释 CRF 的大部分变化。当把 PA 和 CRF 都作为综合评分的预测因素时,剧烈强度的重要性增加了:结论:CRF 在 PA 与心脏代谢健康之间的关联中发挥着高度相互关联的作用,这表明除了对 CRF 的影响外,PA 对心脏代谢健康的直接影响有限。研究结果强调了足够强度的 PA 与 CRF 之间关系的重要性,而 CRF 又与更好的心脏代谢健康相关联。
{"title":"Fitness-related physical activity intensity explains most of the association between accelerometer data and cardiometabolic health in persons 50-64 years old.","authors":"Jonatan Fridolfsson, Elin Ekblom-Bak, Örjan Ekblom, Göran Bergström, Daniel Arvidsson, Mats Börjesson","doi":"10.1136/bjsports-2023-107451","DOIUrl":"10.1136/bjsports-2023-107451","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the physical activity (PA) intensity associated with cardiometabolic health when considering the mediating role of cardiorespiratory fitness (CRF).</p><p><strong>Methods: </strong>A subsample of males and females aged 50-64 years from the cross-sectional Swedish CArdioPulmonary bioImage Study was investigated. PA was measured by accelerometry and CRF by a submaximal cycle test. Cardiometabolic risk factors, including waist circumference, systolic blood pressure, high-density lipoprotein, triglycerides and glycated haemoglobin, were combined to a composite score. A mediation model by partial least squares structural equation modelling was used to analyse the role of CRF in the association between PA and the composite score.</p><p><strong>Results: </strong>The cohort included 4185 persons (51.9% female) with a mean age of 57.2 years. CRF mediated 82% of the association between PA and the composite score. The analysis of PA patterns revealed that moderate intensity PA explained most of the variation in the composite score, while vigorous intensity PA explained most of the variation in CRF. When including both PA and CRF as predictors of the composite score, the importance of vigorous intensity increased.</p><p><strong>Conclusion: </strong>The highly interconnected role of CRF in the association between PA and cardiometabolic health suggests limited direct effects of PA on cardiometabolic health beyond its impact on CRF. The findings highlight the importance of sufficient PA intensity for the association with CRF, which in turn is linked to better cardiometabolic health.</p>","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":null,"pages":null},"PeriodicalIF":11.6,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141598527","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 : 2024-09-10DOI: 10.1136/bjsports-2024-108481
Eric Tsz-Chun Poon, Waris Wongpipit, Hong-Yat Li, Stephen Heung-Sang Wong, Parco M Siu, Alice Pik-Shan Kong, Nathan A Johnson
Objective To assess the effectiveness of high-intensity interval training (HIIT) compared with traditional moderate-intensity continuous training (MICT) and/or non-exercise control (CON) for modification of metabolic syndrome (MetS) components and other cardiometabolic health outcomes in individuals with MetS. Design Systematic review and meta-analysis Data sources Five databases were searched from inception to March 2024. Study appraisal and synthesis Meta-analyses of randomised controlled trials (RCTs) comparing HIIT with MICT/CON were performed for components of MetS (waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), high-density lipoprotein cholesterol (HDL-C), triglyceride (TG), and fasting blood glucose (BG)) and clinically relevant cardiometabolic health parameters. Subgroup moderator analyses were conducted based on the intervention duration and HIIT volume. Results Out of 4819 studies, 23 RCTs involving 1374 participants were included (mean age: 46.2–67.0 years, 55% male). HIIT significantly improved WC (weighted mean difference (WMD) –4.12 cm, 95% CI –4.71 to –3.53), SBP (WMD –6.05 mm Hg, 95% CI –8.11 to –4.00), DBP (WMD –3.68 mm Hg, 95% CI –5.70 to –1.65), HDL-C (WMD 0.12 mmol/L, 95% CI 0.04 to 0.20), TG (WMD –0.34 mmol/L, 95% CI –0.41 to –0.27) and BG (WMD –0.35 mmol/L, 95% CI –0.54 to –0.16) compared with CON (all p<0.01). HIIT approaches demonstrated comparable effects to MICT across all parameters. Subgroup analyses suggested that HIIT protocols with low volume (ie, <15 min of high-intensity exercise per session) were not inferior to higher volume protocols for improving MetS components. Conclusion This review supports HIIT as an efficacious exercise strategy for improving cardiometabolic health in individuals with MetS. Low-volume HIIT appears to be a viable alternative to traditional forms of aerobic exercise. The datasets analysed in this review are available from the corresponding author on reasonable request.
{"title":"High-intensity interval training for cardiometabolic health in adults with metabolic syndrome: a systematic review and meta-analysis of randomised controlled trials","authors":"Eric Tsz-Chun Poon, Waris Wongpipit, Hong-Yat Li, Stephen Heung-Sang Wong, Parco M Siu, Alice Pik-Shan Kong, Nathan A Johnson","doi":"10.1136/bjsports-2024-108481","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108481","url":null,"abstract":"Objective To assess the effectiveness of high-intensity interval training (HIIT) compared with traditional moderate-intensity continuous training (MICT) and/or non-exercise control (CON) for modification of metabolic syndrome (MetS) components and other cardiometabolic health outcomes in individuals with MetS. Design Systematic review and meta-analysis Data sources Five databases were searched from inception to March 2024. Study appraisal and synthesis Meta-analyses of randomised controlled trials (RCTs) comparing HIIT with MICT/CON were performed for components of MetS (waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), high-density lipoprotein cholesterol (HDL-C), triglyceride (TG), and fasting blood glucose (BG)) and clinically relevant cardiometabolic health parameters. Subgroup moderator analyses were conducted based on the intervention duration and HIIT volume. Results Out of 4819 studies, 23 RCTs involving 1374 participants were included (mean age: 46.2–67.0 years, 55% male). HIIT significantly improved WC (weighted mean difference (WMD) –4.12 cm, 95% CI –4.71 to –3.53), SBP (WMD –6.05 mm Hg, 95% CI –8.11 to –4.00), DBP (WMD –3.68 mm Hg, 95% CI –5.70 to –1.65), HDL-C (WMD 0.12 mmol/L, 95% CI 0.04 to 0.20), TG (WMD –0.34 mmol/L, 95% CI –0.41 to –0.27) and BG (WMD –0.35 mmol/L, 95% CI –0.54 to –0.16) compared with CON (all p<0.01). HIIT approaches demonstrated comparable effects to MICT across all parameters. Subgroup analyses suggested that HIIT protocols with low volume (ie, <15 min of high-intensity exercise per session) were not inferior to higher volume protocols for improving MetS components. Conclusion This review supports HIIT as an efficacious exercise strategy for improving cardiometabolic health in individuals with MetS. Low-volume HIIT appears to be a viable alternative to traditional forms of aerobic exercise. The datasets analysed in this review are available from the corresponding author on reasonable request.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":null,"pages":null},"PeriodicalIF":18.4,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142166130","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 : 2024-09-09DOI: 10.1136/bjsports-2024-108624
Mark R Mackie, Martin Schwellnus, Jane S Thornton
{"title":"Infographic. International Olympic Committee (IOC) consensus statement and clinical decision-making guide on acute respiratory illness in athletes.","authors":"Mark R Mackie, Martin Schwellnus, Jane S Thornton","doi":"10.1136/bjsports-2024-108624","DOIUrl":"10.1136/bjsports-2024-108624","url":null,"abstract":"","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":null,"pages":null},"PeriodicalIF":11.6,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141757206","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 : 2024-09-09DOI: 10.1136/bjsports-2024-108426
Anne Inger Mørtvedt
{"title":"Exploring usability in exercise interventions: from conceptualisation to measurement and application (PhD Academy Award).","authors":"Anne Inger Mørtvedt","doi":"10.1136/bjsports-2024-108426","DOIUrl":"10.1136/bjsports-2024-108426","url":null,"abstract":"","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":null,"pages":null},"PeriodicalIF":11.6,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141431410","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}