Pub Date : 2025-12-15DOI: 10.1136/bjsports-2025-110606
Mitchell Selhorst,Emily Sweeney,Lisa C Martin,Jingzhen Yang,Jason Benedict,Madison Brna, ,Anastasia N Fischer
OBJECTIVESTo compare the effects of initiating physical therapy (PT) immediately versus resting before starting PT on pain and dysfunction over 12 months in adolescent athletes (10-19 years) with active lumbar spondylolysis.METHODSThis prospective multicentre trial randomised participants to immediate PT or rest before PT. The immediate PT group began PT within 7 days and progressed based on pain and function. The rest before PT group started PT once symptoms resolved and progressed based on time. The primary outcome was pain and disability (Micheli Functional Scale) between groups over time, measured at baseline, 1 (primary end point), 3 and 12 months. Time to return to sport and the recurrence rate of low back pain (LBP) were also assessed. Outcomes were analysed using an intention-to-treat approach.RESULTSSixty-four participants (median age 14.2 years; 40% female) were randomised to immediate PT (n=30) and rest before PT (n=34). At 1 month, the immediate PT group showed significant improvements in pain and disability (mean difference on Micheli Functional Scale of 21.3, 95% CI 28.7 to 13.9; p<0.001). They also returned to sport 38 days sooner (p<0.001), with fewer recurrences of LBP over 12 months (3% vs 29%; p=0.01). There were no adverse events.CONCLUSIONSClinicians may consider prescribing PT immediately after diagnosing active lumbar spondylolysis instead of rest. Immediate PT showed greater initial improvements in pain and dysfunction, a quicker return to sport and a lower recurrence of LBP compared with rest before PT among adolescent athletes with spondylolysis.TRIAL REGISTRATION NUMBERNCT05505981.
目的比较立即开始物理治疗（PT）与开始前休息对患有活动性腰椎裂症的青少年运动员（10-19岁）12个月疼痛和功能障碍的影响。该前瞻性多中心试验将参与者随机分为立即PT组或在PT前休息组。立即PT组在7天内开始PT，并根据疼痛和功能进展。一旦症状消退并根据时间进展，在PT组开始PT前的休息。主要结局是各组间疼痛和残疾（Micheli功能量表）随时间变化，分别在基线、1个月（主要终点）、3个月和12个月进行测量。恢复运动的时间和腰痛（LBP）的复发率也被评估。使用意向治疗方法分析结果。结果64名参与者（中位年龄14.2岁，40%为女性）随机分为立即PT组（n=30）和PT前休息组（n=34）。1个月时，立即PT组疼痛和残疾均有显著改善（Micheli功能量表的平均差异为21.3,95% CI 28.7至13.9;p<0.001）。他们恢复运动的时间也提前了38天（p<0.001），在12个月内LBP的复发率更低（3% vs 29%; p=0.01）。没有不良事件发生。结论临床医生可考虑在诊断活动性腰椎峡部裂后立即开PT而不是休息。在患有峡部裂的青少年运动员中，与术前休息相比，即刻PT在疼痛和功能障碍方面表现出更大的初步改善，更快地恢复运动，更低的下腰痛复发。试验注册号05505981。
{"title":"Immediate physical therapy is beneficial for adolescent athletes with active lumbar spondylolysis: a multicentre randomised trial.","authors":"Mitchell Selhorst,Emily Sweeney,Lisa C Martin,Jingzhen Yang,Jason Benedict,Madison Brna, ,Anastasia N Fischer","doi":"10.1136/bjsports-2025-110606","DOIUrl":"https://doi.org/10.1136/bjsports-2025-110606","url":null,"abstract":"OBJECTIVESTo compare the effects of initiating physical therapy (PT) immediately versus resting before starting PT on pain and dysfunction over 12 months in adolescent athletes (10-19 years) with active lumbar spondylolysis.METHODSThis prospective multicentre trial randomised participants to immediate PT or rest before PT. The immediate PT group began PT within 7 days and progressed based on pain and function. The rest before PT group started PT once symptoms resolved and progressed based on time. The primary outcome was pain and disability (Micheli Functional Scale) between groups over time, measured at baseline, 1 (primary end point), 3 and 12 months. Time to return to sport and the recurrence rate of low back pain (LBP) were also assessed. Outcomes were analysed using an intention-to-treat approach.RESULTSSixty-four participants (median age 14.2 years; 40% female) were randomised to immediate PT (n=30) and rest before PT (n=34). At 1 month, the immediate PT group showed significant improvements in pain and disability (mean difference on Micheli Functional Scale of 21.3, 95% CI 28.7 to 13.9; p<0.001). They also returned to sport 38 days sooner (p<0.001), with fewer recurrences of LBP over 12 months (3% vs 29%; p=0.01). There were no adverse events.CONCLUSIONSClinicians may consider prescribing PT immediately after diagnosing active lumbar spondylolysis instead of rest. Immediate PT showed greater initial improvements in pain and dysfunction, a quicker return to sport and a lower recurrence of LBP compared with rest before PT among adolescent athletes with spondylolysis.TRIAL REGISTRATION NUMBERNCT05505981.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"50 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145765436","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 : 2025-12-12DOI: 10.1136/bjsports-2025-110471
Victoria Louise Roberts,Natalie Galea,Tania King
{"title":"Coercive control of athletes: an insidious form of organisational violence in sport.","authors":"Victoria Louise Roberts,Natalie Galea,Tania King","doi":"10.1136/bjsports-2025-110471","DOIUrl":"https://doi.org/10.1136/bjsports-2025-110471","url":null,"abstract":"","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"93 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145732707","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 : 2025-12-12DOI: 10.1136/bjsports-2025-110406
Kentaro Yamagata,Richard Weiler,Raghav T Bhatia,Jamie S McPhee,Charlotte M Cowie,Sanjay Sharma,Aneil Malhotra
OBJECTIVESStudies to date have under-represented cardiac characteristics of para athletes, despite their unique cardiovascular physiology and risks. This study examined the cardiac electrical and structural characteristics and outcomes of pre-participation cardiac screening in elite para-football players.METHODSBetween 2011 and 2024, 156 consecutive para-football players underwent pre-participation evaluation comprising a health questionnaire, 12-lead ECG and echocardiogram. Players with symptoms or abnormal preliminary investigations were evaluated further, including exercise testing and cardiac MRI. Findings were compared with 1000 consecutive sex-matched and ethnicity-matched non-para-football players. Mean follow-up was 4.7±3.1 years.RESULTSThe mean age of para-football players was 21.2±5.2 years. The majority were male (71.2%) and white ethnicity (84%), followed by mixed-race (7.1%), Asian (4.5%) and Afro-Caribbean (3.8%) ethnicity. Para-football players reported cardiac symptoms more frequently and required more follow-up than non-para players (14.7% vs 6.6%; p=0.001). Para players demonstrated less sinus bradycardia (35.3% vs 44.5%; p=0.037) and a similar prevalence of abnormal T-wave inversion (1.9% vs 3.0%; p=0.622). A short PR interval was observed in 4.5% of para players compared with 0.5% of non-para players (p<0.001), although QTc intervals were similar between the two groups (402±24 ms vs 399±19 ms; p=0.138). Four (2.6%) para-football players received diagnoses associated with sudden cardiac death (SCD) versus three (0.3%) non-para players (p=0.005). Six (3.8%) para-football players were diagnosed with minor cardiovascular conditions versus 1.8% non-para players (p=0.17). In total, 10 (6.4%) para-football players were diagnosed with cardiac pathology versus 21 (2.1%) non-para-football players (p=0.005), all of whom required management or were kept under surveillance. No SCD events occurred over 4.7±3.1 years of follow-up in para-football players.CONCLUSIONIn this study, para-football players were three times more likely to be diagnosed with a cardiac condition requiring management and/or surveillance compared with non-para players. Moreover, para-football players had a higher prevalence of serious cardiac disease associated with SCD. Cardiac screening inclusive of ECG is warranted in this growing cohort of athletes.
目的：尽管残疾人运动员具有独特的心血管生理和风险，但迄今为止的研究对其心脏特征的代表性不足。本研究考察了精英足球运动员参加前心脏筛查的心脏电和结构特征和结果。方法2011年至2024年间，156名残疾人足球运动员接受了赛前评估，包括健康问卷、12导联心电图和超声心动图。有症状或初步调查异常的球员将接受进一步评估，包括运动测试和心脏MRI。研究人员对1000名性别匹配和种族匹配的非准足球运动员的研究结果进行了比较。平均随访4.7±3.1年。结果残疾人足球运动员平均年龄为21.2±5.2岁。大多数是男性（71.2%）和白人（84%），其次是混合种族（7.1%），亚洲（4.5%）和非洲-加勒比（3.8%）种族。残疾人足球运动员比非残疾人足球运动员报告心脏症状的频率更高，需要更多的随访（14.7% vs 6.6%; p=0.001）。Para运动员表现出较少的窦性心动过缓（35.3% vs 44.5%, p=0.037）和相似的异常t波倒置患病率（1.9% vs 3.0%, p=0.622）。尽管QTc间隔在两组之间相似（402±24 ms vs 399±19 ms, p=0.138），但有4.5%的残疾人运动员与0.5%的非残疾人运动员的PR间隔较短（p<0.001）。4名残疾人足球运动员（2.6%）被诊断为心脏性猝死（SCD），而3名非残疾人足球运动员（0.3%）被诊断为心脏性猝死（SCD） （p=0.005）。6名残疾人足球运动员（3.8%）被诊断患有轻微心血管疾病，而非残疾人足球运动员为1.8% （p=0.17）。总共有10名（6.4%）准足球运动员被诊断为心脏病变，而21名（2.1%）非准足球运动员被诊断为心脏病变（p=0.005），他们都需要管理或保持监测。在4.7±3.1年的随访中，准足球运动员没有发生SCD事件。结论：在这项研究中，与非残疾人运动员相比，残疾人足球运动员被诊断为需要管理和/或监测的心脏疾病的可能性高出三倍。此外，准足球运动员与SCD相关的严重心脏病的患病率更高。在这一不断增长的运动员群体中，包括ECG在内的心脏筛查是必要的。
{"title":"Outcomes of cardiac screening in elite para-football players in the United Kingdom.","authors":"Kentaro Yamagata,Richard Weiler,Raghav T Bhatia,Jamie S McPhee,Charlotte M Cowie,Sanjay Sharma,Aneil Malhotra","doi":"10.1136/bjsports-2025-110406","DOIUrl":"https://doi.org/10.1136/bjsports-2025-110406","url":null,"abstract":"OBJECTIVESStudies to date have under-represented cardiac characteristics of para athletes, despite their unique cardiovascular physiology and risks. This study examined the cardiac electrical and structural characteristics and outcomes of pre-participation cardiac screening in elite para-football players.METHODSBetween 2011 and 2024, 156 consecutive para-football players underwent pre-participation evaluation comprising a health questionnaire, 12-lead ECG and echocardiogram. Players with symptoms or abnormal preliminary investigations were evaluated further, including exercise testing and cardiac MRI. Findings were compared with 1000 consecutive sex-matched and ethnicity-matched non-para-football players. Mean follow-up was 4.7±3.1 years.RESULTSThe mean age of para-football players was 21.2±5.2 years. The majority were male (71.2%) and white ethnicity (84%), followed by mixed-race (7.1%), Asian (4.5%) and Afro-Caribbean (3.8%) ethnicity. Para-football players reported cardiac symptoms more frequently and required more follow-up than non-para players (14.7% vs 6.6%; p=0.001). Para players demonstrated less sinus bradycardia (35.3% vs 44.5%; p=0.037) and a similar prevalence of abnormal T-wave inversion (1.9% vs 3.0%; p=0.622). A short PR interval was observed in 4.5% of para players compared with 0.5% of non-para players (p<0.001), although QTc intervals were similar between the two groups (402±24 ms vs 399±19 ms; p=0.138). Four (2.6%) para-football players received diagnoses associated with sudden cardiac death (SCD) versus three (0.3%) non-para players (p=0.005). Six (3.8%) para-football players were diagnosed with minor cardiovascular conditions versus 1.8% non-para players (p=0.17). In total, 10 (6.4%) para-football players were diagnosed with cardiac pathology versus 21 (2.1%) non-para-football players (p=0.005), all of whom required management or were kept under surveillance. No SCD events occurred over 4.7±3.1 years of follow-up in para-football players.CONCLUSIONIn this study, para-football players were three times more likely to be diagnosed with a cardiac condition requiring management and/or surveillance compared with non-para players. Moreover, para-football players had a higher prevalence of serious cardiac disease associated with SCD. Cardiac screening inclusive of ECG is warranted in this growing cohort of athletes.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"20 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145732708","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 : 2025-12-11DOI: 10.1136/bjsports-2025-110387
Richard Weiler,Kristina Fagher,Alice Berntsson,Osman Hassan Ahmed
{"title":"Different games, different rules: what is the best way to manage heading in para football?","authors":"Richard Weiler,Kristina Fagher,Alice Berntsson,Osman Hassan Ahmed","doi":"10.1136/bjsports-2025-110387","DOIUrl":"https://doi.org/10.1136/bjsports-2025-110387","url":null,"abstract":"","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"8 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145728422","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 : 2025-12-04DOI: 10.1136/bjsports-2025-110865
Patrick Vallance
{"title":"Neural deficits relevant to pain symptoms and functional impairments in individuals with Achilles or patellar tendinopathy (PhD Academy Award).","authors":"Patrick Vallance","doi":"10.1136/bjsports-2025-110865","DOIUrl":"https://doi.org/10.1136/bjsports-2025-110865","url":null,"abstract":"","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"246 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145673903","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 : 2025-12-04DOI: 10.1136/bjsports-2025-110720
Maurice Douryang,Yossa Nzeuwa Irma Belinda,Lervasen Pillay
{"title":"Physical activity implementation for cancer care and prevention in Sub-Saharan Africa: a call to action.","authors":"Maurice Douryang,Yossa Nzeuwa Irma Belinda,Lervasen Pillay","doi":"10.1136/bjsports-2025-110720","DOIUrl":"https://doi.org/10.1136/bjsports-2025-110720","url":null,"abstract":"","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"115 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145673956","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 : 2025-12-03DOI: 10.1136/bjsports-2025-111042
Dominic Charles Townsend,Tony Scholes,Mark Gillett
{"title":"Concussion in football: the case for temporary concussion substitutions.","authors":"Dominic Charles Townsend,Tony Scholes,Mark Gillett","doi":"10.1136/bjsports-2025-111042","DOIUrl":"https://doi.org/10.1136/bjsports-2025-111042","url":null,"abstract":"","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"33 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145664328","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 : 2025-12-03DOI: 10.1136/bjsports-2024-109586
Suzi Edwards,Meaghan Harris,Sean Docking,Jill L Cook,Ebonie Kendra Rio
{"title":"Adolescence is a critical time for patellar tendon development: it is time to rethink our current approach to patellar tendinopathy.","authors":"Suzi Edwards,Meaghan Harris,Sean Docking,Jill L Cook,Ebonie Kendra Rio","doi":"10.1136/bjsports-2024-109586","DOIUrl":"https://doi.org/10.1136/bjsports-2024-109586","url":null,"abstract":"","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"14 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145664026","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 : 2025-12-02DOI: 10.1136/bjsports-2025-111060
Kay M Crossley,Jenna Schulz,Brooke Patterson,Garrett S Bullock,Emily E Heming,Andrew George Ross,Isla J Shill,Kathryn J Schneider,H Paul Dijkstra,Jackie L Whittaker,Carolyn Emery
{"title":"The road to consensus: lessons learned from FAIR and recommendations for future consensus activities.","authors":"Kay M Crossley,Jenna Schulz,Brooke Patterson,Garrett S Bullock,Emily E Heming,Andrew George Ross,Isla J Shill,Kathryn J Schneider,H Paul Dijkstra,Jackie L Whittaker,Carolyn Emery","doi":"10.1136/bjsports-2025-111060","DOIUrl":"https://doi.org/10.1136/bjsports-2025-111060","url":null,"abstract":"","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"21 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145657052","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}
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