Pub Date : 2025-11-04DOI: 10.1136/bjsports-2024-109595
Noortje Riedstra, Fleur Boel, Michiel MA van Buuren, Harbeer Ahedi, Vahid Arbabi, Nigel K Arden, Sara J Baart, Sita M A Bierma-Zeinstra, Flavia Cicutini, Timothy Cootes, Kay M Crossley, David T Felson, Willem-Paul Gielis, Joshua J Heerey, Graeme Jones, Stefan Kluzek, Nancy E Lane, Claudia Lindner, John A Lynch, Joyce van Meurs, Andrea Britt Mosler, Amanda E Nelson, Michael C Nevitt, Edwin H G Oei, Jos Runhaar, Jinchi Tang, Harrie Weinans, Rintje Agricola
Objective To assess the relationship between pincer morphology and incident radiographic hip osteoarthritis (RHOA) and study-specific subgroups. Methods Hips completely free of RHOA at baseline and with follow-up within 4–8 years were drawn from the World COACH consortium. The lateral centre edge angle (LCEA) was calculated uniformly on all baseline radiographs. Moderate pincer morphology was defined as an LCEA ≥40°, and severe pincer morphology as an LCEA ≥45° in sensitivity analyses. The primary outcome was incident RHOA defined by a harmonised OA score. A logistic regression model with generalised mixed effects with three levels (within-cohort, within-person and within-hip side correlation) adjusted for age, biological sex and body mass index (BMI) was employed. Descriptive statistics are reported for age, biological sex and BMI. Results 18 935 hips from nine cohorts were included. 4894 hips (25.8%) had moderate pincer morphology. Within 8 years (mean 6.0±1.7 years), 352 hips (1.9%) developed RHOA. Moderate pincer morphology was not associated with RHOA (OR 1.15 (0.92–1.51)), whereas severe pincer morphology was significantly associated (OR 1.50 95% CI 1.05 to 2.15). Moderate pincer morphology in groups aged 40–50 (RR 2.67, 95% CI 1.43 to 4.95) and BMI ≥25 (RR 1.23 95% CI 0.98 to 1.71) had a higher risk compared with non-pincer hips. Women (RR 1.20 95% CI 0.93 to 1.56) with pincer morphology may be more at risk than men (RR 0.95 95% CI 0.57 to 1.58). Conclusion The odds of developing RHOA within 8 years for hips with severe pincer morphology are 1.5 times higher than pincer-free hips, whereas moderate pincer morphology was not significantly associated with RHOA. Further research is necessary to uncover high risk subgroups of pincer morphology. Data are available upon reasonable request. Data may be obtained from a third party and are not publicly available. We encourage the use of data by third parties, although this is subject to approval by the steering committees of the World COACH consortium and the participating cohorts, as well as to legal boundaries regarding data ownership. A standardised data request form is available for which will be reviewed uniformly in order to consistently handle World COACH data requests.
目的探讨钳形形态与髋关节骨关节炎（RHOA）的关系及研究特异性亚组。方法选取基线时完全无RHOA的髋关节，随访时间为4-8年。在所有基线x线片上均匀计算侧中心边缘角（LCEA）。在敏感性分析中，中度钳形被定义为LCEA≥40°，重度钳形被定义为LCEA≥45°。主要结局是由统一OA评分定义的偶发RHOA。采用一个具有三个水平（队列内、个人内和髋侧相关）的广义混合效应的logistic回归模型，对年龄、生物性别和体重指数（BMI）进行调整。报告了年龄、生理性别和BMI的描述性统计数据。结果共纳入9个队列的18935例髋关节。4894例（25.8%）髋部呈中等钳形。8年内（平均6.0±1.7年）352髋（1.9%）发生RHOA。中度钳形形态与RHOA无关（OR 1.15(0.92-1.51)），而重度钳形形态与RHOA显著相关（OR 1.50 95% CI 1.05 - 2.15）。40-50岁中度钳形髋关节组（RR 2.67, 95% CI 1.43 ~ 4.95）和BMI≥25组（RR 1.23, 95% CI 0.98 ~ 1.71）与非钳形髋关节组相比风险更高。钳形形态的女性（RR 1.20 95% CI 0.93至1.56）可能比男性（RR 0.95 95% CI 0.57至1.58）更危险。结论严重钳形髋关节在8年内发生RHOA的几率是无钳形髋关节的1.5倍，而中度钳形髋关节与RHOA无显著相关性。需要进一步的研究来揭示钳形的高风险亚群。如有合理要求，可提供资料。数据可能会从第三方获得，并且不会公开提供。我们鼓励第三方使用数据，尽管这需要得到世界教练联盟指导委员会和参与队列的批准，以及关于数据所有权的法律界限。提供了一份标准化的数据请求表格，将对其进行统一审查，以便始终一致地处理世界教练数据请求。
{"title":"Severe pincer morphology is associated with incident hip osteoarthritis: prospective individual participant data from 18 935 hips from the World COACH consortium","authors":"Noortje Riedstra, Fleur Boel, Michiel MA van Buuren, Harbeer Ahedi, Vahid Arbabi, Nigel K Arden, Sara J Baart, Sita M A Bierma-Zeinstra, Flavia Cicutini, Timothy Cootes, Kay M Crossley, David T Felson, Willem-Paul Gielis, Joshua J Heerey, Graeme Jones, Stefan Kluzek, Nancy E Lane, Claudia Lindner, John A Lynch, Joyce van Meurs, Andrea Britt Mosler, Amanda E Nelson, Michael C Nevitt, Edwin H G Oei, Jos Runhaar, Jinchi Tang, Harrie Weinans, Rintje Agricola","doi":"10.1136/bjsports-2024-109595","DOIUrl":"https://doi.org/10.1136/bjsports-2024-109595","url":null,"abstract":"Objective To assess the relationship between pincer morphology and incident radiographic hip osteoarthritis (RHOA) and study-specific subgroups. Methods Hips completely free of RHOA at baseline and with follow-up within 4–8 years were drawn from the World COACH consortium. The lateral centre edge angle (LCEA) was calculated uniformly on all baseline radiographs. Moderate pincer morphology was defined as an LCEA ≥40°, and severe pincer morphology as an LCEA ≥45° in sensitivity analyses. The primary outcome was incident RHOA defined by a harmonised OA score. A logistic regression model with generalised mixed effects with three levels (within-cohort, within-person and within-hip side correlation) adjusted for age, biological sex and body mass index (BMI) was employed. Descriptive statistics are reported for age, biological sex and BMI. Results 18 935 hips from nine cohorts were included. 4894 hips (25.8%) had moderate pincer morphology. Within 8 years (mean 6.0±1.7 years), 352 hips (1.9%) developed RHOA. Moderate pincer morphology was not associated with RHOA (OR 1.15 (0.92–1.51)), whereas severe pincer morphology was significantly associated (OR 1.50 95% CI 1.05 to 2.15). Moderate pincer morphology in groups aged 40–50 (RR 2.67, 95% CI 1.43 to 4.95) and BMI ≥25 (RR 1.23 95% CI 0.98 to 1.71) had a higher risk compared with non-pincer hips. Women (RR 1.20 95% CI 0.93 to 1.56) with pincer morphology may be more at risk than men (RR 0.95 95% CI 0.57 to 1.58). Conclusion The odds of developing RHOA within 8 years for hips with severe pincer morphology are 1.5 times higher than pincer-free hips, whereas moderate pincer morphology was not significantly associated with RHOA. Further research is necessary to uncover high risk subgroups of pincer morphology. Data are available upon reasonable request. Data may be obtained from a third party and are not publicly available. We encourage the use of data by third parties, although this is subject to approval by the steering committees of the World COACH consortium and the participating cohorts, as well as to legal boundaries regarding data ownership. A standardised data request form is available for which will be reviewed uniformly in order to consistently handle World COACH data requests.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"61 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145441204","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 : 2025-11-04DOI: 10.1136/bjsports-2025-111050
Jackie L Whittaker, Carolyn Emery, Merete Møller, Margo Mountjoy, Debbie Palmer, Jenna M Schulz, Kay M Crossley
Female, woman and girl sport has never been more visible,1 with full gender parity reached for the first time at the Paris 2024 Olympic Games, and record attendances set at the 2025’s European football championships and Rugby World Cup. Participation is surging from youth to senior levels, professionalism is accelerating and global audiences are catching up. Yet, as the fields, courts, pools and stadiums fill, female/woman/girl athletes remain chronically under-represented in the scientific evidence underpinning injury prevention. Across the more than 650 studies synthesised in the Female, woman and girl Athlete Injury pRevention (FAIR) consensus,2–7 fewer than 40% included female/woman/girl-specific data, and most failed to disaggregate female/woman/girl data from male/man/boy data. Also limited were data on female/woman/girl-specific injuries (eg, breast injuries) and considerations (eg, menstrual cycle, pregnancy-related and menopause experiences). These omissions result in a vicious cycle; under-representation limits understanding, which limits understanding evidence gaps, which limits justification and opportunities for funding, which perpetuates under-representation—ultimately undermining the health of female/woman/girl athletes. Without data, the story of female/woman/girl athlete injury risk is left to the imagination. When evidence is missing, myths fill the gaps: it must be their hips, hormones or fragility . These narratives perpetuate gendered stereotypes that undermine female/woman/girl athletes’ legitimacy, opportunities and performance. They also distract attention from the complex web of sociocultural, environmental and structural factors that shape injury risk6 including inequitable access to performance pathways, under-resourced medical support, ill-fitting equipment, unequal scheduling and a culture that normalises pain and silence. Many factors drive the under-representation of female/woman/girl athletes in research. Historically, injury prevention strategies were typically developed from male/man/boys’ data and systems and supporting infrastructure were built to fund, recruit and support research on male/man/boy athletes. This inertia continues to privilege …
{"title":"Road to FAIR: where are all the female, woman and girl athletes?","authors":"Jackie L Whittaker, Carolyn Emery, Merete Møller, Margo Mountjoy, Debbie Palmer, Jenna M Schulz, Kay M Crossley","doi":"10.1136/bjsports-2025-111050","DOIUrl":"https://doi.org/10.1136/bjsports-2025-111050","url":null,"abstract":"Female, woman and girl sport has never been more visible,1 with full gender parity reached for the first time at the Paris 2024 Olympic Games, and record attendances set at the 2025’s European football championships and Rugby World Cup. Participation is surging from youth to senior levels, professionalism is accelerating and global audiences are catching up. Yet, as the fields, courts, pools and stadiums fill, female/woman/girl athletes remain chronically under-represented in the scientific evidence underpinning injury prevention. Across the more than 650 studies synthesised in the Female, woman and girl Athlete Injury pRevention (FAIR) consensus,2–7 fewer than 40% included female/woman/girl-specific data, and most failed to disaggregate female/woman/girl data from male/man/boy data. Also limited were data on female/woman/girl-specific injuries (eg, breast injuries) and considerations (eg, menstrual cycle, pregnancy-related and menopause experiences). These omissions result in a vicious cycle; under-representation limits understanding, which limits understanding evidence gaps, which limits justification and opportunities for funding, which perpetuates under-representation—ultimately undermining the health of female/woman/girl athletes. Without data, the story of female/woman/girl athlete injury risk is left to the imagination. When evidence is missing, myths fill the gaps: it must be their hips, hormones or fragility . These narratives perpetuate gendered stereotypes that undermine female/woman/girl athletes’ legitimacy, opportunities and performance. They also distract attention from the complex web of sociocultural, environmental and structural factors that shape injury risk6 including inequitable access to performance pathways, under-resourced medical support, ill-fitting equipment, unequal scheduling and a culture that normalises pain and silence. Many factors drive the under-representation of female/woman/girl athletes in research. Historically, injury prevention strategies were typically developed from male/man/boys’ data and systems and supporting infrastructure were built to fund, recruit and support research on male/man/boy athletes. This inertia continues to privilege …","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"28 2 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145441205","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 : 2025-11-04DOI: 10.1136/bjsports-2025-110978
Patrick C Wheeler, Roger Hawkes, Graham Holloway
The British Association of Sport & Exercise Medicine (BASEM) is the UK’s largest multiprofessional membership association. It has about 1200 members within the UK and internationally, spanning graduates and undergraduates from medicine, physiotherapy and many other disciplines. Having started from informal meetings in 1952, BASEM has grown considerably over the last 73 years to become a large international organisation in SEM, running educational training courses and internationally acclaimed annual conferences, being supported financially through its co-ownership of the BJSM since 1996. The journey has not always been smooth, and there have been many challenges to overcome. It has survived many ups and downs over the last 70 years and is now progressing in its journey to form a UK College of Sport, Exercise and Musculoskeletal Medicine with the Faculty of Sport & Exercise Medicine (FSEM), thereby bringing the many benefits of BASEM as a membership association and FSEM as a standard setting body into a single combined organisation, delivering a single, clear voice to support all that it does. Paraphrasing BASEM’s charitable aims,1 the objectives of BASEM are: The formation of a new UK College furthers these objectives and will allow BASEM’s legacy to thrive well in this ever-changing 21st century. Although individuals had worked in sport many decades previously, the origin of the organisation known now as ‘BASEM’ can be traced back to 1952 when the ‘British Association of Sports Medicine’ (BASM) was founded. Its initial members were …
{"title":"Brief history of BASEM: from infancy, through great steps, (some) stumbles, to growth and evolution","authors":"Patrick C Wheeler, Roger Hawkes, Graham Holloway","doi":"10.1136/bjsports-2025-110978","DOIUrl":"https://doi.org/10.1136/bjsports-2025-110978","url":null,"abstract":"The British Association of Sport & Exercise Medicine (BASEM) is the UK’s largest multiprofessional membership association. It has about 1200 members within the UK and internationally, spanning graduates and undergraduates from medicine, physiotherapy and many other disciplines. Having started from informal meetings in 1952, BASEM has grown considerably over the last 73 years to become a large international organisation in SEM, running educational training courses and internationally acclaimed annual conferences, being supported financially through its co-ownership of the BJSM since 1996. The journey has not always been smooth, and there have been many challenges to overcome. It has survived many ups and downs over the last 70 years and is now progressing in its journey to form a UK College of Sport, Exercise and Musculoskeletal Medicine with the Faculty of Sport & Exercise Medicine (FSEM), thereby bringing the many benefits of BASEM as a membership association and FSEM as a standard setting body into a single combined organisation, delivering a single, clear voice to support all that it does. Paraphrasing BASEM’s charitable aims,1 the objectives of BASEM are: The formation of a new UK College furthers these objectives and will allow BASEM’s legacy to thrive well in this ever-changing 21st century. Although individuals had worked in sport many decades previously, the origin of the organisation known now as ‘BASEM’ can be traced back to 1952 when the ‘British Association of Sports Medicine’ (BASM) was founded. Its initial members were …","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"1 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145441202","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 : 2025-11-04DOI: 10.1136/bjsports-2025-109904
Brooke E Patterson, Carly D McKay, Meghan L Critchley, Destiny Lutz, Sallie M Cowan, Nicholas Kolesky, Vanda White, Allison M Ezzat, Andrew G Ross, William M Adams, Eva Ageberg, Clare L Ardern, Marelise Badenhorst, Molly Coventry, Marc-Olivier Dubé, Stacey Emmonds, Libby J Gracias, K. Alix Hayden, Hanna Lindblom, Merete Møller, Christine Holm Moseid, Nancy Harrington (Quinn), Dai Sugimoto, Evert Verhagen, Kate K Yung, Phathokuhle C Zondi, Carolyn A Emery, Kay M Crossley, Oluwatoyosi B A Owoeye
Objective To synthesise evidence related to the dissemination and implementation (D&I) of injury prevention interventions for female, woman and/or girl (female/woman/girl) athletes. Design Scoping review. Data sources MEDLINE, APA PsycInfo, Cochrane Databases for Systematic Review, Cochrane Central Register for Controlled Trials Registry, EMBASE, CINAHL, SPORTDiscus, ERIC, ProQuest Dissertation and Theses Global. Eligibility Primary research including ≥25% female/woman/girl athletes of any age or people working with them (eg, coaches), participating in sports competition and/or performance, were eligible. Papers reporting D&I outcomes (eg, coach knowledge, adoption and maintenance) related to an injury prevention intervention and/or a factor (eg, coach beliefs) associated with D&I outcomes were included. Results 220 papers with 419 494 participants (96 790 athletes (49% female/woman/girl), 277 923 coaches (59% working with females/women/girls) and 44 781 others) across 81 sports were included. 89% of the papers were from Europe, Oceania and North America. Papers included amateur (n=175), sub-elite (n=10), elite (n=63) and Para sport (n=2) athletes. Interventions were training strategies (n=113), personal protective equipment (PPE, n=41), policy/rules/laws (n=5) or other (n=61, eg, multimodal). There were >650 D&I outcomes; adoption was the most common, followed by athlete and coach perceptions and attitudes about injury prevention. Key facilitators of D&I were previous injury experience, higher competition levels and positive perceptions and attitudes. Conclusion Most studies on D&I of injury prevention interventions for female/woman/girl athletes were descriptive and related to athletes and coaches. Engaging people across the socio-ecological system (eg, parents, health professionals and administrators) and prioritising under-represented regions, populations and D&I-focused trials may enhance D&I outcomes and ultimately reduce injury risk in female/woman/girl athletes. Data are available upon reasonable request. Data can be made available upon reasonable request to the corresponding author. Please email the corresponding author with a written proposal outlining the specific research aims and analysis plan and why these specific data are needed. A formal data-sharing agreement between institutions will be required.
{"title":"Dissemination and implementation of injury prevention interventions: a scoping review for the Female, woman and girl Athlete Injury pRevention (FAIR) consensus","authors":"Brooke E Patterson, Carly D McKay, Meghan L Critchley, Destiny Lutz, Sallie M Cowan, Nicholas Kolesky, Vanda White, Allison M Ezzat, Andrew G Ross, William M Adams, Eva Ageberg, Clare L Ardern, Marelise Badenhorst, Molly Coventry, Marc-Olivier Dubé, Stacey Emmonds, Libby J Gracias, K. Alix Hayden, Hanna Lindblom, Merete Møller, Christine Holm Moseid, Nancy Harrington (Quinn), Dai Sugimoto, Evert Verhagen, Kate K Yung, Phathokuhle C Zondi, Carolyn A Emery, Kay M Crossley, Oluwatoyosi B A Owoeye","doi":"10.1136/bjsports-2025-109904","DOIUrl":"https://doi.org/10.1136/bjsports-2025-109904","url":null,"abstract":"Objective To synthesise evidence related to the dissemination and implementation (D&I) of injury prevention interventions for female, woman and/or girl (female/woman/girl) athletes. Design Scoping review. Data sources MEDLINE, APA PsycInfo, Cochrane Databases for Systematic Review, Cochrane Central Register for Controlled Trials Registry, EMBASE, CINAHL, SPORTDiscus, ERIC, ProQuest Dissertation and Theses Global. Eligibility Primary research including ≥25% female/woman/girl athletes of any age or people working with them (eg, coaches), participating in sports competition and/or performance, were eligible. Papers reporting D&I outcomes (eg, coach knowledge, adoption and maintenance) related to an injury prevention intervention and/or a factor (eg, coach beliefs) associated with D&I outcomes were included. Results 220 papers with 419 494 participants (96 790 athletes (49% female/woman/girl), 277 923 coaches (59% working with females/women/girls) and 44 781 others) across 81 sports were included. 89% of the papers were from Europe, Oceania and North America. Papers included amateur (n=175), sub-elite (n=10), elite (n=63) and Para sport (n=2) athletes. Interventions were training strategies (n=113), personal protective equipment (PPE, n=41), policy/rules/laws (n=5) or other (n=61, eg, multimodal). There were >650 D&I outcomes; adoption was the most common, followed by athlete and coach perceptions and attitudes about injury prevention. Key facilitators of D&I were previous injury experience, higher competition levels and positive perceptions and attitudes. Conclusion Most studies on D&I of injury prevention interventions for female/woman/girl athletes were descriptive and related to athletes and coaches. Engaging people across the socio-ecological system (eg, parents, health professionals and administrators) and prioritising under-represented regions, populations and D&I-focused trials may enhance D&I outcomes and ultimately reduce injury risk in female/woman/girl athletes. Data are available upon reasonable request. Data can be made available upon reasonable request to the corresponding author. Please email the corresponding author with a written proposal outlining the specific research aims and analysis plan and why these specific data are needed. A formal data-sharing agreement between institutions will be required.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"18 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145441186","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 : 2025-11-04DOI: 10.1136/bjsports-2025-110067
Nicholas Kuzik, Veronik Sicard, Mark S Tremblay, Adrienne Davis, Gurinder Sangha, Keith Owen Yeates, Roger Zemek, Andrée-Anne Ledoux
Objective Optimal balances of sedentary behaviour, physical activity and sleep (collectively termed movement behaviours) for concussion management remain unknown. We sought to determine the optimal daily distribution of movement behaviours for reducing postconcussion symptom burden in children and adolescents. Methods This secondary analysis of the Paediatric Concussion Assessment of Rest and Exertion (PedCARE) study included participants aged 10 to <18 years with an acute concussion (>48 hours of presenting to emergency department). Health and Behaviour Inventory (HBI) concussion symptoms were measured at a 2-week post-emergency department follow-up. Persisting symptoms after concussion (PSAC) were classified through reliable change in total HBI scores. Movement behaviours were measured with accelerometers over 13 days. For each day of movement behaviours, compositional regression models were built to determine the optimal daily movement behaviours for predicting HBI scores and PSAC probability. Results Analyses included 259 participants (45% female, mean age 13.3 years). Compared with the average, movement behaviours associated with optimal postconcussion outcomes followed a trend of initially more rest (eg, day 2: 11.5 (95% CI 8.8 to 12.7) hours/day of sleep and 8.5 (95% CI 6.5 to 11.3) hours/day sedentary). Optimal patterns also included above-average moderate-to-vigorous physical activity across the 13 days (eg, days 2, 7, 13:0.6 (95% CI 0.2 to 1.2), 1.5 (95% CI 1.2 to 1.7), 1.1 (95% CI 0.2 to 1.7) hours/day, respectively), with increased light physical activity emerging as optimal later in recovery (eg, day 10:5.5 (95% CI 5.0 to 5.8) hours/day). Conclusions This is the first study to use compositional data analyses to identify an optimal distribution of movement behaviours for concussion symptom recovery in children and adolescents. Our results can inform concussion management protocols that balance rest and activity throughout recovery. Data are available on reasonable request.
目的脑震荡治疗中久坐行为、身体活动和睡眠（统称为运动行为）的最佳平衡尚不清楚。我们试图确定运动行为的最佳日常分布，以减少儿童和青少年脑震荡后症状负担。方法：对儿童脑震荡休息和运动评估（PedCARE）研究的二次分析纳入了到急诊室就诊10至48小时的参与者。健康和行为量表（HBI）脑震荡症状在急诊科随访2周后测量。通过HBI总分的可靠变化对脑震荡后持续症状（PSAC）进行分类。在13天内用加速度计测量运动行为。对于每天的运动行为，构建组合回归模型，以确定预测HBI评分和PSAC概率的最佳每日运动行为。结果纳入259名参与者（女性45%，平均年龄13.3岁）。与平均值相比，与最佳脑震荡后结果相关的运动行为遵循最初更多休息的趋势（例如，第2天：每天11.5 （95% CI 8.8至12.7）小时睡眠和8.5 （95% CI 6.5至11.3）小时久坐）。最佳模式还包括在13天内（例如，第2天、第7天、第13:6 .6 （95% CI 0.2至1.2）、第1.5 （95% CI 1.2至1.7）、第1.1 （95% CI 0.2至1.7）小时/天）进行高于平均水平的中度至剧烈体育活动，在恢复后期（例如，第10:5.5 （95% CI 5.0至5.8）小时/天）增加轻度体育活动是最佳的。结论：这是第一个使用成分数据分析来确定儿童和青少年脑震荡症状恢复的最佳运动行为分布的研究。我们的结果可以为脑震荡的管理方案提供信息，在恢复过程中平衡休息和活动。如有合理要求，可提供资料。
{"title":"Optimal movement behaviours for postconcussion symptom recovery in children and adolescents: a compositional analysis of the PedCARE cohort","authors":"Nicholas Kuzik, Veronik Sicard, Mark S Tremblay, Adrienne Davis, Gurinder Sangha, Keith Owen Yeates, Roger Zemek, Andrée-Anne Ledoux","doi":"10.1136/bjsports-2025-110067","DOIUrl":"https://doi.org/10.1136/bjsports-2025-110067","url":null,"abstract":"Objective Optimal balances of sedentary behaviour, physical activity and sleep (collectively termed movement behaviours) for concussion management remain unknown. We sought to determine the optimal daily distribution of movement behaviours for reducing postconcussion symptom burden in children and adolescents. Methods This secondary analysis of the Paediatric Concussion Assessment of Rest and Exertion (PedCARE) study included participants aged 10 to <18 years with an acute concussion (>48 hours of presenting to emergency department). Health and Behaviour Inventory (HBI) concussion symptoms were measured at a 2-week post-emergency department follow-up. Persisting symptoms after concussion (PSAC) were classified through reliable change in total HBI scores. Movement behaviours were measured with accelerometers over 13 days. For each day of movement behaviours, compositional regression models were built to determine the optimal daily movement behaviours for predicting HBI scores and PSAC probability. Results Analyses included 259 participants (45% female, mean age 13.3 years). Compared with the average, movement behaviours associated with optimal postconcussion outcomes followed a trend of initially more rest (eg, day 2: 11.5 (95% CI 8.8 to 12.7) hours/day of sleep and 8.5 (95% CI 6.5 to 11.3) hours/day sedentary). Optimal patterns also included above-average moderate-to-vigorous physical activity across the 13 days (eg, days 2, 7, 13:0.6 (95% CI 0.2 to 1.2), 1.5 (95% CI 1.2 to 1.7), 1.1 (95% CI 0.2 to 1.7) hours/day, respectively), with increased light physical activity emerging as optimal later in recovery (eg, day 10:5.5 (95% CI 5.0 to 5.8) hours/day). Conclusions This is the first study to use compositional data analyses to identify an optimal distribution of movement behaviours for concussion symptom recovery in children and adolescents. Our results can inform concussion management protocols that balance rest and activity throughout recovery. Data are available on reasonable request.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"29 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145441201","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 : 2025-10-29DOI: 10.1136/bjsports-2025-110371
Chit K Leung, Angus P Yu, Joshua DK Bernal, Francesco Recchia, Daniel YT Fong, Stephen HS Wong, Derwin KC Chan, Catherine M Capio, Clare CW Yu, Sam WS Wong, Cindy HP Sit, Calvin P Cheng, Ya-Jun Chen, Walter R Thompson, Parco M Siu
Importance Aerobic exercise is an evidence-based treatment for depression. However, current exercise recommendations do not account for the limited functional capacity of patients with chronic illness and comorbid depression. Consequently, these recommendations risk being inappropriate and having low therapeutic application in this population. Objective To examine the dose-response relationship between aerobic exercise volume and the severity of depressive symptoms, and to determine the exercise volume needed to alleviate depressive symptoms to the minimally important difference (MID) threshold in patients with chronic illness and comorbid depression. Data sources We searched four databases (PubMed, Embase, Web of Science and PsycINFO) for randomised controlled trials published between database inception and May 2025, without language restrictions. Study selection We included studies that compared the effects of aerobic exercise interventions with passive controls on depressive symptoms in adults with chronic illness and comorbid depression. Data extraction and synthesis Data extraction was performed independently by two reviewers using a standardised form. A random-effects meta-analysis was employed to calculate the pooled estimate (Hedges’ g) and the 95% CI. Meta-regression was conducted to determine the dose-response relationship between aerobic exercise volume and the severity of depressive symptoms. Main outcome and measure The prespecified primary outcome was depressive symptoms and was assessed using validated depression rating scales. Results 36 randomised controlled trials involving 2500 patients were included. Aerobic exercise compared with passive controls reduced the severity of depressive symptoms in patients with chronic illness and comorbid depression (Hedges’ g: −0.73, 95% CI −0.99 to –0.46, p<0.001, I2=81%). Additionally, aerobic exercise had a dose-response effect of −0.01 (95% CI −0.016 to –0.002, p=0.014) per 10 metabolic equivalent of task minutes per week (MET-min/week) on the severity of depressive symptoms. A weekly volume of 405 MET-min/week was found to alleviate depressive symptoms to an extent perceived as important (MID) by patients with chronic illness and comorbid depression. Conclusions and relevance This study presents a dose-response relationship between aerobic exercise volume and the severity of depressive symptoms, suggesting that minimal volumes of aerobic exercise can confer improvements. Importantly, it informs stakeholders that achieving the WHO recommendation of 450 MET-min/week is not mandatory to elicit improvements in depressive symptoms. These findings underscore that irrespective of the functional capacity of patients with chronic illness and comorbid depression, aerobic exercise remains a viable strategy to manage their depressive symptoms. PROSPERO registration number CRD42021282103. Data are available upon reasonable request.
有氧运动是一种循证治疗抑郁症的方法。然而，目前的运动建议并没有考虑到慢性疾病和共病抑郁症患者的有限功能。因此，这些建议可能是不合适的，并且在这一人群中具有较低的治疗应用。目的探讨有氧运动量与抑郁症状严重程度的量效关系，确定慢性疾病伴发抑郁症患者将抑郁症状缓解至最小重要差异（MID）阈值所需的运动量。我们检索了四个数据库（PubMed, Embase， Web of Science和PsycINFO），检索了数据库建立至2025年5月期间发表的随机对照试验，没有语言限制。研究选择我们纳入了比较有氧运动干预和被动控制对慢性疾病和共病抑郁症成人抑郁症状影响的研究。数据提取和综合数据提取由两名审稿人使用标准化表格独立完成。采用随机效应荟萃分析计算汇总估计值（Hedges ' g）和95% CI。进行meta回归以确定有氧运动量与抑郁症状严重程度之间的剂量-反应关系。主要结局和测量预先指定的主要结局是抑郁症状，并使用有效的抑郁评定量表进行评估。结果纳入36项随机对照试验，涉及2500例患者。与被动对照组相比，有氧运动降低了慢性疾病和共病抑郁症患者抑郁症状的严重程度（Hedges ' g: - 0.73, 95% CI: - 0.99至-0.46,p<0.001, I2=81%）。此外，有氧运动对抑郁症状严重程度的剂量反应效应为- 0.01 （95% CI - 0.016至-0.002,p=0.014）每10代谢当量每周任务分钟（MET-min/week）。研究发现，405 MET-min/周的周量可在慢性疾病和共病抑郁症患者认为重要（MID）的程度上缓解抑郁症状。结论和相关性本研究提出了有氧运动量与抑郁症状严重程度之间的剂量-反应关系，提示少量的有氧运动量可以改善抑郁症状。重要的是，它告知利益攸关方，达到世卫组织建议的每周450 MET-min并非强制要求改善抑郁症状。这些发现强调，无论患有慢性疾病和共病抑郁症的患者的功能能力如何，有氧运动仍然是控制其抑郁症状的可行策略。普洛斯彼罗注册号CRD42021282103。如有合理要求，可提供资料。
{"title":"Dose-response effects of aerobic exercise on reducing depression in patients with chronic illness and comorbid depression: a systematic review and meta-analysis","authors":"Chit K Leung, Angus P Yu, Joshua DK Bernal, Francesco Recchia, Daniel YT Fong, Stephen HS Wong, Derwin KC Chan, Catherine M Capio, Clare CW Yu, Sam WS Wong, Cindy HP Sit, Calvin P Cheng, Ya-Jun Chen, Walter R Thompson, Parco M Siu","doi":"10.1136/bjsports-2025-110371","DOIUrl":"https://doi.org/10.1136/bjsports-2025-110371","url":null,"abstract":"Importance Aerobic exercise is an evidence-based treatment for depression. However, current exercise recommendations do not account for the limited functional capacity of patients with chronic illness and comorbid depression. Consequently, these recommendations risk being inappropriate and having low therapeutic application in this population. Objective To examine the dose-response relationship between aerobic exercise volume and the severity of depressive symptoms, and to determine the exercise volume needed to alleviate depressive symptoms to the minimally important difference (MID) threshold in patients with chronic illness and comorbid depression. Data sources We searched four databases (PubMed, Embase, Web of Science and PsycINFO) for randomised controlled trials published between database inception and May 2025, without language restrictions. Study selection We included studies that compared the effects of aerobic exercise interventions with passive controls on depressive symptoms in adults with chronic illness and comorbid depression. Data extraction and synthesis Data extraction was performed independently by two reviewers using a standardised form. A random-effects meta-analysis was employed to calculate the pooled estimate (Hedges’ g) and the 95% CI. Meta-regression was conducted to determine the dose-response relationship between aerobic exercise volume and the severity of depressive symptoms. Main outcome and measure The prespecified primary outcome was depressive symptoms and was assessed using validated depression rating scales. Results 36 randomised controlled trials involving 2500 patients were included. Aerobic exercise compared with passive controls reduced the severity of depressive symptoms in patients with chronic illness and comorbid depression (Hedges’ g: −0.73, 95% CI −0.99 to –0.46, p<0.001, I2=81%). Additionally, aerobic exercise had a dose-response effect of −0.01 (95% CI −0.016 to –0.002, p=0.014) per 10 metabolic equivalent of task minutes per week (MET-min/week) on the severity of depressive symptoms. A weekly volume of 405 MET-min/week was found to alleviate depressive symptoms to an extent perceived as important (MID) by patients with chronic illness and comorbid depression. Conclusions and relevance This study presents a dose-response relationship between aerobic exercise volume and the severity of depressive symptoms, suggesting that minimal volumes of aerobic exercise can confer improvements. Importantly, it informs stakeholders that achieving the WHO recommendation of 450 MET-min/week is not mandatory to elicit improvements in depressive symptoms. These findings underscore that irrespective of the functional capacity of patients with chronic illness and comorbid depression, aerobic exercise remains a viable strategy to manage their depressive symptoms. PROSPERO registration number CRD42021282103. Data are available upon reasonable request.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"160 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145396869","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 : 2025-10-28DOI: 10.1136/bjsports-2025-110988
Christopher MacDonald,Mia Bennekou,Julie Midtgaard,Henning Langberg,Daniel E Lieberman
{"title":"Clarifying the real challenge: adherence, not efficacy, is the barrier to exercise as medicine.","authors":"Christopher MacDonald,Mia Bennekou,Julie Midtgaard,Henning Langberg,Daniel E Lieberman","doi":"10.1136/bjsports-2025-110988","DOIUrl":"https://doi.org/10.1136/bjsports-2025-110988","url":null,"abstract":"","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"150 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145380786","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 : 2025-10-28DOI: 10.1136/bjsports-2025-109892
Roberto Luis Zagury,Fabrício Braga
{"title":"Exercise: the ugly duckling of diabetes treatment?","authors":"Roberto Luis Zagury,Fabrício Braga","doi":"10.1136/bjsports-2025-109892","DOIUrl":"https://doi.org/10.1136/bjsports-2025-109892","url":null,"abstract":"","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"59 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145380779","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 : 2025-10-28DOI: 10.1136/bjsports-2025-111034
Emily E Heming, Stephen W West, Brooke Patterson, Garrett S Bullock, Tara-Leigh McHugh, Isla J Shill, Andrea M Bruder, Ash T Kolstad, Carly D McKay, Merete Møller, Kay M Crossley, Carolyn A Emery
Girls’ participation in sport is rising globally.1 2 Despite the immediate and long-term benefits of sport,3 injury rates in girls are some of the highest reported.4 5 Empirical evidence to support sport-related injury prevention efforts among girls is limited, particularly research that guides evidence-informed policies and programmes.6 Existing solutions are often based on boy-specific or combined data across all genders and sexes, with insufficient reporting of gender and sex.6 In the Female, woman and/or girl Athlete Injury pRevention (FAIR) Consensus, injury prevention, implementation and related practical recommendations are proposed.6 However, only 38% of the papers that informed the Consensus reported female, woman and/or girl disaggregated data, with even fewer studies specific to only female/girl athletes. This limited evidence underscores the urgent need for our research community to better support females/girls as developing athletes. It is not enough to translate evidence from boy, male and woman athletes for girls participating in sport. This editorial encourages a call to action to prioritise the development, investigation, implementation and evaluation of injury prevention strategies (eg, policy/rules/laws, personal protective equipment (PPE), training, secondary prevention (ie, strategies to reduce risk of recurrent injuries or complications following initial injury)) that are tailored specifically for female and girl athletes.7 8 Biological and developmental differences shape injury risk and, therefore, should influence mitigation strategies. During puberty, sex differences in growth, size, body composition and physical characteristics create periods of increased vulnerability, while variation in maturation influences physical readiness for sport.9 Psychological development (eg, cognition, emotional regulation and identity formation) also shapes how girls experience training and competition.9 Designing prevention programmes that account for these developmental changes is critical (eg, mouthguards specifically designed for female/girl athletes). Sociocultural gender differences further influence participation and …
{"title":"Raising girls in sport: unique considerations for injury prevention","authors":"Emily E Heming, Stephen W West, Brooke Patterson, Garrett S Bullock, Tara-Leigh McHugh, Isla J Shill, Andrea M Bruder, Ash T Kolstad, Carly D McKay, Merete Møller, Kay M Crossley, Carolyn A Emery","doi":"10.1136/bjsports-2025-111034","DOIUrl":"https://doi.org/10.1136/bjsports-2025-111034","url":null,"abstract":"Girls’ participation in sport is rising globally.1 2 Despite the immediate and long-term benefits of sport,3 injury rates in girls are some of the highest reported.4 5 Empirical evidence to support sport-related injury prevention efforts among girls is limited, particularly research that guides evidence-informed policies and programmes.6 Existing solutions are often based on boy-specific or combined data across all genders and sexes, with insufficient reporting of gender and sex.6 In the Female, woman and/or girl Athlete Injury pRevention (FAIR) Consensus, injury prevention, implementation and related practical recommendations are proposed.6 However, only 38% of the papers that informed the Consensus reported female, woman and/or girl disaggregated data, with even fewer studies specific to only female/girl athletes. This limited evidence underscores the urgent need for our research community to better support females/girls as developing athletes. It is not enough to translate evidence from boy, male and woman athletes for girls participating in sport. This editorial encourages a call to action to prioritise the development, investigation, implementation and evaluation of injury prevention strategies (eg, policy/rules/laws, personal protective equipment (PPE), training, secondary prevention (ie, strategies to reduce risk of recurrent injuries or complications following initial injury)) that are tailored specifically for female and girl athletes.7 8 Biological and developmental differences shape injury risk and, therefore, should influence mitigation strategies. During puberty, sex differences in growth, size, body composition and physical characteristics create periods of increased vulnerability, while variation in maturation influences physical readiness for sport.9 Psychological development (eg, cognition, emotional regulation and identity formation) also shapes how girls experience training and competition.9 Designing prevention programmes that account for these developmental changes is critical (eg, mouthguards specifically designed for female/girl athletes). Sociocultural gender differences further influence participation and …","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"59 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145381661","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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