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 Data source Published and unpublished cohort study data.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":"68 1","pages":""},"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}
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":"8 1","pages":""},"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":" ","pages":"1083-1086"},"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":" ","pages":"1089-1090"},"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}
Pub Date : 2024-09-09DOI: 10.1136/bjsports-2024-108131
Harry A Brown, Samuel Chalmers, Thomas H Topham, Brad Clark, Andrew Jowett, Tim Meyer, Ollie Jay, Julien D Périard
Objective: To evaluate the efficacy of the Fédération Internationale de Football Association (FIFA) cooling break policy against alternative cooling configurations in attenuating thermal strain during simulated football in the heat.
Methods: 12 males (age: 27±6 years, V̇O2peak: 61±7 mL/kg/min) completed five 90 min intermittent treadmill football match simulations in 40°C and 41% relative humidity (32°C wet-bulb globe temperature) with different cooling configurations: regular match without cooling breaks (REG), 3 min breaks without cooling (BRKno-cool), 3 min breaks with cooling (BRKcool: current FIFA policy; chilled fluid ingestion and ice towel across neck and shoulders), 5 min extended half-time without cooling breaks (ExtHTonly) and 3 min cooling breaks with 5 min ExtHT (ExtHTcool). Rectal temperature (Tre), heart rate, whole-body sweat rate (WBSR) and rating of perceived exertion (RPE) were recorded. Data are presented as mean (95% CIs).
Results: Final Tre was lower in BRKno-cool (0.20°C (0.01, 0.39), p=0.038), BRKcool (0.39°C (0.21, 0.57), p<0.001) and ExtHTcool (0.40°C (0.22, 0.58), p<0.001) than REG (39.1°C (38.8, 39.3)). Mean Tre was lower in ExtHTcool (38.2°C (38.0, 38.4)) than BRKcool (38.3°C (38.1, 38.5), p=0.018), BRKno-cool and ExtHTonly (38.4°C (38.2, 38.6), p<0.001) and REG (38.5°C (38.3, 38.7), p<0.001). Mean heart rate was lower during BRKcool (6 beats/min (4, 7), p<0.001) and ExtHTcool (7 beats/min (6, 8), p<0.001) compared with REG. WBSR was comparable across trials (p≥0.07) and RPE was attenuated during BRKcool (0.4 (0.1, 0.7), p=0.004) and ExtHTcool (0.5 (0.2, 0.7), p=0.002), compared with REG.
Conclusion: BRKcool and ExtHTcool attenuated thermal, cardiovascular and perceptual strain during a simulated football match in the heat. Additional strategies may be required in field settings or under harsher conditions.
{"title":"Efficacy of the FIFA cooling break heat policy during an intermittent treadmill football simulation in hot conditions in trained males.","authors":"Harry A Brown, Samuel Chalmers, Thomas H Topham, Brad Clark, Andrew Jowett, Tim Meyer, Ollie Jay, Julien D Périard","doi":"10.1136/bjsports-2024-108131","DOIUrl":"10.1136/bjsports-2024-108131","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy of the Fédération Internationale de Football Association (FIFA) cooling break policy against alternative cooling configurations in attenuating thermal strain during simulated football in the heat.</p><p><strong>Methods: </strong>12 males (age: 27±6 years, V̇O<sub>2peak</sub>: 61±7 mL/kg/min) completed five 90 min intermittent treadmill football match simulations in 40°C and 41% relative humidity (32°C wet-bulb globe temperature) with different cooling configurations: regular match without cooling breaks (REG), 3 min breaks without cooling (BRK<sub>no-cool</sub>), 3 min breaks with cooling (BRK<sub>cool</sub>: current FIFA policy; chilled fluid ingestion and ice towel across neck and shoulders), 5 min extended half-time without cooling breaks (ExtHT<sub>only</sub>) and 3 min cooling breaks with 5 min ExtHT (ExtHT<sub>cool</sub>). Rectal temperature (T<sub>re</sub>), heart rate, whole-body sweat rate (WBSR) and rating of perceived exertion (RPE) were recorded. Data are presented as mean (95% CIs).</p><p><strong>Results: </strong>Final T<sub>re</sub> was lower in BRK<sub>no-cool</sub> (0.20°C (0.01, 0.39), p=0.038), BRK<sub>cool</sub> (0.39°C (0.21, 0.57), p<0.001) and ExtHT<sub>cool</sub> (0.40°C (0.22, 0.58), p<0.001) than REG (39.1°C (38.8, 39.3)). Mean T<sub>re</sub> was lower in ExtHT<sub>cool</sub> (38.2°C (38.0, 38.4)) than BRK<sub>cool</sub> (38.3°C (38.1, 38.5), p=0.018), BRK<sub>no-cool</sub> and ExtHT<sub>only</sub> (38.4°C (38.2, 38.6), p<0.001) and REG (38.5°C (38.3, 38.7), p<0.001). Mean heart rate was lower during BRK<sub>cool</sub> (6 beats/min (4, 7), p<0.001) and ExtHT<sub>cool</sub> (7 beats/min (6, 8), p<0.001) compared with REG. WBSR was comparable across trials (p<i>≥</i>0.07) and RPE was attenuated during BRK<sub>cool</sub> (0.4 (0.1, 0.7), p=0.004) and ExtHT<sub>cool</sub> (0.5 (0.2, 0.7), p=0.002), compared with REG.</p><p><strong>Conclusion: </strong>BRK<sub>cool</sub> and ExtHT<sub>cool</sub> attenuated thermal, cardiovascular and perceptual strain during a simulated football match in the heat. Additional strategies may be required in field settings or under harsher conditions.</p>","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":" ","pages":"1044-1051"},"PeriodicalIF":11.6,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141726915","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-2024-108710
David F Hanff, Astrid van Ovost, Bruce B Forster, Adam Weir
A 17-year-old male right-footed footballer presented with a 6-month history of left-sided groin pain which was persistent despite resting for 6 weeks. Pain occurred during running and daily activities including climbing the stairs and turning over in bed. On examination, the cardinal findings were tenderness of the pubic bone near the adductor insertion on the left side and pubic pain during resisted adduction. An initial pelvic radiograph was suboptimal due to overlying bowel gas but did show minor cortical irregularities (arrow, figure 1A) and features of an immature pubic symphysis including non-fused apophysis on the inferior side of the pubic symphysis and lower region joint lines are not yet fully ossified. MRI examination showed features, together with the clinical findings, that are typical for pubic apophysitis. There was bilateral extensive bone marrow oedema of the whole part shown of the pubic symphysis (arrow, figure 1B) on the coronal fat-suppressed sequence. A more focal high fluid signal along the left apophysis was also seen (arrow, figure 1C). Cortical irregularity on the left side with cystic and erosion-like configurations and widening of the pubic symphysis …
{"title":"Pubic apophysitis – an important cause of groin pain in young athletes","authors":"David F Hanff, Astrid van Ovost, Bruce B Forster, Adam Weir","doi":"10.1136/bjsports-2024-108710","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108710","url":null,"abstract":"A 17-year-old male right-footed footballer presented with a 6-month history of left-sided groin pain which was persistent despite resting for 6 weeks. Pain occurred during running and daily activities including climbing the stairs and turning over in bed. On examination, the cardinal findings were tenderness of the pubic bone near the adductor insertion on the left side and pubic pain during resisted adduction. An initial pelvic radiograph was suboptimal due to overlying bowel gas but did show minor cortical irregularities (arrow, figure 1A) and features of an immature pubic symphysis including non-fused apophysis on the inferior side of the pubic symphysis and lower region joint lines are not yet fully ossified. MRI examination showed features, together with the clinical findings, that are typical for pubic apophysitis. There was bilateral extensive bone marrow oedema of the whole part shown of the pubic symphysis (arrow, figure 1B) on the coronal fat-suppressed sequence. A more focal high fluid signal along the left apophysis was also seen (arrow, figure 1C). Cortical irregularity on the left side with cystic and erosion-like configurations and widening of the pubic symphysis …","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"32 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142160542","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-2023-108043
Paul D Kirwan, Trevor Duffy, Helen P French
Objectives: To investigate if daily treatment with glyceryl trinitrate (GTN) ointment, over 24 weeks combined with a 12-week eccentric exercise programme is more effective for chronic mid-portion Achilles tendinopathy than placebo ointment and eccentric exercise.
Methods: This was a single-site randomised double-blind placebo-controlled trial at an acute hospital, Dublin, Ireland. Patients with chronic mid-portion Achilles tendinopathy were randomised to either 24 weeks of daily GTN ointment or placebo ointment. Both groups received an identical 12-week eccentric exercise programme. The primary outcome measure was the Victorian Institute of Sport Assessment-Achilles (VISA-A) questionnaire at 24 weeks, which measures pain, function and activity. Secondary outcomes included pain severity, self-reported physical function, calf muscle function, pressure pain thresholds and ultrasound changes. Statistical analyses were performed according to intention-to-treat principles.
Results: 76 patients (30 women; 46 men, mean age±SD, 45.6±8.2 years) were recruited for the trial. Significant improvements in VISA-A scores occurred in both groups at 6-week, 12-week and 24-week follow-up. The increase was not significantly different between groups, adjusted mean between-group difference from baseline to week 6, -1.33 (95% CI -6.96 to 4.31); week 12, -1.25 (95% CI -8.0 to 5.49) and week 24, -3.8 (95% CI -10.6 to 3.0); negative values favour GTN. There was no significant between-group difference in any of the secondary outcome measures at 6, 12 and 24 weeks.
Conclusions: Adding daily GTN ointment over 24 weeks to a 12-week eccentric exercise programme did not improve pain, function and activity level in patients with chronic mid-portion Achilles tendinopathy when compared with placebo ointment.
研究目的研究每日使用三硝酸甘油酯（GTN）软膏治疗 24 周，并结合为期 12 周的偏心运动计划是否比安慰剂软膏和偏心运动对慢性中段跟腱病更有效：这是一项在爱尔兰都柏林一家急症医院进行的单点随机双盲安慰剂对照试验。慢性跟腱中段病变患者被随机分配到每天使用GTN软膏或安慰剂软膏24周的治疗组。两组患者均接受为期 12 周的相同偏心运动计划。主要结果是在24周时进行的维多利亚体育研究所跟腱评估（VISA-A）问卷调查，该问卷调查用于测量疼痛、功能和活动。次要结果包括疼痛严重程度、自我报告的身体功能、小腿肌肉功能、压痛阈值和超声波变化。统计分析按照意向治疗原则进行：试验共招募了 76 名患者（30 名女性；46 名男性，平均年龄（±SD）为 45.6±8.2 岁）。在 6 周、12 周和 24 周的随访中，两组患者的 VISA-A 评分均有显著改善。从基线到第6周，调整后的组间平均差异为-1.33（95% CI -6.96至4.31）；第12周为-1.25（95% CI -8.0至5.49）；第24周为-3.8（95% CI -10.6至3.0）；负值有利于GTN。在6周、12周和24周的次要结果测量中，组间差异均不明显：结论：与安慰剂软膏相比，在为期12周的偏心运动计划中添加24周的每日GTN软膏并不能改善慢性跟腱中段病变患者的疼痛、功能和活动水平。
{"title":"Topical glyceryl trinitrate (GTN) and eccentric exercises in the treatment of mid-portion achilles tendinopathy (the NEAT trial): a randomised double-blind placebo-controlled trial.","authors":"Paul D Kirwan, Trevor Duffy, Helen P French","doi":"10.1136/bjsports-2023-108043","DOIUrl":"10.1136/bjsports-2023-108043","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate if daily treatment with glyceryl trinitrate (GTN) ointment, over 24 weeks combined with a 12-week eccentric exercise programme is more effective for chronic mid-portion Achilles tendinopathy than placebo ointment and eccentric exercise.</p><p><strong>Methods: </strong>This was a single-site randomised double-blind placebo-controlled trial at an acute hospital, Dublin, Ireland. Patients with chronic mid-portion Achilles tendinopathy were randomised to either 24 weeks of daily GTN ointment or placebo ointment. Both groups received an identical 12-week eccentric exercise programme. The primary outcome measure was the Victorian Institute of Sport Assessment-Achilles (VISA-A) questionnaire at 24 weeks, which measures pain, function and activity. Secondary outcomes included pain severity, self-reported physical function, calf muscle function, pressure pain thresholds and ultrasound changes. Statistical analyses were performed according to intention-to-treat principles.</p><p><strong>Results: </strong>76 patients (30 women; 46 men, mean age±SD, 45.6±8.2 years) were recruited for the trial. Significant improvements in VISA-A scores occurred in both groups at 6-week, 12-week and 24-week follow-up. The increase was not significantly different between groups, adjusted mean between-group difference from baseline to week 6, -1.33 (95% CI -6.96 to 4.31); week 12, -1.25 (95% CI -8.0 to 5.49) and week 24, -3.8 (95% CI -10.6 to 3.0); negative values favour GTN. There was no significant between-group difference in any of the secondary outcome measures at 6, 12 and 24 weeks.</p><p><strong>Conclusions: </strong>Adding daily GTN ointment over 24 weeks to a 12-week eccentric exercise programme did not improve pain, function and activity level in patients with chronic mid-portion Achilles tendinopathy when compared with placebo ointment.</p>","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":" ","pages":"1035-1043"},"PeriodicalIF":11.6,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11420712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141626035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-09DOI: 10.1136/bjsports-2024-108090
Kate N Jochimsen, Jeffrey G Caron, Ana-Maria Vranceanu, Jonathan Greenberg
{"title":"Why psychological factors are still being sidelined in sport-related concussion treatment and what we can do about it.","authors":"Kate N Jochimsen, Jeffrey G Caron, Ana-Maria Vranceanu, Jonathan Greenberg","doi":"10.1136/bjsports-2024-108090","DOIUrl":"10.1136/bjsports-2024-108090","url":null,"abstract":"","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":" ","pages":"1032-1034"},"PeriodicalIF":11.6,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11384183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141859069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-09DOI: 10.1136/bjsports-2024-108539
James H Hull, Martin Schwellnus, Maarit Valtonen
{"title":"Point-of-care testing to detect respiratory infections in athletes: what is the role?","authors":"James H Hull, Martin Schwellnus, Maarit Valtonen","doi":"10.1136/bjsports-2024-108539","DOIUrl":"10.1136/bjsports-2024-108539","url":null,"abstract":"","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":" ","pages":"1030-1032"},"PeriodicalIF":11.6,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141757208","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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