Pub Date : 2024-11-28DOI: 10.1136/bjsports-2023-107532
Maddy Sheppard-Perkins, Lindsay Bradley, Sarah Beaudry, Francine Darroch
{"title":"Someone in their corner: trauma- and violence-informed approaches to disclosures of maltreatment in sport.","authors":"Maddy Sheppard-Perkins, Lindsay Bradley, Sarah Beaudry, Francine Darroch","doi":"10.1136/bjsports-2023-107532","DOIUrl":"10.1136/bjsports-2023-107532","url":null,"abstract":"","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":" ","pages":"1311-1312"},"PeriodicalIF":11.6,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142008292","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 : 2024-11-26DOI: 10.1136/bjsports-2023-107712
Antony Palmer, Scott Fernquest, Ines Rombach, Alice Harin, Ramy Mansour, Susan Dutton, H Paul Dijkstra, Tony Andrade, Sion Glyn-Jones
Objective To report a 3-year follow-up from the FemoroAcetabular Impingement Trial, comparing arthroscopic surgery with physiotherapy in the management of femoroacetabular impingement (FAI) syndrome for the dual primary outcomes of radiographic hip osteoarthritis (OA) and patient-reported outcome measures of activities of daily living. Methods Two-group parallel, assessor-blinded, pragmatic randomised controlled trial across seven sites. 222 participants aged 18–60 years with FAI syndrome confirmed clinically and radiologically were randomised (1:1) to receive arthroscopic hip surgery (n=112) or physiotherapy (n=110). Dual primary outcome measure was minimum joint space width (mJSW) on anteroposterior radiograph at 38 months post-randomisation and Hip Outcome Score ADL (HOS ADL) (higher score indicates superior outcomes). Secondary outcome measures were Scoring Hip Osteoarthritis with MRI (SHOMRI) (lower score indicates less pathology). Results mJSW, HOS ADL and MRI data were available for 45%, 77% and 62% of participants at 38 months, respectively. No significant difference in mJSW was seen between groups at 38 months. HOS ADL was higher in the arthroscopy group (mean (SD) 84.2 (17.4)) compared with the physiotherapy group (74.2 (21.9)), difference 8.9 (95% CI 7.0, 10.8)). SHOMRI score total at 38 months was lower in the arthroscopy group (mean (SD) 9.22 (11.43)) compared with the physiotherapy group (22.76 (15.26)), differences (95% CIs) −15.94 (–18.69, –13.19). Conclusions No difference was seen between groups on radiographic measures of OA progression. Patients with FAI syndrome treated surgically may experience superior pain and function outcomes, and less MRI-measured cartilage damage compared with physiotherapy. Trial registration number [NCT01893034][1]. Data are available upon reasonable request. Anonymised patient level data can be made available on reasonable request after approval from the trial management committee and after signing a data access agreement. Proposals should be directed to the corresponding author. Consent was not obtained for data sharing but the presented data is anonymised and the risk of identification is low. [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT01893034&atom=%2Fbjsports%2Fearly%2F2024%2F11%2F26%2Fbjsports-2023-107712.atom
{"title":"Medium-term results of arthroscopic hip surgery compared with physiotherapy and activity modification for the treatment of femoroacetabular impingement syndrome: a multi-centre randomised controlled trial","authors":"Antony Palmer, Scott Fernquest, Ines Rombach, Alice Harin, Ramy Mansour, Susan Dutton, H Paul Dijkstra, Tony Andrade, Sion Glyn-Jones","doi":"10.1136/bjsports-2023-107712","DOIUrl":"https://doi.org/10.1136/bjsports-2023-107712","url":null,"abstract":"Objective To report a 3-year follow-up from the FemoroAcetabular Impingement Trial, comparing arthroscopic surgery with physiotherapy in the management of femoroacetabular impingement (FAI) syndrome for the dual primary outcomes of radiographic hip osteoarthritis (OA) and patient-reported outcome measures of activities of daily living. Methods Two-group parallel, assessor-blinded, pragmatic randomised controlled trial across seven sites. 222 participants aged 18–60 years with FAI syndrome confirmed clinically and radiologically were randomised (1:1) to receive arthroscopic hip surgery (n=112) or physiotherapy (n=110). Dual primary outcome measure was minimum joint space width (mJSW) on anteroposterior radiograph at 38 months post-randomisation and Hip Outcome Score ADL (HOS ADL) (higher score indicates superior outcomes). Secondary outcome measures were Scoring Hip Osteoarthritis with MRI (SHOMRI) (lower score indicates less pathology). Results mJSW, HOS ADL and MRI data were available for 45%, 77% and 62% of participants at 38 months, respectively. No significant difference in mJSW was seen between groups at 38 months. HOS ADL was higher in the arthroscopy group (mean (SD) 84.2 (17.4)) compared with the physiotherapy group (74.2 (21.9)), difference 8.9 (95% CI 7.0, 10.8)). SHOMRI score total at 38 months was lower in the arthroscopy group (mean (SD) 9.22 (11.43)) compared with the physiotherapy group (22.76 (15.26)), differences (95% CIs) −15.94 (–18.69, –13.19). Conclusions No difference was seen between groups on radiographic measures of OA progression. Patients with FAI syndrome treated surgically may experience superior pain and function outcomes, and less MRI-measured cartilage damage compared with physiotherapy. Trial registration number [NCT01893034][1]. Data are available upon reasonable request. Anonymised patient level data can be made available on reasonable request after approval from the trial management committee and after signing a data access agreement. Proposals should be directed to the corresponding author. Consent was not obtained for data sharing but the presented data is anonymised and the risk of identification is low. [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT01893034&atom=%2Fbjsports%2Fearly%2F2024%2F11%2F26%2Fbjsports-2023-107712.atom","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"181 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142718402","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 : 2024-11-25DOI: 10.1136/bjsports-2024-108766
Yetsa A Tuakli-Wosornu, Kirsty Burrows, Kari Fasting, Mike Hartill, Ken Hodge, Keith Kaufman, Emma Kavanagh, Sandra L Kirby, Jelena G MacLeod, Margo Mountjoy, Sylvie Parent, Minhyeok Tak, Tine Vertommen, Daniel J A Rhind
Objective Interpersonal violence (IV) in sport is challenging to define, prevent and remedy due to its subjectivity and complexity. The 2024 International Olympic Committee Consensus on Interpersonal Violence and Safeguarding aimed to synthesise evidence on IV and safeguarding in sport, introduce a new conceptual model of IV in sport and offer more accessible safeguarding guidance to all within the sports ecosystem by merging evidence with insights from Olympic athletes. Methods A 15-member expert panel performed a scoping review following Joanna Briggs Institute methodologies. A seminal works-driven approach was used to identify relevant grey literature. Four writing groups were established focusing on: definitions/epidemiology, individual/interpersonal determinants, contextual determinants and solutions. Writing groups developed referenced scientific summaries related to their respective topics, which were discussed by all members at the consensus meeting. Recommendations were then developed by each group, presented as voting statements and circulated for confidential voting following a Delphi protocol with ≥80% agreement defined a priori as reaching consensus. Results Of 48 voting statements, 21 reached consensus during first-round voting. Second-round and third-round voting saw 22 statements reach consensus, 5 statements get discontinued and 2 statements receive minority dissension after failing to reach agreement. A total of 43 statements reached consensus, presented as overarching (n=5) and topical (n=33) consensus recommendations, and actionable consensus guidelines (n=5). Conclusion This evidence review and consensus process elucidated the characterisation and complexity of IV and safeguarding in sport and demonstrates that a whole-of-system approach is needed to fully comprehend and prevent IV. Sport settings that emphasise mutual care, are athlete centred, promote healthy relationships, embed trauma and violence-informed care principles, integrate diverse perspectives and measure IV prevention and response effectiveness will exemplify safe sport. A shared responsibility between all within the sports ecosystem is required to advance effective safeguarding through future research, policy and practice.
{"title":"IOC consensus statement: interpersonal violence and safeguarding in sport","authors":"Yetsa A Tuakli-Wosornu, Kirsty Burrows, Kari Fasting, Mike Hartill, Ken Hodge, Keith Kaufman, Emma Kavanagh, Sandra L Kirby, Jelena G MacLeod, Margo Mountjoy, Sylvie Parent, Minhyeok Tak, Tine Vertommen, Daniel J A Rhind","doi":"10.1136/bjsports-2024-108766","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108766","url":null,"abstract":"Objective Interpersonal violence (IV) in sport is challenging to define, prevent and remedy due to its subjectivity and complexity. The 2024 International Olympic Committee Consensus on Interpersonal Violence and Safeguarding aimed to synthesise evidence on IV and safeguarding in sport, introduce a new conceptual model of IV in sport and offer more accessible safeguarding guidance to all within the sports ecosystem by merging evidence with insights from Olympic athletes. Methods A 15-member expert panel performed a scoping review following Joanna Briggs Institute methodologies. A seminal works-driven approach was used to identify relevant grey literature. Four writing groups were established focusing on: definitions/epidemiology, individual/interpersonal determinants, contextual determinants and solutions. Writing groups developed referenced scientific summaries related to their respective topics, which were discussed by all members at the consensus meeting. Recommendations were then developed by each group, presented as voting statements and circulated for confidential voting following a Delphi protocol with ≥80% agreement defined a priori as reaching consensus. Results Of 48 voting statements, 21 reached consensus during first-round voting. Second-round and third-round voting saw 22 statements reach consensus, 5 statements get discontinued and 2 statements receive minority dissension after failing to reach agreement. A total of 43 statements reached consensus, presented as overarching (n=5) and topical (n=33) consensus recommendations, and actionable consensus guidelines (n=5). Conclusion This evidence review and consensus process elucidated the characterisation and complexity of IV and safeguarding in sport and demonstrates that a whole-of-system approach is needed to fully comprehend and prevent IV. Sport settings that emphasise mutual care, are athlete centred, promote healthy relationships, embed trauma and violence-informed care principles, integrate diverse perspectives and measure IV prevention and response effectiveness will exemplify safe sport. A shared responsibility between all within the sports ecosystem is required to advance effective safeguarding through future research, policy and practice.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"16 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142697083","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 : 2024-11-24DOI: 10.1136/bjsports-2024-109323
Stian Langgård Jørgensen
In this PhD project, we prospectively included 86 patients with knee osteoarthritis (OA) who were scheduled for a total knee arthroplasty (TKA). The project was divided into two phases: Phase 1, compared the relationship between lower limb sit-to-stand power (STS Power) and maximal isometric knee extensor strength (knee extensor maximal isometric voluntary contraction (MVC)), respectively, with objective measures of physical function and patient-reported outcomes. Phase 2, investigated the effectiveness of preoperative low-load blood flow restricted resistance training (BFR-RT) compared with usual preoperative medical care on postoperative measures of physical function, lower limb strength and patient-reported outcomes obtained 3 and 12 months after TKA. The number of TKA procedures due to knee OA is rising globally, with ~20% of the patients perceiving insufficient postoperative outcomes. Moreover, patients undergoing TKA demonstrate a lower level of physical function 1 year postoperatively compared with healthy peers.1 Interestingly, performing preoperative heavy-load resistance strength training (HL-RT) to improve preoperative lower limb strength in patients with knee and hip OA scheduled for joint replacement surgery has demonstrated to enhance postoperative physical function.2 However, a previous study3 reported that about 25% …
在这个博士项目中，我们前瞻性地纳入了 86 名计划接受全膝关节置换术（TKA）的膝关节骨性关节炎（OA）患者。该项目分为两个阶段：第一阶段，比较下肢坐立力量（STS Power）和最大等长膝关节伸肌力量（膝关节伸肌最大等长自主收缩（MVC））分别与身体功能客观测量指标和患者报告结果之间的关系。第二阶段研究了术前低负荷血流限制阻力训练（BFR-RT）与术前常规医疗护理相比，对TKA术后3个月和12个月的身体功能、下肢力量和患者报告结果的影响。在全球范围内，因膝关节 OA 而接受 TKA 手术的人数不断增加，其中约有 20% 的患者认为术后效果不佳。1 有趣的是，对计划接受关节置换手术的膝关节和髋关节 OA 患者进行术前重负荷抗阻力力量训练（HL-RT）以改善术前下肢力量，已被证明可增强术后身体功能。
{"title":"Improving treatment in patients scheduled for total knee arthroplasty: the role of preoperative low-load blood flow restricted resistance training(PhD Academy Award)","authors":"Stian Langgård Jørgensen","doi":"10.1136/bjsports-2024-109323","DOIUrl":"https://doi.org/10.1136/bjsports-2024-109323","url":null,"abstract":"In this PhD project, we prospectively included 86 patients with knee osteoarthritis (OA) who were scheduled for a total knee arthroplasty (TKA). The project was divided into two phases: Phase 1, compared the relationship between lower limb sit-to-stand power (STS Power) and maximal isometric knee extensor strength (knee extensor maximal isometric voluntary contraction (MVC)), respectively, with objective measures of physical function and patient-reported outcomes. Phase 2, investigated the effectiveness of preoperative low-load blood flow restricted resistance training (BFR-RT) compared with usual preoperative medical care on postoperative measures of physical function, lower limb strength and patient-reported outcomes obtained 3 and 12 months after TKA. The number of TKA procedures due to knee OA is rising globally, with ~20% of the patients perceiving insufficient postoperative outcomes. Moreover, patients undergoing TKA demonstrate a lower level of physical function 1 year postoperatively compared with healthy peers.1 Interestingly, performing preoperative heavy-load resistance strength training (HL-RT) to improve preoperative lower limb strength in patients with knee and hip OA scheduled for joint replacement surgery has demonstrated to enhance postoperative physical function.2 However, a previous study3 reported that about 25% …","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"24 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142697082","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 : 2024-11-21DOI: 10.1136/bjsports-2024-108343
Daniel Castellanos Dolk, Henrik Hedevik, Helena Stigson, Per Wretenberg, Joanna Kvist, Anders Stålman
Objective To determine and compare the incidence rate (IR) of anterior cruciate ligament reconstruction (ACL-R) among higher-level athletes across six sports in the Swedish National Knee Ligament Registry (SNKLR). Methods Patient data from the SNKLR, between 2005 and 2020, was linked to team and event data of six sports (football, handball, basketball, ice hockey, floorball and alpine sports) to identify higher-level athletes aged 15–40 with ACL-R. Unadjusted and adjusted IR ratios (IRRs) with 99% CIs were calculated between sports, sex, age and divisions. Results Female athletes had a 3.3 times higher ACL-R IR compared with males (1.08 vs 0.32, IRR=3.33, 99% CI: 2.65 to 4.19) per 1000 athlete exposures (AE). Basketball had the largest difference in ACL-R IR per 1000 AE between females and males (1.26 vs 0.22, IRR=5.69, 99% CI: 2.79 to 11.60). Female second-division athletes had higher ACL-R IR per 1000 AE compared with female highest-division athletes (1.27 vs 0.76, IRR=1.67, 99% CI: 1.30 to 2.15). No significant association between age and IR was observed. Compared with football, lower ACL-R IR was observed in floorball and ice hockey in females, as well as in floorball, basketball and ice hockey in males. Conclusion Female athletes had higher ACL-R IRs than males and second-division female athletes had higher ACL-R IRs than highest-division female athletes. Lower ACL-R IRs were observed in floorball and ice hockey compared with football for both sexes. The remaining sports had ACL-R IRs similar to football, except basketball where rates were lower for male athletes. No data are available.
目的 确定并比较瑞典国家膝关节韧带登记处（SNKLR）中六项运动的高水平运动员前交叉韧带重建（ACL-R）的发病率（IR）。方法 将瑞典国家膝关节韧带登记处 2005 年至 2020 年间的患者数据与六项运动（足球、手球、篮球、冰球、地掷球和高山运动）的团队和赛事数据连接起来，以识别 15-40 岁患有前交叉韧带重建术的高水平运动员。计算了不同运动项目、性别、年龄和组别之间未经调整和调整的内部比率（IRRs）以及 99% CIs。结果 每 1000 名运动员（AE）中，女运动员的前交叉韧带损伤 IR 值是男运动员的 3.3 倍（1.08 vs 0.32，IRR=3.33，99% CI：2.65 至 4.19）。篮球运动中，女性和男性每 1000 次接触中 ACL-R IR 的差异最大（1.26 vs 0.22，IRR=5.69，99% CI：2.79 to 11.60）。与最高级别的女运动员相比，二级运动员每 1000 AE 的 ACL-R IR 值更高（1.27 vs 0.76，IRR=1.67，99% CI：1.30 至 2.15）。年龄与 IR 之间无明显关联。与足球相比，女子地掷球和冰上曲棍球的 ACL-R IR 值较低，男子地掷球、篮球和冰上曲棍球的 ACL-R IR 值也较低。结论 女性运动员的 ACL-R IR 值高于男性运动员，乙级女运动员的 ACL-R IR 值高于最高级别的女运动员。与足球相比，地掷球和冰上曲棍球男女运动员的前交叉韧带-R 内径都较低。其余运动项目的 ACL-R IR 与足球相似，但篮球除外，男运动员的 ACL-R IR 率较低。暂无数据。
{"title":"Nationwide incidence of anterior cruciate ligament reconstruction in higher-level athletes in Sweden: a cohort study from the Swedish National Knee Ligament Registry linked to six sports organisations","authors":"Daniel Castellanos Dolk, Henrik Hedevik, Helena Stigson, Per Wretenberg, Joanna Kvist, Anders Stålman","doi":"10.1136/bjsports-2024-108343","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108343","url":null,"abstract":"Objective To determine and compare the incidence rate (IR) of anterior cruciate ligament reconstruction (ACL-R) among higher-level athletes across six sports in the Swedish National Knee Ligament Registry (SNKLR). Methods Patient data from the SNKLR, between 2005 and 2020, was linked to team and event data of six sports (football, handball, basketball, ice hockey, floorball and alpine sports) to identify higher-level athletes aged 15–40 with ACL-R. Unadjusted and adjusted IR ratios (IRRs) with 99% CIs were calculated between sports, sex, age and divisions. Results Female athletes had a 3.3 times higher ACL-R IR compared with males (1.08 vs 0.32, IRR=3.33, 99% CI: 2.65 to 4.19) per 1000 athlete exposures (AE). Basketball had the largest difference in ACL-R IR per 1000 AE between females and males (1.26 vs 0.22, IRR=5.69, 99% CI: 2.79 to 11.60). Female second-division athletes had higher ACL-R IR per 1000 AE compared with female highest-division athletes (1.27 vs 0.76, IRR=1.67, 99% CI: 1.30 to 2.15). No significant association between age and IR was observed. Compared with football, lower ACL-R IR was observed in floorball and ice hockey in females, as well as in floorball, basketball and ice hockey in males. Conclusion Female athletes had higher ACL-R IRs than males and second-division female athletes had higher ACL-R IRs than highest-division female athletes. Lower ACL-R IRs were observed in floorball and ice hockey compared with football for both sexes. The remaining sports had ACL-R IRs similar to football, except basketball where rates were lower for male athletes. No data are available.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"23 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142684525","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 : 2024-11-20DOI: 10.1136/bjsports-2024-108107
Olivier Girard
Climate change and global warming may prompt the relocation of future Summer and Winter Olympic/Paralympic Games to higher elevations, driven by the pursuit of sustainability and emerging health concerns for athletes.1 This shift could be motivated by the quest for safer environmental conditions, aiming to reduce thermal stress in Summer Olympics/Paralympics or ensure adequate snow conditions in Winter Games. While the Summer Olympic and Paralympic Games have traditionally been held during the hot summer season in the northern hemisphere, relocating the competition to a different time of year could lead to safer environmental conditions, even at sea level. Organising the 2022 FIFA World Cup in winter in Qatar, instead of during the hottest months, serves as a notable example. However, rescheduling the Summer Games may lead to scheduling conflicts with other major sporting events, reducing global participation and viewership, while also disrupting athletes’ training cycles and potentially impacting their performance. With the exception of Mexico City in 1968, situated at an altitude of 2300 metres above sea level, no other Summer Olympic/Paralympic Games have been held at altitudes exceeding 530 metres (Munich in 1972).2 A thorough investigation is needed to understand the impact of moderate terrestrial altitude on various sports and the required athletic preparations for optimal performance at higher elevations. Essentially, the argument centres on altitude providing a cooler and more moderate climate, addressing challenges posed by extreme heat in …
{"title":"Elevating the games: the future of the Olympics and Paralympics at higher altitudes","authors":"Olivier Girard","doi":"10.1136/bjsports-2024-108107","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108107","url":null,"abstract":"Climate change and global warming may prompt the relocation of future Summer and Winter Olympic/Paralympic Games to higher elevations, driven by the pursuit of sustainability and emerging health concerns for athletes.1 This shift could be motivated by the quest for safer environmental conditions, aiming to reduce thermal stress in Summer Olympics/Paralympics or ensure adequate snow conditions in Winter Games. While the Summer Olympic and Paralympic Games have traditionally been held during the hot summer season in the northern hemisphere, relocating the competition to a different time of year could lead to safer environmental conditions, even at sea level. Organising the 2022 FIFA World Cup in winter in Qatar, instead of during the hottest months, serves as a notable example. However, rescheduling the Summer Games may lead to scheduling conflicts with other major sporting events, reducing global participation and viewership, while also disrupting athletes’ training cycles and potentially impacting their performance. With the exception of Mexico City in 1968, situated at an altitude of 2300 metres above sea level, no other Summer Olympic/Paralympic Games have been held at altitudes exceeding 530 metres (Munich in 1972).2 A thorough investigation is needed to understand the impact of moderate terrestrial altitude on various sports and the required athletic preparations for optimal performance at higher elevations. Essentially, the argument centres on altitude providing a cooler and more moderate climate, addressing challenges posed by extreme heat in …","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"170 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142678524","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 : 2024-11-20DOI: 10.1136/bjsports-2024-108270
James O'Brien, Torstein Dalen-Lorentsen, Joar Harøy
Multiple injury prevention exercise programmes have demonstrated efficacy under randomised controlled conditions.1 However, successfully implementing these programmes under real-world conditions poses a significant challenge. It is well documented that football teams modify programmes to better fit their specific context, drawing not only on evidence from randomised controlled trials (RCTs) but also their past experiences, guidelines and individual player screening data.2 Furthermore, evaluation of injury prevention programmes under real-world conditions demonstrates that increased programme adaptability, variation and individualisation can facilitate implementation efforts.2 Modifying efficacious programmes can potentially enhance context-specificity but may also jeopardise fidelity. Replicating the exact protocol from an RCT increases the chances of achieving the desired injury reduction, but failing to consider the intricacies of the specific implementation context and modify the intervention accordingly increases the risk of poor adherence. Balancing these dual aspirations of fidelity and context-specific modifications has been coined the adaptation-fidelity dilemma.3 To evaluate implementation outcomes, sports injury prevention researchers have embraced the Reach Effectiveness Adoption Implementation Maintenance (RE-AIM) framework.4–6 While this has heightened awareness of different implementation factors and common pitfalls, most analyses only consider teams’ use of interventions in their original (RCT) form. But programme modifications are common2 7 and failing to assess and analyse them will paint an incomplete picture of real-world adherence. Taking the example of the Copenhagen Adduction Exercise (CAE), under RCT conditions, the programme reduced the risk of groin problems …
{"title":"Refining the recipe or spoiling the broth? Reframing perceptions of programme adaptation in sports injury prevention","authors":"James O'Brien, Torstein Dalen-Lorentsen, Joar Harøy","doi":"10.1136/bjsports-2024-108270","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108270","url":null,"abstract":"Multiple injury prevention exercise programmes have demonstrated efficacy under randomised controlled conditions.1 However, successfully implementing these programmes under real-world conditions poses a significant challenge. It is well documented that football teams modify programmes to better fit their specific context, drawing not only on evidence from randomised controlled trials (RCTs) but also their past experiences, guidelines and individual player screening data.2 Furthermore, evaluation of injury prevention programmes under real-world conditions demonstrates that increased programme adaptability, variation and individualisation can facilitate implementation efforts.2 Modifying efficacious programmes can potentially enhance context-specificity but may also jeopardise fidelity. Replicating the exact protocol from an RCT increases the chances of achieving the desired injury reduction, but failing to consider the intricacies of the specific implementation context and modify the intervention accordingly increases the risk of poor adherence. Balancing these dual aspirations of fidelity and context-specific modifications has been coined the adaptation-fidelity dilemma.3 To evaluate implementation outcomes, sports injury prevention researchers have embraced the Reach Effectiveness Adoption Implementation Maintenance (RE-AIM) framework.4–6 While this has heightened awareness of different implementation factors and common pitfalls, most analyses only consider teams’ use of interventions in their original (RCT) form. But programme modifications are common2 7 and failing to assess and analyse them will paint an incomplete picture of real-world adherence. Taking the example of the Copenhagen Adduction Exercise (CAE), under RCT conditions, the programme reduced the risk of groin problems …","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"1 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142678523","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}
Objective We aimed to investigate the association of cardiorespiratory fitness (CRF) with cognitive function and dementia risk, taking genetic predisposition for dementia into account. Methods Within the UK Biobank, 61 214 dementia-free participants aged 39–70 years were followed for up to 12 years. CRF score was estimated using a 6 min submaximal exercise test on a stationary bike and divided into tertiles (ie, low, moderate, and high; standardised by age and sex). Global cognitive function was evaluated at baseline. Dementia was identified based on medical history and medical records. Genetic predisposition for dementia was estimated using the polygenic risk score for Alzheimer’s disease (PRSAD), tertiled as low, moderate, or high. Data were analysed using linear regression, Poisson regression, and Laplace regression. Results Compared with low CRF, high CRF was related to better global cognitive function (β=0.05, 95% CI 0.04 to 0.07). Over the follow-up period, 553 individuals developed dementia. Compared with low CRF, the incidence rate ratio (IRR) of all dementia was 0.60 (95% CI 0.48 to 0.76) for high CRF, and the onset of all dementia was delayed by 1.48 (95% CI 0.58 to 2.39) years among people with high versus low CRF. Among people with a moderate/high polygenic risk score, high CRF attenuated all dementia risk by 35% (IRR 0.65, 95% CI 0.52 to 0.83). Conclusion High CRF is associated with better cognitive performance at baseline, and lower dementia risk long-term. High CRF could mitigate the impact of genetic predisposition on the development of dementia by 35%. Data may be obtained from a third party and are not publicly available.
{"title":"Association of cardiorespiratory fitness with dementia risk across different levels of genetic predisposition: a large community-based longitudinal study","authors":"Shuqi Wang, Liyao Xu, Wenzhe Yang, Jiao Wang, Abigail Dove, Xiuying Qi, Weili Xu","doi":"10.1136/bjsports-2023-108048","DOIUrl":"https://doi.org/10.1136/bjsports-2023-108048","url":null,"abstract":"Objective We aimed to investigate the association of cardiorespiratory fitness (CRF) with cognitive function and dementia risk, taking genetic predisposition for dementia into account. Methods Within the UK Biobank, 61 214 dementia-free participants aged 39–70 years were followed for up to 12 years. CRF score was estimated using a 6 min submaximal exercise test on a stationary bike and divided into tertiles (ie, low, moderate, and high; standardised by age and sex). Global cognitive function was evaluated at baseline. Dementia was identified based on medical history and medical records. Genetic predisposition for dementia was estimated using the polygenic risk score for Alzheimer’s disease (PRSAD), tertiled as low, moderate, or high. Data were analysed using linear regression, Poisson regression, and Laplace regression. Results Compared with low CRF, high CRF was related to better global cognitive function (β=0.05, 95% CI 0.04 to 0.07). Over the follow-up period, 553 individuals developed dementia. Compared with low CRF, the incidence rate ratio (IRR) of all dementia was 0.60 (95% CI 0.48 to 0.76) for high CRF, and the onset of all dementia was delayed by 1.48 (95% CI 0.58 to 2.39) years among people with high versus low CRF. Among people with a moderate/high polygenic risk score, high CRF attenuated all dementia risk by 35% (IRR 0.65, 95% CI 0.52 to 0.83). Conclusion High CRF is associated with better cognitive performance at baseline, and lower dementia risk long-term. High CRF could mitigate the impact of genetic predisposition on the development of dementia by 35%. Data may be obtained from a third party and are not publicly available.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"178 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142673238","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 : 2024-11-14DOI: 10.1136/bjsports-2024-108125
Lennert Veerman, Jakob Tarp, Ruth Wijaya, Mary Njeri Wanjau, Holger Möller, Fiona Haigh, Peta Lucas, Andrew Milat
Objective: Low physical activity (PA) levels are associated with increased mortality. Improved measurement has resulted in stronger proven associations between PA and mortality, but this has not yet translated to improved estimates of the disease burden attributable to low PA. This study estimated how much low PA reduces life expectancy, and how much life expectancy could be improved by increasing PA levels for both populations and individuals.
Methods: We applied a predictive model based on device-measured PA risk estimates and a life-table model analysis, using a life-table of the 2019 US population based on 2017 mortality data from the National Centre for Health Statistics. The participants included were 40+ years with PA levels based on data from the 2003-2006 National Health and Nutritional Examination Survey. The main outcome was life expectancy based on PA levels.
Results: If all individuals were as active as the top 25% of the population, Americans over the age of 40 could live an extra 5.3 years (95% uncertainty interval 3.7 to 6.8 years) on average. The greatest gain in lifetime per hour of walking was seen for individuals in the lowest activity quartile where an additional hour's walk could add 376.3 min (~6.3 hours) of life expectancy (95% uncertainty interval 321.5 to 428.5 min).
Conclusion: Higher PA levels provide a substantial increase in population life expectancy. Increased investment in PA promotion and creating PA promoting living environments can promote healthy longevity.
目的：体力活动（PA）水平低与死亡率增加有关。测量方法的改进使 PA 与死亡率之间的关联得到了更有力的证实，但这尚未转化为对低 PA 导致的疾病负担的更准确估计。本研究估算了低 PA 会减少多少预期寿命，以及通过提高人群和个人的 PA 水平可改善多少预期寿命：我们采用了基于设备测量的 PA 风险估算和生命表模型分析的预测模型，使用了基于美国国家卫生统计中心 2017 年死亡率数据的 2019 年美国人口生命表。根据 2003-2006 年全国健康与营养调查的数据，参与者的 PA 水平均在 40 岁以上。主要结果是基于运动量水平的预期寿命：结果：如果所有的人都像前 25% 的人口那样积极锻炼，40 岁以上的美国人平均可多活 5.3 年（95% 的不确定区间为 3.7 至 6.8 年）。活动量最低的四分位人群每步行一小时可增加的寿命最多，步行一小时可增加 376.3 分钟（约 6.3 小时）的预期寿命（95% 不确定区间为 321.5 分钟至 428.5 分钟）：结论：较高的活动量水平可大幅延长人口的预期寿命。结论：较高的活动量水平可大幅延长人口的预期寿命。增加对活动量推广的投资和创造促进活动量的生活环境可促进健康长寿。
{"title":"Physical activity and life expectancy: a life-table analysis.","authors":"Lennert Veerman, Jakob Tarp, Ruth Wijaya, Mary Njeri Wanjau, Holger Möller, Fiona Haigh, Peta Lucas, Andrew Milat","doi":"10.1136/bjsports-2024-108125","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108125","url":null,"abstract":"<p><strong>Objective: </strong>Low physical activity (PA) levels are associated with increased mortality. Improved measurement has resulted in stronger proven associations between PA and mortality, but this has not yet translated to improved estimates of the disease burden attributable to low PA. This study estimated how much low PA reduces life expectancy, and how much life expectancy could be improved by increasing PA levels for both populations and individuals.</p><p><strong>Methods: </strong>We applied a predictive model based on device-measured PA risk estimates and a life-table model analysis, using a life-table of the 2019 US population based on 2017 mortality data from the National Centre for Health Statistics. The participants included were 40+ years with PA levels based on data from the 2003-2006 National Health and Nutritional Examination Survey. The main outcome was life expectancy based on PA levels.</p><p><strong>Results: </strong>If all individuals were as active as the top 25% of the population, Americans over the age of 40 could live an extra 5.3 years (95% uncertainty interval 3.7 to 6.8 years) on average. The greatest gain in lifetime per hour of walking was seen for individuals in the lowest activity quartile where an additional hour's walk could add 376.3 min (~6.3 hours) of life expectancy (95% uncertainty interval 321.5 to 428.5 min).</p><p><strong>Conclusion: </strong>Higher PA levels provide a substantial increase in population life expectancy. Increased investment in PA promotion and creating PA promoting living environments can promote healthy longevity.</p>","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615180","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 : 2024-11-13DOI: 10.1136/bjsports-2024-108748
Nathan R Weeldreyer, Jeison C De Guzman, Craig Paterson, Jason D Allen, Glenn A Gaesser, Siddhartha S Angadi
Objective The purpose of this review was to assess the joint relationship of cardiorespiratory fitness (CRF) and Body Mass Index (BMI) on both cardiovascular disease (CVD) and all-cause mortality risk. Design A systematic review and meta-analysis was conducted. Pooled HR and 95% CI were calculated using a three-level restricted maximum likelihood estimation random-effects model with robust variance estimation. The reference group was normal weight-fit and was compared with normal weight-unfit, overweight-unfit and fit, and obese-unfit and fit. Data sources Electronic databases (PubMed/MEDLINE, Web of Science and SportDiscus) were searched following registration on PROSPERO. Eligibility criteria Articles meeting the following criteria were included: (1) published between January 1980 and February 2023, (2) prospective cohort study, (3) CRF assessed using a maximal or VO2peak exercise test, (4) BMI reported and directly measured, (5) joint impact of CRF and BMI on all-cause mortality or CVD mortality were analysed, and (6) the reference group was normal weight, fit individuals. Results 20 articles were included in the analysis resulting in a total of 398 716 observations. Compared with the reference group, overweight-fit (CVD HR (95% CI): 1.50 (0.82–2.76), all-cause HR: 0.96 (0.61–1.50)) and obese-fit (CVD: 1.62 (0.87–3.01), all-cause: 1.11 (0.88–1.40)) did not have a statistically different risk of mortality. Normal weight-unfit (CVD: 2.04 (1.32–3.14), all-cause: 1.92 (1.43–2.57)), overweight-unfit (CVD: 2.58 (1.48–4.52), all-cause: 1.82 (1.47–2.24)) and obese-unfit (CVD: 3.35 (1.17–9.61), all-cause: 2.04 (1.54–2.71)) demonstrated 2–3-fold greater mortality risks. Conclusions CRF is a strong predictor of CVD and all-cause mortality and attenuates risks associated with overweight and obesity. These data have implications for public health and risk mitigation strategies. Data are available upon reasonable request.
{"title":"Cardiorespiratory fitness, body mass index and mortality: a systematic review and meta-analysis","authors":"Nathan R Weeldreyer, Jeison C De Guzman, Craig Paterson, Jason D Allen, Glenn A Gaesser, Siddhartha S Angadi","doi":"10.1136/bjsports-2024-108748","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108748","url":null,"abstract":"Objective The purpose of this review was to assess the joint relationship of cardiorespiratory fitness (CRF) and Body Mass Index (BMI) on both cardiovascular disease (CVD) and all-cause mortality risk. Design A systematic review and meta-analysis was conducted. Pooled HR and 95% CI were calculated using a three-level restricted maximum likelihood estimation random-effects model with robust variance estimation. The reference group was normal weight-fit and was compared with normal weight-unfit, overweight-unfit and fit, and obese-unfit and fit. Data sources Electronic databases (PubMed/MEDLINE, Web of Science and SportDiscus) were searched following registration on PROSPERO. Eligibility criteria Articles meeting the following criteria were included: (1) published between January 1980 and February 2023, (2) prospective cohort study, (3) CRF assessed using a maximal or VO2peak exercise test, (4) BMI reported and directly measured, (5) joint impact of CRF and BMI on all-cause mortality or CVD mortality were analysed, and (6) the reference group was normal weight, fit individuals. Results 20 articles were included in the analysis resulting in a total of 398 716 observations. Compared with the reference group, overweight-fit (CVD HR (95% CI): 1.50 (0.82–2.76), all-cause HR: 0.96 (0.61–1.50)) and obese-fit (CVD: 1.62 (0.87–3.01), all-cause: 1.11 (0.88–1.40)) did not have a statistically different risk of mortality. Normal weight-unfit (CVD: 2.04 (1.32–3.14), all-cause: 1.92 (1.43–2.57)), overweight-unfit (CVD: 2.58 (1.48–4.52), all-cause: 1.82 (1.47–2.24)) and obese-unfit (CVD: 3.35 (1.17–9.61), all-cause: 2.04 (1.54–2.71)) demonstrated 2–3-fold greater mortality risks. Conclusions CRF is a strong predictor of CVD and all-cause mortality and attenuates risks associated with overweight and obesity. These data have implications for public health and risk mitigation strategies. Data are available upon reasonable request.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"69 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142600975","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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