Sports Medicine - Open最新文献

{"title":"Are Asymmetry-Focused Training Interventions More Effective than General Programs in Reducing Interlimb Asymmetries and Improving Athletic Performance? A Systematic Review.","authors":"Antonio Martos-Arregui, Iago Rojas-Cepero, Xing Zhang, Amador García-Ramos, Francisco Javier Rojas-Ruiz, Mar Cepero-González","doi":"10.1186/s40798-026-01119-5","DOIUrl":"10.1186/s40798-026-01119-5","url":null,"abstract":"<p><strong>Background: </strong>Interlimb asymmetries (ILA) have been associated with an increased risk of injury and decreased athletic performance. However, despite the growing number of training interventions targeting ILA, their comparative effectiveness relative to general strength and conditioning approaches has not yet been systematically reviewed.</p><p><strong>Objective: </strong>This systematic review aimed to compare the effectiveness of asymmetry-focused training interventions versus general training programs in reducing ILA and improving physical performance in athletic populations. Specifically, it sought to compare individualized training programs that first identify the weaker limb during pre-testing and subsequently prescribe a greater training stimulus to that limb with general training protocols that apply the same training stimulus to both limbs, as well as unilateral approaches with bilateral training strategies.</p><p><strong>Methods: </strong>Following PRISMA 2020 guidelines, a systematic search was conducted in Web of Science, PubMed, and SPORTDiscus up to April 2025. Eligible studies involved healthy athletes (aged 12-30 years) who completed ≥4-week lower-limb training interventions that either applied a greater stimulus to the weaker limb (e.g., starting sets with the weaker side or adding volume) or used unilateral training approaches that applied the same training stimulus to both limbs regardless of baseline ILA values. To be included, studies were required to assess both pre-to-post changes in ILA and at least one physical performance outcome. The risk of bias was assessed using a modified Cochrane tool.</p><p><strong>Results: </strong>Eleven studies comprising 297 athletes met the inclusion criteria. Reductions in ILA were more consistent in asymmetry-focused and unilateral training groups compared to general and bilateral training groups, respectively. Most interventions also led to improvements in physical performance, with asymmetry-focused and unilateral protocols typically producing greater gains in single-limb tasks, although bilateral training showed more favourable effects in bilateral tasks. However, variability in training protocols and outcome measures across studies limits the generalizability of these findings.</p><p><strong>Conclusion: </strong>Asymmetry-focused strategies, such as starting unilateral exercises with the weaker limb or increasing its training volume, appear to be more effective for reducing ILA than non-individualized unilateral training. These approaches are practical, safe, and potentially beneficial in athletic settings. However, further high-quality research is needed to confirm their superiority over non asymmetry-focused unilateral or bilateral training and to establish clear guidelines for their implementation. Registration PROSPERO-CRD420251023232.</p>","PeriodicalId":21788,"journal":{"name":"Sports Medicine - Open","volume":"12 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Camera-Based AI-Assisted Scoring for the Balance Error Scoring System: A Cross-sectional Validity and Agreement Study.","authors":"Yushi Chen, Jiayan Cheng, Tsz Yuen Frank Wang, Shanshan Zheng, Le Yu, Xiao'ao Xue, Yang Sun, Yinghui Hua","doi":"10.1186/s40798-026-01122-w","DOIUrl":"10.1186/s40798-026-01122-w","url":null,"abstract":"<p><strong>Background: </strong>The Balance Error Scoring System (BESS) is widely used to assess static postural control in sports medicine and rehabilitation. However, conventional real-time scoring is observer dependent and may be influenced by rater experience, viewing angle, attention, and the interpretation of transient or overlapping errors. This study evaluated the criterion-related validity and agreement of a camera-based artificial intelligence (AI)-assisted BESS relative to consensus video-review manual scoring and compared its error magnitude with on-site manual scoring.</p><p><strong>Methods: </strong>This single-center cross-sectional study included 80 of 84 recruited participants: 40 healthy controls, 20 with chronic ankle instability (CAI), and 20 after anterior cruciate ligament reconstruction (ACLR). All participants completed the standard six-condition BESS protocol. Scores were obtained using AI-assisted, on-site manual, and consensus video-review manual scoring; the latter was prespecified as the pragmatic manual reference standard. Primary total-score analyses included Pearson correlation, the intraclass correlation coefficient (ICC) with 95% confidence intervals (CIs), Bland-Altman mean difference and 95% limits of agreement (LoA), mean absolute error (MAE), and root mean square error (RMSE). Condition- and group-specific analyses were exploratory.</p><p><strong>Results: </strong>For the total BESS score, AI-assisted scoring versus the reference showed r = 0.989, ICC = 0.989 (95% CI 0.982-0.993), a mean difference of 0.188 errors, 95% LoA from -2.063 to 2.438 errors, an MAE of 0.787 errors, and an RMSE of 1.157 errors. On-site manual scoring versus the reference showed r = 0.922, ICC = 0.920 (95% CI 0.877-0.948), a mean difference of -0.612 errors, 95% LoA from -6.680 to 5.455 errors, an MAE of 2.212 errors, and an RMSE of 3.136 errors. Condition-specific discrepancies were larger in the single-leg and tandem-stance conditions. Exploratory group comparisons showed higher total BESS scores in individuals with CAI than in healthy controls.</p><p><strong>Conclusions: </strong>Camera-based AI-assisted BESS scoring showed strong total-score agreement with the pragmatic manual reference standard and smaller discrepancies than on-site manual scoring. This approach may support more standardized BESS assessment; however, external validation and longitudinal reliability testing are required before interchangeability with manual scoring can be considered.</p>","PeriodicalId":21788,"journal":{"name":"Sports Medicine - Open","volume":"12 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping Research on Warm-Up in Athletes: A Scoping Review with Evidence Gap Map.","authors":"João Bruno, Eduardo Abade, Raynier Montoro-Bombú, Rohit Kumar Thapa, Hugo Sarmento","doi":"10.1186/s40798-026-01123-9","DOIUrl":"10.1186/s40798-026-01123-9","url":null,"abstract":"<p><strong>Background: </strong>Warm-up is a central preparatory phase of training and competition, aimed at optimizing physiological and neuromuscular readiness for subsequent performance and reducing the risk of injury. However, the athlete warm-up literature spans diverse sports, populations, and intervention models, with substantial variability in protocol content, outcome selection, and reporting. No prior scoping review with an Evidence Gap Map (EGM) has comprehensively mapped this evidence across sports, warm-up modalities, and outcome domains.</p><p><strong>Objectives: </strong>To map the landscape of warm-up evidence in athletes, identify the main intervention types and outcome domains investigated, and locate key evidence gaps related to methodology, population coverage, sport specificity, and real-world applicability.</p><p><strong>Methods: </strong>A scoping review with EGM was conducted in accordance with PRISMA-ScR guidance, with methodological considerations informed by the PRISMA 2020 statement. Searches were performed in PubMed, Scopus, SPORTDiscus, and Web of Science Core Collection for studies published up to 20th January 2026. Eligible studies examined warm-up practices in athletes across competitive sports and evaluated performance, injury-related, physiological, or neuromuscular outcomes. Data were synthesized descriptively and organized within an EGM according to sport, age subgroup, warm-up type, and reported outcomes.</p><p><strong>Results: </strong>The search yielded 27,644 records, of which 964 studies published between 1972 and 2026 were included. Most studies examined acute, proxy-based performance outcomes, especially jump, sprint, agility/change-of-direction, and strength/power measures. Physiological and neuromuscular responses were also frequently assessed, whereas injury-related outcomes, competition-referent outcomes, and implementation-focused variables were comparatively scarce. The EGM identified recurring gaps in injury endpoints, underrepresented sports, incomplete reporting of dose variables, and limited ecological validity for feasibility, adherence, and real-world deployment.</p><p><strong>Conclusions: </strong>In the current warm-up evidence, the majority of the research studied warm-up as a strategy for acute performance readiness. In addition, studies on injury reduction remain limited compared to acute performance enhancement, reflecting a surveillance and reporting gap. Evidence for competition-referent transfer and real-world implementation also remains limited.</p><p><strong>Protocol registration: </strong>OSF: https://osf.io/f3msz, DOI: 10.17605/OSF.IO/7H9ZV.</p>","PeriodicalId":21788,"journal":{"name":"Sports Medicine - Open","volume":"12 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13654918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of a Revised V-Slope Algorithm for Automated First Ventilatory Threshold Detection in Healthy Adults.","authors":"Margot Vermeiren, Kaatje Goetschalckx, Herwig Van Opstal, Jomme Claes, Leen Van Langenhoven, Nicholas Cauwenberghs, Rik Willems, Evangelos Ntalianis, Tatiana Kuznetsova, Veronique Cornelissen, Peter Sinnaeve","doi":"10.1186/s40798-026-01124-8","DOIUrl":"10.1186/s40798-026-01124-8","url":null,"abstract":"<p><strong>Background and objectives: </strong>The first ventilatory threshold (VT1) is a key indicator of submaximal aerobic fitness. Its determination typically relies on visual assessment, which is time-consuming and subject to interobserver variability. Automated solutions may offer a more objective, reproducible and time-efficient alternative. This study evaluated the accuracy of a revised V-slope method.</p><p><strong>Methods: </strong>This retrospective study was conducted at University Hospitals Leuven, Belgium, using cardiopulmonary exercise test (CPET) data of 271 healthy adults collected between 2010 and 2020. Automated VT1 detection using a revised V-slope algorithm was compared with manual determination via the visual V-slope method in 262 participants with a determinable VT1. Agreement was evaluated using Bland-Altman analysis, intraclass correlation coefficients (ICC), Deming regression and equivalence testing (TOST). Interobserver agreement was evaluated using ICC.</p><p><strong>Results: </strong>Median oxygen uptake at VT1 was higher with automated compared to manual assessment (1151 vs. 1122 mL/min; p < 0.001). Mean difference was 29 mL/min (95% CI [19, 40]. Relative mean bias was 2.2% ± 7.1% (LoA [- 11.7 to 16.0%], with excellent agreement (ICC 0.97 [95% CI 0.96-0.98] and a Deming regression slope of 0.95 [95% CI 0.92-0.99] and intercept of 26.1 mL/min [95% CI -11.9 to 64.7]. TOST with equivalence bounds [- 100, 100] was significant (p < 0.001; 90% CI [20, 38]).</p><p><strong>Conclusion: </strong>The revised V-slope algorithm demonstrated strong group-level agreement with visual assessment for VT1 determination, supporting the reliability and practical applicability for large-scale research applications in healthy adults. However, given the observed individual-level variability, caution is warranted when applying automated VT1 values to guide exercise prescription for individual patients without expert review.</p>","PeriodicalId":21788,"journal":{"name":"Sports Medicine - Open","volume":"12 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13654909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Glucose Metabolic Reprogramming in Exercise-Attenuated Osteoporosis: a Narrative Review.","authors":"Chu Li, Yuting He, Kaihong Weng, Shihua Zhang, Xiquan Weng, Yu Yuan","doi":"10.1186/s40798-026-01121-x","DOIUrl":"10.1186/s40798-026-01121-x","url":null,"abstract":"<p><strong>Background: </strong>The aging population has led to a significant increase in the prevalence of osteoporosis, making it an important public health issue. Emerging evidence suggests that osteoporosis is related to glucose metabolic reprogramming (GMR). Exercise is an effective non-pharmacological intervention method, and regulating GMR may be one of the pathways through which exercise improves bone health.</p><p><strong>Main body: </strong>GMR plays a critical role in regulating the function of bone cells. It influences the proliferation and differentiation of bone marrow mesenchymal stem cells (BMSCs), osteoblasts, osteocytes, and osteoclasts. Although the exact mechanisms remain to be fully elucidated, emerging studies suggest that metabolic shifts in glycolysis, the pentose phosphate pathway (PPP), and the tricarboxylic acid (TCA) cycle are critical regulators of bone homeostasis. Furthermore, preliminary evidence suggests that exercise modulates these metabolic pathways, thereby contributing to improved bone health and reduced osteoporotic risk.</p><p><strong>Conclusion: </strong>This narrative review provides new insights into the mechanistic understanding that GMR plays essential roles in the initiation and progression of osteoporosis. Different types of exercise may attenuate osteoporosis through the regulation of GMR.</p>","PeriodicalId":21788,"journal":{"name":"Sports Medicine - Open","volume":"12 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13654904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From young aces to injury cases: a qualitative study of stakeholder perspectives on injury risk in junior to elite badminton.","authors":"Brid Stepper, Lars Donath, Hendrik Stagge, Oliver Faude, Anne Hecksteden","doi":"10.1186/s40798-026-01107-9","DOIUrl":"https://doi.org/10.1186/s40798-026-01107-9","url":null,"abstract":"<p><strong>Background: </strong>Competitive badminton is associated with a considerable burden of injuries, particularly during the transition from junior to elite level (ages 16-20). While the sport's dynamic stroke and movement patterns may contribute to injury risk, the factors stakeholders use to assess injury vulnerability remain poorly understood. However, identifying specific causes and indicators that point to an increased risk of injury is essential for prevention. Given the limited case numbers, combining data driven approaches with stakeholders' experiential knowledge may enhance risk assessment. This study explores expert judgement and heuristics regarding injury risk assessment as well as options for risk mitigation during the transitional phase.</p><p><strong>Methods: </strong>Twenty semi-structured in-person interviews were conducted with national-level stakeholders (9 coaches, 5 athletes, 2 association doctors, 2 physiotherapists, 2 strength and conditioning coaches) between October 2023 and July 2024. The interviews had an average duration of 54.4 min. Thematic analysis helped identify common patterns across assessments.</p><p><strong>Results: </strong>Four higher-order themes were identified: Excessive pressure, recovery deficits, unprofessional attitude, and disruptions in training continuity. Six cue families were perceived by stakeholders as informing injury risk assessment: signs of over-motivation, unprofessional attitude, the coaches' subjective perception ('coaches' eye'), upheavals in private life, exposure and signs of wear. While overlaps with the literature were found, stakeholders often downplayed commonly cited objective factors like injury history. Many cues were based on intuitive, experience-driven judgments and were therefore difficult to standardize or quantify.</p><p><strong>Conclusions: </strong>Experts relied on relative risk judgments shaped by experience and situational impressions rather than absolute probabilities. Integrating these practitioner-derived qualitative cues with objective data may enhance context-sensitive injury risk assessment during the junior-to-elite transition. By making experiential heuristics more transparent, the findings offer a foundation for developing more targeted injury mitigation strategies in this critical developmental phase. Further empirical validation is required.</p>","PeriodicalId":21788,"journal":{"name":"Sports Medicine - Open","volume":"12 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Aerobic Exercise on Endothelial Function and Other Cardiovascular Disease Markers in Health and Disease: A Systematic Review and Meta-analysis with Meta-regression of Randomized Controlled Trials.","authors":"Simon Iskra, Gašper Turnšek, Kristina Drole, Armin Paravlić","doi":"10.1186/s40798-026-01110-0","DOIUrl":"10.1186/s40798-026-01110-0","url":null,"abstract":"<p><strong>Background: </strong>Aerobic exercise (AE) has long been recognized as a potent stimulus for improving various cardiovascular disease (CVD)-related markers. Although several meta-analyses have focused on some of these markers, no meta-analysis or meta-regression has comprehensively evaluated the influence of multiple CVD-related markers on endothelial function, assessed by brachial-artery flow-mediated dilation (_baFMD).</p><p><strong>Methods: </strong>This meta-analysis and meta-regression included randomized controlled trials investigating the effect of AE on _baFMD. The primary outcome was pre- to post-intervention changes in _baFMD. Secondary outcomes included endothelial blood biomarkers, hemodynamic measurements, cardiorespiratory fitness, body composition, glucose metabolism, and lipid profile. Pre- to post-intervention changes were summarized using a randomeffects model. Meta-regression analyses were performed to explore whether changes in secondary outcomes moderated changes in _baFMD.</p><p><strong>Results: </strong>Seventy-two studies comprising 3357 participants were included. AE significantly improved _baFMD (mean difference = 2.35%, p < 0.001), corresponding to an estimated 24% reduction in CVD risk. Significant improvements were observed across multiple CVD-related markers. Meta-regression revealed that changes in body weight and body fat (β = - 4.021 and - 1.721), systolic and diastolic blood pressure (β = - 0.525 and - 0.484), maximal oxygen uptake (β = 0.656), and insulin levels (β = 0.381) significantly moderated _baFMD improvements.</p><p><strong>Conclusions: </strong>AE elicits robust improvements in endothelial function and a wide range of CVD-related markers. This is the first meta-analysis to integrate these outcomes through meta-regression, demonstrating that exercise induced enhancements in body composition, cardiorespiratory fitness, blood pressure and insulin regulation collectively contribute to endothelial adaptations. These findings provide new mechanistic insights into the vascular benefits of AE and reinforce its role as a potent nonpharmacological strategy for CVD prevention and vascular health optimization. The protocol was prospectively registered in the Open Science Framework online registry (DOI: https://doi.org/10.17605/OSF.IO/E4QYD ).</p>","PeriodicalId":21788,"journal":{"name":"Sports Medicine - Open","volume":"12 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Heel-Strike Fallacy and Cadence Beliefs in Distance Running: A Narrative Review.","authors":"Aurélien Patoz, Cyrille Gindre, Thibault Lussiana, Bastiaan Breine","doi":"10.1186/s40798-026-01120-y","DOIUrl":"10.1186/s40798-026-01120-y","url":null,"abstract":"<p><p>Running-technique recommendations often convert group-level observations and acute biomechanical responses into universal prescriptions. This narrative review examines three beliefs: rearfoot striking is inherently harmful, 180 steps/min is universally optimal, and increasing cadence while maintaining a given running speed consistently reduces loading and overuse injury risk. Current evidence does not support these generalizations. First, rearfoot striking is not consistently associated with greater impact-related metrics or overuse injury risk, and external impact measures do not directly represent tissue-specific loading. Second, cadence varies substantially with running speed, morphology, footwear, and surface, while energetically optimal cadence varies between individuals rather than being fixed at 180 steps/min. Third, although increasing cadence can acutely modify selected mechanical variables, these responses are heterogeneous, have not been shown to consistently reduce injury risk, and may partly reflect concurrent changes in stance-flight organization. Duty factor (DF), the proportion of the stride spent in contact with the ground, provides a complementary temporal descriptor that can help interpret these cadence-related responses. Under level, submaximal running conditions, DF is associated with selected external and modeled internal loads, but current evidence is predominantly mechanistic. Clinical application should therefore begin by determining whether change is warranted, identifying the tissue-specific or functional objective, and selecting whether and how to modify foot-strike pattern or cadence according to condition-specific evidence and the runner's response. DF may additionally be monitored to characterize accompanying changes in stance-flight organization. Acute biomechanical changes should not be assumed to improve symptoms or performance, or to reduce injury risk. Future studies should test sustained clinical effects, individual response patterns, and transfer to real-world conditions.</p>","PeriodicalId":21788,"journal":{"name":"Sports Medicine - Open","volume":"12 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Psychosocial Factors in Returning to Physical Activity and Sport Among Female Football Players After Anterior Cruciate Ligament Injury: A Scoping Review.","authors":"Skye Meredith, Jessica B Farley, Jane Hunt, Elsa Dent","doi":"10.1186/s40798-026-01118-6","DOIUrl":"https://doi.org/10.1186/s40798-026-01118-6","url":null,"abstract":"<p><strong>Background: </strong>Anterior cruciate ligament (ACL) injuries are an increasingly common knee injury in sport requiring quick direction changes, such as the football codes. Return to physical activity and sport following an ACL injury predominantly focuses on achieving objective milestones to resolve physical impairments, with sex differences reported. However, irrespective of management approach following an ACL injury, many athletes do not return to the same level of sport, if at all, warranting the need to consider psychological and social factors.</p><p><strong>Aim: </strong>The aim of this scoping review was to investigate the role of psychosocial factors in females participating in any football code after an ACL injury, and the impact on return to physical activity and sport.</p><p><strong>Methods: </strong>A systematic search of six electronic databases (SCOPUS, CINAHL, MEDLINE, SPORTDiscus, PsycInfo, and Embase) was conducted on 1 May 2025. Two reviewers independently screened articles against the eligibility criteria to include original research articles that explored the impact of psychosocial factors on return to sport (RTS) or physical activity in females playing any football code with an ACL injury managed surgically or non-surgically. Studies were eligible where participants had a mean age of 18 years or older. Data extraction and narrative synthesis of included studies was undertaken and themes identified to address the research aim.</p><p><strong>Results: </strong>Full-text articles (n = 74) were assessed for eligibility following screening of titles and abstracts (n = 582); seven eligible studies were included. Across the studies, psychosocial barriers and facilitators were perceived to influence RTS at either preinjury or lower competition levels, as well as physical activity, in female footballers. Uncertainty, fear, lack of confidence, and poor social support were identified as perceived barriers to RTS contributing to return at a lower level of competition and the alteration, limitation, or avoidance of physical activity among female footballers. Whilst confidence, motivation, strong social support and athletic identity were identified as perceived facilitators of RTS, helping to build readiness and supporting female footballers to return at their preinjury level or a lower level of competition.</p><p><strong>Conclusion: </strong>Psychosocial factors appear to play an important role in RTS and physical activity following ACL injury in female football players, acting as both barriers and facilitators to recovery. Further high-quality research focussed specifically on female footballers is needed to better understand these relationships and inform targeted screening and interventions.</p>","PeriodicalId":21788,"journal":{"name":"Sports Medicine - Open","volume":"12 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13634023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149114711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frequency and Prognostic Significance of T-wave Inversions in Athletes: A Systematic Review and Meta-analysis.","authors":"Javier Sanmartin, Joan Cartanya-Bonvehi, Helen Valenzuela, Lidia Carballeira, Silvia Montserrat, Adrian Baranchuk, Roberto Elosua","doi":"10.1186/s40798-026-01115-9","DOIUrl":"https://doi.org/10.1186/s40798-026-01115-9","url":null,"abstract":"<p><strong>Background: </strong>T-wave inversions (TWI) are a challenging finding in athletes' electrocardiograms. This study aimed to determine the frequency and prognosis of TWI in athletes.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted following PRISMA guidelines and registered in PROSPERO (CRD42023494038). Data sources were PubMed, Scopus, and Web of Science. We included original research articles reporting on the prevalence or underlying substrates of TWI and providing data on athletes participating in any type of sports, sex, or race. Risk of bias was evaluated using the Joanna Briggs Institute Critical Appraisal Tool for Cross-Sectional Studies. Random-effects models were used. Sensitivity and subgroup analyses (sex, age, ethnicity, diagnostic criteria) were predefined.</p><p><strong>Results: </strong>Of 4,509 articles identified, 115 were selected (258,954 individuals). Substantial heterogeneity was observed among the study results. The global TWI prevalence in athletes > 16 years according to the International criteria was 4% (3%, 1%, and 0% in anterior, inferior, and lateral leads, respectively). Prevalence was higher in Black athletes. TWI was more frequent in athletes than non-athletes (prevalence ratio=1.49; 95% confidence interval: 1.13-1.97). Cardiomyopathy diagnosis among athletes with TWI showed high variability, but in most studies, prevalence was <1%. Acute cardiovascular event incidence was low in most of the studies with high heterogeneity.</p><p><strong>Conclusions: </strong>TWI is more frequent in athletes than non-athletes but remains low overall. While it may reflect physiological exercise related ventricular remodelling, thorough evaluation is essential to exclude structural heart disease. The risk of cardiovascular events is uncertain due to low statistical power and high heterogeneity.</p>","PeriodicalId":21788,"journal":{"name":"Sports Medicine - Open","volume":"12 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149115256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}