Sports Medicine - Open最新文献

{"title":"Ultra-processed Foods and Athletes: Current Insights on Classification, Use, Awareness, and Impact-A Narrative Review.","authors":"Sara F Forbes, Louise M Burke, Evangeline Mantzioris, Adrienne K Forsyth","doi":"10.1186/s40798-026-01098-7","DOIUrl":"10.1186/s40798-026-01098-7","url":null,"abstract":"<p><p>There is growing concern about the impact of food processing on human health and planetary health, with greater dietary exposure to ultra-processed foods being associated with a higher risk of adverse health outcomes. While athletes are encouraged to follow a food first approach, there are situations, where meeting performance goals is not achievable with everyday foods and drinks. In such cases, sports foods, protein-fortified foods, or discretionary foods, which due to their formulation are typically ultra-processed, may be recommended to help achieve specific goals. This review aimed to summarise the existing research on patterns of sports food and ultra-processed food use by athletes. A narrative review methodology was employed. Relevant literature was identified via searches in Google Scholar, Scopus, Web of Science and peak sporting body websites. There is little research on athletes and planetary health. Consumer awareness and knowledge of ultra-processed foods is an emerging area of research; no published studies in athletes were identified. The frequency of processed foods consumption by athletes has been explored in four small studies, with results suggesting frequent use of ultra-processed foods, though classification inconsistencies limit application. No studies specifically asked athletes about their reasons for consuming ultra-processed foods. Convenience and performance were common considerations for athletes when choosing general and sports foods. Benefits of ultra-processed food consumption include microbiological safety, convenience and ease of use. Current literature offers limited insight into how planetary health considerations influence athletes' food choices, and athletes' knowledge, awareness and consumption of ultra-processed foods. Further research is needed to understand the prevalence and patterns of use of sports foods and ultra-processed foods, and how dietitians/nutritionists can help athletes optimise their nutritional strategies which support performance and promote planetary health.</p>","PeriodicalId":21788,"journal":{"name":"Sports Medicine - Open","volume":"12 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13582765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148983674","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":"Comparative Effectiveness of Exercise Interventions for Hamstring Injury Prevention in Football Players: A Systematic Review and Network Meta-analysis.","authors":"Binjie Hong, Xin Hong, Hao Lin, Ziyi Yang, Jun Feng","doi":"10.1186/s40798-026-01087-w","DOIUrl":"10.1186/s40798-026-01087-w","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Hamstring strain injury is a leading time-loss injury in football, yet trials have evaluated diverse exercise-based prevention programs with limited direct head-to-head evidence. This systematic review and network meta-analysis aimed to compare the effectiveness of exercise-based interventions for preventing hamstring injuries in football players using exposure-adjusted incidence rate ratios.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a PRISMA-aligned systematic review and random-effects network meta-analysis of randomized controlled trials in football players comparing exercise-based interventions to prevent hamstring injuries. Searches covered PubMed, Cochrane Library, Embase and Web of Science from inception to January 5, 2026. Interventions were modeled as separate nodes (Nordic hamstring exercise [NHE], FIFA 11, FIFA 11 + , FIFA 11 + Kids, bounding exercise program [BEP], usual training). The primary effect measure was incidence rate ratio (IRR) versus usual training, with ranking by P-scores; exploratory subgroup analyses were conducted by sex-restricted male-only evidence and age group.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Eleven randomized controlled trials involving 9,282 participants were included. The network was connected but largely star-shaped, with most evidence comparing active interventions against usual training and no direct active-active comparisons. FIFA 11 + showed the most consistent exposure-adjusted association with reduced hamstring injury incidence versus usual training (IRR = 0.55, 95% CI 0.31-0.98; P-score = 0.84). FIFA 11 + Kids showed a favorable but imprecise estimate, whereas NHE showed a modest non-significant reduction and FIFA 11 and BEP showed no clear benefit. Male-only findings were broadly consistent with the primary analysis. Age-stratified analyses suggested that the apparent hierarchy was not fully identical across age strata, but subgroup networks were sparse and exploratory. RoB 2 judged three studies as high risk and eight as having some concerns; no trial was judged as overall low risk. Between-study heterogeneity was substantial, and treatment rankings were, therefore, interpreted cautiously.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;In this IRR-based network meta-analysis, FIFA 11 + showed the most consistent exposure-adjusted association with reduced hamstring injury incidence compared with usual training. However, certainty across the primary comparisons ranged from low to very low because of clinical and methodological heterogeneity, sparse direct evidence for several nodes, reliance on indirect active-active comparisons, substantial between-study heterogeneity, and moderate-to-high risk of bias across the included studies. The treatment hierarchy should, therefore, be interpreted as a low-to-very-low-certainty, population-level summary rather than as a basis for firm recommendations. Further well-reported, age- and population-specific head-to-head trials with consistent e","PeriodicalId":21788,"journal":{"name":"Sports Medicine - Open","volume":"12 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13578199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148977970","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 the Japanese Version of the Rating of Fatigue Scale.","authors":"Kaho Suzuki, Takashi Arai","doi":"10.1186/s40798-026-01108-8","DOIUrl":"10.1186/s40798-026-01108-8","url":null,"abstract":"<p><strong>Background: </strong>Fatigue research remains important across a wide range of fields. In Japan, fatigue has become a major social issue, and research using Japanese population data is expected to contribute to both practical interventions and theoretical advances. Although several Japanese scales for assessing fatigue have been developed, brief instruments designed to measure fatigue during ongoing activity are limited. Therefore, this study translated the Rating of Fatigue (ROF) scale into Japanese and examined the validity of the Japanese version (ROF-J).</p><p><strong>Methods: </strong>First, the original ROF was translated into Japanese and back-translated. The comparability of language and similarity of interpretability between the original ROF and the ROF-J were evaluated. These procedures were conducted between July and October 2024. Second, the face validity and concurrent validity of the ROF-J were examined in a questionnaire survey of 85 university students at Tohoku University, Japan, in October 2024. Third, convergent validity was examined by comparing ROF-J scores before and after physical exercise among 35 university sports team members at Tohoku University, Japan, in November 2024.</p><p><strong>Results: </strong>As a result of the comparison between the original ROF and the ROF-j, the comparability of language and similarity of interpretability were generally within acceptable limits. According to the examination of face validity of the ROF-J, participants generally agreed that the ROF-J measured fatigue, supporting its face validity. In addition, ROF-J scores showed a significant positive correlation with scores on an established Japanese fatigue questionnaire, supporting concurrent validity. The survey for examining convergent validity indicated that ROF-J scores increased significantly after exercise.</p><p><strong>Conclusions: </strong>These findings indicate that the ROF-J demonstrates adequate validity. The scale provides a brief and practical Japanese instrument for assessing subjective fatigue during ongoing activity and may facilitate both applied fatigue assessment and future fatigue research in Japan.</p>","PeriodicalId":21788,"journal":{"name":"Sports Medicine - Open","volume":"12 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13569809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148945667","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":"Fast-Acting Caffeine Strategy: A Systematic Review and Meta-Analysis of the Ergogenic Effects of Caffeine Chewing Gum on Physical Performance.","authors":"Hossein Miraftabi, Erfan Berjisian, Craig Pickering, Alvaro Lopez-Samanes, Olivier Girard","doi":"10.1186/s40798-026-01104-y","DOIUrl":"10.1186/s40798-026-01104-y","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Caffeine gum is a fast-acting delivery method that rapidly elevates circulating caffeine levels and may improve physical performance. Given the recent growth in research, an updated systematic review and meta-analysis is warranted.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To evaluate the acute effects of caffeine gum on physical performance compared with placebo, and investigate potential moderators including (1) training status, (2) exercise type, (3) chewing duration, (4) caffeine habituation (i.e., habitual intake), (5) caffeine dosage, and (6) timing of administration relative to exercise.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The review followed the Cochrane Handbook for Systematic Reviews of Interventions and PRISMA guidelines. PubMed, Web of Science, Scopus and SPORTDiscus were searched up to March 2026. Three-level meta-analyses were synthesized for outcomes. Sensitivity analyses addressed assumptions within-subject correlations, outliers, and influential cases. Risk of bias was assessed using standardized tools.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Thirty-one studies were assessed for full-text eligibility, of which 25 (n = 390 participants) met the inclusion criteria and were included in the meta-analysis. Caffeine gum produced a trivial but significant improvement in physical performance (SMD = 0.195, 95% CI [0.115, 0.275], p = 0.001; GRADE: low) with very low heterogeneity (I&lt;sup&gt;2&lt;/sup&gt; = 4%). Three-level variance decomposition indicated that most variability was between studies (64.6%), with no within-study variance. Aerobic endurance showed a small significant effect (p = 0.002), whereas trivial but significant effects were observed for anaerobic performance (p = 0.005) and vertical jump outcomes (p = 0.008). Benefits were evident with a 10-min chewing duration (p = 0.001) for trained individuals (p = 0.018), and among individuals with low (p = 0.003) or moderate (p = 0.013) habitual caffeine intake, but not significant for recreationally active participants (p = 0.676), muscular strength/endurance outcomes (p = 0.372), 5-min chewing duration (p = 0.091), or high habitual caffeine users (p = 0.290). Meta-regression showed a significant dose-response relationship (p = 0.031), whereas the timing of caffeine administration relative to exercise had no effect (p = 0.683). Sensitivity analyses confirmed the robustness of findings across correlation assumptions and leave‑one‑out procedures. Most studies were judged as having some concerns or a high risk of bias. No evidence of publication bias was detected where assessable, although some subgroup analyses could not be formally evaluated because of the limited number of studies. The certainty of the evidence ranged from low to very low.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Caffeine gum produced statistically significant but trivial improvements in physical performance, suggesting limited practical significance. However, even these small improvements may provide a competitive a","PeriodicalId":21788,"journal":{"name":"Sports Medicine - Open","volume":"12 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13558504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921040","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":"Examining the Relationship Between Changes in Lower-Limb Isometric Strength and Subsequent Physical Training Outputs in Elite Australian Rules Football Players.","authors":"Ethan J Grimmond, Tom J Stindl, Alexander C Engel, Tea M Maros, Shane Lehane, Nattai R Borges","doi":"10.1186/s40798-026-01105-x","DOIUrl":"10.1186/s40798-026-01105-x","url":null,"abstract":"<p><strong>Background: </strong>Neuromuscular assessments are commonly used to monitor athletes and inform decisions regarding readiness to train and compete. However, the extent to which changes in neuromuscular performance may influence subsequent training or match-play outputs remains unclear, limiting their practical utility. Accordingly, further investigation is required to determine whether these assessments capture neuromuscular changes that meaningfully influence subsequent physical output.</p><p><strong>Objectives: </strong>This study aimed to examine the acute relationship between changes in pretraining isometric strength and subsequent physical training outputs during preseason in professional Australian Rules football (ARF) players.</p><p><strong>Design: </strong>Prospective longitudinal observational study.</p><p><strong>Methods: </strong>Forty-two professional ARF players were monitored across a 12-week preseason. Pretraining lower-limb isometric strength was assessed via dynamometry (knee flexion [KNEEFLEX] and hip adduction [HIPADD]), with subsequent linear running and change of direction outputs quantified during training using global navigation satellite system devices with integrated triaxial accelerometers. Linear mixed models were used to examine whether changes in pretraining strength from baseline were associated with subsequent training outputs.</p><p><strong>Results: </strong>Analyses revealed that changes in pretraining KNEEFLEX strength from baseline were significantly associated with subsequent running intensity (m min^-1) at > 70% relative maximum velocity (p < 0.05), but not with any other running intensity, acceleration, or deceleration outputs. Changes in HIPADD strength from baseline were associated with subsequent change of direction outputs (efforts min^-1) at Low and Medium magnitude (p < 0.05), but no significant associations were observed with High magnitude outputs.</p><p><strong>Conclusions: </strong>Changes in pretraining lower-limb isometric strength from baseline were significantly associated with subsequent linear running (m min^-1 at > 70% relative maximum velocity) and change of direction (m min^-1 at Low and Medium magnitude) outputs in training among professional ARF players. These findings suggest that both the KNEEFLEX and HIPADD assessments may serve as useful indicators of a player's physical readiness in the context of ARF and may help inform subsequent modification to training load and recovery where appropriate.</p>","PeriodicalId":21788,"journal":{"name":"Sports Medicine - Open","volume":"12 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13550274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907134","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":"Physical Exercise in Immunotherapy.","authors":"Campbell M Johnston, Susan J Kim, Yiyu Zhang, Carolyn Tsung, Eric Kent, Allison May, Hongji Zhang","doi":"10.1186/s40798-026-01101-1","DOIUrl":"10.1186/s40798-026-01101-1","url":null,"abstract":"<p><strong>Background: </strong>Accumulating evidence suggests that physical exercise can favorably modulate the tumor microenvironment (TME) and enhance the efficacy of cancer immunotherapies. MAIN: Exercise has been shown to modulate the immune environment to promote infiltration and function of cell types that confer anti-tumor effects. These effects counteract several mechanisms of immune evasion within the TME that limit the effectiveness of immune checkpoint blockade, particularly therapies targeting PD-1 and PD-L1. Preclinical models demonstrate that exercise not only enhances anti-tumor immune responses, but also sensitizes tumors to checkpoint inhibitors, resulting in improved tumor control. Mechanistically, these benefits appear to be mediated through enhanced cytokine signaling, metabolic reprogramming of immune cells, and alterations in chemokine gradients that facilitate immune cell trafficking.</p><p><strong>Conclusions: </strong>This review summarizes current insights into how exercise impacts tumor biology and immunity and discusses the emerging rationale for integrating structured physical activity into immunotherapeutic regimens. While clinical evidence remains limited, ongoing studies will be critical to determining the translational relevance of these findings across cancer types and patient populations.</p>","PeriodicalId":21788,"journal":{"name":"Sports Medicine - Open","volume":"12 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13542029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887264","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":"Reliability, Device Agreement and Validity of Load-Velocity Profiles: A Systematic Review with Meta-analysis.","authors":"Nina Claassen, Stanislav Dimitri Siegel, Mareike Sproll, Niklas Lebelt, Alyssa Virginia Bargende, Anne Marieke Fasold, Konstantin Warneke","doi":"10.1186/s40798-026-01102-0","DOIUrl":"10.1186/s40798-026-01102-0","url":null,"abstract":"<p><strong>Background: </strong>For a valid one-repetition maximum (1RM) prediction via load-velocity (LV) relationships, high reliability and accuracy must be assumed.</p><p><strong>Objective: </strong>Since individual study results indicate ambivalent prediction, this systematic review and meta-analysis was designed to provide a updated and comprehensive overview, extending knowledge about the validity and reliability of commercially available velocity sensors in Part I and the validity and reliability of velocity-based 1RM prediction models in Part II.</p><p><strong>Methods: </strong>A systematic literature search was conducted in PubMed/MEDLINE, Web of Science, and Scopus. Validity and/or reliability studies or velocity-based 1RM prediction evaluations were included. Methodological quality was assessed using adapted COSMIN. The analysis was performed for intraclass correlation coefficient (ICC), Lin's concordance correlation coefficient (CCC), and Pearson's correlation coefficient (r). The review was preregistered in PROSPERO (CRD42025634595).</p><p><strong>Results: </strong>Sixty-three studies were included for sensor validity and reliability and 38 for 1RM prediction models. Part I: Velocity sensors demonstrated good-to-excellent pooled validity and device agreement (ICC = 0.91-0.92 [0.83-0.97]; k = 55 and 439, respectively); intra- and inter-day reliability were classified as good to excellent with ICC = 0.90-0.91 [0.85-0.95] (k = 228 and 608, respectively), with sensor technology moderating the results. However, substantial heterogeneity and wide ranges of study-level estimates indicated considerable variability across moderators, linear position transducer (LPT) generally showing more consistent performance than inertial measurement units (IMU). Part II: Velocity-based 1RM prediction showed ICCs = 0.90 [0.83-0.94] (k = 124) and ICC = 0.91 [0.72-0.98] (k = 9); for reliability and validity, respectively.</p><p><strong>Discussion: </strong>Commercial velocity sensors generally provide high relative validity and reliability. Results varied depending on exercise complexity, intensity, sensor technology, and modeling approach. While velocity-based 1RM prediction demonstrated high average validity, large heterogeneity in lower body exercises significantly biased the results. Furthermore, the dearth of measurement error and agreement analyses prohibits final conclusions.</p><p><strong>Conclusion: </strong>Therefore, velocity-based monitoring and 1RM prediction require cautious interpretation, as sensor- and exercise-specific evidence remains limited.</p>","PeriodicalId":21788,"journal":{"name":"Sports Medicine - Open","volume":"12 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13542044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887210","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":"Invisible Harms, Visible Benefits? Adverse Event Reporting in Physical Activity Interventions for Neurodevelopmental Disorders: A Meta-analysis and Critical Appraisal.","authors":"Jinrong He, Changhui Peng, Lei Zhang, Dandan Wang, Xiaohuan Tan, Xili Wen, Xin Shen, Xueping Wu","doi":"10.1186/s40798-026-01095-w","DOIUrl":"10.1186/s40798-026-01095-w","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Clinical guidelines and practice increasingly endorse physical activity interventions for individuals with neurodevelopmental disorders. However, because monitoring and reporting of potential intervention-related harms are often incomplete, the current evidence base regarding safety remains limited.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A systematic search of PubMed, Web of Science, Scopus, the Cochrane Library, and EBSCO was conducted on November 11, 2025, followed by three rounds of supplementary snowball searching completed on November 20, 2025. Eligible studies were randomized controlled trials of physical activity interventions in populations with neurodevelopmental disorders. Following prespecified procedures recommended by the CONSORT-Harms extension and the Cochrane Handbook for Systematic Reviews of Interventions, we characterized adverse event monitoring and reporting practices across studies, summarized reasons for participant withdrawal, and considered the potential safety signals these reasons might indicate. Random-effects meta-analyses estimated the relative risk of adverse events for physical activity interventions versus non-exercise controls, and potential moderators were examined via subgroup and meta-regression analyses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among the 41,852 deduplicated records, 309 randomized controlled trials were included, comprising 322 study arms and 13,228 participants with neurodevelopmental disorders. None of the included trials fully complied with CONSORT-Harms recommendations for systematic harm monitoring and reporting. Only 58 trials described adverse event monitoring, mostly using passive, non-prespecified procedures; among those reporting results, approximately one quarter reported at least one adverse event or adverse effect, most commonly intervention-induced delayed-onset muscle soreness, mild pain or irritation, and related psychological discomfort. Among the 201 studies that reported reasons for participant withdrawal, 38 statements were too vague to determine the event characteristics. Sixteen studies reported adverse events (e.g., health problems and emotional discomfort); however, because none used a systematic adjudication procedure, attributing these events to the intervention was difficult. Forty-five studies met the inclusion criteria for meta-analysis. The pooled analysis indicated that physical activity interventions did not significantly increase the risk of reported adverse events (RR = 1.14; 95% CI 0.67-1.94). However, trials with prespecified monitoring procedures had a significantly higher risk estimate (RR = 4.32, 95% CI 1.36-13.68).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Existing reported results suggest that these interventions do not significantly increase the overall risk of adverse events. However, the strength of this conclusion is limited by widespread systematic underreporting in the original studies and by substantial heterogeneity in methods used to","PeriodicalId":21788,"journal":{"name":"Sports Medicine - Open","volume":"12 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13538331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881613","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":"Air Pollution Impairs Marathon Performance: A Cross-Sectional Analysis of 2.7 Million Finishers Across Six World Marathon Majors.","authors":"James A Donaldson, Samuel Cai, Josh Vande Hey, Anna L Hansell, Thomas Yates, G Andre Ng, Jamie O'Driscoll","doi":"10.1186/s40798-026-01099-6","DOIUrl":"10.1186/s40798-026-01099-6","url":null,"abstract":"<p><strong>Background: </strong>Ambient air pollution impairs respiratory and cardiovascular function during exercise, yet evidence on its effects across the full spectrum of endurance performance remains limited.</p><p><strong>Objectives: </strong>To quantify the association between race-day ambient air pollution and marathon finishing time across six World Marathon Majors, and to determine whether effects vary by sex, age group, and performance level.</p><p><strong>Methods: </strong>We analysed 2,756,553 net finishing times from six World Marathon Majors (Berlin, Boston, Chicago, London, New York City, and Tokyo) for editions held between 2010 and 2024. Race-day nitrogen dioxide (NO₂) and fine particulate matter (PM₂.₅) concentrations were obtained from the Copernicus Atmosphere Monitoring Service (CAMS) global reanalysis dataset. Linear mixed-effects models with random intercepts for each of 75 marathon-year events estimated pollution effects on finishing time, adjusting for heat index, wind speed, and temporal trends. Stratified analyses were conducted among 1,815,188 runners with available age data.</p><p><strong>Results: </strong>Of the pollutants examined, NO₂ showed the stronger association with finishing time. Each 1 µg/m³ increase was associated with 1.43 min slower finishing time in men (95% confidence interval [CI] 0.66 to 2.21) and 1.56 min in women (95% CI 0.63 to 2.48). PM₂.₅ effects were not statistically significant: -0.13 min per µg/m³ in men (95% CI -0.67 to 0.40) and -0.14 min per µg/m³ in women (95% CI -0.76 to 0.49). Recreational runners experienced NO₂ effects approximately six-fold larger than elite runners (2.12 vs 0.34 min per µg/m³); expressed as a percentage of mean finishing time, this gradient persisted (0.67% vs 0.18%). Younger runners (18-29 years) showed larger effects than older runners (2.17 vs 1.32 min per µg/m³ for ≥60 years). Kolmogorov-Smirnov tests confirmed that higher NO₂ was associated with rightward shifts across the entire finishing time distribution.</p><p><strong>Conclusions: </strong>Ambient air pollution, particularly NO₂, is associated with impaired marathon performance in a dose-dependent manner, with the largest effects among recreational runners. These findings have implications for race management and public health policy regarding outdoor physical activity in urban environments.</p>","PeriodicalId":21788,"journal":{"name":"Sports Medicine - Open","volume":"12 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857657","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":"Orthometria: Metric Fixation in Digital Health and a Framework for Responsible Use in High-Performance Sport.","authors":"Dean J Miller, Michele Lastella, Ashley-Raye Miles","doi":"10.1186/s40798-026-01100-2","DOIUrl":"10.1186/s40798-026-01100-2","url":null,"abstract":"<p><p>The proliferation of consumer-grade digital health technologies has expanded physiological data collection beyond clinical and laboratory settings. In high-performance sport, these devices offer genuine utility for monitoring sleep, cardiac activity, and recovery. However, their widespread adoption has outpaced frameworks for responsible implementation. This perspective introduces orthometria, derived from ortho- (correct) and -metria (to measure), to describe the counterproductive fixation on digital health metrics collected via commercially available health technology. Orthometria is not proposed as a clinical phenomenon but as a behavioural descriptor for when the collection and review of any physiological metric obtained using a digital health device creates anxiety or has a negative effect on well-being or performance. The construct is introduced not to sensationalise potential risks or deter technology use, but to facilitate clearer discussion, monitoring, and responsible, effective implementation. Drawing on Kolb's Experiential Learning Theory, a five-stage framework is proposed for the responsible implementation of digital health technology in high-performance sport. Future research should explore framework efficacy, validate an orthometria-specific psychometric scale, and examine which metric types most influence athlete behaviour.</p>","PeriodicalId":21788,"journal":{"name":"Sports Medicine - Open","volume":"12 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851503","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}