Sports Medicine最新文献

{"title":"Causal Association Between Sedentary Behaviors and Health Outcomes: A Systematic Review and Meta-Analysis of Mendelian Randomization Studies.","authors":"Ying Gao, Qingyang Li, Luyao Yang, Hanhua Zhao, Di Wang, Arto J Pesola","doi":"10.1007/s40279-024-02090-5","DOIUrl":"10.1007/s40279-024-02090-5","url":null,"abstract":"<p><strong>Background: </strong>Different types of sedentary behavior are associated with several health outcomes, but the causality of these associations remains unclear.</p><p><strong>Objectives: </strong>To conduct a systematic review and meta-analysis of Mendelian randomization (MR) studies investigating the associations between sedentary behaviors and health outcomes.</p><p><strong>Methods: </strong>A systematic search on PubMed, Embase, Web of Science, Scopus, and PsycINFO up to August 2023 was conducted to identify eligible MR studies. We selected studies that assessed associations of genetically determined sedentary behaviors and health outcomes. A meta-analysis was conducted to examine the causal associations when two or more MR studies were available. We graded the evidence level of each MR association based on the results of the main method and sensitivity analyses in MR studies.</p><p><strong>Results: </strong>A total of 31 studies with 168 MR associations between six types of sedentary behavior and 47 health outcomes were included. Results from meta-analyses suggested a total of 47 significant causal associations between sedentary behaviors and health outcomes. Notably, more leisure TV watching is robustly correlated with increased risks of myocardial infarction, coronary artery disease, all-cause ischemic stroke, and type 2 diabetes. Conversely, robust inverse associations were observed between leisure computer use and risks of rheumatoid arthritis, Alzheimer's disease, and gastroesophageal reflux disease.</p><p><strong>Conclusion: </strong>These findings suggest that different types of sedentary behavior have distinct causal effects on health outcomes. Therefore, interventions should focus not only on reducing sedentary time but also on promoting healthier types of sedentary behavior.</p><p><strong>Prospero registration: </strong>CRD42023453828.</p>","PeriodicalId":21969,"journal":{"name":"Sports Medicine","volume":" ","pages":"3051-3067"},"PeriodicalIF":9.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142112158","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}

{"title":"Optimizing Resistance Training for Sprint and Endurance Athletes: Balancing Positive and Negative Adaptations.","authors":"Bas Van Hooren, Per Aagaard, Anthony J Blazevich","doi":"10.1007/s40279-024-02110-4","DOIUrl":"10.1007/s40279-024-02110-4","url":null,"abstract":"<p><p>Resistance training (RT) triggers diverse morphological and physiological adaptations that are broadly considered beneficial for performance enhancement as well as injury risk reduction. Some athletes and coaches therefore engage in, or prescribe, substantial amounts of RT under the assumption that continued increments in maximal strength capacity and/or muscle mass will lead to improved sports performance. In contrast, others employ minimal or no RT under the assumption that RT may impair endurance or sprint performances. However, the morphological and physiological adaptations by which RT might impair physical performance, the likelihood of these being evoked, and the training program specifications that might promote such impairments, remain largely undefined. Here, we discuss how selected adaptations to RT may enhance or impair speed and endurance performances while also addressing the RT program variables under which these adaptations are likely to occur. Specifically, we argue that while some myofibrillar (muscle) hypertrophy can be beneficial for increasing maximum strength, substantial hypertrophy can lead to macro- and microscopic adaptations such as increases in body (or limb) mass and internal moment arms that might, under some conditions, impair both sprint and endurance performances. Further, we discuss how changes in muscle architecture, fiber typology, microscopic muscle structure, and intra- and intermuscular coordination with RT may maximize speed at the expense of endurance, or maximize strength at the expense of speed. The beneficial effect of RT for sprint and endurance sports can be further improved by considering the adaptive trade-offs and practical implications discussed in this review.</p>","PeriodicalId":21969,"journal":{"name":"Sports Medicine","volume":" ","pages":"3019-3050"},"PeriodicalIF":9.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11608172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimising the Dose of Static Stretching to Improve Flexibility: A Systematic Review, Meta-analysis and Multivariate Meta-regression","authors":"Lewis A. Ingram, Grant R. Tomkinson, Noah M. A. d’Unienville, Bethany Gower, Sam Gleadhill, Terry Boyle, Hunter Bennett","doi":"10.1007/s40279-024-02143-9","DOIUrl":"https://doi.org/10.1007/s40279-024-02143-9","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Static stretching is widely used to increase flexibility. However, there is no consensus regarding the optimal dosage parameters for increasing flexibility.</p><h3 data-test=\"abstract-sub-heading\">Objectives</h3><p>We aimed to determine the optimal frequency, intensity and volume to maximise flexibility through static stretching, and to investigate whether this is moderated by muscle group, age, sex, training status and baseline level of flexibility.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Seven databases (CINAHL Complete, Cochrane CENTRAL, Embase, Emcare, MEDLINE, Scopus, and SPORTDiscus) were systematically searched up to June 2024. Randomised and non-randomised controlled trials investigating the effects of a single session (acute) or multiple sessions (chronic) of static stretching on one or more flexibility outcomes (compared to non-stretching passive controls) among adults (aged ≥ 18 years) were included. A multi-level meta-analysis examined the effect of acute and chronic static stretching on flexibility outcomes, while multivariate meta-regression was used to determine the volume at which increases in flexibility were maximised.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Data from 189 studies representing 6654 adults (61% male; mean [standard deviation] age = 26.8 ± 11.4 years) were included. We found a moderate positive effect of acute static stretching on flexibility (summary Hedges’ <i>g</i> = 0.63, 95% confidence interval 0.52–0.75, <i>p</i> &lt; 0.001) and a large positive effect of chronic static stretching on flexibility (summary Hedges’ <i>g</i> = 0.96, 95% confidence interval 0.84–1.09, <i>p</i> &lt; 0.001). Neither effect was moderated by stretching intensity, age, sex or training status, or weekly session frequency and intervention length (chronic static stretching only) [<i>p</i> &gt; 0.05]. However, larger improvements were found for adults with poor baseline flexibility compared with adults with average baseline flexibility (<i>p</i> = 0.01). Furthermore, larger improvements in flexibility were found in the hamstrings compared with the spine following acute static stretching (<i>p</i> = 0.04). Improvements in flexibility were maximised by a cumulative stretching volume of 4 min per session (acute) and 10 min per week (chronic).</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>Static stretching improves flexibility in adults, with no additional benefit observed beyond 4 min per session or 10 min per week. Although intensity, frequency, age, sex and training status do not influence improvements in flexibility, lower flexibility levels are associated with greater improvement following both acute and chronic static stretching. These guidelines for static stretching can be used by coaches and therapists to improve flexibility.</p><h3 data-test=\"abstract-sub-heading\">Clinical Trial Registration</h3><p>PROSPERO CRD42023420168.</p>","PeriodicalId":21969,"journal":{"name":"Sports Medicine","volume":"64 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142753223","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}

{"title":"High-Intensity Interval Training for Cancer Patients: A Review of Key Considerations for Exercise Prescription","authors":"Gilmar Dias-da-Silva, Valéria L. G. Panissa, Sophie F. M. Derchain, Marina L. V. Ferreira, Guilherme D. Telles, Glenda B. B. Buzaglo, Rafaela B. Araújo, Felipe C. Vechin, Miguel S. Conceição","doi":"10.1007/s40279-024-02145-7","DOIUrl":"https://doi.org/10.1007/s40279-024-02145-7","url":null,"abstract":"&lt;h3 data-test=\"abstract-sub-heading\"&gt;Background&lt;/h3&gt;&lt;p&gt;High-intensity interval training (HIIT) performed before, during, and after cancer treatment can attenuate the adverse effects induced by anti-cancer drugs. A clear presentation and rationale of characteristics of HIIT variables is vital to produce the expected HIIT adaptations in cancer patients. However, there are concerns regarding the HIIT protocols used in the cancer literature.&lt;/p&gt;&lt;h3 data-test=\"abstract-sub-heading\"&gt;Objectives&lt;/h3&gt;&lt;p&gt;The aims were to (1) identify the characteristics of HIIT and the formats that have been prescribed, (2) analyze which anchors have been utilized to prescribe effort and pause intensity, (3) examine characteristics of the physical tests used for HIIT prescription, and (4) identify potential adverse events related to HIIT intervention.&lt;/p&gt;&lt;h3 data-test=\"abstract-sub-heading\"&gt;Methods&lt;/h3&gt;&lt;p&gt;This scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, including PubMed, Scopus, and Web of Science databases.&lt;/p&gt;&lt;h3 data-test=\"abstract-sub-heading\"&gt;Results&lt;/h3&gt;&lt;p&gt;A total of 51 studies were retrieved, and the following results were found: (1) Only 25 studies reported all four essential variables for HIIT prescription [effort intensity (effort duration): pause intensity (pause duration)]. Of these studies, 23 used active pause and employed the following prescription (on average): [84% (116 s): 39% (118 s)] when percentage of maximal aerobic power (MAP) [maximal/peak oxygen uptake (&lt;span&gt;({{{V}}})&lt;/span&gt;O&lt;sub&gt;2max/peak&lt;/sub&gt;)/MAP] was used; [124% (161 s): 55% (142 s)] when percentage of anaerobic threshold (AT) was used; [83% (230 s): 62% (165 s)] when maximal heart rate percentage (%HR&lt;sub&gt;max&lt;/sub&gt;) was used. From these 23 studies, 12 used &lt;span&gt;({{{V}}})&lt;/span&gt;O&lt;sub&gt;2max/peak&lt;/sub&gt;/MAP (one of the most recommended variables for HIIT prescription). Seven studies adopted the HIIT-long format, and in the remaining five studies, the format was unclear. (2) Twenty-four studies used fractions of &lt;span&gt;({{{V}}})&lt;/span&gt;O&lt;sub&gt;2max/peak&lt;/sub&gt; or mechanical variables like MAP as anchors for prescribing effort intensity, two studies used AT, 20 studies used fractions of HR&lt;sub&gt;max&lt;/sub&gt;/heart rate reserve, two studies used rate of perceived exertion (RPE), while one used RPE and %&lt;span&gt;({{{V}}})&lt;/span&gt;O&lt;sub&gt;2peak&lt;/sub&gt; concomitantly, and two studies utilized RPE/%HR&lt;sub&gt;max&lt;/sub&gt; concomitantly. Two studies utilized passive resting, 12 studies used %&lt;span&gt;({{{V}}})&lt;/span&gt;O&lt;sub&gt;2peak&lt;/sub&gt;/%MAP for prescribing pause intensity, four studies used AT, seven studies used %HR&lt;sub&gt;max&lt;/sub&gt;, one study used %HR&lt;sub&gt;max&lt;/sub&gt;/%&lt;span&gt;({{{V}}})&lt;/span&gt;O&lt;sub&gt;2peak&lt;/sub&gt;, and two studies used absolute loads. (3) Ten studies did not report the characteristics of the physical tests employed, two studies used submaximal tests, and 39 studies utilized graded exercise tests. (4) Ten studies did not re","PeriodicalId":21969,"journal":{"name":"Sports Medicine","volume":"48 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142718483","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}

{"title":"Relationship Between Physical Literacy and Cardiorespiratory Fitness in Children and Adolescents: A Systematic Review and Meta-analysis","authors":"Tianle Jiang, Guanggao Zhao, Jinmei Fu, Shunli Sun, Ruiming Chen, Delong Chen, Xuewen Hu, Yunong Li, Fanchao Shen, Jin Hong, Haihua Hu","doi":"10.1007/s40279-024-02129-7","DOIUrl":"https://doi.org/10.1007/s40279-024-02129-7","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Physical literacy (PL) can positively affect the health of children, adolescents, and adults, and is closely related to cardiorespiratory fitness (CRF).</p><h3 data-test=\"abstract-sub-heading\">Objective</h3><p>To perform a systematic review and meta-analysis to examine the relationship between overall physical literacy (PL) and CRF in children and adolescents.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Cross-sectional, cohort and experimental studies on the relationship between PL and CRF in children and adolescents were collected by searching the Web of Science Core Collection, PubMed, EBSCOhost, ScienceDirect, Cochrane Library and China National Knowledge Infrastructure (CNKI) databases. Based on the characteristics of the included literature, PL was divided into physical competence (PC), daily behavior (DB), knowledge and understanding (K&amp;U), and motivation and confidence (M&amp;C). R 4.3.6 was used to analyze the combined effect size of PL and the relationships of the four dimensions with CRF among children and adolescents.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>A total of 21 articles were included, 42.9% of which were published after 2020, involving a total of 43,352 children and adolescents from 23 countries or regions. The characteristics of the included studies showed that, except for the K&amp;U of children and adolescents aged 13–18 years, the K&amp;U of other age groups and the PL, PC, DB, M&amp;C of all age groups were significantly positively correlated with CRF. Furthermore, the results of male and female samples in all included studies were the same. The results of the meta-analysis indicated that PL (COR = 0.64, 95% CI 0.58, 0.70), PC (COR = 0.74, 95% CI 0.69, 0.79), DB (COR = 0.49, 95% CI 0.40, 0.57), K&amp;U (COR = 0.41, 95% CI 0.23, 0.56), and M&amp;C (COR = 0.45, 95% CI 0.41, 0.49) were significantly positively correlated with CRF. Regarding DB, total physical activity (TPA) was positively correlated with CRF (COR = 0.49, 95% CI = 0.40, 0.57). Moderate to vigorous physical activity (MVPA), vigorous physical activity (VPA) and high physical activity (HPA) were positively correlated with CRF (COR = 0.16, 95% CI 0.09, 0.22; COR = 0.33, 95% CI 0.22, 0.43; COR = 0.38, 95% CI 0.13, 0.58), but light physical activity (LPA) was negatively correlated with CRF (COR = − 0.20, 95% CI − 0.32, 0.06).</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>PL and CRF are positively correlated among children and adolescents, suggesting that the development of physical literacy has a wide range of effects on children and adolescents’ cardiopulmonary health and that these effects are not limited by PL and its various dimensions or sex. In addition, to exert the positive effect of daily activities on cardiopulmonary health, the intensity of physical activity should reach a moderate level or above.</p>","PeriodicalId":21969,"journal":{"name":"Sports Medicine","volume":"15 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142690585","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}

{"title":"Guiding Evidence-Based Classification in Para Sporting Populations: A Systematic Review of Impairment Measures and Activity Limitations","authors":"Taylor M. Wileman, Marnee J. McKay, Daniel A. Hackett, Timothy J. Watson, Jennifer Fleeton, Ché Fornusek","doi":"10.1007/s40279-024-02132-y","DOIUrl":"https://doi.org/10.1007/s40279-024-02132-y","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>As the focus of classification shifts towards an evidence-based approach, it is crucial to establish a robust system that relies on valid and reliable measures of impairment to ensure legitimate and competitive opportunities for all Para athletes. However, the lack of methods that possess the necessary measurement properties for assessing impairments in Para sporting populations presents significant challenges to developing an evidence-based classification system.</p><h3 data-test=\"abstract-sub-heading\">Objective</h3><p>This review aimed to identify and evaluate measures of impairment and activity limitation measures that have been used to assess eligible impairments in Para sport athletes for potential use in evidence-based classification.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Six electronic databases (MEDLINE, Embase, SPORTDiscus, CINAHL, Scopus, Web of Science) were searched from their earliest record to December 2023.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Fifty-one articles were identified, with twenty-one studies focusing on physical impairment measures. Isometric and grip strength emerged as effective measures. Coordination measures, such as tapping tasks, showed variations with performance. Additionally, six studies focused on intellectual impairments, revealing differences between impaired and non-impaired athletes through generic cognitive tests. Vision impairment measures, including visual acuity and visual field assessments, displayed varying associations with performance across sports.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>Although research on evidence-based classification in Para sport is limited, this review provides valuable insights for sports in developing a testing battery that adheres to evidence-based protocols. Ongoing research efforts by sport governing bodies to prioritise research in this area will improve our understanding of the impairment–performance relationship, leading to better decision making and increased credibility in Para sport classification systems.</p>","PeriodicalId":21969,"journal":{"name":"Sports Medicine","volume":"198 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142684394","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}

{"title":"Acknowledgement to Referees and the Editorial Board.","authors":"","doi":"10.1007/s40279-024-02147-5","DOIUrl":"https://doi.org/10.1007/s40279-024-02147-5","url":null,"abstract":"","PeriodicalId":21969,"journal":{"name":"Sports Medicine","volume":" ","pages":""},"PeriodicalIF":9.3,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682865","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}

{"title":"The Influence of Kinesiophobia on Time to Clinical Recovery in Collegiate Athletes with Concussion","authors":"Daniel J. Rosenblum, Jacob E. Resch","doi":"10.1007/s40279-024-02144-8","DOIUrl":"https://doi.org/10.1007/s40279-024-02144-8","url":null,"abstract":"&lt;h3 data-test=\"abstract-sub-heading\"&gt;Background&lt;/h3&gt;&lt;p&gt;Several factors such as acute symptom severity, premorbid anxiety, and depression have been associated with concussion recovery. Elevated kinesiophobia has been associated with recovery from musculoskeletal conditions, as well as increased reaction time and vestibular–ocular motor dysfunction following concussion. However, kinesiophobia has yet to be evaluated as a modifier of concussion recovery time.&lt;/p&gt;&lt;h3 data-test=\"abstract-sub-heading\"&gt;Objectives&lt;/h3&gt;&lt;p&gt;This study was designed to evaluate the role of acute kinesiophobia levels on days until clinical recovery in collegiate athletes with concussion. We hypothesized that collegiate athletes with elevated Tampa Scale of Kinesiophobia (TSK) scores would take a greater number of days to achieve clinical recovery compared with athletes with lower values.&lt;/p&gt;&lt;h3 data-test=\"abstract-sub-heading\"&gt;Methods&lt;/h3&gt;&lt;p&gt;Division I collegiate athletes diagnosed with a concussion (&lt;i&gt;N&lt;/i&gt; = 113, 19.9 ± 1.5 years, 42% female) participated in this descriptive laboratory study. Participants were assigned to high [≥ 37 (H-TSK, &lt;i&gt;n&lt;/i&gt; = 54)] or low [&lt; 37 (L-TSK, &lt;i&gt;n&lt;/i&gt; = 59)] TSK groups on the basis of the first TSK values recorded within 72 h of their concussion. Participants were also administered the Revised Head Injury Scale (HIS-r) to assess symptom severity within 72 h of injury. The Immediate Postconcussion and Cognitive Test (ImPACT) battery was administered at baseline and used to gather demographic variables such as biological sex, age, history of anxiety/depression, and concussion history, and as part of the athletes’ symptom-free assessment. Days until clinical recovery between H-TSK and L-TSK groups were compared using a Mann–Whitney &lt;i&gt;U&lt;/i&gt; test. Spearman’s rank correlation coefficients were calculated to determine the relationship between TSK and days until clinical recovery in addition to other modifiers of recovery. Multiple linear regression was used to evaluate days until clinical recovery as a function of the TSK total score, controlling for the HIS-r and ImPACT variables.&lt;/p&gt;&lt;h3 data-test=\"abstract-sub-heading\"&gt;Results&lt;/h3&gt;&lt;p&gt;Days until clinical recovery was significantly longer in the H-TSK group (median difference = 2.5 days, &lt;i&gt;p&lt;/i&gt; &lt; 0.001) compared with the L-TSK group. A significant, moderate positive correlation between the TSK score and days to clinical recovery (&lt;i&gt;ρ&lt;/i&gt; = 0.45, &lt;i&gt;p&lt;/i&gt; &lt; 0.001) was observed, which was also the strongest correlation among all variables. Our regression model demonstrated that for every point increase on the TSK, days until clinical recovery increased by 0.23 while controlling for total symptom severity, age, concussion history, psychiatric history, and biological sex (&lt;i&gt;β&lt;/i&gt; = 0.23, &lt;i&gt;p&lt;/i&gt; = 0.018). All other variables entered into the regression were not statistically significant.&lt;/p&gt;&lt;h3 data-test=\"abstract-sub-heading\"&gt;Conclusions&lt;/h3&gt;&lt;p&gt;Our data suggest that athletes with TSK ","PeriodicalId":21969,"journal":{"name":"Sports Medicine","volume":"170 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142678520","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}

{"title":"Associations Between Instrumented Mouthguard-Measured Head Acceleration Events and Post-Match Biomarkers of Astroglial and Axonal Injury in Male Amateur Australian Football Players","authors":"Lauren J. Evans, William T. O’Brien, Gershon Spitz, Steven Mutimer, Becca Xie, Lauren P. Giesler, Brendan P. Major, James W. Hickey, Spencer S. H. Roberts, Biswadev Mitra, Terence J. O’Brien, Sandy R. Shultz, Stuart J. McDonald","doi":"10.1007/s40279-024-02138-6","DOIUrl":"https://doi.org/10.1007/s40279-024-02138-6","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Advances in instrumented mouthguards (iMGs) allow for accurate quantification of single high-acceleration head impacts and cumulative head acceleration exposure in collision sports. However, relationships between these measures and risk of brain cell injury remain unclear.</p><h3 data-test=\"abstract-sub-heading\">Aim</h3><p>The purpose of this study was to quantify measures of non-concussive head impact exposure and assess their association with blood glial fibrillary acidic protein (GFAP), neurofilament light (NfL) and phosphorylated-tau-181 (p-tau-181) levels in male Australian football players.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>A total of 31 athletes underwent in-season (24 h post-match) and post-season (&gt; 5 weeks) blood collections and/or wore HITIQ Nexus A9 iMGs measuring peak linear (PLA) and rotational (PRA) acceleration. Match footage was used to verify and code impacts. Blood GFAP, NfL, and p-tau-181 were quantified using Simoa and natural log transformed for analysis. Associations between post-match biomarkers and within match maximum single impact and cumulative PLA/PRA were assessed with linear mixed models.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>In-season versus post-season elevations were found for GFAP (mean difference 0.14, 95% CI 0.01–0.26, <i>p</i> = 0.033), NfL (mean difference = 0.21, 95% CI 0.09–0.32, <i>p</i> = 0.001) and p-tau-181 (mean difference = 0.49, 95% CI 0.33–0.65, <i>p</i> &lt; 0.001). Post-match GFAP was associated with maximum single impact PLA (<i>B</i> = 0.003, 95% CI 0.0002–0.005, <i>p</i> = 0.036), cumulative PLA (<i>B</i> = 0.001, 95% CI 0.0002–0.002, <i>p</i> = 0.017), cumulative PRA (<i>B</i> = 0.01, 95% CI 0.002–0.02, <i>p</i> = 0.014), and impact number (<i>B</i> = 0.03, 95% CI 0.003–0.05, <i>p</i> = 0.029) within a single match. Change in NfL levels between two-matches correlated with cumulative PLA (<i>r</i> = 0.80, 95% CI 0.38–0.95, <i>p</i> = 0.005), PRA (<i>r</i> = 0.71, 95% CI 0.19–0.92, <i>p</i> = 0.019) and impact number (<i>r</i> = 0.63, 95% CI 0.05–0.89, <i>p</i> = 0.038).</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Maximum and cumulative head accelerations in Australian football, measured by iMGs, were associated with elevated blood biomarkers of brain injury, highlighting the potential of both technologies for head impact management in collision sports.</p>","PeriodicalId":21969,"journal":{"name":"Sports Medicine","volume":"14 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142673210","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}

{"title":"Head Kinematics Associated with Off-Field Head Injury Assessment (HIA1) Events in a Season of English Elite-Level Club Men’s and Women’s Rugby Union Matches","authors":"David Allan, James Tooby, Lindsay Starling, Ross Tucker, Éanna Falvey, Danielle Salmon, James Brown, Sam Hudson, Keith Stokes, Ben Jones, Simon Kemp, Patrick O’Halloran, Matt Cross, Melanie Bussey, Gregory Tierney","doi":"10.1007/s40279-024-02146-6","DOIUrl":"https://doi.org/10.1007/s40279-024-02146-6","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Objectives</h3><p>The purpose of this study was to investigate head kinematic variables in elite men’s and women’s rugby union and their ability to predict player removal for an off-field (HIA1) head injury assessment.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Instrumented mouthguard (iMG) data were collected for 250 men and 132 women from 1865 and 807 player-matches, respectively, and synchronised to video-coded match footage. Head peak resultant linear acceleration (PLA), peak resultant angular acceleration (PAA) and peak change in angular velocity (dPAV) were extracted from each head acceleration event (HAE). HAEs were linked to documented HIA1 events, with ten logistical regression models for men and women, using a random subset of non-case HAEs, calculated to identify kinematic variables associated with HIA1 events. Receiver operating characteristic curves (ROC) were used to describe thresholds for HIA1 removal.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Increases in PLA and dPAV were significantly associated with an increasing likelihood of HIA1 removal in the men’s game, with an OR ranging from 1.05–1.12 and 1.13–1.18, respectively. The optimal values to maximise for both sensitivity and specificity for detecting an HIA1 were 1.96 krad⋅s⁻², 24.29 g and 14.75 rad⋅s⁻¹ for PAA, PLA and dPAV, respectively. Only one model had any significant variable associated with increasing the likelihood of a HIA1 removal in the women’s game—PAA with an OR of 8.51 (1.23–58.66). The optimal values for sensitivity and specificity for women were 2.01 krad⋅s⁻², 25.98 g and 15.38 rad⋅s⁻¹ for PAA, PLA and dPAV, respectively.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>PLA and dPAV were predictive of men’s HIA1 events. Further HIA1 data are needed to understand the role of head kinematic variables in the women’s game. The calculated spectrum of sensitivity and specificity of iMG alerts for HIA1 removals in men and women present a starting point for further discussion about using iMGs as an additional trigger in the existing HIA process.</p>","PeriodicalId":21969,"journal":{"name":"Sports Medicine","volume":"38 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643187","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}