Myles Calder Murphy, Andrea Bruder, Vanessa R Sutton, Garth Allen, Andrea Mosler, Jonathan Hodgson, Simone Radavelli-Bagatini, Evert Verhagen, Joanne Kemp, Caroline Jones, Joletta Belton, Debra Langridge
{"title":"Cocreating a programme to prevent injuries and improve performance in Australian Police Force recruits: consumer, industry partner and researcher involvement protocol.","authors":"Myles Calder Murphy, Andrea Bruder, Vanessa R Sutton, Garth Allen, Andrea Mosler, Jonathan Hodgson, Simone Radavelli-Bagatini, Evert Verhagen, Joanne Kemp, Caroline Jones, Joletta Belton, Debra Langridge","doi":"10.1136/bmjsem-2025-002632","DOIUrl":"10.1136/bmjsem-2025-002632","url":null,"abstract":"<p><p>We are conducting a research program to cocreate, implement and evaluate an injury prevention intervention for the Western Australia (WA) Police Force Recruit Training Academy. This programme of research has three primary phases: (1) cocreate an injury prevention intervention for the WA Police Force with WA Force recruits, WA Police Force staff, health professionals and injury prevention experts, (2) implement the injury prevention intervention into WA Police Force Recruit training and (3) evaluate the reach, effectiveness, adoption, implementation and maintenance of the injury prevention intervention. Our research programme includes the involvement of consumers, industry partners and researchers. To ensure collaboration and to measure our consumer, industry partner and researcher involvement, we have developed a protocol, including qualitative and quantitative evaluation, to address potential barriers to involvement. Thus, this protocol details our consumer, industry partner and researcher involvement plan across all three phases of this 5-year project and how we will evaluate their experience and influence. Our primary objective is to ensure meaningful consumer, industry partner and researcher involvement at all stages of the research process and evaluate how the research programme was influenced by consumer, industry partner and researcher involvement.</p>","PeriodicalId":47417,"journal":{"name":"BMJ Open Sport & Exercise Medicine","volume":"11 2","pages":"e002632"},"PeriodicalIF":3.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
David Munro, Stephanie Greenspan, Joanna Nicholas, Melanie I Stuckey
{"title":"Circus-specific extension of the 6th International Consensus Statement on Concussion in Sport.","authors":"David Munro, Stephanie Greenspan, Joanna Nicholas, Melanie I Stuckey","doi":"10.1136/bmjsem-2025-002524","DOIUrl":"10.1136/bmjsem-2025-002524","url":null,"abstract":"<p><p>While sport-related concussion (SRC) is a known risk in circus arts, no published guidelines exist to guide post-concussion return to circus, contributing to inadequate management in this population. The Concussion in Sport Group (CISG) published the 6th international consensus statement in 2023, providing updated guidance and assessment tools for the management of SRC. Sport and dance organisations have adapted these recommendations for their specific settings. The aim of this extension statement was to extend the CISG guideline to the circus arts training and performance context. Development included a review of literature, creation of the initial drafts by the working group, feedback from external reviewers and integration of the feedback into a final draft approved by the working group. This statement includes circus-specific recommendations for: (1) baseline testing; (2) immediate postinjury management including adapted Maddocks questions; (3) a criterion-based return-to-circus progression including guidance by circus discipline; (4) prognostic considerations; (5) risk reduction/prevention. While ongoing research specific to SRC in circus is needed, this guideline supports and advises circus organisations to develop concussion management protocols and policies. It also informs clinicians to assist their understanding of the unique aspects and demands of circus arts to provide tailored clinical care in the rehabilitation of circus artists as they return to training and performance following SRC.</p>","PeriodicalId":47417,"journal":{"name":"BMJ Open Sport & Exercise Medicine","volume":"11 2","pages":"e002524"},"PeriodicalIF":3.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ida Karoline Bach Jensen, Anne Dsane Jessen, Steffie Vang Gundersen, Caroline Borup Roland, Signe de Place Knudsen, Saud Abdulaziz Alomairah, Jane M Bendix, Tine D Clausen, Ole Hartvig Mortensen, Grete Teilmann, Bente Stallknecht, Ellen Løkkegaard, Stig Molsted
{"title":"Mother's heart rate: a valid way to measure physical activity during pregnancy? Data from the FitMum RCT.","authors":"Ida Karoline Bach Jensen, Anne Dsane Jessen, Steffie Vang Gundersen, Caroline Borup Roland, Signe de Place Knudsen, Saud Abdulaziz Alomairah, Jane M Bendix, Tine D Clausen, Ole Hartvig Mortensen, Grete Teilmann, Bente Stallknecht, Ellen Løkkegaard, Stig Molsted","doi":"10.1136/bmjsem-2025-002458","DOIUrl":"10.1136/bmjsem-2025-002458","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to compare Garmin-estimated daily minutes of moderate-to-vigorous-intensity physical activity (MVPA) with daily minutes of MVPA assessed using heart rate (HR) thresholds based on maximum HR and HR reserve (HRR), respectively. Furthermore, we explored pregnancy-related HR changes.</p><p><strong>Methods: </strong>The FitMum study included 220 healthy pregnant women before gestational age week 15+0 wearing Garmin vívosport activity trackers continuously until delivery. The activity trackers measured MVPA based on a proprietary algorithm including HR and accelerometry (model 1). We assessed MVPA as time above 64% of maximum HR with (model 2a) and without (model 2b) a minimum of 10 consecutive minutes of MVPA. In model 3, we assessed MVPA as time above 40% of HRR.</p><p><strong>Results: </strong>Model 2a assigned less MVPA compared with model 1 (mean bias: -3.66 min/day). Model 2b assigned more MVPA compared with model 1 (mean bias: 16.82 min/day) and Model 2a (mean bias: 20.48 min/day). Model 3 assigned more MVPA compared with model 2b (mean bias: 12.00 min/day). Resting and average HR increased during pregnancy.</p><p><strong>Conclusion: </strong>Using HR for assessing MVPA offers transparency. The Garmin algorithm (model 1) assigned more MVPA compared with the HR model (model 2a). Removing the 10-min bout criterion resulted in more MVPA (Model 2a vs 2b). Using the HRR for assessing MVPA (model 3) resulted in more MVPA compared with using the maximum HR (model 2b). Resting and average HR resembled findings from previous studies.</p>","PeriodicalId":47417,"journal":{"name":"BMJ Open Sport & Exercise Medicine","volume":"11 2","pages":"e002458"},"PeriodicalIF":3.9,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12104894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Uzo Ehiogu, Volker Rainer Schöffl, Gareth Jones, Matthew Buckthorpe, Stephen Patterson
{"title":"Developing consensus for upper limb rehabilitation, physical preparation and return to climbing in adults: protocol for an international e-Delphi study.","authors":"Uzo Ehiogu, Volker Rainer Schöffl, Gareth Jones, Matthew Buckthorpe, Stephen Patterson","doi":"10.1136/bmjsem-2025-002584","DOIUrl":"10.1136/bmjsem-2025-002584","url":null,"abstract":"<p><p>Climbing has grown into a grassroots participation sport and Olympic discipline. The high loads expressed through the upper limb may increase the risk of injury in this population. This may also affect rehabilitation and return to sport (RTS) considerations after injury. Treatment, management, rehabilitation and RTS parameters after injury are poorly documented. The aim of this study is to reach international expert consensus on the postinjury and surgical rehabilitation, physical preparation and RTS strategies in a range of climbers. This will provide a framework for the safe RTS of climbers. The study will be reported in accordance with guidance on conducting and reporting Delphi Studies guidelines. Panel members will be recruited with expertise in either the delivery of healthcare and/or physical preparation of climbers. The electronic Delphi is anticipated to consist of three irritative rounds. Round 1 will consist of open and closed questions to generate a broad range of statements on the rehabilitation, RTS and outcome measures used after climbing injury. In round 2, all participants will be provided with a summary of the current literature of the rehabilitation and RTS strategies for upper limb sports injuries. Rounds 2 and 3 will consist of a summary of the results from the previous round including any dissonance. Participants will be asked to anonymously rate responses on a 5-point Likert scale. The study steering group and patient public involvement representatives will be involved from conceptualisation until final dissemination.</p>","PeriodicalId":47417,"journal":{"name":"BMJ Open Sport & Exercise Medicine","volume":"11 2","pages":"e002584"},"PeriodicalIF":3.9,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Ending nuclear weapons, before they end us.","authors":"Chris Zielinski","doi":"10.1136/bmjsem-2025-002692","DOIUrl":"10.1136/bmjsem-2025-002692","url":null,"abstract":"","PeriodicalId":47417,"journal":{"name":"BMJ Open Sport & Exercise Medicine","volume":"11 2","pages":"e002692"},"PeriodicalIF":3.9,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12086925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hannah Walton, Hamish Gornall, Isla J Shill, Anthony P Turner, Neil Graham, Lara Paul, Sharief Hendricks, Ross Tucker, Debbie Palmer
{"title":"Lowering the maximum legal tackle height in Scottish community women's rugby: an injury surveillance and video analysis study across two seasons.","authors":"Hannah Walton, Hamish Gornall, Isla J Shill, Anthony P Turner, Neil Graham, Lara Paul, Sharief Hendricks, Ross Tucker, Debbie Palmer","doi":"10.1136/bmjsem-2025-002499","DOIUrl":"https://doi.org/10.1136/bmjsem-2025-002499","url":null,"abstract":"<p><strong>Objectives: </strong>The tackle carries the highest risk of concussion in women's rugby union. To reduce concussion risk, a lowered maximum tackle height (LTH) law, lowering the maximum legal tackle height from the shoulder to below the base of the sternum, was implemented across Scottish community rugby. This study aimed to assess the effect of the LTH on player head-contact events, proximity (location nearest the head (~30 cm)) and concussion incidence in Scottish women's community rugby.</p><p><strong>Methods: </strong>A retrospective video analysis study, alongside prospective injury data collection, compared differences in game metrics, tackle characteristics and time-loss injury (including concussion) between the pre-LTH (2022/2023) and LTH (2023/2024) seasons.</p><p><strong>Results: </strong>Head-to-head and head-to-shoulder proximity to the opponent for the tackler (head: rate ratio (RR):0.71 (95% CI 0.62 to 0.82), shoulder: RR:0.73 (95% CI 0.65 to 0.83)), and ball-carrier (head: RR:0.67 (95% CI 0.58 to 0.77), shoulder: RR:0.68 (95% CI 0.58 to 0.79)) were lower in the LTH season. Head contact to the opponent's shoulder decreased for the tackler (RR: 0.65 (95% CI 0.46 to 0.91)) and ball-carrier (RR: 0.52 (95% CI 0.35 to 0.78)). Tackler body position was lower (upright: RR:0.79 (95% CI 0.75 to 0.83), bent at waist: RR:1.34 (95% CI 1.25 to 1.42)), reducing red-zone (above the base of the sternum) contacts (RR:0.81 (95% CI 0.76 to 0.85)). Although non-significant, tackler concussion rates dropped (IR: 2.83 to 0.52/1000 player match hours; RR: 0.18 (95% CI 0.004 to 1.52)), while ball-carrier concussion rates increased (IR: 1.89 to 4.70/1000 player match hours; RR: 2.49 (95%CI 0.69 to 11.06)).</p><p><strong>Conclusion: </strong>Lowering the maximum tackle height to below the base of the sternum showed a reduction in red-zone contacts, head-to-head proximity and head-to-shoulder contact for the tackler and ball-carrier. There were no significant differences in concussion rates in the present study, and the limitations surrounding the small sample of injuries highlight the need for further research on the effect of injury prevention initiatives in women's rugby.</p>","PeriodicalId":47417,"journal":{"name":"BMJ Open Sport & Exercise Medicine","volume":"11 2","pages":"e002499"},"PeriodicalIF":3.9,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Emilie Mass Dalhaug, Birgitte Sanda, Kari Bø, Wendy J Brown, Kaia Øvstedal, Sofia Brevik-Persson, Lene A H Haakstad
{"title":"Is fetal well-being jeopardised during high-intensity interval training?","authors":"Emilie Mass Dalhaug, Birgitte Sanda, Kari Bø, Wendy J Brown, Kaia Øvstedal, Sofia Brevik-Persson, Lene A H Haakstad","doi":"10.1136/bmjsem-2025-002496","DOIUrl":"https://doi.org/10.1136/bmjsem-2025-002496","url":null,"abstract":"<p><strong>Abstract: </strong></p><p><strong>Objectives: </strong>To explore the acute effects of high-intensity interval training on fetal heart rate (FHR) and uteroplacental blood flow.</p><p><strong>Method: </strong>Elite (n=10) and recreational athletes (n=50) participated in an experimental laboratory study involving 5×5 min intervals of high-intensity exercise on both a treadmill and cycle ergometer, with a 4 min pause between intervals for measurement of FHR and uteroplacental blood flow. Target intensity was 17 on Borg's rating of perceived exertion (RPE) scale and 90% of estimated maximal maternal heart rate (MHR<sub>max</sub>).</p><p><strong>Results: </strong>Mean exercise intensity was 16.4 (SD 1.0) RPE and 89.4 (SD 3.8) % of MHR<sub>max</sub> during running and 16.0 (SD 1.0) RPE and 84.6 (SD 5.0) % of MHR<sub>max</sub> during cycling. Mean FHR was 140.9 (SD 27.4) beats per minute (bpm) during pauses between running bouts and 148.9 (SD 16.0) bpm during pauses between cycling bouts. Six cases of prolonged fetal bradycardia (<100 bpm for >3 min) occurred during running, leading to the termination of exercise. The mothers exercised at 17-18 on Borg's RPE scale and 86.4%-92.6% of MHR<sub>max</sub> in these cases. All cases were normalised within 8 min of ending the protocol. There were no cases of prolonged fetal bradycardia during cycling. Exercise was terminated for three women during running and two women during cycling due to fetal tachycardia (≥180 bpm for >4 min during rest).</p><p><strong>Conclusion: </strong>Despite cases of fetal bradycardia and tachycardia, our results indicate that highly active women can engage in multiple intervals of high-intensity interval training without apparent harm to fetal well-being.</p>","PeriodicalId":47417,"journal":{"name":"BMJ Open Sport & Exercise Medicine","volume":"11 2","pages":"e002496"},"PeriodicalIF":3.9,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Interaction of accelerometer-measured physical activity and genetic risk on cardiovascular diseases: a prospective cohort study from UK Biobank.","authors":"Chaoyu Xu, Qingrong Zhang, Sihua Xu, Yiyuan Xiao, Liangyu Zhao, Tuojian Li, Wenjie Guo, Yanling Zhong, Haitao Chen","doi":"10.1136/bmjsem-2025-002547","DOIUrl":"https://doi.org/10.1136/bmjsem-2025-002547","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate the interactions of physical activity and polygenic risk score (PRS) on risks of atrial fibrillation, coronary heart disease (CHD), hypertension, and ischaemic stroke.</p><p><strong>Methods: </strong>This study included 91 629 participants from UK Biobank in this study, all of whom had worn a wrist-worn accelerometer for 7 consecutive days. We computed total volume of physical activity (TPA) and time spent in moderate to vigorous intensity physical activity (MVPA) and light intensity physical activity (LPA). Cox proportional hazard models were used to evaluate associations of physical activity with the four cardiovascular outcomes. Interactions between physical activity and PRS were investigated on multiplicative and additive scales.</p><p><strong>Results: </strong>During a median follow-up of 7.9 years, 3811 atrial fibrillation, 3994 CHD, 7345 hypertension and 1001 ischaemic stroke cases were recorded. TPA, MVPA and LPA were all negatively associated with risks of the four cardiovascular outcomes, generally independent of genetic risk. Association between LPA and atrial fibrillation was U-shaped among low-PRS stratum (p=0.01), and association between TPA and hypertension was attenuated with genetic risk increasing (p=0.02). Attributable risk (AR) of inactivity was higher in the high-PRS population. For example, increasing MVPA resulted in a twofold greater reduction in CHD cases among individuals with high PRS (AR=2.17%) than among those with low PRS (AR=1.09%).</p><p><strong>Conclusions: </strong>Increasing physical activity, including LPA, was associated with a reduced risk of cardiovascular diseases. The extent of this benefit may differ among individuals with different genetic risks.</p>","PeriodicalId":47417,"journal":{"name":"BMJ Open Sport & Exercise Medicine","volume":"11 2","pages":"e002547"},"PeriodicalIF":3.9,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Use of physical exertion to enhance objective testing following mild traumatic brain injury: a systematic review.","authors":"Katherine Forch, Mangor Pedersen, Duncan Reid, Nicola Cm Towersey, Sharon Olsen","doi":"10.1136/bmjsem-2024-002385","DOIUrl":"https://doi.org/10.1136/bmjsem-2024-002385","url":null,"abstract":"<p><strong>Background: </strong>Assessment of recovery from mild traumatic brain injury (mTBI) is complex and challenging. Post-exertion testing, where individuals undergo objective testing following physical exercise, has shown promise in identifying mTBI-related impairments that may not be evident at rest, but could hinder a safe return to sport.</p><p><strong>Objectives: </strong>To conduct a systematic review to determine if physical exertion affects objective physiological or sensorimotor tests differently in individuals with mTBI compared with healthy controls.</p><p><strong>Methods: </strong>A systematic search of 11 databases and five trial registries on 30 May 2024 identified reports that: (i) compared individuals aged 12-65 years within 12 months of mTBI against healthy control participants, (ii) investigated the effects of a single session of physical exertion and (iii) collected before, during or after exertion, objective measures of physiological or sensorimotor function. Risk of bias was assessed with the Risk Of Bias In Non-randomized Studies of Interventions tool. Results were analysed descriptively.</p><p><strong>Results: </strong>The review included 22 studies with 536 participants wih mTBI. Risk of bias was deemed high. At rest, 8/22 (36%) studies detected differences in physiological responses between participants wih mTBI and healthy control participants. During or after exertion, 21/22 (96%) studies detected differences in physiological responses, including cardiovascular, respiratory and cerebral autoregulation.</p><p><strong>Conclusion: </strong>The findings indicate that objective testing during or after physical exertion can enhance the ability to detect mTBI-related impairments in various physiological parameters, and this concept could be considered when monitoring recovery and return to sport. Further studies are needed.</p><p><strong>Prospero registration number: </strong>CRD42023411681.</p>","PeriodicalId":47417,"journal":{"name":"BMJ Open Sport & Exercise Medicine","volume":"11 2","pages":"e002385"},"PeriodicalIF":3.9,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Florian Forelli, Patrice Marine, Ayrton Moiroux-Sahraoui, Jean Mazeas, Mathias Thoelen, Bram Swinnen, Mario Bizzini, Nicky Van Melick, Alexandre Rambaud
{"title":"Velocity-based training in mid- and late-stage rehabilitation after anterior cruciate ligament reconstruction: a narrative review and practical guidelines.","authors":"Florian Forelli, Patrice Marine, Ayrton Moiroux-Sahraoui, Jean Mazeas, Mathias Thoelen, Bram Swinnen, Mario Bizzini, Nicky Van Melick, Alexandre Rambaud","doi":"10.1136/bmjsem-2025-002503","DOIUrl":"https://doi.org/10.1136/bmjsem-2025-002503","url":null,"abstract":"<p><p>Resistance training is critical for strength development and physical recovery after anterior cruciate ligament reconstruction (ACLR). Traditional percentage-based training (PBT) methods, which often focus on maximal strength and training to failure, are not able to objectify rapid force development. Velocity-based training (VBT), using movement velocity as a metric for training intensity, offers a promising alternative. This article promotes the use of VBT in ACLR rehabilitation, emphasising its potential to enhance neuromuscular recovery and return-to-sport outcomes. A narrative review of current literature focuses on mid- and late-stage rehabilitation to examine how VBT can address PBT limitations and improve functional recovery and sports performance. VBT provides several advantages, including real-time feedback, individualised load adjustments and better alignment with daily physiological variations. It facilitates the accurate training load prescriptions, enhances motivation and reduces unnecessary fatigue. Monitoring load-velocity profiles and velocity-loss thresholds enables more effective strength and hypertrophy adaptations without reaching muscular failure. In midstage rehabilitation, VBT not only helps to restore muscle strength and hypertrophy using submaximal loads and individualised velocity profiles but also addresses unwanted neuroplasticity following ACLR by providing augmented feedback and facilitating an external focus. In late-stage rehabilitation, VBT focuses on improving explosive strength and power, crucial for sports performance. Despite its benefits, VBT application in rehabilitation is limited by a lack of data on injured populations and specific exercises, such as open-chain single-joint movements. Integrating VBT allows practitioners to enhance traditional rehabilitation protocols, potentially leading to better clinical outcomes and providing a more personalised rehabilitation process.</p>","PeriodicalId":47417,"journal":{"name":"BMJ Open Sport & Exercise Medicine","volume":"11 2","pages":"e002503"},"PeriodicalIF":3.9,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}