BMJ Open Sport & Exercise Medicine最新文献

{"title":"Methodological quality and reporting using time-to-event data in sports science and medicine: a scoping review.","authors":"Jordi Cortés, Rasmus Oestergaard Nielsen, Martí Casals","doi":"10.1136/bmjsem-2025-002800","DOIUrl":"10.1136/bmjsem-2025-002800","url":null,"abstract":"<p><p>Time-to-event is a powerful statistical approach increasingly used in sports science and medicine to examine time-to-event outcomes such as time to sports injury occurrence, career duration and recovery processes. This scoping review aims to systematically assess the methodological quality and reporting practices of studies published within the sports science and medicine domain using time-to-event techniques (eg, Cox regression). We conducted a scoping review of 138 original studies published between 2013 and 2023. Studies were identified from PubMed and Web of Science, and methodological reporting was evaluated using the Statistical Analyses and Methods in the Published Literature guidelines, focusing on statistical methods, model assumptions, censoring and reporting of survival measures. Reporting deficiencies were widespread. Over 90% of studies did not report the number of individuals at risk at each time point, 75% did not adequately address assumptions underlying survival models and 62% did not clearly define the purpose of the analysis. Only 20% reported median survival times when pertinent, and reporting of HRs and reasons for censoring was often incomplete. Slight improvements were observed in studies published after 2020, but major gaps remain. These findings highlight the need for improved methodological transparency, adherence to reporting standards and comprehensive statistical education. Enhancing these aspects will strengthen the reproducibility, interpretability and practical relevance of time-to-event studies in sports science and medicine.</p>","PeriodicalId":47417,"journal":{"name":"BMJ Open Sport & Exercise Medicine","volume":"11 4","pages":"e002800"},"PeriodicalIF":3.2,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12684184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145716278","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":"Exercise for chronic musculoskeletal pain: time to prescribe with precision.","authors":"Nitin Kumar Arora, Lars Donath, Clint Miller, Patrick J Owen, Christopher Neason, Evert Verhagen, Nash Anderson, Yorgi Mavros, Amy Harwood, Nicola Sewry, Daniel L Belavý","doi":"10.1136/bmjsem-2025-003076","DOIUrl":"10.1136/bmjsem-2025-003076","url":null,"abstract":"","PeriodicalId":47417,"journal":{"name":"BMJ Open Sport & Exercise Medicine","volume":"11 4","pages":"e003076"},"PeriodicalIF":3.2,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12666146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145662068","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":"Barriers and facilitators to the initiation and maintenance of exercise training for women with clinically severe obesity before, during and after participation in a weight loss study: a qualitative investigation.","authors":"Daniel van den Hoek, Clint Miller, Steve Fraser, Bronwyn Sudholz, Steve Selig, John Dixon, Megan Teychenne","doi":"10.1136/bmjsem-2025-002583","DOIUrl":"10.1136/bmjsem-2025-002583","url":null,"abstract":"<p><p>Women with clinically severe obesity are at risk of poor physical and mental health. Lifestyle interventions must be developed to support exercise participation for this group. The factors influencing the involvement of women with clinically severe obesity in such programmes require investigation. This study aimed to identify barriers and facilitators to the initiation and maintenance of exercise training for women with severe obesity before, during and after participation in a weight loss study. Women with obesity were recruited for participation in a randomised controlled trial (n=60) investigating the effects of energy restriction (ER) with (energy restriction plus exercise (EXER): n=30) and without (ER: n=30) the addition of exercise. Following the 12-month intervention, n=11 (all from the EXER group) women agreed to participate and were interviewed to retrospectively explore their experiences of exercise engagement before, during and after the programme. Participants also provided their own suggestions for improving future exercise and weight loss programmes. Data were then transcribed verbatim, and reflective thematic analysis was used. Five themes related to intrapersonal and social components of the social ecological model were constructed and included: 'weight', 'concerns about physical limitations' and 'exercise confidence and enjoyment'. Social themes were 'work and family commitments' and 'accountability and support'. Women with clinically severe obesity most commonly reported intrapersonal and social influences of exercise participation. This study's results may help inform the exercise programme development of practitioners and further intervention development at a population level.</p>","PeriodicalId":47417,"journal":{"name":"BMJ Open Sport & Exercise Medicine","volume":"11 4","pages":"e002583"},"PeriodicalIF":3.2,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12666175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145661945","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":"Traumatic knee injury healthcare pathways and outcomes: the Australian Knee Injury Inception Cohort Study (KIICS) protocol.","authors":"Marc-Olivier Dubé, Kay M Crossley, Andrea M Bruder, Brooke E Patterson, Sean Kaplan, Melissa J Haberfield, Christian J Barton, Stephanie R Filbay, Michelle M Dowsey, Sean I Docking, Joshua R Zadro, Iliana N Ackerman, Joanna Kvist, Evangelos Pappas, Tenille Moselen, Adam G Culvenor","doi":"10.1136/bmjsem-2025-002983","DOIUrl":"10.1136/bmjsem-2025-002983","url":null,"abstract":"<p><p>Decision-making for the optimal management of traumatic knee injuries can be challenging. Clinical trials reveal only small differences between surgical and non-surgical approaches, while patient and clinician biases, as well as healthcare access issues, may also influence management. Little is known about the real-world healthcare pathways for patients with a knee injury, as well as the person- and/or healthcare-related factors that influence management strategies and outcomes. The Australian Knee Injury Inception Cohort Study (KIICS) aims to: (1) describe healthcare pathways following acute knee injury (including the timing and type of healthcare consultations); (2) identify patient- and/or healthcare-related predictors of management strategy (ie, surgical vs non-surgical); and (3) examine the long-term outcome of different injury types, healthcare pathways and management strategies. KIICS is a nationwide prospective longitudinal inception cohort study recruiting Australians who have sustained an acute knee injury within the previous 6 months that disrupted daily activities or sports and led to a healthcare consultation. Participants will complete online questionnaires at enrolment and at 6 months, 1, 2, 5 and 10 years post-injury. The data to be collected will include sociodemographic characteristics, knee injury history, the sequence of healthcare consultations and referral patterns, and management strategies (ie, surgical vs non-surgical). Patient-reported outcomes will include knee pain and instability, knee-related quality of life, patient-acceptable symptom state, health-related quality of life, mental health, fear of reinjury, return-to-sport status and activity level. Detailed statistical analysis plans will be developed to address the study's key research questions, informing clinical practice, shared decision-making and healthcare policy.</p>","PeriodicalId":47417,"journal":{"name":"BMJ Open Sport & Exercise Medicine","volume":"11 4","pages":"e002983"},"PeriodicalIF":3.2,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12666194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145662268","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":"Graduation-stage physical fitness as a predictor of operational performance and injury risk among police recruits: a prospective cohort study.","authors":"Dongming Jia","doi":"10.1136/bmjsem-2025-002871","DOIUrl":"https://doi.org/10.1136/bmjsem-2025-002871","url":null,"abstract":"<p><strong>Objectives: </strong>This study examined whether physical fitness at the point of police academy graduation predicts early-career outcomes, including job performance and musculoskeletal injury risk.</p><p><strong>Methods: </strong>In a 12-month prospective cohort study, 240 police recruits (74.2% male; mean age 22.1 years) were assessed during the final week of academy training. Graduation-stage fitness was summarised by a composite fitness index (0-100; higher=better) from sex-standardised domain scores. Job performance was assessed using the Behaviourally Anchored Rating Scale (BARS) at 12 months, while injury incidence was monitored via official records, compensation claims and self-reported events. Multivariable linear regression and Cox proportional hazards models were used to examine associations, adjusting for age, sex, body mass index, baseline physical activity (measured by International Physical Activity Questionnaire-Short Form) and pre-existing musculoskeletal conditions.</p><p><strong>Results: </strong>Graduation-stage fitness significantly predicted BARS-rated job performance (β=0.21; 95% CI 0.12 to 0.30; p<0.001), with specific effects in communication (p=0.042) and use-of-force judgement (p=0.017). Each 1-point increase in fitness score was associated with an 11% reduction in injury hazard (HR 0.89; 95% CI 0.83 to 0.95; p<0.001). High-fitness recruits remained injury-free significantly longer (median 9 vs 4 months; log-rank p<0.001).</p><p><strong>Conclusions: </strong>Graduation-stage physical fitness is a strong and actionable predictor of early-career success and injury resilience in law enforcement. These findings support incorporating fitness assessments at academy exit into operational readiness protocols, guiding evidence-based deployment decisions and targeted postacademy conditioning programmes.</p>","PeriodicalId":47417,"journal":{"name":"BMJ Open Sport & Exercise Medicine","volume":"11 4","pages":"e002871"},"PeriodicalIF":3.2,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12645639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145641140","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":"Acute anterior cruciate ligament injuries can be repaired through conservative treatment with early protective motion: a single-group cohort study.","authors":"Hiroko Ueki, Sadao Niga, Sachiyuki Tsukada, Masayoshi Saito, Hiroshi Mori, Yuji Ikezawa, Hideya Yoshimura, Hideyuki Koga","doi":"10.1136/bmjsem-2025-002802","DOIUrl":"10.1136/bmjsem-2025-002802","url":null,"abstract":"<p><strong>Objectives: </strong>Early protective motion (EPM) treatment, using a rigid functional knee brace for acute anterior cruciate ligament (ACL) injuries, has been reported to restore ACL function. This study aimed to investigate the probabilities of return to sports and reinjury rate associated with EPM treatment and the result of restoring ACL function and morphology in MRI more than 2 years after injury in patients with acute injured ACL.</p><p><strong>Methods: </strong>This study included sports players with primary acute ACL injuries, straight-shaped tears and normal-volume bands on sagittal MRI, with a minimum of 2-year follow-up. If the ACL is treatable based on MRI, Lachman test and KT-1000 measurements after 3 months of knee brace use, EPM treatment can continue. The time of RTS, reinjury rate and KT measurements before and after treatment were analysed. In addition, the reinjury group and the non-reinjury group were compared.</p><p><strong>Results: </strong>Thirty-one patients participated in this study. KT measurements at injury, brace removal and final follow-up were 5.8 mm (IQR, 4.5-7.0), 0.0 mm (IQR, -0.5-0.5) and 0.0 mm (IQR, 0.0-0.5), respectively. 77.4% returned to sports at their preinjury level and had ACL repair on MRI after more than 2 years post-injury. Reinjury occurred in 22.6%, with no significant demographic differences between the reinjury and non-reinjury groups.</p><p><strong>Conclusion: </strong>After EPM treatment with at least 2 years of follow-up, 77.4% of patients returned to sports with restored ACL function. MRIs taken over 2 years post-injury confirmed ACL morphology repair, following strict case selection based on MRI within 2 weeks of injury.</p>","PeriodicalId":47417,"journal":{"name":"BMJ Open Sport & Exercise Medicine","volume":"11 4","pages":"e002802"},"PeriodicalIF":3.2,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12658557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145649618","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":"Longitudinal monitoring of handgrip strength in rheumatoid arthritis: a window into for disease activity-a systematic review with meta-analysis.","authors":"Rafaela Cavalheiro do Espirito Santo, Leonardo Peterson Dos Santos, Geiziane Melo, Viney Dubey, Cesar Agostinis-Sobrinho","doi":"10.1136/bmjsem-2025-002617","DOIUrl":"10.1136/bmjsem-2025-002617","url":null,"abstract":"<p><strong>Objective: </strong>Handgrip strength (HGS) is a simple, non-invasive measure associated with disability, frailty and disease activity in chronic conditions such as rheumatoid arthritis (RA). However, longitudinal changes in HGS and their implications in RA remain underexplored. This study aimed to systematically review changes in HGS over time and its associations with disease status and follow-up duration in patients with RA.</p><p><strong>Design: </strong>Systematic review and meta-analysis.</p><p><strong>Data sources: </strong>A search of PUBMED, EMBASE and WEB OF SCIENCE were searched for cohort studies up to July 2025.</p><p><strong>Eligibility criteria: </strong>Studies including RA patients, assessing HGS and employing an observational design.</p><p><strong>Results: </strong>From 4301 studies (including 737 identified through citation tracking), 27 met the inclusion criteria, comprising 2742 individuals (mostly women (1784; 65.1%)), aged 19-87 years, with disease duration ranging from 2 months to 47 years. Participants generally had low to moderate disease activity and moderate to severe physical disability. Overall, HGS slightly increased over time (standardised mean difference; SMD 0.25; 95% CI 0.07 to 0.43). Greater improvements were observed in early RA (SMD 0.46; 95% CI 0.30 to 0.61), while no significant changes were found in established RA. HGS increased in patients followed for ≤1 year (SMD 0.25; 95% CI 0.07 to 0.43) and >1-5 years (SMD 0.43; 95% CI 0.05 to 0.81), but not beyond 5 years.</p><p><strong>Conclusion: </strong>Patients with early RA tend to improve HGS over time, whereas those with longer disease duration show stable strength levels. HGS may serve as a useful marker for monitoring function and guiding personalised care in RA.</p><p><strong>Prospero registration number: </strong>CRD42023473416.</p>","PeriodicalId":47417,"journal":{"name":"BMJ Open Sport & Exercise Medicine","volume":"11 4","pages":"e002617"},"PeriodicalIF":3.2,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12658546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145649642","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":"Harmonisation and implementation of sports-related concussion guidelines in European youth football: the REFORM Erasmus+ project.","authors":"Giulia Gorgoni, Gabriel Monthuley, Thor Einar Andersen, Nora Kümmeth-Gangel, Ivana Pavlinac Dodig, Demet Dinç, Tim Meyer, Anna Nordström","doi":"10.1136/bmjsem-2025-002928","DOIUrl":"https://doi.org/10.1136/bmjsem-2025-002928","url":null,"abstract":"<p><strong>Introduction: </strong>Sports-related concussions (SRCs) are frequently under-reported in youth sports, especially football, due to limited awareness, inconsistent reporting practices and a lack of medical personnel at the grassroots level. Concussion management protocols vary widely across regions, highlighting the need for a standardised approach. This study aims to harmonise SRC education and management practices in European youth football through an interdisciplinary collaboration involving football associations, healthcare professionals and academic institutions from Norway, Germany, Croatia and Turkey. The project will develop and implement educational resources (eg, toolkits, workshops and a Massive Open Online Course (MOOC)) targeted at coaches, players, parents, referees and medical personnel.</p><p><strong>Methods and analysis: </strong>Using a participatory action research design guided by the Logical Framework Approach, the project will develop, pilot and evaluate concussion education tools across diverse football contexts. Surveys, focus groups and participatory workshops will be used to assess changes in knowledge, attitudes and behaviours. Quantitative data will be analysed using descriptive statistics, while qualitative data from focus groups and interviews will undergo reflexive thematic analysis. Engagement metrics from MOOCs and toolkits will also be tracked.</p><p><strong>Ethics and dissemination: </strong>Ethics approval has been obtained in all participating countries. Informed consent (or parental consent for minors) will be secured for all participants. Dissemination will occur through UEFA, national football associations and complemented by social media outreach and presentations at sports conferences. The project is expected to enhance stakeholder awareness, improve concussion management protocols and provide a scalable model for concussion education in grassroots football across Europe.</p>","PeriodicalId":47417,"journal":{"name":"BMJ Open Sport & Exercise Medicine","volume":"11 4","pages":"e002928"},"PeriodicalIF":3.2,"publicationDate":"2025-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12645643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145641147","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":"Fear Avoidance after Concussion Tool (FACT): patient-reported outcome measure development and content validation.","authors":"Liam J Sherwood, Gill Cowen, Mandy Vidovich, Jeanette Hasleby, Jon Patricios, Myles C Murphy","doi":"10.1136/bmjsem-2025-002811","DOIUrl":"10.1136/bmjsem-2025-002811","url":null,"abstract":"<p><strong>Objective: </strong>No valid patient-reported outcome measures (PROMs) exist to evaluate fear avoidance behaviour following concussion. This study developed a new PROM to evaluate fear avoidance behaviour following concussion and assessed the PROM content validity.</p><p><strong>Design: </strong>PROM development was performed using a qualitative study, and content validation was performed using a mixed-methods approach.</p><p><strong>Methods: </strong>The development phase consisted of compiling potentially relevant items (eg, questions) from other PROMs proposed to measure fear avoidance before proceeding to a series of one-on-one semistructured interviews with patient and professional participants. The content validity (relevance, comprehensibility and comprehensiveness) of the PROM was first assessed by professional participants using an online survey, before further assessment by patient participants during one-on-one semistructured interviews.</p><p><strong>Results: </strong>For PROM development, seven patient participants (n=4 men) and seven professional participants (n=4 men) from six clinical professions were included, who generated 119 potentially relevant items under seven distinct domains. Key themes that emerged during development were a strong preference for a short PROM, with a simple scale, that has clinical utility. 38 professional participants (47% women) and seven patient participants completed the content validation. Thus, the final PROM (Fear Avoidance after Concussion Tool or FACT) has content validity, consists of 28 items, with four items per domain. The seven domains of the FACT are: general, physical, psychological, hypervigilance, cognitive, social and work.</p><p><strong>Conclusion: </strong>The FACT has been developed to evaluate fear avoidance behaviour following concussion and has content validity. Future research should evaluate other measurement properties before implementation.</p>","PeriodicalId":47417,"journal":{"name":"BMJ Open Sport & Exercise Medicine","volume":"11 4","pages":"e002811"},"PeriodicalIF":3.2,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12606469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145514546","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":"#Utviklingsklar: a club-based intervention to develop plans and practices for injury prevention in youth sport-acceptability, practicality, possibilities and challenges among club leaders, coaches and workshop leaders.","authors":"Solveig Hausken-Sutter, Christian Moen, Emilie Scholten Sjølie, Christian Thue Bjørndal, Grethe Myklebust, Merete Møller, Hege Grindem","doi":"10.1136/bmjsem-2025-002766","DOIUrl":"10.1136/bmjsem-2025-002766","url":null,"abstract":"<p><p>Effective youth sport injury interventions exist, but their use in applied settings is limited by low coach adherence and lack of contextual adaptation. To address this, the #Utviklingsklar intervention was developed, a club-based intervention for youth handball and football, based on interdisciplinary programme theory and collaboration with sport organisation partners and user groups (club leaders, coaches, parents, players). The intervention supports coaches and club leaders in developing team-specific plans to improve injury-preventive practices for warm-up, strength training and pain and injury management. This qualitative feasibility study, based on observation and interview data, examines the acceptability, practicality, possibilities and challenges of #Utviklingsklar's e-learning and workshop activities. Three workshops led by physiotherapists were observed, involving 23 participants (17 coaches, three club leaders and three workshop leaders). Subsequently, 15 participants consented to be interviewed, comprising 10 coaches, two club leaders and three workshop leaders. Data were analysed using deductive thematic analysis principles. The e-learning was found to be user-friendly, accessible and relevant, while the workshop was valued for fostering discussions and collaboration around team-specific injury prevention plans and practices. However, some coaches sought more tailored content (ie, topics related to their own specific training sessions and players), and workshop leaders expressed a need for additional preparation and practice time to feel confident in their roles. Improved communication of #Utviklingsklar's flexible approach, along with enhanced preparation and practice for workshop leaders in supporting coaches' and club leaders' development of team-specific plans and practices, is needed to enhance understanding and engagement across clubs.</p>","PeriodicalId":47417,"journal":{"name":"BMJ Open Sport & Exercise Medicine","volume":"11 4","pages":"e002766"},"PeriodicalIF":3.2,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12606477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145514551","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}