BMJ Open Sport & Exercise Medicine最新文献

{"title":"Associations of academic performance, sports participation, disordered eating and menstrual cycle irregularities in adolescents: a population-based study.","authors":"Sara Maria Margareeta Mörö, Elina Holopainen, Viivi Saari, Silja Kosola","doi":"10.1136/bmjsem-2025-003078","DOIUrl":"10.1136/bmjsem-2025-003078","url":null,"abstract":"<p><strong>Background: </strong>Regular menstruation is an important indicator of well-being in adolescent females. We aimed to assess risk factors associated with menstrual cycle irregularities in a population-based cohort of high school students.</p><p><strong>Methods: </strong>In the fall of 2022, we recruited a cohort of 1161 first-year female students from 21 socio-economically diverse high schools in the capital region of Finland. Participants completed an online survey addressing menstruation, academic performance and sports participation and validated questionnaires (the Sick-Control-One stone-Fat-Food (SCOFF) eating disorder screening tool and School Burnout Inventory).</p><p><strong>Results: </strong>Of 935 (81%) participants (mean age 16) not using hormonal preparations, 336 (37%) reported irregular menstruation. Elevated School Burnout Inventory scores (per point OR 1.03, 95% CI 1.01 to 1.05), lower body mass index (OR 1.86, 95% CI 1.12 to 3.08) and high SCOFF scores (OR 2.09, 95% CI 1.40 to 3.10) were associated with irregular menstruation. Overall physical activity levels showed no significant association with menstruation. In subgroup analysis, low body mass index and disordered eating symptoms were associated with irregular menstruation among casual exercisers whereas school burnout was associated with irregular menstruation among competitive athletes.</p><p><strong>Conclusion: </strong>School-related stress, eating and exercise habits should be evaluated among high school students presenting with menstrual irregularities, as these factors may be relevant in identifying adolescents at risk of more severe reproductive dysfunctions, including amenorrhoea.</p>","PeriodicalId":47417,"journal":{"name":"BMJ Open Sport & Exercise Medicine","volume":"12 3","pages":"e003078"},"PeriodicalIF":3.2,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13358262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438460","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":"Putting sport injury prevention into practice: a qualitative study in a small Western European high-income country.","authors":"Aude Aguilaniu, Camille Tooth, Justine Benoit-Piau, Caroline Mouton, Nina Goedert, Jérôme Pauls, Christian Nührenbörger, Evert Verhagen, Romain Seil","doi":"10.1136/bmjsem-2026-003318","DOIUrl":"10.1136/bmjsem-2026-003318","url":null,"abstract":"<p><p>Despite strong scientific evidence supporting sports injury prevention, implementation in real-world sport settings remains limited. Understanding how prevention is perceived and practised by those directly involved in sport is essential to ensure effective implementation. This qualitative study explored how injury prevention is perceived, practised and implemented within the sport ecosystem of a small Western European high-income country (Luxembourg). Semi-structured interviews were carried out across the Luxembourgish sport ecosystem, including athletes, coaches, healthcare professionals and institutional representatives. Interviews were conducted until data saturation was reached. Data were analysed inductively following grounded theory principles using ATLAS.ti, with open, axial and selective coding to develop core dimensions grounded in participants' experiences. 12 participants acknowledged the importance of injury prevention and shared a strong commitment to athlete health. However, prevention was often perceived as reactive, medicalised or disconnected from performance objectives, which limited sustained engagement. Participants emphasised the need to reframe prevention as a performance-enhancing and integral component of training rather than an additional constraint. Three key facilitators for effective implementation emerged: (1) clear and coordinated communication between stakeholders and institutions, (2) early integration of injury prevention in youth sport through engaging and age-appropriate approaches and (3) structured education and long-term support for coaches, who were identified as central gatekeepers of daily practice. Although Luxembourg's small size and close-knit networks were seen as opportunities for collaboration, fragmented structures and inconsistent communication currently hinder coherent implementation. Luxembourg offers a favourable context to embed injury prevention within sport culture, yet greater system-level coordination is required. Reframing prevention around performance, strengthening coach education, promoting early engagement and improving cross-institutional communication may enhance adherence and sustainability. These findings provide practical insights for other sport systems seeking to translate evidence-based injury prevention into effective field practice.</p>","PeriodicalId":47417,"journal":{"name":"BMJ Open Sport & Exercise Medicine","volume":"12 3","pages":"e003318"},"PeriodicalIF":3.2,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13343015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413168","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":"Reference equations for peak oxygen uptake during cycle ergometry based on body composition estimates.","authors":"Everton Santana, Nicholas Cauwenberghs, Patrick Khoury, Jomme Claes, Evangelos Ntalianis, Ross Arena, Matthew Harber, Kaatje Goetschalckx, Leonard A Kaminsky, Véronique Cornelissen, Jonathan Myers, Francois Haddad, Tatiana Kuznetsova","doi":"10.1136/bmjsem-2025-003127","DOIUrl":"10.1136/bmjsem-2025-003127","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To derive sex-specific peak oxygen uptake (VO&lt;sub&gt;2&lt;/sub&gt;peak) reference equations for cycle ergometer cardiopulmonary exercise testing (CPET) that integrate estimations of lean body mass (eLBM) and body fat percentage (eBF) based on sex, age, height and weight.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We pooled data from apparently healthy adults who performed cycle ergometry in Belgium (FLEMENGHO and iCOMPEER cohorts) and the USA (FRIEND registry). Per subgroup of sex, age and body mass index (BMI), 70% of the data was used for training the equations and 30% for testing them.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The cohort consisted of 1778 females and 1243 males. For females, the mean age was 49.8±13.3 years, BMI 27.1±4.9 kg·m&lt;sup&gt;-2&lt;/sup&gt; and VO&lt;sub&gt;2&lt;/sub&gt;peak 1488.4±360.3 mL·min&lt;sup&gt;-1&lt;/sup&gt;. For males, the mean age was 50.2±13.3 years, BMI 27.6±4.0 kg·m&lt;sup&gt;-2&lt;/sup&gt; and VO&lt;sub&gt;2&lt;/sub&gt;peak 2467.1±595.5 mL·min&lt;sup&gt;-1&lt;/sup&gt;. The reference equation for females was &lt;math&gt; &lt;mstyle&gt; &lt;mrow&gt; &lt;mstyle&gt; &lt;mtable&gt; &lt;mtr&gt;&lt;mtd&gt;&lt;mi&gt;V&lt;/mi&gt; &lt;msub&gt;&lt;mi&gt;O&lt;/mi&gt; &lt;mrow&gt;&lt;mn&gt;2&lt;/mn&gt; &lt;mrow&gt;&lt;mi&gt;p&lt;/mi&gt; &lt;mi&gt;e&lt;/mi&gt; &lt;mi&gt;a&lt;/mi&gt; &lt;mi&gt;k&lt;/mi&gt;&lt;/mrow&gt; &lt;mo&gt;,&lt;/mo&gt; &lt;mtext&gt; &lt;/mtext&gt; &lt;mrow&gt;&lt;mi&gt;f&lt;/mi&gt; &lt;mi&gt;e&lt;/mi&gt; &lt;mi&gt;m&lt;/mi&gt; &lt;mi&gt;a&lt;/mi&gt; &lt;mi&gt;l&lt;/mi&gt; &lt;mi&gt;e&lt;/mi&gt; &lt;mi&gt;s&lt;/mi&gt;&lt;/mrow&gt; &lt;/mrow&gt; &lt;/msub&gt; &lt;mrow&gt;&lt;mo&gt;[&lt;/mo&gt; &lt;mrow&gt;&lt;mrow&gt;&lt;mi&gt;m&lt;/mi&gt; &lt;mi&gt;L&lt;/mi&gt;&lt;/mrow&gt; &lt;mo&gt;×&lt;/mo&gt; &lt;msup&gt;&lt;mrow&gt;&lt;mi&gt;m&lt;/mi&gt; &lt;mi&gt;i&lt;/mi&gt; &lt;mi&gt;n&lt;/mi&gt;&lt;/mrow&gt; &lt;mrow&gt;&lt;mo&gt;-&lt;/mo&gt; &lt;mn&gt;1&lt;/mn&gt;&lt;/mrow&gt; &lt;/msup&gt; &lt;/mrow&gt; &lt;mo&gt;]&lt;/mo&gt;&lt;/mrow&gt; &lt;/mtd&gt; &lt;/mtr&gt; &lt;mtr&gt;&lt;mtd&gt;&lt;mspace&gt;&lt;/mspace&gt; &lt;mo&gt;=&lt;/mo&gt; &lt;mn&gt;1335.9&lt;/mn&gt; &lt;mo&gt;+&lt;/mo&gt; &lt;mn&gt;31.3&lt;/mn&gt; &lt;mo&gt;×&lt;/mo&gt; &lt;mrow&gt;&lt;mi&gt;e&lt;/mi&gt; &lt;mi&gt;L&lt;/mi&gt; &lt;mi&gt;B&lt;/mi&gt; &lt;mi&gt;M&lt;/mi&gt;&lt;/mrow&gt; &lt;mrow&gt;&lt;mo&gt;(&lt;/mo&gt; &lt;mrow&gt;&lt;mi&gt;k&lt;/mi&gt; &lt;mi&gt;g&lt;/mi&gt;&lt;/mrow&gt; &lt;mo&gt;)&lt;/mo&gt;&lt;/mrow&gt; &lt;/mtd&gt; &lt;/mtr&gt; &lt;mtr&gt;&lt;mtd&gt;&lt;mspace&gt;&lt;/mspace&gt; &lt;mspace&gt;&lt;/mspace&gt; &lt;mo&gt;-&lt;/mo&gt; &lt;mn&gt;21.8&lt;/mn&gt; &lt;mo&gt;×&lt;/mo&gt; &lt;mrow&gt;&lt;mi&gt;e&lt;/mi&gt; &lt;mi&gt;B&lt;/mi&gt; &lt;mi&gt;F&lt;/mi&gt;&lt;/mrow&gt; &lt;mrow&gt;&lt;mo&gt;(&lt;/mo&gt; &lt;mi&gt;%&lt;/mi&gt; &lt;mo&gt;)&lt;/mo&gt;&lt;/mrow&gt; &lt;mo&gt;-&lt;/mo&gt; &lt;mn&gt;0.119&lt;/mn&gt; &lt;mo&gt;×&lt;/mo&gt; &lt;msup&gt;&lt;mrow&gt;&lt;mi&gt;a&lt;/mi&gt; &lt;mi&gt;g&lt;/mi&gt; &lt;mi&gt;e&lt;/mi&gt;&lt;/mrow&gt; &lt;mrow&gt;&lt;mn&gt;2&lt;/mn&gt;&lt;/mrow&gt; &lt;/msup&gt; &lt;/mtd&gt; &lt;/mtr&gt; &lt;/mtable&gt; &lt;/mstyle&gt; &lt;/mrow&gt; &lt;/mstyle&gt; &lt;/math&gt; .In the test set, the SE of VO&lt;sub&gt;2&lt;/sub&gt;peak estimates (SEE) was 279.9 mL·min&lt;sup&gt;-1&lt;/sup&gt;. For males, the equation was &lt;math&gt; &lt;mstyle&gt; &lt;mrow&gt; &lt;mstyle&gt; &lt;mtable&gt; &lt;mtr&gt;&lt;mtd&gt;&lt;mi&gt;V&lt;/mi&gt; &lt;msub&gt;&lt;mi&gt;O&lt;/mi&gt; &lt;mrow&gt;&lt;mn&gt;2&lt;/mn&gt; &lt;mrow&gt;&lt;mi&gt;p&lt;/mi&gt; &lt;mi&gt;e&lt;/mi&gt; &lt;mi&gt;a&lt;/mi&gt; &lt;mi&gt;k&lt;/mi&gt;&lt;/mrow&gt; &lt;mo&gt;,&lt;/mo&gt; &lt;mtext&gt; &lt;/mtext&gt; &lt;mrow&gt;&lt;mi&gt;m&lt;/mi&gt; &lt;mi&gt;a&lt;/mi&gt; &lt;mi&gt;l&lt;/mi&gt; &lt;mi&gt;e&lt;/mi&gt; &lt;mi&gt;s&lt;/mi&gt;&lt;/mrow&gt; &lt;/mrow&gt; &lt;/msub&gt; &lt;mrow&gt;&lt;mo&gt;[&lt;/mo&gt; &lt;mrow&gt;&lt;mrow&gt;&lt;mi&gt;m&lt;/mi&gt; &lt;mi&gt;L&lt;/mi&gt;&lt;/mrow&gt; &lt;mo&gt;×&lt;/mo&gt; &lt;msup&gt;&lt;mrow&gt;&lt;mi&gt;m&lt;/mi&gt; &lt;mi&gt;i&lt;/mi&gt; &lt;mi&gt;n&lt;/mi&gt;&lt;/mrow&gt; &lt;mrow&gt;&lt;mo&gt;-&lt;/mo&gt; &lt;mn&gt;1&lt;/mn&gt;&lt;/mrow&gt; &lt;/msup&gt; &lt;/mrow&gt; &lt;mo&gt;]&lt;/mo&gt;&lt;/mrow&gt; &lt;/mtd&gt; &lt;/mtr&gt; &lt;mtr&gt;&lt;mtd&gt;&lt;mspace&gt;&lt;/mspace&gt; &lt;mo&gt;=&lt;/mo&gt; &lt;mn&gt;2264.4&lt;/mn&gt; &lt;mo&gt;+&lt;/mo&gt; &lt;mn&gt;42.5&lt;/mn&gt; &lt;mo&gt;×&lt;/mo&gt; &lt;mrow&gt;&lt;mi&gt;e&lt;/mi&gt; &lt;mi&gt;L&lt;/mi&gt; &lt;mi&gt;B&lt;/mi&gt; &lt;mi&gt;M&lt;/mi&gt;&lt;/mrow&gt; &lt;mrow&gt;&lt;mo&gt;(&lt;/mo&gt; &lt;mrow&gt;&lt;mi&gt;k&lt;/mi&gt; &lt;mi&gt;g&lt;/mi&gt;&lt;/mrow&gt; &lt;mo&gt;)&lt;/mo&gt;&lt;/mrow&gt; &lt;/mtd&gt; &lt;/mtr&gt; &lt;mtr&gt;&lt;mtd&gt;&lt;mspace&gt;&lt;/mspace&gt; &lt;mspace&gt;&lt;/mspace&gt; &lt;mo&gt;-&lt;/mo&gt; &lt;mn&gt;71.2&lt;/mn&gt; &lt;mo&gt;×&lt;/mo&gt; &lt;mrow&gt;&lt;mi&gt;e&lt;/mi&gt; ","PeriodicalId":47417,"journal":{"name":"BMJ Open Sport & Exercise Medicine","volume":"12 3","pages":"e003127"},"PeriodicalIF":3.2,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13358861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438414","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":"More time spent in moderate-to-vigorous physical activity and sleep is associated with a lower incidence of hip or knee osteoarthritis.","authors":"Mathilde Mura, Berta Portugal, Caroline Mouton, Romain Seil, Laurent Malisoux","doi":"10.1136/bmjsem-2025-003144","DOIUrl":"10.1136/bmjsem-2025-003144","url":null,"abstract":"<p><strong>Introduction: </strong>Osteoarthritis is the second most prevalent musculoskeletal disorder and mostly affects hip and knee joints. Movement behaviours have been associated with the incidence of osteoarthritis. However, previous studies have mainly relied on self-reported questionnaires. Moreover, the inherently compositional nature of 24-hour movement behaviours has not yet been considered.</p><p><strong>Objective: </strong>This prospective study aims to investigate the association between objective device-measured movement behaviours and incident hip and knee osteoarthritis, accounting for the compositional nature of movement behaviours.</p><p><strong>Methods: </strong>Data from the UK Biobank cohort were used, which included individuals aged 40-69 years old. Seven days movement behaviours were measured with a wrist-worn triaxial accelerometer. Incident hip and knee osteoarthritis cases were prospectively ascertained on hospital inpatient data. Compositional Cox proportional hazard models were used.</p><p><strong>Results: </strong>85 706 individuals were included in the study between 2013 and 2015. During a mean follow-up of 7.6 years, 5308 participants were diagnosed with hip and knee osteoarthritis. Results showed that reallocating 30 min/day to moderate-to-vigorous physical activity from sedentary time (HR=0.98, 95% CI 0.97 to 0.99) or from light physical activity (HR=0.94, 95% CI 0.92 to 0.96) was associated with lower incidence of hip and knee osteoarthritis. Similarly, reallocating 30 min/day to sleep from sedentary time (HR=0.97, 95% CI 0.96 to 0.99) or from light physical activity (HR=0.93, 95% CI 0.92 to 0.95) was associated with lower incidence hip and knee osteoarthritis.</p><p><strong>Conclusion: </strong>Using objective measures of movement behaviours, this study provides evidence that moderate-to-vigorous physical activity and sleep may play important roles in hip and knee osteoarthritis prevention, while accounting for the other movement behaviours. Further research is needed to understand whether the associations are causal.</p>","PeriodicalId":47417,"journal":{"name":"BMJ Open Sport & Exercise Medicine","volume":"12 3","pages":"e003144"},"PeriodicalIF":3.2,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13343115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413162","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-induced intestinal barrier dysfunction: a potential contributor to athlete mental health.","authors":"Andrew Del Colle, Ottavio V Vitolo, Malte Christian Claussen","doi":"10.1136/bmjsem-2025-003171","DOIUrl":"10.1136/bmjsem-2025-003171","url":null,"abstract":"<p><p>Athlete mental health has become a growing concern across endurance, aesthetic and weight-sensitive sports. While psychosocial factors play major roles, emerging evidence suggests biological pathways related to gastrointestinal function may contribute. Intense exercise induces transient intestinal barrier dysfunction through splanchnic hypoperfusion, hyperthermia and tight-junction disruption, increasing permeability and microbial product exposure. These changes resemble biomarker patterns in psychiatric populations, where elevated zonulin, lipopolysaccharide and intestinal fatty-acid binding protein are associated with anxiety, depression and neuroinflammation. This viewpoint proposes a bidirectional model linking exercise-induced gut barrier stress and mood disturbance. Gut-derived signals including vagal afferent activation and cytokine-mediated tryptophan-kynurenine shifts may influence mood-regulating brain regions, while psychological stress reciprocally impairs gut integrity via corticotropin-releasing hormone and sympathetic activation. Female athletes may face heightened vulnerability through hypoestrogenic states and psychosocial pressures. While exercise physiology and psychiatric literatures remain separate, their convergence highlights an under-recognised dimension of athlete health warranting clinical awareness and Relative Energy Deficiency in Sport integration. Research priorities include longitudinal athlete studies and multi-omics approaches to determine whether gut barrier dysfunction is a contributor, modifier or parallel correlate of athlete mental health.</p>","PeriodicalId":47417,"journal":{"name":"BMJ Open Sport & Exercise Medicine","volume":"12 2","pages":"e003171"},"PeriodicalIF":3.2,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13331041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391767","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":"Incremental diagnostic value of 24-hour Holter monitoring during training in elite athlete preparticipation screening.","authors":"Ramon Pi-Rusiñol, Marga Calvo, Gonzalo Grazioli, Marian Adame, Carlos Eduardo Bolaños Gómez, Josep Brugada, Marta Sitges, Gil Rodas, Maria Sanz de la Garza","doi":"10.1136/bmjsem-2026-003258","DOIUrl":"10.1136/bmjsem-2026-003258","url":null,"abstract":"<p><strong>Background: </strong>Preparticipation cardiovascular evaluation (PPE) is widely recommended to reduce the risk of sudden cardiac events in athletes; however, the optimal screening protocol remains debated. Although resting ECG and echocardiography are commonly used, intermittent arrhythmias may remain undetected.</p><p><strong>Objective: </strong>To assess whether the addition of 24-hour ambulatory ECG (Holter) monitoring, including during sleep and training, increases the detection of potentially pathological cardiovascular findings.</p><p><strong>Design and settings: </strong>This observational cross-sectional study included athletes (aged 14-42 years) from a Spanish elite multisport professional club undergoing pre-season PPE during the 2023-2024. All athletes completed a standardised evaluation comprising medical history and physical examination, resting 12-lead ECG, transthoracic echocardiography and 24-hour wireless Holter monitoring performed during daily activities including at least one training session. Detection rates of potentially pathological findings were compared across screening test combinations.</p><p><strong>Participants: </strong>Of 343 athletes recruited, 299 (79.6% male; mean age 22 years) were included in the final analysis.</p><p><strong>Results: </strong>Potentially pathological findings prompting further evaluation were identified in 34 athletes (11.3%). The addition of any single test to medical history and physical examination significantly increased detection rates. Holter monitoring identified more intermittent arrhythmic events, particularly during exercise or sleep, whereas resting ECG more frequently detected repolarisation abnormalities. Echocardiography primarily contributed to the identification of structural abnormalities. Following a comprehensive evaluation, only one athlete was disqualified from competition.</p><p><strong>Conclusions: </strong>In elite athletes, integrating Holter monitoring into PPE improved the detection of intermittent arrhythmias that may be missed by a resting ECG alone, and providing complementary diagnostic information and representing a useful adjunct to echocardiography in comprehensive cardiovascular screening strategies, particularly in selected high-risk athletic populations. Future longitudinal studies are warranted to determine the clinical significance of these findings.</p>","PeriodicalId":47417,"journal":{"name":"BMJ Open Sport & Exercise Medicine","volume":"12 2","pages":"e003258"},"PeriodicalIF":3.2,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13289309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148319758","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 effects of marathon running on the heart: a systematic review and meta-analysis.","authors":"Inarota Laily, Niels van Steijn, Putra Rizki, Ralph de Vries, Lies D Liastuti, Aeilko H Zwinderman, Evert Verhagen, Adrianus J Bakermans, Harald T Jorstad","doi":"10.1136/bmjsem-2026-003201","DOIUrl":"10.1136/bmjsem-2026-003201","url":null,"abstract":"<p><strong>Background: </strong>Marathon running has numerous cardiovascular effects. Studies report transient physiological changes, while others identify possible harmful cardiovascular changes. This systematic review and meta-analysis aimed to characterise acute cardiac effects of marathon running.</p><p><strong>Methods: </strong>A systematic search was conducted in PubMed, Embase, and SPORTDiscus up to 11 April 2025. Studies were included if they reported (i) primary data (ii) in English (iii) healthy adults completing a road marathon, (iv) quantitative pre- and post-marathon cardiac effects. After data extraction (myocardial biomarkers, morphology, and function), random-effect meta-analyses were performed to determine mean differences and relative changes between pre- and post-marathon. Meta-regression analyses were performed in metrics with ≥7 studies.</p><p><strong>Results: </strong>Of 9080 articles, 69 were eligible for systematic review (3274 participants: age 30-55 years, >80% men) and 49 for meta-analysis on three biomarkers, 18 echocardiography metrics, and five cardiac MRI metrics. Marathon running-induced increases in circulating troponin T (+42 (32.6, 52.3) ng/L; p<0.001), troponin I (+77 (55.1, 98.3) ng/L; p<0.001) and N-terminal pro B-type natriuretic peptide (NT-proBNP) (+114 (89.0, 138.6) ng/L; p<0.001). On echocardiography, left ventricular (LV) volume and diastolic function, and right ventricular (RV) systolic function decreased post-marathon, while RV end-systolic and diastolic volumes increased. Cardiac MRI revealed an increase in LV ejection fraction. On meta-regression analysis, these responses varied according to age, sex, training status and marathon performance.</p><p><strong>Conclusion: </strong>Marathon running induces acute changes in biomarkers of myocardial injury, cardiac structure and function. The clinical significance and potential for harm of these changes are yet to be established.</p><p><strong>Prospero registration number: </strong>CRD42023399120.</p>","PeriodicalId":47417,"journal":{"name":"BMJ Open Sport & Exercise Medicine","volume":"12 2","pages":"e003201"},"PeriodicalIF":3.2,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13264885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148259982","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":"Psycho-social-contextual landscape of return to sport after hamstring strain injuries: a scoping review.","authors":"Salvatore Di Liberto, Kenny Guex, Mario Bizzini, Diarmuid Strokes, Catherine Blake, James Matthews","doi":"10.1136/bmjsem-2025-003159","DOIUrl":"10.1136/bmjsem-2025-003159","url":null,"abstract":"<p><strong>Objectives: </strong>Hamstring strain injuries (HSI) are a leading cause of time loss and reinjury in elite sport, yet return-to-sport (RTS) decisions remain largely based on physical criteria. This scoping review aimed to map the psychological, social and contextual factors associated with RTS after HSI and to examine how psychological readiness has been conceptualised in RTS after HSI.</p><p><strong>Methods: </strong>Following Joanna Briggs Institute methodology, seven databases (MEDLINE, Embase, PsycINFO, CINAHL, SPORTDiscus, Scopus and ProQuest) were systematically searched for studies published until September 2025 in five languages. Eligible studies included original research identifying or describing psychological, social or contextual factors influencing RTS after HSI. Methodological quality was assessed using the Mixed Methods Appraisal Tool and the Oxford Centre for Evidence-Based Medicine. Data were synthesised thematically.</p><p><strong>Results: </strong>10 studies (n=663 participants, mostly in elite football) met the inclusion criteria. Three overarching domains were identified. Psychological factors were most frequently reported, including anxiety, fear of reinjury or failure and self-perceived readiness, as well as motivation and self-efficacy. Social factors encompassed therapeutic alliance, communication within the rehabilitation team and hierarchical dynamics within professional environments. Contextual factors referred to situational and organisational influences such as season timing, resource availability and operational practices. Psychological readiness was inconsistently defined and typically assessed informally rather than through validated instruments.</p><p><strong>Conclusions: </strong>Psychological, social and contextual factors are under-screened in RTS after HSI. Incorporating structured psychosocial screening and shared decision-making alongside physical criteria may improve RTS safety and sustainability. Athlete-centred research is warranted to refine the assessment of psychological readiness and inform holistic, context-sensitive RTS frameworks.</p>","PeriodicalId":47417,"journal":{"name":"BMJ Open Sport & Exercise Medicine","volume":"12 2","pages":"e003159"},"PeriodicalIF":3.2,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13223650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148151619","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":"Cardiac troponin patterns in athletes completing Norseman Xtreme Triathlon.","authors":"Martin Bonnevie-Svendsen, Erle Viktoria Edvardsson, Kjersti Oppen, Jørgen Melau, Christoffer Nyborg, Frode Wirum Sæter, Kristian Berge, Torbjørn Omland, Jonny Hisdal","doi":"10.1136/bmjsem-2025-002810","DOIUrl":"10.1136/bmjsem-2025-002810","url":null,"abstract":"<p><strong>Objective: </strong>Cardiac troponins (cTns) are frequently measured in patients when suspecting coronary artery disease (CAD). However, recent studies suggest that elevated cTns following exercise may predict CAD and increased mortality. Although the mechanisms underlying postexercise cTn increase remain unclear, the cardiac troponin I (cTnI)/cardiac troponin T (cTnT) ratio shows promise for distinguishing cardiac pathologies. This study assesses the dynamics of cTnI and cTnT concentrations and the cTnI/cTnT ratio in serum samples collected 1-2 days before, within 1 hour after and 11-24 hour after completing Norseman Xtreme Triathlon.</p><p><strong>Methods: </strong>Using Abbott's STAT High Sensitive Troponin-I assay and Roche's Elecsys Troponin T hs assay, we measured cTnI and cTnT in venous serum of 93 adult triathletes.</p><p><strong>Results: </strong>Concentrations of cTnI, cTnT and cTnI/cTnT ratio increased from baseline to immediately after the race (cTnI median (25-75 percentile) from (3 (2-6) ng/L) to 69 (37-156) ng/L, cTnT from (6 (5-8) ng/L) to 40 (24-55) ng/L and cTnI/cTnT from (0.5 (0.3-0.8)) to 2.1 (1.5-2.9), all p<0.001). Serum cTnI and cTnT concentrations remained elevated the day after the race, whereas the cTnI/cTnT ratio declined the day after the race compared with baseline levels. Three participants displayed higher cTnI levels, and 14 participants showed higher cTnI/cTnT ratios the day after the race compared with immediately after.</p><p><strong>Conclusion: </strong>Serum concentrations of cTnI, cTnT and the cTnI/cTnT ratio increase immediately after a long-distance triathlon, and concentrations trend towards normalisation the next day. The clinical implications are unknown and warrant further investigation.</p>","PeriodicalId":47417,"journal":{"name":"BMJ Open Sport & Exercise Medicine","volume":"12 2","pages":"e002810"},"PeriodicalIF":3.2,"publicationDate":"2026-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13182439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147976410","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":"Early adapted physical activity to prevent and manage aromatase inhibitor-induced musculoskeletal pain in breast cancer: protocol for a hybrid effectiveness-implementation randomised controlled trial (APIS).","authors":"Nathalie Piazzon, Elise Verot, Annick Gérard, Amandine Baudot, Florence Carrouel, Marion Cortet","doi":"10.1136/bmjsem-2025-003179","DOIUrl":"10.1136/bmjsem-2025-003179","url":null,"abstract":"<p><p>Aromatase inhibitors are the standard adjuvant hormone therapy for postmenopausal women with hormone-sensitive breast cancer. However, nearly half of patients experience aromatase inhibitor-associated musculoskeletal syndrome (AIMSS), predominantly pain, which compromises quality of life and treatment adherence. While adapted physical activity offers proven benefits in oncology, its specific role in preventing or managing AIMSS remains unclear. Moreover, the maintenance of physical activity throughout the care pathway in real-world settings is limited, underscoring the need for hybrid approaches that assess both clinical effectiveness and implementation. In response to these challenges, the primary study aim will be to compare the prevalence of musculoskeletal pain at 6 months of aromatase inhibitor therapy between patients who initiate a personalised, adapted physical activity programme at the beginning of the care pathway and those who receive usual care. Secondary aims will be to (1) assess additional effects of the intervention on physical health, psychosocial well-being and treatment adherence, (2) explore contextual factors influencing programme implementation in routine oncology care and (3) identify potential risk factors for the development of AIMSS. The APIS study is a hybrid type I effectiveness-implementation randomised controlled trial including 182 postmenopausal women with non-metastatic hormone-sensitive breast cancer.APIS will generate new evidence on the clinical and implementation effectiveness of early personalised adapted physical activity in preventing AIMSS. The hybrid design will support the development of sustainable, patient-centred interventions potentially improving quality of life, adherence to hormone therapy and long-term outcomes in breast cancer survivorship. Trial registration number NCT07295457.</p>","PeriodicalId":47417,"journal":{"name":"BMJ Open Sport & Exercise Medicine","volume":"12 2","pages":"e003179"},"PeriodicalIF":3.2,"publicationDate":"2026-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13182384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147976437","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}