{"title":"Association of early versus late care seeking for sport-related concussion in adolescent athletes in Canada: a historical cohort study.","authors":"David Youngwoo Oh, Darrin Germann, Carolina Cancelliere, Mohsen Kazemi, Cameron Marshall, Sheilah Hogg-Johnson","doi":"10.1136/bmjsem-2024-002241","DOIUrl":"10.1136/bmjsem-2024-002241","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to examine the association of time to recovery between early versus late presentation to outpatient community-based concussion management clinics following sport-related concussion (SRC) among adolescent Canadian athletes.</p><p><strong>Methods: </strong>Using electronic health records (between January 2017 and December 2019) from the Complete Concussion Management Inc (CCMI) database, this was a historical cohort study of Canadian athletes aged 12-18 presenting for care early (0-7 days) or late (8-28 days) after SRC. Time-to-recovery was defined as the date of clinician clearance to return to sport. Propensity scores were first derived from logistic regression with early versus late clinical presentation as the outcome. Cox proportional hazards regression analysis was then used to model the relationship between early versus late clinical presentation and time to recovery, while including the propensity score to adjust for confounding. The association was expressed using hazard rate ratios (HRR) with 95% CIs.</p><p><strong>Results: </strong>A total of 4696 patient records (mean age of 14.71 (±1.69 SD); 57.7% male) were eligible. Early presentation to a concussion management clinic following SRC was associated with faster time to recovery (adjusted HRR 1.23; 95% CI 1.14 to 1.32, p<0.001). This association was consistent within each quintile of the propensity score. The median time to recovery was 18 versus 22 days in the early and late groups, respectively.</p><p><strong>Conclusion: </strong>Adolescent athletes with SRC have favourable recovery trajectories when presenting for care up to 28 days. Time to recovery (clinician clearance to return to sport) may be quicker with an earlier presentation which can lead to a faster return to sport.</p>","PeriodicalId":47417,"journal":{"name":"BMJ Open Sport & Exercise Medicine","volume":"11 1","pages":"e002241"},"PeriodicalIF":3.9,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11808907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392211","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":"Association between the use of daily injury risk estimation feedback (I-REF) based on machine learning techniques and injuries in athletics (track and field): results of a prospective cohort study over an athletics season.","authors":"Pierre-Eddy Dandrieux, Laurent Navarro, David Blanco, Alexis Ruffault, Christophe Ley, Antoine Bruneau, Spyridon Spyros Iatropoulos, Joris Chapon, Karsten Hollander, Pascal Edouard","doi":"10.1136/bmjsem-2024-002331","DOIUrl":"10.1136/bmjsem-2024-002331","url":null,"abstract":"<p><strong>Abstract: </strong></p><p><strong>Objective: </strong>To analyse the association between the level of use of injury risk estimation feedback (I-REF) provided to athletes and the injury burden during an athletics season.</p><p><strong>Method: </strong>We conducted a prospective cohort study over a 38-week follow-up period on athletes competing at the French Federation of Athletics. Athletes completed daily questionnaires on their athletics activity, psychological state, sleep, self-reported level of I-REF use, and injuries. I-REF provided a daily estimation of the injury risk for the next day, ranging from 0% (no risk of injury) to 100% (maximum risk of injury). The primary outcome was the injury burden during the follow-up, defined as the number of days with injury per 1000 hours of athletics activity. A negative binomial regression model was used to analyse the association between self-reported I-REF use and the injury burden.</p><p><strong>Results: </strong>Of the 897 athletes who met the inclusion criteria, 112 (38% women) were included in the analysis. The mean daily response rate of the follow-up was 37%±30%. The primary analysis found no significant association between the self-reported I-REF use and the injury burden (n=112, <i>e</i> <sup>β</sup>: 0.992, 95% CI: 0.977 to 1.007; p=0.308). However, when considering athletes' daily response rate in secondary analysis, for a response rate of at least 9%, we observed a significant association between the self-reported level of I-REF use and the injury burden (n=76, <i>e</i> <sup>β</sup>: 0.981, 95% CI: 0.965 to 0.998; p=0.027).</p><p><strong>Conclusions: </strong>Daily injury risk estimation feedback using machine learning was not associated with reducing injury burden.</p>","PeriodicalId":47417,"journal":{"name":"BMJ Open Sport & Exercise Medicine","volume":"11 1","pages":"e002331"},"PeriodicalIF":3.9,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11808868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392204","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}
Ravi Prakash, Rashmi Pathak, Ziyi Chen, Daniel Tai, Ursa BezanPetric, Estefanie Garduno Rapp, Folefac D Atem, Michael S Khazzam, Nitin B Jain
{"title":"Risk factors associated with degenerative glenohumeral osteoarthritis.","authors":"Ravi Prakash, Rashmi Pathak, Ziyi Chen, Daniel Tai, Ursa BezanPetric, Estefanie Garduno Rapp, Folefac D Atem, Michael S Khazzam, Nitin B Jain","doi":"10.1136/bmjsem-2024-002247","DOIUrl":"10.1136/bmjsem-2024-002247","url":null,"abstract":"<p><strong>Objective: </strong>Glenohumeral (GH) osteoarthritis (OA) is the third most common large joint disease, after hip and knee OA. This study aimed to identify risk factors for GH OA.</p><p><strong>Methods: </strong>We used data from the Dallas Shoulder cohort, including individuals aged 40-85. Those with confirmed GH OA based on X-ray were cases, and those without were controls. Univariate, least absolute shrinkage and selection operator and multivariate analyses identified risk factors, including age, body mass index (BMI), sex, work-related shoulder problems, shoulder disability, dislocation, previous trauma, surgery, smoking, hypertension, diabetes, depression, heart disease, OA, night pain and overall sleep quality.</p><p><strong>Results: </strong>A total of 1827 cases and 1556 controls were identified for GH OA. In univariate analysis, significant associations with GH OA were found for increasing age (>40 to ≤50: OR 3.29, 95% CI 2.44 to 4.45; >50 to ≤60: OR 5.90, 95% CI 4.49 to 7.77; >60 to ≤70: OR 12.18, 95% CI 9.22 to 16.08 and >70: OR 16.54, 95% CI 12.47 to 21.94), higher BMI (≤19: OR 1.44, 95% CI 1.01 to 2.04; >25 to ≤30: OR 1.57, 95% CI 1.32 to 1.86; >30 to ≤35: OR 1.85, 95% CI 1.54 to 2.22 and >35: OR 1.77, 95% CI 1.28 to 2.45), prior shoulder injury (OR 1.30; 95% CI 1.12 to 1.50), shoulder surgery history (OR 0.71; 95% CI 0.57 to 0.87), shoulder pain at night (OR 1.35; 95% CI 1.07 to 1.70) and hypertension (OR 0.70; 95% CI 0.60 to 0.81). In multivariate analysis, significant associations remained for age (>40 to ≤50: OR 2.99, 95% CI 2.21 to 4.06; >50 to ≤60: OR 5.48, 95% CI 4.14 to 7.23; >60 to ≤70: OR 11.22, 95% CI 8.44 to 14.88 and >70: OR 16.65, 95% CI 12.45 to 22.17), BMI (≤19: OR 1.49, 95% CI 1.01 to 2.20; >25 to ≤30: OR 1.45, 95% CI 1.20 to 1.77; >30 to ≤35: OR 1.70, 95% CI 1.39 to 2.09 and >35: OR 1.78, 95% CI 1.25 to 2.55) and previous shoulder trauma (OR 0.80; 95% CI 0.68 to 0.94).</p><p><strong>Conclusion: </strong>We identified increasing age and higher BMI as factors associated with GH OA. Due to the large sample size, many risk factors were assessed. Since the shoulder is not a weight-bearing joint, the BMI-GH OA link is likely molecular and systemic, warranting further investigation.</p><p><strong>Level of evidence: </strong>Prognostic level III.</p>","PeriodicalId":47417,"journal":{"name":"BMJ Open Sport & Exercise Medicine","volume":"11 1","pages":"e002247"},"PeriodicalIF":3.9,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11804196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383620","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}
Yasutaka Ojio, Rei Amemiya, John L Oliffe, Simon M Rice
{"title":"Mental health help-seeking knowledge, attitudes and behaviour among male elite rugby players: the role of masculine health-related values.","authors":"Yasutaka Ojio, Rei Amemiya, John L Oliffe, Simon M Rice","doi":"10.1136/bmjsem-2024-002275","DOIUrl":"10.1136/bmjsem-2024-002275","url":null,"abstract":"<p><strong>Objectives: </strong>Masculine norms of toughness and self-reliance can discourage help-seeking among elite athletes who are men. Effective ways to leverage masculine norms for help-seeking is a relatively unexplored area in athlete mental health. The study aimed to investigate how masculine health-related values measured by the Intentions Masculine Values Scale (IMVS) affect help-seeking behaviours among male elite rugby players.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted among 220 Japanese male elite rugby players in the Japan Rugby League One (response rate: 40.6%). Participants completed an online survey assessing help-seeking knowledge, attitudes and behaviours, along with masculine health-related values using the IMVS. Psychological safety within sports settings was evaluated using the Sport Psychological Safety Inventory (SPSI). Multiple regression analyses examined relationships between help-seeking behaviours and IMVS/SPSI.</p><p><strong>Results: </strong>The Open and Selfless IMVS value was significantly associated with help-seeking knowledge (β=0.059, p=0.009) and attitudes (β=0.064, p=0.006), increasing recognition of the need for help and willingness to seek it. However, no significant association with actual help-seeking behaviour was found (β=-0.006, p=0.774). The Healthy and Autonomous IMVS value was associated with lower help-seeking behaviour (β=0.060, p=0.010), indicating higher autonomy may inhibit seeking professional support. The SPSI was not significantly related to help-seeking measures.</p><p><strong>Conclusion: </strong>Findings highlight critical gaps between intention and actual help-seeking behaviour among male elite athletes. Further research is needed to explore additional cultural and organisational factors that may better explain help-seeking behaviour and inform effective intervention strategies.</p>","PeriodicalId":47417,"journal":{"name":"BMJ Open Sport & Exercise Medicine","volume":"11 1","pages":"e002275"},"PeriodicalIF":3.9,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190901","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}
Emily M Smith, Kelly Drager, Erik M Groves, Leigh Gabel, Steven K Boyd, Lauren A Burt
{"title":"New approach to identifying elite winter sport athletes' risk of relative energy deficiency in sport (REDs).","authors":"Emily M Smith, Kelly Drager, Erik M Groves, Leigh Gabel, Steven K Boyd, Lauren A Burt","doi":"10.1136/bmjsem-2024-002320","DOIUrl":"10.1136/bmjsem-2024-002320","url":null,"abstract":"<p><strong>Objectives: </strong>Relative energy deficiency in sport (REDs) is a syndrome resulting from problematic low energy availability (LEA). Low areal bone mineral density (aBMD) is a primary indicator of LEA, measured by dual X-ray absorptiometry (DXA). High-resolution peripheral quantitative CT (HR-pQCT) is an advanced imaging device that provides measures of volumetric BMD (vBMD), bone microarchitecture, geometry and strength. This study aimed to assess the prevalence of REDs in elite winter sport athletes and to observe the associations in bone parameters using HR-pQCT in athletes identified as at-risk or not at-risk of REDs.</p><p><strong>Methods: </strong>Participants included 101 elite athletes (24.1±4.4 SD years; 52% female). The REDs Clinical Assessment Tool (CAT2) was used to determine REDs risk. HR-pQCT scans of the non-dominant radius and left tibia were analysed on REDs risk grouping.</p><p><strong>Results: </strong>17 athletes (17%; 71% female) were at-risk based on the REDs CAT2. After covarying for lean mass, OR suggested a higher likelihood of REDs risk classification for athletes with low cortical thickness, cortical area, total vBMD and bone strength.</p><p><strong>Conclusions: </strong>Impaired total vBMD, bone strength and cortical bone parameters were approximately twice as likely (OR: 1.9-3.0) in athletes at-risk of REDs. Results agree with the consensus statement that HR-pQCT may identify impaired bone health in athletes at-risk of REDs. Future directions should use HR-pQCT to explore REDs risk longitudinally, using bone change over time, as this may provide greater insight. Using advanced imaging to explore REDs risk in a population of winter high-performance athletes is novel.</p>","PeriodicalId":47417,"journal":{"name":"BMJ Open Sport & Exercise Medicine","volume":"11 1","pages":"e002320"},"PeriodicalIF":3.9,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081673","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}
Thomas Molloy, Benjamin Gompels, Simone Castagno, Stephen McDonnell
{"title":"The Cambridge Knee Injury Tool (CamKIT): a clinical prediction tool for acute soft tissue knee injuries.","authors":"Thomas Molloy, Benjamin Gompels, Simone Castagno, Stephen McDonnell","doi":"10.1136/bmjsem-2024-002357","DOIUrl":"10.1136/bmjsem-2024-002357","url":null,"abstract":"<p><strong>Background/aim: </strong>This study focuses on the development of the Cambridge Knee Injury Tool (CamKIT), a clinical prediction tool developed as a 12-point scoring tool based on a modified e-Delphi study.</p><p><strong>Methods: </strong>A retrospective cohort evaluation was conducted involving 229 patients presenting to a Major Trauma Centre with acute knee pain over 3 months. The evaluation extracted data on the 12 scoring tool variables as well as diagnostic and management pathway outcomes. CamKIT scores for the injured and non-injured cohorts were then calculated and evaluated.</p><p><strong>Results: </strong>The CamKIT yielded a median score of 7.5 (IQR: 6-9) in the injured cohort, compared with a median score of 2 (IQR: 1-4) in the non-injured cohort, with a statistically significant difference (p<0.0001). When constructed as a three-tier risk stratification tool, the CamKIT produces a sensitivity of 100%, a specificity of 94.3%, a positive predictive value of 89% and a negative predictive value of 100% for diagnosing clinically significant soft tissue knee injuries.</p><p><strong>Conclusion: </strong>The CamKIT provides a non-invasive tool that has the potential to streamline the diagnostic process and empower healthcare workers in resource-stretched settings by instilling confidence and promoting accuracy in clinical decision-making. The CamKIT also has the potential to support efficiency in the secondary healthcare setting by enabling more targeted and timely use of specialist resources. This research contributes to the ongoing efforts to enhance patient outcomes and the overall quality of care in managing acute knee injuries.</p>","PeriodicalId":47417,"journal":{"name":"BMJ Open Sport & Exercise Medicine","volume":"11 1","pages":"e002357"},"PeriodicalIF":3.9,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11780958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080776","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}
Armando Calleja-Rodríguez, Beatriz Ruiz-Ruiz, Ángel González-de-la-Flor, María García Arrabé
{"title":"Translation, cultural adaptation and validation of the Achilles Tendon Total Rupture Score (ATRS) into Spanish: a study protocol.","authors":"Armando Calleja-Rodríguez, Beatriz Ruiz-Ruiz, Ángel González-de-la-Flor, María García Arrabé","doi":"10.1136/bmjsem-2024-002423","DOIUrl":"10.1136/bmjsem-2024-002423","url":null,"abstract":"<p><p>The Achilles tendon is the strongest and largest tendon in the human body, yet it is also the most frequently ruptured. The incidence of Achilles tendon rupture (ATR) is increasing due to an ageing population, rising obesity rates and greater sports participation. The Achilles Tendon Total Rupture Score (ATRS) is a validated patient-reported outcome measure widely used to assess clinical and functional outcomes after ATR. However, there is no culturally adapted and validated Spanish version of this tool, limiting its applicability in Spanish-speaking populations. The aim is to translate, culturally adapt and validate the Spanish version of the ATRS following international guidelines and to analyse its psychometric properties for assessing clinical and functional outcomes in patients with ATR. This study protocol outlines a cross-sectional design adhering to Strengthening the Reporting of Observational Studies in Epidemiology and Checklist for Reporting Results of Internet E-Surveys guidelines for observational studies and online surveys. The ATRS will be translated and culturally adapted, psychometric analysis will follow COnsensus-based Standards for the selection of health Measurement INstruments standards, including reliability, validity and sensitivity assessments. Participants will include patients treated surgically for ATR in hospitals across Madrid and healthy controls recruited through social media. Sociodemographic, clinical and functional data will also be collected to support the validation process. This study protocol was approved by the Universidad Europea de Madrid Institutional Board (Approval ID: CI 2024/897) prior to data collection based one the Declaration of Helsinki. The study's findings will be distributed to athletes, physicians and academics via peer-reviewed publications and national/international conferences.</p>","PeriodicalId":47417,"journal":{"name":"BMJ Open Sport & Exercise Medicine","volume":"11 1","pages":"e002423"},"PeriodicalIF":3.9,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11781081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081029","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}
Anne Inger Mørtvedt, Tron Krosshaug, Erich J Petushek
{"title":"Perspectives on usability and adoption of a new ACL injury prevention programme for female handball players: a mixed methods approach.","authors":"Anne Inger Mørtvedt, Tron Krosshaug, Erich J Petushek","doi":"10.1136/bmjsem-2024-001965","DOIUrl":"10.1136/bmjsem-2024-001965","url":null,"abstract":"<p><p>Effective injury prevention programmes (IPPs) hold promise for mitigating ACL injuries in female handball players, yet adherence remains a challenge. This mixed methods study explores the relationship between programme usability characteristics and the potential effectiveness of a newly developed ACL IPP through survey and interview data from 23 female handball players aged 15-18 and their four coaches. Players' knee abduction moment (KAM) was measured during a cutting task and used to measure potential effectiveness. Findings reveal significant correlations between reductions in KAM and players' perceived effectiveness of the programme in reducing ACL injury risk and their intention to use it (Spearman's rho (r<sub>s</sub>) -0.52, 95% CI -0.78 to -0.1, p=0.02 and r<sub>s</sub> -0.46, 95% CI -0.75 to -0.03, p=0.04, respectively). Coaches and players identified efficiency and perceived effectiveness as key factors influencing programme adoption. Concerns regarding programme length and doubts about exercise efficacy and transferability emerged as barriers, while perceived effectiveness, efficiency and enjoyability were facilitators for programme use. Players' suggestions for programme improvement included shortening the duration and incorporating playful elements. Design thinking sessions yielded strategies to optimise time efficiency and integrate IPPs into existing training routines. The study reaffirms the importance of balancing programme effectiveness with practicality and clear communication about its purpose and benefits to facilitate programme adoption. Enhancing programme usability and involving all end-users in the design process are crucial steps toward promoting the acceptance and adoption of IPPs among target populations.</p>","PeriodicalId":47417,"journal":{"name":"BMJ Open Sport & Exercise Medicine","volume":"11 1","pages":"e001965"},"PeriodicalIF":3.9,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11781089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081675","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}
Jonathan Schütze, Benedikt Bernhard, Noah Greisser, Philippe Joss, Sarah Manser, Anselm W Stark, Isaac Shiri, Catherine Gebhard, Maryam Pavlicek, Matthias Wilhelm, Christoph Gräni
{"title":"Sports behaviour and adherence to sports and exercise recommendations in patients with myocarditis.","authors":"Jonathan Schütze, Benedikt Bernhard, Noah Greisser, Philippe Joss, Sarah Manser, Anselm W Stark, Isaac Shiri, Catherine Gebhard, Maryam Pavlicek, Matthias Wilhelm, Christoph Gräni","doi":"10.1136/bmjsem-2024-002218","DOIUrl":"10.1136/bmjsem-2024-002218","url":null,"abstract":"<p><strong>Aim: </strong>In the clinical setting of acute myocarditis, existing guidelines recommend refraining from moderate-intensity to high-intensity sports for 3-6 months, yet the extent to which these recommendations are implemented by clinicians and followed by patients remains unclear.</p><p><strong>Methods: </strong>From January 2020 to December 2023, consecutive patients with myocarditis according to European Society of Cardiology criteria were prospectively enrolled. Myocarditis was categorised into acute, subacute and non-acute myocarditis. Patients completed a sports questionnaire and sports behaviour was categorised into no sports (NSP), recreational (REC) or competitive sports (COMP).</p><p><strong>Results: </strong>A total of 165 patients with myocarditis (mean age 50±17 years, 35% women) completed the questionnaire. Overall 73 (44%) patients received sports counselling. A total of 44 (72%) patients engaged in sports (REC+COMP) with acute or subacute myocarditis, received sports counselling with 38 (87%) adhering. Overall COMP patients (all male) received more counselling (11/11; 100%) compared with REC (53/105; 50%) and NSP (9/49; 18%). Of 39 women in the REC group, 14 (36%) received recommendations, whereas of 66 men 39 (59%) received recommendations (p<0.001). Of all patients engaged in sports, 55% received recommendations. Self-reported adherence to recommendations was significantly lower in COMP (73%) compared with REC (92%, p<0.001).</p><p><strong>Conclusion: </strong>Although only half of the myocarditis patients received counselling regarding sports activity, adherence to these recommendations was generally high but varied by activity level. Women received fewer recommendations overall compared with men. While competitive athletes were counselled more frequently than recreational athletes, they were less likely to adhere to the recommendations.</p>","PeriodicalId":47417,"journal":{"name":"BMJ Open Sport & Exercise Medicine","volume":"11 1","pages":"e002218"},"PeriodicalIF":3.9,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11781083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081678","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}
Ruth Leese, Ash Kolstad, Ricardo T Sant'Anna, Carly D McKay, Stephen W West
{"title":"High tackle headache: implications of referee agreement for tackle height law change.","authors":"Ruth Leese, Ash Kolstad, Ricardo T Sant'Anna, Carly D McKay, Stephen W West","doi":"10.1136/bmjsem-2024-002347","DOIUrl":"10.1136/bmjsem-2024-002347","url":null,"abstract":"<p><strong>Objectives: </strong>Rugby Union has a relatively high risk of injury. Early evidence suggests a benefit of lowering tackle height to reduce head and neck injuries, although concerns persist among stakeholders regarding implementation challenges. This study aimed to understand whether referees can reach the same conclusion regarding tackle height in a controlled environment (ie, video) and whether priming influenced these decisions.</p><p><strong>Methods: </strong>Forty-eight active referees completed a questionnaire based on high-tackle decision-making guidelines after watching tackles. Participants were randomly assigned one of two instructional videos containing a high or legal tackle to investigate the impact of priming on law interpretation.</p><p><strong>Results: </strong>The percent agreement regarding tackle height was 78.1% between participants, 62.7% between participants and an experienced analyst, and 74.0% between participants and a gold-standard referee. Mean intra-rater reliability when determining whether a tackle was high was substantial (percent agreement: 91.2%). For high tackles, 83% of participants agreed on the danger level, 57% on the contact location and 71% on the presence of mitigating factors. No significant effects of priming were observed. Inter-rater agreement among participants and the gold-standard referee was moderate for all items except danger and height, which showed strong agreement.</p><p><strong>Conclusion: </strong>These results suggest a need for improved referee training to support changes to the legal tackle height.</p>","PeriodicalId":47417,"journal":{"name":"BMJ Open Sport & Exercise Medicine","volume":"11 1","pages":"e002347"},"PeriodicalIF":3.9,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11781086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081550","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}