BMJ Open Sport & Exercise Medicine最新文献

{"title":"Lowered tackle height law variation in Scottish men's community rugby: a video analysis evaluation of 18 702 tackles across two seasons.","authors":"Hamish Gornall, Hannah Walton, Isla Shill, Neil Graham, Lara Paul, Sharief Hendricks, Ross Tucker, Debbie Palmer","doi":"10.1136/bmjsem-2025-002492","DOIUrl":"https://doi.org/10.1136/bmjsem-2025-002492","url":null,"abstract":"<p><strong>Background/objectives: </strong>The tackle has the highest risk and causes the most concussions in rugby union. As such, law variation prevention strategies aiming to reduce head contact have been introduced. This study investigated whether a law variation lowering the maximum legal height of the tackle, from the shoulder to the base of the sternum, was an effective approach to change players' tackling behaviour and reduce head contact events in Scottish men's community rugby.</p><p><strong>Methods: </strong>This retrospective video analysis study compared game metrics and tackle characteristics from the pre (2022/2023) to lowered tackle height (LTH) season (2023/2024). Sixty games were analysed (30 each season), variables coded for the tackle event included tackle type, body position, contact point and head contact.</p><p><strong>Results: </strong>The rate of bent at waist tackling increased during the LTH season (rate ratio (RR)=1.22 (95% CI 1.17 to 1.27)), which resulted in tacklers making initial contact with the ball carriers' lower torso or arms more often (RR=1.08 (95% CI 1.03 to 1.14)). While overall tackler head contact to the ball carrier (any region) increased (RR=1.12 (95% CI 1.06 to 1.18)), head-to-head contacts with the ball carrier decreased (RR=0.55 (95% CI 0.33 to 0.92)) and head to upper leg contacts increased (RR=1.39 (95% CI 1.24 to 1.56)).</p><p><strong>Conclusions: </strong>Lowering the maximum legal height of the tackle in men's community rugby led to increased rates of bent at waist tackling, resulting in more tackles making initial contact with the ball carrier's lower torso and legs. This change in behaviour likely reduced the rate of contact between tackler and ball carrier heads.</p>","PeriodicalId":47417,"journal":{"name":"BMJ Open Sport & Exercise Medicine","volume":"11 2","pages":"e002492"},"PeriodicalIF":3.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001533","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":"Disadvantage starts early: academy football has high levels of oral disease.","authors":"Saul N Konviser, Martine Nurek, Ian Needleman, Peter Fine","doi":"10.1136/bmjsem-2024-002245","DOIUrl":"https://doi.org/10.1136/bmjsem-2024-002245","url":null,"abstract":"<p><strong>Abstract: </strong></p><p><strong>Objectives: </strong>We have previously reported high levels of oral disease in professional senior team footballers in England and Wales. In this study, we aimed to determine the prevalence of oral disease in professional academy footballers, to identify if problems start earlier and to inform health promotion strategies.</p><p><strong>Method: </strong>Professional academy football clubs in England (footballers aged 16-18 years) were invited to participate. Questionnaires were used to collect oral health behaviours and self-reported impacts and validated clinical outcomes to assess oral health.</p><p><strong>Results: </strong>160 academy footballers were recruited from 10 English academy football clubs, of whom 86.8% (n=139) were men and 13.2% (n=21) were women, with a median age of 16.9 years. We identified high levels of oral disease: 31.2% (n=50) had dental caries requiring treatment; 76.8% (n=123) had gingivitis; and 22.5% (n=36) had periodontitis. Tooth wear affecting up to at least 50% of tooth structure was present in 15.5% (n=25) of participants. While 76.2% (n=122) self-reported brushing their teeth twice a day, 15.5% (n=25) brushed once or less a day and 21% (n=34) had not attended the dentist for >2 years. There was a general perception that oral health issues impacted the sporting performance of participants.</p><p><strong>Conclusion: </strong>In this study, the prevalence of oral diseases among professional academy footballers in England was high and greater than found in national surveys of a similar age demographic. Urgent action is needed to embed oral health promotion in development and youth football, to reverse and prevent the disadvantages that will have lifelong consequences for treatment burden, quality of life and sporting performance.</p>","PeriodicalId":47417,"journal":{"name":"BMJ Open Sport & Exercise Medicine","volume":"11 2","pages":"e002245"},"PeriodicalIF":3.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054186","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":"Evaluating the efficacy of integrated injury prevention strategy combined with education in adolescent badminton players with early sports specialisation: a randomised controlled trial protocol.","authors":"Payal Vasant Dhawale, Vishnu Vardhan, Sarath Babu, Arunmozhi Ranganathan","doi":"10.1136/bmjsem-2025-002456","DOIUrl":"10.1136/bmjsem-2025-002456","url":null,"abstract":"<p><p>In recent years, there has been growing concern about the high rate of injuries in adolescent players, particularly those who engage in early sports specialisation, and there is a need for more effective and integrated sports-specific strategies that can reduce the rate of injuries and improve physical performance in this population. The primary purpose of this study is to compare the efficacy of an integrated injury prevention strategy combined with education versus conventional approaches in reducing injury rates, improving parental and coach awareness and enhancing physical performance in adolescent badminton players with early sports specialisation. Participants will be randomly assigned to either the integrated injury prevention strategy combined with the education or conventional approach group. The study will be conducted over 6 months, with measurements taken at baseline, and 6 months. The primary outcome measures will include injury rates, parental and coach awareness and physical performance. The results of this study will help determine whether the integrated approach can reduce injury rates, improve parent and coach awareness and enhance physical performance. Additionally, the study will assess the cost-effectiveness of the integrated approach and the level of player satisfaction. In conclusion, the outcomes of this randomised controlled trial will be useful for creating better injury prevention strategies for this group of athletes. This intervention trial is prospectively registered with Clinical Trials Registry India (CTRI Number-CTRI/2024/12/078261).</p>","PeriodicalId":47417,"journal":{"name":"BMJ Open Sport & Exercise Medicine","volume":"11 2","pages":"e002456"},"PeriodicalIF":3.9,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11977468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812720","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":"Can 4 weeks of real-world active breaks improve glycaemic management in sedentary adults with type 1 diabetes? The EXTOD-Active randomised control trial protocol.","authors":"Joseph G Jenkins, Matthew Cocks, Parth Narendran, Robert C Andrews, Beverley M Shields, Sam N Scott, Samuel J E Lucas, Catarina Rendeiro, Katie Hesketh","doi":"10.1136/bmjsem-2025-002594","DOIUrl":"10.1136/bmjsem-2025-002594","url":null,"abstract":"<p><p>Sedentary behaviour is associated with an increased risk of cardiovascular disease and all-cause mortality in individuals with type 1 diabetes (T1D). Recent laboratory-based research suggests that breaking up prolonged sedentary periods improves glycaemic markers in people with T1D. However, the effects of breaking up sedentary behaviour for prolonged periods in real-world settings remain unknown. This study aims to assess the effect of 4 weeks of active breaks on time spent within the target glycaemic range (time in range (TIR), 3.9-10.0 mmol/L) in adults with T1D Adults with T1D (n=118) who are sedentary for ≥8 hours per day will first complete a 7-day baseline assessment. Participants will then be randomised into either a control group (maintenance of habitual lifestyle) or an intervention group, where active breaks (3 min of self-paced walking every 30 min between 09:00 and 17:00, Monday through Friday) will be prescribed for 4 weeks. Activity levels (activPAL), TIR (via continuous glucose monitor), insulin dose and carbohydrate intake will be monitored throughout. The effect of active breaks on TIR will be compared between baseline and week 4, with data analysed using analysis of covariance (ANCOVA). The trial has been approved in the UK by the West Midlands-Solihull Ethics Committee (22/WM/0221). The findings from the study will be disseminated through peer-reviewed journals and presentations at national and international scientific conferences. Trial registration number NCT05706298.</p>","PeriodicalId":47417,"journal":{"name":"BMJ Open Sport & Exercise Medicine","volume":"11 2","pages":"e002594"},"PeriodicalIF":3.9,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804475","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":"Effects of aerobic dance on systolic blood pressure in stage one hypertensive adults in Uganda.","authors":"Loyce Nahwera, Edwin Kiptolo Boit, Constance A N Nsibambi, Mshilla Maghanga, Lucy-Joy Wachira","doi":"10.1136/bmjsem-2024-002325","DOIUrl":"10.1136/bmjsem-2024-002325","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effects of a 12-week aerobic dance programme on systolic blood pressure (SBP) in stage one hypertensive adults.</p><p><strong>Methods: </strong>This study employed an experimental research design. 36 out of 58 stage one hypertensive adults randomly assigned into experimental and control groups completed the programme. SBP was measured using a mercury sphygmomanometer at baseline and post programme. The experimental group participants trained thrice a week, 45 min per session, and at a moderate intensity, but the control group continued doing their daily routines. Data were analysed using SPSS V.20. A two-tailed t-test was used to compare the mean differences of the two groups. A p value of <0.05 was considered statistically significant.</p><p><strong>Results: </strong>The experimental group had a mean SBP of 143.83±6.382 mm Hg at baseline, while the control had 137.61±6.400 mm Hg. After a 12-week aerobic dance programme, the mean SBP of the experimental group reduced to 136.33±9.191 mm Hg, while that of the control group increased to 139.56±9.954 mm Hg. This implies that the 12-week aerobic dance programme reduced the SBP of the experimental group by -7.50 mm Hg while that of the control group remained more or less the same by having a marginal increment of 1.50 mm Hg. The changes were statistically significant (p<0.002) after a 12-week aerobic dance programme.</p><p><strong>Conclusion: </strong>The aerobic dance programme effectively manages the SBP of stage one hypertensive adults. In Uganda, stakeholders and policymakers should consider incorporating aerobic dance as a non-pharmacological method for hypertension management protocols.</p>","PeriodicalId":47417,"journal":{"name":"BMJ Open Sport & Exercise Medicine","volume":"11 2","pages":"e002325"},"PeriodicalIF":3.9,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804476","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":"Prevalence, incidence and burden of health problems across playing positions in elite male handball players: a 45-week prospective cohort study.","authors":"Kristina Drole, Aglaja Busch, Armin Paravlic, Mojca Doupona, Kathrin Steffen","doi":"10.1136/bmjsem-2025-002460","DOIUrl":"10.1136/bmjsem-2025-002460","url":null,"abstract":"<p><strong>Objectives: </strong>To describe the prevalence, incidence and burden of injuries and illnesses, including their patterns (mechanisms, affected body parts/organ systems) across playing positions (wing, back, line and goalkeeper) in elite adult male handball players.</p><p><strong>Methods: </strong>The Slovenian version of the Oslo Sports Trauma Research Center Questionnaire on Health Problems (OSTRC-H2-SLO) was used to record health problems (HP) weekly during the 45-week handball season 2022/23.</p><p><strong>Results: </strong>The study included 189 athletes (age: 23.3±4.4 years). With a weekly response rate of 93%, the mean weekly prevalence of HP was 13.3% (95% CI: 12% to 15%). The overall incidence was 2.2 HP per player per year (95% CI: 1.9 to 2.4), with a cumulative 3318 days lost and a mean time loss of 10.7 days per problem. Acute injuries represented the highest prevalence, incidence and more than 4× greater burden than overuse injuries and illnesses. The knee was the most frequently injured site for both acute and overuse injuries. For acute injuries, the ankle was the second most affected site, while the pelvis/lower back and shoulder were common in overuse injuries. Respiratory illnesses comprised 48% of all illnesses. Wings had the highest prevalence (17%), while backs exhibited the highest incidence (0.99 HP per player per year 95% CI 0.84-1.17), and goalkeepers faced the longest time-loss per HP.</p><p><strong>Conclusion: </strong>Our findings emphasise the need for position-specific medical care and prevention programmes, targeting knee, ankle, pelvis/lower back, shoulder and respiratory tract. Wings and backs require particular attention due to their high prevalence and burden, while goalkeepers need specialised rehabilitation protocols.</p><p><strong>Trial registration number: </strong>NCT05471297.</p>","PeriodicalId":47417,"journal":{"name":"BMJ Open Sport & Exercise Medicine","volume":"11 2","pages":"e002460"},"PeriodicalIF":3.9,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803320","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":"Mediation of obesity-related variables in the association between physical fitness and cardiometabolic risk in children and adolescents: a systematic review and meta-analysis.","authors":"João Francisco de Castro Silveira, José Francisco López-Gil, Cézane Priscila Reuter, Ana Paula Sehn, Letícia Borfe, Nelson Carvas Junior, Karin Allor Pfeiffer, Paulo Henrique Guerra, Lars Bo Andersen, Antonio Garcia-Hermoso, Anelise Reis Gaya","doi":"10.1136/bmjsem-2024-002366","DOIUrl":"10.1136/bmjsem-2024-002366","url":null,"abstract":"<p><strong>Objective: </strong>To examine the mediation of obesity-related variables in the association between physical fitness and cardiometabolic risk in children and adolescents.</p><p><strong>Design: </strong>Systematic review and meta-analysis.</p><p><strong>Data sources: </strong>Studies from electronic databases from inception to 31 December 2023.</p><p><strong>Eligibility criteria for selecting studies: </strong>Included were 123 observational studies (cross-sectional and longitudinal) that assessed risk by constructing a continuous score incorporating cardiometabolic parameters. Studies were considered if they evaluated at least one fitness component as an exposure in children and adolescents (5-19 years). Thirty-one were included in the main meta-analyses.</p><p><strong>Results: </strong>Cross-sectional findings indicate that cardiorespiratory fitness is modestly but beneficially associated with cardiometabolic risk, either indirectly via obesity-related variables (indirect standardized beta coefficient [β_Indirect]=-0.17; 95% confidence interval [CI] -0.23; -0.11; inconsistency index [I²]=94.4%) or directly and independently from obesity-related variables (r=-0.11; 95% CI -0.15; -0.07; I²=87.4%), whereas muscular fitness seems to be associated with risk only via obesity-related variables (β_Indirect=-0.34; 95% CI -0.47; -0.20; I²=85.1%). There was no cross-sectional difference between biological sexes (p≥0.199). Longitudinal findings indicate no total (r=-0.12; 95% CI -0.24; 0.01; I²=23.1%) and direct (r=-0.03; 95% CI -0.08; 0.03; I²=0%) associations.</p><p><strong>Conclusion: </strong>The association between fitness and risk appears to take place either indirectly through the reduction of obesity-related levels or directly by influencing risk. The latter underscores that the inverse association extends beyond a mere reduction in obesity-related variables, encompassing specific enhancements linked to exercise training, including increased metabolic efficiency, and cardiovascular capacity.</p><p><strong>Prospero registration number: </strong>CRD42022354628.</p>","PeriodicalId":47417,"journal":{"name":"BMJ Open Sport & Exercise Medicine","volume":"11 2","pages":"e002366"},"PeriodicalIF":3.9,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796371","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":"Successful rapid return to performance following non-operative treatment of proximal hamstring tendon avulsion in elite athletes.","authors":"Kenny Lauf, Anne D van der Made, Richard Jaspers, Rik Tacken, Mario Maas, Gino Kerkhoffs","doi":"10.1136/bmjsem-2025-002468","DOIUrl":"10.1136/bmjsem-2025-002468","url":null,"abstract":"<p><strong>Objectives: </strong>Proximal hamstring tendon avulsion injuries are severe and potentially career-threatening for elite athletes. Until now, no data have been published on the non-operative treatment of this injury in elite athletes. Therefore, the objective of this case series was to describe return to performance in elite athletes after non-operative treatment of full-thickness proximal hamstring tendon avulsion injuries as well as provide detailed description of the rehabilitation process and provide a mechanobiological hypothesis on processes leading to successful outcomes.</p><p><strong>Methods: </strong>In this retrospective case series, we included three elite athletes with four MRI-confirmed acute proximal hamstring tendon avulsions of the conjoint tendon and/or the semimembranosus tendon who opted for non-operative treatment following shared decision-making, consisting of an individualised rehabilitation programme. The primary outcome was time to return to performance (in weeks). Secondary outcomes were time to and rate of return to competition, rate of return to performance and re-injury rate.</p><p><strong>Results: </strong>Four proximal hamstring tendon avulsions in three elite athletes were included. All elite athletes returned to performance within 8-33 weeks, which for three out of four cases was at Olympic (gold medal) level.</p><p><strong>Conclusion: </strong>This (pilot) case series indicates that non-operative treatment for full-thickness proximal hamstring avulsion injury can result in return to performance in elite athletes. Non-operative treatment may therefore be a viable treatment option in selected (elite) athletes.</p>","PeriodicalId":47417,"journal":{"name":"BMJ Open Sport & Exercise Medicine","volume":"11 2","pages":"e002468"},"PeriodicalIF":3.9,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796594","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 study of five seasons of upper limb injuries in training and matches in elite female rugby union at club and national team level.","authors":"Caroline Sarah White, Paul Garner, Keith A Stokes, Sean Williams, Ian Horsley, Simon P T Kemp, Andy Soundy","doi":"10.1136/bmjsem-2024-002359","DOIUrl":"10.1136/bmjsem-2024-002359","url":null,"abstract":"<p><strong>Background: </strong>Data on upper limb injuries in elite female rugby athletes are limited. This study aims to describe the incidence, severity and burden of upper limb injuries over five seasons in elite women's rugby at both the club and international levels in training and matches.</p><p><strong>Methods: </strong>A longitudinal cohort study was conducted from the 2017/2018 to 2021/2022 seasons, involving female players from the English club top tier and international team. Data on upper limb injuries were reported by team medical staff, capturing injury type, location, severity and mechanism. Injury incidence was calculated per 1000 hours of match/training exposure, and burden was measured by multiplying incidence by severity.</p><p><strong>Results: </strong>A total of 190 upper limb injuries were recorded, with shoulder injuries the most common, representing 43% of all injuries. Median severity (mid-range of injury severity within the data) in international settings was lower than in club settings (Club matches 38 days, IQR 65, international matches 15 days, IQR 55). Injury burden (which is derived from injury mean severity and injury incidence) was significantly higher at international level (club matches, 265 days/1000 hours, 95% CI 213 to 328; club training 6 days/1000 hours, 95% CI 6 to 8; international matches 2638 days/1000 hours, 95% CI 2000 to 3481; international training 51 days/1000 hours, 95% CI 30 to 88).</p><p><strong>Conclusions: </strong>The current study data highlight a low injury severity at an international level. Although the international injury severity rate is higher than club injury incidence and burden. Hand injuries were more common within club training settings, and the shoulder was more prevalent in all other settings.</p>","PeriodicalId":47417,"journal":{"name":"BMJ Open Sport & Exercise Medicine","volume":"11 2","pages":"e002359"},"PeriodicalIF":3.9,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796285","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":"Long-term left atrial adaptations to reduced training load in former elite athletes: a long-term follow-up longitudinal observational study.","authors":"Mikkel Aaroee, Susanne Glasius Tischer, Robin Christensen, Ahmad Sajadieh, Christian Have Dall, Jens Jakob Thune, Hanne Rasmusen","doi":"10.1136/bmjsem-2024-002379","DOIUrl":"10.1136/bmjsem-2024-002379","url":null,"abstract":"<p><strong>Objective: </strong>Our objective was to evaluate the effects of long-term reduced training on the left atrium (LA) in elite endurance athletes and to elucidate sex-specific differences in LA detraining patterns.</p><p><strong>Methods: </strong>In this long-term longitudinal echocardiographic study of 50 active elite endurance athletes a follow-up examination was performed 7 years after retirement from the elite programme. All echocardiographic measurements were indexed for body surface area. We analysed the changes between baseline and follow-up measures using analysis of covariance models adjusted for baseline level, sex and enrolment age as covariates. Results are reported as least squares means with two-sided 95% CIs.</p><p><strong>Results: </strong>LA enlargement (left atrial maximum volume index) remained unchanged from baseline (change from baseline: 1.4mL/m², 95% CI: -0.7 to 3.5 mL/m²) despite significant reductions in VO₂max (change from baseline: -864mL/min, 95% CI: -1091 to -637 mL/min). In contrast, left ventricular (LV) end-diastolic volume was reduced (change from baseline: -8mL/m², 95% CI: -11 to -5 mL/m²), consistent with reduced VO₂max. LA contraction strain was increased (change from baseline: 1.4%, 95% CI: 0.4% to 2.5%), while LV filling pressure increased (E/e' change from baseline: 0.4, 95% CI: 0.1 to 0.7).</p><p><strong>Conclusions: </strong>7 years of reduced training does not reverse exercise-induced LA enlargement in former elite endurance athletes. LA contractile function improved with higher LV filling pressure, suggesting that age-related LV pressure increases may contribute to chronic LA dilation, though irreversible adaptations like fibrosis cannot be ruled out.</p><p><strong>Trial registration number: </strong>NCT05555849.</p>","PeriodicalId":47417,"journal":{"name":"BMJ Open Sport & Exercise Medicine","volume":"11 2","pages":"e002379"},"PeriodicalIF":3.9,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796351","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}