British Journal of Sports Medicine最新文献

{"title":"ICON 2023: International Scientific Tendinopathy Symposium Consensus – the core outcome set for Achilles tendinopathy (COS-AT) using a systematic review and a Delphi study of professional participants and patients","authors":"Robert-Jan de Vos, Karin Gravare Silbernagel, Peter Malliaras, Tjerk Sleeswijk Visser, Hakan Alfredson, Inge van den Akker-Scheek, Mathijs van Ark, Annelie Brorsson, Ruth Chimenti, Sean Docking, Pernilla Eliasson, Kenneth Farnqvist, Zubair Haleem, Shawn L Hanlon, Jean-Francois Kaux, Rebecca Samantha Kearney, Paul D Kirwan, Kornelia Kulig, Bhavesh Kumar, Trevor Lewis, Umile Giuseppe Longo, Tun Hing Lui, Nicola Maffulli, Adrian James Mallows, Lorenzo Masci, Dennis McGonagle, Dylan Morrissey, Myles Calder Murphy, Richard Newsham-West, Katarina Maria Nilsson-Helander, Richard Norris, Francesco Oliva, Seth O’Neill, Koen Peers, Ebonie Kendra Rio, Igor Sancho, Alex Scott, Kayla D Seymore, Sze-Ee Soh, Patrick Vallance, Jan A N Verhaar, Arco C van der Vlist, Adam Weir, Jennifer Ann Zellers, Bill Vicenzino","doi":"10.1136/bjsports-2024-108263","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108263","url":null,"abstract":"To develop a core outcome set for Achilles tendinopathy (COS-AT) for use in clinical trials we performed a five-step process including (1) a systematic review of available outcome measurement instruments, (2) an online survey on truth and feasibility of the available measurement instruments, (3) an assessment of the methodological quality of the selected outcome measurement instruments, (4) an online survey on the outcome measurement instruments as COS and (5) a consensus in-person meeting. Both surveys were completed by healthcare professionals and patients. The Outcome Measures in Rheumatology guidelines with a 70% threshold for consensus were followed. We identified 233 different outcome measurement instruments from 307 included studies; 177 were mapped within the International Scientific Tendinopathy Symposium Consensus core domains. 31 participants (12 patients) completed the first online survey (response rate 94%). 22/177 (12%) outcome measurement instruments were deemed truthful and feasible and their measurement properties were evaluated. 29 participants (12 patients) completed the second online survey (response rate 88%) and three outcome measurement instruments were endorsed: the Victorian Institute of Sports Assessment-Achilles questionnaire, the single-leg heel rise test and evaluating pain after activity using a Visual Analogue Scale (VAS, 0–10). 12 participants (1 patient) attended the final consensus meeting, and 1 additional outcome measurement instrument was endorsed: evaluating pain during activity/loading using a VAS (0–10). It is recommended that the identified COS-AT will be used in future clinical trials evaluating the effectiveness of an intervention. This will facilitate comparing outcomes of intervention strategies, data pooling and further progression of knowledge about AT. As COS-AT is implemented, further evidence on measurement properties of included measures and new outcome measurement instruments should lead to its review and refinement.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":null,"pages":null},"PeriodicalIF":18.4,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142231289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of occupational and leisure-time physical activity with all-cause mortality: an individual participant data meta-analysis","authors":"Pieter Coenen, Maaike A Huysmans, Andreas Holtermann, Richard P Troiano, Paul Jarle Mork, Steinar Krokstad, Els Clays, Bart Cillekens, Dirk De Bacquer, Mette Aadahl, Line Lund Kårhus, Anette Sjøl, Lars Bo Andersen, Jussi Kauhanen, Ari Voutilainen, Richard M Pulsford, Emmanuel Stamatakis, Uri Goldbourt, Annette Peters, Barbara Thorand, Annika Rosengren, Lena Björck, Kyle Sprow, Kristin Franzon, Miguel Rodriguez-Barranco, Leila Luján-Barroso, Anders Knutsson, Lars Alfredsson, Martin Bahls, Till Ittermann, Alexander Kluttig, Lamiaa Hassan, Miriam Wanner, Matthias Bopp, Jacob Louis Marott, Peter Schnohr, Børge Grønne Nordestgaard, Knut Eirik Dalene, Ulf Ekelund, Johan Clausen, Magnus Thorsten Jensen, Christina Bjørk Petersen, Niklas Krause, Jos Twisk, Willem van Mechelen, Allard J van der Beek","doi":"10.1136/bjsports-2024-108117","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108117","url":null,"abstract":"Objective Health effects of different physical activity domains (ie, during leisure time, work and transport) are generally considered positive. Using Active Worker consortium data, we assessed independent associations of occupational and leisure-time physical activity (OPA and LTPA) with all-cause mortality. Design Two-stage individual participant data meta-analysis. Data source Published and unpublished cohort study data. Eligibility criteria Working participants aged 18–65 years. Methods After data harmonisation, we assessed associations of OPA and LTPA with all-cause mortality. In stage 1, we analysed data from each study separately using Cox survival regression, and in stage 2, we pooled individual study findings with random-effects modelling. Results In 22 studies with up to 590 497 participants from 11 countries, during a mean follow-up of 23.1 (SD: 6.8) years, 99 743 (16%) participants died. Adjusted for LTPA, body mass index, age, smoking and education level, summary (ie, stage 2) hazard ration (HRs) and 95% confidence interval (95% CI) for low, moderate and high OPA among men (n=2 96 134) were 1.01 (0.99 to 1.03), 1.05 (1.01 to 1.10) and 1.12 (1.03 to 1.23), respectively. For women (n=2 94 364), HRs (95% CI) were 0.98 (0.92 to 1.04), 0.96 (0.92 to 1.00) and 0.97 (0.86 to 1.10), respectively. In contrast, higher levels of LTPA were inversely associated with mortality for both genders. For example, for women HR for low, moderate and high compared with sedentary LTPA were 0.85 (0.81 to 0.89), 0.78 (0.74 to 0.81) and 0.75 (0.65 to 0.88), respectively. Effects were attenuated when adjusting for income (although data on income were available from only 9 and 6 studies, for men and women, respectively). Conclusion Our findings indicate that OPA may not result in the same beneficial health effects as LTPA. Data may be obtained from a third party and are not publicly available. All aggregated data are provided in this manuscript, including the supplementary files. Part of the individual participant are available on request, while other parts may be obtained from a third party and are not publicly available.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":null,"pages":null},"PeriodicalIF":18.4,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142166131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-intensity interval training for cardiometabolic health in adults with metabolic syndrome: a systematic review and meta-analysis of randomised controlled trials","authors":"Eric Tsz-Chun Poon, Waris Wongpipit, Hong-Yat Li, Stephen Heung-Sang Wong, Parco M Siu, Alice Pik-Shan Kong, Nathan A Johnson","doi":"10.1136/bjsports-2024-108481","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108481","url":null,"abstract":"Objective To assess the effectiveness of high-intensity interval training (HIIT) compared with traditional moderate-intensity continuous training (MICT) and/or non-exercise control (CON) for modification of metabolic syndrome (MetS) components and other cardiometabolic health outcomes in individuals with MetS. Design Systematic review and meta-analysis Data sources Five databases were searched from inception to March 2024. Study appraisal and synthesis Meta-analyses of randomised controlled trials (RCTs) comparing HIIT with MICT/CON were performed for components of MetS (waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), high-density lipoprotein cholesterol (HDL-C), triglyceride (TG), and fasting blood glucose (BG)) and clinically relevant cardiometabolic health parameters. Subgroup moderator analyses were conducted based on the intervention duration and HIIT volume. Results Out of 4819 studies, 23 RCTs involving 1374 participants were included (mean age: 46.2–67.0 years, 55% male). HIIT significantly improved WC (weighted mean difference (WMD) –4.12 cm, 95% CI –4.71 to –3.53), SBP (WMD –6.05 mm Hg, 95% CI –8.11 to –4.00), DBP (WMD –3.68 mm Hg, 95% CI –5.70 to –1.65), HDL-C (WMD 0.12 mmol/L, 95% CI 0.04 to 0.20), TG (WMD –0.34 mmol/L, 95% CI –0.41 to –0.27) and BG (WMD –0.35 mmol/L, 95% CI –0.54 to –0.16) compared with CON (all p<0.01). HIIT approaches demonstrated comparable effects to MICT across all parameters. Subgroup analyses suggested that HIIT protocols with low volume (ie, <15 min of high-intensity exercise per session) were not inferior to higher volume protocols for improving MetS components. Conclusion This review supports HIIT as an efficacious exercise strategy for improving cardiometabolic health in individuals with MetS. Low-volume HIIT appears to be a viable alternative to traditional forms of aerobic exercise. The datasets analysed in this review are available from the corresponding author on reasonable request.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":null,"pages":null},"PeriodicalIF":18.4,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142166130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pubic apophysitis – an important cause of groin pain in young athletes","authors":"David F Hanff, Astrid van Ovost, Bruce B Forster, Adam Weir","doi":"10.1136/bjsports-2024-108710","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108710","url":null,"abstract":"A 17-year-old male right-footed footballer presented with a 6-month history of left-sided groin pain which was persistent despite resting for 6 weeks. Pain occurred during running and daily activities including climbing the stairs and turning over in bed. On examination, the cardinal findings were tenderness of the pubic bone near the adductor insertion on the left side and pubic pain during resisted adduction. An initial pelvic radiograph was suboptimal due to overlying bowel gas but did show minor cortical irregularities (arrow, figure 1A) and features of an immature pubic symphysis including non-fused apophysis on the inferior side of the pubic symphysis and lower region joint lines are not yet fully ossified. MRI examination showed features, together with the clinical findings, that are typical for pubic apophysitis. There was bilateral extensive bone marrow oedema of the whole part shown of the pubic symphysis (arrow, figure 1B) on the coronal fat-suppressed sequence. A more focal high fluid signal along the left apophysis was also seen (arrow, figure 1C). Cortical irregularity on the left side with cystic and erosion-like configurations and widening of the pubic symphysis …","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":null,"pages":null},"PeriodicalIF":18.4,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142160542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of exercise, metformin and their combination on glucose metabolism in individuals with abnormal glycaemic control: a systematic review and network meta-analysis","authors":"Tong Zhao, Qize Yang, Joshua F Feuerbacher, Bizhu Yu, Christian Brinkmann, Sulin Cheng, Wilhelm Bloch, Moritz Schumann","doi":"10.1136/bjsports-2024-108127","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108127","url":null,"abstract":"Objective To compare the efficacy of exercise, metformin and their combination on glucose metabolism in individuals with abnormal glycaemic control. Design Systematic review and network meta-analysis. Data sources Embase, Web of Science, PubMed/MEDLINE and SPORTDiscus. Eligibility criteria Randomised controlled trials involving exercise, metformin or their combined treatments in individuals with prediabetes or type 2 diabetes mellitus (T2DM) were included. Outcomes included haemoglobin A1c (HbA1c), 2-hour glucose during oral glucose tolerance test, fasting glucose, fasting insulin and homeostasis model assessment of insulin resistance (HOMA-IR). Results 407 articles with 410 randomised controlled trials (n=33 802) were included. In prediabetes, the exercise showed greater efficacy than metformin on HbA1c levels (mean difference −0.16%, 95% CI (−0.23 to −0.09) vs −0.10%, 95% CI (−0.21 to 0.02)), 2-hour glucose (−0.68 mmol/L, 95% CI (−0.97 to −0.39) vs 0.01 mmol/L, 95% CI (−0.38 to 0.41)) and HOMA-IR (−0.54, 95% CI (−0.71 to −0.36) vs −0.23, 95% CI (−0.55 to 0.10)), while the efficacy on fasting glucose was comparable (−0.26 mmol/L, 95% CI (−0.32 to −0.19) vs −0.33 mmol/L, 95% CI (−0.45 to −0.21)). In T2DM, metformin was more efficacious than exercise on HbA1c (−0.88%, 95% CI (−1.07 to −0.69) vs −0.48%, 95% CI (−0.58 to −0.38)), 2-hour glucose (−2.55 mmol/L, 95% CI (−3.24 to −1.86) vs −0.97 mmol/L, 95% CI (−1.52 to −0.42)) and fasting glucose (−1.52 mmol/L, 95% CI (−1.73 to −1.31) vs −0.85 mmol/L, 95% CI (−0.96 to −0.74)); exercise+metformin also showed greater efficacy in improving HbA1c (−1.23%, 95% CI (−2.41 to –0.05)) and fasting glucose (−2.02 mmol/L, 95% CI (−3.31 to –0.74)) than each treatment alone. However, the efficacies were modified by exercise modality and metformin dosage. Conclusion Exercise, metformin and their combination are efficacious in improving glucose metabolism in both prediabetes and T2DM. The efficacy of exercise appears to be superior to metformin in prediabetes, but metformin appears to be superior to exercise in patients with T2DM. PROSPERO registration number CRD42023400622. Data are available upon reasonable request. Data are available on reasonable request by contacting the corresponding author.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":null,"pages":null},"PeriodicalIF":18.4,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142144266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Injury-inciting circumstances of sudden-onset hamstring injuries: video analyses of 63 match injuries in male professional football players in the Qatar Stars League (2013–2020)","authors":"Robin Vermeulen, Nicol van Dyk, Rod Whiteley, Karim Chamari, Warren Gregson, Lorenzo Lolli, Roald Bahr, Johannes L Tol, Andreas Serner","doi":"10.1136/bjsports-2023-106722","DOIUrl":"https://doi.org/10.1136/bjsports-2023-106722","url":null,"abstract":"Objective To describe and categorise the injury-inciting circumstances of sudden-onset hamstring match injuries in professional football players using systematic video analysis. Methods Using a prospective injury surveillance database, all sudden-onset hamstring match injuries in male football players (18 years and older) from the Qatar Stars League between September 2013 and August 2020 were reviewed and cross-referenced with broadcasted match footage. Videos with a clear observable painful event (ie, a player grabbing their posterior thigh) were included. Nine investigators independently analysed all videos to describe and categorise injury-inciting circumstances. We used three main categories: playing situation (eg, time of injury), player action(s) (eg, running) and other considerations (eg, contact). Player action(s) and other considerations were not mutually exclusive. Results We included 63 sudden-onset hamstring match injuries out of 295 registered injuries between 2013 and 2020. Running was involved in 86% of injuries. Hamstring injuries occurred primarily during acceleration of 0–10 m (24% of all injuries) and in general at different running distances (0–50 m) and speeds (slow to fast). At 0–10 m distance, indirect player-to-player contact and inadequate balance were involved in 53% and 67% of the cases, respectively. Pressing occurred in 46% of all injuries (injured player pressing opponent: 25%; being pressed by opponent: 21%) and frequently involved player-to-player contact (69% of the cases when the injured player was pressing vs 15% of the cases when the opponent was pressing) and inadequate balance (82% vs 50%, respectively). Other player actions that did not involve running (n=9, 14% of all injuries) were kicking (n=6) and jumping (n=3). Conclusion The injury-inciting circumstances of sudden-onset hamstring match injuries in football varied. The most common single-player action (24%) was acceleration over a distance of <10 m. Pressing, inadequate balance and indirect contact were frequently seen player actions. Injury prevention research in football should look beyond high-speed running as the leading risk factor for sudden-onset hamstring injuries. Data are available upon reasonable request. Data may be obtained from a third party and are not publicly available. Not applicable.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":null,"pages":null},"PeriodicalIF":18.4,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142144267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of exercise interventions on prevention of sport-related concussion and related outcomes: a systematic review and meta-analysis","authors":"Branimir Ivanic, Anna Cronström, Kajsa Johansson, Eva Ageberg","doi":"10.1136/bjsports-2024-108260","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108260","url":null,"abstract":"Objective To review the efficacy of exercise interventions on sport-related concussion (SRC) incidence, as well as on linear and rotational head accelerations, and isometric neck strength and to assess reporting completeness of exercise interventions using the Consensus on Exercise Reporting Template (CERT). Design Systematic review and meta-analysis, according to the Prisma in Exercise, Rehabilitation, Sport medicine and SporTs science guidelines. Data sources Six databases (MEDLINE, Embase, CINAHL, Scopus, Web of Science CC and SPORTDiscus) were searched up to 26 June 2023. Eligibility criteria for selecting studies Randomised controlled trials (RCTs), cluster RCTs or quasi-experimental studies, evaluating exercise interventions on SRC incidence, linear and rotational head accelerations, and/or isometric neck strength in male and/or female athletes of any age, and/or in a healthy general population. Results A total of 26 articles were included. A large effect size was observed for resistance training (RT) on isometric neck strength (standardised mean difference (SMD) 0.85; 95% CI 0.57 to 1.13; high-quality evidence). Non-significant effect sizes were observed for neuromuscular warm-up programmes on SRC incidence (risk ratio 0.69; 95% CI 0.39 to 1.23; low-quality evidence), or for RT on linear head acceleration (SMD −0.43; 95% CI −1.26 to 0.40; very low-quality evidence) or rotational head acceleration (SMD 0.08; 95% CI −0.61 to 0.77; low-quality evidence). No studies assessed the impact of RT on SRC incidence. CERT scores ranged from 4 to 16 (out of 19) with median score of 11.5 (IQR 9–13). Conclusion RT increases isometric neck strength, but the effect on SRC incidence is unknown. More adequately powered and rigorous trials are needed to evaluate the effect of exercise interventions on SRC incidence, and on linear and rotational head accelerations. Future studies should follow CERT guidelines, as the included interventions were generally not reported in sufficient detail for accurate replication. PROSPERO registration number CRD42023435033. All data relevant to the study are included in the article or uploaded as online supplemental information. Not applicable.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":null,"pages":null},"PeriodicalIF":18.4,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142144240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiligament knee injury (MLKI): an expert consensus statement on nomenclature, diagnosis, treatment and rehabilitation","authors":"Iain Robert Murray, Navnit S Makaram, Andrew G Geeslin, Jorge Chahla, Gilbert Moatshe, Kay Crossley, Michelle E Kew, Aileen Davis, Maria Tuca, Hollis Potter, Dina C Janse van Rensburg, Carolyn A Emery, SeungPyo Eun, Hege Grindem, Frank R Noyes, Robert G Marx, Chris Harner, Bruce A Levy, Enda King, James L Cook, Daniel B Whelan, George F Hatch, Christopher J Wahl, Kristian Thorborg, James J Irrgang, Nicolas Pujol, Michael J Medvecky, Michael J Stuart, Aaron J Krych, Lars Engebretsen, James P Stannard, Peter MacDonald, Romain Seil, Gregory C Fanelli, Travis G Maak, K Donald Shelbourne, Evert Verhagen, Volker Musahl, Michael T Hirschmann, Mark D Miller, Robert C Schenck, Robert F LaPrade","doi":"10.1136/bjsports-2024-108089","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108089","url":null,"abstract":"Multiligament knee injuries (MLKIs) represent a broad spectrum of pathology with potentially devastating consequences. Currently, disagreement in the terminology, diagnosis and treatment of these injuries limits clinical care and research. This study aimed to develop consensus on the nomenclature, diagnosis, treatment and rehabilitation strategies for patients with MLKI, while identifying important research priorities for further study. An international consensus process was conducted using validated Delphi methodology in line with British Journal of Sports Medicine guidelines. A multidisciplinary panel of 39 members from 14 countries, completed 3 rounds of online surveys exploring aspects of nomenclature, diagnosis, treatment, rehabilitation and future research priorities. Levels of agreement (LoA) with each statement were rated anonymously on a 5-point Likert scale, with experts encouraged to suggest modifications or additional statements. LoA for consensus in the final round were defined ‘a priori’ if >75% of respondents agreed and fewer than 10% disagreed, and dissenting viewpoints were recorded and discussed. After three Delphi rounds, 50 items (92.6%) reached consensus. Key statements that reached consensus within nomenclature included a clear definition for MLKI (LoA 97.4%) and the need for an updated MLKI classification system that classifies injury mechanism, extent of non-ligamentous structures injured and the presence or absence of dislocation. Within diagnosis, consensus was reached that there should be a low threshold for assessment with CT angiography for MLKI within a high-energy context and for certain injury patterns including bicruciate and PLC injuries (LoA 89.7%). The value of stress radiography or intraoperative fluoroscopy also reached consensus (LoA 89.7%). Within treatment, it was generally agreed that existing literature generally favours operative management of MLKI, particularly for young patients (LoA 100%), and that single-stage surgery should be performed whenever possible (LoA 92.3%). This consensus statement will facilitate clinical communication in MLKI, the care of these patients and future research within MLKI.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":null,"pages":null},"PeriodicalIF":18.4,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142138264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cryotherapy for treating soft tissue injuries in sport medicine: a critical review","authors":"Sebastien Racinais, Valentin Dablainville, Yohan Rousse, Mohammed Ihsan, Marie-Elaine Grant, Wolfgang Schobersberger, Richard Budgett, Lars Engebretsen","doi":"10.1136/bjsports-2024-108304","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108304","url":null,"abstract":"Sports medicine physicians and physiotherapists commonly use cryotherapy (eg, ice application) postinjury to decrease tissue temperature with the objective of reducing pain, limiting secondary injury and inflammation, and supporting healing. However, besides the analgesic effect of cryotherapy, a literature search revealed no evidence from human studies that cryotherapy limits secondary injury or has positive effects on tissue regeneration. Thus, our current understanding of the potential mechanisms and applications of cryotherapy largely relies on the results from animal studies. Importantly, treatment should not aim at obliterating the inflammatory and regeneration processes but instead aim to restore an adapted/normal regulation of these processes to improve function and recovery. However, some animal studies suggest that cryotherapy may delay or impair tissue regeneration. With the translation of laboratory animal studies to human sport medicine being limited by different injury and muscle characteristics, the effect of cryotherapy in patients with musculoskeletal injuries is uncertain. Thus, pending the results of human studies, cryotherapy may be recommended in the first 6 hours following an injury to reduce pain (and possibly haematoma), but it should be used with caution beyond 12 hours postinjury as animal studies suggest it may interfere with tissue healing and regeneration.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":null,"pages":null},"PeriodicalIF":18.4,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142138263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A decade on: successes and future directions for integrating physical activity into healthcare curricula in the UK and EU","authors":"Ann Bernadette Gates, Fiona Moffatt, George S Metsios","doi":"10.1136/bjsports-2024-108607","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108607","url":null,"abstract":"In 2014, as part of the outcomes from the inaugural World Heart Federations Emerging Leaders’ work,1 a network of collaborators and change agents set about strengthening the capacity of healthcare professionals (HCPs) to support patients and communities to be more physically active. The intent was to influence the prevention, treatment and rehabilitation of noncommunicable diseases (NCDs) and poor health, in the context of research demonstrating that even brief physical activity advice during routine consultations can translate to significant clinical outcomes.2 The community of practice3 aim was simple: to upskill, through capacity building, key frontline professionals of any healthcare discipline to be more confident, capable and competent in implementing interventions to mitigate NCDs. This included enabling HCPs to promote greater physical activity by their patients and use their leadership influence to effect wide-scale change in society.4 Previous initiatives across UK medical and health schools to access free physical activity and health resources and implement them through curriculum change resulted in slow and inconsistent uptake. Similar suboptimal outcomes were reflected in other countries.5 However, in 2019, the European Union (EU) ERASMUS+Virtual Advice, Nurturing, Guidance on Universal Action, Research and Development for physical activity and sport engagement (VANGUARD) project enabled five European schools of medicine (and one UK-based physiotherapy school) to embed bespoke resources, secure academic support and empower future HCPs. The VANGUARD project objectives were to: 1. Embed physical activity in the EU undergraduate curricula of future frontline HCPs (medical doctors and subsequently allied health professions) in these six European countries to help promote and sustain health. 2. Foster meaningful collaborative partnerships in the implementation, methodology and evaluation of physical activity in the EU curricula of future frontline HCPs. 3. Develop an at-scale approach, led by future HCPs, in the critical role of physical activity/sport in the prevention and treatment …","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":null,"pages":null},"PeriodicalIF":18.4,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142138303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}