BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine
{"title":"Correction: Medium-term results of arthroscopic hip surgery compared with physiotherapy and activity modification for the treatment of femoroacetabular impingement syndrome: a multi-centre randomised controlled trial","authors":"BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine","doi":"10.1136/bjsports-2023-107712corr1","DOIUrl":"https://doi.org/10.1136/bjsports-2023-107712corr1","url":null,"abstract":"Palmer A, Fernquest S, Rombach I FAIT Study Group, et al. Medium-term …","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"52 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144645377","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":"Turning our attention towards dual tasking in shoulder instability rehabilitation","authors":"David Lalor","doi":"10.1136/bjsports-2025-109634","DOIUrl":"https://doi.org/10.1136/bjsports-2025-109634","url":null,"abstract":"Shoulder dislocations present a significant challenge to the global health system. With an unacceptable recurrence rate of 39% in the first year after first-time traumatic anterior shoulder dislocation, advancing shoulder instability management remains crucial.1 Currently, it is recommended that non-surgical management of shoulder instability should include immobilisation, exercises focusing on range of motion, progressive strength, motor control and rate of force development, and sport-specifics and psychological readiness.2 This editorial proposes the addition of dual tasking to typical non-operative management as a means of enhancing its efficacy. Dual tasking, or ‘divided attention’, describes the ability to simultaneously provide attention to or switch between two or more stimuli.3 The limited resource theory of divided attention implies that only a single pool of attentional resources is divided among competing stimuli, directly influencing sensorimotor integration and task performance.3 This supports the inclusion of dual tasking in rehabilitation, with the hypothesis that athletes who are more competent at performing motor tasks while simultaneously attending to stimuli in their environment may have improved outcomes, such as reduced risk of injury.4 To date, the traditional non-surgical management of shoulder instability has been built around strength-based rehabilitation, secondary to clinical reasoning in physiotherapy tending to follow a biomedical framework of pursuing an observable objective deficit with a corrective intervention.5 This objective lens would assume that strength and function after shoulder instability are correlated in a somewhat linear fashion. However, in the case of shoulder instability, …","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"12 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144710623","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":"May the (horizontal) force be with you: the role of ankle function and horizontal force production on hamstring injury risk and rehabilitation.","authors":"Nicol van Dyk,Javier Pecci","doi":"10.1136/bjsports-2024-109485","DOIUrl":"https://doi.org/10.1136/bjsports-2024-109485","url":null,"abstract":"","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"13 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144701304","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":"International Olympic Committee consensus-driven guidelines for athlete mental health support at sporting events.","authors":"Margo Mountjoy,Scott Sloan,Msomah Ali-Zada,Abhinav Bindra,Cheri Blauwet,Richard Budgett,Kirsty Burrows,Alan Currie,Lars Engebretsen,Uğur Erdener,Andrew Massey,David McDuff,Jane Moran,Rosemary Purcell,Margot Putukian,Jane S Thornton,Gloria Viseras,Joanna Fear,Vincent Gouttebarge","doi":"10.1136/bjsports-2025-109646","DOIUrl":"https://doi.org/10.1136/bjsports-2025-109646","url":null,"abstract":"Event-related mental health problems among elite athletes are prevalent. However, empirical details on the development and implementation of a comprehensive mental health support programme at international sporting events are lacking. Therefore, this paper aims to provide consensus-driven, evidence-based recommendations to guide such a development and implementation. An 8-stage process based on the RAND-UCLA Appropriateness Method was adopted to collate and synthesise the available literature on this topic, to identify gaps in the scientific evidence and to enlist expert experience from a multidisciplinary expert panel to fill these gaps. Within such a process, the existing scientific literature was explored while experts (including athletes) were consulted to reach consensus on the recommendations. Accordingly, a robust pre-event plan is required to ensure the successful implementation of a comprehensive mental health programme during sport events, focussing on promotion, prevention, treatment and recovery. During sporting events, according to the defined pre-event plan, various activities targeting athletes, coaches, the entourage, officials or fans should be implemented: for example, educational programmes to decrease stigma, raise awareness and support help-seeking, a mental fitness area for decompression and relaxation, inperson mental health services provided by qualified mental health professionals with sport-specific as well as trauma-informed and violence-informed skills and mental health surveillance in parallel with the existing injury and illness surveillance programmes. Post event, a thorough evaluation of the implemented activities should be conducted while surveillance data should be analysed to identify areas requiring future targeted intervention(s). Also, particular attention should be given to postevent mental health support including the use of decompression interventions to support adjustment, emotional processing and reintegration.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"37 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144693347","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}
Kalle Torvaldsson, Kristina Fagher, Wayne Derman, Lars Engebretsen, Hanna Lindblom, Alexandre Dias Lopes, Phoebe Runciman, Martin Schwellnus, Torbjørn Soligard, Sofi Sonesson, Kathrin Steffen, Martin Hägglund
{"title":"Injury and illness epidemiology in elite athletes during the Olympic, Youth Olympic and Paralympic Games: a systematic review and meta-analysis","authors":"Kalle Torvaldsson, Kristina Fagher, Wayne Derman, Lars Engebretsen, Hanna Lindblom, Alexandre Dias Lopes, Phoebe Runciman, Martin Schwellnus, Torbjørn Soligard, Sofi Sonesson, Kathrin Steffen, Martin Hägglund","doi":"10.1136/bjsports-2025-109980","DOIUrl":"https://doi.org/10.1136/bjsports-2025-109980","url":null,"abstract":"Objective To systematically review and synthesise the incidence and characteristics of injuries and illnesses among athletes participating in the Olympic, Youth Olympic and Paralympic Games. Design Systematic review and meta-analysis. Data sources PubMed, Embase, CINAHL, Scopus and Web of Science were searched up to 2 July 2024, and Google Scholar, ClinicalTrials.gov and WHO International Clinical Trials Registry Platform up to 12 December 2023. Eligibility criteria for selecting studies Cohort studies conducted during the Games reporting injuries and illnesses among athletes. Risk of bias was assessed using the Joanna Briggs Institute critical appraisal tool for prevalence studies, and certainty of evidence using the Grading of Recommendations, Assessment, Development and Evaluation framework. Results 27 articles were included (10 Olympic, 4 Youth Olympic and 13 Paralympic Games). 23 articles had low, 3 moderate and 1 high risk of bias. Certainty of evidence was high to moderate for Olympic, high to low for Youth Olympic and low for Paralympic Games. Injury incidences per 1000 athlete-days were 6.5 (95% CI 5.9 to 7.2) during Olympic, 10.5 (95% CI 9.4 to 11.8) during Youth Olympic and 14.3 (95% CI 9.9 to 20.7) during Paralympic Games. Illness incidences per 1000 athlete-days were 3.6 (95% CI 2.8 to 4.7), 6.9 (95% CI 6.1 to 7.8) and 9.7 (95% CI 6.5 to 14.4), respectively. Lower limb injuries were frequent during Olympic and Youth Olympic Games, upper limb injuries during Paralympic Games and respiratory illnesses across all Games cohorts. Conclusions Injury and illness incidences were highest in Paralympic Games, followed by Youth Olympic and Olympic Games. Incidences and patterns of injury and illness were sport and context specific, which could inform future prevention strategies. PROSPERO registration number CRD42023475334. All data relevant to the study are included in the article or uploaded as supplementary information.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"665 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144678026","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}
Leonardo Azevedo Alvares, Marcus Vl Dos Santos Quaresma, Fernanda Patti Nakamoto, Lívia Marcela Santos, Lucas Soglio Navarro, Giovanna Soglio Navarro, Bruno Marcos Mazoca Orozco, Beatriz Meconi Cardoso Sá, Gabriel Barasnevicius Achkar, Camila Guazzelli Marques, Renata Cleia Claudino Barbosa, Raphael Einsfeld Simões Ferreira
{"title":"Body composition, exercise-related performance parameters and associated health factors of transgender women, cisgender women and cisgender men volleyball players.","authors":"Leonardo Azevedo Alvares, Marcus Vl Dos Santos Quaresma, Fernanda Patti Nakamoto, Lívia Marcela Santos, Lucas Soglio Navarro, Giovanna Soglio Navarro, Bruno Marcos Mazoca Orozco, Beatriz Meconi Cardoso Sá, Gabriel Barasnevicius Achkar, Camila Guazzelli Marques, Renata Cleia Claudino Barbosa, Raphael Einsfeld Simões Ferreira","doi":"10.1136/bjsports-2024-108601","DOIUrl":"10.1136/bjsports-2024-108601","url":null,"abstract":"<p><strong>Objective: </strong>The inclusion of transgender athletes in competitive sports has promoted significant dialogue and controversy among exercise-related professionals. The objective of this study was to investigate body composition, exercise-related performance parameters and associated health-related factors of transgender women (TW), cisgender women (CW) and cisgender men (CM) amateur volleyball players.</p><p><strong>Methods: </strong>This was a cross-sectional study comprising TW, CW and CM amateur volleyball players eligible with the following characteristics: 'gender incongruent' (for TW only); age between 18 and 35 years; body mass index (BMI) between 18.0 and 29.9 kg/m<sup>2</sup>; 'very active' according to the International Physical Activity Questionnaire, and engaged in regular volleyball training for at least 1 year. All participants were assessed for body composition, blood biomarkers, handgrip strength, countermovement jump height (CMJ), squat jump height (SQJ) and maximum oxygen consumption (V̇O<sub>2max</sub>).</p><p><strong>Results: </strong>69 amateur volleyball players were initially evaluated, but only 23 met the inclusion criteria and were included in the study (7 TW, 8 CW and 8 CM). Age (p=0.07) and BMI (p=0.26) were similar between groups. Estradiol (p=0.47), total testosterone (p=1.00) and haemoglobin (p=1.00) levels did not differ between TW and CW. However, analysis not adjusted by confounding variables showed that CM presented higher testosterone levels (p<0.001), haemoglobin levels (p=0.03), lean body mass (p=0.03), handgrip strength (p<0.001), CMJ (p<0.001), SQJ (p=0.012) and V̇O<sub>2max</sub> (mL/min) (p=0.001) compared with TW. When adjusted by confounding variables, all p values were <0.05, except for SQJ (p=0.062).</p><p><strong>Conclusion: </strong>TW athletes displayed similar exercise performance and biomarkers compared with CW but lower results compared with CM.</p>","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":" ","pages":"1073-1085"},"PeriodicalIF":11.6,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448044","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":"Unfolding the complexity of anterior cruciate ligament injury through systems thinking methods (PhD Academy Award)","authors":"Charis Tsarbou","doi":"10.1136/bjsports-2025-110409","DOIUrl":"https://doi.org/10.1136/bjsports-2025-110409","url":null,"abstract":"My thesis aimed to investigate the aetiology of anterior cruciate ligament (ACL) injury, propose preventive measures and offer implications for ACL injury prevention and rehabilitation programmes by integrating innovative systems thinking methods. ACL injury is a complex phenomenon wherein various risk factors interact dynamically, thereby influencing the likelihood of injury in athletes.1 2 In light of this, it is essential to investigate the interrelationships among the risk factors to develop effective injury prevention strategies. Furthermore, screening tests that can be easily administered in field settings multiple times throughout the season, without compromising the validity and reliability of the data obtained, are necessary to identify possible negative adaptations in athletes. My doctoral research was structured into two primary phases. The initial phase involved a qualitative study that aimed to develop a Causal Loop Diagram (CLD) model and elucidate the aetiology of ACL injuries. The formulation of the ACL-CLD was achieved through the application of systems thinking techniques, specifically group model building. This process integrated a comprehensive literature review on ACL risk factors with structured scripts designed to engage stakeholders and incorporate their feedback.3 The second phase employed a quantitative approach to assess the relationships …","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"73 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144652143","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":"Safe sport, whistleblowing and contextual learning: truly safe to speak up?","authors":"Sian Knott (Harries), Colin Paterson, E Kavanagh","doi":"10.1136/bjsports-2025-110457","DOIUrl":"https://doi.org/10.1136/bjsports-2025-110457","url":null,"abstract":"Few issues pose a more urgent threat to athlete health and well-being than the ongoing crisis of abuse in sport.1 There has been growing awareness of the types, prevalence and risk factors of abuse, articulated most recently in the International Olympic Committee (IOC) consensus statement on interpersonal violence and safeguarding in sport,2 alongside broader questions concerning persistent integrity breaches across all levels of sport.3 Recently, global media headlines too often reflect the presence of both individual and collective misconduct and institutionalised harm, highlighting the pervasiveness of these issues. Significant change in sport relies on effective reporting processes, where people at all levels of sport can call out behaviour that breaches boundaries and puts people at risk. Yet, an expectation or particularly the obligation to speak up4 creates a persistent tension: people do not always feel safe enough to do so. Speaking up can include raising concerns about issues such as safety, well-being or conduct, often occurring informally, while whistleblowing is the process of formally reporting serious wrongdoing, unethical behaviour, severe harm or unsafe behaviours, typically through official channels, often when other routes have failed.5 Too often, “speaking up” is framed exclusively as something athletes must do, but welfare is not an athlete-only issue, and all support staff have a responsibility in this sphere.6 Across sport, support staff, including physiotherapists, psychologists and performance scientists, often described as the athlete entourage,3 frequently find themselves in ethically complex situations, where challenging decisions or questioning authority can feel personally and professionally …","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"19 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144611009","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}
Garrett S Bullock, Anu M Räisänen, Chelsea Martin, Maitland Martin, Jean-Michel Galarneau, Jackie L Whittaker, Justin M Losciale, Mario Bizzini, Matthew N Bourne, Hendrik Paul Dijkstra, Marc-Olivier Dubé, Alix Hayden, Michael Girdwood, Martin Hägglund, Shreya McLeod, Nonhlanhla Sharon Mkumbuzi, Andrea Britt Mosler, Myles Calder Murphy, Grethe Myklebust, Merete Møller, Juliana M Ocarino, Oluwatoyosi B A Owoeye, Debbie Palmer, Kati Pasanen, Ebonie Kendra Rio, Kristian Thorborg, Marienke van Middelkoop, Evert Verhagen, Stuart J Warden, Matthew Whalan, Kay M Crossley, Carolyn Emery
{"title":"Prevention strategies for lower extremity injury: a systematic review and meta-analyses for the Female, Woman and Girl Athlete Injury Prevention (FAIR) Consensus","authors":"Garrett S Bullock, Anu M Räisänen, Chelsea Martin, Maitland Martin, Jean-Michel Galarneau, Jackie L Whittaker, Justin M Losciale, Mario Bizzini, Matthew N Bourne, Hendrik Paul Dijkstra, Marc-Olivier Dubé, Alix Hayden, Michael Girdwood, Martin Hägglund, Shreya McLeod, Nonhlanhla Sharon Mkumbuzi, Andrea Britt Mosler, Myles Calder Murphy, Grethe Myklebust, Merete Møller, Juliana M Ocarino, Oluwatoyosi B A Owoeye, Debbie Palmer, Kati Pasanen, Ebonie Kendra Rio, Kristian Thorborg, Marienke van Middelkoop, Evert Verhagen, Stuart J Warden, Matthew Whalan, Kay M Crossley, Carolyn Emery","doi":"10.1136/bjsports-2025-109910","DOIUrl":"https://doi.org/10.1136/bjsports-2025-109910","url":null,"abstract":"Objective Examine the effectiveness and unintended consequences of prevention strategies for reducing female/woman/girl athletes’ lower extremity (LE) injuries. Design Systematic review with meta-analyses and Grading of Recommendations, Assessment, Development and Evaluation. Data sources Systematic search of eight data sources. Eligibility Primary data studies with a comparison group(s) investigating injury prevention strategies for sport-related LE injuries with ≥1 female/woman/girl in each study group. Results Across 82 studies—including 48 randomised controlled trials (59%), 16 quasiexperimental studies (20%), 16 cohort studies (20%) and 1 cross-sectional study (1%)—a total of 154 561 participants were included, of whom 84 915 (55%) were females/women/girls. Neuromuscular training (NMT)-based programmes (n=60, 73%) were the most frequently studied intervention, followed by personal protective equipment (PPE) (n=9, 11%), policy/rule change (n=4, 5%) and education (n=6, 7%). The median Downs and Black score for all studies was 17 (range: 5–24). Point estimate from pooled results from nine studies revealed that NMT programmes, which include LE balance, strength, agility and change of direction exercises, with a minimum dose of 10 min two times per week, reduced female/woman/girl athletes’ LE injuries by 19% (0.81, 95% CI 0.61% to 1.08%; low certainty evidence). Point estimate of pooled results from six studies uncovered that NMT reduced ankle sprains by 39% (0.61, 95% CI 0.36% to 1.03%; moderate certainty evidence). NMT significantly reduced anterior cruciate ligament (ACL) injuries by 61% (0.39, 95% CI 0.25% to 0.60%; high certainty evidence). Conclusion NMT programmes can reduce female/woman/girl athletes’ ACL injuries by up to 61% and ankle sprains by 39%, highlighting the need for widespread implementation of NMT programmes. Evidence informing PPE, policy/rule changes and education to prevent female/woman/girl athletes’ LE injuries is needed. PROSPERO registration number CRD42024486715. Data are available upon reasonable request. Deidentified data can be made available upon reasonable request to the corresponding author. Please email the corresponding author with a written proposal outlining the specific research aims and analysis plan and why these specific data are needed. A formal data sharing agreement between institutions will be required.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"14 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144611010","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}
Ruyi Yu, Stephanie L Duncombe, Yuta Nemoto, Raphael HO Araujo, Hsin-Fang Chung, Gregore I Mielke
{"title":"Physical activity trajectories and accumulation over adulthood and their associations with all-cause and cause-specific mortality: a systematic review and meta-analysis","authors":"Ruyi Yu, Stephanie L Duncombe, Yuta Nemoto, Raphael HO Araujo, Hsin-Fang Chung, Gregore I Mielke","doi":"10.1136/bjsports-2024-109122","DOIUrl":"https://doi.org/10.1136/bjsports-2024-109122","url":null,"abstract":"Objective To understand the associations of trajectories and accumulation of physical activity (PA) over adulthood with all-cause, cardiovascular disease (CVD), and cancer mortality. Design Systematic review and meta-analyses. Data sources PubMed, Embase, Scopus, Cochrane Library, Web of Science, CINAHL, MEDLINE, SPORTDiscus, and reference lists of included studies. Eligibility criteria Population-based prospective studies with (1) non-clinical adult population, (2) PA assessed ≥2 timepoints as exposure, (3) all-cause, CVD or cancer mortality as outcomes with risk measures, and (4) publication up to 9 April 2024 and in English. Results 85 studies with three main types of PA exposure (ie, trajectory, time-varying, and cumulative/average) were included. Of these, 77 assessed all-cause mortality, 34 assessed CVD mortality, and 15 assessed cancer mortality. Overall, higher PA was associated with lower risks of all outcomes. Consistently and increasingly active individuals had around 20–40% lower risk of all-cause mortality and 30-40% lower risk of CVD mortality; however, the associations with decreasing PA patterns were less evident. Time-varying and cumulative/average PA illustrated similar inverse associations between higher PA levels and all-cause and CVD mortality. The associations were weaker and less robust for cancer mortality. Non-linear dose-response associations suggested risk reductions in all-cause and CVD mortality for meeting PA guidelines, but consistent/increasing PA below the guidelines also provided health benefits. Conclusions Consistently/increasingly accumulated PA over adulthood can reduce the risk of all-cause and CVD mortality, while the health benefits from decreasing PA patterns require further exploration. Data are available upon reasonable request. Data and codes are available from authors upon reasonable request.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"88 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144603279","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}