{"title":"Using real-time data capture strategies and within-subject studies to better understand the physical activity health paradox","authors":"Genevieve F Dunton, Britni R Belcher","doi":"10.1136/bjsports-2024-108363","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108363","url":null,"abstract":"Growing evidence suggests that although leisure time physical activity (LTPA) (ie, performed for sports and recreation) leads to positive cardiovascular disease (CVD) outcomes, occupational physical activity (OPA) (ie, activity occurring at work) may not decrease the risk of CVD morbidity and mortality. The potentially contradictory health effects of LTPA and OPA are referred to as the physical activity health paradox.1 OPA and LTPA occur in different contexts and settings that may differentially contribute to cardiometabolic health risk. LTPA typically consists of a wider range of body movements performed at levels that are sufficiently intense to improve cardiorespiratory fitness and metabolism, is performed voluntarily, and often occurs over shorter durations with adequate recovery time in between episodes. On the other hand, OPA typically includes static loading, lifting heavy objects, repetitive or painful body movements and postures, long durations (>8 hours) with low control, and inadequate periods of recovery in between episodes, which may attenuate health benefits or possibly increase health risks. For many minority and low-income populations, occupations such as cleaning, retail, cooking and elder/childcare constitute a common setting for OPA in the USA and other developed nations. Although individuals from socioeconomically disadvantaged backgrounds are physically active for large portions of each day performing these types of occupations, they remain in relatively poor health compared with their higher-income counterparts.2 OPA may represent a cause of health disparities that is not well understood. Minority and …","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"1 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144278441","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}
James W Smallcombe, Thomas H Topham, Harry A Brown, Megan Tiong, Brad Clark, Carolyn Broderick, Samuel Chalmers, John Orchard, Yorgi Mavros, Julien D Périard, Ollie Jay
{"title":"Thermoregulation and dehydration in children and youth exercising in extreme heat compared with adults","authors":"James W Smallcombe, Thomas H Topham, Harry A Brown, Megan Tiong, Brad Clark, Carolyn Broderick, Samuel Chalmers, John Orchard, Yorgi Mavros, Julien D Périard, Ollie Jay","doi":"10.1136/bjsports-2025-109832","DOIUrl":"https://doi.org/10.1136/bjsports-2025-109832","url":null,"abstract":"Objective To compare hyperthermia and physiological dehydration risk during exercise heat stress between children of different ages and adults and evaluate an existing adult sweat rate calculator in children. Methods 68 fit and recreationally active children aged 10–16 years (31 girls), and 24 adults aged 18–40 years (11 females) completed three separate 45 min treadmill walking/running trials at different intensities on different days at 30°C, 40% relative humidity (RH) (WARM) or 40°C, 30% RH (HOT). Exposures were randomised to elicit intensities scaled to (1) fitness, (2) mass and (3) surface area. Core (gastrointestinal (Tgi)) temperature was measured continuously and dehydration determined using body mass changes. Results Except for 60% V̇O2peak in WARM, in which adults exhibited a greater Tgi rise compared with 10–13 years, there was no effect of age on Tgi during exercise (p≥0.176). Physiological rates of dehydration were not affected by age in WARM (p≥0.08) or HOT (p≥0.08). Mean predicted sweat rate error was +0.08 kg/hour (95% CIs: −0.10, +0.25) across WARM and HOT, and 80.5% of variability in sweating was explained by the adult sweat rate calculator. Conclusions Using the most comprehensive paediatric exercise heat stress dataset from a single study to date, we show that children aged 10–16 years are at a similar risk of hyperthermia and dehydration as adults during exercise up to 40°C. This supports recent changes to paediatric sport heat policies that were based on limited data. Practitioners can potentially reduce behavioural dehydration risks from inadequate fluid consumption using an existing adult sweat rate calculator for children. Data are available on reasonable request. Permission for reuse of data must be obtained in writing from the corresponding author.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"6 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144278442","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}
SANDRO Remo FREITAS, Carlos Cruz-Montecinos, Lucimere Bohn, Caroline Pieta-Dias, Fátima Baptista, Hirofumi Tanaka, Anthony John Blazevich, Kazunori Nosaka, Yasuo Kawakami, Walter Herzog, Sébastien Ratel, Ronei Silveira Pinto
{"title":"Powerpenia: moving towards the detection of meaningful human ‘skeletal muscle’ power loss","authors":"SANDRO Remo FREITAS, Carlos Cruz-Montecinos, Lucimere Bohn, Caroline Pieta-Dias, Fátima Baptista, Hirofumi Tanaka, Anthony John Blazevich, Kazunori Nosaka, Yasuo Kawakami, Walter Herzog, Sébastien Ratel, Ronei Silveira Pinto","doi":"10.1136/bjsports-2024-109187","DOIUrl":"https://doi.org/10.1136/bjsports-2024-109187","url":null,"abstract":"By 2050, the global human population is expected to have more than 10 billion people with~17% adults over 65 years old.1 This ageing population is at higher risk of age-associated declines in motor function and an increased prevalence of multiple health disorders.2 3 Research and public policies aimed at detecting and preventing the accelerated decline of motor functional status throughout the life cycle are essential to address this. This editorial introduces the concept of ‘powerpenia’ and presents insights for its potential clinical application in the future. The term ‘powerpenia’ has been introduced to describe a decline in ‘skeletal muscle’ power associated with ageing, disease and/or physical inactivity, and is proposed as a new biomarker of healthy ageing.4 Unlike the original concepts of sarcopenia and dynapenia, powerpenia centres on the power output observed during motor tasks derived from ‘skeletal muscle’ contractions.4 Compared with maximal strength and muscle mass, power is known to decline with age more rapidly, and to have higher association with an increased risk of falling, functional competence and quality of life in older adults.4 The introduction of the powerpenia concept is further supported by the recent exclusion of power testing (but not maximal strength testing) in the global conceptual definition of sarcopenia proposed by the Global Leadership Initiative in Sarcopenia .5 Moreover, multiple factors can influence the ageing rate (eg, sleep), which means that two human individuals of the same chronological age may be ageing at different rates. Our perspective is that human motor power is a better marker of biological age compared with muscle mass and strength; …","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"8 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144260487","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":"Breaking through barriers for type 1 diabetes: introducing Breakthrough T1D","authors":"Christopher Bright","doi":"10.1136/bjsports-2025-110281","DOIUrl":"https://doi.org/10.1136/bjsports-2025-110281","url":null,"abstract":"Type 1 diabetes (T1D) impacts around 9.5 million people (1.9 million people under 20) across the world and is a leading chronic health condition impacting those under the age of 18.1 As the condition is lifelong and requires exogenous insulin following diagnosis, it is also classified as a hidden disability in the UK, under the Equality Act 2010. However, when it comes to sport and exercise, mainstream participation is this community’s only option.2 Breakthrough T1D is the leading global charity, aiming to improve lives today, while working towards a future without T1D. By funding groundbreaking research, advocating for better access and supporting the T1D community, Breakthrough T1D is opening doors that were once closed by the diagnosis. The charity listens and harnesses lived experience to advocate for improvements across society for those with the condition. In doing this, physical activity, exercise and sport have been a theme which is highlighted as an area the community is seeking greater support with.3 This may not be a surprise, with low numbers of policies, guidelines and references to the …","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"78 3 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144252071","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}
Jasmine Titova, Margie H Davenport, Kate Ames, Melanie Hayman
{"title":"Navigating preconception and pregnancy in elite athletes: insights from Australian elite female athletes, athlete support staff and sport organisational staff","authors":"Jasmine Titova, Margie H Davenport, Kate Ames, Melanie Hayman","doi":"10.1136/bjsports-2024-109163","DOIUrl":"https://doi.org/10.1136/bjsports-2024-109163","url":null,"abstract":"Objectives The primary objective of this study was to explore the experiences and beliefs of elite female athletes, athlete support staff and sport organisational staff regarding preconception and pregnancy in Australian elite athletes. Secondary objectives were to identify barriers and enablers encountered by elite athletes during preconception and pregnancy, and to use the study findings to develop recommendations to inform future pregnancy policies within sporting organisations. Methods 58 participants comprising 27 elite athletes, 20 support staff (eg, coaches, physicians, physiotherapists) and 11 sport organisational staff (eg, general managers, athlete well-being officers) from 25 sports participated in either a focus group (n=45) or semi-structured interview (n=13) conducted between 14 August 2023 and 21 November 2023. Focus groups and interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis. Results The vast majority of athletes felt that organisational support for preconception and pregnancy was inadequate. Their feedback was categorised into four distinct themes: (1) planning, fertility and disclosure; (2) mindset; (3) training during preconception and pregnancy and (4) access to support and information. Within these themes, participants highlighted barriers (eg, lack of knowledge, impaired fertility, pregnancy symptoms) and opportunities for organisations to improve the current level of support provided (eg, education, fertility treatments, training flexibility). Overall, 22 recommendations were developed to guide Australian sporting organisations in future pregnancy policies. Conclusion Australian elite female athletes continue to face numerous barriers during preconception and pregnancy. Sporting organisations can use the findings and recommendations within this study to develop pregnancy policies, which better support female athletes. Data are available on reasonable request. The data that support the findings of this study are available on reasonable request.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"139 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144238104","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}
Alessandro Pellegrini, Alice Ranzini, Fabio Esposito, Francesco Della Villa, Matteo Zago
{"title":"Systematic video analysis of 57 hamstring injuries in women’s football (soccer): injury mechanisms, situational patterns and biomechanics","authors":"Alessandro Pellegrini, Alice Ranzini, Fabio Esposito, Francesco Della Villa, Matteo Zago","doi":"10.1136/bjsports-2024-109157","DOIUrl":"https://doi.org/10.1136/bjsports-2024-109157","url":null,"abstract":"Objective To investigate the occurrence and inciting events of hamstring injuries (HSIs) in elite women’s football through video analysis, describing the mechanism, situational patterns and biomechanics of the sport-specific activities performed before and at the time of injury. Methods A descriptive observational study was conducted using video analysis of HSIs from top national and international women’s football competitions across seven seasons (2017/2018 to 2023/2024). Three raters independently categorised HSIs following the Football Injury Inciting Circumstances Classification System and analysed joint and trunk kinematics. Results Among 109 identified HSIs, 57 (52%) were eligible for analysis. Most injuries (74%) were non-contact, with 51% occurring during running and 49% during stretch-type movements, including kicking and duelling. These patterns involved ball interaction in 68% and duels in 51% of cases. Injuries predominantly occurred in offensive situations (72%), with moderate to high horizontal speed and minimal vertical movement. Biomechanical analysis indicated frequent knee extension and hip flexion. Conclusion HSIs in women’s football predominantly occur during movements with high eccentric demand of the hamstring muscles, with non-contact mechanisms being most common. HSIs are not solely linked to high-speed running but can also occur during propulsion and braking phases, or overstretching activities with an open or closed kinetic chain. HSIs often resulted from complex movements involving multiple tasks simultaneously under high physical and mental demands, in unpredictable and evolving scenarios. Data are available upon reasonable request.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"1 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144238095","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":"Neurophysiological characteristics accompanying runners with Achilles tendinopathy and their influence in triceps surae performance (PhD Academy Award)","authors":"Gabriel Lima Fernandes","doi":"10.1136/bjsports-2025-109801","DOIUrl":"https://doi.org/10.1136/bjsports-2025-109801","url":null,"abstract":"My PhD aimed to explore the influence of cortical and corticospinal mechanisms of motor control and their influence in plantarflexor performance in runners with Achilles tendinopathy and whether it affected each muscle of the triceps surae differently (figure 1). Alongside neurophysiological measures, I also measured plantarflexor peak isometric torque, using isokinetic dynamometry, and endurance, as the maximal number of single-leg heel raises (SLHR). The first study focused on the brain’s role in motor control, where I investigated short-interval intracortical inhibition (SICI) to the triceps surae. In the second study, I shifted attention to α-motoneurons, specifically motor units, which consist of a group of muscle fibres innervated by the same α-motoneuron. This study explored the central nervous system’s independent control of each triceps surae muscle during isometric contractions and examined whether these control strategies differ between individuals with and without Achilles tendinopathy. Finally, I investigated a potential strategy to selectively increase lateral gastrocnemius activation of the by positioning the foot inwards during isometric plantarflexion. Figure 1 Changes in cortical and corticospinal circuits in runners with Achilles tendinopathy and their influence on plantarflexor performance. Achilles tendinopathy is a highly prevalent injury among runners and often becomes chronic, with many patients failing to respond to conservative treatment. …","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"26 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144238096","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}
Kristian Thorborg, Nikolina Kuburovic, Jenny Viderø Gunnarsson, Laura Mønsted Krohn, N Cederström, Michael Skovdal Rathleff
{"title":"Psychosocial aspects of sports injuries are on the agenda: but what can be measured and assessed during rehabilitation and return to sport?","authors":"Kristian Thorborg, Nikolina Kuburovic, Jenny Viderø Gunnarsson, Laura Mønsted Krohn, N Cederström, Michael Skovdal Rathleff","doi":"10.1136/bjsports-2024-109256","DOIUrl":"https://doi.org/10.1136/bjsports-2024-109256","url":null,"abstract":"The impact and consequences of sports-related injuries involve a complex interplay between biological, psychological and social factors. Psychological factors are important because anxiety, fear of reinjury, kinesiophobia, optimism, self-motivation and perceived social support are linked with sports injury rehabilitation and return-to-sport outcomes.1–3 Wiese-Bjornstal et al. 4 proposed an integrated model to illustrate how psychosocial reactions among injured athletes are comprised of cognitive components (ie, a sense of loss, pressure, stress, pain, optimism and pessimism), affective components (ie, fear of movement and reinjury, anxiety, anger and frustration) and behavioural components (ie, risky behaviour, social connection and coping). While this model has gained recognition worldwide, more specific suggestions on how these psychosocial factors can be measured and assessed are lacking.3 4 The aim of this editorial is to review our existing tools for the measurement and evaluation of psychological factors during the sports injury rehabilitation and return-to-sport process. High-quality psychological care is important to all injured athletes, and measuring psychosocial factors can provide valuable insights and help monitor their ‘injury experience’. This is, however, often overlooked in standard clinical evaluations, which tend to focus primarily on tissue damage and physical function. Psychosocial measurement instruments assessing psychosocial aspects should provide valuable context-specific insights into an athlete’s psychosocial state and well-being. …","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"33 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228751","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}
Erin Hoare, Lisa S Olive, Kristin L McGinty-Minister, Caragh McMurtry, Courtney C Walton, Kate Hall, Claudia L Reardon, Rosemary Purcell, Michael Berk
{"title":"Neurodiversity and the mental health and well-being of elite athletes","authors":"Erin Hoare, Lisa S Olive, Kristin L McGinty-Minister, Caragh McMurtry, Courtney C Walton, Kate Hall, Claudia L Reardon, Rosemary Purcell, Michael Berk","doi":"10.1136/bjsports-2024-109325","DOIUrl":"https://doi.org/10.1136/bjsports-2024-109325","url":null,"abstract":"Mental health and well-being among elite athletes are accepted as central to athletic performance. Maximising health, and more recently, mental health,1 2 in elite sport is thus pivotal to the physical competencies that underpin athletic success. Neurodiversity is an umbrella term used to recognise the natural variations of all individuals, with neurodivergence often used to refer to attention-deficit/hyperactivity disorder (ADHD), autism, and other neurodevelopmental differences. Given the importance of mental health, it is surprising that the performance and personal impacts of neurodiversity in elite athletes have not been more substantially evaluated. ADHD and autism are highly prevalent in the general community.3–5 Elite athletes represent a unique subsection of the general community, and evidence increasingly suggests that autism and ADHD may occur at greater rates in athletes compared with non-athlete cohorts—convincingly greater than that of the general population.6 Within the elite athlete subgroup are some common traits through which increased neurodivergence can be hypothesised, including competitive advantage to high performance. As examples, elite sport requires commitment to routine, exclusive focus and consistent and rapid response to emerging stimuli such as responding to changes in the field or an opponent’s behaviour. The ability to hyperfocus, that is, to focus intensely on a single topic or activity for extended periods of time, is often a core strength of autism and may be adaptive in the context of the rigours and routine demanded of training in …","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"52 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144218736","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 different aerobic high-intensity interval training prescription approaches on cardiorespiratory fitness and performance in distance runners (PhD Academy Award)","authors":"Raffaele Mazzolari","doi":"10.1136/bjsports-2025-110186","DOIUrl":"https://doi.org/10.1136/bjsports-2025-110186","url":null,"abstract":"The aim of my PhD was to investigate how different approaches to prescribing aerobic high-intensity interval training (HIIT) influence cardiorespiratory fitness and performance in distance runners. Specifically, I compared three methods: a physiological approach (PHY), which individualises intensity using the Delta concept, based on the second lactate threshold (vLT2) and peak treadmill speed (Vpeak); a race pace-based approach (RACE), which sets intensity relative to target (10 000 m) race speed; and a standardised ‘one-size-fits-all’ approach (STD), in which all runners followed the same group-based training protocol, irrespective of individual physiological characteristics. The comparisons PHY versus RACE and PHY versus STD were treated as distinct research questions. This project sought to determine whether laboratory-based, physiologically individualised HIIT prescriptions are more effective at improving cardiorespiratory fitness than more commonly used, less individualised approaches. Moreover, I investigated whether prescribing HIIT based on race pace optimises performance compared with physiological prescriptions. Finally, I explored the variability in Vpeak and 10 000 m speed at vΔ50 (the speed midway between vLT2 and Vpeak) to assess whether these could serve as simpler alternatives to the Delta concept for individualising HIIT. The rationale for my PhD is illustrated in figure 1. Outside the experimental part of my PhD, I also reviewed the use of equivalence and non-inferiority designs to complement or replace traditional null hypothesis testing, aiming to …","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"11 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144218735","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}