British Journal of Sports Medicine最新文献

{"title":"Exercise collapse associated with sickle cell trait: from consensus to confusion","authors":"Francis O’Connor, John Walsh","doi":"10.1136/bjsports-2025-109960","DOIUrl":"https://doi.org/10.1136/bjsports-2025-109960","url":null,"abstract":"Sickle cell trait (SCT) and its association with exertional rhabdomyolysis (ER) and exercise-related death (ERD) in warfighters and athletes (WA) are significant and controversial issues confronting sports medicine communities and the US Department of Defense (DoD). Although SCT carrier status is largely considered a benign condition, potential risks, in particular with intense repetitive or continuous exertion, are increasingly recognised. The deaths of two soldiers in 2010 prompted the convening of a summit by the Consortium for Health and Military Performance at the Uniformed Services University in Bethesda, Maryland.1 In collaboration with the American College of Sports Medicine, interested DoD entities, the American Medical Society for Sports Medicine, the American Society of Hematology and selected members of the haematology and sports medicine community met to discuss SCT with particular emphasis on mitigating risk in WA. During that summit, the term ‘exercise collapse associated with sickle cell trait’ (ECAST) was adopted, recognising the increased relative risk of both ER and ERD in WA, in the absence of a clearly recognised pathophysiology. A subsequent series of ECAST events in military personnel in 2019 prompted a reevaluation of current efforts and called for a second consensus conference. As a result of that conference, the US Army adopted a policy for SCT screening and education to align with all other DoD services. Consensus management strategies included identification of the struggling warfighter or athlete, with urgent medical assessment to include the provision of oxygen, the availability of an automated external defibrillator …","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"25 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143893124","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":"Female endurance athletes: smaller hearts but similar relationship between ventricular size, fitness and fibrosis as male athletes","authors":"Stephanie Rowe, Kristel Janssens, Amy Mitchell, Paolo D’Ambrosio, Jarne De Paepe, Sofie Van Soest, Margarita Calvo-Lopez, Oscar Cullen, Luke Spencer, Christophe Dausin, Olivier Ghekiere, Jan Bogaert, Lieven Herbots, Youri Bekhuis, Rik Pauwels, Rik Willems, Hein Heidbuchel, Guido Claessen, André La Gerche","doi":"10.1136/bjsports-2024-109503","DOIUrl":"https://doi.org/10.1136/bjsports-2024-109503","url":null,"abstract":"Objectives Exercise-induced cardiac remodelling is well described in male athletes but incompletely understood in females. This study aimed to examine sex differences in cardiac structure, function and fibrosis relative to fitness and to determine reference ranges for ‘normal’ chamber size in a large cohort of healthy male and female highly trained endurance athletes. Methods This multicentre international study used cardiac MRI and cardiopulmonary exercise testing (VO2peak) to assess sex-specific relationships between measures of biventricular chamber size, function, fibrosis and VO2peak. Results Of the 364 endurance athletes included, 36.5% were female. Compared with males, female athletes achieved lower VO2peak (51 (40–57) vs 59 (41–65) mL/kg/min, p<0.001), had smaller absolute and body surface area (BSA)-indexed left and right end-diastolic volumes (LVEDV, respectively) but similar volumes when indexed to fat-free mass. Both sexes showed a strong association between LVEDV and VO2peak (r=0.60–0.66) and a similar coefficient describing the linear relationship between VO2peak and LVEDV (Females: VO2peak(mL/min)=12.1×LVEDV+963.9; males: VO2peak=15.3×LVEDV+806.8, p=0.100) and BSA-indexed LVEDV (females: VO2peak (mL/kg/min)=0.37×LVEDV/BSA+12.5; males: VO2peak=0.51×LVEDV/BSA-1.2, p=0.059). There was no difference between right ventricular (RV) measures and VO2peak; however, males had 3.8 times higher odds of reduced RV ejection fraction. Prevalent myocardial scar was similar for both female (14.2%) and male (19.9%) athletes (p=0.180). Conclusions Female and male athletes demonstrate similar cardiac remodelling relative to fitness and no sex difference in myocardial scar. The female athlete’s heart can show profound adaptation, and previous assertions that female hearts have lesser capacity for remodelling should be reappraised. Data are available on reasonable request.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"8 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143890034","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":"Impact of exercise on health outcomes in people with cancer: an umbrella review of systematic reviews and meta-analyses of randomised controlled trials","authors":"Xue-Li Bai, Yu Li, Zan-Fei Feng, Fan Cao, Dong-Dong Wang, Jing Ma, Dan Yang, Dong-Run Li, Qian Fang, Ying Wang, Xiao-Feng Jiang, Dong-Hui Huang, Xiao-Ying Li, Jia-Kai Guo, Na Zhao, Zhi-Tong Li, Qi-Peng Ma, Lei Wang, Qi-Jun Wu, Ting-Ting Gong","doi":"10.1136/bjsports-2024-109392","DOIUrl":"https://doi.org/10.1136/bjsports-2024-109392","url":null,"abstract":"Objective To examine the comprehensive health impacts of exercise on people with cancer by systematically summarising existing evidence and assessing the strength and reliability of the associations. Design Umbrella review of meta-analyses. Data source PubMed, Embase, Cochrane and Web of Science databases were searched from their inception to 23 July 2024. Eligibility criteria for selecting studies Meta-analyses of randomised controlled trials that investigated the associations between exercise and health outcomes among people with cancer. Results This umbrella review identified 485 associations from 80 articles, all evaluated as moderate to high quality using A Measurement Tool to Assess Systematic Reviews (AMSTAR). Two hundred and sixty (53.6%) associations were statistically significant (p<0.05), 81/485 (16.7%) were supported by high-certainty evidence according to the Grading of Recommendations Assessment, Development, and Evaluation criteria. Compared with usual care or no exercise, moderate- to high-certainty evidence supported the view that exercise significantly mitigates adverse events associated with cancer and its treatments (eg, cardiac toxicity, chemotherapy-induced peripheral neuropathy, cognitive impairment and dyspnoea). Exercise also modulates body composition and biomarkers (eg, insulin, insulin-like growth factor-1, insulin-like growth factor-binding protein-1 and C-reactive protein) in people with cancer, and enhances sleep quality, psychological well-being, physiological functioning and social interaction, while improving overall quality of life. Conclusion Exercise reduces adverse events and enhances well-being through a range of health outcomes in people with cancer. Data are available upon reasonable request.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"29 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143890040","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":"NICE Standard for low back pain and sciatica needs urgent revision","authors":"Crystian B Oliveira, Gustavo C Machado, Martin Underwood, Chris G Maher","doi":"10.1136/bjsports-2025-109817","DOIUrl":"https://doi.org/10.1136/bjsports-2025-109817","url":null,"abstract":"Low back pain is the leading cause of years lived with disability, imposing an enormous economic burden on society. In the UK, the cost of treating low back pain in general practice alone was estimated to be £3.2 billion in 2015, with 80% of these costs attributed to healthcare consultations.1 The healthcare costs of low back pain and neck pain were estimated to be US$134.5 billion in the USA in 2016.2 In 2016, the National Institute for Health and Care Excellence (NICE) released a guideline containing evidence-based recommendations for the management of low back pain and sciatica.3 Subsequently, NICE published the Clinical Care Standard in 2017 focusing on priority areas for healthcare quality improvement for the management of low back pain and sciatica.4 The NICE Standard is composed of a set of ‘quality statements’ describing the high quality care that should be provided and ‘quality measures’ to assess the care specified in the statement.5 Our view, however, is that health service planners, clinicians and patients are not well served by the 2017 NICE Standard.4 In this viewpoint, we discuss the problems with the 2017 NICE Standard and suggest how the Standard could be revised so that it better reflects the current evidence and provides more helpful guidance for clinicians. The evidence of the effectiveness of the interventions discussed in this viewpoint is provided in online supplemental file 1. ### Supplementary data [bjsports-2025-109817supp001.pdf] The recommendations in the 2017 NICE Standard are underpinned by the 2016 NICE guideline for the management of low back pain and sciatica.3 4 As the NICE guideline was issued nearly 10 years ago, some of the recommendations and, consequently, the NICE Standard are not in line with the most recent evidence. Three interventions that are recommended in the Standard (risk stratification, self-management and radiofrequency denervation) …","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"53 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143884294","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":"Empowering older adults for physical health and strength programme.","authors":"Shyh Poh Teo, Asmah Husaini, Sharimawati Sharbini","doi":"10.1136/bjsports-2024-109476","DOIUrl":"10.1136/bjsports-2024-109476","url":null,"abstract":"","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":" ","pages":"685-686"},"PeriodicalIF":11.6,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143363665","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":"Blood flow restriction: methods and apparatus still matter.","authors":"Luke Hughes, Nicholas Rolnick, Alexander Franz, Johnny Owens, Patrick Michael Swain, Christoph Centner, Jeremy P Loenneke, Stuart Anthony Warmington","doi":"10.1136/bjsports-2024-109365","DOIUrl":"10.1136/bjsports-2024-109365","url":null,"abstract":"","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":" ","pages":"623-625"},"PeriodicalIF":11.6,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370522","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":"Prehospital care of suspected spine-injured lacrosse athletes: a systematic search, evidence review, and consensus recommendations.","authors":"Thomas G Bowman, Richard J Boergers, Shane V Caswell, Darryl Conway, William J Mills, Margot Putukian, Mandy Merritt, Jason D Vescovi, Edward Strapp, Kellie Loehr, Jennifer Monnin, Rebecca Vozzo, Robert Hatch, Caroline Wesley Siler, Samantha E Scarneo-Miller","doi":"10.1136/bjsports-2024-108951","DOIUrl":"10.1136/bjsports-2024-108951","url":null,"abstract":"<p><p>Lacrosse has experienced significant growth in popularity worldwide and will return to the Summer Olympic Games in 2028. While there are published consensus recommendations for prehospital care of athletes with suspected spine injuries, there are currently no recommendations specific to lacrosse athletes with and without circulation, airway, or breathing (CAB) compromise. The document aims to determine evidence- and consensus-based best practices and provide implementation recommendations to guide healthcare professionals in the prehospital care of suspected spine-injured lacrosse athletes. We comprised a consensus group of 15 individuals with diverse clinical, research, and administrative experiences to ensure broad representation across lacrosse competition levels. Peer-reviewed scientific and medical research literature was systematically searched for articles on spine injury in lacrosse participants to derive evidence-based recommendations. Following a modified Delphi approach with three rounds of voting, the author panel developed ten consensus-based best practices and implementation recommendations related to the care of potentially spine-injured lacrosse athletes with and without CAB compromise. In addition, recommendations are provided to guide the implementation of key preparations before lacrosse participation, such as developing and distributing an emergency action plan, lacrosse-specific policies and procedures, and cardiopulmonary resuscitation and automated external defibrillator requirements. All recommendations obtained acceptable levels of agreeability, feasibility, and clarity from at least 80% of the panel. The recommendations provide prehospital care guidance for healthcare professionals and event organisers aimed at improving patient outcomes following suspected spine injury.</p>","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":" ","pages":"630-639"},"PeriodicalIF":11.6,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373730","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":"'Post-rehabilitation phase' in professional football: are we optimising player support after return to play?","authors":"Ben Dixon, Jill Alexander, Damian Harper","doi":"10.1136/bjsports-2024-109458","DOIUrl":"10.1136/bjsports-2024-109458","url":null,"abstract":"","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":" ","pages":"625-627"},"PeriodicalIF":11.6,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063927","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":"Development and validation of the Wisconsin Sport Specialization Questionnaire (WISSQ) for older adolescent athletes.","authors":"Stephanie A Kliethermes,Evan O Nelson,Kevin M Biese,Margaret Alison Brooks,Roger Brown,Timothy McGuine,Madison N Renner,Traci R Snedden,Emily Srygler,Andrew Watson,David R Bell","doi":"10.1136/bjsports-2024-108453","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108453","url":null,"abstract":"OBJECTIVEThe proliferation of youth sport specialisation may be concerning for the overall health of adolescent athletes, but no validated tool to measure specialisation exists. We aimed to assess the measurement properties and validate the Wisconsin Sport Specialization Questionnaire (WISSQ) in older adolescent athletes.METHODSUsing previously developed sport specialisation items with established content validity, questionnaires were administered to 14-18-year-old athletes residing in both regional and national settings, who were participating in organised sport. Confirmatory factor analyses and Rasch partial credit modelling independently assessed structural and concurrent validity and reliability in both datasets. The best-fitting national model was then fit onto the regional data to further assess the stability of the measurement properties.RESULTSThe regional and national data included 474 (77% female, 86% non-Hispanic White) and 564 (38% female, 63% non-Hispanic White) athletes, respectively. Twelve of 25 items were retained in three domains (n=4 social, n=5 motivation, n=3 physical). One item cross-loaded on both the motivation and physical domains. The adapted regional (comparative fit index (CFI), 0.97; Tucker-Lewis index (TLI), 0.97; root mean square error of approximation (RMSEA), 0.04) and national (CFI, 0.99; TLI, 0.99; RMSEA, 0.05) datasets achieved good model fit. Internal consistency among the three subdomains ranged from Ω=0.78-0.88 (national) to Ω=0.73-0.83 (regional). All items contributed appropriately to measuring the construct of sport specialisation in the regional (infit/outfit: 0.77-1.16) and national (infit/outfit: 0.74-1.16) datasets.CONCLUSIONSWe present the first validated tool to measure youth sport specialisation while considering physical, motivational and social characteristics of sport participation. The WISSQ is a valid, reliable assessment of sport specialisation in older adolescent athletes.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"7 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143872037","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":"Infographic. School-based factors promoting physical activity participation for children and adolescents with disabilities.","authors":"Yuyang Deng,Xuecheng Li,Jiafu Huang,Justin A Haegele,Brett Smith,Chunxiao Li","doi":"10.1136/bjsports-2025-109933","DOIUrl":"https://doi.org/10.1136/bjsports-2025-109933","url":null,"abstract":"","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"7 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143872034","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}