Emmanuel Stamatakis, Matthew Ahmadi, Raaj Kishore Biswas, Borja del Pozo Cruz, Cecilie Thøgersen-Ntoumani, Marie H Murphy, Angelo Sabag, Scott Lear, Clara Chow, Jason M R Gill, Mark Hamer
{"title":"Device-measured vigorous intermittent lifestyle physical activity (VILPA) and major adverse cardiovascular events: evidence of sex differences","authors":"Emmanuel Stamatakis, Matthew Ahmadi, Raaj Kishore Biswas, Borja del Pozo Cruz, Cecilie Thøgersen-Ntoumani, Marie H Murphy, Angelo Sabag, Scott Lear, Clara Chow, Jason M R Gill, Mark Hamer","doi":"10.1136/bjsports-2024-108484","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108484","url":null,"abstract":"Background Vigorous intermittent lifestyle physical activity (VILPA) refers to brief bouts of intense physical activity embedded into daily life. Objective To examine sex differences in the dose–response association of VILPA with major adverse cardiovascular events (MACE) and its subtypes. Methods Using multivariable-adjusted cubic splines, we examined the associations of daily VILPA duration with overall MACE and its subtypes (incident myocardial infarction, heart failure and stroke) among non-exercisers (individuals self-reporting no leisure-time exercise and no more than one recreational walk per week) in the UK Biobank. We also undertook analogous analyses for vigorous physical activity among exercisers (individuals self-reporting participation in leisure-time exercise and/or recreational walking more than once a week). Results Among 13 018 women and 9350 men, there were 331 and 488 all MACE, respectively, over a 7.9-year follow-up. In women, daily VILPA duration exhibited a near-linear dose–response association with all MACE, myocardial infarction and heart failure. In men, dose-reponse curves were less clear with less evidence of statistical signifigance. Compared with women with no VILPA, women’s median daily VILPA duration of 3.4 min was associated with hazard ratios (HRs; 95% confidence intervals) of 0.55 (0.41 to 0.75) for all MACE and 0.33 (0.18 to 0.59) for heart failure. Women’s minimum doses of 1.2–1.6 min of VILPA per day were associated with HRs of 0.70 (0.58 to 0.86) for all MACE, 0.67 (0.50 to 0.91) for myocardial infarction, and 0.60 (0.45 to 0.81) for heart failure. The equivalent analyses in UK Biobank’s accelerometry sub-study exercisers suggested no appreciable sex differences in dose–response. Conclusions Among non-exercising women, small amounts of VILPA were associated with a substantially lower risk of all MACE, myocardial infarction and heart failure. VILPA may be a promising physical activity target for cardiovascular disease prevention, particularly in women unable or not willing to engage in formal exercise. The data that support the findings of this study are available from the UK Biobank, but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Data are, however, available from the authors upon reasonable request and with permission of the UK Biobank. ES and MA had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. The statistical code used in the analyses of this manuscript is available upon request. The authors have archived the statistical code of multiple similar manuscripts, e.g. <https://zenodo.org/record/7187927%23.Y0ZfoHZBy3A>.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"61 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142519438","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}
Bryan Holtzman, Rose K Kelly, Grace H Saville, Lauren McCall, Kaya A Adelzedah, Samantha R Sarafin, Prakruthi Nikam, Isabella Meneguzzi, Abby McIntyre, Emily K Kraus, Kathryn E Ackerman
{"title":"Low energy availability surrogates are associated with Relative Energy Deficiency in Sport outcomes in male athletes","authors":"Bryan Holtzman, Rose K Kelly, Grace H Saville, Lauren McCall, Kaya A Adelzedah, Samantha R Sarafin, Prakruthi Nikam, Isabella Meneguzzi, Abby McIntyre, Emily K Kraus, Kathryn E Ackerman","doi":"10.1136/bjsports-2024-109165","DOIUrl":"https://doi.org/10.1136/bjsports-2024-109165","url":null,"abstract":"Objectives To determine the association between surrogates of low energy availability (EA) and proposed health and performance outcomes of Relative Energy Deficiency in Sport (REDs) in a clinical sample of adolescent and young adult male athletes. Methods Male athletes ages 15–30 years presenting to a sports medicine clinic at two tertiary care centres were invited to complete a survey about athlete health and well-being. Participants were divided into low EA and adequate EA groups based on survey responses. The associations between low EA and REDs outcomes were evaluated using χ2 tests and ORs were calculated using binomial logistic regression (significance: p<0.05). Results Low EA was associated with increased frequency of self-reported immunological, metabolic, psychological, cardiovascular and gastrointestinal dysfunction; reduced endurance performance, response to training, judgement, coordination and muscle strength; and increased irritability and depression. Low EA athletes were more likely to have self-reported cardiovascular dysfunction (OR 2.87, 95% CI 1.56 to 5.26) and psychological illness (OR 3.23, 95% CI 1.91 to 5.41), decreased training response (OR 2.64, 95% CI 1.38 to 5.03) and endurance performance (OR 2.26, 95% CI 1.13 to 4.52) and were less likely to have self-reported gonadal dysfunction (OR 0.49, 95% CI 0.30 to 0.81), than adequate EA athletes (p<0.05). Conclusions Low EA surrogates are associated with many adverse health outcomes and performance effects of REDs in male athletes. More prospective REDs research in males is needed to improve various aspects of REDs screening in young male athletes. No data are available.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"59 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142490362","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":"Relative energy deficiency in sport (REDs): the role of the physiotherapist","authors":"Manon Dauvergne, Marie-Elaine Grant, Margo Mountjoy","doi":"10.1136/bjsports-2024-108751","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108751","url":null,"abstract":"Knowledge of relative energy deficiency in sport (REDs) has grown significantly between 2018 and 2022 with over 170 original publications in this period. The latest International Olympic Committee (IOC) consensus statement on REDs was published in 2023 in the British Journal of Sports Medicine in a dedicated edition with 10 accompanying narrative reviews and editorials.1 The 2023 IOC REDs consensus statement includes the following: Figure 1 REDs health conceptual model. The effects of LEA exist on a continuum. While some exposure to LEA is mild and transient termed adaptable LEA (arrow depicted in white), problematic LEA is associated with a variety of adverse REDs outcomes (arrow depicted in red). *Mental health issues can either precede REDs or be the result of REDs. LEA, low energy availability; REDs, relative energy deficiency in sport. As recommended in the consensus statement, a multidisciplinary approach is essential when managing REDs. This includes the creation of a safe and trusting therapeutic relationship, which includes active listening and the prioritisation of holistic care.1 Members of the multidisciplinary athlete health and performance team should be knowledgeable in REDs-related science and have clinical competence in the recognition and treatment of REDs. Gillbanks et al identified a lack of vigilance for the signs or symptoms of REDs among physiotherapists, as well …","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"14 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142490440","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}
Tine Vertommen, Mary Woessner, Emma Kavanagh, Sylvie Parent, Aurélie Pankowiak, Leen Haerens, Cleo Schyvinck, Bram Constandt, Ramón Spaaij, Vidar Stevens, Annick Willem, Margo Mountjoy
{"title":"‘First, do no harm’: conducting research on interpersonal violence in sport","authors":"Tine Vertommen, Mary Woessner, Emma Kavanagh, Sylvie Parent, Aurélie Pankowiak, Leen Haerens, Cleo Schyvinck, Bram Constandt, Ramón Spaaij, Vidar Stevens, Annick Willem, Margo Mountjoy","doi":"10.1136/bjsports-2024-108767","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108767","url":null,"abstract":"It was Hippocrates who stated ‘First, do no harm’, and we believe the sentiment of this medical principle is one that every researcher should embody when conducting research on interpersonal violence (IV) in sport. Conducting such research presents unique considerations for researchers, particularly in relation to supporting participant and researcher well-being. Similarly, approaching this sensitive topic with clear definitions of IV in sport and an understanding of trauma- and violence-informed care (TVIC) is paramount to the protection and care of everyone involved in the research. The landscape for researching IV in sport that has rapidly emerged to investigate its determinants from various lenses including ethical, sociological, psychological, criminological and organisational.1 2 The siloed nature of research on IV in sport also has led to inconsistency in terminology, hindering effective communication and collaboration within and outside the field. The terms used to describe and study IV in sport have a profound impact on how the problem is communicated and understood. The use of diverging definitions creates challenges for determining what is within or outside the scope of research, limits our ability to meaningfully compare prevalences and experiences reported across projects, and impacts methodological considerations such as the effective recruitment of participants. Currently, terms such as maltreatment, non-accidental violence, harm, harassment, abuse and IV are used interchangeably, and clarification on the use of terminologies is essential. This paper aligns with the latest International Olympic Committee (IOC) Consensus Statement1 and the WHO’s typology of violence3 and focuses on ‘ interpersonal violence’, which differs from self-directed and collective violence (box 1). Box 1 ### Glossary with operationalised definitions of interpersonal violence in sport","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"13 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142488810","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}
Wojciech Waleriańczyk, Jarosław Krzywański, Joanna Gorgol, Katarzyna Konopka, Agata Kuśmierczyk, Grzegorz Lisek, Piotr Maleszka, Małgorzata Sławińska, Olga Surała, Grzegorz Więcław, Katarzyna Wójcik, Hubert Krysztofiak
{"title":"Diagnostic effectiveness of the Sport Mental Health Assessment Tool 1 supplemented with a brief clinical intake interview in a cohort of Polish elite Olympic athletes","authors":"Wojciech Waleriańczyk, Jarosław Krzywański, Joanna Gorgol, Katarzyna Konopka, Agata Kuśmierczyk, Grzegorz Lisek, Piotr Maleszka, Małgorzata Sławińska, Olga Surała, Grzegorz Więcław, Katarzyna Wójcik, Hubert Krysztofiak","doi":"10.1136/bjsports-2024-108919","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108919","url":null,"abstract":"Objective Several studies have used the Sport Mental Health Assessment Tool 1 (SMHAT-1) among athletes but none have combined SMHAT-1 with a subsequent clinical intake interview. The aim of this study was to evaluate the diagnostic effectiveness of SMHAT-1 supplemented by a brief, in-person clinical intake interview in evaluating the prevalence of mental health concerns in elite athletes. Methods Sections 1 and 2 from SMHAT-1 were administered in person during the routine biannual medical check-up for Olympic athletes at the National Centre for Sports Medicine in Poland. Immediately after completing the measures, all athletes were interviewed by qualified psychologists who evaluated their mental health and provided recommendations. Results A total of 1121 elite athletes (545 female, 576 male) aged 18–53 (M=24.39, SD=5.09) were evaluated 2–8 months before the 2024 Paris Olympic Games; 72.4% scored above the triage threshold and 51% were positively screened in SMHAT-1’s section 2. Based on the subsequent mental health evaluation, only 9.5% showed signs of persistent mental health concerns and required referral to a mental health specialist. In 24.2%, their distress levels/symptoms were assessed as occasional and normal in relation to demands, and they underwent a psychoeducational intervention or were advised to consult a sports psychologist. Female athletes scored significantly higher in most questionnaires. Conclusion SMHAT-1 proved a useful addition to the routine medical check-ups for elite athletes. Extending SMHAT-1 with a brief clinical intake interview substantially elevated the efficacy of the mental health evaluation, with an additional benefit of raising mental health literacy. All data relevant to the study are included in the article or uploaded as supplementary information. All data were anonymised and shared [online supplemental file 2][1]. [1]: #DC3","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"194 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142488985","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}
Alec Kenneth McKenzie, Andrea Hams, Jonathon Headrick, Alex Donaldson, Rick Dann, Joseph Coyne, Steven John Duhig
{"title":"Identifying evidence-practice gaps for shoulder injury risk factors in competitive swimmers: uniting literature and expert opinion.","authors":"Alec Kenneth McKenzie, Andrea Hams, Jonathon Headrick, Alex Donaldson, Rick Dann, Joseph Coyne, Steven John Duhig","doi":"10.1136/bjsports-2023-108023","DOIUrl":"10.1136/bjsports-2023-108023","url":null,"abstract":"<p><strong>Objectives: </strong>To identify evidence-practice gaps regarding shoulder injury risk factors in competitive swimmers.</p><p><strong>Methods: </strong>We gathered insights from 27 swimming experts including elite swimmers, coaches, high-performance staff and applied researchers using Concept Mapping. Participants brainstormed, sorted and rated (from 1 (least) to 10 (most) important and modifiable) their ideas of shoulder injury risk factors in competitive swimmers. Proposed risk factors rated above the grand mean for importance (6.2±0.4) or modifiability (6.5±0.5) ratings were considered highly important/modifiable. Expert opinions were then juxtaposed with systematic review findings to identify overlaps or convergences.</p><p><strong>Results: </strong>Brainstorming generated 126 proposed shoulder injury risk factors for competitive swimmers, subsequently refined to 61 unique proposed risk factors by removing duplicates and combining similar responses. The participants sorted the 61 risk factors into seven distinct clusters. Experts perceived 36/61 proposed risk factors as highly important, of which 6 were supported by literature, 6 showed no association with injury, 2 had conflicting evidence and the remaining 22 have not yet been investigated, suggesting an evidence-practice gap. Three proposed risk factors 'inconsistent training load', 'poor stroke technique' and 'low posterior shoulder strength-endurance' exhibited high perceived importance, high perceived modifiability and supporting evidence.</p><p><strong>Conclusion: </strong>An evidence-practice gap was identified for 28 proposed risk factors perceived as highly important by swimming experts despite either (1) no relevant empirical research (n=22), or (2) no association with injury (n=6) from synthesised evidence. Greater collaboration between researchers and practitioners is needed to effectively address shoulder injury risk factors in competitive swimmers.</p>","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":" ","pages":"1187-1195"},"PeriodicalIF":11.6,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141892840","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}
Pascal Edouard, Pierre-Eddy Dandrieux, Milan Klöwer, Astrid Junge, Sébastien Racinais, Pedro Branco, Karsten Hollander, Laurent Navarro
{"title":"Association between feel-like temperatures and injury risk during international outdoor athletic championships: a prospective cohort study on 29 579 athlete starts during 10 championships","authors":"Pascal Edouard, Pierre-Eddy Dandrieux, Milan Klöwer, Astrid Junge, Sébastien Racinais, Pedro Branco, Karsten Hollander, Laurent Navarro","doi":"10.1136/bjsports-2023-108050","DOIUrl":"https://doi.org/10.1136/bjsports-2023-108050","url":null,"abstract":"Objective To analyse associations between feel-like temperatures measured with the universal thermal climate index (UTCI) and injury rates during international athletic championships. Methods During 10 international outdoor athletic championships from 2007 to 2022, in-competition injuries were collected by medical teams and local organising committees. UTCI was extracted hourly from a global reanalysis of observed atmospheric conditions during each championship. We performed Poisson regressions with incidence rates (number of injuries per 1000 athlete starts) as outcomes and UTCI as a predictive variable adjusted for sex, for all and time-loss injuries, for different injured tissue types (ie, muscle, tendon, ligament, articular, bone and skin) and specific discipline (ie, sprints, hurdles, jumps, throws, middle distance, long distance, marathon and race walking). Results A total of 1203 in-competition injuries were reported for 29 579 athlete starts. For all in-competition injuries (ie, all injured tissue types and all disciplines), higher UTCI was associated with lower incidence rates for time-loss injuries (IRR=0.98, 95% CI 0.97 to 0.98) but not for all injuries (IRR=1.00, 95% CI 1.00 to 1.01). Based on injured tissue type with all disciplines included, higher UTCI was associated with lower incidence rates for all (IRR=0.97, 95% CI 0.97 to 0.98) and time-loss (IRR=0.96, 95% CI 0.96 to 0.96) muscle injuries. Based on the specific discipline, higher UTCI was associated with lower incidence rates for all and time-loss muscle injuries for sprints (IRR=0.95, 95% CI 0.95 to 0.96, and IRR=0.94, 95% CI 0.93 to 0.94, respectively), hurdles (IRR=0.97, 95% CI 0.96 to 97, and IRR=0.95, 95% CI 0.94 to 0.96, respectively) and throws (IRR=0.97, 95% CI 0.97 to 0.98). Conclusions Higher feel-like temperatures were associated with a decreased risk of time-loss and muscle injuries, particularly in sprints, hurdles and throws. Although the precise mechanism for lower injury rates with higher feel-like temperatures requires further investigation, adapting preparations such as warm-up or clothing to forecasted weather conditions may be of benefit. Data are available upon reasonable request. Meteorological data are from ERA5 HEAT (Di Napoli, 2022) and specifically for the championships available at Navarro and Klöwer, 2024. Navarro, L, & Klöwer, M (2024). milankl/AthleticsChampionshipsHeat: Meteorological data and analysis scripts for BJSM 2024 publication (v2.0). Zenodo. <https://doi.org/10.5281/zenodo.13908135>. Injury data are available upon reasonable request. Requests for data sharing from appropriate researchers and entities will be considered on a case-by-case basis. Interested parties should contact the corresponding author Pascal Edouard (pascal.edouard@univ-st-etienne.fr).","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"31 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142487493","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}
Evert Verhagen, Ben Clarsen, Larisa van der Graaff, Roald Bahr
{"title":"Do not neglect injury severity and burden when assessing the effect of sports injury prevention interventions: time to paint the whole picture.","authors":"Evert Verhagen, Ben Clarsen, Larisa van der Graaff, Roald Bahr","doi":"10.1136/bjsports-2024-108215","DOIUrl":"10.1136/bjsports-2024-108215","url":null,"abstract":"","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":" ","pages":"1166-1169"},"PeriodicalIF":11.6,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11503035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141537660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Stephen W West, Sam J Hudson, Lindsay Starling, Matthew Cross, Sean Williams, Carly D McKay, Dario Cazzola, John H M Brooks, Rory Murray, Andy Williams, Simon P T Kemp, Keith A Stokes
{"title":"Twenty year analysis of professional men’s rugby union knee injuries from the English premiership shows high rates and burden","authors":"Stephen W West, Sam J Hudson, Lindsay Starling, Matthew Cross, Sean Williams, Carly D McKay, Dario Cazzola, John H M Brooks, Rory Murray, Andy Williams, Simon P T Kemp, Keith A Stokes","doi":"10.1136/bjsports-2024-108639","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108639","url":null,"abstract":"Objectives To determine the rates, severity and burden of knee injuries in professional male rugby union from the English Premiership. Methods Injury and exposure data were captured over 20 seasons using a prospective cohort design. Knee injury incidence, days’ absence and burden were recorded for each injury type and by pitch surface type for match and training. Results The rate of knee injury in matches was 9.8/1000 hours (95% CIs 9.3–10.3). Mean days lost were 50 (95% CI 46 to 53) in matches and 51 (95% CI 44 to 57) in training. In matches, medial collateral ligament injuries were the most common, while anterior cruciate ligament (ACL) injuries had the highest mean severity and burden. There was no significant change in the count of knee injuries over time; however, average severity increased significantly (annual change: 2.18 days (95% CI 1.60 to 2.77); p<0.001). The incidence of match knee injury was 44% higher on artificial pitches than grass pitches (incidence rate ratio: 1.44 (95% CI 1.21 to 1.69); p<0.01), with no significant difference in severity between surfaces. In matches, the tackle was the event most commonly associated with knee injuries for all diagnoses, except ACL injuries (running). In training, running was a more common injury event than the tackle. Conclusion Knee injuries in matches are common and severe in English professional men’s rugby union. Despite an increased focus on player conditioning and injury prevention throughout the study period, rates of knee injury remained stable, and resulting days’ absence increased. New strategies for the prevention of knee injuries should be considered a priority. All data relevant to the study are included in the article or uploaded as supplementary information. All publicly available data are included in the article or uploaded as online supplemental information. Furthermore, detail of all injury types are published annually as reports for the Professional Rugby Injury Surveillance Project.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"34 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142487492","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}
Laura R C Montgomery, Michael Swain, Amabile B Dario, Mary O'Keeffe, Tie P Yamato, Jan Hartvigsen, Simon French, Christopher Williams, Steve Kamper
{"title":"Does sedentary behaviour cause spinal pain in children and adolescents? A systematic review with meta-analysis","authors":"Laura R C Montgomery, Michael Swain, Amabile B Dario, Mary O'Keeffe, Tie P Yamato, Jan Hartvigsen, Simon French, Christopher Williams, Steve Kamper","doi":"10.1136/bjsports-2024-108648","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108648","url":null,"abstract":"Objective To evaluate whether sedentary behaviour is a risk or prognostic factor for spinal pain in children and adolescents. Specifically, to estimate the (1) direction and strength of the association; (2) risk of spinal pain onset and (3) effect on spinal pain prognosis. Design Systematic review with meta-analysis. Data sources Electronic searches of MEDLINE, Embase, CINAHL and Web of Science up to 23 March 2023. Eligibility criteria for selecting studies Reports estimating the effect of sedentary behaviour on spinal pain in young people (≤19 years). Results We included 129 reports, 14 were longitudinal (n = 8 433) and 115 were cross-sectional (n > 697 590). We incorporated 86 studies into meta-analyses. (1) From cross-sectional data, we found low certainty evidence of a small positive association between sedentary behaviour and spinal pain (adjusted odds ratio 1.25 (95% CI 1.17 to 1.33), k = 44, n > 92 617). (2) From longitudinal data, we found low certainty evidence of no increased risk for the onset of spinal pain due to sedentary behaviour (adjusted risk ratio 1.07 (95% CI 0.84 to 1.35), k = 4, n = 1 292). (3) No studies assessed prognosis. Conclusion Cross-sectional data suggest minimally higher odds of spinal pain for children and adolescents who engage in greater sedentary behaviours. However, longitudinal data do not support a causal relationship, indicating that sedentary behaviour does not increase the risk for onset of spinal pain. Due to the low certainty of evidence, these findings must be interpreted with caution. We found no evidence of the effect sedentary behaviour has on spinal pain prognosis in children and adolescents, highlighting a considerable gap in the literature. All data relevant to the study are included in the article or uploaded as online supplemental information.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"25 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142487494","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}