British Journal of Sports Medicine最新文献

{"title":"Dr Diamond plays his part to save the heart!","authors":"Anusha Lekshminarayanan, Amy Valasek","doi":"10.1136/bjsports-2024-109134","DOIUrl":"https://doi.org/10.1136/bjsports-2024-109134","url":null,"abstract":"Survival from out-of-hospital sudden cardiac arrest (SCA) is roughly 10%.1 Higher rates of survival are achieved by the administration of prompt cardiopulmonary resuscitation (CPR) and early defibrillation.1–3 Bystander administered CPR improves survival by approximately three-fold.4 Without an automated external defibrillator (AED) available on-site after an exercise-related SCA, neurological impairment is estimated at 90%.5 Yet, public awareness of the importance of AEDs for survival is relatively low.6 While annual screening to identify common structural or electrical cardiac conditions is still debated, the importance of timely CPR and AED application cannot be overstated.7 In 1999, Project ADAM was launched in the USA in honour of a multisport high school athlete, Adam, who collapsed during a basketball game. Despite CPR, an AED was not used during his event, and Adam did not survive his SCA. Initially begun by Dr. Stuart Berger (a paediatric cardiologist in Wisconsin), today, there are over 40 Project ADAM affiliate healthcare sites active across the USA. Through this initiative, many schools, summer camps, youth sports programmes, day care centres …","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"24 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142867303","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":"Elite para athletes with active coping behaviour are less likely to report a sports injury","authors":"Kristina Fagher, Linda Sällström, Örjan Dahlström, Jenny Jacobsson, Toomas Timpka, Jan Lexell","doi":"10.1136/bjsports-2024-108192","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108192","url":null,"abstract":"Objective Elite para athletes report a high incidence of sports injuries. Research suggests that athletes’ strategies to manage adversities may influence the sports injury risk, but knowledge about para athletes’ coping behaviours and their association with injuries is limited. The aim was to describe the distribution of coping behaviours in Swedish elite para athletes by sex, age, impairment, sport and to examine associations between coping behaviours and the probability of reporting a prospective sports injury during a 52-week study period. Method Eighty-three para athletes participating in the ‘Sports-related injuries and illnesses in Paralympic sport study’ completed the Brief COPE Inventory. Over the following 52 weeks, athletes reported any sports injuries they sustained. The analysis of coping behaviours comprised descriptive statistics and linear regression, and associations between coping behaviour and the probability of being injured were examined by logistic regression analyses. Results The most frequently used coping behaviours were acceptance, active coping and planning. The most common less-useful coping behaviour was self-blame. Athletes with more active coping behaviours were less likely to report an injury, and using humour as coping behaviour was associated with a higher probability of injury among young athletes. Also, athletes with physical impairment reported a higher use of active coping and emotional support compared with athletes with visual impairment, and athletes participating in individual sports used acceptance as a coping behaviour to a larger extent than athletes in team sports. Conclusion Use of active coping in Swedish elite para athletes was associated with a lower likelihood of reporting an injury. Young athletes using humour as a coping strategy had a higher likelihood of reporting an injury. The results suggest that support of active coping behaviours and a sport context fostering help-seeking behaviours should be considered in future prevention measures. Data are available upon reasonable request.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"89 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142867304","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":"Questioning the rules of engagement: a critical analysis of the use of limb symmetry index for safe return to sport after anterior cruciate ligament reconstruction","authors":"Rebecca Simonsson, Axel Sundberg, Ramana Piussi, Johan Högberg, Carl Senorski, Roland Thomeé, Kristian Samuelsson, Francesco Della Villa, Eric Hamrin Senorski","doi":"10.1136/bjsports-2024-108079","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108079","url":null,"abstract":"Objective To evaluate the association between limb symmetry index (LSI) in quadriceps and hamstrings strength together with hop tests, as a proxy of recovery, and the deviation from being symmetrical (LSI 100%), with a safe return to sport (RTS) after anterior cruciate ligament reconstruction (ACL-R). Methods Athletes between 15 and 30 years old with a preinjury Tegner activity level ≥6 were eligible for inclusion. Data were extracted from a rehabilitation-specific registry, Project ACL (Gothenburg, Sweden) at the time of or after RTS for each athlete. The outcome of interest in this study was a safe RTS—not suffering a second ACL injury within 2 years from RTS—addressed by using the LSI in five different ways with results from the test battery which include five tests of muscle function at or after the time of RTS. Logistic regression analyses were performed with safe RTS as a dependent variable and presented with ORs and 95% CIs. Results In total, 233 athletes (51.1% women) were included. The best-differentiating cut-offs for strength and hop tests showed non-significantly poor discriminatory ability between athletes who had a safe RTS and those who did not (Youden J 0.09–0.24 and area under the curve 0.50–0.59). Athletes who had ≥80% or ≥85% LSI had significantly lower odds of safe RTS compared with athletes who did not meet the cut-offs of safe RTS (OR=0.32 (95% CI 0.12 to 0.87) and OR=0.39 (95% CI 0.18 to 0.84), respectively). There was no effect of a 1% increase in LSI or deviation from 100% symmetry on safe RTS. Conclusion The use of LSI from tests of muscle function to determine safe RTS after ACL-R, that is, RTS without sustaining a second ACL injury within 2 years, cannot differentiate between athletes who had a safe RTS and those who did not, regardless of whether LSI was used as cut-offs, incremental or as deviation from symmetry. Thus, it is of clinical importance that clinicians do not solely rely on the LSI to clear athletes for RTS. Data are available on reasonable request. Data can be obtained on request due to privacy reasons and ethical statements.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"40 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142867305","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":"Dr David Sabgir and Walk with a Doc—every step counts","authors":"Amy Valasek, Anusha Lekshminarayanan","doi":"10.1136/bjsports-2024-108983","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108983","url":null,"abstract":"Physical activity is a universal prescription that benefits people of all ages. From childhood to adulthood, movement is important for the human development, health and wellness.1–3 Yet across all continents, populations remain physically inactive leading to a rise in health comorbidities and chronic disease.4–6 Sports medicine physicians are faced with inactive populations in clinical practice and are uniquely positioned to confront this enormous challenge. The integration of exercise medicine and physical activity promotion into training curricula for medical students, residents and sports medicine fellowships is key to facilitate change.7–12 Each step towards physical activity promotion clinically could lead to healthier populations. Dr David Sabgir, an adult cardiologist in Ohio, is a great example of a singular physician who incorporated physical activity promotion into his clinical practice to make a global impact. He grew increasingly frustrated with his inability to effectively change his patients’ inactivity. The thousands of conversations he had with patients regarding the importance of physical activity for health were not fruitful nor were the exercise prescriptions or follow-up …","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"76 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142867277","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":"Mouthguards for the prevention of orofacial trauma in sport: the Faculty of Sport and Exercise Medicine (UK) position statement.","authors":"Irfan Ahmed, Julie Gallagher, Ian Needleman, Rachel Bower, Paul Ashley, Asma Aloui, John Patrick Haughey, Gofrane Abdellaoui, Peter Fine","doi":"10.1136/bjsports-2024-108663","DOIUrl":"10.1136/bjsports-2024-108663","url":null,"abstract":"","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":" ","pages":"1475-1477"},"PeriodicalIF":11.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388174","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. Mitigating exertional heat illness risk in tennis.","authors":"Joss Connell","doi":"10.1136/bjsports-2024-108355","DOIUrl":"10.1136/bjsports-2024-108355","url":null,"abstract":"","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":" ","pages":"1551-1552"},"PeriodicalIF":11.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141589672","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":"Quantitative analysis of effectiveness and associated factors of exercise on symptoms in osteoarthritis: a pharmacodynamic model-based meta-analysis.","authors":"Shun Han, Ting Li, Ying Cao, Zewei Li, Yiying Mai, Tianxiang Fan, Muhui Zeng, Xin Wen, Weiyu Han, Lijun Lin, Lixin Zhu, Siu Ngor Fu, Kim L Bennell, David J Hunter, Changhai Ding, Lujin Li, Zhaohua Zhu","doi":"10.1136/bjsports-2023-107625","DOIUrl":"10.1136/bjsports-2023-107625","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate the time point and magnitude of peak effectiveness of exercise and the effects of various exercise modalities for osteoarthritis (OA) symptoms and to identify factors that significantly affect the effectiveness of exercise.</p><p><strong>Design: </strong>Pharmacodynamic model-based meta-analysis (MBMA).</p><p><strong>Data sources: </strong>Embase, PubMed, Cochrane Library, Web of Science and Scopus were searched for randomised controlled trials (RCTs) examining the effect of exercise for OA from inception to 20 November 2023.</p><p><strong>Eligibility criteria: </strong>RCTs of exercise interventions in patients with knee, hip or hand OA, using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) subscales or Visual Analogue Scale (VAS) pain scores as outcome measures, were included. The minimum clinically important difference (MCID) for WOMAC total, pain, stiffness, function and VAS pain was 9.0, 1.6, 0.8, 5.4 and 0.9, respectively.</p><p><strong>Results: </strong>A total of 186 studies comprising 12 735 participants with symptomatic or radiographic knee, hip or hand OA were included. The effectiveness of exercise treatments peaked at 1.6-7.2 weeks after initiation of exercise interventions. Exercise was more effective than the control, but the differences in the effects of exercise compared with control on all outcomes were only marginally different with the MCID (7.5, 1.7, 1.0, 5.4 and 1.2 units for WOMAC total, pain, stiffness, function and VAS pain, respectively). During a 12-month treatment period, local exercise (strengthening muscles and improving mobilisations of certain joints) had the best effectiveness (WOMAC pain decreasing by 42.5% at 12 weeks compared with baseline), followed by whole-body plus local exercise. Adding local water-based exercise (eg, muscle strengthening in warm water) to muscle strengthening exercise and flexibility training resulted in 7.9, 0.5, 0.7 and 8.2 greater improvements in the WOMAC total score, pain, stiffness and function, respectively. The MBMA models revealed that treatment responses were better in participants with more severe baseline symptom scores for all scales, younger participants for the WOMAC total and pain scales, and participants with obesity for the WOMAC function. Subgroup analyses revealed participants with certain characteristics, such as female sex, younger age, knee OA or more severe baseline symptoms on the WOMAC pain scale, benefited more from exercise treatment.</p><p><strong>Conclusion: </strong>Exercise reaches peak effectiveness within 8 weeks and local exercise has the best effectiveness, especially if local water-based exercise is involved. Patients of female sex, younger age, obesity, knee OA or more severe baseline symptoms appear to benefit more from exercise treatment than their counterparts.</p>","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":" ","pages":"1539-1550"},"PeriodicalIF":11.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406151","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":"Maternal and fetal responses to acute high-intensity resistance exercise during pregnancy","authors":"Amy N Moolyk, Megan K Wilson, Brittany A Matenchuk, Gyanjot Bains, Matthew J Gervais, Jenna B Wowdzia, Margie H Davenport","doi":"10.1136/bjsports-2024-108804","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108804","url":null,"abstract":"Objective To examine maternal and fetal cardiovascular responses to high-intensity resistance exercise in pregnancy. Methods 10 healthy pregnant (26.4±3.2 weeks gestation) and 10 healthy non-pregnant individuals were recruited (34.8±6 and 33.5±2.9 years, respectively). At least 48 hours after baseline strength testing to determine 10-repetition maximum (10 RM), participants completed 10 repetitions of barbell back squat, bench press and deadlift at 70%, 80% and 90% of 10 RM with free breathing, followed by 10 repetitions at 90% 10 RM with a Valsalva manoeuvre. Maternal heart rate was monitored continuously. Fetal heart rate, umbilical systolic/diastolic (S/D) ratio, resistive index (RI) and pulsatility index (PI), as well as maternal blood pressure, glucose and lactate were assessed immediately before and after exercise. Results The amount of weight lifted and the rate of perceived exertion by pregnant and non-pregnant participants were similar throughout each exercise. Maternal heart rate increased with the amount of weight lifted, peaking with the use of the Valsalva manoeuvre (squat: 137.3±8.4 bpm; bench press: 110.5±10.4 bpm; deadlift: 130.7±9.0 bpm). Fetal bradycardia was not observed, and fetal heart rate did not change from pre-to-post exercise (squat: p=0.639; bench press: p=0.682; deadlift: p=0.847). Umbilical blood flow metrics, such as RI, remained within normal ranges throughout each set of squats (p=0.642), bench press (p=0.287) and deadlifts (p=0.614). Conclusion Our findings suggest that high-intensity resistance exercises are well tolerated by both mother and fetus, including while using the Valsalva manoeuvre. Data are available upon reasonable request.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"4 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142841618","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":"Association of cardiorespiratory fitness with the incidence and progression trajectory of cardiometabolic multimorbidity","authors":"Yanchun Chen, Hongxi Yang, Dun Li, Lihui Zhou, Jing Lin, Xin Yin, Weiling Yang, Ying Gao, Qing Zhang, Sean X Leng, Yaogang Wang","doi":"10.1136/bjsports-2024-108955","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108955","url":null,"abstract":"Objectives This study examined the relationship of cardiorespiratory fitness (CRF) in the transition from healthy status to first cardiometabolic disease, subsequent cardiometabolic multimorbidity and further to death. Methods We used data from the UK Biobank of 47 484 participants without cardiometabolic diseases at baseline. CRF was assessed via a 6 min incremental ramp cycle ergometer test and expressed in metabolic equivalent of tasks (METs, 1 MET=3.5 mL/kg/min). Cardiometabolic multimorbidity was defined as at least two diseases among diabetes, hypertension, coronary heart disease and stroke. Results Over 12.5 years median follow-up, 8123 participants developed first cardiometabolic disease, 1958 developed cardiometabolic multimorbidity and 2177 died. CRF was associated with different transition stages in cardiometabolic multimorbidity development. The HRs (95% CIs) per MET increase in CRF were 0.94 (0.93 to 0.95) and 0.97 (0.96 to 0.99) for transitions from healthy baseline to first cardiometabolic disease and subsequent cardiometabolic multimorbidity. Per MET increase in CRF was associated with reduced risk of transition from healthy baseline to death (HR: 0.97, 95% CI 0.95 to 0.99), but not for the transition from first cardiometabolic disease and cardiometabolic multimorbidity to death. When first cardiometabolic disease was divided into specific cardiometabolic diseases, there were comparable trends of CRF on the disease-specific transitions from healthy baseline to first cardiometabolic disease and subsequent cardiometabolic multimorbidity. Conclusion Higher CRF was associated with a lower risk of progression from a healthy state to first cardiometabolic disease and subsequently to cardiometabolic multimorbidity. These findings suggest that improving CRF is a potential strategy for preventing cardiometabolic multimorbidity development. Data are available upon reasonable request. The data that support the findings of this study are available from UK Biobank (<https://www.ukbiobank.ac.uk/>), 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 UK Biobank.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"12 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142841554","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":"Concurrent symptom domains and associations with recovery timelines among collegiate athletes with sport-related concussion","authors":"Bernadette A D'Alonzo, Andrea LC Schneider, Ian J Barnett, Christina L Master, Roy H Hamilton, Douglas J Wiebe","doi":"10.1136/bjsports-2024-108351","DOIUrl":"https://doi.org/10.1136/bjsports-2024-108351","url":null,"abstract":"Objective Concussion symptoms can be clustered into domains and understanding how multiple symptom domains present clinically may guide more accurate interventions. We investigate the associations between concurrent symptom domains and clinical recovery outcomes, as well as the role of sex in these relationships. Methods We analysed data from the Ivy League–Big Ten Epidemiology of Concussion Study and included sport-related concussions (SRC) across five academic years 2015–2016/2019–2020 with complete data (n=1160). We used symptoms from the Sport Concussion Assessment Tool 22-symptom evaluation, previously categorised into symptom domains. Symptom profiles characterise how athletes endorse concurrent symptom domains. Outcomes are time (in days) from SRC to symptom resolution, return to academics, and full play. Results Females more commonly endorsed headache, sensory, and affective symptom domains. Four classes/symptom profiles emerged: (1) ‘low’ on all domains, (2) ‘high’ on headache and sensory domains, (3) ‘high’ on vestibulo-ocular, cognitive, and sleep domains, and (4) ‘high’ on all domains. Time to symptom resolution, return to academics, and return to play were consistently shorter among class/symptom profile 1 compared with other classes/profiles. Compared with class/profile 1, the chance of having symptoms resolve was lower among classes/profiles 2, 3, and 4 (HR 0.74, 95% CI 0.63 to 0.88; HR 0.74, 95% CI 0.60 to 0.92; HR 0.50, 95% CI 0.43 to 0.57, respectively). Results were similar for return to academics and full play outcomes. Interactions with sex were not statistically significant. Conclusions Four symptom profiles characterised how concussion symptom domains co-occur. We found differences in recovery timelines among these groups, but not by sex. Findings inform and support targeted, symptom domain-specific interventions in concussion management. No data are available. Data are not publicly available due to current data sharing policies of the Ivy League-Big Ten Epidemiology of Concussion Study.","PeriodicalId":9276,"journal":{"name":"British Journal of Sports Medicine","volume":"1 1","pages":""},"PeriodicalIF":18.4,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142841560","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}