Global participation in sport and leisure-time physical activities: A systematic review and meta-analysis

Childhood predictors of high school sport participation and effects of participation on young adult activity and mental health

INTRODUCTION

In the United States, sport is a common form of youth physical activity (PA) with demonstrated health benefits. However, limited longitudinal dataexists on the psychosocial determinants and consequences of youth sport participation. This study examined grade 6 (11-12-year-old) predictors of high school organized sport participation and effects of high school sport participation on age 26 behavior, mental health and wellbeing.

METHODS

Structural equation models tested relationships using the National Institute for Child Health and Human Development (NICHD) Study of Early Child Care and Youth Development (SECCYD). Half of the sample was male, and played organized sports at ages 15 and 18. Eighty percent of the sample was white.

RESULTS

Grade 6 predictors of playing high school sport were: child enjoys PA, parent enjoys PA, parent feels physical education (PE) is important, and vigorous PA minutes/week. Playing sports at ages 15 and 18 was associated with better wellbeing, lower depression, increased sport and fitness activity participation. Enjoyment of PA was directly associated with fitness activities at age 26, more than a decade later. High school sport participation at both age 15 and 18 further mediated relationships between enjoyment with wellbeing and depression at age 26.

DISCUSSION

Sport participation is a common accessible means of PA, and participating in sports in high school is associated with better mental health and PA outcomes at age 26. Fostering enjoyment of PA during childhood helps shape PA in early adulthood and adult mental health benefits derived from high school sport participation.

Wearing Compression Socks During Running Does Not Change Physiological, Running Performance, and Perceptual Outcomes: A Systematic Review With Meta-Analysis

BACKGROUND

Compression socks are a popular feature for runners and are widely advertised by the industry. Limited high-quality evidence has summarized the effects of compression socks during running. We aimed to investigate the effects of wearing compression socks compared with placebo or regular socks during running on physiological parameters, running performance, and perceptual outcomes.

METHODS

The protocol was registered at PROSPERO (CRD42022330437). Five databases (MEDLINE, Embase, CINAHL, SPORTDiscus, and Web of Science) were searched. Clinical trials exploring the effect of compression socks during running on physiological parameters, performance, and perceptual outcomes were included. The Cochrane risk of bias 2 tool was used to assess the risk of bias.

RESULTS

We included 28 trials (600 runners), with 16 trials (284 runners) contributing to meta-analysis. For physiological outcomes (eg, heart rate mean difference [95% CI = 0.82 [-0.39 to 2.03] and blood lactate concentration mean difference [95% CI] = 0.30 [-0.39 to 0.98]), pooled analysis indicated low to moderate-certainty evidence that compression socks do not differ from regular socks. For running performance (eg, running speed mean difference [95% CI] = -0.24 [-0.79 to 0.31] and time to exhaustion standardized mean difference [95% CI] = -0.26 [-0.65 to 0.13]), pooled analysis indicated very low to low-certainty evidence that compression socks do not differ from regular socks. For perceptual outcomes (eg, perceived exertion standardized mean difference [95% CI] = 0.06 [-0.17 to 0.29] and lower limb muscle soreness standardized mean difference [95% CI] = 0.08 [-0.35 to 0.51]), pooled analysis indicated very low to moderate-certainty evidence that compression socks do not differ from regular socks.

CONCLUSION

There is very low to moderate-certainty evidence that wearing compression socks during running does not benefit physiological, running performance, or perceptual outcomes compared with regular socks.

Unpacking the relationship between autism, sport participation, and adolescent health: A causal mediation analysis

BACKGROUND

Autistic children are less likely to participate in sport than non-autistic children, and sport participation may improve health and health related quality of life. It is therefore possible that sport participation may partially mediate the association between autism and adolescent health and health related quality of life. Sport participation may have distinct effects for autistic and non-autistic children, and these effects may also differ between team and individual sports.

OBJECTIVES

The study had two objectives. First, to estimate cumulative effects of sport participation (team or individual) between ages 8-15 on adolescent health and health related quality of life and determine whether effects of sport participation differed for autistic children compared to non-autistic children. Second, to determine whether sport participation (team or individual) mediated the relationship between autism and adolescent health and health related quality of life.

METHODS

Methods for causal mediation analysis were used to analyse data from a representative cohort of Australian children (n = 313 autistic; 6346 non-autistic) between ages 8-15. Sport participation was reported by parents from ages 8-15. Outcomes at age 14-15 included body mass index, the Pediatric Quality of Life Inventory, the Strengths and Difficulties Questionnaire, and the Short Moods and Feelings Questionnaire.

RESULTS

Non-autistic children's health benefited from all forms of sport. For autistic children, however, team sport participation was linked to worse mental health and no benefit in physical health. Individual sport improved physical health related quality of life, but not body mass index or mental health for autistic children. The mediation hypothesis was not supported.

CONCLUSIONS

Our findings suggest that greater efforts are needed to adapt community sport to encourage equitable participation and ensure that participation benefits autistic children's health and health-related quality of life equally.

Transformative approaches for effective clinical trials to reduce the disease burden of osteoarthritis

Osteoarthritis (OA) is a leading cause of disability and morbidity that has eluded development of effective disease modifying drugs and therapies. While established OA in the form of symptomatic radiographic disease is a recognizable final common pathway, OA development encompasses a broad spectrum of pathological changes, susceptibilities, and etiological pathways that cannot be considered a single disease process. Beginning with preclinical disease where radiographs are normal, the concept of pre-osteoarthritis (pre-OA) offers a systems-based approach to OA prevention by targeting reduction of OA risk prior to the onset of definable OA. Early OA ensues when cellular, molecular, and joint tissue changes begin to overlap that of OA, a process that can begin before the onset of definitive symptoms or radiographic changes. A myriad of pathways and crossroads of pre-OA and early OA eventually leads to poorly irreversible symptomatic radiographic OA. With increasing recognition of pre-OA and early OA markers, pathways and subtypes, opportunities arise to address these new therapeutic targets. The current status of clinical trials in OA was identified as a critical barrier to progress by the 2022 National Institute of Arthritis, Musculoskeletal, and Skin Diseases (NIAMS) Roundtable on "Cartilage Preservation and Restoration in Knee Osteoarthritis: Challenges, Gaps, and Opportunities". This manuscript summarizes the recommendations of the work group established from the Roundtable to address this issue. The work group recommends that clinical trial design and endpoints evolve to effectively evaluate new treatment approaches suitable for pre-osteoarthritis and early OA by different criteria than what has been set for symptomatic radiographic OA. While symptomatic improvement is the primary goal for palliation of irreversible established OA, important goals for treating earlier disease states include disease modification and prevention, with the potential to alter the natural history of progressive OA. Because symptoms may not correlate with structural changes in pre-OA and early OA, the primary outcomes in these trials need to match the intended mechanistic target and the therapeutic goal for the disease state being treated. The purpose of this manuscript is to transform the approach to clinical trials in OA by establishing a new benchmark of identifying critical outcomes that are appropriate for the joint disease states and subtypes of the target patient population, and the therapeutic or mechanistic target of the intervention being tested. By shifting the approach from using standardized outcomes based on established OA towards customizing clinical trials according to these principles, new precision medicine strategies to address the full spectrum of disease from pre-OA to OA can be more readily advanced into clinical practice.

Do Different Two-Dimensional Camera Speeds Detect Different Lower-Limb Kinematics Measures? A Laboratory-Based Cross-Sectional Study

Background/Objectives: Football poses a high risk of sustaining lower-limb injuries, particularly anterior cruciate ligament (ACL) injuries, owing to the frequent jumping and landing movements. Identifying risk factors for these injuries is crucial to successful prevention. Two-dimensional (2D) video analysis is a commonly employed tool for assessing movement patterns and determining injury risk in clinical settings. This study aims to investigate whether variations in the camera frame rate impact the accuracy of key angle measurements (knee valgus, hip adduction (HADD), and lateral trunk flexion (LTF)) in male football players during high-risk functional tasks such as single-leg landing and 45° side-cutting. Methods: This laboratory-based cross-sectional study included 29 football players (mean (SD) age: 24.37 [3.14] years). The frontal plane projection angle (FPPA), HADD, and LTF during single-leg landing and side-cutting tasks were measured using two different camera frame rates: 30 frames per second (fps) and 120 fps. The 2D kinematic data were analyzed using Quintic Biomechanics software. Results: Significant differences in FPPA scores during single-leg landing were observed between the 30 fps and 120 fps for both the dominant (mean difference = 2.65 [95% confidence interval [CI]: 0.76-4.55], p = 0.008) and non-dominant leg (3.53 [1.53-5.54], p = 0.001). Additionally, the FPPA of the right leg during the side-cutting task showed significant differences (2.18 [0.43-3.93], p = 0.016). The LTF of the right leg during side-cutting displayed a significant variation between frame rates (-2.69 [-5.17--0.22], p = 0.034). No significant differences in HADD were observed. Conclusions: Compared with a 30 fps camera, a high-speed (120 fps) camera demonstrated a superior performance in delivering accurate kinematic assessments of lower-limb injury risk factors. This improved precision supports injury screening, rehabilitation monitoring, and return-to-play decision-making through determining subtle biomechanical deficits crucial for lower-limb injury prevention and management.

Selecting Resistance Training Exercises for Novices: A Delphi Study with Expert Consensus

Resistance training (RT) is a form of exercise that provides numerous health benefits. One barrier to participation may be the technical demands associated with some exercises. While recommendations for RT, including the number of repetitions, sets, rest, and training loads are established, recommendations for exercise selection have not been addressed. We used a Delphi-type method in three iterative surveys. In the first survey, 17 experts rated the technical complexity of 77 different strength training exercises as having low, moderate, or high technical demands. A second survey was generated based on the first, such that exercises receiving a majority high complexity vote were removed. In the second survey, experts rated the remaining exercises as either appropriate or too advanced for a novice. Exercises were deemed appropriate if 70% agreement was reached. Lastly, experts rated exercises as being appropriate for adults over the age of 60. Experts agreed that 41 different exercises were appropriate for novices and that 32 of the exercises were appropriate for novice adults over the age of 60. Our findings provide recommendations for program design to compliment already established recommendations for RT of repetitions, sets, rest periods, and training loads.

Mediating role of organized sports participation on the relationship between body fatness and arterial wall thickness among adolescents: ABCD Growth Study

BACKGROUND

Participation in sports is the main manifestation/subdomain of physical exercise in adolescents and affects cardiovascular health in different ways.

OBJECTIVES

To analyze the relationship between body fatness and arterial wall thickness as well as the mediating role of sports participation in this relationship among adolescents.

METHODS

This cross-sectional study is linked to the ABCD-Growth Study conducted in Presidente Prudente, Brazil. The study sample included 402 adolescents (275 boys and 127 girls) aged 11-17 years recruited from schools (non-sport group) and sports clubs (sports group). Sex-stratified multivariate model was created using structural equation modelling (SEM) with carotid (CIMT) and femoral arterial wall thickness (FIMT) as dependent variables were assessed by an ultrasound device. Body fatness percentage (BF) as the independent variable and was assessed by whole-body dual-energy X-ray absorptiometry, and sports participation as a moderator was assessed by face-to-face interviews. The maturity offset and dyslipidemia were treated as confounders in the mediation models.

RESULTS

In girls, body fatness was positively associated with FIMT (r = 0.210 [95%CI: 0.035; 0.372]) but not with CIMT (r= -0.148 [95%CI: -0.314; 0.027]), whereas sports participation was not associated with vascular structure. In boys, body fatness was inversely related to CIMT (r= -0.285 [95%CI: -0.390; -0.172]) and positively to FIMT (r = 0.129 [95%CI: 0.011; 0.244]), whereas sports participation was inversely related to FIMT (r= -0.142 [95%CI: -0.256; -0.024]). Among boys, sports participation mediated 7.4% of the relationship between body fatness and FIMT, and the association between body fatness and FIMT remained significant (r = 0.168 [95%CI: 0.037; 0.299]).

CONCLUSIONS

Sports participation mediates the relationship between BF and arterial thickness in adolescent boys.

Physical activity and risk of depression in adolescents: A systematic review and meta-analysis of prospective observational studies

BACKGROUND

While the benefits of physical activity (PA) on depression in adults have been well-established, its impact on depression in adolescents remains understudied. This study aimed to examine the relationship between PA and depression in adolescents, aggregating published prospective observational studies.

METHODS

We searched MEDLINE, Embase, Cochrane, and PsycINFO, for prospective observational studies that examined the relationship between PA and depression in adolescents from the inception of these databases to November 17, 2022, without any language restrictions. Two independent reviewers performed data extraction and assessed the risk of bias. We utilized a random-effects model to calculate the pooled odds ratios (ORs) and 95 % confidence intervals (95%CIs). Subgroup analyses were conducted to explore potential sources of heterogeneity.

RESULTS

This study included 11 original articles, involving 59,786 adolescents (46.4 % male). Primary analysis revealed that adolescents who engaged in higher levels of PA showed a 3 % significantly decreased risk of developing depression compared to those with lower levels (OR = 0.97, 95%CI = 0.94-0.99, P = 0.01; I2 = 41.7 %). Sensitivity analyses confirmed the robustness of these findings. Subgroup analyses demonstrated heterogeneity to be primarily attributed to data source, geographic region, and follow-up period (Pinteraction< 0.01, 0.01 and 0.01, respectively), while no significant sex-specific association was found (Pinteraction = 0.30).

CONCLUSIONS

Our systematic review and meta-analysis of prospective observational studies indicates that higher levels of PA are associated with a reduced risk of depression in adolescents. This highlights the need for policies to promote increased PA levels among adolescents for the prevention of depression.

Individual physical activity preferences of adolescents in the Czech Republic and Poland: a 14-year comparative study reflecting the gender trends and prospective responses to global lifestyle challenges

BACKGROUND

The global decline in physical activity (PA) among the youth has been exacerbated by the pandemic's impact on their lifestyles. Addressing these adverse effects post-pandemic by supporting preferred physical activities among young individuals is crucial. The aim of the study is to investigate and compare the long-term trends in PA preferences among individuals in Poland and the Czech Republic, exploring the impact of global lifestyle challenges over the past 14 years, including the pandemic, on PA behaviors and choices.

METHODS

The study design is cross-sectional and data gathering was in the period between 2007 and 2020, this research encompassed 19,235 participants aged 15 to 26. PA preferences were gauged using the Questionnaire on Physical Activity Preferences, while actual PA levels were measured through the International Physical Activity Questionnaire-Long Form. Crossing table, Kruskal-Wallis ANOVA, binary logistic regression and effect size coefficients were conducted.

RESULTS

Among the participants, individual physical activities were favoured by 24% of Czech and 25% of Polish boys, and 23% of Czech and 25% of Polish girls. A positive correlation was found between the preference for running and higher levels of recreational, vigorous, and overall weekly PA. Additionally, an increased preference for running was associated with a higher likelihood of meeting weekly PA recommendations for both girls (OR = 1.82, CI = 1.62-2.04, p < 0.001) and boys (OR = 1.61, CI = 1.44-1.82, p < 0.001) in both countries.

CONCLUSIONS

Over a 14-year period, swimming, cycling, and running emerged as the most preferred PA across both Czech and Polish youth, with a notable increase in running, especially among Czech boys. Polish boys and girls also showed a growing preference for running, while Polish girls demonstrated a notable increase in badminton and ice-skating. The preference for running was associated with a higher likelihood of meeting PA recommendations, especially among Polish boys and Czech girls. Notably, activities like running, swimming, and cycling exhibited resilience to both pandemic-related restrictions and broader global lifestyle challenges, underscoring the importance of long-term monitoring of PA preferences for effective health promotion.

Physical activity engagement among Black African-born immigrant women in the United States: Results from the 2011 to 2018 National Health Interview Surveys

INTRODUCTION

Black women in the US, including Black African immigrant women, have the lowest rates of physical activity (PA). This study aimed to identify sociodemographic, anthropometric, and health characteristics associated with PA engagement among African-born Black women immigrants.

METHODS

The sample consisted of 736 Black African-born women respondents the 2011-2018 National Health Interview Surveys. The outcomes of interest were aerobic activity, strengthening activity, and combined aerobic and strengthening activity. Independent variables of interest included sociodemographic characteristics, health behaviors, and anthropometrics. Descriptive statistics and multivariable adjusted logistic regression analyses were performed.

RESULTS AND DISCUSSION

Of the 736 women, 43.1 % were sufficiently active in aerobic activities and 17.4 % met the strengthening activity guidelines. Overall, only 15.7 % of the participants met the guidelines for total PA (aerobic and strength), while 55 % did not meet any guidelines. Participants who consumed alcohol were more likely to be sufficiently active in aerobic activity compared to those who abstained (AOR = 3.54, 95 % CI [2.43,5.16]). Factors negatively associated with sufficient aerobic activity were smoking (AOR = 0.42, 95 % CI [0.19,0.92] and having obesity (AOR = 0.50, 95 % CI [0.33,0.75]). The odds of meeting strengthening activity guidelines were greater among those with high school education (AOR = 2.94, 95 % CI [1.20, 7.20]) and more than high school (AOR = 2.54, 95 % CI [1.09,5.95]) than among those with less than high school education, Additionally, being in the US 15 years or more (AOR = 2.15, 95 % CI [1.18-3.91]). and a current drinker (AOR = 2.14, 95 % CI [1.22-3.75]) was positively associated with meeting strength guidelines.

IMPLICATIONS

Findings provide missing information about Black African immigrant women's participation in PA and suggest that more research is needed to understand how African immigrant women make decisions about PA. The findings join calls to disaggregate data and health related research on Africans.

Using complex systems to understand running-related injuries

This study aims to investigate anthropometric and training characteristics associated with injuries in runners using a complex approach. We conducted a cross-sectional study with 97 Brazilian runners of both sexes (age: 39.1 ± 11.5 years; body mass index: 24.2 ± 4.2 kg/m2). A web survey was used for data collection, including age, sex, body weight, body height, training volume/frequency, session duration, running pace and injury information (yes or no; the number of injuries). The partial correlation parameter was used for network estimation, considering both sexes. For women, injury occurrence was positively and strongly associated with training frequency (r = 0.57) and the number of competitions (r = 0.64), while for men, a negative and strong association was found with age (r=-0.69), and positive associations were observed with BMI (r = 0.89) and training volume (r = 0.82). Network centrality showed that training session duration and the number of competitions/year presented a higher expected influence value for women (-1.47) and men (-1.31). Using a non-linear approach with Brazilian non-professional runners, training characteristics had a stronger influence on running-related injuries.

Relationship of Skeletal Muscle Mass, Length of Sports Experience, and Sexual Maturity with Bone Density and Geometry in Adolescent Athletes

OBJECTIVE

To identify the relationship between length of sports experience, muscle mass, and sexual maturity with bone mineral density (BMD) and geometry in adolescent basketball and track and field athletes.

METHOD

The study included adolescent (11-18 years) athletes, of both sexes, who practiced basketball (n = 26) or track and field (n = 24). Skeletal muscle mass was measured by bioelectrical impedance analysis. Data on sports training and sexual maturity were collected through a questionnaire. Total body, lumbar, femoral, and forearm BMD were determined by dual-energy X-ray absorptiometry. Femoral scans were used to generate bone geometry measurements (femur strength index, cross-sectional area, cross-sectional moment of inertia, section modulus, and buckling ratio). Bone outcomes were compared between modalities by the Mann-Whitney U-test or Student's t-test and by analysis of covariance with adjustment for sports experience, sexual maturity, and skeletal muscle mass.

RESULTS

In the crude analysis, the basketball group had higher mean values for height, body weight, muscle mass, femoral neck BMD, cross-sectional area, and cross-sectional moment of inertia. In the covariate-adjusted analysis, the track and field group had higher total-body-less-head (0.995 vs. 1.035, p = 0.043), lumbar (1.012 vs. 1.107, p = 0.005), and radial (0.734 vs. 0.800, p = 0.005) BMD. Muscle mass was the main covariate influencing bone parameters, followed by sexual maturity.

CONCLUSION

Skeletal muscle mass was the main determinant of bone outcomes in adolescent athletes, followed by sexual maturity, underscoring the importance of considering these variables when assessing bone health in this population.

Habits Related to Strength Training of Brazilian Recreational Runners

Despite strength training (ST) being well characterized by professional runners, little is known about the inclusion of ST models for recreational runners. Thus, the present study aimed to investigate the presence of ST in the training practices of recreational runners, with a focus on understanding its characteristics and the motivations of recreational athletes for including ST in their routines. To this end, 801 recreational runners (493 male and 308 female) completed a structured questionnaire regarding their training habits, the inclusion of ST, and its characteristics, concerning the type of ST, training volume, and the reasons for including ST in their training programs. To assess the possible associations between categorical variables, data were analyzed using the chi-square test for independent samples. Approximately 625 runners (78.1%) reported that they included ST in their training routine, with a statistically significant difference between the sexes (men: 73.5% vs. women: 85.4%; X2 = 14.09; p = 0.01). Traditional strength training (TST) was the predominant type of ST included (78.5%), with most participants performing 2-4 sets and 8-12 repetitions per set at a frequency of 3-4 sessions per week. The importance of ST was primarily attributed to performance improvement (85%). The results suggest that recreational runners incorporate different types of ST into their training routines, with TST being the predominant type perceived by runners as a valuable asset for improving running performance.

Instrumenting Parkrun: Usefulness and Validity of Inertial Sensors

The analysis of running gait has conventionally taken place within an expensive and restricted laboratory space, with wearable technology offering a practical, cost-effective, and unobtrusive way to examine running gait in more natural environments. This pilot study presents a wearable inertial measurement unit (IMU) setup for the continuous analysis of running gait during an outdoor parkrun (i.e., 5 km). The study aimed to (1) provide analytical validation of running gait measures compared to time- and age-graded performance and (2) explore performance validation. Ten healthy adults (7 females, 3 males, mean age 37.2 ± 11.7 years) participated. The participants wore Axivity AX6 IMUs on the talus joint of each foot, recording tri-axial accelerometer and gyroscope data at 200 Hz. Temporal gait characteristics-gait cycle, ground contact time, swing time, and duty factor-were extracted using zero-crossing algorithms. The data were analyzed for correlations between the running performance, foot strike type, and fatigue-induced changes in temporal gait characteristics. Strong correlations were found between the performance time and both the gait cycle and ground contact time, with weak correlations for foot strike types. The analysis of asymmetry and fatigue highlighted modest changes in gait as fatigue increased, but no significant gender differences were found. This setup demonstrates potential for in-field gait analysis for running, providing insights for performance and injury prevention strategies.

A Systematic Review of the Mediators of Resistance Training Behavior

BACKGROUND

Resistance training (RT) has been identified as an important lifestyle activity for health. While systematic reviews have examined behavior change techniques (BCTs) used in interventions and potential correlates of RT behavior, the connection between BCTs and changes in putative mediators and RT participation have yet to be linked. The purpose of this review was to examine RT intervention effects, as coded by BCT clusters, on behavior change via capability, opportunity, and motivation as putative mediators of that change.

METHOD

Literature searches were concluded in January of 2023, using three databases. Eligible studies included a comparison group, assessed RT as an outcome, included BCTs, assessed potential mediators, and were in English. The initial search yielded 1050 hits, which was reduced to 5 to independent RT interventions. Screening of previous reviews yielded three additional papers for a total of 8 papers. Each paper was assessed for the associations between intervention effects (as BCT clusters) on mechanisms of action (a path), effects of mechanisms of action on behavior (b path), and indirect (ab path) and direct (c path) effects of BCT clusters.

RESULTS

There was support that interventions had significant effects on capability and opportunity with inconclusive effects on motivation (a path). Both capabilities and motivation had associations with RT behavior (b path). The examined studies showed that changes in capabilities have the strongest support as a mediator with some support for motivation as a mediator (ab path). Studies that used more BCT clusters seemed to have a more positive effect on behavior, yet there were no trends to suggest any one crucial BCT cluster (c path).

CONCLUSION

Current evidence suggests that capabilities and motivation are important to target in RT interventions. Future interventions would be well suited to utilize behavior change techniques that address these mediators.

Pediatric Concussion Injuries in Soccer: Emergency Department Trends in the United States From 2012 to 2023

Background

Because of growing concerns regarding repeated head trauma, in 2016, the United States Soccer Federation (USSF) banned headers for athletes aged ≤10 years and limited athletes aged 11 to 13 years to practicing headers for 30 minutes per week.

Purpose

To assess whether the USSF header policy was associated with fewer soccer-related concussions after the 2015 season.

Study Design

Descriptive epidemiology study.

Methods

A retrospective cohort from the National Electronic Injury Surveillance System database was assessed. Age, sex, and injury type were extracted for all soccer-related emergency department visits between January 1, 2012, and December 31, 2023. Univariate and multiple regression analyses were used to assess concussions as a percentage of all soccer-related injuries based on sex, age group (6-9, 10-13, and 14-17 years), and year. The following time frames were assessed: 2012-2015, 2016-2019, and 2020-2023.

Results

The proportion of concussions decreased from 8.2% of all soccer-related injuries in 2012-2015 to 6.1% in 2020-2023 (P < .01). The relative risk reduction for soccer-related concussions presenting to an emergency department in 2020-2023 compared with 2012-2015 was 25.6%. Overall, the proportion of concussions among 10- to 13-year-old and 14- to 17-year-old players was higher than for 6- to 9-year-old players (6.6% and 8.9% vs 4.9%, respectively; P < .01). Despite having a lower frequency of soccer-related injuries overall, female players had a greater proportion of concussions than male players (9.6% vs 6.2% of all soccer-related injuries; P < .01). In the multiple regression analysis, injuries that occurred in 2020-2023 were associated with lower odds of concussion compared with 2012-2015 (odds ratio [OR], 0.75 [95% CI, 0.69-0.81]). Compared with 6- to 9-year-old and male players, the 10- to 13-year-old (OR, 1.30 [95% CI, 1.16-1.45]), 14- to 17-year-old (OR, 1.79 [95% CI, 1.61-1.99]), and female players (OR, 1.53 [95% CI, 1.43-1.63]) were associated with higher odds of concussion.

Conclusion

A 25.6% reduction in the relative risk of presenting to the emergency department with a soccer-related concussion was found when comparing 2020-2023 (after USSF header policy implementation) with 2012-2015 (before policy implementation). The USSF youth soccer header policy may improve player safety by reducing head impacts in the pediatric population.

Co-creation of injury prevention measures for competitive adolescent distance runners: knowledge, behavior, and needs of athletes and coaches enrolled on England Athletics' Youth Talent Programme

This study assessed the knowledge, behavior, and needs of competitive adolescent (16-18 years) distance runners and distance running coaches enrolled as part of England Athletics' Youth Talent Programme in relation to the prevention of running-related injury (RRI). Two online surveys were developed and distributed to the distance runners (survey one) and coaches (survey two). Both surveys included sections related to: (1) current knowledge; (2) current behavior; (3) need and support for RRI prevention measures; and (4) possible content and form of RRI prevention measures. A total of 39 distance runners (36% of total possible sample) completed survey 1, and 29 coaches (32% of total possible sample) completed survey 2. Key findings included that the majority of distance runners and coaches: (1) agreed that it is 'very important' to try to prevent RRI; (2) are currently implementing something in practice (e.g., strength training) to prevent RRI; and (3) view the creation of RRI prevention measures as an important initiative. Differences between distance runners and coaches were identified in relation to their understanding of the most common causes of RRI. Interestingly, distance runners identified a modifiable cause of RRI (i.e., too much training) as the most common cause of RRI, while coaches selected a non-modifiable cause of RRI (i.e., growth and maturation). These key findings were supplemented by competitive adolescent runners and distance running coaches detailing their delivery preferences for such RRI prevention measures. Results from this study will help inform subsequent steps of the larger co-creation process, with an emphasis on developing multifaceted and context-specific RRI prevention measures that are deemed to be feasible and acceptable for real-world implementation.

Epidemiology of Testicular Trauma in Sports: Analysis of the National Electronic Injury Surveillance System Database

BACKGROUND

The epidemiology of testicular trauma in sports on a national scale has not been well studied. Timely management and treatment after testicular trauma is critical to avoid serious, long-term ramifications of mismanagement.

OBJECTIVE

The aim was to analyze trends in sports-related testicular trauma based on specific sports and patient demographic characteristics over time.

METHODS

The National Electronic Injury Surveillance System was queried for emergency department cases between 2012 and 2021 with injuries in the pubic region related to 10 commonly played sports. Variables examined included patient age, race, disposition, and sport using incidence rate, incidence rate ratios, and χ2 analysis.

RESULTS

There were an estimated 28,844 emergency department cases of sports-related testicular trauma between 2012 and 2021. Young patients, aged between 10 and 14 years and 15 and 19 years, accounted for most cases, and results of χ2 analysis showed a significant difference in incidence based on age group (p < 0.01). Most injuries occurred while athletes played basketball, football, and soccer (73.6%).

CONCLUSIONS

Sports-related testicular trauma injury rates remained steady between 2012 and 2021, which suggests greater efforts are necessary to reduce the incidence of sports-related testicular trauma. Education efforts should focus on 10- to 19-year-olds because they have the highest incidence. Given the high incidence in sports like basketball and soccer compared with football and lacrosse, testicular trauma seems to be a risk for athletes competing both recreationally and competitively.

Investigating the beliefs of Saudi females regarding physical activity: a qualitative exploration

PURPOSE

Saudi women have been deprived of equal access to and opportunities for an active lifestyle due to sociocultural restrictions. Using the theory of planned behaviour, this elicitation study aimed to explore the salient beliefs of young Saudi women aged 18-35 regarding physical activity (PA).

METHODS

A descriptive qualitative methodology was utilized using a semi-structured interview. A total of 25 transcribed interviews were coded. Content analysis was used to identify the salient beliefs and to rank-order the beliefs using an adaptation of Burnard's model.

FINDINGS

Thirty-five salient beliefs were identified as dominant factors in the decision to engage in PA. The salient beliefs about PA are classified as positive (related to advantages, social approval, and enabling) and negative (related to disadvantages, social disapproval, and barriers). These included behavioural beliefs (concerning physical/psychological well-being and social opportunities), normative beliefs (concerning family, community, international and local media influencers' expectations), and control beliefs (concerning personal, social, natural, and built environment enablers as well as constraints).

CONCLUSIONS

Due to the elicited beliefs, young women may be able to adopt more active lifestyles and change their inactive behaviour. Addressing negative beliefs can help change their inactive behaviour. Strengthening positive beliefs and facilitators is also beneficial.

Mediating Role of Job Satisfaction in the Relationship Between Leisure-Time Physical Activity and Emotional State of Healthcare Workers: A Cross-Sectional Survey

BACKGROUND

Work-related stress among healthcare employees can lead to burnout, worsened mood, and job dissatisfaction. Although physical activity is known to enhance mood and mental health, its impact on job satisfaction and emotional well-being in healthcare workers is under-researched. This study aimed to explore the associations between leisure-time physical activity (LTPA), job satisfaction, and emotional state and to investigate the mediating role of job satisfaction in the effect of LTPA on the emotional state of healthcare workers.

METHODS

A self-administered questionnaire, including items on LTPA, job satisfaction, and the emotional state, was distributed to 98 healthcare workers affiliated with the Bari Polyclinic Hospital (Mean age = 46.3; SD = 15.4 years). Composite measures of global job satisfaction and emotional state were extracted by Factor Analysis using the principal components method. The relationship between LTPA, job satisfaction, and the emotional state was investigated through General Linear Model (GLM) mediation models.

RESULTS

There was no significant direct effect of LTPA on negative emotional states (β = -0.08, p = 0.37). However, job satisfaction significantly mediated this relationship (β = -0.09, p = 0.04), indicating that engaging in LTPA increased job satisfaction, which in turn reduced negative emotional states. Similarly, LTPA did not have a significant direct effect on positive emotional states (β = 0.06, p = 0.48), but it indirectly resulted in increased positive emotional states through its positive impact on job satisfaction (β = 0.12, p = 0.03).

CONCLUSIONS

The findings indicate that LTPA indirectly influences both negative and positive emotional states through job satisfaction. Engaging in LTPA enhances job satisfaction, which subsequently leads to reductions in negative emotional states and increases in positive emotional states among healthcare workers. These results underscore the importance of promoting physical activity as a strategy to improve job satisfaction (JS) and the emotional well-being of healthcare workers.

Epidemiology of Sports-Related Tendon Ruptures Presenting to Emergency Departments in the United States

BACKGROUND

Participation in recreational and competitive sports can predispose people to musculoskeletal injuries. Chronic overuse with insufficient recovery, overloading, and direct contact can result in acute primary tendon ruptures. There is scarce literature regarding the epidemiology of sports-related acute primary tendon ruptures in the United States (US).

PURPOSE

To identify the incidence rate (IR) of sports-related acute primary tendon ruptures presenting to US emergency departments using the National Electronic Injury Surveillance System (NEISS) database and describe the trends in the IR from 2001 to 2020.

STUDY DESIGN

Descriptive epidemiology study.

METHODS

The NEISS database was queried using injury case narratives; cases with a clear diagnosis of an acute primary tendon rupture were included in the final analysis. National estimates, estimated IRs (reported as per 1,000,000 person-years at risk), and temporal trends in the annual IR (reported as average annual percent change) of acute primary tendon ruptures were calculated using NEISS sample estimates and US Census Bureau population estimates.

RESULTS

An estimated total of 141,382 patients (95% confidence interval [CI], 107,478-175,286) presented to US emergency departments with a sports-related tendon rupture over the study period (IR, 22.9 person-years at risk [95% CI, 17.4-28.3]). The mean age was 37.7 years (95% CI, 37.0-38.5). Of all cases of a tendon rupture identified from 2001 to 2020, 60.1% were secondary to exercise/sports-related injury mechanisms. An Achilles tendon rupture was the most common injury, representing 55.9% of cases. Basketball was the most common sports-related injury mechanism, accounting for 36.6% of cases. The overall injury rate in male patients was 7.7 times that of female patients (IR ratio, 7.7 [95% CI, 4.4-13.5]; P < .05). The annual incidence of all sports-related tendon ruptures in the US increased significantly from 2001 to 2020 (average annual percent change, 1.9 [95% CI, 1.0-2.8]; P < .01).

CONCLUSION

Recreational/competitive sports participation accounted for a large proportion of acute primary tendon ruptures in the US during the study period.

Validity and reliability of running gait measurement with the ViMove2 system

Running biomechanics have traditionally been analysed in laboratory settings, but this may not reflect natural running gait. Wearable technology has the potential to enable precise monitoring of running gait beyond the laboratory. This study aimed to evaluate the analytical validity and intra-session reliability of temporal running gait outcomes measured by the ViMove2 wearable system in healthy adults. Seventy-four healthy adults (43 males, 31 females, aged 18-55 years) wore the inertial device, ViMove2 on the tibia. Participants ran on a treadmill for one minute at various speeds (8, 10, 12, 14km/hr), completed in a standardised shoe (Saucony Guide Runner). Running gait was measured with the ViMove2 wearable and 3D motion capture (Vicon). Temporal running gait outcomes included ground contact time (GCT) and cadence (steps/min). GCT and cadence from the ViMove2 had face validity with expected changes in outcome with different running speeds, but ViMove2 tended to over-estimate GCT, and under-estimate cadence compared to the reference, especially at slower speeds. GCT demonstrated moderate to good agreement to the reference at speeds >10km/hr, but poor agreement at 8km/hr and within female runners. Cadence had moderate to excellent agreement across speeds compared to the reference. GCT and cadence had excellent reliability across speeds, but at 8km/hr GCT had good agreement between trials. Overall, temporal gait outcomes of GCT and cadence can be measured with the ViMove2, but accuracy and reliability are impacted at slow running speeds and within female runners. Future work is needed to clarify sex or speed-dependent corrections to algorithms / outcomes to aid interpretation and application.

Look, over there! A streaker! - Qualitative study examining streaking as a behaviour change technique for habit formation in recreational runners

Background

Running as a form of physical activity is beneficial to overall health and wellbeing. The aim of the study is to examine 'run streaking' (i.e. running on consecutive days, for a minimum period of time or distance, typically at least one mile) as a technique for habit formation and behaviour change.

Methods

Qualitative semi-structured interviews with 21 recreational adult runners (11 female and 10 male). Run streak length ranged from a minimum of 100 days to over 4500 days. Transcripts were analysed using a hybrid deductive-inductive thematic analysis.

Results

Run streaking was reported to lead to several benefits, health improvements and a sense of accomplishment, although many run streakers reported running through injuries and lack of recovery. Accounts of run streaking showed features of automaticity indicative of habitual behaviour. Other behavioural processes identified included motivation, identity, self-regulation and social support. Behavioural streaking showed the potential to influence change in behaviours other than running.

Conclusion

Accounts of run streaking demonstrate an interplay between automatic and deliberate processes in the maintenance of running behaviour. Behavioural streaking is a technique that could be used in other behaviour change contexts beyond running to support habit formation.

Running shoe cushioning properties at the rearfoot and forefoot and their relationship to injury: study protocol for a randomised controlled trial on leisure-time runners

Previous work has demonstrated the protective effect of shoe cushioning on injury risk in leisure-time runners, but most models currently available on the market have greater cushioning than those investigated so far. Also, the optimal level of cushioning and the role of cushioning on the forepart of the shoe for injury prevention are still unknown. The main aim of this study is to determine whether (1) current 'extra soft' cushioning material at the rear part of the shoe reduces injury risk compared with stiffer material and (2) cushioning under the forepart of the shoe also contributes to injury risk reduction. This randomised trial with a 6-month intervention will involve 1000+ healthy leisure-time runners who will randomly receive one of the three running shoe versions. Study shoe versions will differ in their cushioning properties (ie, stiffness) at the rear or the forepart. Participants will self-report any lower limb or lower back problems on a dedicated electronic system every week, while the system will collect training data from the participant's sports watch. Time-to-event analyses will be used to compare injury risk between the three study groups and to investigate the association between the runner's characteristics, cushioning level and position, training and injury risk. The study was approved by the National Ethics Committee for Research (Ref: 202405/02 v2.0), and the protocol has been registered on https://clinicaltrials.gov/ (NCT06384872, 02/08/2024). Outcomes will be disseminated through presentations at international conferences and publications in peer-reviewed journals, popular magazines and specialised websites.

Can Foot Orthoses Benefit Symptomatic Runners? Mechanistic and Clinical Insights Through a Scoping Review

BACKGROUND

Running is a widely practiced sport worldwide associated with a host of benefits on cardiovascular, metabolic, musculoskeletal, and mental health, but often leads to musculoskeletal overuse injuries. The prescription of a foot orthosis (FO) is common to manage musculoskeletal impairments during physical activity or functional tasks. Although FOs are frequently prescribed by clinicians for symptomatic populations of runners, the existing literature supporting the prescription of FOs in runners has predominantly focused on either uninjured individuals or a mix of uninjured and symptomatic populations. Thus, the effects of FOs on the treatment and/or prevention of overuse running injuries need to be investigated to guide future research and assist clinicians in their decision-making process.

MAIN BODY

This scoping review aimed to evaluate the immediate and long-term effects of FOs on lower limb biomechanics, neuromuscular parameters, and pain and disability in symptomatic runners, and to identify factors that may influence the effects of FOs. Five databases (CINAHL, SPORTDiscus, MEDLINE, Embase, and Web of Science) were searched, resulting in 2536 studies. A total of 30 studies, published between 1992 and 2023 (730 symptomatic runners), were included following the removal of duplicates and the screening process. Wearing FOs while running is related to an immediate and a long-term decrease in pain and symptoms of overuse running injuries. Also, wearing FOs while running decreases eversion at the foot/ankle complex, leads to a more lateral plantar pressure at the heel and forefoot, and may change running motor control strategies. Finally, the effectiveness of FOs is influenced by its added features.

CONCLUSIONS

This study provides recommendations for future research such as the need for standardized methods in describing FOs, considering participant characteristics such as foot morphology, and comparing different types of FOs. Also, this scoping review provides valuable insights for guiding the prescription and design of FOs, and suggests that integrating FOs into a comprehensive treatment plan may yield better results than standalone first-line treatments. Nonetheless, this scoping review highlights the need for future research to explore the optimal integration of FOs into injury-specific treatment plans.

Running Plus Strength Training Positively Affects Muscle Strength and Quality in Both Younger (Below 50 Years Old) and Older (Above 50 Years Old) Women

BACKGROUND/OBJECTIVES

Sarcopenia is a muscular disease characterized by loss of muscular strength and function, affecting mainly women, and associated with increased mortality risk. The aim of this study was to compare active women with inactive women of different age groups regarding muscle mass, strength, and muscle quality.

METHODS

This study included 147 women (85 runners and 62 inactive), divided into <50 and ≥50 years old. Participants were evaluated for knee flexor and extensor peak torque (PT), body composition, and training habits.

RESULTS

For knee extensor muscles, there was an age group effect (F(2.146) = 40.5; p < 0.001) on absolute PT (Nm); an age group effect (F(2.146) = 44.1; p < 0.001) and a physical activity group effect (F(2.146) = 113.0; p < 0.001) on PT adjusted by body mass (Nm/kg); and an age group effect (F(2.146) = 36.9; p < 0.001) and a physical activity group effect (F(2.146) = 6.1; p = 0.014) on PT adjusted by lean mass (Nm/kgLM). There was no interaction effect.

CONCLUSION

In both age groups, active women had greater strength and higher muscle quality than inactive women, but the difference in strength, muscle mass, and muscle quality between younger and older women were the same among runners and inactive women.

The effects of core muscle fatigue on lower limbs and trunk during single-leg drop landing: A comparison between recreational runners with and without dynamic knee valgus

BACKGROUND

A deficit in neuromuscular trunk control can impact the lower limb motion, predisposing runners to injuries. This deficit may show a greater impact on runners with dynamic knee valgus. This study aimed to compare the effect of core fatigue on kinetic, kinematic, and electromyographic parameters of the trunk and lower limbs during single-leg drop landing between runners with and without dynamic knee valgus.

METHODS

Twenty-seven recreational runners were allocated to the valgus (n = 14) and non-valgus groups (n = 13). They performed the test before and after a fatigue protocol, taking a step forward and landing on the force platform while maintaining balance. The fatigue protocol included isometric and dynamic exercises performed consecutively until voluntary exhaustion. The vertical ground reaction force, the sagittal and frontal plane angles, and the electromyographic activity were evaluated. The integral of electromyographic activity was calculated into three movement phases. ANOVA with repeated measures was used to verify the group, time, and interaction effects.

RESULTS

After fatigue, both groups showed a significant reduction in the minimum (p = 0.01) and maximum (p = 0.02) knee angles in the frontal plane (more dynamic knee valgus) and greater gluteus medius activity (p = 0.05) from the peak of knee flexion to the end of the movement. The valgus group had a greater hip excursion (p = 0.01) and vertical linear shoulder displacement (p = 0.02) than the non-valgus.

CONCLUSION

Our results suggest that core fatigue can impact the local muscle and the distal joint and that the groups presented different strategies to deal with the demand during landing.

Comparison of Weekly Training Load and Acute: Chronic Workload Ratio Methods to Estimate Change in Training Load in Running

CONTEXT

Before examining the impact of training load on injury risk in runners, it is important to gain insight into the differences between methods that are used to measure change in training load.

OBJECTIVE

To investigate differences between 4 methods when calculating change in training load: (1) weekly training load; (2) acute : chronic workload ratio (ACWR), coupled rolling average (RA); (3) ACWR, uncoupled RA; (4) ACWR, exponentially weighted moving average (EWMA).

DESIGN

Descriptive epidemiology study.

SETTING

This study is part of a randomized controlled trial on running injury prevention among recreational runners. Runners received a baseline questionnaire and a request to share global positioning system training data.

PATIENTS OR OTHER PARTICIPANTS

Runners who registered for running events (distances 10-42.195 km) in the Netherlands.

MAIN OUTCOME MEASURE(S)

The primary outcome measure was the predefined significant increase in training load (weekly training loads ≥ 30% progression and ACWRs ≥ 1.5), based on training distance. Proportional Venn diagrams visualized the differences between the methods.

RESULTS

A total of 430 participants (73.3% men; mean age = 44.3 ± 12.2 years) shared their global positioning system training data for a total of 22 839 training sessions. For the weekly training load, coupled RA, uncoupled RA, and EWMA method, respectively, 33.4% (95% CI = 32.8, 34.0), 16.2% (95% CI = 15.7, 16.6), 25.8% (95% CI = 25.3, 26.4), and 18.9% (95% CI = 18.4, 19.4) of the training sessions were classified as significant increases in training load. Of the training sessions with significant increases in training load, 43.0% from the weekly training load method were different than the coupled RA and EWMA methods. Training sessions with significant increases in training load based on the coupled RA method showed 100% overlap with the uncoupled RA and EWMA methods.

CONCLUSIONS

The difference in the change in training load measured by weekly training load and ACWR methods was high. To validate an appropriate measure of change in training load in runners, future research on the association between training loads and running-related injury risk is needed.

Incidence and biomechanical risk factors for running-related injuries: A prospective cohort study

Background

Injuries among runners is significant, yet the contributing risk factors remain elusive. The objective of this study was to examined the incidence and biomechanical elements associated with running-related injuries.

Methods

A 24-week prospective study was carried out. Injury incidence was calculated per 1000 h of running, with participants completing bi-monthly online questionnaires. Biomechanical risk factors, encompassing plantar pressure, muscle strength of hip and knee muscles, core stability, dorsiflexion, passive hip internal rotation, lower extremity length, Q-angle, and shank-forefoot alignment, were assessed at baseline. Logistic regression was used to investigate the relationship between injury incidence and these biomechanical risk factors.

Results

Ninety-eight runners participated in the study. Injury incidence was 8.1 per 1000 h of running, with 41 runners experiencing musculoskeletal injuries during the follow-up period. The knee emerged as the most commonly affected joint, constituting 28.4 % of injuries. The Odds Ratio for hip external rotator muscle strength was .84 (95 % Confidence Interval = .71 - .99).

Conclusion

Greater force during hip external rotation was identified as a protective factor against running injuries. These findings bear significance for the formulation and implementation of preventive strategies.

Sports participation plays a relevant role in the relationship between birth weight and bone mineral content in adolescents

The Developmental Origins of Health and Disease hypothesis (DOHaD) proposes that growth during the prenatal period might play a critical role in health, affecting the development of diseases, such as osteoporosis. Bone health is particularly affected by human behaviors when sports participation constitutes the main manifestation of physical exercise. The aim of this study is to analyze the relationship between birth weight (BW) and bone mineral content (BMC) among adolescents, as well as to identify if sports participation and maturity can affect this relationship. The sample was composed of adolescents with ages ranging from 11 to 18 years, stratified according to normal birth weight (n = 331), low birth weight (n = 36), and macrosomia (n = 47), extracted from a wider cross-sectional study (ABCD Growth Study). BW was self-reported by the adolescent's parent. Sports participation was assessed by face-to-face interview. BMC was assessed using dual-energy X-ray absorptiometry. In the multivariate models, the relationships between BW and BMC remained non-significant, while sports participation was significantly related to BMC on lower limbs among boys (r = 0.154; p value = .001) and BMC of upper limbs among girls (r = 0.124; p value = .044). APHV was related to BMC of upper limbs among boys (r = 0.137; p value = .001). In conclusion, BMC was not affected by BW, while this phenomenon seems to be significantly affected by the positive impact of sports participation and maturation on it.

Building running-friendly cities: effects of streetscapes on running using 9.73 million fitness tracker data in Shanghai, China

The association between built environment and physical activity has been recognized. However, how and to what extent microscale streetscapes are related to running activity remains underexplored, partly due to the lack of running data in large urban areas. Moreover, few studies have examined the interactive effects of macroscale built environment and microscale streetscapes. This study examines the main and interactive effects of the two-level environments on running intensity, using 9.73 million fitness tracker data from Keep in Shanghai, China. Results of spatial error model showed that: 1) the explanatory power of microscale streetscapes was higher than that of macroscale built environment with R2 of 0.245 and 0.240, respectively, which is different from the prior finding that R2 is greater for macroscale built environment than for microscale streetscape; 2) sky and green view indexes were positively associated with running intensity, whereas visual crowdedness had a negative effect; 3) there were negative interactions of land use Herfindahl-Hirschman index with sky and green view indexes, while a positive interaction was observed for visual crowdedness. To conclude, greener, more open and less visually crowded streetscapes, can promote running behavior and enhance the benefits of land use mix as well. The findings highlight the importance of streetscapes in promoting running behavior, instead of a supplement to macroscale built environment.

A social media game to increase physical activity among older adult women: protocol of a randomized controlled trial to evaluate CHALLENGE

BACKGROUND

Older adult women often do not engage in sufficient physical activity (PA) and can encounter biological changes that exacerbate the negative effects of inadequate activity. Wearable activity monitors can facilitate PA initiation, but evidence of sustained behavior change is lacking. Supplementing wearable technologies with intervention content that evokes enjoyment, interest, meaning, and personal values associated with PA may support long term adherence. In this paper, we present the protocol of an NIA-funded study designed to evaluate the efficacy of CHALLENGE for increasing step count and motivation for PA in insufficiently active older women (Challenges for Healthy Aging: Leveraging Limits for Engaging Networked Game-based Exercise). CHALLENGE uses social media to supplement wearable activity monitors with the autonomy-supportive frame of a game. We hypothesize that CHALLENGE will engender playful experiences that will improve motivation for exercise and lead to sustained increases in step count.

METHODS

We will recruit 300 healthy, community dwelling older adult women on a rolling basis and randomize them to receive either the CHALLENGE intervention (experimental arm) or an activity monitor-only intervention (comparison arm). Participants in both groups will receive a wearable activity monitor and personalized weekly feedback emails. In the experimental group, participants will also be added to a private Facebook group, where study staff will post weekly challenges that are designed to elicit playful experiences while walking. Assessments at baseline and 6, 12, and 18 months will measure PA and motivation-related constructs. We will fit linear mixed-effects models to evaluate differences in step count and motivational constructs, and longitudinal mediation models to evaluate if interventional effects are mediated by changes in motivation. We will also conduct thematic content analysis of text and photos posted to Facebook and transcripts from individual interviews.

DISCUSSION

By taking part in a year-long intervention centered on imbuing walking behaviors with playful and celebratory experiences, participating older adult women may internalize changes to their identity and relationship with PA that facilitate sustained behavior change. Study results will have implications for how we can harness powerful and increasingly ubiquitous technologies for health promotion to the vast and growing population of older adults in the U.S. and abroad.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier NCT04095923. Registered September 17th, 2019.

The treatment, outcomes and management of hand, wrist, finger, and thumb injuries in the professional/amateur contact sport athletes: A scoping review

INTRODUCTION

Amateur and professional participation in sport and physical activity worldwide is increasing in popularity, which in turn is increasing the volume and types of injuries sustained by athletes. Ensuring these injuries are treated appropriately and efficiently is paramount for athletes' recovery and return to sport in a timely and safe manner.

METHODS

A scoping review to map the evidence regarding the treatment, outcomes and management of hand, wrist, finger, and thumb injuries in the professional/amateur athlete from contact sports. A search of seven electronic databases; SPORTdiscus, CINAHL, Medline, Scopus, Web of Science, Embase and Cochrane Library and grey literature was conducted in January 2024. The reporting of the review is in line with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews Checklist. Inductive content analysis was used to examine the data and the Critical Appraisal Skills Programme was used to appraise the quality of the included studies.

RESULTS

Eight papers met the inclusion criteria and three themes emerged addressing the return to play/sport, surgical and conservative treatment and the most common/reoccurring injuries sustained from contact sports.

CONCLUSION

Managing hand, wrist, finger, and thumb injuries in athletes requires a varied approach depending on the type of injury, treatment options, and external pressures. While conservative treatment is common and effective, surgical intervention may be necessary in certain cases to improve recovery and facilitate a faster return to sport. Preventive measures in high-risk sports settings could help reduce the incidence of these injuries.

Return to Play and Performance After Anterior Cruciate Ligament Reconstruction in Soccer Players: A Systematic Review of Recent Evidence

BACKGROUND

The available literature referring to the return to play (RTP) and performance after anterior cruciate ligament reconstruction (ACLR) has already been comprehensively summarized in team sports such as basketball or American Football. Therefore, in this sense, it is necessary to synthesize evidence relating to the mentioned parameters in soccer players who underwent ACLR.

OBJECTIVE

The aim of this systematic review was to examine RTP and the performance of soccer players after ACLR.

METHODS

Three electronic databases, Web of Science, Scopus, and PubMed, have been comprehensively searched to identify relevant articles. The following inclusion criteria were applied: (1) the sample of respondents consisted of soccer players irrespective of their age, sex, or level of competition; (2) athletes experienced anterior cruciate ligament injury and underwent ACLR; (3) outcomes estimated referred to the RTP, RTP at the preinjury level of competition, RTP time, performance, and career duration of soccer players; (4) studies were written in the English language. The methodological quality of the research was evaluated using the Methodological Index for Non-Randomized Studies (MINORS).

RESULTS

Databases searched yielded a total of 694 studies, of which 17 fulfilled the eligibility criteria and were included in the final analysis. These included 3657 soccer players, 2845 males and 812 females, who underwent ACLR and most commonly competed at the elite, national, amateur, and recreational levels. The results obtained indicated that 72% of soccer players successfully RTP and 53% RTP at the preinjury level of participation after ACLR. In addition, recent evidence provided in this literature review demonstrated that mean RTP time was 264 days or 8.7 months. Moreover, the majority of the studies unambiguously suggested that performance related to statistical aspects noticeably deteriorated compared with both the preinjury period and noninjured athletes. The mean career length of soccer players following ACL surgery was approximately between 4 and 5 years.

CONCLUSION

Although a high percentage of athletes RTP after a relatively short period of absence from the sports field compared with other sports closely related to soccer, ACLR negatively impacts soccer players' performance and career duration.

Adolescent track and field injuries presenting to US emergency departments

OBJECTIVES

Track and field (T&F) is a highly popular sport for adolescents. The diversity of running, jumping, and throwing events within the sport can result in unique injury patterns for adolescent track and field participants. The purpose of this study was to estimate injury risk in adolescent T&F and describe the types of injuries resulting in ED visits, classified by T&F events.

METHODS

Emergency department (ED) data from the National Electronic Injury Surveillance System were obtained for a 20-year period from 2000 through 2019. Cases involving 14- to 18-year-olds participating in T&F were classified by sex, case severity, involved body region, and the T&F event patients were engaged in at the time of their injury. National estimates and Injury rates were calculated using national high school T&F participation data. Longitudinal trends in ED visits were measured using linear regression. Rate ratios (RRs) were used to compare the risk and severity of ED visits by sex.

RESULTS

8,060 track and field related ED encounters were observed, representing an estimated 272,227 encounters nationally over the 20-year study period. The rate of ED encounters increased significantly over the study period (p < 0.001). Adolescent females exhibited a higher rate of ED encounters (RR: 1.23, 95% CI: 1.22-1.24), but a lower rate of hospital admissions (RR: 0.68, 95% CI: 0.64-0.73) compared to males. The lower extremity was the most commonly injured body region for most T&F events, but this differed for sprinting, high jumping, shot put, and javelin events. Most T&F events resulted in unique injury patterns characteristic of their athletic demands.

CONCLUSIONS

There was an increasing trend of ED visits from adolescent T&F participants throughout the 20-year study period with different injury patterns observed by sex and T&F event discipline.

What choices of visual correction do people make for recreational running?

PURPOSE

Recreational runners who need refractive visual correction will need to choose the type of visual correction (spectacles, contact lenses, or no correction) to wear when running. The prevalence of correction choices and distinguishing demographic features associated with these choices of correction were investigated.

METHODS

A 26-item online questionnaire covering demographics, running habits, and visual corrections used was answered by 941 people. Participants were aged 18 years or older, considered themselves a recreational runner and reported needing refractive correction for everyday life. Bivariate analyses and binary logistic regression were used to determine the variables independently associated with including or avoiding types of correction for running.

RESULTS & CONCLUSIONS

Participants ran an average of 3.8times, 3.6hours, and 33.4km per week. Running habits were not associated with type of visual correction, suggesting that visual correction does not present a barrier to participating in recreational running. Solely using spectacles for running was the most common choice (38.8%) and they were worn for running at least sometimes by 65.8%. Fewer people wore spectacles for running than for general purposes (98.9%), suggesting spectacles have limitations for running. Spectacle wear for running was significantly associated with not having contact lenses available and longer duration of wearing visual correction. Running without correction was a common choice, with 15.5% of the sample only running without correction, and 26.2% running at least sometimes without their visual correction. Not wearing correction was significantly associated with not having contact lenses, a shorter duration of wearing visual correction, and a lower myopic refractive error. Contact lenses were the sole correction for running for 15.6% and were worn for running at least sometimes by 40.5%. Contact lenses were significantly more likely to be used by women and younger runners. Signposting runners to contact lenses if this has not previously been considered is recommended.

Types of leisure-time physical activity participation in childhood and adolescence, and physical activity behaviours and health outcomes in adulthood: a systematic review

BACKGROUND

Youth leisure-time physical activity participation benefits physical activity habits and health outcomes later in life. However, it is unknown if certain types of leisure-time physical activity contribute to these benefits in different ways; this knowledge could enhance public health efforts. This systematic review aimed to synthesise evidence of the longitudinal associations between childhood and adolescent leisure-time physical activity on adulthood physical activity behaviours and health outcomes.

METHODS

A systematic search of the literature was conducted across five databases from inception to July 2022. English, peer-reviewed observational studies with a minimum of two timepoints of data collection were eligible for inclusion. We included studies that investigated the association between participation in leisure-time physical activity types in children and adolescents (i.e., 5-18 years), and physical activity, mental health, or cardiovascular outcomes in adulthood (i.e., ≥ 18 years).

RESULTS

Fourteen studies were included in the review, totalling 34,388 observations across five countries. Running in adolescence was associated with increased adulthood physical activity in both sexes, while sports involvement was associated with an increase in physical activity in males only. Adolescent team sports participation was associated with reduced odds of early adulthood depression, with varying findings for anxiety disorders. There was preliminary evidence of minimum threshold requirements for participation in certain activities before associations with future physical activity or health outcome benefits were observed.

CONCLUSIONS

Preliminary findings suggest that the lifelong behavioural and health benefits of adolescent participation in leisure-time physical activity appear to be related to the type of activity undertaken, with potential differences between sexes. With the rarity of longitudinal studies spanning from childhood into adulthood, these findings provide important insights for public health strategies to optimise lifelong health and physical activity participation.

PROSPERO REGISTRATION

CRD42022347792.

Exercise Adherence in Older and Middle-Aged Adults With Coronary Artery Disease Before and During COVID-19

BACKGROUND

Regular exercise is advised for individuals given a diagnosis of cardiovascular disease. COVID-19 presented challenges to exercise adherence.

OBJECTIVE

The objective of this study was to determine long-term exercise adherence and whether individuals with cardiovascular disease adhered to American Heart Association/American College of Cardiology Foundation guidelines before and during the COVID-19 pandemic.

METHODS

This is an observational cross-sectional study in which men (73%) and women discharged from a multiwide hospital system after an acute coronary event were enrolled. Participants completed 3 questionnaires, including the Exercise Adherence Rating Scale.

RESULTS

Five hundred eighty-two individuals (mean [SD] age, 67 [9.8] years) completed the survey. Fifty-three percent of participants met minimum exercise guidelines during COVID-19. Exercise days per week decreased significantly during COVID-19 in women ( P = .013) but not significant for men ( P = .301). Categorized by age, the decrease was significant for middle-aged women ( P = .002), not older women ( P = .336). Men exercised more minutes per session ( P = .034), and had greater exercise adherence ( P = .003) and greater exercise intensity ( P < .001). Overall, women participated less in cardiac rehabilitation ( P = .046) and reported the greatest disparity in exercise adherence and intensity.

CONCLUSION

Exercise after an acute event is beneficial, and the percentage of individuals meeting recommended guidelines should be higher considering the relationship between exercise and the possibility of future cardiac events. On the basis of the many physical and mental benefits of maintaining exercise, healthcare practitioners are encouraged to screen all patients for exercise adherence with a major emphasis on educating women and older adults.

Junior parkrun pilot in Australia: A real world evaluation

ISSUE ADDRESSED

Regular physical activity is important for children's health. Parkrun supports communities to deliver free, weekly, 5 km events in 22 countries around the world and is the largest physical activity model delivered at scale in the world. Junior parkrun aims to encourage children aged 4-14 years to be active outdoors through providing safe, cost-free and non-competitive weekly timed walk, run or jog over a 2-km distance. The aim of this study is to evaluate the junior parkrun pilot in Australia.

METHODS

A process evaluation was conducted using routinely collected data of junior parkrun participants, as well as a self-completed questionnaire.

RESULTS

A total of 1827 children had registered and participated in at least one junior parkrun over the course of the pilot period. Participants had, on average, attended 10% of the junior parkrun events including and subsequent to their first participation by the end of the study period. Majority of parents (61%) said that junior parkrun had increased their child's physical activity either a little or a lot, and most agreed or strongly agreed that junior parkrun was fun (90%), enjoyable (91%), energising (85%) and challenging (70%).

CONCLUSION

The junior parkrun pilot appears to show promise in Australia for enabling children to engage in physical activity, in their local communities in a fun and inclusive way.

SO WHAT

Parkrun junior can co-exist with other organised sports programs; however, it can also specifically target those not participating in any sports, given the high levels of enjoyment in a non-competitive, non-team environment.

Effects of a 12 week community-based high-level mobility programme on sustained participation in physical activity by adolescents with cerebral palsy: a single subject research design study

PURPOSE

To assess if a high-level mobility programme (HLMP) can promote sustained participation in physical activity by adolescents with cerebral palsy.

METHODS

Eight adolescents with cerebral palsy, Gross Motor Function Classification System levels I-II, 11-16 years, participated in 24 community-based group HLMP sessions across 12 weeks. Participants set attendance, involvement, and physical performance goals, completed activity diaries over 58 weeks and undertook physical capacity tests. Measures of activity frequency and diversity (attendance) and involvement level were collected weekly across baseline (4-6 weeks), intervention (12 weeks), and nine months follow-up (including Covid lockdown).

RESULTS

Median attendance was 23 of 24 HLMP sessions. Attendance goal/s attainment was highest during COVID lockdown. Involvement goals were consistently attained throughout all phases. Physical performance goal/s attainment was highest during intervention phase but reduced during nine months follow-up. Frequency of participation in physical activities varied greatly across study phases (range 0-33 episodes/week) with stable variety of activities and generally high 'involvement.' During the intervention, seven participants improved physical capacity and six maintained, or increased, the gains six months later.

CONCLUSION

Most participants improved physical capacity post-intervention but only some had sustained attendance and involvement in physical activity, highlighting the complexity of physical activity participation.

Quantifying Hitting Load in Racket Sports: A Scoping Review of Key Technologies

PURPOSE

This scoping review aims to identify the primary racket and arm-mounted technologies based on inertial measurement units that enable the quantification of hitting load in racket sports.

METHODS

A comprehensive search of several databases (PubMed, SPORTDiscus, Web of Science, and IEEE Xplore) and Google search engines was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) extension for scoping reviews guidelines. Included records primarily focused on monitoring hitting load in racket sports using commercialized racket or arm-mounted inertial sensors through noncompetitive and competitive racket-sports players.

RESULTS

A total of 484 records were identified, and 19 finally met the inclusion criteria. The largest number of systems found were compatible with tennis (n = 11), followed by badminton (n = 4), table tennis (n = 2), padel (n = 1), and squash (n = 1). Four sensor locations were identified: grip-attached (n = 8), grip-embedded (n = 6), wrist (n = 3), and dampener sensors (n = 2). Among the tennis sensors, only 4 out of the 11 (36.4%) demonstrated excellent reliability (>.85) in monitoring the number of shots hit either during analytic drills or during simulated matches. None of the other racket-sports sensors have undergone successful, reliable validation for hitting-volume quantification.

CONCLUSIONS

Despite recent advancements in this field, the quantification of hitting volume in racket sports remains a challenge, with only a limited number of tennis devices demonstrating reliable results. Thus, further progress in technology and research is essential to develop comprehensive solutions that adequately address these specific requirements.

Sports participation in childhood and adolescence and physical activity intensity in adulthood

OBJECTIVES

The aim of the present study was to analyze the association between sports participation in childhood and adolescence and the practice of physical activity at different intensities in adulthood, and to verify if some sports participation characteristics such as number of sports; type of sport (individual, collective or a combination of both) and total estimated sports participation time are associated with the different physical activity intensities in adulthood.

DESIGN

This is a cross-sectional study.

METHODS

This study included 129 young adults of both sexes aged 18-25 years. Sports participation in childhood (7-10 years) and adolescence (11-17 years) was retrospectively estimated through specific questionnaire. Light, moderate, vigorous and moderate to vigorous intensity physical activity was objectively estimated by accelerometers. To verify the association between SP in childhood and adolescence and BP intensities in adults, multiple linear regression was adopted, with 5% significance.

RESULTS

Analyses showed that, in females, sports participation in childhood (β = 0.315; R2 = 0.14; P = 0.020) and persistence in sports participation (β = 0.364; R2 = 0.18; P = 0.007) were positive predictors of vigorous physical activity in adulthood. In addition, the comparison according to the specificities of the sport practice, indicated that participation in two or more sports in childhood, one sport and collective sports in adolescence and at least one year of sports participation throughout childhood and adolescence were associated with longer time in vigorous physical activity intensity and MVPA (minutes/day) in adult females (P < 0.05).

CONCLUSIONS

It could be concluded that sports participation indicators in childhood and adolescence were considered predictors of vigorous physical activity in adult females. In addition, number of sports, type of sport and practice time in childhood and adolescence seem to predict vigorous and moderate to vigorous levels of physical activity for adult females.

Mechanism of Knee Injuries in the National Basketball Association: A Video-Based Analysis

Background

To characterize the mechanism of knee injuries among NBA players during the 2010-2020 seasons using video-based analysis.

Methods

An injury database of NBA players was queried for knee injuries from the 2006-07 to 2020-21 seasons and cross-referenced with NBA injury reports. Youtube.com was searched to identify available injury footage. The mechanism of knee injury during play was analyzed by three independent reviewers. Non-mechanistic data related to the injury was gathered from news reports and official NBA websites.

Results

A total of 2,868 knee injuries occurred in NBA players from 2010 to 2020 seasons; 121 had high quality videos for analysis. The most common mechanism of injury was knee flexion in valgus with internal rotation (27.3%, p < 0.001), which was associated with injury to the ACL (55.2%, p=0.0001). Injuries occurred most often with control of the ball (62.8%, p=0.0064), while on offense (73.6%, p=0.0001), and without contact (71.1%, p=0.0001). A 28.1% incidence of re-injury was observed in the first 3-year period, and 43.8% of knee injuries required surgery. The average number of games missed due to injury requiring surgery was 55.1 games compared to 8.5 games in those treated nonoperatively (p < 0.0001).

Conclusion

Understanding mechanisms of knee injury may guide preventative strategies and injury management programs in NBA players. Video-based analysis reveals the situational characteristics and mechanisms of knee injuries, but further studies are needed to develop injury prevention programs, efficacy of prevention strategies, and rehabilitation to minimize games missed from these injuries.

Resistance training presents beneficial effects on bone development of adolescents engaged in swimming but not in impact sports: ABCD Growth Study

BACKGROUND

Sports practice during adolescence is important to enhance bone development, although it may provide different effects depending on the mechanical impact present in the sport. Besides, resistance training (RT) may also induce bone changes directly (via muscle contractions) and indirectly (via myokines). However, there have been no studies analyzing the longitudinal influence of engaging in sport with and without added mechanical load. Thus, this study aims to analyze the combined effects of sports participation and resistance training on areal bone mineral density (aBMD) accrual in adolescent athletes participating in swimming and impact sports for 12-months.

METHODS

This was a 12-month longitudinal study. The sample comprised 91 adolescents (21 females) aged 10 to 18 years, engaged in impact sports (basketball, tennis, track & field, baseball and gymnastics, n = 66) and non-impact sport (swimming, n = 25). The sample was divided according to resistance training participation: impact sports only (n = 45), impact sports + resistance training (n = 21), swimming-only (n = 17) and swimming + resistance training (n = 8). aBMD and soft tissues were measured using dual-energy X-ray absorptiometry. Generalized linear models analysis was used for the resistance training (RT) x type of sport interaction in predicting aBMD changes overtime, adjusting for maturation, sex and baseline aBMD.

RESULTS

After 12-months, all groups showed a significant increase in aBMD, except for the swimming groups (regardless of resistant training), which showed a significant loss in spine aBMD (-0.045 [-0.085 to -0.004] g/cm2 in swimming-only and - 0.047 [-0.073 to -0.021] g/cm2 in swimming + RT). In comparisons between groups, only swimming + RT group, compared with swimming-only group presented higher upper limbs aBMD (0.096 g/cm2 [0.074 to 0.118] in swimming + RT vs. 0.046 [0.032 to 0.060] g/cm2 in swimming only; p < 0.05) and whole body less head (WBLH) aBMD (0.039 [0.024 to 0.054] g/cm2 in swimming + RT vs. 0.017 [0.007 to 0.027] g/cm2 swimming-only; p < 0.05).

CONCLUSION

Despite the significant gain in aBMD in all groups and body sites after 12-months, except for the spine site of swimmers, the results indicate that participation in RT seems to improve aBMD accrual in swimmers at the upper limbs and WBLH.

Injury patterns and healthcare utilisation by runners of the New York City Marathon

Objectives

The purpose of this study was to describe injury patterns and healthcare utilisation of marathon runners.

Methods

This was a previously reported 16-week prospective observational study of runners training for the New York City Marathon. Runners completed a baseline survey including demographics, running experience and marathon goal. Injury surveys were collected every 4 weeks during training, as well as 1 week before and 1 week after the race. Injury details collected included anatomic location, diagnosis, onset, and treatment received.

Results

A total of 1049 runners were enrolled. Injuries were reported by 398 (38.4%) during training and 128 (14.1%) during the marathon. The overall prevalence of injury was 447/1049 (42.6%). Foot, knee and hip injuries were most common during training, whereas knee, thigh and foot injuries were most common during the race. The most frequent tissue type affected was the category of muscle, tendon/fascia and bursa. The prevalence of overuse injuries increased, while acute injuries remained constant throughout training. Hamstring injuries had the highest prevalence of diagnosis with 38/564 injuries (6.7%). Of the 447 runners who reported an injury, 224 (50.1%) received medical care. Physical therapy was the most common medical care received with 115/1037 (11.1%) runners during training and 44/907 (4.9%) postrace.

Conclusion

Runners training and participating in a marathon commonly experience injuries, especially of the foot and knee, which often are overuse soft tissue injuries. Half of the injured runners sought out medical care for their injury. Understanding the patterns of injuries affecting marathon runners could help guide future injury prevention efforts.

Effects of 12-week gait retraining on plantar flexion torque, architecture, and behavior of the medial gastrocnemius in vivo

Objective

This study aims to explore the effects of 12-week gait retraining (GR) on plantar flexion torque, architecture, and behavior of the medial gastrocnemius (MG) during maximal voluntary isometric contraction (MVIC).

Methods

Thirty healthy male rearfoot strikers were randomly assigned to the GR group (n = 15) and the control (CON) group (n = 15). The GR group was instructed to wear minimalist shoes and run with a forefoot strike pattern for the 12-week GR (3 times per week), whereas the CON group wore their own running shoes and ran with their original foot strike pattern. Participants were required to share screenshots of running tracks each time to ensure training supervision. The architecture and behavior of MG, as well as ankle torque data, were collected before and after the intervention. The architecture of MG, including fascicle length (FL), pennation angle, and muscle thickness, was obtained by measuring muscle morphology at rest using an ultrasound device. Ankle torque data during plantar flexion MVIC were obtained using a dynamometer, from which peak torque and early rate of torque development (RTD50) were calculated. The fascicle behavior of MG was simultaneously captured using an ultrasound device to calculate fascicle shortening, fascicle rotation, and maximal fascicle shortening velocity (Vmax).

Results

After 12-week GR, 1) the RTD50 increased significantly in the GR group (p = 0.038), 2) normalized FL increased significantly in the GR group (p = 0.003), and 3) Vmax increased significantly in the GR group (p = 0.018).

Conclusion

Compared to running training, GR significantly enhanced the rapid strength development capacity and contraction velocity of the MG. This indicates the potential of GR as a strategy to improve muscle function and mechanical efficiency, particularly in enhancing the ability of MG to generate and transmit force as well as the rapid contraction capability. Further research is necessary to explore the effects of GR on MG behavior during running in vivo.

ChatGPT Generated Training Plans for Runners are not Rated Optimal by Coaching Experts, but Increase in Quality with Additional Input Information

ChatGPT may be used by runners to generate training plans to enhance performance or health aspects. However, the quality of ChatGPT generated training plans based on different input information is unknown. The objective of the study was to evaluate ChatGPT-generated six-week training plans for runners based on different input information granularity. Three training plans were generated by ChatGPT using different input information granularity. 22 quality criteria for training plans were drawn from the literature and used to evaluate training plans by coaching experts on a 1-5 Likert Scale. A Friedmann test assessed significant differences in quality between training plans. For training plans 1, 2 and 3, a median rating of <3 was given 19, 11, and 1 times, a median rating of 3 was given 3, 5, and 8 times and a median rating of >3 was given 0, 6, 13 times, respectively. Training plan 1 received significantly lower ratings compared to training plan 2 for 3 criteria, and 15 times significantly lower ratings compared to training plan 3 (p < 0.05). Training plan 2 received significantly lower ratings (p < 0.05) compared to plan 3 for 9 criteria. ChatGPT generated plans are ranked sub-optimally by coaching experts, although the quality increases when more input information are provided. An understanding of aspects relevant to programming distance running training is important, and we advise avoiding the use of ChatGPT generated training plans without an expert coach's feedback.

Motor skill competence and moderate- and vigorous-intensity physical activity: a linear and non-linear cross-sectional analysis of eight pooled trials

BACKGROUND

Few studies have examined the relationship between motor skill competence and device-measured physical activity in large samples and none have used non-linear modelling. This study assessed the linear and non-linear associations between motor skill competence and physical activity in children using pooled data from eight studies.

METHODS

Cross-sectional ActiGraph accelerometer and motor skills competence data from 988 children (50.8% boys) aged 3-11 years were included. Total, object control and locomotor skill competence were assessed using the Test of Gross Motor Skill Development. Linear mixed models were fitted to examine linear associations between motor skill competence and physical activity. Then, restricted cubic splines models were used to assess potential non-linear relationships. Interactions by sex and age were assessed.

RESULTS

There was evidence of positive linear associations between total skill, and object control and locomotor skills, with moderate- and vigorous-intensity physical activity; however, the associations with total skill competence and object control better fitted a non-linear model. Non-linear models indicated associations were positive but relatively weak in the low to mid ranges of TGMD/object control scores but at high ranges (~ > 70 out of 100/ and ~ 35 out of 50) the association strength increased for both moderate- and vigorous-intensity physical activity. There were sex interactions for locomotor skills only, specifically for vigorous activity with boys having a stronger positive association than girls.

CONCLUSIONS

There appears to be a threshold for object control skill proficiency that children need to reach to enhance their physical activity levels which provides support for a motor skill "proficiency barrier". This provides a tangible benchmark for children to achieve in motor competence programs.

'Benched' the effect of the COVID-19 lockdown on injury incidence in sub-elite football in Australia: a retrospective population study using injury insurance records

OBJECTIVES

The primary aim of this study was to compare injury rates pre- and post-COVID-19 lockdown in sub-elite football (soccer) players by analysing the full season and the first month of each season between 2018 and 2020. Secondary aims were to describe the incidence, location and type of injuries and to compare injuries by age group and sex.

DESIGN

Descriptive epidemiological study.

METHODS

A de-identified insurance database was retrospectively coded using the Orchard Sports Injury Classification System. Injury incidence per 1000 hours as well as incidence rate ratios (IRR) with confidence intervals were calculated.

RESULTS

No significant difference was found in the overall incidence rate in 2020 compared with the 2018 and 2019 seasons (IRR, 1.04 [95% CI, 0.96-1.13]; p = 0.294). However, overall injuries increased by 26% (IRR: 1.26 [95% CI 1.07-1.47]; p < 0.005) and joint sprains increased by 45% (IRR: 1.45 [95% CI 1.14-1.84]; p < 0.005) in the first month of 2020 compared with 2018-2019. Between 2018 and 2020, there were 4149 injury insurance claims, with anterior cruciate ligament (ACL) ruptures accounting for 19% of all injuries. When comparing sex, female players had significantly more ankle sprains whilst male players suffered more dental injuries.

CONCLUSIONS

This study adds to a growing body of evidence investigating injury rates post-COVID-19 lockdowns in sport. Sub-elite players appear to be at higher risk of joint injuries within the first month of training following a period of lockdown. Overall, stakeholders involved in sub-elite football should prioritise knee and ankle joint injury prevention.