The primary aim of my PhD thesis was to investigate the long-term impact of premature birth, defined as any birth occurring before the 37th week of gestation, on the acute physiological responses and adaptation to high-altitude exposure, at rest and during exercise. Specifically, my work aimed to elucidate the mechanisms underlying the specific cardiovascular, cerebrovascular, respiratory, muscular

Objective To develop and evaluate a new patient-reported outcome measure (PROM) to assess people’s knowledge and beliefs about low back pain. Methods This study followed the COnsensus-based Standards for the selection of health Measurement INstruments guidelines. An 18-item preliminary version of the Back pain Knowledge and beliefs Survey (BacKS) was generated based on evidence-based key messages and

Objectives Physical activity guidelines inform policy and practice in promoting healthier lifestyles. The WHO advocates for distinct recommendations for each country to address variation in needs, resources and context. Specific regional recommendations for three underactive populations facing unique barriers to movement are lacking—people with chronic conditions, disability and advanced age. We review

Objective Physical activity confers physical and psychosocial benefits for cancer patients and decreases morbidity and mortality, but adherence varies. High-intensity interval training (HIIT) is time-efficient and may improve adherence. Our aim was to determine barriers and enablers of adherence to HIIT in patients diagnosed with cancer. Design Systematic review and meta-analysis. Data source PubMed-MEDLINE

Objective To evaluate radiographic knee osteoarthritis (OA) progression, development of knee OA, patient-reported outcomes and knee muscle strength at 10-year follow-up after arthroscopic partial meniscectomy (APM) or exercise therapy for degenerative meniscal tears. Methods Randomised controlled trial including 140 participants, with a degenerative meniscal tear and no or minimal radiographic OA changes

Approximately 4400 athletes from 184 nations competed in 22 sports at the 2024 Paris Paralympic Games. However, it is recognised that athletes with more severe disabilities and high support needs are under-represented in sport, and strategies to increase representation are required. Focusing on individuals with cerebral palsy (CP), we present evidence that people with high support needs are also under-represented

In 2014, as part of the outcomes from the inaugural World Heart Federations Emerging Leaders’ work,1 a network of collaborators and change agents set about strengthening the capacity of healthcare professionals (HCPs) to support patients and communities to be more physically active. The intent was to influence the prevention, treatment and rehabilitation of noncommunicable diseases (NCDs) and poor

To develop a core outcome set for Achilles tendinopathy (COS-AT) for use in clinical trials we performed a five-step process including (1) a systematic review of available outcome measurement instruments, (2) an online survey on truth and feasibility of the available measurement instruments, (3) an assessment of the methodological quality of the selected outcome measurement instruments, (4) an online

Objectives To investigate the physical activity (PA) intensity associated with cardiometabolic health when considering the mediating role of cardiorespiratory fitness (CRF). Methods A subsample of males and females aged 50–64 years from the cross-sectional Swedish CArdioPulmonary bioImage Study was investigated. PA was measured by accelerometry and CRF by a submaximal cycle test. Cardiometabolic risk

Objectives Patients with rheumatoid arthritis (RA) have substantially elevated risk for cardiovascular diseases, and low cardiorespiratory fitness (VO2max) is a major mediator. The aim of this assessor-blinded, two-armed multicentre randomised controlled trial was to evaluate the effects of high-intensity interval training (HIIT) and strength exercise on cardiovascular health, physical fitness and

Objective To assess the effectiveness of high-intensity interval training (HIIT) compared with traditional moderate-intensity continuous training (MICT) and/or non-exercise control (CON) for modification of metabolic syndrome (MetS) components and other cardiometabolic health outcomes in individuals with MetS. Design Systematic review and meta-analysis Data sources Five databases were searched from

Objective Health effects of different physical activity domains (ie, during leisure time, work and transport) are generally considered positive. Using Active Worker consortium data, we assessed independent associations of occupational and leisure-time physical activity (OPA and LTPA) with all-cause mortality. Design Two-stage individual participant data meta-analysis. Data source Published and unpublished

A 17-year-old male right-footed footballer presented with a 6-month history of left-sided groin pain which was persistent despite resting for 6 weeks. Pain occurred during running and daily activities including climbing the stairs and turning over in bed. On examination, the cardinal findings were tenderness of the pubic bone near the adductor insertion on the left side and pubic pain during resisted

Objective To review the efficacy of exercise interventions on sport-related concussion (SRC) incidence, as well as on linear and rotational head accelerations, and isometric neck strength and to assess reporting completeness of exercise interventions using the Consensus on Exercise Reporting Template (CERT). Design Systematic review and meta-analysis, according to the Prisma in Exercise, Rehabilitation

Objective To compare the efficacy of exercise, metformin and their combination on glucose metabolism in individuals with abnormal glycaemic control. Design Systematic review and network meta-analysis. Data sources Embase, Web of Science, PubMed/MEDLINE and SPORTDiscus. Eligibility criteria Randomised controlled trials involving exercise, metformin or their combined treatments in individuals with prediabetes

Objective To describe and categorise the injury-inciting circumstances of sudden-onset hamstring match injuries in professional football players using systematic video analysis. Methods Using a prospective injury surveillance database, all sudden-onset hamstring match injuries in male football players (18 years and older) from the Qatar Stars League between September 2013 and August 2020 were reviewed

Multiligament knee injuries (MLKIs) represent a broad spectrum of pathology with potentially devastating consequences. Currently, disagreement in the terminology, diagnosis and treatment of these injuries limits clinical care and research. This study aimed to develop consensus on the nomenclature, diagnosis, treatment and rehabilitation strategies for patients with MLKI, while identifying important

Need to put the health effects of standing in the research spotlight. Since the turn of the century, the spotlight on the cardiometabolic risks of prolonged sitting has overshadowed the health effects of perhaps the greatest behavioural change in the transition from hunter-gatherers to modern humans: the remarkable increase in time spent standing.1 As an example, figure 1 makes a comparison in device-measured

Sports medicine physicians and physiotherapists commonly use cryotherapy (eg, ice application) postinjury to decrease tissue temperature with the objective of reducing pain, limiting secondary injury and inflammation, and supporting healing. However, besides the analgesic effect of cryotherapy, a literature search revealed no evidence from human studies that cryotherapy limits secondary injury or has

The global youth sports landscape continues to exhibit pronounced growth providing increasing and exciting opportunities for youth athletes to compete on the world’s sports stage. Likewise, there is a parallel growing concern whether the existing minimum age eligibility requirements (AERs) across the International Federations for youth participation in the Olympic Games are appropriate. For those sport

Epidemiological studies through injury and illness surveillance and data collection are fundamental to protect athlete health. To encourage consistency in definitions and methodology, and to allow for data comparison between studies, consensus statements have been published in various sports. The aim of the International Olympic Committee (IOC) consensus by Bahr et al 1 on methods for collecting and

From injury and illness management to recovery, cryotherapy is commonly used by athletes and their support personnel.1 And the simplest version of this remains the application of ice. However, the use of ice is not trivial, nor should it be taken for granted. Apart from logistical challenges related to production, transportation and storage, ice is often used to obtain benefits which are not evidence-based

With the pronounced ongoing growth of global youth sports, opportunities for and participation of youth athletes on the world sports stage, including the Olympic Games, are expected to escalate. Yet, adolescence is a vulnerable period of development and inherently dynamic, with non-linear and asynchronous progression of physical, physiological, psychological and social attributes. These non-concurrent

Objectives The objectives of this study are to describe the prevalence of therapeutic use exemptions (TUEs) among athletes competing in four Olympic and four Paralympic games. The secondary objective was to present the prohibited substance and methods classes associated with TUEs. Methods Data from the Anti-Doping Administration and Management System were extracted for this cross-sectional observation

Background Exposure to air pollution can affect the health of individuals with respiratory disease, but may also impede the health and performance of athletes. This is potentially relevant for people travelling to and competing in the Olympic and Paralympic Games (OPG) in Paris. We describe anticipated air quality in Paris based on historical monitoring data and describe the impact of the process on

Objective To describe the incidence and characteristics of injuries and illnesses among Team USA athletes competing at the Santiago 2023 Pan American Games (PAG) and Parapan American Games (PPAG), with a particular focus on the incidence of respiratory illnesses and on injuries for sports new to the Olympic and Paralympic programmes. Methods Illnesses and injuries occurring among the 870 Team USA athletes

Objectives This cohort study reported descriptive statistics in athletes engaged in Summer and Winter Olympic sports who sustained a sport-related concussion (SRC) and assessed the impact of access to multidisciplinary care and injury modifiers on recovery. Methods 133 athletes formed two subgroups treated in a Canadian sport institute medical clinic: earlier (≤7 days) and late (≥8 days) access. Descriptive

Objective To describe the evidence pertaining to associations between growth, maturation and injury in elite youth athletes. Design Scoping review. Data sources Electronic databases (SPORTDiscus, Embase, PubMed, MEDLINE and Web of Science) searched on 30 May 2023. Eligibility criteria Original studies published since 2000 using quantitative or qualitative designs investigating associations between

Background There is increasing recognition of the prevalence and risk factors for mental health symptoms and disorders among adult elite athletes, with less research involving elite youth athletes. This scoping review aimed to characterise the mental health and well-being of elite youth athletes who travel internationally and compete for their sport. Method Four databases were searched in March 2023

Objective The objective of this study is to characterise the key factors that influence positive engagement and desirable developmental outcomes in sport among elite youth athletes by summarising the methods, groups and pertinent topical areas examined in the extant published research. Design Scoping review. Data sources We searched the databases SPORTDiscus, APA PsycINFO, Web of Science and Sports

Sudden cardiac arrest (SCA) is the leading cause of sudden death in athletes during high-level, organised sport. Patient-related and event-related factors provide an opportunity for rapid intervention and the potential for high survival rates. The aim of this consensus was to develop a best-practice guideline for dedicated field-of-play medical teams responding to SCA during an organised sporting event

Objective To elicit expert opinion and gain consensus on specific exercise intervention parameters to minimise hip bone mineral density (BMD) loss following traumatic lower limb amputation. Methods In three Delphi rounds, statements were presented to a panel of 13 experts from six countries. Experts were identified through publications or clinical expertise. Round 1 involved participants rating their

Objective To examine the acute and chronic effects of reducing prolonged sedentary time (ST) with physical activity (PA) on cognitive and brain health. Design Systematic review and meta-analysis. Data sources PubMed, Scopus, CINAHL, PsycINFO, SPORTDiscus, Web of Science, and ProQuest Dissertation and Theses. Eligibility criteria Randomised controlled trials (RCTs) published from inception to 17 June

Objective To assess whether National Football League (NFL) players diagnosed with a concussion have an increased risk of injury after return to football. Methods A retrospective cohort study analysed the hazard of subsequent time-loss lower extremity (LEX) or any musculoskeletal injury among NFL players diagnosed with a concussion in 2015–2021 preseason or regular season games compared with: (1) all

Growing research supports the central role of psychological factors, including anxiety and depression, in recovery from sport-related concussion (SRC).1 Indeed, mental health is among the most robust predictors of concussion outcomes, including SRC.1 This is reflected in the recent Consensus Statement on Concussion in Sport,2 which explicitly recommends consideration of anxiety, depression and psychological

Objective The objective is to determine the association and absolute risk of femoroacetabular impingement syndrome (FAIS) for the development of radiographic hip osteoarthritis (RHOA). Methods This is a nationwide, multicentre prospective cohort study (Cohort Hip and Cohort Knee) with 1002 individuals aged between 45 and 65 years. Hips without definitive RHOA (Kellgren-Lawrence (KL) grade≤1) at baseline

These infographics seek to summarise the International Olympic Committee (IOC) consensus statements on acute respiratory illness in athletes.1 2 Figure 1 provides a brief overview from the IOC consensus statement Part 1: acute respiratory infections,1 and Part 2: non-infective acute respiratory illness.2 Figure 2 provides the Sport & Exercise Medicine (SEM) clinician with an algorithm to guide clinical

Acute respiratory illness (ARI) is the most common reason athletes seek acute medical care and represents a significant challenge to the sport and exercise medicine (SEM) clinician working ‘in the field’.1 Faced with this issue, there is a need to determine if symptoms are caused by an acute respiratory infection (ARInf), establish if a specific antimicrobial treatment is indicated, evaluate the risk

Objective Less than half of servicewomen report loss of menses during initial military training. However, self-reported menstrual status may not accurately reflect hypothalamic-pituitary-ovarian (HPO) axis suppression and may underestimate reproductive health consequences of military training. Our aim was to characterise HPO axis function during US Army Basic Combat Training (BCT) in non-hormonal contraceptive-using

Objective To evaluate the efficacy of the Fédération Internationale de Football Association (FIFA) cooling break policy against alternative cooling configurations in attenuating thermal strain during simulated football in the heat. Methods 12 males (age: 27±6 years, V̇O2peak: 61±7 mL/kg/min) completed five 90 min intermittent treadmill football match simulations in 40°C and 41% relative humidity (32°C

Objectives To investigate if daily treatment with glyceryl trinitrate (GTN) ointment, over 24 weeks combined with a 12-week eccentric exercise programme is more effective for chronic mid-portion Achilles tendinopathy than placebo ointment and eccentric exercise. Methods This was a single-site randomised double-blind placebo-controlled trial at an acute hospital, Dublin, Ireland. Patients with chronic

Orthopaedic and sports medicine clinicians can improve outcomes for transgender patients by understanding the physiological effects of gender-affirming hormone therapy (GAHT). This narrative review investigated the role of GAHT on bone mineral density, fracture risk, thromboembolic risk, cardiovascular health and ligament/tendon injury in this population. A search from the PubMed database using relevant

Heerey et al recently published a valuable article regarding the reactive nature of current approaches to hip osteoarthritis (OA) in athletes.1 We agree primary prevention is a desirable path to decrease the incidence of hip OA and pain, but as stated, reducing workloads is challenging as it corresponds with (and worsens) critical sport development timelines of talent identification and skill acquisition

It was New Year’s Eve, and in a few hours, we would be heading into 2014. It was going to be a great year that would see me graduating as a medical doctor after five long years. Home for the Christmas holidays and eager to impress my family with my imaginary gymnastic skills, I jumped into the air, landing rather ungracefully. We all heard a loud ‘pop’ followed by my scream. With immediate swelling

As the world eagerly anticipates the opening of each new Olympic and Paralympic Games, medical teams and team physicians prepare to care for the optimal health and performance of thousands of athletes. While injuries and illnesses at the Games are inevitable,1–3 research points to a powerful tool to help us care better: the athlete voice. An increasing awareness of the positive impact on health outcomes

A literature review and three consecutive studies were developed to offer insights into usability testing and construct clarity within the realm of exercise interventions. The overarching goal was to accurately characterise and quantify the multidimensional concept of exercise programme usability, laying a robust foundation for measurement and subsequent improvement. Through the development and rigorous

Objective To compare the effects of aerobic training combined with muscle strength training (hereafter referred to as combined training) to aerobic training alone on cardiovascular disease risk indicators in patients with coronary artery disease (CAD). Design Systematic review with meta-analysis. Data sources MEDLINE, Embase, CINAHL, SPORTDiscus, Scopus, trial registries and grey literature sources

Objective The objective is to comprehensively classify the types, topics and populations represented in the published lacrosse literature. Design Mapping review. Protocol registration at Open Science Framework (). Data sources 10 electronic databases were searched from inception to 31 March 2023. Eligibility criteria Peer-reviewed studies in English that included lacrosse were eligible. Publications

Objectives College athletes are at elevated risk for sexual violence, yet few formally report it and screening for sexual violence is uncommon. This study aimed to evaluate the nature of screening occurring among college athletes and collect athletes’ opinions on how best to screen for sexual violence. Methods This was a mixed-methods study combining a cross-sectional survey with small group interviews

Objective To investigate if a combination of an online and onsite implementation strategy was superior to an online-only strategy in enhancing the use of an injury prevention exercise programme (IPEP) and in reducing the risk of shoulder, knee and ankle injuries in youth community handball players (age 11–17) over a handball season. Methods In this 30-week hybrid effectiveness-implementation cluster

Following the International Olympic Committee’s (IOC) consensus statement on the methods for collecting and reporting epidemiological data on injury and illness in sports,1 2 the International Tennis Federation’s Sports Science Committee, in collaboration with selected external experts, developed a tennis-specific extension.3 This initiative aimed to standardise health surveillance for non-disabled

Objective To synthesise the existing literature relating to barriers and enablers encountered by elite athletes during preconception and pregnancy for the purpose of identifying key recommendations and actionable steps to inform the development of pregnancy guidelines to support preconception and pregnancy in national sporting organisations. Design Mixed-methods systematic review with thematic analysis

Degenerative cervical myelopathy (DCM) is a clinical condition of upper motor neuron lesion signs, that is confirmed with advanced imaging demonstrating compression of the spinal cord in the cervical spine.1 Common symptoms of DCM include loss of upper and lower limb strength and coordination, gait dysfunction, and bladder and bowel dysfunction.2 The difference between DCM and other sports-related

Abuse and harassment in sports can present in many forms1 2 and are dishearteningly common, having disproportionate effects on groups who experience structural and systemic inequities such as athletes living with a disability3, 2SLGBTQIA+athletes4 and children and youth.3 Despite consistently low rates of disclosure of abuse in sports, moving forward with disclosure can be an effective catalyst towards

Objectives The objectives of this study are to examine the association of physical activity in parents with physical activity in their adult offspring and explore if the offspring’s genetic liability (ie, polygenic risk score) to physical activity influences this association. Methods The Trøndelag Health Study cohort is a population-based longitudinal study with data collected in 1984–1986, 1995–1997

Objective This cross-sectional retrospective and prospective study implemented the 2023 International Olympic Committee Relative Energy Deficiency in Sport (REDs) Clinical Assessment Tool version 2 (CAT2) to determine the current severity of REDs (primary outcome) and future risk of bone stress injuries (BSI, exploratory outcome) in elite athletes. Methods Female (n=143; 23.3±4.3 years) and male (n=70;

Objective Concerns exist about the possible detrimental effects of exercise training on aortic size and valve function in individuals with bicuspid aortic valve (BAV). This multicentre international study aimed to determine the characteristics of aortic size and valve function in athletes versus non-athletes with BAV and athletes with tricuspid aortic valve (TAV). Methods We enrolled competitive athletes

Objective To analyse the association between Ankle-GO score during the return to sport process and the probability of becoming a coper 1 year after lateral ankle sprain (LAS). Copers were defined as patients returning to their preinjury sport without loss of function and reporting no episodes of reinjury or giving-way. Methods Two months after a LAS, patients performed the Ankle-GO assessment which

This infographic offers guidance for sports practitioners and wheelchair rugby (WR) players to enhance performance and stability during WR using abdominal binders. The Paralympic sport of WR is played by individuals with an impairment that affects all four limbs, including cervical spinal cord injuries (SCIs) (tetraplegia), limb deficiencies, polio, cerebral palsy and other neurological disorders.

Objectives To characterise the respiratory health of elite rowers using a systematic screening approach to assess respiratory health (SARAH) and identify the associations between SARAH findings and acute respiratory illness (ARI) and chest wall injury (CWI). Methods A systematic screening approach was conducted in a cohort of elite rowers. The assessment employed validated respiratory questionnaires