| 1. |
- Aasa, Ulrika, et al.
(författare)
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Injuries among weightlifters and powerlifters : a systematic review
- 2017
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Ingår i: British Journal of Sports Medicine. - : BMJ. - 0306-3674 .- 1473-0480. ; 51:4, s. 211-219
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Tidskriftsartikel (refereegranskat)abstract
- Background Olympic weightlifting and powerlifting are two sports that expose the body to great forces. Injury characteristics have not been systematically reviewed for these two growing sports.Objective The purpose of this study was to systematically review the literature regarding various definitions of injuries used, injury localisation, the prevalence and incidence of injuries and the associated risk factors for injuries in weightlifting and powerlifting.Design Systematic review.Data sources Five databases, PubMed, MEDLINE, SPORTDiscus, Scopus and Web of Science, were searched between 9 March and 6 April 2015.Eligibility criteria for selecting studies Studies assessing injury incidence and prevalence in Olympic weightlifting and powerlifting were included. The Quality assessment tool for observational cohort and cross-sectional studies was used to assess methodological quality.Results 9 studies were included in the review. Injury was defined fairly consistently across studies. Most studies were of low methodological quality. The spine, shoulder and the knee were the most common injury localisations in both sports. The injury incidence in weightlifting was 2.4–3.3 injuries/1000 hours of training and 1.0–4.4 injuries/1000 hours of training in powerlifting. Only one retrospective study had analysed possible risk factors.Summary/conclusions The risk of injury in both sports were similar to other non-contact sports also requiring strength/power, but low compared to contact sports. The severity of injuries differed in the included studies. Since little has been studied regarding possible risk factors to injuries, further research is therefore warranted to explain why athletes get injured and how to prevent injuries.Trial registration number PROSPERO CRD42015014805.
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| 5. |
- Alfredson, Håkan, et al.
(författare)
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A treatment algorithm for managing Achilles tendinopathy : new treatment options.
- 2007
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Ingår i: British Journal of Sports Medicine. - : BMJ. - 0306-3674 .- 1473-0480. ; 41:4, s. 211-216
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Forskningsöversikt (refereegranskat)abstract
- Achilles tendinopathy affects athletes, recreational exercisers and even inactive people. The pathology is not inflammatory; it is a failed healing response. The source of pain in tendinopathy could be related to the neurovascular ingrowth seen in the tendon's response to injury. The treatment of Achilles tendinopathy is primarily conservative with an array of effective treatment options now available to the primary care practitioner. If conservative treatment is not successful, then surgery relieves pain in the majority of cases. Directing a patient through the algorithm presented here will maximise positive treatment outcomes.
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| 6. |
- Alfredson, Håkan
(författare)
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Can specific treatment prevent progressive tendon degeneration?
- 2011
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Ingår i: British Journal of Sports Medicine. - : BMJ Journals. - 0306-3674 .- 1473-0480. ; 45:4, s. 334-
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Tidskriftsartikel (refereegranskat)abstract
- Background Tendon degeneration is generally believed to be irreversible.Objective To use ultrasound to study the Achilles midportion tendon structure and thickness before and after treatment of chronic painful tendinosis.Design Prospective study.Patients and interventions Middle aged patients on varying activity levels, having midportion chronic Achilles tendinosis, were followed with ultrasound examinations before and after treatment with eccentric training, sclerosing polidocanol injections and surgical scraping.Outcome measurements Tendon thickness and structure.Results 89 patients successfully treated (pain-free during tendon loading) with eccentric training (n=22), sclerosing polidocanol injections (n=38) and surgical scraping (n=29), had a significantly thinner Achilles midportion and a more normal tendon structure, after compared to before, treatment.Conclusion For the Achilles midportion, tendon degeneration might not be irreversible. The findings indicate a possible regeneration potential.
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| 7. |
- Alfredson, Håkan
(författare)
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Midportion Achilles tendinosis and the plantaris tendon
- 2011
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Ingår i: British Journal of Sports Medicine. - Loughborough : British Assoc. of Sport and Medicine. - 0306-3674 .- 1473-0480. ; 45:13, s. 1023-1025
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: When re-operating patients with midportion Achilles tendinosis, having had a poor effect of ultrasound (US) and Doppler-guided scraping, the author found the involvement of the plantaris tendon to be a likely reason for the poor result. The aim of this study was to investigate the occurrence of a plantaris tendon in close relation to the Achilles tendon in consecutive patients with midportion Achilles tendinosis undergoing treatment with US and Doppler-guided scraping. Material and methods: This study includes 73 consecutive tendons with chronic painful midportion Achilles tendinosis, where US+Doppler examination showed thickening, irregular tendon structure, hypo-echoic regions, and localised high blood flow outside and inside the ventral Achilles midportion. The tendons were treated with US+Doppler-guided scraping, via a medial incision. If there was a plantaris tendon located in close relation to the medial Achilles, it was extirpated. Results: An invaginated, or ‘close by located’, enlarged plantaris tendon was found in 58 of 73 (80%) tendons. Preliminary clinical results of the combined procedure, US + Doppler-guided surgical scraping and extirpation of the plantaris tendon, are very promising. Conclusions: A thickened plantaris tendon located in close relation to the medial Achilles seems common in patients with chronic painful midportion tendinosis. The role of the plantaris tendon in midportion Achilles tendinosis needs to be further evaluated and should be kept in mind when treating this condition.
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| 8. |
- Alfredson, Håkan, et al.
(författare)
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No normalisation of the tendon structure and thickness after intratendinous surgery for chronic painful midportion Achilles tendinosis.
- 2009
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Ingår i: British journal of sports medicine. - : BMJ. - 1473-0480 .- 0306-3674. ; 43:12, s. 948-9
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To characterise Achilles tendon structure and thickness a minimum of 8 years after intra-tendinous surgery. Material and METHODS: Fourteen patients (16 tendons; 9 men and 5 women, mean age 43 years, range 27-55) surgically treated (intra-tendinous surgery) for chronic painful midportion Achilles tendinosis, were followed with clinical examination and grey-scale ultrasonography for a minimum of 8 years (range 8-16 years, mean 13 years). RESULTS: All patients were satisfied with the result of surgery and were active in Achilles tendon loading activities without restrictions. In all operated tendons, structural abnormalities remained and tendons remained thicker than normal tendons. CONCLUSIONS: Resection of tendinosis is associated with persistent structural abnormalities and thickening of the tendon 13 years after surgery, despite successful clinical outcomes.
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| 9. |
- Alfredson, Håkan, et al.
(författare)
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Partial midportion Achilles tendon ruptures: new sonographic findings helpful for diagnosis.
- 2011
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Ingår i: British Journal of Sports Medicine. - : BMJ. - 0306-3674 .- 1473-0480. ; 45:5, s. 429-432
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Partial Achilles tendon ruptures are not always easy to diagnose. A history including a sudden onset of pain, and/or relative weakness in plantar flexion force, are indicators. The most loaded side of the Achilles tendon is the dorsal side (skin side). OBJECTIVE: To evaluate the ultrasound (US) and Doppler (CD) findings in patients with a suspected partial rupture in the Achilles tendon. Material and METHODS: Seventeen patients (16 men and 1 woman) with a mean age of 36 years (range 23-71) were examined clinically and by US+CD because of midportion Achilles tendon pain. There was an acute onset in 14/17 patients, and all had painful weakness during tendon loading activity. RESULTS: In all patients the US examination showed a partial Achilles tendon rupture, presented as a disrupted dorsal (skin side) tendon line and an irregular tendon structure mainly located in the dorsal and mid-tendon. The size of the rupture varied from 1/3 to 2/3 of the tendon thickness. In the dorsal part of the tendon, corresponding to the region with disrupted tendon line and irregular structure, CD examination showed high blood flow-most often of a longitudinal character. Six of the patients were surgically treated, and macroscopical examination verified the ultrasound findings, showing disruption on the dorsal side, and a partial rupture in the dorsal and mid- tendon. CONCLUSIONS: Ultrasound and Doppler examination can be helpful tools to diagnose partial midportion Achilles tendon ruptures. The characteristic findings of a disrupted dorsal tendon line, and high blood flow in the structurally abnormal dorsal tendon, indicate a partial rupture.
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| 10. |
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| 11. |
- Alfredson, Håkan
(författare)
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Ultrasound and Doppler-guided mini-surgery to treat midportion Achilles tendinosis : results of a large material and a randomised study comparing two scraping techniques.
- 2011
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Ingår i: British Journal of Sports Medicine. - : BMJ. - 0306-3674 .- 1473-0480. ; 45:5, s. 407-410
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Treatment based on ultrasound (US) and colour Doppler (CD) findings in midportion Achilles tendinosis has shown promising results. In a randomised study on a small patient material, similar short-term clinical results were demonstrated with surgery outside the tendon and sclerosing polidocanol injections, but surgical treatment led to a faster return to activity.OBJECTIVE: To evaluate the clinical results of US and CD-guided mini-surgery (scraping) outside the ventral tendon in a larger patient material and, in a randomised study, compare two different techniques for surgical scraping.MATERIAL AND METHODS: 103 patients (66 men, 37 women), mean age 43 years (range 24-77), with midportion tendinosis in 125 Achilles tendons were included. Patients from a large group (88 tendons), and a randomised study (37 tendons), were in local anaesthesia treated with a US and CD-guided new surgical approach outside the ventral tendon. All patients in the large group, and one arm of the randomised study, were treated open with a scalpel, while the other arm of the randomised study were treated percutaneously. Pain during Achilles tendon loading activity (Visual Analogue Scale (VAS)), and satisfaction with treatment, were evaluated.RESULTS: Before surgery, the mean VAS was 73. After surgery (follow-up mean 18 months, range 6-33), the mean VAS was 3 in 111 tendons (89%) from satisfied patients back in full Achilles tendon loading activity. In the randomised study, there were no significant differences in the results between open treatment with a scalpel and percutaneous treatment with a needle.CONCLUSIONS: US and CD-guided scraping show good short-term results in midportion Achilles tendinosis.
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| 12. |
- Alfredson, Håkan, et al.
(författare)
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Unilateral surgical treatment for patients with midportion Achilles tendinopathy may result in bilateral recovery
- 2014
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Ingår i: British Journal of Sports Medicine. - : BMJ Publishing Group. - 0306-3674 .- 1473-0480. ; 48:19, s. 1421-1424
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Bilateral midportion Achilles tendinopathy/tendinosis is not unusual, and treatment of both sides is often carried out. Experiments in animals suggest of the potential involvement of central neuronal mechanisms in Achilles tendinosis. OBJECTIVES: To evaluate the outcome of surgery for Achilles tendinopathy. METHODS: This observational study included 13 patients (7 men and 6 women, mean age 53 years) with a long duration (6-120 months) of chronic painful bilateral midportion Achilles tendinopathy. The most painful side at the time for investigation was selected to be operated on first. Treatment was ultrasound-guided and Doppler-guided scraping procedure outside the ventral part of the tendon under local anaesthetic. The patients started walking on the first day after surgery. Follow-ups were conducted and the primary outcome was pain by visual analogue scale. In an additional part of the study, specimens from Achilles and plantaris tendons in three patients with bilateral Achilles tendinosis were examined. RESULTS: Short-term follow-ups showed postoperative improvement on the non-operated side as well as the operated side in 11 of 13 patients. Final follow-up after 37 (mean) months showed significant pain relief and patient satisfaction on both sides for these 11 patients. In 2 of 13 patients operation on the other, initially non-operated side, was instituted due to persisting pain. Morphologically, it was found that there were similar morphological effects, and immunohistochemical patterns of enzyme involved in signal substance production, bilaterally. CONCLUSION: Unilateral treatment with a scraping operation can have benefits contralaterally; the clinical implication is that unilateral surgery may be a logical first treatment in cases of bilateral Achilles tendinopathy.
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| 13. |
- Alfredson, Håkan
(författare)
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Where to now with Achilles tendon treatment?
- 2011
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Ingår i: British Journal of Sports Medicine. - : BMJ Publishing Group. - 0306-3674 .- 1473-0480. ; 45:5, s. 386-386
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Tidskriftsartikel (refereegranskat)
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| 14. |
- Alonso, Juan-Manuel, et al.
(författare)
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Preparticipation injury complaint is a risk factor for injury : a prospective study of the Moscow 2013 IAAF Championships.
- 2015
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Ingår i: British Journal of Sports Medicine. - : BMJ Publishing Group. - 0306-3674 .- 1473-0480. ; 49:17, s. 1118-U45
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To determine the health status of athletes before the start of an international athletics championship and to determine whether preparticipation risk factors predicted in-championship injuries.METHODS: At the beginning of the 2013 International Association of Athletics Federations (IAAF) World Championships, all registered athletes (n=1784) were invited to complete a preparticipation health questionnaire (PHQ) on health status during the month preceding the championships. New injuries that occurred at the championships were prospectively recorded.RESULTS: The PHQ was completed by 698 (39%) athletes; 204 (29.2%) reported an injury complaint during the month before the championships. The most common mode of onset of preparticipation injury complaints was gradual (43.6%). Forty-nine athletes in the study reported at least one injury during the championships. Athletes who reported a preparticipation injury complaint were at twofold increased risk for an in-championship injury (OR=2.09; 95% CI 1.16 to 3.77); p=0.014). Those who reported a preparticipation gradual-onset injury complaint were at an almost fourfold increased risk for an in-championship time-loss injury (OR=3.92; 95% CI 1.69 to 9.08); p=0.001). Importantly, the preparticipation injury complaint severity score was associated with the risk of sustaining an in-championship injury (OR=1.14; 95% CI 1.06 to 1.22); p=0.001).SUMMARY AND CONCLUSIONS: About one-third of the athletes participating in the study reported an injury complaint during the month before the championships, which represented a risk factor for sustaining an injury during the championship. This study emphasises the importance of the PHQ as a screening tool to identify athletes at risk of injuries before international championships.
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| 15. |
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| 16. |
- Andersson, Gustav, et al.
(författare)
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Substance P accelerates hypercellularity and angiogenesis in tendon tissue and enhances paratendinitis in response to Achilles tendon overuse in a tendinopathy model
- 2011
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Ingår i: British Journal of Sports Medicine. - Loughborough : British Assoc. of Sport and Medicine. - 0306-3674 .- 1473-0480. ; 45:13, s. 1017-1022
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Tidskriftsartikel (refereegranskat)abstract
- Background Tenocytes produce substance P (SP) and its receptor (neurokinin-1 receptor (NK-1R) is expressed throughout the tendon tissue, expecially in patients with tendinopathy and tissue changes (tendinosis) including hypercellularity and vascular proliferation. Considering the known effects of SP, one might ask whether SP contributes to these canges.Objectives To test whether development of tendinosislike changes (hypercellularity and angiogenesis) is accelerated during a 1-week course of ecercise with local administration of SP in an establish Achilles tendinopathy model.Methods Rabbits were subjected to a protocol of Achilles tendon overuse for 1 week, in conjunction with SP injections in the paratenon. Exercised control animals received NaCl injections or no injections, and unexercised, uninjected controls were also used. Tenocyte number and vascular density, as well as paratendinous inflammation, were evaluated. Immunohistochemistry and in sity hybridisation to detect NK-1R were conducted.Results There was a significant increase in tenocyte number in the SP-injected and NaCl-injected groups compared with both unexercised and exercised, uninjected controls. Tendon blood vessels increased in number in the SP-injected group compared with unexercised controls, a finding not seen in NaCl-injected controls or in uninjected, exercised animals. Paratendinous inflammation was more pronounced in the SP-injected group than in the NaCl controls. NK-1R was detected in blood vessel walls, nerves, inflammatory cells and tenocytes.Conclusions SP accelerated the development of tendinosis-like changes in the rabbit. Achilles tendon, which supports theories of a potential role of SP in tendinosis development; a fact of clinical interest since SP effects can be effectively blocked. The angiogenic response to SP injections seems related to parateninitis.
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| 17. |
- Andersson, Gustav, 1983-, et al.
(författare)
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Tenocyte hypercellularity and vascular proliferation in a rabbit model of tendinopathy : contralateral effects suggest the involvement of central neuronal mechanisms
- 2011
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Ingår i: British Journal of Sports Medicine. - : BMJ. - 0306-3674 .- 1473-0480. ; 45:5, s. 399-406
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Tidskriftsartikel (refereegranskat)abstract
- Objective To determine whether there are objective findings of tendinosis in a rabbit tendinopathy model on exercised and contralateral (non-exercised) Achilles tendons. Design Four groups of six New Zealand white rabbits per group were used. The animals of one (control) group were not subjected to exercise/stimulation. Interventions Animals were subjected to a protocol of electrical stimulation and passive flexion-extension of the right triceps surae muscle every second day for 1, 3 or 6 weeks. Main Outcome Measures Tenocyte number and vascular density were calculated. Morphological evaluations were also performed as well as in-situ hybridisation for vascular endothelial growth factor (VEGF) messenger RNA. Results There was a significant increase in the tenocyte number after 3 and 6 weeks of exercise, but not after 1 week, in comparison with the control group. This was seen in the Achilles tendons of both legs in experimental animals, including the unexercised limb. The pattern of vascularity showed an increase in the number of tendon blood vessels in rabbits that had exercised for 3 weeks or more, compared with those who had exercised for 1 week or not at all. VEGF-mRNA was detected in the investigated tissue, with the reactions being more clearly detected in the tendon tissue with tendinosis-like changes (6-week rabbits) than in the normal tendon tissue (control rabbits). Conclusions There were bilateral tendinosis-like changes in the Achilles tendons of rabbits in the current model after 3 weeks of training, suggesting that central neuronal mechanisms may be involved and that the contralateral side is not appropriate as a control.
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| 18. |
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| 19. |
- Ardern, Clare, 1985-, et al.
(författare)
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2016 Consensus statement on return to sport from the First World Congress in Sports Physical Therapy, Bern
- 2016
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Ingår i: British Journal of Sports Medicine. - : BMJ PUBLISHING GROUP. - 0306-3674 .- 1473-0480. ; 50:14, s. 853-864
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Tidskriftsartikel (refereegranskat)abstract
- Deciding when to return to sport after injury is complex and multifactorial-an exercise in risk management. Return to sport decisions are made every day by clinicians, athletes and coaches, ideally in a collaborative way. The purpose of this consensus statement was to present and synthesise current evidence to make recommendations for return to sport decision-making, clinical practice and future research directions related to returning athletes to sport. A half day meeting was held in Bern, Switzerland, after the First World Congress in Sports Physical Therapy. 17 expert clinicians participated. 4 main sections were initially agreed upon, then participants elected to join 1 of the 4 groups-each group focused on 1 section of the consensus statement. Participants in each group discussed and summarised the key issues for their section before the 17-member group met again for discussion to reach consensus on the content of the 4 sections. Return to sport is not a decision taken in isolation at the end of the recovery and rehabilitation process. Instead, return to sport should be viewed as a continuum, paralleled with recovery and rehabilitation. Biopsychosocial models may help the clinician make sense of individual factors that may influence the athletes return to sport, and the Strategic Assessment of Risk and Risk Tolerance framework may help decision-makers synthesise information to make an optimal return to sport decision. Research evidence to support return to sport decisions in clinical practice is scarce. Future research should focus on a standardised approach to defining, measuring and reporting return to sport outcomes, and identifying valuable prognostic factors for returning to sport.
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| 20. |
- Ardern, Clare, et al.
(författare)
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2018 International Olympic Committee consensus statement on prevention, diagnosis and management of paediatric anterior cruciate ligament (ACL) injuries
- 2018
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Ingår i: British Journal of Sports Medicine. - : BMJ. - 0306-3674 .- 1473-0480. ; 52:7, s. 422-438
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Tidskriftsartikel (refereegranskat)abstract
- In October 2017, the International Olympic Committee hosted an international expert group of physiotherapists and orthopaedic surgeons who specialise in treating and researching paediatric ACL injuries. Representatives from the American Orthopaedic Society for Sports Medicine, European Paediatric Orthopaedic Society, European Society for Sports Traumatology, Knee Surgery & Arthroscopy, International Society of Arthroscopy Knee Surgery and Orthopaedic Sports Medicine, Pediatric Orthopaedic Society of North America and Sociedad Latinoamericana de Artroscopia, Rodilla y Deporte attended. Physiotherapists and orthopaedic surgeons with clinical and research experience in the field, and an ethics expert with substantial experience in the area of sports injuries also participated. Injury management is challenging in the current landscape of clinical uncertainty and limited scientific knowledge. Injury management decisions also occur against the backdrop of the complexity of shared decision-making with children and the potential long-term ramifications of the injury. This consensus statement addresses six fundamental clinical questions regarding the prevention, diagnosis and management of paediatric ACL injuries. The aim of this consensus statement is to provide a comprehensive, evidence-informed summary to support the clinician, and help children with ACL injury and their parents/guardians make the best possible decisions.
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| 26. |
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| 27. |
- Ardern, Clare L, et al.
(författare)
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Implementing the 27 PRISMA 2020 Statement items for systematic reviews in the sport and exercise medicine, musculoskeletal rehabilitation and sports science fields : The PERSiST (implementing Prisma in Exercise, Rehabilitation, Sport medicine and SporTs science) guidance
- 2022
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Ingår i: British Journal of Sports Medicine. - : BMJ. - 0306-3674 .- 1473-0480. ; 56:4, s. 175-195
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Tidskriftsartikel (refereegranskat)abstract
- Poor reporting of medical and healthcare systematic reviews is a problem from which the sports and exercise medicine, musculoskeletal rehabilitation, and sports science fields are not immune. Transparent, accurate and comprehensive systematic review reporting helps researchers replicate methods, readers understand what was done and why, and clinicians and policy-makers implement results in practice. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement and its accompanying Explanation and Elaboration document provide general reporting examples for systematic reviews of healthcare interventions. However, implementation guidance for sport and exercise medicine, musculoskeletal rehabilitation, and sports science does not exist. The Prisma in Exercise, Rehabilitation, Sport medicine and SporTs science (PERSiST) guidance attempts to address this problem. Nineteen content experts collaborated with three methods experts to identify examples of exemplary reporting in systematic reviews in sport and exercise medicine (including physical activity), musculoskeletal rehabilitation (including physiotherapy), and sports science, for each of the PRISMA 2020 Statement items. PERSiST aims to help: (1) systematic reviewers improve the transparency and reporting of systematic reviews and (2) journal editors and peer reviewers make informed decisions about systematic review reporting quality.
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| 28. |
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| 30. |
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| 31. |
- Ardern, Clare, et al.
(författare)
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The impact of psychological readiness to return to sport and recreational activities after anterior cruciate ligament reconstruction
- 2014
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Ingår i: British Journal of Sports Medicine. - : BMJ Publishing Group. - 0306-3674 .- 1473-0480. ; 48:22, s. 1613-U50
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Tidskriftsartikel (refereegranskat)abstract
- Background This cross-sectional study aimed to examine whether appraisal of knee function, psychological and demographic factors were related to returning to the preinjury sport and recreational activity following anterior cruciate ligament (ACL) reconstruction. Method 164 participants completed a questionnaire battery at 1-7 years after primary ACL reconstruction. The battery included questionnaires evaluating knee self-efficacy, health locus of control, psychological readiness to return to sport and recreational activity, and fear of reinjury; and self-reported knee function in sport-specific tasks, knee-related quality of life and satisfaction with knee function. The primary outcome was returning to the preinjury sport or recreational activity. Results At follow-up, 40% (66/164) had returned to their preinjury activity. Those who returned had more positive psychological responses, reported better knee function in sport and recreational activities, perceived a higher knee-related quality of life and were more satisfied with their current knee function. The main reasons for not returning were not trusting the knee (28%), fear of a new injury (24%) and poor knee function (22%). Psychological readiness to return to sport and recreational activity, measured with the ACL-Return to Sport after Injury scale (was most strongly associated with returning to the preinjury activity). Age, sex and preinjury activity level were not related. Conclusions Less than 50% returned to their preinjury sport or recreational activity after ACL reconstruction. Psychological readiness to return to sport and recreation was the factor most strongly associated with returning to the preinjury activity. Including interventions aimed at improving this in postoperative rehabilitation programmes could be warranted to improve the rate of return to sport and recreational activities.
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| 32. |
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| 33. |
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| 34. |
- Armstrong, Neil, et al.
(författare)
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Aerobic fitness and its relationship to sport, exercise training and habitual physical activity during youth
- 2011
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Ingår i: British Journal of Sports Medicine. - : BMJ. - 0306-3674 .- 1473-0480. ; 45:11, s. 849-858
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Forskningsöversikt (refereegranskat)abstract
- Aim To analyse aerobic fitness and its relationship with sport participation, exercise training and habitual physical activity (HPA) during youth. Methods Studies were located through computer searches of Medline, SPORT Discus and personal databases. Systematic reviews of time trends in aerobic fitness/performance, and exercise training and peak oxygen uptake (peak VO(2)) are reported. Results Peak VO(2) increases with age and maturation. Boys' peak VO(2) is higher than girls'. Despite data showing a decrease in performance test estimates of aerobic fitness there is no compelling evidence to suggest that young people have low levels of peak VO(2) or that it is declining over time. The primary time constant of the VO(2) kinetics response to moderate and heavy intensity exercise slows with age and the VO(2) kinetics response to heavy intensity exercise is faster in boys. There is a negative correlation between lactate threshold as a percentage of peak VO(2) and age but differences related to maturation or sex remain to be proven. Young athletes have higher peak VO(2), a faster primary time constant and accumulate less blood lactate at the same relative exercise intensity than their untrained peers. Young people can increase their peak VO(2) through exercise training but a meaningful relationship between aerobic fitness and HPA has not been demonstrated. Conclusions During youth the responses of the components of aerobic fitness vary in relation to age, maturation and sex. Exercise training will enhance aerobic fitness but a relationship between young people's current HPA and aerobic fitness remains to be proven.
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| 35. |
- Asker, Martin, et al.
(författare)
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Risk factors for, and prevention of, shoulder injuries in overhead sports : a systematic review with best-evidence synthesis.
- 2018
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Ingår i: British Journal of Sports Medicine. - : BMJ. - 0306-3674 .- 1473-0480. ; 52:20, s. 312-1319
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Forskningsöversikt (refereegranskat)abstract
- OBJECTIVE: To assess the evidence for risk factors and prevention measures for shoulder injuries in overhead sports.DESIGN: Systematic review with best-evidence synthesis.DATA SOURCES: Medline (Ovid), PubMed (complementary search), Embase (Elsevier), Cochrane (Wiley), SPORTDiscus (Ebsco) and Web of Science Core Collection (Thomson Reuters), from 1 January 1990 to 15 May 2017.ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Randomised controlled trials, cohort studies and case-control studies on risk factors or prevention measures for shoulder injuries in overhead sports. The eligible studies were quality assessed using the Scottish Intercollegiate Guidelines Network criteria.RESULTS: Of 4778 studies identified, 38 were eligible for quality review and 17 met the quality criteria to be included in the evidence synthesis. One additional quality study presented a shoulder injury prevention programme. Most studies focused on baseball, lacrosse or volleyball (n=13). The risk factors examined included participation level (competition vs training) (n=10), sex (n=4), biomechanics (n=2) and external workload (n=2). The evidence for all risk factors was limited or conflicting. The effect of the prevention programme within the subgroup of uninjured players at baseline was modest and possibly lacked statistical power.CONCLUSIONS: All investigated potential risk factors for shoulder injury in overhead sports had limited evidence, and most were non-modifiable (eg, sex). There is also limited evidence for the effect of shoulder injury prevention measures in overhead sports.PROSPERO TRIAL REGISTRATION NUMBER: CRD42015026850.
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| 36. |
- Askling, Carl M, et al.
(författare)
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Acute hamstring injuries in Swedish elite football : a prospective randomised controlled clinical trial comparing two rehabilitation protocols.
- 2013
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Ingår i: British Journal of Sports Medicine. - : BMJ. - 0306-3674 .- 1473-0480. ; 47:15, s. 953-9
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Hamstring injury is the single most common injury in European professional football and, therefore, time to return and secondary prevention are of particular concern.OBJECTIVE: To compare the effectiveness of two rehabilitation protocols after acute hamstring injury in Swedish elite football players by evaluating time needed to return to full participation in football team-training and availability for match selection.STUDY DESIGN: Prospective randomised comparison of two rehabilitation protocols.METHODS: Seventy-five football players with an acute hamstring injury, verified by MRI, were randomly assigned to one of two rehabilitation protocols. Thirty-seven players were assigned to a protocol emphasising lengthening exercises, L-protocol and 38 players to a protocol consisting of conventional exercises, C-protocol. The outcome measure was the number of days to return to full-team training and availability for match selection. Reinjuries were registered during a period of 12 months after return.RESULTS: Time to return was significantly shorter for the players in the L-protocol, mean 28 days (1SD±15, range 8-58 days), compared with the C-protocol, mean 51 days (1SD±21, range 12-94 days). Irrespective of protocol, stretching-type of hamstring injury took significantly longer time to return than sprinting-type, L-protocol: mean 43 vs 23 days and C-protocol: mean 74 vs 41 days, respectively. The L-protocol was significantly more effective than the C-protocol in both injury types. One reinjury was registered, in the C-protocol.CONCLUSIONS: A rehabilitation protocol emphasising lengthening type of exercises is more effective than a protocol containing conventional exercises in promoting time to return in Swedish elite football.
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| 37. |
- Askling, Carl M, et al.
(författare)
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Acute hamstring injuries in Swedish elite sprinters and jumpers : a prospective randomised controlled clinical trial comparing two rehabilitation protocols.
- 2014
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Ingår i: British Journal of Sports Medicine. - : BMJ. - 0306-3674 .- 1473-0480. ; 48:7, s. 532-9
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Hamstring strain is a common injury in sprinters and jumpers, and therefore time to return to sport and secondary prevention become of particular concern.OBJECTIVE: To compare the effectiveness of two rehabilitation protocols after acute hamstring injury in Swedish elite sprinters and jumpers by evaluating time needed to return to full participation in the training process.STUDY DESIGN: Prospective randomised comparison of two rehabilitation protocols.METHODS: Fifty-six Swedish elite sprinters and jumpers with acute hamstring injury, verified by MRI, were randomly assigned to one of two rehabilitation protocols. Twenty-eight athletes were assigned to a protocol emphasising lengthening exercises, L-protocol, and 28 athletes to a protocol consisting of conventional exercises, C-protocol. The outcome measure was the number of days to return to full training. Re-injuries were registered during a period of 12 months after return.RESULTS: Time to return was significantly shorter for the athletes in the L-protocol, mean 49 days (1SD±26, range 18-107 days), compared with the C-protocol, mean 86 days (1SD±34, range 26-140 days). Irrespective of protocol, hamstring injuries where the proximal free tendon was involved took a significantly longer time to return than injuries that did not involve the free tendon, L-protocol: mean 73 vs 31 days and C-protocol: mean 116 vs 63 days, respectively. Two reinjuries were registered, both in the C-protocol.CONCLUSIONS: A rehabilitation protocol emphasising lengthening type of exercises is more effective than a protocol containing conventional exercises in promoting time to return in Swedish elite sprinters and jumpers.
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| 38. |
- Askling, Carl Magnus, 1951-, et al.
(författare)
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High-speed running type or stretching-type of hamstring injuries makes a difference to treatment and prognosis
- 2012
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Ingår i: British Journal of Sports Medicine. - : BMJ. - 0306-3674 .- 1473-0480. ; 46:2, s. 86-87
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Tidskriftsartikel (refereegranskat)abstract
- The article focuses on the two distinct types of hamstring muscle strains, highlighting the applicable rehabilitation approaches. It notes that acute hamstring strains are distinguished by the injury situations, namely the high-speed running type, and the stretching type, with the former requiring shorter rehabilitation period than the latter. It cites a comparative study of two rehabilitation protocols, pointing out that rehabilitation is shorter with lengthening exercises.
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| 39. |
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| 40. |
- Backman, Ludvig J., et al.
(författare)
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Substance P reduces TNF-α-induced apoptosis in human tenocytes through NK-1 receptor stimulation
- 2014
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Ingår i: British Journal of Sports Medicine. - : BMJ Publishing Group Ltd. - 0306-3674 .- 1473-0480. ; 48:19, s. 1414-1420
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: It has been hypothesised that an upregulation of the neuropeptide substance P (SP) and its preferred receptor, the neurokinin-1 receptor (NK-1 R), is a causative factor in inducing tenocyte hypercellularity, a characteristic of tendinosis, through both proliferative and antiapoptotic stimuli. We have demonstrated earlier that SP stimulates proliferation of human tenocytes in culture.AIM: The aim of this study was to investigate whether SP can mediate an antiapoptotic effect in tumour necrosis factor-α (TNF-α)-induced apoptosis of human tenocytes in vitro.RESULTS: A majority (approximately 75%) of tenocytes in culture were immunopositive for TNF Receptor-1 and TNF Receptor-2. Exposure of the cells to TNF-α significantly decreased cell viability, as shown with crystal violet staining. TNF-α furthermore significantly increased the amount of caspase-10 and caspase-3 mRNA, as well as both BID and cleaved-poly ADP ribosome polymerase (c-PARP) protein. Incubation of SP together with TNF-α resulted in a decreased amount of BID and c-PARP, and in a reduced lactate dehydrogenase release, as compared to incubation with TNF-α alone. The SP effect was blocked with a NK-1 R inhibitor.DISCUSSION: This study shows that SP, through stimulation of the NK-1 R, has the ability to reduce TNF-α-induced apoptosis of human tenocytes. Considering that SP has previously been shown to stimulate tenocyte proliferation, the study confirms SP as a potent regulator of cell-turnover in tendon tissue, capable of stimulating hypercellularity through different mechanisms. This gives further support for the theory that the upregulated amount of SP seen in tendinosis could contribute to hypercellularity.
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| 41. |
- Bahr, Roald, et al.
(författare)
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Evidence-based hamstring injury prevention is not adopted by the majority of Champions League or Norwegian Premier League football teams: the Nordic Hamstring survey
- 2015
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Ingår i: British Journal of Sports Medicine. - : BMJ PUBLISHING GROUP. - 0306-3674 .- 1473-0480. ; 49:22
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Tidskriftsartikel (refereegranskat)abstract
- Background The Nordic hamstring (NH) exercise programme was introduced in 2001 and has been shown to reduce the risk of acute hamstring injuries in football by at least 50%. Despite this, the rate of hamstring injuries has not decreased over the past decade in male elite football. Aim To examine the implementation of the NH exercise programme at the highest level of male football in Europe, the UEFA Champions League (UCL), and to compare this to the Norwegian Premier League, Tippeligaen, where the pioneer research on the NH programme was conducted. Design Retrospective survey. Setting/participants 50 professional football teams, 32 from the UCL and 18 from Tippeligaen. Methods A questionnaire, based on the Reach, Efficacy, Adoption, Implementation and Maintenance framework, addressing key issues related to the implementation of the NH programme during three seasons from 2012 through 2014, was distributed to team medical staff using electronic survey software. Results The response rate was 100%. Of the 150 club-seasons covered by the study, the NH programme was completed in full in 16 (10.7%) and in part in an additional 9 (6%) seasons. Consequently, 125 (83.3%) club-seasons were classified as non-compliant. There was no difference in compliance between the UCL and Tippeligaen in any season (chi(2): 0.41 to 0.52). Conclusions Adoption and implementation of the NH exercise programme at the highest levels of male football in Europe is low; too low to expect any overall effect on acute hamstring injury rates.
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| 42. |
- Bahr, Roald, et al.
(författare)
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International Olympic Committee consensus statement: methods for recording and reporting of epidemiological data on injury and illness in sport 2020 (including STROBE Extension for Sport Injury and Illness Surveillance (STROBE-SIIS))
- 2020
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Ingår i: British Journal of Sports Medicine. - : BMJ PUBLISHING GROUP. - 0306-3674 .- 1473-0480. ; 54:7, s. 372-389
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Tidskriftsartikel (refereegranskat)abstract
- Injury and illness surveillance, and epidemiological studies, are fundamental elements of concerted efforts to protect the health of the athlete. To encourage consistency in the definitions and methodology used, and to enable data across studies to be compared, research groups have published 11 sport-specific or setting-specific consensus statements on sports injury (and, eventually, illness) epidemiology to date. Our objective was to further strengthen consistency in data collection, injury definitions and research reporting through an updated set of recommendations for sports injury and illness studies, including a new Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist extension. The IOC invited a working group of international experts to review relevant literature and provide recommendations. The procedure included an open online survey, several stages of text drafting and consultation by working groups and a 3-day consensus meeting in October 2019. This statement includes recommendations for data collection and research reporting covering key components: defining and classifying health problems; severity of health problems; capturing and reporting athlete exposure; expressing risk; burden of health problems; study population characteristics and data collection methods. Based on these, we also developed a new reporting guideline as a STROBE Extension-the STROBE Sports Injury and Illness Surveillance (STROBE-SIIS). The IOC encourages ongoing in- and out-of-competition surveillance programmes and studies to describe injury and illness trends and patterns, understand their causes and develop measures to protect the health of the athlete. Implementation of the methods outlined in this statement will advance consistency in data collection and research reporting.
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| 43. |
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| 44. |
- Bandholm, Thomas, et al.
(författare)
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Writing up your clinical trial report for a scientific journal : The REPORT trial guide for effective and transparent research reporting without spin
- 2022
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Ingår i: British Journal of Sports Medicine. - : BMJ. - 0306-3674 .- 1473-0480. ; 56:12, s. 683-691
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Forskningsöversikt (refereegranskat)abstract
- The REPORT guide is a 'How to' guide to help you report your clinical research in an effective and transparent way. It is intended to supplement established first choice reporting tools, such as Consolidated Standards of Reporting Trials (CONSORT), by adding tacit knowledge (ie, learnt, informal or implicit knowledge) about reporting topics that we have struggled with as authors or see others struggle with as journal reviewers or editors. We focus on the randomised controlled trial, but the guide also applies to other study designs. Topics included in the REPORT guide cover reporting checklists, trial report structure, choice of title, writing style, trial registry and reporting consistency, spin or reporting bias, transparent data presentation (figures), open access considerations, data sharing and more.
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| 45. |
- Bangsbo, Jens, et al.
(författare)
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Copenhagen Consensus statement 2019 : physical activity and ageing
- 2019
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Ingår i: British Journal of Sports Medicine. - London : BMJ Publishing Group Ltd. - 0306-3674 .- 1473-0480. ; 53:14, s. 856-858
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Tidskriftsartikel (refereegranskat)abstract
- From 19th to 22nd November 2018, 26 researchers representing nine countries and a variety of academic disciplines met in Snekkersten, Denmark, to reach evidence-based consensus about physical activity and older adults. It was recognised that the term ‘older adults’ represents a highly heterogeneous population. It encompasses those that remain highly active and healthy throughout the life-course with a high intrinsic capacity to the very old and frail with low intrinsic capacity. The consensus is drawn from a wide range of research methodologies within epidemiology, medicine, physiology, neuroscience, psychology and sociology, recognising the strength and limitations of each of the methods. Much of the evidence presented in the statements is based on longitudinal associations from observational and randomised controlled intervention studies, as well as quantitative and qualitative social studies in relatively healthy community-dwelling older adults. Nevertheless, we also considered research with frail older adults and those with age-associated neurodegenerative diseases, such as Alzheimer’s and Parkinson’s disease, and in a few cases molecular and cellular outcome measures from animal studies. The consensus statements distinguish between physical activity and exercise. Physical activity is used as an umbrella term that includes both structured and unstructured forms of leisure, transport, domestic and work-related activities. Physical activity entails body movement that increases energy expenditure relative to rest, and is often characterised in terms of intensity from light, to moderate to vigorous. Exercise is defined as a subset of structured physical activities that are more specifically designed to improve cardiorespiratory fitness, cognitive function, flexibility balance, strength and/or power. This statement presents the consensus on the effects of physical activity on older adults’ fitness, health, cognitive functioning, functional capacity, engagement, motivation, psychological well-being and social inclusion. It also covers the consensus on physical activity implementation strategies. While it is recognised that adverse events can occur during exercise, the risk can be minimised by carefully choosing the type of activity undertaken and by consultation with the individual’s physician when warranted, for example, when the individual is frail, has a number of co-morbidities, or has exercise-related symptoms, such as chest pain, heart arrhythmia or dizziness. The consensus was obtained through an iterative process that began with the presentation of the state-of-the-science in each domain, followed by group and plenary discussions. Ultimately, the participants reached agreement on the 30-item consensus statements.
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| 46. |
- Bangsbo, Jens, et al.
(författare)
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The Copenhagen Consensus Conference 2016 : children, youth, and physical activity in schools and during leisure time
- 2016
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Ingår i: British Journal of Sports Medicine. - : BMJ Publishing Group Ltd. - 0306-3674 .- 1473-0480. ; 50:19, s. 1177-1178
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- From 4 to 7 April 2016, 24 researchers from 8 countries and from a variety of academic disciplines gathered in Snekkersten, Denmark, to reach evidence-based consensus about physical activity in children and youth, that is, individuals between 6 and 18 years. Physical activity is an overarching term that consists of many structured and unstructured forms within school and out-of-school-time contexts, including organised sport, physical education, outdoor recreation, motor skill development programmes, recess, and active transportation such as biking and walking. This consensus statement presents the accord on the effects of physical activity on children's and youth's fitness, health, cognitive functioning, engagement, motivation, psychological well-being and social inclusion, as well as presenting educational and physical activity implementation strategies. The consensus was obtained through an iterative process that began with presentation of the state-of-the art in each domain followed by plenary and group discussions. Ultimately, Consensus Conference participants reached agreement on the 21-item consensus statement.
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| 47. |
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| 48. |
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| 49. |
- Bateman, Marcus, et al.
(författare)
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Development of a core outcome set for lateral elbow tendinopathy (COS-LET) using best available evidence and an international consensus process
- 2022
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Ingår i: British Journal of Sports Medicine. - : BMJ Publishing Group Ltd. - 0306-3674 .- 1473-0480. ; 56:12, s. 657-666
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To develop a core outcome set for lateral elbow tendinopathy (COS-LET) and to provide guidance for outcome evaluation in future studies.METHODS: We implemented a multi-stage mixed-methods design combining two systematic reviews, domain mapping of outcome measurement instruments to the core domains of tendinopathy, psychometric analysis of instruments, two patient focus groups and a Delphi study incorporating two surveys and an international consensus meeting. Following the OMERACT guidelines, we used a 70% threshold for consensus.RESULTS: 38 clinicians/researchers and 9 patients participated. 60 instruments were assessed for inclusion. The only instrument that was recommended for the COS-LET was Patient Rated Tennis Elbow Evaluation (PRTEE) for the disability domain. Interim recommendations were made to use: the PRTEE function subscale for the function domain; PRTEE pain subscale items 1, 4 and 5 for the pain over a specified time domain; pain-free grip strength for the physical function capacity domain; a Numerical Rating Scale measuring pain on gripping for the pain on activity/loading domain; and time off work for the participation in life activities domain. No recommendations could be made for the quality-of-life, patient rating of condition and psychological factors domains.CONCLUSIONS: The COS-LET comprises the PRTEE for the disability domain. Interim-use recommendations included PRTEE subscales, time off work, pain-free grip strength and a Numerical Rating Scale measuring pain on gripping. Further work is required to validate these interim measures and develop suitable measures to capture the other domains.
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| 50. |
- Beaven, Christopher, 1977-
(författare)
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Effectiveness of post-match recovery strategies in rugby players
- 2006
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Ingår i: British Journal of Sports Medicine. - 0306-3674 .- 1473-0480. ; 40, s. 260-263-
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To examine the effectiveness of four interventions on the rate and magnitude of muscle damage recovery, as measured by creatine kinase (CK).Methods: 23 elite male rugby players were monitored transdermally before, immediately after, 36 hours after, and 84 hours after competitive rugby matches. Players were randomly assigned to complete one of four post-match strategies: contrast water therapy (CWT), compression garment (GAR), low intensity active exercise (ACT), and passive recovery (PAS).Results: Significant increases in CK activity in transdermal exudate were observed as a result of the rugby match (p<0.01). The magnitude of recovery in the PAS intervention was significantly worse than in the ACT, CWT, and GAR interventions at the 36 and 84 hour time points (p<0.05).Conclusions: An enhanced rate and magnitude of recovery was observed in the ACT, CWT, and GAR treatment groups when compared with the PAS group. Low impact exercise immediately post-competition, wearing compression garments, or carrying out contrast water therapy enhanced CK clearance more than passive recovery in young male athletes.
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