Effect of supervision and athlete age and sex on exercise-based injury prevention programme effectiveness in sport:a meta-analysis of 44 studies

We aimed to evaluate the influence of supervision, athlete age and sex and programme duration and adherence on exercise-based injury prevention programme effectiveness in sport. Databases were searched for randomized controlled trials evaluating exercise-based injury prevention programme effectiveness compared to “train-as-normal”. A random effects meta-analysis for overall effect and pooled effects by sex and supervision and meta-regression for age, intervention duration and adherence were performed. Programmes were effective overall (risk ratio (RR) 0.71) and equally beneficial for female-only (0.73) and male-only (0.65) cohorts. Supervised programmes were effective (0.67), unlike unsupervised programmes (1.04). No significant association was identified between programme effectiveness and age or intervention duration. The inverse association between injury rate and adherence was significant (β=-0.014, p = 0.004). Supervised programmes reduce injury by 33%, but there is no evidence for the effectiveness of non-supervised programmes. Females and males benefit equally, and age (to early middle age) does not affect programme effectiveness

Running with injury: A study of UK novice and recreational runners and factors associated with running related injury

ObjectivesTo investigate the incidence and type of running related injuries in novice and recreational UK runners, and identify factors associated with injury.DesignRetrospective cross-sectional study.MethodsNovice and recreational runners were recruited through UK parkrun to complete a web-based survey. 1145 respondents reported information on demographics, personal characteristics, and running training characteristics (training goal, novice runners’ training plans, frequency of running, running experience, running terrain). Current and previous injuries were self-reported and questions from the Oslo Sports Trauma Centre Questionnaire for overuse injury were completed. Chi-squared tests and binomial logistic regression were performed.Results570 runners had a current injury and 86% were continuing to run despite their injury causing pain, directly affecting their performance and causing a reduction of running volume. In the first year of running, runners using a self-devised training programme were more likely to be injured compared with using a structured programme such as Couch to 5 K. Running experience of over 2 years was protective (OR 0.578–0.65). Males were 1.45 times more likely to be injured. Other factors associated with current injury were wearing orthotics (OR 1.88), and lack of previous injuries in the past 12 months (OR 1.44).ConclusionsMore experienced runners have a lower rate of injury. A novice runner should use a recognised structured training programme. These results suggest that graduated loading is important for novice runners, and that load modification may be important whilst recovering from an injury, however full recovery from previous injury may prevent future injury

Running coaches and running group leaders’ engagement with, and beliefs and perceived barriers to prehabilitation and injury prevention strategies for runners

ObjectivesTo identify which pre-and post-run injury risk reduction activities and prehabilitation (prehab) strategies Coaches and Running Group Leaders (Coaches/RGLs) engage in with runners; to explore their beliefs on why runners get injured; to identify Coaches/RGLs confidence providing injury prevention activities, and what they believe are effective for reducing risk of injury; to identify their perceived barriers to including prehab during running coaching/training.DesignSurvey; Participants: UK Coaches/RGLs (N = 100)Outcome measuresOnline questionnaire with open, closed and Likert scale questions.ResultsMost Coaches/RGLs performed active warm-ups (97%), cool-downs (94%),gave injury prevention advice (91%), and advice on recovery strategies (84%) during training. Fewer coaches/RGLs incorporated prehab (67%). Although they collectively exhibited a wide range of knowledge, individually there was less consistency and confidence providing this. Prehab was rated as very important for injury risk reduction, with supervision recommended to facilitate runner engagement. Coaches/RGLs found conflicting advice, time, environment, and resistance from runners as barriers to incorporating prehab into training.ConclusionCoaches/RGLs believe prehab is important for runners however lack of confidence and knowledge appeared to limit the wider inclusion of prehab with runners. Coaches/RGLs welcomed reputable information on prehab from evidence-based sources. This may assist in reducing injury

Menstrual cycle and hormonal contraceptive symptom severity and frequency in athletic females

The purpose of this study was to determine symptom severity and frequency in female exercisers and athletes from a diverse range of sports who have a menstrual cycle (MC) or use hormonal contraceptives (HCs). An additional aim was to explore the perceived impact of MC/HC use upon exercise and sport performance. In total, 604 self-identifying female athletes and exercisers (M = 29.4 years, SD = 9.0) from 85 sports/activities completed a survey which included: sport/exercise participation, bleeding characteristics, HC use, symptom severity/frequency, symptom management strategies, menstrual product use, and perceived impact of MC/HC use on exercise performance. The data were subject to mixed-methods analysis. Over one third (n = 225; 37.25%) of participants reported current HC use. Ninety-five percent (95.36%) of participants experienced symptoms related to MC or HC use. Physiological, psychological, and affective symptoms were all among the most prevalent. The most frequently noted severe and very severe symptoms for all participants, MC and HC users, were abdominal cramps (36.92%, 39.32%, and 32.89%, respectively), mood changes (26.16%, 25.07%, and 28.00%, respectively), and tiredness (25.33%, 25.59%, and 24.89%, respectively). Symptom impact was self-managed through medical and/or other (cognitive/behavioral) strategies. Qualitative content analysis of the data produced four overarching themes: (a) the impact of symptoms, (b) menstrual stigma and taboos, (c) protective factors, and (d) coping strategies. In conclusion, menstruation is a multifaceted, unique experience that impacts upon sport/exercise performance. Practitioners should consider athletes’ distinct needs, including the frequency of occurrence and severity of their symptomatic experiences, when facilitating menstruation-supportive training, avoiding a “one-size fits-all” approach

Spinal motion and muscle activity during active trunk movements – comparing sheep and humans adopting upright and quadrupedal postures

Sheep are used as models for the human spine, yet comparative in vivo data necessary for validation is limited. The purpose of this study was therefore to compare spinal motion and trunk muscle activity during active trunk movements in sheep and humans. Three-dimensional kinematic data as well as surface electromyography (sEMG) of spinal flexion and extension was compared in twenty-four humans in upright (UR) and 4-point kneeling (KN) postures and in 17 Austrian mountain sheep. Kinematic markers were attached over the sacrum, posterior iliac spines, and spinous and transverse processes of T5, T8, T11, L2 and L5 in humans and over the sacrum, tuber sacrale, T5, T8, T12, L3 and L7 in sheep. The activity of erector spinae (ES), rectus abdominis (RA), obliquus externus (OE), and obliquus internus (OI) were collected. Maximum sEMG (MOE) was identified for each muscle and trial, and reported as a percentage (MOE%) of the overall maximally observed sEMG from all trials. Spinal range of motion was significantly smaller in sheep compared to humans (UR / KN) during flexion (sheep: 6–11°; humans 12–34°) and extension (sheep: 4°; humans: 11–17°). During extension, MOE% of ES was greater in sheep (median: 77.37%) than UR humans (24.89%), and MOE% of OE and OI was greater in sheep (OE 76.20%; OI 67.31%) than KN humans (OE 21.45%; OI 19.34%), while MOE% of RA was lower in sheep (21.71%) than UR humans (82.69%). During flexion, MOE% of RA was greater in sheep (83.09%) than humans (KN 47.42%; UR 41.38%), and MOE% of ES in sheep (45.73%) was greater than KN humans (14.45%), but smaller than UR humans (72.36%). The differences in human and sheep spinal motion and muscle activity suggest that caution is warranted when ovine data are used to infer human spine biomechanics

Intrinsic and extrinsic variables impacting upper quarter Y-balance test scores in sporting cohorts: A systematic review

IntroductionThe upper quarter y-balance test (YBT-UQ) is a functional screening tool used to detect musculoskeletal injury risk, aid rehabilitation, and monitor dynamic function, strength and control, yet little is currently known about intrinsic and extrinsic factors that influence reach scores.ObjectivesThis systematic review aimed to determine if age, sex, or interventions influenced reach scores and whether between-limb differences were common in non-injured sporting populations, with a secondary aim to identify if sport impacted YBT-UQ reach.MethodsWeb of Science, PubMed, and SportDiscus were systematically searched from January 2012 to November 16, 2023, revealing twenty-three studies satisfying inclusion criteria of published in English between 2012 and 2023, healthy participants of any age including both males and females, athletic populations, YBT-UQ use to assess upper limb mobility/stability, report normalised reach scores, and peer-reviewed full-texts. Methodological quality was evaluated via National Institutes of Health (NIH) quality assessment tools for controlled interventions, observational cohort and cross-sectional designs, and pre-post with no control group.ResultsAge, sex, sport, and fatigue were influencing factors; greater reach scores were achieved in older athletes (i.e. >18 years), males, and in a well-rested state. Between-limb differences were not common in sporting populations; therefore, asymmetries may be useful for practitioners to aid injury risk identification.ConclusionThis is the first systematic review investigating YBT-UQ influencing factors and thereby provides context for clinicians regarding characteristics that impact reach scores in sporting populations, from which normative values could be determined and further aid clinical decisions or areas to improve regarding injury risk

Enablers and barriers in ultra-running: a comparison of male and female ultra-runners

Female participation rates in ultra-running is considerably lower than that of males, but the reasons for this are not fully understood. In this study, online questionnaire responses were collected from ultra-runners taking part in the Scottish Jedburgh 3 Peaks ultra and Highland Fling race. One-to-one-semi-structured phone interviews were conducted with a subset of runners to further explore themes from questionnaire responses. Similar experiences among male and female ultra-runners were identified. Enablers were: wanting a challenge, nature/outdoors, and the friendliness of the ultra-community. The main barrier was training time. Qualitative responses suggested negotiation-efficacy was important for factoring in training around work and family commitments, and although a greater proportion of males had dependants compared to females, female participation was considerably lower than males. This may be due to the historical influences of traditional gender roles however this effect may be diminishing as female participation in Scottish ultra-races appears to be increasing

Do workplace fish tanks influence employee wellbeing and cognitive performance? An embedded mixed-methods study

Evidence from “pet-friendly” workplaces highlights potential benefits associated with taking companion animals to work, including reduced stress among employees. Ornamental fishes carry a much lower risk than other companion animals and may be a suitable alternative in situations where other animals would introduce too great a risk (e.g., allergy, accidental injury). The aim of this study was to investigate whether watching an aquarium during the working day influenced employee wellbeing through the reduction of stress and improvements in stress-related outcomes. An embedded mixed-methods study was conducted, comprising two within-subjects trials (Trials A and B) and a qualitative follow-up. Participants were university employees and research students who participated during their working day. In Trial A (n = 30), the immediate effects of watching live fishes on mood, physiological stress, and cognitive performance were compared with the effects of watching a fish video or resting quietly. Although some outcomes improved from pre- to post-activity, there was no evidence that watching fishes (live or video) had greater effects than resting quietly. In Trial B (n = 27), the effects of repeatedly engaging in the same three activities over several weeks were examined. Watching fish videos was associated with improvements in “high pleasure-low arousal” and overall job-related affective wellbeing, but no further effects of condition were found. Qualitative follow-up data collected from a subset of participants from the experimental trials (n = 13) indicated that all three activities may be beneficial as leaving their desks provided detachment from work for a short period. Qualitative data suggested that live fishes were perceived as more engaging, but this did not translate to quantitative findings. Locating fish aquaria within offices (rather than a separate workplace location) may promote wellbeing by encouraging “microbreaks”; further research is needed to investigate this hypothesis

In vivo magnetic resonance imaging features of spinal muscles in the ovine model

BackgroundMuscle fatty infiltration (MFI) has been identified in patients with spinal pain using magnetic resonance imaging (MRI). Even though sheep are a commonly used animal model for the human spine, comparative sheep MFI data from MRI is not available. Determining MFI in sheep spinal muscles using acquisition protocols commonly used in man will identify the applicability of this approach in future sheep model studies, such that the effects of spinal interventions on muscle can be assessed prior to their use in a human (clinical) population.ObjectiveTo quantify ovine lumbar spine MFI using three-dimensional two-point Dixon and T1-weighted sequences.MethodsT1-weighted and Dixon lumbar spine axial sequences were collected in 14 healthy Austrian mountain sheep using a 1.5-T MRI. At each vertebrae, the region of interest of psoas major and minor (PS), multifidus (M), and longissimus (L) were identified. To determine MFI from the T1-weighted images, the mean pixel intensity (MPI) was calculated as a percentage of subcutaneous or intermuscular fat. For the Dixon images, fat sequence MPI was calculated as a percentage of the summed fat and water sequence MPIs. Spinal degeneration was graded and correlated to MFI. Dixon MFI was compared to T1-weighted MFI obtained from subcutaneous and intermuscular fat.ResultsFor every muscle, T1-weighted MFI calculated using subcutaneous fat scored significantly lower than Dixon MFI and T1-weighted MFI calculated using intermuscular fat (p 0.05), although significant differences were found for PS.ConclusionIn sheep, Dixon sequences provide an acceptable comparison to T1-weighted sequences for lumbar extensor MFI based on intermuscular fat. However, compared to the human literature, ovine lumbar musculature contains greater MFI, making interspecies comparisons more complex

Effect of supervision and athlete age and sex on exercise-based injury prevention programme effectiveness in sport: A meta-analysis of 44 studies

We aimed to evaluate the influence of supervision, athlete age and sex and programme duration and adherence on exercise-based injury prevention programme effectiveness in sport. Databases were searched for randomized controlled trials evaluating exercise-based injury prevention programme effectiveness compared to “train-as-normal”. A random effects meta-analysis for overall effect and pooled effects by sex and supervision and meta-regression for age, intervention duration and adherence were performed. Programmes were effective overall (risk ratio (RR) 0.71) and equally beneficial for female-only (0.73) and male-only (0.65) cohorts. Supervised programmes were effective (0.67), unlike unsupervised programmes (1.04). No significant association was identified between programme effectiveness and age or intervention duration. The inverse association between injury rate and adherence was significant (β=-0.014, p = 0.004). Supervised programmes reduce injury by 33%, but there is no evidence for the effectiveness of non-supervised programmes. Females and males benefit equally, and age (to early middle age) does not affect programme effectiveness