ISSN / EISSN: 01121642 / 11792035
Published by: Springer Nature
Total articles ≅ 3,657
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Sports Medicine pp 1-12; https://doi.org/10.1007/s40279-022-01797-7
Background: Playing football is associated with a high risk of injury. Injury prevention is a priority as injuries not only negatively impact health but also potentially performance. Various multi-component exercise-based injury prevention programs for football players have been examined in studies. Objective: We aimed to investigate the efficacy of multi-component exercise-based injury prevention programs among footballers of all age groups in comparison to a control group. Methods: We conducted a systematic review and meta-analysis of randomized and cluster-randomized controlled trials. CINAHL, Cochrane, PubMed, Scopus, and Web of Science databases were searched from inception to June 2022. The following inclusion criteria were used for studies to determine their eligibility: they (1) include football (soccer) players; (2) investigate the preventive effect of multi-component exercise-based injury prevention programs in football; (3) contain original data from a randomized or cluster-randomized trial; and (4) investigate football injuries as the outcome. The risk of bias and quality of evidence were assessed using the Cochrane Risk of Bias Tool and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE), respectively. The outcome measures were the risk ratio (RR) between the intervention and the control group for the overall number of injuries and body region-specific, contact, and non-contact injuries sustained during the study period in training and match play. Results: Fifteen randomized and cluster-randomized controlled trials with 22,177 players, 5080 injuries, and 1,587,327 exposure hours fulfilled the inclusion criteria and reported the required outcome measures. The point estimate (RR) for the overall number of injuries was 0.71 (95% confidence interval [CI] 0.59–0.85; 95% prediction interval [PI] 0.38–1.32) with very low-quality evidence. The point estimate (RR) for lower limb injuries was 0.82 (95% CI 0.71–0.94; 95% PI 0.58–1.15) with moderate-quality evidence; for hip/groin injuries, the RR was 0.56 (95% CI 0.30–1.05; 95% PI 0.00–102.92) with low-quality evidence; for knee injuries, the RR was 0.69 (95% CI 0.52–0.90; 95% PI 0.31–1.50) with low-quality evidence; for ankle injuries, the RR was 0.73 (95% CI 0.55–0.96; 95% PI 0.36–1.46) with moderate-quality evidence; and for hamstring injuries, the RR was 0.83 (95% CI 0.50–1.37) with low-quality evidence. The point estimate (RR) for contact injuries was 0.70 (95% CI 0.56–0.88; 95% PI 0.40–1.24) with moderate-quality evidence, while for non-contact injuries, the RR was 0.78 (95% CI 0.55–1.10; 95% PI 0.25–2.47) with low-quality evidence. Conclusions: This systematic review and meta-analysis indicated that the treatment effect associated with the use of multi-component exercise-based injury prevention programs in football is uncertain and inconclusive. In addition, the majority of the results are based on low-quality evidence. Therefore, future high-quality trials are needed to provide more reliable evidence. Clinical Trial Registration: PROSPERO CRD42020221772.
Sports Medicine pp 1-2; https://doi.org/10.1007/s40279-022-01803-y
Sports Medicine pp 1-23; https://doi.org/10.1007/s40279-022-01806-9
Background: The current literature on the chronic effects of static stretching (SS) exercises on muscle strength and power is unclear and controversial. Objective: We aimed to examine the chronic effects of SS exercises on muscle strength and power as well as flexibility in healthy individuals across the lifespan. Design: Systematic review with meta-analysis of (randomized) controlled trials. Data Sources: A systematic literature search was conducted in the databases PubMed, Web of Science, Cochrane Library, and SPORTDiscus up to May 2022. Eligibility Criteria for Selecting Studies: We included studies that investigated the chronic effects of SS exercises on at least one muscle strength and power outcome compared to an active/passive control group or the contralateral leg (i.e., using between- or within-study designs, respectively) in healthy individuals, irrespective of age, sex, and training status. Results: The main findings of 41 studies indicated trivial-to-small positive effects of chronic SS exercises on muscle strength (standardized mean difference [SMD] = 0.21, [95% confidence interval 0.10–0.32], p = 0.001) and power (SMD = 0.19, 95% confidence interval 0.12–0.26], p < 0.001). For flexibility, moderate-to-large increases were observed (SMD = 0.96, [95% confidence interval 0.70–1.22], p < 0.001). Subgroup analyses, taking the participants’ training status into account, revealed a larger muscle strength improvement for sedentary (SMD = 0.58, p < 0.001) compared with recreationally active participants (SMD = 0.16, p = 0.029). Additionally, larger flexibility gains were observed following passive (SMD = 0.97, p < 0.001) compared with active SS exercises (SMD = 0.59, p = 0.001). The chronic effects of SS on muscle strength were moderated by the proportion of female individuals in the sample (β = 0.004, p = 0.042), with higher proportions experiencing larger gains. Other moderating variables included mean age (β = 0.011, p < 0.001), with older individuals showing larger muscle strength gains, and the number of repetitions per stretching exercise and session (β = 0.023, p = 0.004 and β = 0.013, p = 0.008, respectively), with more repetitions associated with larger muscle strength improvements. Muscle power was also moderated by mean age (β = 0.006, p = 0.007) with larger gains in older individuals. The meta-regression analysis indicated larger flexibility gains with more repetitions per session (β = 0.094, p = 0.016), more time under stretching per session (β = 0.090, p = 0.026), and more total time under stretching (β = 0.078, p = 0.034). Conclusions: The main findings indicated that chronic SS exercises have the potential to improve muscle strength and power. Such improvements appear to benefit sedentary more than recreationally active participants. Likewise, chronic SS exercises result in a marked enhancement in flexibility with larger effects of passive, as compared with active, SS. The results of the meta-regression analysis for muscle strength indicated larger benefits of chronic SS exercises in samples with higher proportions of female, older participants, and a higher number of repetitions per stretching exercise and session. For muscle power, results suggested larger gains for older participants. Regarding flexibility, findings indicated larger benefits following a higher number of repetitions per exercise and a longer time under stretching per session as well as a longer total time under stretching.
Sports Medicine pp 1-3; https://doi.org/10.1007/s40279-023-01811-6
Sports Medicine pp 1-2; https://doi.org/10.1007/s40279-023-01810-7
Sports Medicine pp 1-16; https://doi.org/10.1007/s40279-022-01801-0
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Sports Medicine pp 1-21; https://doi.org/10.1007/s40279-022-01808-7
Background: The most effective way to cope with high blood sugar spikes is to engage in physical activity in temporal proximity to food intake. However, so far, it is unclear as to whether there is an optimal time for physical activity around food intake. Objectives: We aimed to identify the impact of pre- and post-meal exercise on postprandial glucose excursions in humans with and without type 2 diabetes mellitus. Methods: We conducted a systematic review with meta-analysis, PROSPERO registration number: CRD42022324070. We screened MEDLINE/PubMed, Cochrane/CINAHL/EMBASE, and Web of Knowledge until 1 May, 2022. We used the risk of bias rating with the crossover extension of the Cochrane risk of bias assessment tool II. Standardized mean differences (SMDs, Hedges’ g) with 95% confidence intervals (CIs) were calculated as pooled effect estimates of a random-effects meta-analysis. Eligibility criteria included three-armed randomized controlled trials comparing the acute effects of pre- and post-meal exercise to a no-exercise control in humans. Results: Eight randomized controlled trials (crossover trials, high risk of bias) with 30 interventions in 116 participants (47 diagnosed with type 2 diabetes, 69 without type 2 diabetes) were eligible. Exercise after meal ingestion (real food or meal replacement drinks) led to a reduction in postprandial glucose excursions compared with exercise before eating (15 effect sizes; SMD = 0.47 [95% CI 0.23, 0.70]) and an inactive control condition (15 effect sizes; SMD = 0.55 [95% CI 0.34, 0.75]. Pre-meal exercise did not lead to significantly lower postprandial glucose compared to an inactive control (15 effect sizes; SMD = − 0.13 [95% CI − 0.42, 0.17]). The time between meal and exercise (estimate = − 0.0151; standard error = 0.00473; Z = − 3.19; p = 0.001; 95% CI − 0.024, − 0.006) had a moderating influence on postprandial glucose excursions. Conclusions: Exercise, i.e., walking, has a greater acute beneficial impact on postprandial hyperglycemia when undertaken as soon as possible after a meal rather than after a longer interval or before eating. Clinical Trial Registration: The review was pre-registered in the PROSPERO database (CRD42022324070). The date of submission was 07.04.2022, with the registration on 08.05.2022.
Sports Medicine pp 1-25; https://doi.org/10.1007/s40279-022-01798-6
Taper is a common training strategy used to reduce fatigue and enhance athletic performance. However, currently, no review has summarised what psychological research has been conducted examining taper, what this research shows and what future research needs to be undertaken to extend the field. Consequently, a scoping review was conducted with three aims: (a) to determine the characteristics of psychological research examining taper, (b) to summarise psychological research collected during taper with adult athletes and coaches, and (c) to identify gaps in psychological research examining taper. Forty-eight articles were identified following an exhaustive search strategy and charted following scoping review guidelines. Results showed most research was quantitative, used a longitudinal design, was conducted in swimming, triathlon, cycling or across multiple sports, and used a university-, regional- or national-level male athlete sample. Eight themes were developed to summarise the research: Mood, Perception of Effort, Perceived Fatigue and Wellness, Recovery-Stress, Taper as a Stressor, Stress Tolerance, Psychological Preparation and Cognitive Functioning. Additionally, four research recommendations were identified: (a) conducting exploratory research that examines the impact taper has on athletes’ and coaches’ competition preparation and stress experience, (b) asking more advanced psychological questions and conducting multi-disciplinary research, (c) including a more diverse participant sample in studies and (d) examining the impact of psychological interventions during taper. Overall, this scoping review has highlighted the limited research examining the psychology of taper and the need for focused research that asks more complex questions across diverse populations.
Sports Medicine pp 1-3; https://doi.org/10.1007/s40279-023-01809-0
Sports Medicine pp 1-19; https://doi.org/10.1007/s40279-022-01805-w
The physiological determinants of high-intensity exercise tolerance are important for both elite human performance and morbidity, mortality and disease in clinical settings. The asymptote of the hyperbolic relation between external power and time to task failure, critical power, represents the threshold intensity above which systemic and intramuscular metabolic homeostasis can no longer be maintained. After ~ 60 years of research into the phenomenon of critical power, a clear understanding of its physiological determinants has emerged. The purpose of the present review is to critically examine this contemporary evidence in order to explain the physiological underpinnings of critical power. Evidence demonstrating that alterations in convective and diffusive oxygen delivery can impact upon critical power is first addressed. Subsequently, evidence is considered that shows that rates of muscle oxygen utilisation, inferred via the kinetics of pulmonary oxygen consumption, can influence critical power. The data reveal a clear picture that alterations in the rates of flux along every step of the oxygen transport and utilisation pathways influence critical power. It is also clear that critical power is influenced by motor unit recruitment patterns. On this basis, it is proposed that convective and diffusive oxygen delivery act in concert with muscle oxygen utilisation rates to determine the intracellular metabolic milieu and state of fatigue within the myocytes. This interacts with exercising muscle mass and motor unit recruitment patterns to ultimately determine critical power.