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Preview: British Journal of Sports Medicine current issue

British Journal of Sports Medicine current issue



British Journal of Sports Medicine RSS feed -- current issue



 



Sex, drugs and rock 'n roll

2017-09-18T02:09:25-07:00

The Dutch are very proud to be known as open-minded people. We don’t feel uncomfortable talking about ribald things as sex, drugs and rock ‘n roll. However, the Netherlands are much more than just that.

During the Dutch Golden Age, trade, science and art from Holland were among the most acclaimed in the world. The VOC (Verenigde Oostindische Compagnie/United East Indies Company) was an innovative company with international trade in many countries all over the world. Merchants explored the world and were searching for bright spots for successful trading.

Nowadays, the VSG (Vereniging voor Sportgeneeskunde/Dutch Sports Medicine Association) is pre-eminent in the field of Sport & Exercise Medicine. Due to the enormous efforts of the VSG, sport and exercise medicine has now been recognised as a medical specialty in the Netherlands and well-trained sport and exercise physicians practise in a growing number of Dutch and overseas hospitals.

In this VSG...




Bright spots, physical activity investments that work: Agita Mundo global network

2017-09-18T02:09:25-07:00

Programme Card

  • Which of the seven best investments the programme addresses?

  • Agita Mundo activities are represented under two of the seven best investments, including mass media campaign and community-wide campaigns for physical activity.

  • What sectors it involves: Agita Mundo works through many sectors, including communities, schools, worksites, healthcare settings and mass media.

  • Estimated programme reach

  • Agita Mundo network annual celebrations take place between 6 April to 10 May, with typically more than 2000 events annually worldwide. The Agita Mundo network has been responsible for connecting more than 200 organisations all across the globe.

  • What is unique about this programme?

  • Agita Mundo is a global movement based on promoting physical activity through social mobilisation that has shown impressive longevity and uptake across many parts of the world.

  • Key contact(s): Victor KR Matsudo Estelle V. Lambert

  • Programme website: http://www.portalagita.org.br/en/#

  • Background and...



    The 'weekend warrior physical activity pattern: how little is enough?

    2017-09-18T02:09:25-07:00

    The dose–response relationship between physical activity and health is of great interest to policy makers, clinicians and individuals. Several recent analyses of large-scale population data have advanced our understanding, particularly in teasing apart minimal and optimal physical activity dosage. For example, if we focus on ‘minimal’ dose, 15 min a day of moderate-intensity exercise lowered mortality in a sample of more than 400 000 adults from Taiwan.1 A recent meta-analysis of nine cohort studies revealed that undertaking some moderate to vigorous physical activity (MVPA) but less than the guidelines was associated with 22% reduction in mortality risk in older adults.2 For those fortunate to be able to be performing the ‘optimal’ levels of physical activity, an analysis of more than 600 000 adults of all ages from the USA and Europe showed that a nearly optimal threshold for longevity occurred at three to five times the physical activity recommendation (39%...




    Massage and postexercise recovery: the science is emerging

    2017-09-18T02:09:25-07:00

    Athletes use a variety of postexercise recovery techniques with the belief that they are effective at enhancing return to competition and training. Common modalities include massage, cold water immersion, compression, electrical stimulation, vibration therapy and a combination of one or more of these strategies. Other approaches include diet and hydration protocols, active recovery and sleep. Despite their popularity, the evidence for the effectiveness of most of these modalities is rather limited, although recent efforts are advancing their science which should help in the recommendation of optimal indications and protocols.

    The scientific literature on postexercise massage has accelerated in the last decade. A number of clinical and animal studies have addressed biological plausibility. Clinical studies have investigated the long-held claims that massage mediates leucocyte migration and attenuates the inflammatory response to exercise,1 as well as decreases pain, muscle tone and hyperactivity.2 These reports suggest that massage...




    Launch of new series: bright spots, physical activity investments that work

    2017-09-18T02:09:25-07:00

    Background

    The technological, economical and labour trends that practically eliminated the need for daily physical activity in much of the developed and increasingly in the developing world occurred far too rapidly for human physiology to efficiently adapt. The result is the escalating epidemic of chronic diseases that are contributed to or amplified by physical inactivity. Re-engineering the world to help us prioritise physical activity presents many challenges. There is no single solution or ‘silver bullet’. Understanding a complex problem like physical inactivity requires interdisciplinary thinking and appreciation of both the local and global context. What is clear is that tackling physical inactivity requires a multisectoral response that goes well beyond the traditional healthcare settings and involves, for example, government entities, non-governmental organisations, and private industry. Launched in 2012, the Investments that Work for Physical Activity initiative,1 builds on the 2010 Toronto Charter for Physical Activity2...




    The Bangkok Declaration on Physical Activity for Global Health and Sustainable Development

    2017-09-18T02:09:25-07:00

    Final Post Congress 5 December 2016

    We the delegates and hosts of the 6th International Congress on Physical Activity and Public Health, the biennial meeting of the International Society for Physical Activity and Health (ISPAH), with representatives from 72 countries and held in Bangkok, Thailand, and ISPAH members: 

  • Recognise physical activity includes all forms of human movement and active living, including walking, exercise as well as sport, and is a natural behaviour that confers many benefits. 

  • Endorse the urgency of addressing non-communicable diseases (NCDs), including type 2 diabetes, cardiovascular diseases, numerous cancers, respiratory disease, dementia and poor mental health, which contribute to a significant burden of premature death, disease and disability and associated social and economic burdens to all countries. 

  • Reaffirm that physical inactivity is one of the key modifiable risk factors for NCDs and is a cornerstone strategy for reducing the burden of NCDs, as articulated in the WHO Global...




  • The economic burden of physical inactivity: a systematic review and critical appraisal

    2017-09-18T02:09:25-07:00

    Objective

    To summarise the literature on the economic burden of physical inactivity in populations, with emphases on appraising the methodologies and providing recommendations for future studies.

    Design

    Systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO registration number CRD42016047705).

    Data sources

    Electronic databases for peer-reviewed and grey literature were systematically searched, followed by reference searching and consultation with experts.

    Eligibility criteria

    Studies that examined the economic consequences of physical inactivity in a population/population-based sample, with clearly stated methodologies and at least an abstract/summary written in English.

    Results

    Of the 40 eligible studies, 27 focused on direct healthcare costs only, 13 also estimated indirect costs and one study additionally estimated household costs. For direct costs, 23 studies used a population attributable fraction (PAF) approach with estimated healthcare costs attributable to physical inactivity ranging from 0.3% to 4.6% of national healthcare expenditure; 17 studies used an econometric approach, which tended to yield higher estimates than those using a PAF approach. For indirect costs, 10 studies used a human capital approach, two used a friction cost approach and one used a value of a statistical life approach. Overall, estimates varied substantially, even within the same country, depending on analytical approaches, time frame and other methodological considerations.

    Conclusion

    Estimating the economic burden of physical inactivity is an area of increasing importance that requires further development. There is a marked lack of consistency in methodological approaches and transparency of reporting. Future studies could benefit from cross-disciplinary collaborations involving economists and physical activity experts, taking a societal perspective and following best practices in conducting and reporting analysis, including accounting for potential confounding, reverse causality and comorbidity, applying discounting and sensitivity analysis, and reporting assumptions, limitations and justifications for approaches taken. We have adapted the Consolidated Health Economic Evaluation Reporting Standards checklist as a guide for future estimates of the economic burden of physical inactivity and other risk factors.




    Does leisure time physical activity protect against low back pain? Systematic review and meta-analysis of 36 prospective cohort studies

    2017-09-18T02:09:25-07:00

    Background

    There are plausible mechanisms whereby leisure time physical activity may protect against low back pain (LBP) but there have been no quality systematic reviews and meta-analyses of the subject.

    Objective

    This review aims to assess the effect of leisure time physical activity on non-specific LBP.

    Methods

    Literature searches were conducted in PubMed, Embase, Web of Science, Scopus and Google Scholar databases from their inception through July 2016. Methodological quality of included studies was evaluated. A random-effects meta-analysis was performed, and heterogeneity and publication bias were assessed.

    Results

    Thirty-six prospective cohort studies (n=158 475 participants) qualified for meta-analyses. Participation in sport or other leisure physical activity reduced the risk of frequent or chronic LBP, but not LBP for > 1 day in the past month or past 6–12 months. Risk of frequent/chronic LBP was 11% lower (adjusted risk ratio (RR)=0.89, CI 0.82 to 0.97, I2=31%, n=48 520) in moderately/highly active individuals, 14% lower (RR=0.86, CI 0.79 to 0.94, I2=0%, n=33 032) in moderately active individuals and 16% lower (RR=0.84, CI 0.75 to 0.93, I2=0%, n=33 032) in highly active individuals in comparison with individuals without regular physical activity. For LBP in the past 1–12 months, adjusted RR was 0.98 (CI 0.93 to 1.03, I2=50%, n=32 654) for moderate/high level of activity, 0.94 (CI 0.84 to 1.05, I2=3%, n=8549) for moderate level of activity and 1.06 (CI 0.89 to 1.25, I2=53%, n=8554) for high level of activity.

    Conclusions

    Leisure time physical activity may reduce the risk of chronic LBP by 11%–16%. The finding, however, should be interpreted cautiously due to limitations of the original studies. If this effect size is proven in future research, the public health implications would be substantial.




    Physical activity and exercise for erectile dysfunction: systematic review and meta-analysis

    2017-09-18T02:09:25-07:00

    Background

    A growing body of evidence suggests that physical activity and exercise may improve erectile function.

    Objective

    To conduct a systematic review and meta-analysis evaluating the effects of physical activity modalities and exercise on erectile function in erectile dysfunction trials.

    Methods

    A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement. We searched 6 electronic databases between January 1990 and July 2016 and hand-searched reference lists for randomised controlled trials. Only patients with a diagnosis of erectile dysfunction were included. The mean differences between intervention and control groups were calculated for meta-analysis.

    Results

    7 studies were eligible, including 478 participants allocated to aerobic, pelvic or combined exercise interventions. Follow-up ranged from 8 weeks to 2 years. The risk of bias in the trials was deemed moderate to high mainly due to impossible blinding of patients and personnel, as well as questionable blinding of outcome assessors. Random-effects meta-analyses were performed. Pooled data showed a statistically significant improvement in erectile function score (mean difference 3.85, 95% CI 2.33 to 5.37). A benefit was still demonstrable after a sensitivity analysis because the mean difference in International Index of Erectile Function (IIEF) score ranged from 3.39 (95% CI 1.92 to 4.87) to 4.28 (95% CI 2.54 to 6.02). A benefit was also detected in short-term and long-term interventions as well as in trials evaluating physical activity and exercise alone or in addition to usual care.

    Conclusions

    The present study suggests that physical activity and exercise interventions improve patient-reported erectile dysfunction, particularly aerobic exercise with moderate-to-vigorous intensity.




    What is the effect of health coaching on physical activity participation in people aged 60 years and over? A systematic review of randomised controlled trials

    2017-09-18T02:09:25-07:00

    Background

    Physical inactivity is common in older age, yet increased activity benefits older people in terms of preventing chronic disease and maximising independence. Health coaching is a behaviour change intervention that has been shown to increase physical activity in clinical populations. This systematic review and meta-analysis investigated the effect of health coaching on physical activity, mobility, quality of life and mood in older people.

    Methods

    MEDLINE, EMBASE, CENTRAL, PsycINFO, PEDro, SPORTDiscus, LILACS and CINAHL databases were used to identify randomised controlled trials which evaluated the effect of health coaching on physical activity (primary outcome) among people aged 60+. Secondary outcomes were mobility, quality of life and mood. We calculated standardised mean differences (SMDs, Hedges’ g) with 95% CIs from random effects meta-analyses.

    Results

    27 eligible trials were included. Health coaching had a small, statistically significant effect on physical activity (27 studies; SMD = 0.27; 95% CI 0.18 to 0.37; p<0.001). There was no evidence of an effect of health coaching on mobility (eight studies; SMD = 0.10; 95% CI –0.03 to 0.23; p=0.13), quality of life (eight studies; SMD = 0.07; 95% CI –0.06 to 0.20; p<0.05) or mood (five studies; SMD = 0.02; 95% CI –0.12 to 0.16; p=0.83).

    Conclusions

    Health coaching significantly increased physical activity in people aged 60+. There was no evidence of an effect of health coaching on quality of life, mobility and mood, so different approaches may be required to impact on these outcomes.




    Using Web 2.0 applications to promote health-related physical activity: findings from the WALK 2.0 randomised controlled trial

    2017-09-18T02:09:25-07:00

    Background/Aim

    Web 2.0 internet technology has great potential in promoting physical activity. This trial investigated the effectiveness of a Web 2.0-based intervention on physical activity behaviour, and the impact on website usage and engagement.

    Methods

    504 (328 women, 126 men) insufficiently active adult participants were randomly allocated to one of two web-based interventions or a paper-based Logbook group. The Web 1.0 group participated in the existing 10 000 Steps programme, while the Web 2.0 group participated in a Web 2.0-enabled physical activity intervention including user-to-user interaction through social networking capabilities. ActiGraph GT3X activity monitors were used to assess physical activity at four points across the intervention (0, 3, 12 and 18 months), and usage and engagement were assessed continuously through website usage statistics.

    Results

    Treatment groups differed significantly in trajectories of minutes/day of physical activity (p=0.0198), through a greater change at 3 months for Web 2.0 than Web 1.0 (7.3 min/day, 95% CI 2.4 to 12.3). In the Web 2.0 group, physical activity increased at 3 (mean change 6.8 min/day, 95% CI 3.9 to 9.6) and 12 months (3.8 min/day, 95% CI 0.5 to 7.0), but not 18 months. The Logbook group also increased physical activity at 3 (4.8 min/day, 95% CI 1.8 to 7.7) and 12 months (4.9 min/day, 95% CI 0.7 to 9.1), but not 18 months. The Web 1.0 group increased physical activity at 12 months only (4.9 min/day, 95% CI 0.5 to 9.3). The Web 2.0 group demonstrated higher levels of website engagement (p=0.3964).

    Conclusions

    In comparison to a Web 1.0 intervention, a more interactive Web 2.0 intervention, as well as the paper-based Logbook intervention, improved physical activity in the short term, but that effect reduced over time, despite higher levels of engagement of the Web 2.0 group.

    Trial registration number

    ACTRN12611000157976.




    Infographic. Physical activity benefits for adults and older adults

    2017-09-18T02:09:25-07:00

    Over one third of the UK's adult population fail to meet the Chief Medical Officers' (CMOs') recommended physical activity (PA) guidelines for health.1 Knowledge of the CMOs' PA recommendations is low amongst healthcare workers2 despite physical inactivity being the most prevalent risk factor for non-communicable disease, which accounts for 80% of deaths in the UK.3 Without this fundamental knowledge, healthcare workers remain inadequately prepared to deliver effective PA advice.

    This infographic is the first in a series of three published by the four UK CMOs (England, Scotland, Wales and Northern Ireland) to make their PA recommendations simpler both for healthcare workers to use and for the public to understand. The CMOs created an expert PA committee, with a range of clinical, academic and communications expertise, to develop this infographic, which is designed to facilitate effective PA counselling and aid consultation between healthcare workers...







    The Students As LifeStyle Activists (SALSA) program

    2017-09-18T02:09:25-07:00

    Background

    Adolescence is a critical time for developing healthy lifestyle behaviours. It is a period where young people assume a greater responsibility for their physical activity and eating habits, which often persist into adulthood.1 Schools are an ideal setting for promoting health, as most adolescents attend school and can be easily reached. There is also strong evidence demonstrating that school-based programmes can increase physical activity and improve dietary habits of students.2 3

    The Students As LifeStyle Activists (SALSA) programme uses a peer educational model, driven by students, to promote physical activity and healthy eating in a supportive school environment.4 Our premise is that students not only learn through teaching their peers, but they also serve as powerful motivators and role models for others.5 Adolescents can also be effective ‘change agents’ within their family and the wider school community.

    ...