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Background: Scholars have suggested that students’ views of what is important for them to know as Physical Education (PE) teachers are a result of what is assessed in Physical Education Teacher Education (PETE). Thus, there is a risk that students will reproduce content areas such as sports and assess sport-techniques without much critical consideration. In this study, however, the risk of reproducing what is prioritised in PETE is seen as an opportunity regarding the potential reproduction of other content areas than sports. Based on the regulative principles of PE and PETE that privilege sport skills and hinder creative movement learning, we focus on a content area in PETE that provides opportunities for students to engage in creative collaboration and examine how this content area is realised in school PE. Hence, we have chosen to explore ‘Movement Composition’, a content area which has a long tradition at one of the PETE universities in Sweden. Based on an overarching interest in whether and how PETE matters, this exploratory study focuses on the potential transferability of Movement Composition as a particular content area in the transition from PETE to PE. Purpose and research question: The purpose of this study is to explore Movement Composition as a content area undergoing the transition from PETE to school PE. The research question is: How is the pedagogic discourse of Movement Composition constructed, recontextualised and realised in the transition from PETE to school PE? Methods: Data was generated through an interview with one of the initiators of Movement Composition. Stimulated Recall interviews and Zoom interviews were also conducted with a group of five PETE students and three experienced PE teachers. In addition, documents such as the study guide, course literature, and written assignments associated with Movement Composition in the PETE programme were included in the empirical material. In the analysis, the combination of Bernstein’s pedagogic device and the Swedish didactics of PE research tradition was used to identify the pedagogic discourse of Movement Composition in the transition from PETE to school PE. Findings: The findings show how the pedagogic discourse of Movement Composition as a content area is constructed, recontextualised and realised in the transition from PETE to school PE. The construction of Movement Composition as a pedagogic discourse in PETE is about how the content area (the what) is selected and organised for pedagogical purposes. The recontextualisation of Movement Composition is about how the pedagogic discourse is interpreted and translated in relation to the PE syllabus. The realisation of Movement Composition involves how the content area in PETE is implemented in PE practice. Conclusions: This exploratory study has shown that what is articulated as a relevant content area and the way it is taught, learned, and assessed in PETE in many regards survives the transition to school PE. The transition from PETE to school PE does not only involve reproduction of sports and sport-techniques from one context to another. PETE also contributes to the use of creative, collaborative, and student-centred learning tasks in school PE. Exploring Movement Composition in the transition from physical education teacher education to school PE

Background The risk of sustaining a graft rupture after anterior cruciate ligament reconstruction (ACLR) is high. Contributing risk factors are, however, still not clearly identified. Objective The aim of this systematic review was to identify and quantify risk factors for graft rupture after ACLR. Methods A systematic review with meta-analysis (PROSPERO CRD42020140129) based on PRISMA guidelines was performed. MEDLINE, CINAHL and EMBASE were searched from inception to September 2021. Prospective and retrospective studies addressing risk factors for graft rupture after ACLR in males/females of all ages were considered. Meta-analyses using a random effect model (effect measure: odds ratio [OR] with 95% confidence interval [CI]) were performed. The GRADE tool was used to assess evidence quality. Results Following full-text screening of 310 relevant papers, 117 were eventually included, incorporating up to 133,000 individuals in each meta-analysis. Higher Tegner activity level (≥ 7 vs Conclusion Conspicuous risk factors for graft rupture were mainly sports and hereditary related. Few studies investigated function-related modifiable factors or included sports exposure data.

Background: Despite increasing support for models in physical education, ambiguity exists concerning the role of teachers in the implementation of models. Very generally, some scholarship seems to suggest that teachers should work as technicians and use models in an instrumental manner. Other scholarship suggests that teachers should use models in ways that are responsive to the contexts in which they are working. This suggestion positions teachers more as craftspeople. Ambiguity is problematic given that teachers have been identified as 'key players' when it comes to the implementation of models. How teachers are positioned in research may have a significant impact on further research and pedagogical practices. Purpose: This paper has two specific aims. First, we aim to provide a detailed map of how scholars have positioned teachers within physical education models literature. Second, we aim to provide a reinterpretation of our findings using Deweyan theory. Data production: The scoping review conducted here is based on the framework provided by Arksey and O'Malley [2005. "Scoping Studies: Towards a Methodological Framework." International Journal of Social Research Methodology 8 (1): 19-32]. It involved: (1) the development of a research question which was: in which ways does PE models literature position teachers? (2) the identification of potentially relevant literature through searches of the Web of Science, SPORT Discus and Google Scholar databases. The search terms used were: 'Physical education' AND 'Models-based practice;' OR; 'Pedagogical model;' OR; 'Instructional model;' OR; 'Curriculum model;' OR; 'Model;' OR; 'Teacher,' and literature needed to be published between 2010 and 2021 in English, (3) the selection of literature for the review. This occurred as an iterative process that involved going back and forth between the potentially relevant literature and our research question, (4) charting of the literature, done through inductive thematic analysis. This involved a close inspection of the included texts and the identification of recurring types of positioning in the corpus, and (5) a theoretical reinterpretation of teacher positioning achieved in models scholarship. Findings: In the physical education scholarship on pedagogical models, teachers are positioned as: (1) resistant to using models; (2) incapable of using models correctly; (3) mechanical reproducers of models; (4) struggling implementers of models; (5) needing models to change their ordinary practices; (6) capable of using models correctly with support; (7) adapters of models, and (8) collaborators with researchers when implementing models. Discussion: Three issues are raised for discussion. The first relates to the potential disempowerment of teachers achieved by models. The second relates to the relationship between teachers and researchers. The third relates to how models themselves are conceived. Conclusion: The paper is concluded with two general reflections that follow from the issues raised in the discussion.

Purpose To study the epidemiology and return to play characteristics of anterior and posterior ankle impingement syndromes (AAIS and PAIS) over 18 consecutive seasons in male professional soccer players. Methods Between the 2001–2002 and 2018–2019 seasons, 120 European soccer teams were followed prospectively for various seasons. Time loss injuries and player exposures were recorded individually in 6754 unique players. Injury incidence and burden were reported as the number of injuries and days absence per 1000 h with 95% confidence intervals (CIs). Injury severity was reported as median absence in days with the interquartile range (IQR). Results Out of 25,462 reported injuries, 93 (0.4%) were diagnosed as AAIS (38%) or PAIS (62%) in 77 players. AAIS and PAIS were similar regarding injury characteristics except for a greater proportion of AAIS having a gradual onset (69% vs.47%; P = 0.03) and being re-injuries (31% vs. 9%; P = 0.01). Impingement syndromes resulted in an overall incidence of 0.03 injuries (95% CI 0.02–0.03) per 1000 h and an injury burden of 0.4 absence days per 1000 h. PAIS incidence was significantly higher than that for AAIS [0.02 (95% CI 0.002–0.03) vs. 0.01 (95% CI 0.005–0.01) injuries per 1000 h (RR = 1.7). The absence was significantly longer in AAIS than in PAIS [10 (22) vs. 6 (11) days; P = 0.023]. Impingement syndromes that presented with a gradual onset had longer absences in comparison to impingement with an acute onset [8 (22) vs. 5 (11) days; P = 0.014]. Match play was associated with a higher incidence and greater injury burden than training: 0.08 vs. 0.02 injuries per 1000 h (RR 4.7), respectively, and 0.9 vs. 0.3 days absence per 1000 h (RR 2.5). Conclusion Ankle injuries are frequent in men’s professional soccer and ankle impingement is increasingly recognized as a common source of pain, limited range of motion, and potential time loss. In our study, ankle impingement was the cause of time loss in less than 0.5% of all injuries. PAIS was more frequently reported than AAIS, but AAIS was associated with more absence days and a higher re-injury rate than PAIS. The findings in this study can assist the physician in best practice management on ankle impingment syndromes in professional football. Level of evidence II.

Physical education (PE) has significant potential to shape how young people experience their own and others’ bodies. This potential has not always been realized in positive ways and some research suggests that experiences in PE have contributed to young people’s dissatisfaction with their appearances. The broad aim of this review is to provide a comprehensive understanding of body image as a pedagogical issue within PE. A narrative approach to the review is adopted that enables us to summarize, compare, explain and interpret various types of research relevant to our aim. From the databases ERIC, SCOPUS and PsycInfo, 25 articles were identified that deal with either body image in typical PE lessons or researcher-led attempts to influence students’ body image (what we have termed ‘pedagogic interventions’). Main findings are that: (1) PE has been presented as both part of the cause and a potential site of intervention to the problem of negative body image; (2) Researchers have based pedagogic interventions on four types of guiding principles; and (3) Researchers have made an array of recommendations for practitioners relating to gender, time, professional development and the characteristics of the pedagogical interventions. Findings are discussed in relation to broader research on body image in society and in PE with a focus on how the findings might inform further scientific practice.

Objectives: To compare neuromuscular control and hop performance between youth and adult male and female football players. Design: Cross-sectional study. Participants: 119 youth players (13-16 years; 68 males) and 88 adult players (17-26 years; 44 males). Main outcome measures: Neuromuscular control assessed with drop vertical jump (DVJ) and tuck jump assessment (TJA). Hop performance assessed with single-leg hop for distance and side hop. Results: Adult females had smaller normalized knee separation distances (NKSD) during DVJ at initial contact (77.9 +/- 18.5 vs. 86.1 +/- 11.0, p = 0.010) and at maximum knee flexion (59.7 +/- 23.4 vs.74.1 +/- 18.1, p = 0.001) compared to youth females. TJA revealed more technique errors in youths compared to adults (males 10 (8-11) vs. 8 (7-10); females 11 (9-12) vs. 9 (8-11), p < 0.05). Youths demonstrated inferior hop performance (males single-leg hop 142 +/- 18 vs. 163 +/- 17, side hop 41 +/- 12 vs. 52 +/- 12, p < 0.001; females side hop 32 +/- 10 vs. 38 +/- 14, p < 0.05). Conclusions: Youth players demonstrated reduced neuromuscular control during TJA and inferior hop performance compared to adult players. Adult female players demonstrated greater knee valgus during DVJ compared to youth female players. Funding Agencies|Swedish Research Council [2015-02414, 2018-03135]; Medical Research Council of Southeast Sweden [FORSS-936990]; Swedish Research Council for Sport Science (CIF) [P2015-0150, FO2016-0021, FO2018-0012, P2018-0167]; Region OEurostergoEurotland [LIO-527921, LIO-722051]; Futurum-the Academy for Healthcare, Region JoEuronkoEuroping County, Sweden [FUTURUM-766791, FUTURUM-767001]Licensing: This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

Despite the International System of Units (SI), as well as several publications guiding researchers on correct use of terminology, there continues to be widespread misuse of mechanical terms such as ‘work’ in sport and exercise science. A growing concern is the misuse of the term ‘load’. Terms such as ‘training load’ and ‘PlayerLoad’ are popular in sport and exercise science vernacular. However, a ‘load’ is a mechanical variable which, when used appropriately, describes a force and therefore should be accompanied with the SI-derived unit of the newton (N). It is tempting to accept popular terms and nomenclature as scientific. However, scientists are obliged to abide by the SI and must pay close attention to scientific constructs. This communication presents a critical reflection on the use of the term ‘load’ in sport and exercise science. We present ways in which the use of this term breaches principles of science and provide practical solutions for ongoing use in research and practice.

Purpose: The aims of this study were to assess (1) the day-to-day variability in, and (2) the magnitude and time-course of adaptation of physiological parameters (i.e., maximal oxygen uptake [VO2max], heart rate [HR], blood lactate concentration, respiratory exchange ratio [RER], ratings of perceived exertion [RPE], and time-to-exhaustion [TTE]) in response to an intervention involving three incremental ramp tests per week for 9 weeks. Methods: Twelve participants (25 ± 4 yrs, VO2max, 47.8 ± 5.2 mL∙min−1∙kg−1 (means ± SD)) completed the entire experimental procedure. The tests comprised a 5-min constant workload to obtain submaximal parameters followed by an incremental protocol until exhaustion. Results: The mean day-to-day variability for the maximal value of VO2 was 2.8%, 1.1% for HR, 18.1% for blood lactate concentration, 2.1% for RER, 1.1% for RPE, and 5.0% for TTE. The values for the corresponding submaximal variables were 3.8% for VO2, 2.1% for HR, 15.6% for blood lactate concentration, 2.6% for RER and 6.0% for RPE. VO2max (+4.7% ± 3.5%), TTE (+17.9% ± 8.6%), and submaximal HR (−3.2 ± 3.5%) improved significantly. Except for RPE (p < 0.01), there were no alterations in the coefficient of variation for any parameter. On the group level, the first changes greater than the day-to-day variability in VO2max, TTE, and submaximal HR were observed after 21, 12, and 9 training sessions, respectively. Conclusion: Based on our findings, we recommend that training studies include assessment of the reliability of the measurements, for example, the CVs in the specific laboratory to be able to judge if the changes detected are actually physiological. Validerad;2023;Nivå 2;2023-07-12 (sofila)

In para-kayak, athletes with unilateral above knee amputation (AK) and athletes with below knee amputation (BK) compete in the same class. This has been questioned since previous research have shown that the legs are important for paddling performance. The purpose was therefore to examine differences in kinematic and kinetic performance variables between AK and BK para-kayak athletes and the amputated (A) and non-amputated (NA) sides. Eleven AK and six BK athletes on international level participated. 3D kinematic and kinetic data were collected for the body, seat, footrest and paddle during kayak ergometer paddling. There were no significant differences between the groups in main performance variables such as power output or paddle force. Differences between the groups were only seen in the hip joint in flexion range of motion, flexion and extension angular velocity and flexion moment where BK demonstrated larger values. The NA side demonstrated greater values compared to the A side in posterior force at the seat and in hip flexion moment. As there were no significant differences between the groups in the majority of the examined key performance variables, the results suggest that athletes with unilateral AK and BK amputation may be able to compete in the same class. At the time of Johanna Rosen's dissertation, the paper was submitted and under review.Funded by International Canoe Federation (ICF) and Swedish Research Council for Sport Science (CIF)

The overall aim of this study was to explore how upper secondary school students (age 16-19) in Sweden perceive physical education and health (PEH) through the assessment practices they experience in this subject. In particular, the study aimed to examine the students' experiences of what can be considered as valid knowledge and what the students perceive to form the basis for assessment in PEH. Data were collected by conducting focus group interviews with a total of 38 students from four different upper secondary schools in southern Sweden. The focus groups cohered around discussing three different vignettes that were constructed based on various 'pedagogical dilemmas' identified through earlier research on valid knowledge and assessment in PEH. Data were analysed by drawing on Scott's (2008) institutional theory in order to demonstrate how regulative, normative and cultural-cognitive conditions shape practices and assessment in PEH. The results highlight that there is a misalignment between curriculum objectives and assessment in Swedish PEH practice, where the cultural-cognitive conditions as strongly associated with club sports are more influential in the construction of valid knowledge and assessment practice than the regulative and normative conditions as stipulated in the PEH curriculum. The results also demonstrate that there is an ongoing prioritisation of practical over theoretical knowledge in PEH practice, involving an emphasis on doing and being active without any clear learning objectives. It is argued that clearly communicated learning objectives and assessment criteria can help achieve a better alignment between curriculum intentions, pedagogy and assessment in PEH. Bibliografiskt granskad

The present study aims to describe accelerometer-assessed physical activity (PA) patterns and fulfillment of PA recommendations in a large sample of middle-aged men and women, and to study differences between subgroups of socio-demographic, socio-economic, and lifestyle-related variables. A total of 27 890 (92.5% of total participants, 52% women, aged 50–64 years) middle-aged men and women with at least four days of valid hip-worn accelerometer data (Actigraph GT3X+, wGT3X+ and wGT3X-BT) from the Swedish CArdioPulmonary bioImage Study, SCAPIS, were included. In total, 54.5% of daily wear time was spent sedentary, 39.1% in low, 5.4% in moderate, and only 0.1% in vigorous PA. Male sex, higher education, low financial strain, born in Sweden, and sedentary/light working situation were related to higher sedentary time, but also higher levels of vigorous PA. High BMI and having multiple chronic diseases associated strongly with higher sedentary time and less time in all three PA intensities. All-year physically active commuters had an overall more active PA pattern. The proportion fulfilling current PA recommendations varied substantially (1.4% to 92.2%) depending on data handling procedures and definition used. Twenty-eight percent was defined as having an “at-risk” behavior, which included both high sedentary time and low vigorous PA. In this large population-based sample, a majority of time was spent sedentary and only a fraction in vigorous PA, with clinically important variations between subgroups. This study provides important reference material and emphasizes the importance of a comprehensive assessment of all aspects of the individual PA pattern in future research and clinical practice.

Several sports have published consensus statements on methods and reporting of epidemiological studies concerning injuries and illnesses with football (soccer) producing one of the first guidelines. This football-specific consensus statement was published in 2006 and required an update to align with scientific developments in the field. The International Olympic Committee (IOC) recently released a sports-generic consensus statement outlining methods for recording and reporting epidemiological data on injury and illness in sport and encouraged the development of sport-specific extensions.The Fédération Internationale de Football Association Medical Scientific Advisory Board established a panel of 16 football medicine and/or science experts, two players and one coach. With a foundation in the IOC consensus statement, the panel performed literature reviews on each included subtopic and performed two rounds of voting prior to and during a 2-day consensus meeting. The panel agreed on 40 of 75 pre-meeting and 21 of 44 meeting voting statements, respectively. The methodology and definitions presented in this comprehensive football-specific extension should ensure more consistent study designs, data collection procedures and use of nomenclature in future epidemiological studies of football injuries and illnesses regardless of setting. It should facilitate comparisons across studies and pooling of data.

IntroductionAlthough maximal oxygen uptake (VO2max) is generally recognized as the single best indicator of aerobic fitness in youth, interpretation of this parameter and the extent to which it can be improved by training remain controversial, as does the relative importance of VO2max for performance in comparison to other factors such as power production. Here, we examined the influence of endurance training on the VO2max, muscle power and sports-related performance of cross-country skiers attending a school specializing in sports, as well as potential relationships between any changes observed to one another and/or to perceived stress scale (Cohen) and certain blood parameters.MethodsOn two separate occasions, prior to the competition season and separated by one year of endurance training, the 12 participants (5 males, 7 females, 17 ± 1 years) carried out tests for VO2max on a treadmill, explosive power utilizing countermovement jumps (CMJ) and ski-specific maximal double pole performance (DPP) employing roller skis on a treadmill. Blood levels of ferritin (Fer), vitamin D (VitD) and hemoglobin (Hg) were monitored, and stress assessed with a questionnaire.ResultsDPP improved by 10 ± 8% (P DiscussionWhereas one year of endurance training improved the cross-country ski-specific performance of young athletes significantly, the increase in their maximal oxygen uptake was minimal. Since DPP was not correlated with VO2max, jumping power or the levels of certain blood parameters, the improvement observed probably reflected better upper-body performance.

Background Resistance exercise has a beneficial impact on physical function for patients receiving oncological treatment. However, there is an inter-individual variation in the response to exercise and the tolerability to high-intensity exercise. Identifying potential moderating factors, such as inflammation and treatment type, for changes in muscle strength is important to improve the effectiveness of exercise programs. Therefore, we aimed to investigate if inflammation and type of oncological treatment moderate the effects of exercise intensity (high vs. low-moderate) on muscular strength changes in patients with breast (BRCA) or prostate cancer (PRCA). Methods Participants with BRCA (n = 286) and PRCA (n = 65) from the Physical training and Cancer study (Phys-Can) were included in the present study. Participants performed a combined resistance- and endurance exercise program during six months, at either high or low-moderate intensity. Separate regression models were estimated for each cancer type, with and without interaction terms. Moderators included in the models were treatment type (i.e., neo/adjuvant chemotherapy—yes/no for BRCA, adjuvant androgen deprivation therapy (ADT)—yes/no for PRCA)), and inflammation (interleukin 6 (IL6) and tumor necrosis factor-alpha (TNFα)) at follow-up. Results For BRCA, neither IL6 (b = 2.469, 95% CI [− 7.614, 12.552]) nor TNFα (b = 0.036, 95% CI [− 6.345, 6.418]) levels moderated the effect of exercise intensity on muscle strength change. The same was observed for chemotherapy treatment (b = 4.893, 95% CI [− 2.938, 12.724]). Similarly, for PRCA, the effect of exercise intensity on muscle strength change was not moderated by IL6 (b = − 1.423, 95% CI [− 17.894, 15.048]) and TNFα (b = − 1.905, 95% CI [− 8.542, 4.732]) levels, nor by ADT (b = − 0.180, 95% CI [− 11.201, 10.841]). Conclusions The effect of exercise intensity on muscle strength is not moderated by TNFα, IL6, neo/adjuvant chemotherapy, or ADT, and therefore cannot explain any intra-variation of training response regarding exercise intensity (e.g., strength gain) for BRCA or PRCA in this setting. Trial registration: ClinicalTrials.gov NCT02473003.

Background Despite good physical function, many athletes do not return to sports after an anterior cruciate ligament reconstruction (ACLR). One important reason for this is fear of new injury. The aim of this study was to investigate young athletes’ experiences of knee-related fear after an ACLR and how they perceive this fear to affect them in their sporting and everyday life. Methods A qualitative interview study was conducted, using semi-structured interviews. Athletes who were active in contact or pivoting sport before an ACL injury, with the goal of returning to the same sport and who scored highly on fear of new injury at six months post-ACLR, were asked to participate. Ten athletes (six women and four men, aged 17–25 years), were interviewed by an independent researcher, 7–9 months after ACLR. Content analysis employing an abductive approach was used. Results The analysis resulted in three categories with associated subcategories: 1. The expressions of fear; (i) reason for fear, (ii) changes in fear over time, and (iii) injury situation. 2. Reactions, consequences, and adaptations; (i) reactions, (ii) behavioural adaptation and influence on rehabilitation and daily life, (iii) present consequences, and (iv) consequences for the future. 3. Fear and adaptations related to returning to sports; (i) fear related to returning to sports and, (ii) adaptations in sports and life due to fear. Fear was described in broad and complex ways, with fear of a new injury being expressed as one of several aspects. Various reasons (e.g., seeing others getting injured in the past, previous experience of injury, failed rehabilitation, perceived knee instability) were given to explain the fear, and athletes reacted both physically and mentally to fear. Both positive and negative adaptations to fear were described, in both daily life and sports. Conclusion The results contribute to an increased understanding of fear as an essential psychological factor to consider during rehabilitation and leaves the way open for research to investigate how physiotherapists can work to manage fear better among ACLR patients.

Objectives: To investigate risk factors for injury and illness in female and male youth floorball players (12-17 years) during a 26-week floorball season. Design: Prospective cohort study. Setting: Recreational youth sport. Participants: 471 players (142 females) 12-17 years. Main outcome measures: Weekly survey including questions about stress, sleep quality, well-being, sport exposure and average weekly rating of perceived exertion (RPE). Acute:chronic workload ratio (ACWR) was calculated. The Oslo Sports Trauma Research Center questionnaire on health problems was used. Predictors of new injury and illness were examined using multi-level logistic regression models with weekly measures nested within individuals. Results: Higher stress, poorer sleep quality and well-being increased the odds of a new injury in the subsequent week by 8% (2.0-13.5%), 10% (4.2-15.9%) and 8% (2.4-13.5%) per 1 unit increase. Higher stress, and poorer well-being increased the odds of illness by 8% (2.6-12.6%), and 12% (7.2-16.6%). ACWR below 0.8 or above 1.3 increased the odds of illness by 34% (4.9-70.8%). Conclusions: Perceived stress, well-being, and sleep quality were associated with injury and illness occurrence in the subsequent week. ACWR outside the range 0.8-1.3 was associated with illness the subsequent week. Trial registration: Clinical Trials registration NCT03309904. (c) 2022 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). Funding Agencies|Swedish Research Council; Swedish Research Council for Sport Science [2015-02414, 2018-03135]; [P2018-0167]

Athletes with an anterior cruciate ligament (ACL) injury followed by ACL reconstruction (ACLR) often perform various testing to guide return to sport, but preinjury data are rarely available for comparison. This longitudinal case-control study reports absolute value and between-leg symmetry data on maximal performances for single-leg hop height and distance, muscle strength, and side hop landing mechanics of an 18-year-old female soccer athlete collected 5 months before sustaining an ACL injury and again at 10, 13, and 29 months post-ACLR. Her data were compared across test sessions and to cross-sectional data of 15 asymptomatic female athletes.

Background While the psychosocial risk factors for traumatic injuries have been comprehensively investigated, less is known about psychosocial factors predisposing athletes to overuse injuries. Objective The aim of this review was to systematically identify studies and synthesise data that examined psychosocial risk factors for overuse injuries in athletes. Design Systematic review. Data Sources MEDLINE, Web of Science and PsycINFO databases, supplemented by hand searching of journals and reference lists. Eligibility Criteria for Selecting Studies Quantitative and qualitative studies involving competitive athletes, published prior to July 2021, and reporting the relationship between psychosocial variables and overuse injury as an outcome were reviewed. This was limited to academic peer-reviewed journals in Swedish, English, German, Spanish and French. An assessment of the risk of bias was performed using modified versions of the RoBANS and SBU Quality Assessment Scale for Qualitative Studies. Results Nine quantitative and five qualitative studies evaluating 1061 athletes and 27 psychosocial factors were included for review. Intra-personal factors, inter-personal factors and sociocultural factors were found to be related to the risk of overuse injury when synthesised and reported according to a narrative synthesis approach. Importantly, these psychosocial factors, and the potential mechanisms describing how they might contribute to overuse injury development, appeared to be different compared with those already known for traumatic injuries. Conclusions There is preliminary evidence that overuse injuries are likely to partially result from complex interactions between psychosocial factors. Coaches and supporting staff are encouraged to acknowledge the similarities and differences between traumatic and overuse injury aetiology.

IntroductionTraditional recordings of muscle activation often involve time-consuming application of surface electrodes affixed to the skin in laboratory environments. The development of textile electromyography (EMG) electrodes now allows fast and unobtrusive assessment of muscle activation in ecologically valid environments. In this study, textile EMG shorts were used to assess whether performing squats with the barbell resting freely on the shoulders or using a Smith machine for a fixed barbell movement path is preferable for maximizing lower limb muscle activation.MethodsSixteen athletes performed free and fixed barbell squats in a gym with external loads equivalent to their body mass. Quadriceps, hamstrings and gluteus maximus activation was measured bilaterally with textile EMG electrodes embedded in shorts.ResultsMean quadriceps activation was greater for the free compared with the fixed movement path for the right (mean difference [MD] 14μV, p = 0.04, ηp2 = 0.28) and left leg (MD 15μV, p = 0.01, ηp2 = 0.39) over the entire squat and specifically during the first half of the eccentric phase for the left leg (MD 7μV, p = 0.04, d = 0.56), second half of the eccentric phase for both legs (right leg MD 21μV, p = 0.05, d = 0.54; left leg MD 23μV, p = 0.04, d = 0.52) and the first half of the concentric phase for both legs (right leg MD 24μV, p = 0.04, d = 0.56; left leg MD 15μV, p = 0.01, d = 0.72). Greater hamstrings activation for the free path was seen for the second half of the eccentric phase (left leg MD 4μV, p = 0.03, d = 0.58) and first half of the concentric phase (right leg MD 5μV, p = 0.02, d = 0.72). No significant differences were found for gluteus maximus.DiscussionTextile EMG electrodes embedded in shorts revealed that to maximize thigh muscle activity during loaded squats, a free barbell movement path is preferable to a fixed barbell movement path.

ObjectivesTo: (1) describe hamstring injury incidence and burden in male professional football players over 21 seasons (2001/02 to 2021/22); (2) analyse the time-trends of hamstring muscle injuries over the most recent eight seasons (2014/15 to 2021/22); and (3) describe hamstring injury location, mechanism and recurrence rate.Methods3909 players from 54 teams (in 20 European countries) from 2001/02 to 2021/22 (21 consecutive seasons) were included. Team medical staff recorded individual player exposure and time-loss injuries. Time-trend analyses were performed with Poisson regression using generalised linear models.Results2636 hamstring injuries represented 19% of all reported injuries, with the proportion of all injuries increasing from 12% during the first season to 24% in the most recent season. During that same period, the percentage of all injury absence days caused by hamstring injuries increased from 10% to 20%. Between 2014/15 and 2021/22, training hamstring injury incidence increased (6.7% annually, 95% CI 1.7% to 12.5%) as did burden (9.0% annually, 95% CI 1.2% to 18.3%). During those years, the match hamstring injury incidence also increased (3.9% annually, 95% CI 0.1% to 7.9%) and with the same trend (not statistically significant) for match hamstring injury burden (6.2% annually, 95% CI −0.5% to 15.0%).ConclusionsHamstring injury proportions—in number of injuries and total absence days—doubled during the 21-year period of study. During the last eight seasons, hamstring injury rates have increased both in training and match play.

Background: A new anterior cruciate ligament (ACL) injury after ACL reconstruction is a feared outcome. Purpose: To study the risk of new knee injuries in female soccer players 5 to 10 years after primary unilateral ACL reconstruction and to compare players who returned to soccer with (1) players who did not return and (2) knee-healthy soccer players (controls). Study Design: Cohort study; Level of evidence, 2. Methods: Demographic, soccer-specific, and surgical data were recorded at baseline for 317 female soccer players (mean ± SD age, 20.1 ± 2.7 years) 1.6 ± 0.7 years after ACL reconstruction and for 119 matched controls (mean age, 19.5 ± 2.5 years). Data on new knee injuries and soccer-playing status were collected 5 to 10 years after ACL reconstruction via a questionnaire. Results: Among players with ACL reconstruction, 222 (70%) responded at a mean 6.5 ± 1.0 years after primary ACL reconstruction. We compared 3 cohorts: (1) among 163 players with ACL reconstruction who returned to soccer, 68 (42%) sustained 44 reruptures and 29 contralateral ruptures; (2) among 59 players with ACL reconstruction who did not return to soccer, 11 (19%) sustained 9 reruptures and 2 contralateral ruptures; and (3) among 113 knee-healthy controls, 12 (11%) sustained 13 ACL injuries. Players who returned had a >2-fold higher risk of a new ACL injury than players who did not return (risk ratio, 2.24; 95% CI, 1.27-3.93; P = .005) and a 4-fold higher risk than controls (risk ratio, 3.93; 95% CI, 2.23-6.91; P Conclusion: Two-thirds of female soccer players with ACL reconstruction who returned to soccer sustained a new knee injury within 5 to 10 years; 42% had a new ACL injury. Their risk of a new knee injury and knee surgery was 2 to 5 times greater than that for players who did not return and for knee-healthy controls. New injury may have negative consequences for long-term knee health and should be a critical consideration in the decision to return to play.

Highlights • In Swedish 70-year-olds, prevalence of probable/confirmed sarcopenia was low (2%). • Only moderate-to-vigorous physical activity (MVPA) was associated with reduced sarcopenia. • There was no threshold in associations between MVPA bout duration and sarcopenia. • Greater MVPA was not associated with increased incidence of 12-month falls., Purpose This study was aimed to determine associations of accelerometer-determined time and bouts of sedentary behavior, light physical activity (LPA), and moderate-to-vigorous PA (MVPA) with sarcopenia and incident falls over 12 months. Methods A total of 3334 Swedish 70-year-olds were assessed for sarcopenia, as defined by the revised definition of the European Working Group on Sarcopenia in Older People. Assessments were based on low scores for appendicular lean mass (dual-energy X-ray absorptiometry), hand grip strength, and the Timed Up and Go test. For 7 days after baseline, total time and total number of bouts (≥10 min of continuous activity at a given intensity) of activity performed at sedentary, LPA, and MVPA intensities were assessed by accelerometer. Incident falls were self-reported 6 months and 12 months after baseline. Results Only 1.8% of participants had probable or confirmed sarcopenia. After multivariable adjustment for other levels of activity, only greater MVPA time was associated with a decreased likelihood of having low appendicular lean mass, low hand grip strength, and slow Timed Up and Go time as defined by the European Working Group on Sarcopenia in Older People criteria (all p < 0.05), and only MVPA time was associated with lower likelihood of probable or confirmed sarcopenia (odds ratio = 0.80, 95% confidence interval: 0.71–0.91 h/week). Similar associations were identified for total number of bouts, with no evidence of threshold effects for longer duration of bouts of MVPA. A total of 14% of participants reported ≥1 fall, but neither total time nor bouts of activity was associated with incident falls (all p > 0.05). Conclusion Higher amounts of accelerometer-determined MVPA are consistently associated with a decreased likelihood of sarcopenia and its components, regardless of the length of bouts or amounts of sedentary behavior., Graphical abstract Image, graphical abstract

Individuals with intellectual disability (ID) are less physically active than individuals without ID, and rarely reach the recommended daily level of physical activity (PA). It is understood that both social interaction and the ability to perform physical work affect participation in daily activity as well as PA. Individuals with ID generally have a higher risk of hypertension and obesity-related cardiovascular diseases than individuals without ID. Professional service providers, teachers and parents are often those being asked about potential challenges related to PA, as it is more seldom that this knowledge comes from the target group (ID) themselves. This identifies a lack of knowledge about PA and sports for individuals with ID. The aim of this study was to identify perceptions of, and motivation for, PA and sports among adolescents with ID. Twelve Swedish male and female adolescents with ID participated in the study, which comprised one semi-structured interview. The interviews identified three main categories: Activity, Surroundings and Body- and health awareness. Adolescents with ID seemed intrinsic motivated to participate in PA, organised sports and activities in general. Support from significant others, teachers, family and friends and support as well as the feeling of joy are connected to normative beliefs which all seem crucial. The participants were aware of their limitations, but sometimes feel bullied and afraid of being excluded, which relates to their normative beliefs. Participation in PA and organised sports may be positively associated with health, but limitations such as lack of awareness and support from society challenge the perception of ‘fitting in’. This research has raised the voice of adolescents with ID and identified the need for increased knowledge of their perceptions for a more inclusive world. School PE is an arena where adolescents can still be reached regarding PA and thereby should be prioritised.

Assessment has been identified as an ongoing problem in physical education (PE). Since the student perspective on assessment is often neglected in research, in this paper, we will report on a study that explored students’ experiences of assessment in the Swedish school subject physical education and health (PEH). In particular, the aim of this study was to examine the students’ experiences of having equal opportunities to demonstrate their knowledge and skills when being assessed in PEH. Data was collected by conducting focus group interviews with a total of 38 students from four different upper secondary schools in southern Sweden. Data analysis was conducted by drawing on Scott’s (2008) institutional theory in order to demonstrate how regulative, normative and cultural-cognitive conditions shape assessment practices and students’ experiences of these in PEH. The results show that both teaching and assessment/grading practices in PEH are shaped more by cultural-cognitive conditions as associated with the norms and values of competitive and club sports rather than the regulative and normative conditions outlined in the Swedish Education Act and PEH curriculum that put emphasis on equal opportunities, equitable learning outcomes and explicit assessment criteria. The results also demonstrate how both teachers and students are actively involved in reproducing such teaching and assessment practices in PEH. To conclude, we therefore call for further work to be done with students, teachers and teacher educators of PEH to draw more attention to and more successfully implement the learning and achievement objectives of the curriculum. In addressing the ongoing problem of assessment in PEH we in particular need to better align assessment processes with the curriculum intentions of an equal quality education and teaching for equity. Bibliografiskt granskad

Elite Para athletes report a high incidence of sports injuries, illnesses and other health issues. Despite this, there are few prevention programmes in Para sport, and many of the existing prevention programmes are not adapted to Para athletes. To improve the success of preventive measures, it has been suggested that sports safety work should facilitate health promotion, including athlete health education. Therefore, the overarching aim of this project is to evaluate an accessible health promotion web platform as part of a complex intervention that aims to improve knowledge of athlete health in Para sport. In this protocol, the development, future implementation and evaluation of the intervention are described. To inform the implementation and use of such interventions, it is recommended to involve end users in the development and implementation process. Therefore, a participatory design process, including athletes and the sports organisation, was used to develop an accessible health promotion web platform. To evaluate this complex intervention, a process evaluation combining quantitative evaluation assessing causal pathways with qualitative methods assessing multifaceted pathways will be used. The primary outcomes are injury/illness incidence, athlete health parameters, health literacy and user behaviour. A cohort of elite Para athletes (n=150) from Sweden and South Africa will be invited to participate. This project will be the first that aims to improve athlete health in Para sport through pragmatic and accessible health promotion. It is a boundary-crossing project that will be conducted in a real-world sport setting, including athletes with different socioeconomic backgrounds. Funding Agencies|Swedish Research Council of Sports Sciences [D2021-0018]; Swedish Research Council of Sports Sciences; Norrbacka Eugenia; Folksam; Promobilia

Background Normative values of lifestyle characteristics in adolescent female football players may be used by clinicians and coaches to take actions because the potential important for well-being, performance on the pitch, and risk of injury. The aim was to report descriptive characteristics of lifestyle factors in adolescent female football players and potential changes over 1 year. Methods We included 419 adolescent competitive female football players from 12 clubs and 27 teams (age 14 ± 1 years, range 12–17 years) and 286 were followed over 1 year. The players completed an extensive questionnaire regarding demographics, football-related factors, and lifestyle factors including tobacco consumption, alcohol use, medicine intake, eating and sleeping habits, well-being, stress, coping, and passion. Baseline data are presented for the total cohort and separately for 4 age groups (12, 13, 14, and 15–17 years). Results 12% skipped breakfast, 8% skipped lunch and 11% used protein supplements several days per week. 16% slept less than 8 h/night, 8% had impaired sleep with daytime consequences, and 22% stated that they were tired in daily activities several days per week. 32% experienced stress some or most days/week and 24% were classified as having psychological distress. Medicine intake (23% vs. 34%), skipping breakfast or lunch several days per week (10% vs. 47% and 20 vs. 33%), tiredness (20% vs. 27%), stress (26% vs. 40%), and psychological distress (27% vs. 37%) increased significantly (P = 0.031 to Conclusion Many adolescent female football players skip breakfast and lunch, have insufficient sleep, experience stress and are classified as having psychological distress. These factors increased over 1 year.

Background The risk of injury in adolescent handball is high, and shoulder and knee injuries are among the most frequent and burdensome. The Swedish Knee Control programme reduced the risk of anterior cruciate ligament injuries in female youth football players and traumatic knee injuries in male and female youth floorball players. However, to date, Knee Control has not been evaluated in an elite youth sport setting. The literature on the prevention of shoulder injuries in sport is scarce, and there are to our knowledge no previous studies evaluating the preventative efficacy of injury prevention exercise programmes (IPEPs) on shoulder injuries in adolescent handball players. Objectives To study the preventive efficacy of IPEPs on shoulder and knee injuries in adolescent elite handball players. Methods Eighteen Swedish handball-profiled secondary schools (clusters) with players aged 15–19 years, 54% males were randomised into either the Shoulder Group or Knee Group (interventions) or a Control Group. Players in the Shoulder Group were instructed to perform the Shoulder Control programme, and players in the Knee Group to perform the Knee Control programme, three times per week during May 2018 to May 2019. Control Group players continued their usual training. Outcomes were shoulder and knee injuries defined by the Oslo Sports Trauma Research Center Overuse Injury Questionnaire. Intention-to-treat analyses were performed using Cox regression models with hazard rate ratios (HRRs) with corresponding 95% confidence intervals (CI). Results Six clusters (199 players) in the Shoulder Group, six clusters (216 players) in the Knee Group and six clusters (212 players) in the Control Group were included. There were 100 shoulder injuries and 156 knee injuries. The Shoulder Group had a 56% lower shoulder injury rate, HRR 0.44 (95% CI 0.29 to 0.68), and the Knee Group had a 31% lower knee injury rate, HRR 0.69 (95% CI 0.49 to 0.97) than the Control Group. The absolute risk reduction was 11% and 8%, and the number needed to treat was 9 and 13, respectively. Conclusions Adolescent elite handball players who performed the Shoulder Control and the Knee Control programmes had a lower risk of shoulder and knee injuries, respectively, than players who continued their usual training. Further research on how these two programmes can be combined to reduce knee and shoulder injuries in a time effective way is warranted. Trial registration ISRCTN15946352. Key points The burden of knee and shoulder injuries in handball is high. The Shoulder Control programme reduces the risk and overall burden of shoulder injuries in adolescent elite handball players. The Knee Control programme reduces the risk and overall burden of knee injuries in adolescent elite handball players.

Background No previous systematic review has quantitatively compared the effects of resistance training, endurance training, or concurrent training on hormonal adaptations in children and adolescents. Objective was to examine the effects of exercise training and training type on hormonal adaptations in children and adolescents. Methods A systematic literature search was conducted in the following databases: PubMed, Web of Science, and EBSCO. Eligibility criteria were: population: healthy youth population sample (mean age 4 weeks duration); comparison: control group; outcome: pre- and post-levels of hormones and cytokines; and study design: randomized and non-randomized controlled trials. We used a random-effect model for the meta-analysis. The raw mean difference in hormones from baseline to post-intervention was presented alongside 95% confidence intervals (CI). Further, the certainty of evidence quality and the risk of bias were assessed. Results A total of 3689 records were identified, of which 14 studies were eligible for inclusion. Most studies examined adolescents with fewer studies on children (age N = 5 studies) and females (N = 2 studies). Nine exercise training programs used endurance training, five studies used resistance training, and no eligible study used concurrent training. The meta-analysis showed no significant effect of exercise training on testosterone (MD = 0.84 nmol/L), cortisol (MD = − 17.4 nmol/L), or SHBG (MD = − 5.58 nmol/L). Subgroup analysis showed that resistance training significantly increased testosterone levels after training (MD = 3.42 nmol/L) which was not observed after endurance training (MD = − 0.01 nmol/L). No other outcome differed between training types. Exercise training resulted in small and non-significant changes in GH (MD = 0.48 ng/mL, p = 0.06) and IGF-I (MD = − 22.90 ng/mL, p = 0.07). GH response to endurance training may be age-dependent and evident in adolescents (MD = 0.59 ng/mL, p = 0.04) but not when children and adolescents are pooled (MD = 0.48 ng/mL, p = 0.06). Limited evidence exists to conclude on IL-6 and TNF-α effects of exercise training. Assessments of GRADE domains (risk of bias, consistency, directness, or precision of the findings) revealed serious weaknesses with most of the included outcomes (hormones and cytokines). Conclusions This systematic review suggests that exercise training has small effects on hormonal concentrations in children and adolescents. Changes in testosterone concentrations with training are evident after resistance training but not endurance training. GH's response to training may be affected by maturation and evident in adolescents but not children. Further high-quality, robust training studies on the effect of resistance training, endurance training, and concurrent training are warranted to compare their training-specific effects. Registration: PROSPERO: CRD42021241130.

This study aimed to compare sedentary time (SED) and intensity-specific physical activity (PA) estimates and the associations of SED and PA with body mass index (BMI) and waist circumference (WC) using three different sets of cut-points in preschool-aged children. A total of 751 children (4.7 +/- 0.9 years, boys 52.7%) wore an ActiGraph GT3X+BT accelerometer on their hip for 7 days (24 h). Euclidean norm -1 G with negative values rounded to zero (ENMO) and activity counts from vertical axis (VACounts) and vector magnitude (VMCounts) were derived. Estimates of SED and light, moderate, vigorous, and moderate-to-vigorous PA (MVPA) were calculated for commonly used cut-points by Hildebrand et al., Butte et al., and Evenson et al. Furthermore, the prevalence of meeting the PA recommendation, 180 min/day of which at least 60 min/day being MVPA, were assessed for the cut-points. Multilevel mixed analysis was used to examine associations of SED and PA with BMI and WC. In accordance with the results, SED and PA intensity estimates differed largely across cut-points (i.e., SED = 22-341 min/day; light PA = 52-257 min/day; moderate PA = 5-18 min/day; vigorous PA = 7-17 min/day; MVPA = 13-35 min/day), and the prevalence of children meeting the PA recommendation varied from 4% to 70%. Associations of SED and PA with BMI or WC varied between the cut-points. Our results indicate that SED and PA estimates in preschool-aged children between studies using these cut-points are poorly comparable. Methods facilitating accelerometer-derived PA estimate comparison between studies are highly warranted. Funding Agencies|Folkhalsan Research Center; University of Helsinki; Ministry of Education and Culture in Finland; Ministry of Social Affairs and Health; Academy of FinlandAcademy of Finland [285439, 287288, 288038]; Juho Vainio Foundation; Signe and Ane Gyllenberg Foundation; Finnish Cultural Foundation/South Ostrobothnia Regional Fund; Paivikki and Sakari Sohlberg Foundation; Medicinska Foreningen Liv och Halsa; Finnish Foundation for Nutrition Research; Finnish Food Research Foundation

Background Knowledge regarding adherence is necessary to improve the specificity of exercise interventions during cancer treatment. We aimed to determine adherence to resistance and endurance training interventions in parallel; identify subgroups with similar adherence characteristics; and examine determinants of these subgroups. Methods In the Phys-Can randomised controlled trial, participants (n = 577, 81% women, mean(SD) age 59(12) years, and 50% with BMI ≥ 25 kg/m2) starting (neo-) adjuvant treatment for breast, colorectal or prostate cancer were randomized to 6-month of high (HI) or low-to-moderate intensity (LMI) supervised, group-based resistance training and individual home-based endurance training, with or without behavior change support. Adherence was calculated as performed exercise volume as a proportion of prescribed exercise volume (0–100%), overall (HI and LMI groups) and for frequency, intensity, type and time (FITT principles) (HI group). Adherence to resistance training was plotted against adherence to endurance training overall and for each FITT principle. K-means cluster analysis was used to identify subgroups with similar adherence characteristics. Potential determinants of subgroup membership were examined using multinomial logistic regression. Results We found a positive curvilinear correlation between adherence to resistance and endurance training overall. A similar correlation was seen for adherence to frequency of resistance vs. endurance training in the HI group. In the HI group, adherence to resistance training intensity and time was > 80% for almost all participants. For endurance training adherence ranged from 0 to 100% for each of the FITT principles. Three clusters were identified, representing low, mixed, and high adherence to resistance and endurance training overall. Participants with higher age (Relative risk ratio [95% CI]; LMI: 0.86[0.77–0.96], HI: 0.83[0.74–0.93]), no behaviour change support (LMI: 0.11[0.02–0.56], HI: 0.20[0.05–0.85]), higher cardiorespiratory fitness (LMI: 0.81[0.69–0.94], HI: 0.80[0.69–0.92]), more fatigue (according to the reduced activity subscale of the MFI questionnaire) (LMI: 0.48[0.31–0.73], HI: 0.69[0.52–0.93]) or higher quality of life (LMI: 0.95[0.90–1.00], HI: 0.93[0.88–0.98]) were less likely to be in the low than the high adherence cluster whether randomised to LMI or HI training. Other determinants were specific to those randomised to LMI or HI training. Conclusions In an exercise intervention during cancer treatment, adherence to resistance and endurance training were positively correlated. Personalisation of interventions and additional support for some subgroups of participants may improve adherence. Trial registrationNCT02473003 (clinicaltrials.gov, Registered 16/06/2015).

Background Studies on football and the coronavirus disease 2019 (COVID-19) have mainly focused on the lockdown consequences for player fitness, the resumption of football training, and how to safely restart the league play, but injury data are scarce. Objective To describe the injury incidence and injury burden in men’s professional football teams during the pandemic year of 2020. Methods Nineteen teams in 12 countries prospectively registered data on player-exposure and time-loss injuries throughout 2020. All major football leagues were paused as a direct response to the pandemic in March 2020 and were thereafter completely cancelled or restarted after a lockdown interval of at least two months. Historical data from 43 teams in the same cohort during the five preceding years (2015–2019) were used as reference. Between-season and within-season comparisons were made for injury incidence (number of injuries per 1000 h) and injury burden (number of absence days per 1000 h) with 95% confidence intervals and interquartile ranges. Results There was no increased match injury incidence or injury burden following the restart in 2020 compared with other time periods of 2020 and the corresponding periods 2015–2019. There was an increased training injury incidence and injury burden immediately during the lockdown in 2020, and they remained elevated also following the restart, being higher in 2020 compared with 2015–2019, respectively. The injury characteristics during the first months of the new 2020/21 season (August/September–December) were similar between the five teams that cancelled their 2019/20 season in March 2020 and the 14 teams that restarted their season in May/June 2020. Conclusions There was no increased match injury incidence or injury burden following the COVID-19 lockdown and restart of the football season in 2020, but training injury incidence and injury burden were elevated and higher than in 2015–2019.

Purpose Heat-and-moisture-exchanging devices (HME) are commonly used by endurance athletes during training in sub-zero environments, but their effects on performance are unknown. We investigated the influence of HME usage on running performance at − 15 °C. Methods Twenty-three healthy adults (15 male, 8 female; age 18–53 years; $$\dot{V}{\text O}_{2peak}$$ V ˙ O 2 p e a k men 56 ± 7, women 50 ± 4 mL·kg−1·min−1) performed two treadmill exercise tests with and without a mask-style HME in a randomised, crossover design. Participants performed a 30-min submaximal warm-up (SUB), followed by a 4-min maximal, self-paced running time-trial (TT). Heart rate (HR), respiratory frequency (fR), and thoracic area skin temperature (Tsk) were monitored using a chest-strap device; muscle oxygenation (SmO2) and deoxyhaemoglobin concentration ([HHb]) were derived from near-infra-red-spectroscopy sensors on m. vastus lateralis; blood lactate was measured 2 min before and after the TT. Results HME usage reduced distance covered in the TT by 1.4%, despite similar perceived exertion, HR, fR, and lactate accumulation. The magnitude of the negative effect of the HME on performance was positively associated with body mass (r2 = 0.22). SmO2 and [HHb] were 3.1% lower and 0.35 arb. unit higher, respectively, during the TT with HME, and Tsk was 0.66 °C higher during the HME TT in men. HR (+ 2.7 beats·min−1) and Tsk (+ 0.34 °C) were higher during SUB with HME. In the male participants, SmO2 was 3.8% lower and [HHb] 0.42 arb. unit higher during SUB with HME. Conclusion Our findings suggest that HME usage impairs maximal running performance and increases the physiological demands of submaximal exercise.

Air pistol shooting is a complex sport discipline with high demands on fine motor control and postural stability. Earlier studies have reported questionable results regarding the most important technical components for air pistol shooting. Therefore, the aims of the present study were to investigate the key technical components for air pistol shooting and also to investigate how well the key technical components explain the performance in air pistol shooting. Eighteen national-level air pistol shooters completed a simulated qualifying round consisting of 60 shots. During each shot, shooting score and 17 aiming point trajectory variables were measured with an optoelectronic training device. Principal component analysis revealed five key technical components: aiming time, stability of hold, aiming accuracy, cleanness of triggering and timing of triggering. Four of the five components (not aiming time) correlated significantly (r = .48 –.74; p < 0.05) with shooting score. Two stepwise multiple regression analyses identified aiming accuracy followed by timing of triggering and stability of hold as the most important components, accounting for 75–78% of the variance in shooting score. Accordingly, these components should be in focus by coaches and athletes when conducting tests and training.

Background The effect of concurrent training on the development of maximal strength is unclear, especially in individuals with different training statuses. Objective The aim of this systematic review and meta-analysis study was to compare the effect of concurrent resistance and endurance training with that of resistance training only on the development of maximal dynamic strength in untrained, moderately trained, and trained individuals. Methods On the basis of the predetermined criteria, 27 studies that compared effects between concurrent and resistance training only on lower-body 1-repetition maximum (1RM) strength were included. The effect size (ES), calculated as the standardised difference in mean, was extracted from each study, pooled, and analysed with a random-effects model. Results The 1RM for leg press and squat exercises was negatively affected by concurrent training in trained individuals (ES = – 0.35, p p = 0.08) or untrained individuals (ES = 0.03, p = 0.87) as compared to resistance training only. A subgroup analysis revealed that the negative effect observed in trained individuals occurred only when resistance and endurance training were conducted within the same training session (ES same session = – 0.66, p p = 0.55). Conclusion This study demonstrated the novel and quantifiable effects of training status on lower-body strength development and shows that the addition of endurance training to a resistance training programme may have a negative impact on lower-body strength development in trained, but not in moderately trained or untrained individuals. This impairment seems to be more pronounced when training is performed within the same session than in different sessions. Trained individuals should therefore consider separating endurance from resistance training during periods where the development of dynamic maximal strength is prioritised.

BackgroundThe UEFA Elite Club Injury Study is the largest and longest running injury surveillance programme in football.ObjectiveTo analyse the 18-season time trends in injury rates among male professional football players.Methods3302 players comprising 49 teams (19 countries) were followed from 2000–2001 through 2018–2019. Team medical staff recorded individual player exposure and time-loss injuries.ResultsA total of 11 820 time-loss injuries were recorded during 1 784 281 hours of exposure. Injury incidence fell gradually during the 18-year study period, 3% per season for both training injuries (95% CI 1% to 4% decrease, p=0.002) and match injuries (95% CI 2% to 3% decrease, pConclusionsOver 18 years: (1) injury incidence decreased in training and matches, (2) reinjury rates decreased, and (3) player availability for training and match play increased.

Students’ perceived learning in physical education (PE) is an important yet neglected area of research. Increased knowledge about students’ perceived learning can provide teachers with useful information to promote meaningful learning experiences in PE. Moreover, perceived learning can potentially be an alternative measurement to school grades when analyzing equality of outcome. Given that gender and migration background are associated with equality issues in PE, these groups are of particular focus in this study. With this background, the aim of this paper is threefold: (a) to explore students’ perceived learning in PE in Sweden, (b) to analyze what perceptions of PE are most prominent, and (c) present a way to quantitatively illustrate how perceptions about PE vary across gender and migration background. The analysis was based on a question about students’ perceived learning and was conducted in two steps. First, the students’ answers were categorized using qualitative content analysis. The analysis shows that the perceived learning in PE can be categorized into the following categories: ‘Physical doing’, ‘Emotional experiences’, ‘Health’, ‘Do not learn’, ‘Outdoor Education’ and ‘Social interaction’. Second, by quantitatively illustrate all answers in relation to the six categories, the result showed that the category of ‘Physical doing’ (36%) was the most prominent, and thereafter, in descending order are the categories of ‘Emotional experiences’ (22%), ‘Health’ (18%), ‘Do not learn’ (10%), ‘Outdoor Education’ (10%) and ‘Social interaction’ (4%). The results also showed that regardless of gender and migration background, students have somewhat similar perceptions of what they learn in PE. In this study we: (i) present a categorization of students’ perceived learning in PE, (ii) show that physical doing is a prominent aspect in students answers, lastly (iii) by quantitatively illustrate students’ perceived learning in PE, this study also suggest an alternative measurement to analyze equality in PE.

For more than 40 years, health and physical education (HPE) academics in universities and teacher education colleges have drawn attention to issues of social justice specific to the context of PE and advocated for teachers in fields, gymnasiums and other physical activity spaces to do a better job of promoting more equitable outcomes for all students. Building on this advocacy, in the late 1990s, countries such as Sweden, Norway and New Zealand designed HPE curricula that address social justice. However, limited research has focused specifically on the enactment of social justice in HPE practice. Drawing on a larger international project involving Sweden, Norway and New Zealand the aim of this article is therefore to explore the constitution of social justice pedagogies across these three different HPE contexts and more specifically how HPE teaching practice may be understood from regulative, normative and cultural perspectives on social justice. The data reported on in this paper were generated from educational acts, curriculum documents, observations of HPE lessons in each of the three countries and follow-up teacher interviews. In order to analyse the data, we employed Scott's (2008. Institutions and organizations: Ideas and interests (3rd ed). Sage) institutional theory to further understand and discuss the enactment of social justice across the three different countries in HPE practice. In our representation and analysis of the findings we draw attention to how social justice pedagogies are informed differently by institutionalised governing systems and therefore they may be enacted differently by teachers in different societies. In particular, we highlight the influence of (i) regulative; (ii) normative; (iii) cultural-cognitive elements on practice. We conclude by pointing out the complex interplay between regulative, normative and cultural-cognitive elements that both enable and constrain HPE teachers' enactments of social justice in HPE practice.

PURPOSE: To study the effect of inhaling a beta-agonist (salbutamol) compared to placebo on skiing and cycling performance in well-trained elite athletes. METHODS: Three different exercise protocols were used, all with a cross-over double blind placebo-controlled design. Participants inhaled 800 µg salbutamol or a placebo prior to the test, which was repeated on a following day with the participants inhaling the other substance. Fifteen junior elite skiers performed four free-style high intensity sprints (1100 m/work time 3.5-4.5 min). Twelve elite cyclists carried out a short cycling protocol, starting with two 5 min submaximal workloads followed by a maximal intermittent performance test to exhaustion. Another 12 elite cyclists performed the maximal intermittent performance test to exhaustion after a 150 min long submaximal cycling protocol. RESULTS: Group mean time for the ski sprints increased, with no difference between treatment groups. In the short cycling protocol time to exhaustion was 9.1% (95% CI 52-161) lower after inhaling salbutamol compared to placebo and in the long cycling protocol time to exhaustion was 9.1% (95% CI - 121-267) lower after inhaling salbutamol compared to placebo. Blood lactate, heart rate and ventilation increased during submaximal exercise with salbutamol compared to placebo in the short cycling protocol (p

There is evidence that a knee flexor exercise, the Nordic hamstring exercise (NHE), prevents hamstring injuries. The purpose of this study was therefore to develop, and to determine the reliability of, a novel NHE test device and, further, to determine the effectiveness of a 10-week low volume NHE program on NHE performance. Twenty female football (soccer) players, aged 16–30 years, participated in this study. From a kneeling position on the device, with the ankles secured under a heavy lifting sling, participants leaned forward in a controlled manner as far as possible (eccentric phase) and then returned to the starting position (concentric phase). A tape measure documented the forward distance achieved by the participants in cm. Participants completed three separate occasions to evaluate test-retest reliability. Additionally, 14 players performed a low volume (1 set of 5 repetitions) NHE program once weekly for 10 weeks. No significant test-retest differences in NHE performance were observed. The intra-class correlation coefficient was 0.95 and the coefficient of variation was 3.54% between tests. Mean improvement in the NHE performance test by the players following training was 22% (8.7 cm), p = 0.005. Our test device reliably measured NHE performance and is easy to perform in any setting. Further, NHE performance was improved by a 10-week low volume NHE program. This suggests that even a small dose (1 set of 5 repetitions once weekly) of the NHE may enhance NHE performance.

Purpose Exposure to cold air may harm the airways. It is unclear to what extent heavy exercise adds to the cold-induced effects on peripheral airways, airway epithelium, and systemic immunity among healthy individuals. We investigated acute effects of heavy exercise in sub-zero temperatures on the healthy airways. Methods Twenty-nine healthy individuals underwent whole body exposures to cold air in an environmental chamber at − 15 °C for 50 min on two occasions; a 35-min exercise protocol consisting of a 5-min warm-up followed by 2 × 15 min of running at 85% of VO2max vs. 50 min at rest. Lung function was measured by impulse oscillometry (IOS) and spirometry before and immediately after exposures. CC16 in plasma and urine, and cytokines in plasma were measured before and 60 min after exposures. Symptoms were surveyed pre-, during and post-trials. Results FEV1 decreased after rest (− 0.10 ± 0.03 L, p p = 0.012), with no difference between trials. Exercise in − 15 °C induced greater increases in lung reactance (X5; p = 0.023), plasma CC16 (p p Conclusion Heavy exercise during cold air exposure at − 15 °C induced signs of an airway constriction to a similar extent as rest in the same environment. However, biochemical signs of airway epithelial stress, cytokine responses, and symptoms from the lower airways were more pronounced after the exercise trial.

Background Previous research on inclusive physical education (PE) has often focused on pupils with visible physical disabilities and how best to facilitate and adapt PE so that they can play an active role in the educational situation. Many lessons about inclusion have emerged from this important field. However, less is known about more ‘invisible’ variations. In Sweden, many pupils who are diagnosed with neurodevelopmental disorders (NDD), such as Attention Deficit Hyperactivity Disorder (ADHD) or Autism Spectrum Disorder (ASD), are integrated into mainstream classes. These pupils are often more sensitive to demands and stressful situations and struggle to decode social interactions. When it comes to lessons in PE, little is known about how pupils with NDD experience the educational situation and what they need to do to be successful in PE. Purpose The aim of this article is to explore what PE practices become in classes in which pupils with NDD are integrated in terms of inclusion or exclusion processes. Drawing on the work of John Dewey, we suggest a transactional perspective on inclusion. This facilitates a non-dualistic exploration of inclusive PE and makes it possible to take the experiences of pupils with NDD and their peers into account. Methods In the article we use a transactional framework with a focus on experience, meaning-making and habits using the following analytical questions: (i) What are the experiences of integrated PE? (ii) How do these events appear as inclusive? (iii) How do they appear as exclusive? The data generation consisted of 9 field observations and 13 individual interviews with pupils aged between 10 and 11 years in three classes in two different schools in one municipality. The municipality was awarded a grant by the Swedish authorities to work towards the creation of more favourable school situations for pupils with NDD. Three classes in which pupils with NDD diagnoses were integrated in PE were selected. Findings The study identified four PE practices in which inclusion and exclusion processes were prominent: (i) to organise, (ii) to cooperate, (iii) to sweat and (iv) to win. ‘To organise’ is a comprehensive practice that is transactionally identified and foregrounded by teachers’ actions. The other three are embedded in the practice ‘to organise’, which foregrounds pupils’ actions. The study shows that pupils are included in a certain kind of PE practice when it becomes an organised practice of sweating, competing and cooperating. Conclusion The study reveals that some of the inclusive practices that are designed to support pupils with NDD exclude other pupils with or without NDD. Accordingly, working in an integrated way can be both inclusive and exclusive. It would thus seem that successful inclusive education in PE is as much about group dynamics as about ‘individual pupils with problems’. In order to achieve inclusion, teachers need to focus on actively communicating with pupils, colleagues and parents, on how and what to teach and on what students are supposed to learn. CC BY 4.0Published online: 20 Oct 2020.

Monitoring variations in the functioning of the autonomic nervous system may help personalize training of runners and provide more pronounced physiological adaptations and performance improvements. We systematically reviewed the scientific literature comparing physiological adaptations and/or improvements in performance following training based on responses of the autonomic nervous system (ie, changes in heart rate variability) and predefined training. PubMed, SPORTDiscus, and Web of Science were searched systematically in July 2019. Keywords related to endurance, running, autonomic nervous system, and training. Studies were included if they (a) involved interventions consisting predominantly of running training; (b) lasted at least 3 weeks; (c) reported pre- and post-intervention assessment of running performance and/or physiological parameters; (d) included an experimental group performing training adjusted continuously on the basis of alterations in HRV and a control group; and (e) involved healthy runners. Five studies involving six interventions and 166 participants fulfilled our inclusion criteria. Four HRV-based interventions reduced the amount of moderate- and/or high-intensity training significantly. In five interventions, improvements in performance parameters (3000 m, 5000 m, Loadmax, Tlim) were more pronounced following HRV-based training. Peak oxygen uptake ((Formula presented.)) and submaximal running parameters (eg, LT1, LT2) improved following both HRV-based and predefined training, with no clear difference in the extent of improvement in (Formula presented.). Submaximal running parameters tended to improve more following HRV-based training. Research findings to date have been limited and inconsistent. Both HRV-based and predefined training improve running performance and certain submaximal physiological adaptations, with effects of the former training tending to be greater.

Purpose Hypoxia and exercise are known to separately trigger spleen contraction, leading to release of stored erythrocytes. We studied spleen volume and hemoglobin concentration (Hb) during rest and exercise at three altitudes. Methods Eleven healthy lowlanders did a 5-min modified Harvard step test at 1370, 3700 and 4200 m altitude. Spleen volume was measured via ultrasonic imaging and capillary Hb with Hemocue during rest and after the step test, and arterial oxygen saturation (SaO2), heart rate (HR), expiratory CO2 (ETCO2) and respiratory rate (RR) across the test. Results Resting spleen volume was reduced with increasing altitude and further reduced with exercise at all altitudes. Mean (SE) baseline spleen volume at 1370 m was 252 (20) mL and after exercise, it was 199 (15) mL (P P P P P P Conclusions The spleen contracts and mobilizes stored red blood cells during rest at high altitude and contracts further during exercise, to increase oxygen delivery to tissues during acute hypoxia. The attenuated Hb response to exercise at the highest altitude is likely due to the greater recruitment of the spleen reserve during rest, and that maximal spleen contraction is reached with exercise.

Summary Background Sports activities are the most common way to get an anterior cruciate ligament (ACL) injury. Correct diagnoses in the early phase after the knee injury is essential to establish a rehabilitation plan and, in the case of ACL-diagnosis, to avoid re-injuring the knee with increased risk of meniscal tears and/or osteoarthritis. The aim was to determine whether it is possible to confirm an ACL-injury with the Rolimeter measurements in the acute phase of a knee trauma, and if it correlates with magnetic resonance imaging (MRI) findings or arthroscopy. Material and Methods Thirty-four patients with an acute knee trauma, 20 women and 14 men, aged from 15–44 years, with a mean age of 24.8 (SD ± 7.3) participated. All were examined with the Rolimeter in the acute phase after a suspected ACL-injury. They also underwent MRI (n = 29) or arthroscopy (n = 5) wherein the injury was confirmed. Results A great consistency was seen in diagnosing the ACL-injuries with the Rolimeter measurement compared to MRI findings. The specificity (90.9%), sensitivity (91.3%), accuracy (91.2%), PPV (95.5%) and NPV (83.3%) were high in this study. Conclusions The Rolimeter measurement procedure is a safe and quick method in diagnosing an ACL-injury in the acute phase. Further studies should focus on larger cohorts and compare an early diagnosis to patient related outcome measures and societal/economical gains.

Purpose Pronounced differences in individual physiological adaptation may occur following various training mesocycles in runners. Here we aimed to assess the individual changes in performance and physiological adaptation of recreational runners performing mesocycles with different intensity, duration and frequency. Methods Employing a randomized cross-over design, the intra-individual physiological responses [i.e., peak ($${\dot{\text V}}{\text O}_{2 {\rm peak}}$$ V ˙ O 2 peak ) and submaximal ($${\dot{\text V}}{\text O}_{2 {\rm submax}}$$ V ˙ O 2 submax ) oxygen uptake, velocity at lactate thresholds (V2, V4)] and performance (time-to-exhaustion (TTE)) of 13 recreational runners who performed three 3-week sessions of high-intensity interval training (HIIT), high-volume low-intensity training (HVLIT) or more but shorter sessions of HVLIT (high-frequency training; HFT) were assessed. Results $${\dot{\text V}}{\text O}_{2 {\rm submax}}$$ V ˙ O 2 submax , V2, V4 and TTE were not altered by HIIT, HVLIT or HFT (p > 0.05). $${\dot{\text V}}{\text O}_{2 {\rm peak}}$$ V ˙ O 2 peak improved to the same extent following HVLIT (p = 0.045) and HFT (p = 0.02). The number of moderately negative responders was higher following HIIT (15.4%); and HFT (15.4%) than HVLIT (7.6%). The number of very positive responders was higher following HVLIT (38.5%) than HFT (23%) or HIIT (7.7%). 46% of the runners responded positively to two mesocycles, while 23% did not respond to any. Conclusion On a group level, none of the interventions altered $${\dot{\text V}}{\text O}_{2 {\rm submax}}$$ V ˙ O 2 submax , V2, V4 or TTE, while HVLIT and HFT improved $${\dot{\text V}}{\text O}_{2 {\rm peak}}$$ V ˙ O 2 peak . The mean adaptation index indicated similar numbers of positive, negative and non-responders to HIIT, HVLIT and HFT, but more very positive responders to HVLIT than HFT or HIIT. 46% responded positively to two mesocycles, while 23% did not respond to any. These findings indicate that the magnitude of responses to HIIT, HVLIT and HFT is highly individual and no pattern was apparent.

Introduction Human skeletal muscle is thought to have heightened sensitivity to exercise stimulus when it has been previously trained (i.e., it possesses "muscle memory"). We investigated whether basal and acute resistance exercise-induced gene expression and cell signaling events are influenced by previous strength training history. Methods Accordingly, 19 training naive women and men completed 10 wk of unilateral leg strength training, followed by 20 wk of detraining. Subsequently, an acute resistance exercise session was performed for both legs, with vastus lateralis biopsies taken at rest and 1 h after exercise in both legs (memory and control). Results The phosphorylation of AMPK and eEF2 was higher in the memory leg than that in the control leg at both time points. The postexercise phosphorylation of 4E-BP1 was higher in the memory leg than that in the control leg. The memory leg had lower basal mRNA levels of total PGC1α and, unlike the control leg, exhibited increases in PGC1α-ex1a transcripts after exercise. In the genes related to myogenesis (SETD3, MYOD1, and MYOG), mRNA levels differed between the memory and the untrained leg; these effects were evident primarily in the male subjects. Expression of the novel gene SPRYD7 was lower in the memory leg at rest and decreased after exercise only in the control leg, but SPRYD7 protein levels were higher in the memory leg. Conclusion In conclusion, several key regulatory genes and proteins involved in muscular adaptations to resistance exercise are influenced by previous training history. Although the relevance and mechanistic explanation for these findings need further investigation, they support the view of a molecular muscle memory in response to training.

Few intervention programmes focussing on increasing physical activity among children have been successful long term. It has also become increasingly common among scholars as well as politicians to advocate for organisations within a field to 'join up' to tackle social challenges. Research indicates that collaborative processes may entail challenges in implementing programmes informed by high quality knowledge. The aim of this study was, therefore, to examine partner organisations' conceptions about objectives of an alternative sports programme, how such objectives are meant to be achieved, and how such conceptions may affect children's development of a physically active lifestyle. Qualitative content analysis revealed three underlying lines of thought regarding alternative activities for children, as follows: they should increase the member base through modifications; they should awaken the inherent desire to move through targeting motor skills; and they should transform sports clubs by providing an exercise arena. The article discusses how activities fail to consider children's predisposing factors and what implications this has for the work of promoting children's physical activity. Finally, we suggest that partnerships would benefit from applying a multi-leveled ecological model when designing programmes.

The aims of this study were (a) to describe the kinematics underlying the phenomenon of the knee of the swing leg passing medially in front of the athlete during the single push (SP) phase of the block sprint start, and (b) to determine the relationships between block phase pelvis range of motion (RoM), 1st step width and block phase performance. Three-dimensional kinematic data (250 Hz) were collected from eleven competitive sprinters (100 m PB: 11.17 ± 0.41) performing maximal effort block starts. The joint angles of the rear hip with respect to the pelvis and the pelvis segment angles with respect to the laboratory coordinate system were calculated during the block start phase to the end of the 1st stance. A combination of pelvis list and rotation (not hip adduction) was coupled with the thigh of the swing leg moving medially during the SP phase. A very high positive correlation was found between pelvic list RoM and 1st step width (r = 0.799, p = 0.003). No other significant correlations were found. Attempting to reduce pelvic RoM or changing frontal and transverse plane hip joint angles to minimise medial thigh motion is unlikely to lead to an improvement to performance.

Purpose To investigate the gross efficiency (GE) and delta efficiency (DE) during cycling and running in elite triathletes. Methods Five male and five female elite triathletes completed two incremental treadmill tests with an inclination of 2.5° to determine their GE and DE during cycling and running. The speed increments between the 5-min stages were 2.4 and 0.6 km h−1 during the cycling and running tests, respectively. For each test, GE was calculated as the ratio between the mechanical work rate (MWR) and the metabolic rate (MR) at an intensity corresponding to a net increase in blood-lactate concentration of 1 mmol l−1. DE was calculated by dividing the delta increase in MWR by the delta increase in MR for each test. Pearson correlations and paired-sample t tests were used to investigate the relationships and differences, respectively. Results There was a correlation between GEcycle and GErun (r = 0.66; P = 0.038; R2 = 0.44), but the correlation between DEcycle and DErun was not statistically significant (r = − 0.045; P = 0.90; R2 = 0.0020). There were differences between GEcycle and GErun (t = 80.8; P cycle and DErun (t = 27.8; P Conclusions Elite triathletes with high GE during running also have high GE during cycling, when exercising at a treadmill inclination of 2.5°. For a moderate uphill incline, elite triathletes are more energy efficient during cycling than during running, independent of work rate.