Search

This article comprehensively reviews motor impairments in children with autism spectrum disorder (ASD) to: (1) determine the prevalence of motor problems in children with ASD; (2) understand the nature of motor difficulties in ASD and whether they are consistent with developmental coordination disorder (DCD); and (3) determine if the term DCD was used as a co-occurring diagnosis in children with ASD after publication of the DSM-5 in 2013. The following databases were systematically searched: MEDLINE, EMBASE, CINAHL, and PsycINFO from 2010 to December 2021. Articles were included if they: (1) were peer-reviewed and published in a scientific journal; (2) included children with ASD who were between 5 and 12 years; (3) used motor or function measures to assess motor abilities in children with ASD. Studies that included children with intellectual disabilities were excluded. Two independent reviewers reviewed titles, abstracts, and full-text articles for inclusion. Twenty-seven studies met the inclusion criteria and were assessed for quality by two independent reviewers using the Appraisal tool for Cross-Sectional Studies. The majority of articles (92.5%) indicated that 50–88% of children with ASD had significant motor impairments on standardized motor assessments and/or functional questionnaires. The nature of motor and function problems in ASD were consistent with DCD; however, only three out of 20 papers (15%) that were published from 2014 described the motor problems as DCD. One study reported that 15.1% of children with ASD with motor impairments had a co-occurring diagnosis of DCD, suggesting that DCD is under-recognized in this clinical population. [ABSTRACT FROM AUTHOR]

Barriers and facilitators affecting the social activities of people with congenital physical and communication disabilities are well documented. However, little is known of their experiences of developing sexual and intimate relationships. This study conducted a systematic review of the literature to address this gap in knowledge. Ten online databases were searched for relevant papers between 1990 and 2014. In addition, hand searches of Augmentative and Alternative Communication Journal and the Sexuality and Disability Journal were conducted. Fifteen papers were identified and appraised. The thematic coding approach identified six principal themes. However, the content analysis revealed that the majority of the literature focused on the social needs of people with physical and communication disabilities. Despite evidence that people with disabilities are sexually active, there is little focus on the experiences of people with disabilities developing intimacy and expressing sexuality. The few references to sexuality in the relevant literature focused on protection from abuse, though some researchers called for improved counseling on sexuality and relationships, and improved access to sexual health services. Further research is required to focus on practical and theoretical outcomes to enhance social relationships and sexuality, and offer lovers who use AAC real advice in their search for intimacy. [ABSTRACT FROM AUTHOR]

Background: Male youth soccer players competing at a high level will typically engage in large volumes of soccer training from a young age. However, it is not known whether the high levels of habitual training that these high-performing players are exposed to limit their ability to respond to strength, plyometric or combined training interventions. Objective: The primary aim of our systematic review and meta-analysis was to compare the specific effects of strength, plyometric and combined training with active controls (standard soccer training) on the strength, power and speed characteristics of high-level, highly trained young male soccer players. Methods: We performed a literature search across PubMed, Scopus, CINAHL, Web of Science and SPORTDiscus to identify controlled studies that implemented strength, plyometric or combined training in high-level male youth soccer players. Participants were defined as high level or highly trained based on established guidelines related to either competition level or age-related weekly hours spent in soccer training. Studies needed to report at least one outcome of lower body strength, squat jump, countermovement jump, horizontal power, acceleration (0–10 m), speed (15–40 m) or change of direction speed. A meta-analysis was then performed using a random-effects model to determine the magnitude (Hedge's g) of training responses and whether effects differed across modes of training. Results: From an initial return of 5464 papers, n = 34 studies met the inclusion criteria and provided a total sample of n = 1396 high-level male youth soccer players. Strength, plyometric and combined training resulted in improvements in strength, squat and countermovement jump, horizontal power, acceleration, change of direction speed (all p < 0.05; g = 0.73–1.08, moderate) and speed (p < 0.05; g = 0.40–0.59, small). Lower body strength was the only outcome where training mode had a significant effect (p < 0.05), with plyometric training producing small effects (g = 0.27, p < 0.05) compared with moderate effects for strength (g = 1.07, p < 0.05) and combined (g = 0.75, p < 0.05) training. Prediction intervals for overall effects (all training modes combined) showed that the greatest confidence that future training will lead to positive effects was in the squat and countermovement jump, horizontal power and acceleration (prediction intervals = 0.03–1.81). Conclusions: High-level, highly trained male youth soccer players can experience positive gains in indices of strength, power and speed from strength, plyometric and combined training, and the magnitude of gains are mostly similar across modes of training. Based on prediction intervals, there is a good level of certainty that future strength, plyometric and combined training in this population would lead to positive improvements in vertical and horizontal power and sprint acceleration. [ABSTRACT FROM AUTHOR]

Varicose veins are a common disorder for which different treatments with varied efficacy have been introduced so far. In this study, we review the results of previous studies to evaluate the efficacy of ClosureFast endovenous radiofrequency ablation (RFA) in treating varicose veins. The present study was performed based on the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) protocols, and the results were reported based on the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guideline. Searches were conducted in all authentic online databases, and the retrieved papers were conducted until March 2021 using Mesh keywords. Study data with the necessary quality to enter the meta-analysis were extracted. Data were analyzed using comprehensive meta-analysis (CMA) software version 2. The cutoff level for significance was determined at 0.05. In total, 36 studies with sample size 7404 procedures were included. Radiofrequency ablation success, recurrence, and recanalization rates in the treatment of varicose veins were estimated to be 95%, 7%, and 3% respectively. The most common complications were bruising 13%, induration 11.6%, edema 8%, ecchymosis 7.4%, and numbness 6.3%. This study showed that the radiofrequency ablation method is a high-performance method with few and often transient complications, and the risk of significant complications in using this method to treat varicose veins is low. More studies are needed to evaluate the effectiveness of this method compared to other treatments. [ABSTRACT FROM AUTHOR]

Background: Systematic reviews have shown attachment-based parenting programs to lead to improvements in parenting sensitivity and infant attachment, but none have focused specifically on the impact of attachment-based parenting programs on externalizing symptoms in young children. Objective: The objective of this study was to review published randomized controlled trial evidence regarding the impact of attachment-based early parenting interventions on externalizing behaviors in children aged 1–5 years. Methods: A systematic search of published literature available through to May 2020 was conducted. Seven published papers reporting results from trials testing six attachment-based parenting interventions were identified. Results: Three of the seven programs were shown to be associated with statistically significant improvements in child externalizing behavior (Helping Encourage Affect Regulation, Child-Parent Psychotherapy, Parent–Child Interaction Therapy—Toddlers). For one program (Child-Parent Psychotherapy), there was also evidence in one study that improvements in child externalizing behaviors were sustained at 6-month follow-up. A number of methodological limitations were present among the studies identified, most commonly reliance on parent-report measures of externalizing behavior. Conclusions: Taken together, results indicate that parenting interventions designed to promote secure parent–child attachment relationships may be effective in reducing externalizing behaviors in children aged 1–5 years of age. Further research is required to test programs in different populations and with longer follow-up times. [ABSTRACT FROM AUTHOR]

Background: While a substantial body of work postulates that adaptation (response-shift effects) may serve to hide intervention benefits, much of the research was conducted in observational studies, not randomized-controlled trials. This scoping review identified all clinical trials that addressed response shift phenomena, and characterized how response-shift effects impacted trial findings. Methods: A scoping review was done of the medical literature from 1968 to 2021 using as keywords "response shift" and "clinical trial." Articles were included if they were a clinical trial that explicitly examined response-shift effects; and excluded if they were not a clinical trial, a full report, or if response shift was mentioned only in the discussion. Clinical-trials papers were then reviewed and retained in the scoping review if they focused on randomized participants, showed clear examples of response shift, and used reliable and valid response-shift detection methods. A synthesis of review results further characterized the articles' design characteristics, samples, interventions, statistical power, and impact of response-shift adjustment on treatment effect. Results: The search yielded 2148 unique references, 25 of which were randomized-controlled clinical trials that addressed response-shift effects; 17 of which were retained after applying exclusion criteria; 10 of which were adequately powered; and 7 of which revealed clinically-important response-shift effects that made the intervention look significantly better. Conclusions: These findings supported the presumption that response shift phenomena obfuscate treatment benefits, and revealed a greater intervention effect after integrating response-shift related changes. The formal consideration of response-shift effects in clinical trials research will thus not only improve estimation of treatment effects, but will also integrate the inherent healing process of treatments. Key points: This scoping review supported the presumption that response shift phenomena obfuscate treatment benefits and revealed a greater intervention effect after integrating response-shift related changes. The formal consideration of response-shift effects in clinical trials research will not only improve estimation of treatment effects but will also integrate the inherent healing process of treatments. [ABSTRACT FROM AUTHOR]

Background: Hamstrings neuromuscular function is a crucial component of functional movement, and changes after anterior cruciate ligament (ACL) injury contribute to risk factors for secondary injury and long-term sequelae. To effectively treat muscular impairments, an accurate understanding of hamstrings neuromuscular function in patients with ACL reconstruction (ACLR) is needed. Objective: A systematic review and meta-analysis were undertaken to describe and quantify hamstrings neuromuscular function in individuals with ACLR compared to controls. Methods: We searched PubMed, Web of Science, SPORTDiscus, CINAHL, and EBSCOhost databases in October of 2020 for studies evaluating the difference between hamstrings electromyography (EMG) between individuals with ACLR and controls. Two independent reviewers assessed each paper for inclusion and quality. Means and standard deviations were extracted from each included study to allow random-effect size (ES) meta-analysis calculations for comparison of results. Results: Thirty-four studies were included for final review. From these, 5 categories of neuromuscular outcomes were identified, and studies were grouped accordingly: (1) muscle activation levels (EMG amplitude), (2) co-activation, (3) onset timing, (4) electromechanical delay, and (5) time-to-peak activity. Moderate to strong evidence indicates that individuals with ACLR demonstrate higher hamstrings EMG amplitude (normalized to % maximum voluntary isometric contraction) and hamstrings-to-quadriceps co-activation during gait and stair ambulation compared to controls. In addition, there was moderate evidence of longer electromechanical delay during knee flexion and greater hamstrings-to-quadriceps co-activation during knee extension compared to controls. Conclusions: Greater hamstrings EMG amplitude and co-activation during gait and ambulation tasks and longer electromechanical delay of the hamstrings in individuals with ACLR align with clinical impairments following ACLR and have implications for re-injury risk and long-term joint health, thus warranting attention in rehabilitation. [ABSTRACT FROM AUTHOR]

Background: In recent years, there has been a large expansion in literature pertaining to the game of Australian football (AF). Furthermore, there have been a number of rule changes that are likely to have changed the demands of the game. Based on these advances and changes, it seemed important to conduct a review assessing the scientific literature surrounding the sport.Objective: The review evaluates the match demands of AF, the qualities required for success, and the impact training and competition have on adaptation, injury and fatigue.Methods: A systematic search of PubMed, CINAHL, SPORTDiscus, Web of Science and Scopus for AF literature was conducted; studies investigating match demands, physical qualities, training practices and injury were included. Weighted means and standard deviations were calculated for match demands and physical and anthropometric profiles across playing standards.Results: A total of 1830 articles were retrieved in the initial search, with 888 removed as duplicates, 626 removed for being non-relevant and a further 152 removed for being AF papers but not relevant to the review. As such, 164 AF papers were included in the review. Due to the intermittent high-intensity nature of match-play, players need a wide range of physical and technical qualities to excel, with speed, aerobic fitness, reactive agility and well-developed lean mass being central to success. Training for AF at the elite level is associated with high workloads, with players engaging in numerous training modalities; even altitude and heat training camps have been utilised by Australian Football League (AFL) teams to further augment fitness improvements. While high chronic workloads can be tolerated and are needed for improving physical qualities, careful planning and monitoring of internal and external workloads is required to minimise sharp spikes in load that are associated with injury.Conclusions: There is a complex interaction between numerous contextual factors that influence the match demands that are discussed in this review. Whilst players must have the physical capacities to cope with the intense physical demands of AF matches, the successful execution of technical skills during match-play is central to success. To develop these skills and attributes, specific and carefully planned and monitored training must be performed over a number of years. [ABSTRACT FROM AUTHOR]

Study design:Systematic reviewObjectives:To determine the effect of respiratory muscle training (RMT) on pulmonary function in tetraplegia.Methods:A comprehensive search of the research literature included MEDLINE, EMBASE, CINAHL, ISI Web of Science, PubMed, the relevant Cochrane and clinical trials registers and hand-searching the reference lists of appropriate papers. There was no language restriction. All randomised controlled trials that involved RMT vs control were considered for inclusion. Two reviewers independently selected articles for inclusion, evaluated the methodological quality and extracted data. Additional information was sought from the authors when necessary.Results:Eleven studies (212 participants) were included. A significant benefit of RMT was revealed for five outcomes: vital capacity (mean difference (95% confidence interval))=0.41(0.17-0.64) l, maximal inspiratory pressure=10.66(3.59, 17.72) cmH2O, maximal expiratory pressure=10.31(2.80-17.82) cmH2O, maximum voluntary ventilation=17.51(5.20, 29.81) l min−1 and inspiratory capacity=0.35(0.05, 0.65) l. No effect was found for total lung capacity, peak expiratory flow rate, functional residual capacity, residual volume, expiratory reserve volume or forced expiratory volume in 1 second.Conclusion:RMT increases respiratory strength, function and endurance during the period of training. Further research is needed to determine optimum dosages and duration of effect. This article is based in part on a Cochrane review published in the Cochrane Database of Systematic Reviews (CDSR) 2013, DOI:10.1002/14651858.CD008507.pub2. Cochrane reviews are regularly updated as new evidence emerges and in response to feedback, and the CDSR should be consulted for the most recent version of the review. [ABSTRACT FROM AUTHOR]

Introduction: Colonization with Group B Streptococcus in pregnancy is a major risk factor for neonatal infection. Universal screening for maternal streptococcal colonization and the use of intrapartum antibiotic prophylaxis has resulted in substantial reductions of neonatal early-onset Group B Streptococcus disease. To achieve the best neonatal outcomes, it is imperative for maternity healthcare providers to adhere to screening and management guidelines. Aim: This literature review uses a systematic approach and aims to provide a synthesis of what is known about compliance with Group B Streptococcus screening protocols in a variety of global settings, including maternity homes, private obstetric practice, and hospital clinical environments. Methods: The review was carried out using electronic databases as well as hand-searching of reference lists. Included papers reported primarily on compliance with Group B Streptococcus screening guidelines, potential factors which influence compliance rates, and implementations and outcomes of interventions. Results: Six international studies have been retained which all focused on adherence to Group B Streptococcus screening guidelines and demonstrated that different factors might have an influence on adherence to GBS screening protocols such as financial aspects and high caesarean section rates. Findings of relatively low compliance rates led to recognizing the need of developing improved strategies for optimising antenatal GBS screening adherence. Conclusion: Adhering to Group B Streptococcus screening guidelines to prevent neonatal infection is crucial. Various factors influence compliance rates such as financial aspects and high proportions of caesarean sections. The implementation of strategies and different forms of education can result in improved compliance rates. [ABSTRACT FROM AUTHOR]

Background: Soccer is the most popular sport worldwide, with a long history and currently more than 500 million active participants, of whom 300 million are registered football club members. On the basis of scientific findings showing positive fitness and health effects of recreational soccer, FIFA (Fédération Internationale de Football Association) introduced the slogan 'Playing football for 45 min twice a week-best prevention of non-communicable diseases' in 2010. Objective: The objective of this paper was to perform a systematic review and meta-analysis of the literature to determine the effects of recreational soccer on maximal oxygen uptake ( $$ \dot{V}{\text{O}}_{2\;\hbox{max} } $$ ). Methods: Six electronic databases (MEDLINE, PubMed, SPORTDiscus, Web of Science, CINAHL and Google Scholar) were searched for original research articles. A manual search was performed to cover the areas of recreational soccer, recreational physical activity, recreational small-sided games and $$ \dot{V}{\text{O}}_{2\;\hbox{max} } $$ using the following key terms, either singly or in combination: recreational small-sided games, recreational football, recreational soccer, street football, street soccer, effect, maximal oxygen uptake, peak oxygen uptake, cardiorespiratory fitness, $$ \dot{V}{\text{O}}_{2\;\hbox{max} } $$ . The inclusion criteria were divided into four sections: type of study, type of participants, type of interventions and type of outcome measures. Probabilistic magnitude-based inferences for meta-analysed effects were based on standardised thresholds for small, moderate and large changes (0.2, 0.6 and 1.2, respectively) derived from between-subject standard deviations for baseline fitness. Results: Seventeen studies met the inclusion criteria and were included in the systematic review and meta-analysis. Mean differences showed that $$ \dot{V}{\text{O}}_{2\;\hbox{max} } $$ increased by 3.51 mL/kg/min (95 % CI 3.07-4.15) over a recreational soccer training programme in comparison with other training models. The meta-analysed effects of recreational soccer on $$ \dot{V}{\text{O}}_{2\;\hbox{max} } $$ compared with the controls of no exercise, continuous running and strength training were most likely largely beneficial [effect size (ES) = 1.46; 95 % confidence interval (CI) 0.91, 2.01; I = 88.35 %], most likely moderately beneficial (ES = 0.68; 95 % CI 0.06, 1.29; I = 69.13 %) and most likely moderately beneficial (ES = 1.08; 95 % CI −0.25, 2.42; I = 71.06 %), respectively. In men and women, the meta-analysed effect was most likely largely beneficial for men (ES = 1.22) and most likely moderately beneficial for women (ES = 0.96) compared with the controls. After 12 weeks of recreational soccer with an intensity of 78-84 % maximal heart rate (HR), healthy untrained men improved their $$ \dot{V}{\text{O}}_{2\;\hbox{max} } $$ by 8-13 %, while untrained elderly participants improved their $$ \dot{V}{\text{O}}_{2\;\hbox{max} } $$ by 15-18 %. Soccer training for 12-70 weeks in healthy women resulted in an improvement in $$ \dot{V}{\text{O}}_{2\;\hbox{max} } $$ of 5-16 %. Significant improvements in $$ \dot{V}{\text{O}}_{2\;\hbox{max} } $$ have been observed in patients with diabetes mellitus, hypertension and prostate cancer. Conclusion: Recreational soccer produces large improvements in $$ \dot{V}{\text{O}}_{2\;\hbox{max} } $$ compared to strength training and no exercise, regardless of the age, sex and health status of the participants. Furthermore, recreational soccer is better than continuous endurance running, albeit the additional effect is moderate. This kind of physical activity has great potential for enhancing aerobic fitness, and for preventing and treating non-communicable diseases, and is ideal for addressing lack of motivation, a key component in physical (in)activity. [ABSTRACT FROM AUTHOR]

Exergaming is a combination of exercise and gaming. Evidence shows an association between exercise and cognition in older people. However, previous studies showed inconsistent results on the cognitive benefits of exergaming in people with cognitive impairment. Therefore, this study aims to examine the effect of exergaming intervention on cognitive functions in people with MCI or dementia. A systematic literature search was conducted via OVID databases. Randomized controlled trials (RCTs) examined the effect of an exergaming intervention on cognitive functions in people with MCI or dementia were included. Subgroup analyses were conducted according to the type of intervention and training duration. Twenty RCTs with 1152 participants were identified, including 14 trials for MCI and 6 trials for dementia. In people with MCI, 13 studies used virtual-reality (VR)-based exergaming. Those who received VR-based exergaming showed significantly better global cognitive function [SMD (95%CI) = 0.67 (0.23–1.11)], learning and memory [immediate recall test: 0.79 (0.31–1.27); delayed recall test: 0.75 (0.20–1.31)], working memory [5.83 (2.27–9.39)], verbal fluency [0.58 (0.12–1.03)], and faster in executive function than the controls. For people with dementia, all studies used video-based exergaming intervention. Participants with exergaming intervention showed significantly better global cognitive function than the controls [0.38 (0.10–0.67)]. Subgroup analyses showed that longer training duration generated larger effects. The findings suggest that exergaming impacts cognitive functions in people with MCI and dementia. Cognitive benefits are demonstrated for those with a longer training duration. With technological advancement, VR-based exergaming attracts the attention of people with MCI and performs well in improving cognitive functions. [ABSTRACT FROM AUTHOR]

Background: Ankle sprain is one of the most common musculoskeletal injuries, yet a contemporary review and meta-analysis of prospective epidemiological studies investigating ankle sprain does not exist. Objective: Our aim is to provide an up-to-date account of the incidence rate and prevalence period of ankle sprain injury unlimited by timeframe or context activity. Methods: We conducted a systematic review and meta-analyses of English articles using relevant computerised databases. Search terms included Medical Search Headings for the ankle joint, injury and epidemiology. The following inclusion criteria were used: the study must report epidemiology findings of injuries sustained in an observed sample; the study must report ankle sprain injury with either incidence rate or prevalence period among the surveyed sample, or provide sufficient data from which these figures could be calculated; the study design must be prospective. Independent extraction of articles was performed by two authors using pre-determined data fields. Results: One-hundred and eighty-one prospective epidemiology studies from 144 separate papers were included. The average rating of all the included studies was 6.67/11, based on an adapted version of the STROBE (STrengthening the Reporting of OBservational studies in Epidemiology) guidelines for rating observational studies. 116 studies were considered high quality and 65 were considered low quality. The main findings of the meta-analysis demonstrated a higher incidence of ankle sprain in females compared with males (13.6 vs 6.94 per 1,000 exposures), in children compared with adolescents (2.85 vs 1.94 per 1,000 exposures) and adolescents compared with adults (1.94 vs 0.72 per 1,000 exposures). The sport category with the highest incidence of ankle sprain was indoor/court sports, with a cumulative incidence rate of 7 per 1,000 exposures or 1.37 per 1,000 athlete exposures and 4.9 per 1,000 h. Low-quality studies tended to underestimate the incidence of ankle sprain when compared with high-quality studies (0.54 vs 11.55 per 1,000 exposures). Ankle sprain prevalence period estimates were similar across sub-groups. Lateral ankle sprain was the most commonly observed type of ankle sprain. Conclusions: Females were at a higher risk of sustaining an ankle sprain compared with males and children compared with adolescents and adults, with indoor and court sports the highest risk activity. Studies at a greater risk of bias were more likely to underestimate the risk of ankle sprain. Participants were at a significantly higher risk of sustaining a lateral ankle sprain compared with syndesmotic and medial ankle sprains. [ABSTRACT FROM AUTHOR]

Due to the high level of violence globally, providing intervention for child victims of trauma has become a priority for various government departments and health professionals including occupational therapists. Child appropriate sensory modulation intervention, which has its theoretical origins within the occupational therapy profession, has been suggested as a suitable treatment approach for children who are victims of trauma, since the initial experience of trauma occurs on a somatosensory level. Advances in trauma care indicate that children may experience the effects of trauma as an inability to appropriately regulate and organize sensory responses. This results in sensory modulation dysfunction associated with emotional and behavior difficulties. This scoping review provides an overview of the extent to which sensory modulation dysfunction has been identified and treated in child victims of trauma. Using the Arksey and O'Malley (2005) framework, five databases and three manual hand searches were conducted. This scoping review confirmed the scarcity of research available. The 13 studies which met the inclusion criteria indicated that child victims of trauma (CVT) present with a sensory modulation disorder (SMD). Sensory modulation intervention, within the theoretical framework of Ayres Sensory Integration® (ASI®), alone and in combination with psychotherapy approaches was found to be valuable for CVT, in the studies chartered. Identification and treatment of sensory modulation dysfunction in CVT has been researched and is becoming an area of increasing need. Therefore, to remain relevant to the violent contexts within communities, there is a need to expand research in this field. [ABSTRACT FROM AUTHOR]

Background: This study aims to identify sports interventions for children and adolescents (CaA) with chronic diseases and evaluate their impact on physical, psychological, and social well-being. The findings of this study will contribute to our understanding of the potential benefits of sports interventions for CaA with chronic diseases and inform future interventions to promote their overall health and well-being. Methods: A systematic review was conducted in eight databases. This systematic review followed PRISMA guidelines and utilized a comprehensive search strategy to identify studies on sport-based interventions for CaA with chronic diseases. The review included randomized controlled trials and observational studies that focused on physical and psychosocial outcomes. Results: We screened 10,123 titles and abstracts, reviewed the full text of 622 records, and included 52 primary studies. A total of 2352 participants were assessed with an average of 45 ± 37 participants per study. Among the included studies involving CaA with chronic diseases with an age range from 3 to 18 years, 30% (n = 15) autism spectrum disorders, 21% (n = 11) cerebral palsy, 19% (n = 10) were attention deficit hyperactivity disorder, and 17% (n = 9) obesity. Other diseases included were cancer (n = 5), asthma (n = 1) and cystic fibrosis (n = 1). Interventions involved various sports and physical activities tailored to each chronic disease. The duration and frequency of interventions varied across studies. Most studies assessed physical outcomes, including motor performance and physical fitness measures. Psychosocial outcomes were also evaluated, focusing on behavioural problems, social competencies, and health-related quality of life. Conclusion: Overall, sport-based interventions effectively improved physical and psychosocial outcomes in CaA with chronic diseases. Interventions are generally safe, and participants adhere to the prescribed protocols favorably. Despite that, there is little evidence that interventions are being implemented. Future studies should include interventions tailored to meet the common issues experienced by CaA with chronic conditions, providing a comprehensive understanding of the impact of sports interventions on those affected. Registration: The methodology for this review was pre-determined and registered in the PROSPERO database (registration number: CRD42023397172). Key Points: The study's objective was to examine the impact of sports interventions on CaA with chronic diseases, focusing on physical, psychological, and social well-being. The study's findings showed that sport-based interventions effectively improved physical and psychosocial outcomes in CaA with chronic diseases. Moreover, participants generally adhered favorably to the prescribed intervention protocols. To enhance the impact of sports interventions, future studies should develop tailored interventions addressing the common issues (e.g., limited accessibility and inclusion, psychosocial barriers, variable adherence, etc.) experienced by CaA with chronic conditions, providing a comprehensive understanding of the benefits of these interventions for affected individuals. [ABSTRACT FROM AUTHOR]

Background: Autonomic nervous system (ANS) testing has aided in our ability to evaluate autonomic dysfunction in migraine patients. We reviewed the literature in multiple databases which investigate ANS function in migraine patients and healthy subjects. Methods: This systematic review and meta-analysis examined the respective deep breathing, Valsalva manoeuvre, orthostatic and isometric challenge results, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Meta-analyses of Observational Studies in Epidemiology (MOOSE) statements. Results: Seven articles met all inclusion criteria. Fixed-effects meta-analysis showed migraine patients (n = 424), collectively, had lower interictal autonomic test results compared with healthy controls (n = 268). In detail, this was true for the standardized mean difference (g) of deep breathing (g= -0.32; 95% confidence interval (CI) -0.48, -0.16), orthostatic challenge (g= -0.28; 95% CI -0.44, -0.13) and isometric challenge (g= -0.55; 95% CI -0.71, -0.39) and for the difference of means (MD) of the Valsalva ratio (MD = -0.17; 95% CI -0.23, -0.10). Conclusions: Interictal ANS dysfunction can be identified in migraine patients when compared to healthy controls. These findings indicate the importance to evaluate ANS function in migraine patients - especially, as migraine-specific prophylactic therapies (such as anti-calcitonin gene-related peptide (CGRP) antibodies) may affect the function of the ANS. [ABSTRACT FROM AUTHOR]

Background: Globally, just one in five adolescents meet physical activity guidelines and three-quarters of the school day is spent sitting. It is unclear which types of school-based interventions strategies increase physical activity and reduce sedentary time among adolescents, or how these interventions are implemented influences their effectiveness. Objective: The three aims of our systematic review were to (a) identify intervention strategies used within secondary school settings to improve students' movement behaviours throughout school-based initiatives, delivered at or by the school; (b) determine the overall effect of the interventions (meta-analysis) on physical activity (all intensities), sedentary time, cognitive/academic, physical health and/or psychological outcomes; and (c) describe factors related to intervention implementation. Methods: Searches were conducted in MEDLINE complete, EMBASE, CINAHL, SPORTDiscus, APA PsycINFO, and ERIC in January 2023 for studies that (a) included high school-aged adolescents; (b) involved a school-based intervention to increase physical activity and/or decrease sedentary time; and (c) were published in English. Reported effects were pooled in meta-analyses where sufficient data were obtained. Results: Eighty-five articles, representing 61 interventions, met the inclusion criteria, with 23 unique intervention strategies used. Interventions that involved whole-school approaches (i.e., physical activity sessions, environmental modifications, teacher training, peer support and/or educational resources) were favourably associated with most of the outcomes. The meta-analyses showed: (a) non-significant effects for sedentary time (Standardized mean difference [SMD] = -0.02; 95%CI, -0.14, 0.11), physical activity at all intensities (light: SMD= -0.01; 95%CI, -0.08, 0.05; moderate: SMD = 0.06; 95%CI, -0.09, 0.22; vigorous: SMD = 0.08; 95%CI, -0.02, 0.18; moderate-to-vigorous: SMD = 0.05; 95%CI, -0.01, 0.12) and waist circumference (SMD = 0.09; 95%CI, -0.03, 0.21), and (b) a small statistically significant decrease in body mass index (SMD= -0.09, 95%CI -0.16, -0.0). Factors related to intervention implementation were reported in 51% of the articles. Conclusion: While some intervention approaches demonstrated promise, small or null effects were found in meta-analyses. Future school-based interventions should utilize a whole-school approach designed to increase adolescents' activity across the day. Consistent reporting of implementation will increase understanding of how interventions are adopted, implemented and sustained. Registration: PROSPERO (CRD42020169988). Key Points: School-based interventions with adolescents have had null effects on increasing physical activity and reducing sedentary time. The impact on physical and psychological outcomes has been poorly reported among secondary school students. This review included articles with all experimental study designs, any intervention length, and that reported a variety of outcomes among adolescents in secondary schools (11–18 years old). Although meta-analyses showed that these interventions did not increase physical activity or reduce sedentary time, studies that quantify adiposity markers showed a small decrease in body mass index. The review identified that additional physical activity sessions, environmental modifications, teacher training, peer support, educational resources and/or active lesson strategies were associated with greater benefits. Fidelity and participant responses were the most commonly reported implementation factors, adaptation was the least commonly reported; however, factors associated with effective implementation were not a focus of the included studies. [ABSTRACT FROM AUTHOR]

Background: The adolescent 'growth spurt' results in rapid growth of the skeletal system. It has been theorised that absence of a concomitant increase in muscular adaptations in female athletes may predispose them to an increased risk of anterior cruciate ligament injuries. Objectives: To determine if sex differences exist in landing biomechanics and postural stability of adolescent athletes; with a further objective of determining if such differences are propagated during adolescence. Data sources: The following databases were searched: MEDLINE, EMBASE, CINAHL, PEDro, PubMed, SPORTDiscus and Web of Science. Research papers were identified by including search terms for neuromuscular control, lower limb and pubertal development. Inclusion Criteria: Studies were required to be written in English; report on biomechanical analyses; include landing or postural control tasks; be cross-sectional or longitudinal; and include healthy adolescent/pubertal subjects. Study Appraisal and Synthesis Methods: A modified version of the Strengthening the Reporting of Observational studies in Epidemiology checklist was used to rate methodological quality. Meta-analyses were performed when more than one study reported on an outcome measure. Results: Sixteen articles were included. The overall methodological quality of evaluated studies was low (mean score = 5.75/10 points). Adolescent females exhibited increased knee valgus with increasing maturity. There was no consensus on sex differences in postural stability. Conclusions: With increasing maturation, females are characterized by increased knee valgus during landing tasks. To date, no research has longitudinally investigated postural stability development during adolescence in females, despite the importance of postural control training in injury prevention programmes. Therefore, further research on this topic is warranted. [ABSTRACT FROM AUTHOR]

Background: Patellofemoral pain (PFP) is highly prevalent within both sporting and recreationally active populations. Multiple treatment approaches have been advocated for the management of PFP, attempting to address both intrinsic and extrinsic factors thought to contribute to the development and persistence of pain. A number of predictors of treatment success have been proposed, and evaluated, for directing intervention choice. Objective: Our aim was to systematically review the literature that identifies outcome predictors of specific conservative interventions in the management of PFP, including quality of the current evidence, to guide clinical practice and future studies investigating outcome predictors within this population. Data Sources: The AMED, CINAHL, EMBASE, MEDLINE and Web of Science databases were searched from inception to April 2013. Study Selection: Randomized controlled trials (RCTs) and cohort studies. Study Appraisal and Synthesis Methods: Following initial searching, all potential papers were assessed by two independent reviewers for inclusion using a checklist developed from the inclusion criteria. Cited, and citing, references were also searched in Google Scholar, but unpublished work was not sought. Methodological quality was assessed using a previously designed quality assessment scale. Definitions for levels of evidence were guided by recommendations made by van Tulder et al. Results: Fifteen low-quality (LQ) cohort studies were included. No RCTs were found. This systematic review identified the evaluation of 205 conservative management outcome predictor variables. Of this large number of variables that have been assessed, 19 (9 %) were found to significantly predict a successful outcome. Where two or more outcome predictors and success determinants were consistent between studies, data were pooled. Within these studies, the low number of participants per output variable, and absence of controls, is likely to compromise the validity of the predictor's accuracy. Very limited evidence identified higher functional index questionnaire scores (mean 0.82, 95 % confidence interval [CI] 0.18-1.46), greater forefoot valgus (mean 0.67, 95 % CI 0.05-1.28) and greater rearfoot eversion magnitude peak (mean −0.93, 95 % CI −1.84 to −0.01) to significantly predict improved outcomes with orthoses interventions. Shorter symptom duration ( p = 0.019), lower frequency of pain ( p = 0.012), younger age, faster vastus medialis oblique reflex response time ( p = 0.026), negative patella apprehension, absence of chondromalacia patella, tibial tubercle deviation of <14.6 mm and greater total quadriceps cross-sectional area on magnetic resonance imaging ( p = 0.01), and reduced eccentric average quadriceps peak torque ( p = 0.015) significantly predicted exercise intervention success following multivariate statistical analysis. Limited evidence identified increased Q-angle (mean 0.38, 95 % CI 0.05-0.72) and very limited evidence identified greater usual pain (mean 0.43, 95 % CI 0.01-0.85) to predict taping intervention success. Conclusions: This systematic review provides a comprehensive summary of current derivation level studies identifying indicators of prediction for conservative PFP management. The overall strength of evidence was low. With appropriate caution, clinicians should consider taping for those with greater usual pain, orthoses for older individuals and exercise for younger individuals, and orthoses intervention for patients with greater forefoot valgus and rearfoot eversion magnitude peak. RCTs with evaluation of outcome prediction as a primary aim are clearly warranted to provide clinicians with robust evidence and facilitate evidence-informed, tailored intervention to this heterogeneous patient population. [ABSTRACT FROM AUTHOR]

To identify, appraise and synthesize evidence regarding efficacy of conservative interventions (physiotherapeutic, pharmacological) to improve walking in ambulant adults with cerebral palsy (CP). Standard search and extraction methods were utilised. A descriptive synthesis was performed with additional limited meta-analysis where the same outcome measurements were used and clinical heterogeneity was low. Interventions were considered according to target domain (International Classification of Functioning, Disability and Health). From 1571 papers identified, 10 met inclusion criteria. Study exclusion was predominantly due to gait not being a target of the intervention, or non-adult age range. Five randomised controlled trials were identified. Interventions were diverse and included strength training, sensory cueing, neurodevelopmental training, whole body vibration and spasticity medication. A small between-group effect on gait speed was found, weighted mean difference 0.09 (95 % CI 0.03 to 0.16). Evidence to support efficacy of one physiotherapeutic or pharmacological intervention over another to improve gait in adults with CP is currently limited. Further research is required using standardised gait outcome measures, longer follow up periods and higher quality trial designs. [ABSTRACT FROM AUTHOR]

This systematic review aimed to identify factors significantly associated with the occurrence of epilepsy in autistic individuals and to consider the impact of study quality on findings. Electronic databases were systematically searched on October 2nd, 2020 and records retrieved were limited to those published from 2000 onwards. Study quality was categorised as 'good', 'moderate' or 'weak'. Fifty-three studies were included and in studies where the prevalence of epilepsy was reported (n = 257,892), 18,254 (7%) had co-occurring epilepsy. Intellectual disability/cognitive impairment was the most commonly reported risk factor associated with occurrence of epilepsy in autistic individuals. The evidence supporting other, potentially relevant factors was weak and inconsistent and requires further evaluation. Only 9/53 studies were considered 'good' quality. [ABSTRACT FROM AUTHOR]

Background: Well programmed strength and conditioning training is an indispensable part of the long-term training process for athletes in individual and team sports to improve performance and prevent injuries. Yet, there is a limited number of studies available that examine the effects of resistance training (RT) on muscular fitness and physiological adaptations in elite female athletes. Objectives: This systematic review aimed to summarize recent evidence on the long-term effects of RT or combinations of RT with other strength-dominated exercise types on muscular fitness, muscle morphology, and body composition in female elite athletes. Materials and Methods: A systematic literature search was conducted in nine electronic databases (Academic Search Elite, CINAHL, ERIC, Open Access Theses and Dissertations, Open Dissertations, PsycINFO, PubMed/MEDLINE, Scopus, and SPORTDiscus) from inception until March 2022. Key search terms from the MeSH database such as RT and strength training were included and combined using the operators "AND," "OR," and "NOT". The search syntax initially identified 181 records. After screening for titles, abstracts, and full texts, 33 studies remained that examined the long-term effects of RT or combinations of RT with other strength-dominated exercise types on muscular fitness, muscle morphology, and body composition in female elite athletes. Results: Twenty-four studies used single-mode RT or plyometric training and nine studies investigated the effects of combined training programs such as resistance with plyometric or agility training, resistance and speed training, and resistance and power training. The training duration lasted at least 4 weeks, but most studies used ~ 12 weeks. Studies were generally classified as 'high-quality' with a mean PEDro score of 6.8 (median 7). Irrespective of the type or combination of RT with other strength-dominated exercise regimens (type of exercise, exercise duration, or intensity), 24 out of 33 studies reported increases in muscle power (e.g., maximal and mean power; effect size [ES]: 0.23 < Cohen's d < 1.83, small to large), strength (e.g., one-repetition-maximum [1RM]; ES: 0.15 < d < 6.80, small to very large), speed (e.g., sprint times; ES: 0.01 < d < 1.26, small to large), and jump performance (e.g., countermovement/squat jump; ES: 0.02 < d < 1.04, small to large). The nine studies that examined the effects of combined training showed significant increases on maximal strength (ES: 0.08 < d < 2.41, small to very large), muscle power (ES: 0.08 < d < 2.41, small to very large), jump and sprint performance (ES: 0.08 < d < 2.41, small to very large). Four out of six studies observed no changes in body mass or percentage of body fat after resistance or plyometric training or combined training (ES: 0.026 < d < 0.492, small to medium). Five out of six studies observed significant changes in muscle morphology (e.g., muscle thickness, muscle fiber cross-sectional area; ES: 0.23 < d < 3.21, small to very large). However, one study did not find any changes in muscle morphology (i.e., muscle thickness, pennation angle; ES: 0.1 < d < 0.19, small). Conclusion: Findings from this systematic review suggest that RT or combined RT with other strength-dominated exercise types leads to significant increases in measures of muscle power, strength, speed, and jump performance in elite female athletes. However, the optimal dosage of programming parameters such as training intensity and duration necessary to induce large effects in measures of muscular fitness and their physiological adaptations remain to be resolved in female elite athletes. [ABSTRACT FROM AUTHOR]

Background: Rugby Union is a collision team sport played globally. Despite this, significant concerns have been raised regarding the sport's safety, particularly in youth players. Given this, a review of injury rates, risk factors and prevention strategies is required across different youth age groups as well as in males and females. Objective: The objective of this systematic review (SR) and meta-analysis was to investigate injury and concussion rates, risk factors and primary prevention strategies in youth rugby. Methods: To be included, studies were required to report either rates, risk factors or prevention strategies in youth rugby and to have a randomised controlled trial, quasi-experimental, cohort, case control, or ecological study design. Exclusion criteria included non-peer-reviewed grey literature, conference abstracts, case studies, previous systematic reviews and studies not written in English. Nine databases were searched. The full search strategy and list of sources are available and pre-registered on PROSPERO (Ref: CRD42020208343). Each study was assessed for risk of bias using the Downs and Black quality assessment tool. Meta-analyses were conducted using a DerSimonian Laird random effect model for each age group and sex. Results: Sixty-nine studies were included in this SR. The match injury rates (using a 24-h time-loss definition) were 40.2/1000 match hours (95% CI 13.9–66.5) in males and 69.0/1000 match hours (95% CI 46.8–91.2) in females. Concussion rates were 6.2/1000 player-hours (95% CI 5.0–7.4) for males and 33.9/1000 player-hours (95% CI: 24.1–43.7) for females. The most common injury site was lower extremity (males) and the head/neck (females). The most common injury type was ligament sprain (males) and concussion (females). The tackle was the most common event associated with injury in matches (55% male, 71% females). Median time loss was 21 days for males and 17 days for females. Twenty-three risk factors were reported. The risk factors with the strongest evidence were higher levels of play and increasing age. Primary injury prevention strategies were the focus of only eight studies and included law changes (n = 2), equipment (n = 4), education (n = 1) and training (n = 1). The prevention strategy with the most promising evidence was neuromuscular training. The primary limitations included a broad range of injury definitions (n = 9) and rate denominators (n = 11) used, as well as a limited number of studies which could be included in the meta-analysis for females (n = 2). Conclusion: A focus on high-quality risk factor and primary prevention evaluation should be considered in future studies. Targeting primary prevention and stakeholder education remain key strategies in the prevention, recognition and management of injuries and concussions in youth rugby. [ABSTRACT FROM AUTHOR]

Background: The trunk is the foundation for transfer and dissipation of forces throughout the lower extremity kinetic chain. Individuals with knee disorders may employ trunk biomechanical adaptations to accommodate forces at the knee or compensate for muscle weakness. This systematic review aimed to synthesize the literature comparing trunk biomechanics between individuals with knee disorders and injury-free controls. Methods: Five databases were searched from inception to January 2022. Observational studies comparing trunk kinematics or kinetics during weight-bearing tasks (e.g., stair negotiation, walking, running, landings) between individuals with knee disorders and controls were included. Meta-analyses for each knee disorder were performed. Outcome-level certainty was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE), and evidence gap maps were created. Results: A total of 81 studies investigating trunk biomechanics across six different knee disorders were included (i.e., knee osteoarthritis [OA], total knee arthroplasty [TKA], patellofemoral pain [PFP], patellar tendinopathy [PT], anterior cruciate ligament deficiency [ACLD], and anterior cruciate ligament reconstruction [ACLR]). Individuals with knee OA presented greater trunk flexion during squatting (SMD 0.88, 95% CI 0.58–1.18) and stepping tasks (SMD 0.56, 95% CI 0.13–.99); ipsilateral and contralateral trunk lean during walking (SMD 1.36; 95% CI 0.60–2.11) and sit-to-stand (SMD 1.49; 95% CI 0.90–2.08), respectively. Greater trunk flexion during landing tasks in individuals with PFP (SMD 0.56; 95% CI 0.01–1.12) or ACLR (SMD 0.48; 95% CI 0.21–.75) and greater ipsilateral trunk lean during single-leg squat in individuals with PFP (SMD 1.01; 95% CI 0.33–1.70) were also identified. No alterations in trunk kinematics of individuals with TKA were identified. Evidence gap maps outlined the lack of investigations for individuals with PT or ACLD, as well as for trunk kinetics across knee disorders. Conclusion: Individuals with knee OA, PFP, or ACLR present with altered trunk kinematics in the sagittal and frontal planes. The findings of this review support the assessment of trunk biomechanics in these individuals in order to identify possible targets for rehabilitation and avoidance strategies. Trial registration: PROSPERO registration number: CRD42019129257. [ABSTRACT FROM AUTHOR]

Objectives: A conflicting body of evidence suggests localized periodontal inflammation spreads systemically during pregnancy inducing adverse pregnancy outcomes. This systematic review and meta-analysis aim to specifically evaluate the relationship between periodontitis and preeclampsia. Methods: Electronic searches were carried out in Medline, Pubmed, Embase, Lilacs, Cochrane Controlled Clinical Trial Register, CINAHL, ClinicalTrials.gov, and Google Scholar with no restrictions on the year of publication. We identified and selected observational case–control and cohort studies that analyzed the association between periodontal disease and preeclampsia. This meta-analysis was conducted following the PRISMA checklist and MOOSE checklist. Pooled odds ratios, mean difference, and 95% confidence intervals were calculated using the random effect model. Heterogeneity was tested with Cochran's Q statistic. Results: Thirty studies including six cohort- and twenty-four case–control studies were selected. Periodontitis was significantly associated with increased risk for preeclampsia (OR 3.18, 95% CI 2.26 – 4.48, p < 0.00001), especially in a subgroup analysis including cohort studies (OR 4.19, 95% CI 2.23 – 7.87, p < 0.00001). The association was even stronger in a subgroup analysis with lower-middle-income countries (OR 6.70, 95% CI 2.61 – 17.19, p < 0.0001). Conclusions: Periodontitis appears as a significant risk factor for preeclampsia, which might be even more pronounced in lower-middle-income countries. Future studies to investigate if maternal amelioration of periodontitis prevents preeclampsia might be warranted. [ABSTRACT FROM AUTHOR]

Background: To improve the understanding of the psychological impacts of anterior cruciate ligament (ACL) injury, a systematic review synthesizing the evidence on knee self-efficacy, fear avoidance beliefs and kinesiophobia following ACL injury is needed. Objective: The aim of this systematic review was to investigate knee self-efficacy, fear avoidance beliefs and kinesiophobia following ACL injury, and compare these outcomes following management with rehabilitation alone, early and delayed ACL reconstruction (ACLR). Methods: Seven databases were searched from inception to April 14, 2022. Articles were included if they assessed Tampa Scale of Kinesiophobia (TSK), Knee Self-Efficacy Scale (KSES), or Fear Avoidance Beliefs Questionnaire (FABQ). Risk of bias (RoB) was assessed using domain-based RoB tools (ROBINS-1, RoB 2, RoBANS), and GRADE-assessed certainty of evidence. Random-effects meta-analyses pooled outcomes, stratified by time post-injury (pre-operative, 3–6 months, 7–12 months, > 1–2 years, > 2–5 years, > 5 years). Results: Seventy-three studies (70% high RoB) were included (study outcomes: TSK: 55; KSES: 22; FABQ: 5). Meta-analysis demonstrated worse kinesiophobia and self-efficacy pre-operatively (pooled mean [95% CI], TSK-11: 23.8 [22.2–25.3]; KSES: 5.0 [4.4–5.5]) compared with 3–6 months following ACLR (TSK-11: 19.6 [18.7–20.6]; KSES: 19.6 [18.6–20.6]). Meta-analysis suggests similar kinesiophobia > 3–6 months following early ACLR (19.8 [4.9]) versus delayed ACLR (17.2 [5.0]). Only one study assessed outcomes comparing ACLR with rehabilitation only. Conclusions: Knee self-efficacy and kinesiophobia improved from pre-ACLR to 3–6 months following ACLR, with similar outcomes after 6 months. Since the overall evidence was weak, there is a need for high-quality observational and intervention studies focusing on psychological outcomes following ACL injury. [ABSTRACT FROM AUTHOR]

Background: Having a family history of anterior cruciate ligament (ACL) injury has been investigated in the literature but few studies have focused on this factor specifically or reported their outcomes by sex. Objective: We aimed to systematically review family history as a risk factor for sustaining a primary ACL injury and the impact it has on ACL graft rupture or contralateral ACL injury in male and female individuals. Methods: A literature search was completed in seven databases from inception until March 2021 to investigate primary and subsequent ACL injuries in those with a family history of ACL injury. Articles were screened by prespecified inclusion criteria, and the methodological quality of each study was determined. Study results were combined using an odds ratio (OR) meta-analysis. Subgroup analysis was also completed by sex for primary ACL injury, as well as by graft rupture and contralateral ACL injury for subsequent ACL injuries. Results: Twelve studies were acquired for systematic review and meta-analysis. Four studies that investigated primary ACL injury, seven that investigated ACL graft and/or contralateral ACL ruptures and one study that investigated both primary and subsequent ACL injury. Having a family history of ACL injury increased the odds of injury across all outcomes. Those with a family history had a 2.5 times greater odds for sustaining a primary ACL injury (OR 2.53 [95% confidence interval [CI] 1.96–3.28, p < 0.001)]. There was no significant difference of injury odds for primary ACL injury when analysed by sex. Family history of ACL injury was found to increase the odds of subsequent ACL injury by 2.38 (95% CI 1.64–3.46, p < 0.001) and was significant for both graft ruptures (OR 1.80 [95% CI 1.20–2.71, p = 0.005]) and contralateral ACL injuries (OR 2.28 [95% CI 1.28–4.04, p = 0.005]). When compared directly, the odds of sustaining a graft rupture versus a contralateral ACL injury were similar for those with a family history. Outcomes were not frequently reported by sex for subsequent ACL injuries. Conclusions: Having a family history of ACL injury more than doubles the odds of sustaining a primary or subsequent ACL injury. However, if a family history of ACL injury is present, the sex of the athlete does not increase the risk for primary injury nor is there a difference in the risk for a subsequent graft rupture compared to a contralateral ACL injury. Clinical Trial Registration: PROSPERO: CRD42020186472. [ABSTRACT FROM AUTHOR]

Background: Researchers are capitalising on the strong connections that sport fans have with their teams for health promotion programmes, yet no existing systematic reviews have evaluated the effectiveness of interventions delivered through professional sport. Objective: The aim of this study was to systematically collate, evaluate, and synthesise the evidence on health promotion interventions implemented in professional sport settings. Methods: Randomised controlled trials reporting on adult health promotion initiatives delivered in professional sport settings were identified through electronic database searches in CINAHL, MEDLINE, SPORTDiscus, Scopus, the Cochrane Central Register of Controlled Trials (CENTRAL), and Google Scholar. Data on health-related outcomes (e.g., weight, physical activity, dietary intake) were extracted and synthesised, and random effects meta-analyses were conducted to examine effects for weight and waist circumference. Risk of bias was examined using the Cochrane risk-of-bias tool for randomised controlled trials (RoB 2). Results: Six studies reporting on five unique interventions met the inclusion criteria, and all included studies were gender-sensitised and exclusively targeted men. Intervention effects were observed for several health outcomes, including physical activity, dietary intake, and psychosocial health. All studies aimed to reduce weight, and for most studies (n = 4), weight was a primary outcome, either of the included study or to inform a future definitive trial. Findings from the meta-analysis revealed an overall significant difference in change in weight of − 3.2 kg (95% confidence interval [CI] − 4.6 to − 1.8) and waist circumference of − 3.9 cm (95% CI − 4.9 to − 2.8), both in favour of the intervention group at 12 weeks. Intervention effects were also reported for several other health outcomes (e.g., physical activity, dietary intake, psychosocial health); however, they were not consistently measured across the studies and thus were not meta-analysed. Conclusion: Health promotion interventions delivered through professional sporting organisations can significantly improve weight- and lifestyle-related health outcomes. Representation across the socioeconomic spectrum and across culturally and linguistically diverse groups was limited. As only a limited number of studies met the inclusion criteria for this review, a need exists for rigorously designed interventions, standardised intervention approaches, with long-term follow-up, and the potential for scalability. PROSPERO Registration Number: CRD42019123295. [ABSTRACT FROM AUTHOR]

Background: The use of global positioning system (GPS) devices with the inclusion of microsenor technology in rugby league enables measurement of player activity profiles to understand the demands of match-play and optimise on-field performance. Objective: The aim of this review was to systematically review the use of GPS and microsensor technology to quantify player activity profiles in match-play, and conduct a meta-analysis of relevant movement variables in order to present the contemporary and emerging themes within rugby league. Methods: A systematic search of electronic databases (MEDLINE, SPORTDiscus, CINAHL, Web of Science, Scopus, ScienceDirect, EMBASE, and Google Scholar) from the earliest record to February 2015 was conducted. Permutations of key words included GPS, microtechnology, activity profiles, match demands (movement or physical demands), and rugby league. A meta-analysis was conducted to provide a pooled mean and confidence intervals on comparable data from at least three studies. Results: Twenty-seven studies met the eligibility criteria and included 1270 male participants. The studies reported on GPS use in elite competition ( n = 16) with limited representation of other competition standards: sub-elite ( n = 6), amateur ( n = 1) and junior ( n = 3). All studies reported on movement variables (distance, relative distance, speed and accelerations), with studies analysing movement at high speed ( n = 18, 66.7 %), evaluating collision or impact variables ( n = 15, 55.6 %) and determining the metabolic energy ( n = 2, 7.4 %) associated with rugby league match-play. Activity profiles of varying positions, positional groups and levels of rugby league competition were described. Meta-analysis indicated that the total distance covered by backs and adjustables were both greater than forward positions, but adjustables covered greater relative distance than forwards and backs. Speed zones were typically categorised into six speed zones ranging from 0 to 36 km·h, or into low- and high-intensity movement. Vast inconsistencies were apparent across studies in categorising movement at high speed, posing difficulties for comparison. Meta-analysis indicated that, although the number of repeated high-intensity effort (RHIE) bouts in elite players were similar to sub-elite (and both greater than juniors), the number of efforts per RHIE were significantly greater in elite than sub-elite players. Differential pacing strategies were adopted according to player selection (whole-match vs. interchange), time period within match-play and match outcome, in order to maintain high-intensity performance or to challenge for a win. Sizeable inconsistencies were also identified in the definitions of reported collisions (classified as mild, moderate and heavy) and impacts (six zone categories provided by manufacturer), making comparisons across studies difficult. Collision profiles were different between competition standard and position where elite players and forwards sustained more moderate- and high-intensity collisions than sub-elite players and backs, respectively. The recent inclusion of GPS-derived metabolic indices to activity profiles has also accentuated the distinctive workloads of positional groups during match-play where adjustables demonstrate the highest energy expenditure and metabolic power. Conclusions: This review and the results of the meta-analysis have demonstrated that positional groups have varied kinematic and metabolic demands. During match play, forwards sustain the greatest number of collisions and RHIE bouts, outside backs participate in more high-speed running and cover the greatest distance, and adjustables work at high intensity covering the greatest relative distance with the highest metabolic cost. Therefore, specific training for each positional group should address their match requirements. In addition, sub-elite players exhibit lower intensity of play compared with elite players, as indicated by lower relative distance and less number of efforts per RHIE bout despite similarities in total distance covered and number of RHIE bouts. To prepare them for elite-level play, their training should incorporate higher intensity drills in which greater relative distance and number of efforts per RHIE bout are performed. Furthermore, the lack of consistency in the definition of speed zones, high-intensity movement, collisions and impacts, underscores the difficulties encountered in meaningful comparisons of player activity profiles between studies. Consensus of these definitions would facilitate direct comparisons within rugby league. [ABSTRACT FROM AUTHOR]

The aim of this review was to evaluate current evidence regarding the effects of interventions on physical activity in the subgroup of nursing home residents as well as to critically review the assessment methods used in this regard. Published studies through January 2015 were searched in The Cochrane Library, PubMed, CINAHL, Web of Knowledge, PsycInfo, Psyndex, Psycarticles, CC Med, and DissOnline; and by manual search. For randomized controlled trials (RCTs) to be included, an intervention had to be conducted with nursing home residents aged 65 years and above and physical activity had to be assessed using standardized, quantitative methods. Study quality was evaluated using an established Cochrane rating tool for RCTs. Eight studies met the inclusion criteria. Only one intervention study with main focus on a modification of physical activity behavior could be identified. Physical activity assessments used in the studies were partly limited regarding objectivity or psychometric quality. Hence, the documentation of effects of interventions is restricted. Six studies reported significant increases of physical activity in nursing home residents and thus positive intervention effects, which points at the feasibility and high potential of intervention programs to promote physical activity in this setting. Enhanced individual contact as well as physical exercise combined with behavioral interventions and the inclusion of nursing staff seems to be most effective in this regard. As only one study involved post-intervention follow-up assessments, sustainability of effects remained unclear. [ABSTRACT FROM AUTHOR]

Background: The extent of concussion injury in the rugby codes for women is unclear. Objective: Our aim was to review all published studies reporting concussion injuries from match and training participation in rugby codes and report the pooled data estimates for rugby league and union concussion injury epidemiology. Methods: We conducted a systematic literature analysis of concussion in rugby league and rugby union for published studies from January 1990 to July 2021. Data from 16 studies meeting the inclusion criteria were extracted for women's concussion injuries and were subsequently pooled. Costs from Accident Compensation Corporation (ACC) data were attributed to the results to provide cost estimates. Results: The pooled analysis match injury incidence of women's concussion was higher for rugby league (10.3 per 1000 match hours) than rugby 15 s (2.8 per 1000 match hours) or rugby 7 s (8.9 per 1000 match hours). There was a fourfold difference in the pooled incidence of concussion in women's rugby league (risk ratio [RR] 4.53, 95% confidence interval [CI] 1.8–11.3]; p = 0.0001) when compared with rugby 15 s. There was also a ninefold higher risk of a concussion during match participation compared with training participation for women's rugby 15 s (RR 9.3, 95% CI 1.29–66.78; p = 0.0070). The total estimated costs for the concussions reported were NZ$1,235,101. For rugby 7 s, the pooled concussive injury burden was 33.2 days. Conclusions: Our pooled analysis clarified the extent of concussion injury and the possible associated costs at several levels of the game for women's rugby codes. The pooled mean days lost because of concussions was 33 days. As this was considerably longer than the 7- to 10-day expected timeframe outlined in the Concussion in Sport Consensus statement, these guidelines need to be updated to include sex-specific differences. [ABSTRACT FROM AUTHOR]

Background: Delirium is a serious neurocognitive disorder among surgical patients in the post-anaesthetic care unit (PACU). Despite the development of screening tools to identify delirium, it is not clear which tool is the most accurate and reliable in assessing delirium in the PACU. Aim: To examine the diagnostic accuracy of delirium screening tools used in the PACU. Methods: A systematic literature search of CINAHL, MEDLINE, Embase, PsycINFO and Scopus was conducted, using MeSH terms and relevant keywords, from databases establishment to 23 April 2021. Studies were assessed for methodological quality using the Standards for Reporting of Diagnostic Accuracy Studies (STARD) tool. Results: A total of 1503 studies were screened from the database search, four studies met the inclusion criteria for this review. Six delirium screening tools used in the PACU were identified in the selected studies. Three studies evaluated screening tools in adult surgical patients without cognitive impairment and dementia. Two studies evaluated screening tools among patients who were scheduled for elective surgery. Review results indicated that two tools, the 4A's test (4AT; sensitivity 96%; specificity 99%) and the 3 min diagnostic interview for the Confusion Assessment Method (3D-CAM; sensitivity 100%; specificity 88%), had greatest validity and reliability as a screening tool for detecting delirium in the PACU. Conclusion: Results indicate the 4AT and the 3D-CAM are most accurate screening tools to detect delirium in the PACU. Further research is required to validate those tools among a broader surgical population, including patients with cognitive impairment, dementia and those undergoing emergency surgical procedures. [ABSTRACT FROM AUTHOR]

Parents of children with developmental disabilities are susceptible to mental health problems. Mindfulness-based and acceptance and commitment therapy (ACT)-based interventions can improve their mental well-being. This review examined the effectiveness of mindfulness-based and ACT-based interventions in improving mental well-being and mindfulness among parents of children with developmental disabilities. Six electronic databases were searched, resulting in the inclusion of ten studies published between 2014 and 2020. Meta-analysis was conducted using the random-effect model. The results suggest that mindfulness-based and ACT-based interventions were effective in decreasing parental stress, anxiety and depression, however, the effectiveness of these interventions in increasing parental mindfulness was inconclusive. Based on these findings, we discussed considerations for implementing interventions and identified areas which warrant further research. [ABSTRACT FROM AUTHOR]

Background: Tendinopathy is a clinical diagnosis of localised tendon pain often confirmed by imaging findings. The pathophysiological cause of the pain is unknown and the sympathetic nervous system (SNS) may be implicated. Objective: To review what is known regarding the role of the SNS in human tendinopathy. Study selection: Published data describing sympathetic innervation or an index of sympathetic activity in human tendons were eligible for inclusion. Data sources : Bibliographical databases (AMED, Biological Abstracts, CINAHL Plus, EMBASE, MEDLINE, Scopus, SPORTDiscus and Web of Science) were searched for relevant articles. Reference lists from included articles were screened for additional articles. Study appraisal: Studies were scored with a quality assessment tool to identify potential sources of bias. Each question had an explicit decision rule to guide assessment. Results: Nine case-control and four cross-sectional studies examined sympathetic innervation of tendons. There was evidence suggesting a lack of difference in sympathetic innervation of tendon proper between tendinopathy biopsies and healthy controls. In contrast, the paratendinous tissue showed evidence of increased sympathetic innervation in painful tendons. The most notable increase in SNS markers was seen in abnormal tenocytes from painful tendons. Data from two studies were suitable for meta-analysis. These heterogeneous studies revealed no difference in sympathetic innervation between painful and pain-free tendons. No studies recorded SNS activity in vivo. Conclusion: Sympathetic innervation in painful tendons depends on tissue type. Abnormal tenocytes may have increased capacity for self-production of sympathetic neurotransmitters. Future insight may be gained by measuring global in vivo sympathetic drive in tendinopathy. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to estimate the prevalence, contributory factors, and severity of medication errors associated with direct acting oral anticoagulants (DOACs). Methods: A systematic review and meta-analysis were undertaken by searching 11 databases including Medline, Embase, and CINHAL between January 2008 and September 2020. The pooled prevalence of errors and predictive intervals were estimated using random-effects models using Stata software. Data related to error causation were synthesised according to Reason's accident causation model. Results: From the 5205 titles screened, 32 studies were included which were mostly based in hospitals and included DOAC treatment for thromboembolism and atrial fibrillation. The proportion of study population who experienced either prescription, administration, or dispensing error ranged from 5.3 to 37.3%. The pooled percentage of patients experiencing prescribing error was 20% (95% CI 15–25%; I2 = 96%; 95% PrI 4–43%). Prescribing error constituted the majority of all error types with a pooled estimate of 78% (95%CI 73–82%; I2 = 0) of all errors. The common reported causes were active failures including wrong drug, and dose for the indication. Mistakes such as non-consideration of renal function, and error-provoking conditions such as lack of knowledge were common contributing factors. Adverse events such as potentially fatal intracranial haemorrhage or patient deaths were linked to the errors but causality assessments were often missing. Conclusions: Despite their favourable safety profile, DOAC medication errors are common. There is a need to promote multidisciplinary working, guideline-adherence, training, and education of healthcare professionals, and the use of theory-based and technology-facilitated interventions to minimise errors and maximise the benefits of DOACs usage in all settings. Protocol: A protocol developed as per PRISMA-P guideline is registered under PROSPERO ID = CRD42019122996 [ABSTRACT FROM AUTHOR]

A better understanding of the social-structural factors that influence HIV vulnerability is crucial to achieve the goal of ending the HIV epidemic by 2030. Given the role of neighborhoods in HIV outcomes, synthesis of findings from such research is key to inform efforts toward HIV eradication. We conducted a systematic review to examine the relationship between neighborhood-level factors (e.g., poverty) and HIV vulnerability (via sexual behaviors and substance use). We searched six electronic databases for studies published from January 1, 2007 through November 30, 2017 (PROSPERO CRD42018084384). We also mapped the studies' geographic distribution to determine whether they aligned with high HIV prevalence areas and/or the "Ending the HIV Epidemic: A Plan for the United States". Fifty-five articles met inclusion criteria. Neighborhood disadvantage, whether measured objectively or subjectively, is one of the most robust correlates of HIV vulnerability. Tests of associations more consistently documented a relationship between neighborhood-level factors and drug use than sexual risk behaviors. There was limited geographic distribution of the studies, with a paucity of research in several counties and states where HIV incidence/prevalence is a concern. Neighborhood influences on HIV vulnerability are the consequence of centuries-old laws, policies and practices that maintain racialized inequities (e.g., racial residential segregation, inequitable urban housing policies). We will not eradicate HIV without multi-level, neighborhood-based approaches to undo these injustices. Our findings inform future research, interventions and policies. [ABSTRACT FROM AUTHOR]

Background: The Functional Movement Screen™ (FMS™) is an assessment of human movement that may signal potential deficits that could predispose an otherwise healthy person to injury risk. FMS™ scores are well reported in both athletic and adult samples. However, to date, there has been no comprehensive systematic review and meta-analysis of FMS™ data among school-aged children and adolescents. Objective: We aimed to systematically review and analyse functional movement proficiency of children and adolescents, specifically when assessed using the FMS™, and to establish initial normative values for the FMS™ in this population group and to further estimate differences in functional movement proficiency between the sexes, by school level (i.e., between primary and secondary school-level children and adolescents), and based on differences in child and adolescent body mass index (BMI). Methods: In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, prospective studies were identified from searches across eight databases (MEDLINE, SPORTDiscus, CINAHL, Web of Science, EMBASE, ERIC, PsychINFO and PubMed), without any date restrictions, up to December 2020. The primary meta-analysis estimated the overall FMS™ score for school-aged children and adolescents across published studies. An additional three subgroup meta-analyses estimated comparisons for FMS™ data with school level, sex, and BMI across published studies. FMS™ data were meta-analysed using a number of different meta packages (Schwarzer et al. in Meta-Analysis with R, 1st ed, Springer International Publishing, Berlin, 2015), available in R Studio. Results: A total of 19 articles were included in the systematic review. Meta-analysis revealed a weighted FMS™ mean score of 14.06, with a standardised Tau value of 0.56, signalling a moderate-to-large degree of variability in FMS™ means between studies. The difference in FMS™ means between samples of males (weighted FMS™ mean 13.91) and females (weighted FMS™ mean 14.56) was compatible with a possible small effect size (standardised mean difference − 0.27). The variability in FMS™ means between studies was approximately five times greater in samples of secondary school children (factor difference in Tau values 5.16). The final meta-regression identified a negative association between BMI and FMS™ scores (r = − 0.42), which signalled a moderate-to-large difference in FMS™ scores between healthy weight and overweight children/adolescents. Conclusion: This systematic review and meta-analysis represents a novel and important synthesis of published FMS™ data from groups of children and adolescents. The study signals possible sex- and age-related differences in FMS™ scores, as well as a clear negative relationship between BMI and functional movement proficiency. More longitudinal research is needed to better understand the developmental trajectory and the effects of maturation milestones on FMS™ proficiency. Additional research is also needed to identify the types of interventions that could improve functional movement proficiency among 'at risk' groups, who are susceptible to functional movement deficiency, and whether changes in body composition mediate the relationship between these interventions and the improvement of FMS™ scores. [ABSTRACT FROM AUTHOR]

Background: Investigations of foot strike patterns during overground distance running have foci on prevalence, performance and change in foot strike pattern with increased distance. To date, synthesised analyses of these findings are scarce. Objective: The key objectives of this review were to quantify the prevalence of foot strike patterns, assess the impact of increased running distance on foot strike pattern change and investigate the potential impact of foot strike pattern on performance. Methods: Relevant peer-reviewed literature was obtained by searching EBSCOhost CINAHL, Ovid Medline, EMBASE and SPORTDiscus (inception-2021) for studies investigating foot strike patterns in overground distance running settings (> 10 km). Random effects meta-analyses of prevalence data were performed where possible. Results: The initial search identified 2210 unique articles. After removal of duplicates and excluded articles, 12 articles were included in the review. Meta-analysis of prevalence data revealed that 79% of long-distance overground runners rearfoot strike early, with prevalence rising to 86% with increased distance. In total, 11% of runners changed foot strike pattern with increased distance and of those, the vast majority (84%) do so in one direction, being non-rearfoot strike to rearfoot strike. Analysis of the relationship between foot strike pattern and performance revealed that 5 studies reported a performance benefit to non-rearfoot strike, 1 study reported a performance benefit to non-rearfoot strike in women but not men, 4 studies reported no benefit to non-rearfoot strike or rearfoot strike, and no studies reported a performance benefit of rearfoot strike over non-rearfoot strike. Conclusion: Most overground distance runners rearfoot strike early, and the prevalence of this pattern increases with distance. Of those that do change foot strike pattern, the majority transition from non-rearfoot to rearfoot. The current literature provides inconclusive evidence of a competitive advantage being associated with long-distance runners who use a non-rearfoot strike pattern in favour of a rearfoot strike pattern. [ABSTRACT FROM AUTHOR]

Background: Short-sprint (≤ 20 m) performance is an important quality for success in the football codes. Therefore, developing an evidence base for understanding training methods to enhance short-sprint performance is key for practitioners. However, current systematic reviews are limited by (1) a lack of focus on football code athletes, (2) a lack of consideration of all training modalities and (3) a failure to account for the normal training practices undertaken by intervention groups within their analysis. Therefore, this review aimed to (1) conduct a systematic review of the scientific literature evaluating training interventions upon short-sprint performance within football code athletes, (2) undertake a meta-analysis to assess the magnitude of change of sport-sprint performance following training interventions and (3) identify how moderator variables affect the training response. Methods: A systematic search of electronic databases was conducted. A random-effects meta-analysis was performed to establish standardised mean difference with 95% confidence intervals. This identified the magnitude and direction of the individual training effects of intervention subgroups (primary, secondary, combined-specific, tertiary and combined training methods) on short-sprint performance while considering moderator variables (i.e., football code, sex, age, playing standard, phase of season). Results: 121 studies met the inclusion criteria, totalling 3419 athletes. Significant improvements (small-large) were found between pre- and post-training in short-sprint performance for the combined, secondary, tertiary and combined-specific training methods. No significant effect was found for primary or sport only training. No individual mode was found to be the most effective. Between-subgroup analysis identified that football code, age, playing standard and phase of season all moderated the overall magnitude of training effects. Conclusions: This review provides the largest systematic review and meta-analysis of short-sprint performance development methods and the only one to assess football code athletes exclusively. Practitioners can apply combined, secondary and tertiary training methods to improve short-sprint performance within football code athletes. The application of sport only and primary methods does not appear to improve short-sprint performance. Regardless of the population characteristics, short-sprint performance can be enhanced by increasing either or both the magnitude and the orientation of force an athlete can generate in the sprinting action. Trial Registration: OSF registration https://osf.io/kshqn/. [ABSTRACT FROM AUTHOR]

Background: While chronic exercise training has been demonstrated to be an effective non-pharmacological treatment for chronic low back pain (CLBP), there has been a relative lack of evidence or clinical guidelines for whether a posterior chain resistance training programme provides any benefits over general exercise (GE). Objectives: To determine if chronic posterior chain resistance training (PCRT), defined as exercise programmes of ≥6 weeks duration focused on the thoracic, lumbar and hip extensor musculature, is more effective than GE in improving pain, level of disability, muscular strength and the number of adverse events in recreationally active and sedentary individuals with CLBP. Methods: Four electronic databases were systematically searched from 25 September 2019 until 30 August 2020. Using the Joanna Briggs Institute (JBI) Critical Appraisal Tools checklist for randomized controlled trials (RCTs), articles were critically appraised and compared against the inclusion/exclusion criteria. Standardized mean difference (SMD), risk difference (RD) and confidence interval (CI) were calculated using Review Manager 5.3. Results: Eight articles were included, with a total of 408 participants (203 PCRT, 205 GE). Both PCRT and GE were effective in improving a number of CLBP-related outcomes, but these effects were often significantly greater in PCRT than GE, especially with greater training durations (i.e. 12–16 weeks compared to 6–8 weeks). Specifically, when compared to GE, PCRT demonstrated a greater reduction in pain (SMD = − 0.61 (95% CI − 1.21 to 0.00), p = 0.05; I2 = 74%) and level of disability (SMD = − 0.53 (95% CI − 0.97 to − 0.09), p = 0.02; I2 = 52%), as well as a greater increase in muscle strength (SMD = 0.67 (95% CI 0.21 to 1.13), p = 0.004; I2 = 0%). No differences in the number of adverse events were reported between PCRT and GE (RD = − 0.02 (95% CI − 0.10 to 0.05), p = 0.57; I2 = 72%). Conclusion: Results of the meta-analysis indicated that 12–16 weeks of PCRT had a statistically significantly greater effect than GE on pain, level of disability and muscular strength, with no significant difference in the number of adverse events for recreationally active and sedentary patients with CLBP. Clinicians should strongly consider utilizing PCRT interventions for 12–16 weeks with patients with CLBP to maximize their improvements in pain, disability and muscle strength. Future research should focus on comparing the efficacy and adverse events associated with specific PCRT exercise training and movement patterns (i.e. deadlift, hip lift) in treating this population. Trial registration: PROSPERO CRD42020155700. [ABSTRACT FROM AUTHOR]

Background: Reductions in muscle size and strength occur with aging. These changes can be mitigated by participation in resistance training. At present, it is unknown if sex contributes to differences in adaptation to resistance training in older adults. Objective: The aim of this systematic review was to determine if sex differences are apparent in adaptations to resistance training in older adults. Design: Systematic review with meta-analysis. Data Sources: Web of Science; Science Direct; SPORTDiscus; CINAHL; and MEDLINE were searched from inception to June 2020. Eligibility Criteria: Studies where males and females older than 50 years of age performed identical resistance training interventions and had outcome measures of muscle strength or size. Results: We initially screened 5337 studies. 30 studies (with 41 comparison groups) were included in our review (1410 participants; 651 males, 759 females). Mean study quality was 14.7/29 on a modified Downs and Black checklist, considered moderate quality. Females gained more relative lower-body strength than males (g = − 0.21 [95% CI − 0.33, − 0.10], p = 0.0003) but there were no differences in relative change for upper-body strength (g = − 0.29 [95% CI − 0.62, 0.04], p = 0.08) or relative muscle size (g = 0.10 [95% CI − 0.04, 0.23], p = 0.16). Males gained more absolute upper-body strength (g = 0.48 [95% CI 0.09, 0.88], p = 0.016), absolute lower-body strength (g = 0.33 [95% CI 0.19, 0.47], p < 0.0001), and absolute muscle size (g = 0.45 [95% CI 0.23, 0.66], p < 0.0001). Conclusion: Our results indicate that sex differences in adaptations to resistance training are apparent in older adults. However, it is evident that the interpretation of sex-dependent adaptations to resistance training is heavily influenced by the presentation of the results in either an absolute or relative context. Study Registration: Open Science Framework (osf.io/afn3y/). [ABSTRACT FROM AUTHOR]

Telepsychiatry, the use of televideo in psychiatric assessment and treatment, is utilized throughout Canada. Major depressive disorder (MDD) is common, with significant burdens of suffering and cost. This systematic review explores the literature on the use of televideo to diagnose and treat MDD, particularly acceptability and patient satisfaction, efficacy, and cost-effectiveness. A literature search was conducted for years 1946 to 2019. Study eligibility criteria included: MDD as the condition of interest, use of televideo technology, randomized controlled trials (RCTs), Adult (18 years or older) population, any clinical setting, and any healthcare professional providing care. The study must have included at least one of the following measures, satisfaction, efficacy, and cost-effectiveness. Fourteen studies were included. Satisfaction is equivalent to or significantly higher than face-to-face intervention. Both televideo and control groups found relief from depressive symptoms, with differences either statistically insignificant or in favour of televideo. Despite increased cost upfront for televideo due to the technology required, televideo would eventually be more cost-effective due to reducing travel expenses. Limitations include that there is little RCT data, and what exists often uses a collaborative treatment model. Many studies consisted solely of U.S. Veterans, and have limited generalizability. Further research needed to directly compare psychiatrist assessment over televideo versus in-person, and determine if particular patient subgroups benefit more from televideo or in-person intervention. Systematic review registration number: CRD42016048224. [ABSTRACT FROM AUTHOR]

Background: Running participation continues to increase. The ideal strike pattern during running is a controversial topic. Many coaches and therapists promote non-rearfoot strike (NRFS) running with a belief that it can treat and prevent injury, and improve running economy. Objective: The aims of this review were to synthesise the evidence comparing NRFS with rearfoot strike (RFS) running patterns in relation to injury and running economy (primary aim), and biomechanics (secondary aim). Design: Systematic review and meta-analysis. Consideration was given to within participant, between participant, retrospective, and prospective study designs. Data Sources: MEDLINE, EMBASE, CINAHL, and SPORTDiscus. Results: Fifty-three studies were included. Limited evidence indicated that NRFS running is retrospectively associated with lower reported rates of mild (standard mean difference (SMD), 95% CI 3.25, 2.37–4.12), moderate (3.65, 2.71–4.59) and severe (0.93, 0.32–1.55) repetitive stress injury. Studies prospectively comparing injury risk between strike patterns are lacking. Limited evidence indicated that running economy did not differ between habitual RFS and habitual NRFS runners at slow (10.8–11.0 km/h), moderate (12.6–13.5 km/h), and fast (14.0–15.0 km/h) speeds, and was reduced in the immediate term when an NRFS-running pattern was imposed on habitual RFS runners at slow (10.8 km/h; SMD = − 1.67, − 2.82 to − 0.52) and moderate (12.6 km/h; − 1.26, − 2.42 to − 0.10) speeds. Key biomechanical findings, consistently including both comparison between habitual strike patterns and following immediate transition from RFS to NRFS running, indicated that NRFS running was associated with lower average and peak vertical loading rate (limited-moderate evidence; SMDs = 0.72–2.15); lower knee flexion range of motion (moderate-strong evidence; SMDs = 0.76–0.88); reduced patellofemoral joint stress (limited evidence; SMDs = 0.63–0.68); and greater peak internal ankle plantar flexor moment (limited evidence; SMDs = 0.73–1.33). Conclusion: The relationship between strike pattern and injury risk could not be determined, as current evidence is limited to retrospective findings. Considering the lack of evidence to support any improvements in running economy, combined with the associated shift in loading profile (i.e., greater ankle and plantarflexor loading) found in this review, changing strike pattern cannot be recommended for an uninjured RFS runner. PROSPERO Registration: CRD42015024523. [ABSTRACT FROM AUTHOR]

Background: Concurrent strength and endurance (CSE) training improves distance running performance more than endurance training alone, but the mechanisms underpinning this phenomenon are unclear. It has been hypothesised that biomechanical or neuromuscular adaptations are responsible for improvements in running performance; however, evidence on this topic has not been synthesised in a review. Objective: To evaluate the effect of CSE training on biomechanical and neuromuscular variables in distance runners. Methods: Seven electronic databases were searched from inception to November 2018 using key terms related to running and strength training. Studies were included if the following criteria were met: (1) population: 'distance' or 'endurance' runners of any training status; (2) intervention: CSE training; (3) comparator: running-only control group; (4) outcomes: at least one biomechanical or neuromuscular variable; and, (5) study design: randomised and non-randomised comparative training studies. Biomechanical and neuromuscular variables of interest included: (1) kinematic, kinetic or electromyography outcome measures captured during running; (2) lower body muscle force, strength or power outcome measures; and (3) lower body muscle–tendon stiffness outcome measures. Methodological quality and risk of bias for each study were assessed using the PEDro scale. The level of evidence for each variable was categorised according to the quantity and PEDro rating of the included studies. Between-group standardised mean differences (SMD) with 95% confidence intervals (95% CI) were calculated for studies and meta-analyses were performed to identify the pooled effect of CSE training on biomechanical and neuromuscular variables. Results: The search resulted in 1578 potentially relevant articles, of which 25 met the inclusion criteria and were included. There was strong evidence that CSE training significantly increased knee flexion (SMD 0.89 [95% CI 0.48, 1.30], p < 0.001), ankle plantarflexion (SMD 0.74 [95% CI 0.21–1.26], p = 0.006) and squat (SMD 0.63 [95% CI 0.13, 1.12], p = 0.010) strength, but not jump height, more than endurance training alone. Moderate evidence also showed that CSE training significantly increased knee extension strength (SMD 0.69 [95% CI 0.29, 1.09], p < 0.001) more than endurance training alone. There was very limited evidence reporting changes in stride parameters and no studies examined changes in biomechanical and neuromuscular variables during running. Conclusions: Concurrent strength and endurance training improves the force-generating capacity of the ankle plantarflexors, quadriceps, hamstrings and gluteal muscles. These muscles support and propel the centre of mass and accelerate the leg during running, but there is no evidence to suggest these adaptations transfer from strength exercises to running. There is a need for research that investigates changes in biomechanical and neuromuscular variables during running to elucidate the effect of CSE training on run performance in distance runners. [ABSTRACT FROM AUTHOR]

Background: Although injuries to the head represent a small proportion of all sport injuries, they are of great concern due to their potential long-term consequences, which are even suspected in mild traumatic brain injuries.Objective: The aim of this review was to compare the incidence of concussions and other head injuries in elite level football, rugby, ice hockey and American Football.Methods: Four electronic databases (CINAHL, PsycINFO, Web of Science, PubMed) were searched. Prospective cohort studies on the incidence of concussion in elite athletes aged 17 years or older that were published in an English-language peer-reviewed journal since 2000 were included. Two authors independently evaluated study eligibility and quality. The extracted data on concussions were pooled in a meta-analysis using an inverse-variance fixed-effects model. The extracted data on head injuries were reported in a narrative and tabular summary.Results: The search yielded 7673 results of which 70 articles were included in the qualitative and 47 in the quantitative analysis. In our meta-analysis, we found the highest concussion incidences in rugby match play (3.89 and 3.00 concussions per 1000 h and athletic exposures (AEs), respectively), and the lowest in men’s football training (0.01 and 0.08 per 1000 h and AEs, respectively). Overall, concussions and all head injuries were rare in training when compared to match play. Female players had an increased concussion risk in football and ice hockey when compared to male players.Conclusion: Future research should focus on concussion in women’s contact sports, as there is little evidence available in this area. Methodological deficits are frequent in the current literature, especially regarding sample size and study power, and should be avoided. [ABSTRACT FROM AUTHOR]

Background: Team bat-or-stick sports, including cricket, softball and hockey, are popular among women. However, little is known about the injury profile in this population.Objective: The aim was to describe the incidence, nature and anatomical location of injuries in bat-or-stick sports played by women in a competitive league.Methods: This review was prospectively registered (PROSPERO CRD42015026715). CINAHL, MEDLINE, PsycINFO, PubMed, SPORTDiscus were systematically searched from January 2000 to September 2016, inclusive. Peer-reviewed original research articles reporting the incidence, nature and anatomical location of injuries sustained by women aged 18 + years in competitive bat-or-stick sports were included. Two meta-analyses based on injury incidence proportions (injury IP) and injury rates per 1000 person-days of athletic exposure (AE) were performed.Results: A total of 37 studies satisfied the inclusion criteria, and five had low risk of bias. The weighted injury IP was 0.42 [95% confidence interval (CI) 0.39–0.45]. The weighted injury rate was 6.12 (95% CI 6.05–6.18) overall, and greater in games [15.79 (95% CI 15.65–15.93)] than in practice [3.07 (95% CI 2.99–3.15)]. The ankle was the most commonly injured anatomical location, followed by the hand (including wrist and fingers), knee and head. Soft tissue and ligament injuries were most common types of injuries.Conclusion: Injury prevention in women’s sports is a novel and emerging field of research interest. This review highlights that injury incidence is high among female bat-or-stick players, but little information is known about direct causal mechanisms. This review clearly establishes the need for enhancements to injury data collection. Without this information, it will not be possible to develop evidence-based injury prevention interventions. [ABSTRACT FROM AUTHOR]

A systematic review was undertaken to identify lifestyle intervention studies in South Asian migrant populations to determine the effect on the components of the metabolic syndrome. A total of seven studies were identified, of which six focused on educational advice and the seventh on intensive exercise intervention. Four studies were Randomised Controlled Trials of which two studies reported significant reductions in waist circumference. One of these studies focused on home based education with cooperation of the home cook (adjusted waist reduction of 1.9 cm, 95 % CI 0.52-3.3 cm; p = 0.007) and the other entailed an intensive physical activity program (adjusted waist reduction 3.4 cm, 95 % CI 2.0-4.7 cm). The evidence whether lifestyle intervention studies in South Asians can improve components of the metabolic system is not clear. Further lifestyle interventions for South Asians should be culturally adapted, involve friends and family, especially those with cooking responsibilities. [ABSTRACT FROM AUTHOR]

Background: Many factors are thought to contribute to chronic ankle instability (CAI). Multiple systematic reviews have synthesised the available evidence to identify the primary contributing factors. However, readers are now faced with several systematic reviews that present conflicting findings. Objective: The aim of this systematic review and meta-analysis was to establish the statistical significance and effect size of primary factors contributing to CAI and to identify likely reasons for inconsistencies in the literature. Methods: Relevant health databases were searched: CINAHL, MEDLINE, PubMed, Scopus and SPORTDiscus. Systematic reviews were included if they answered a focused research question, clearly defined the search strategy criteria and study selection/inclusion and completed a comprehensive search of the literature. Included reviews needed to be published in a peer-reviewed journal and needed to review observational studies of factors and/or characteristics of persons with CAI, with or without meta-analysis. There was no language restriction. Studies using a non-systematic review methodology (e.g. primary studies and narrative reviews) were excluded. Methodological quality of systematic reviews was assessed using the modified R-AMSTAR tool. Meta-analysis on included primary studies was performed. Results: Only 17% of primary studies measured a clearly defined CAI population. There is strong evidence to support the contribution of dynamic balance, peroneal reaction time and eversion strength deficits and moderate evidence for proprioception and static balance deficits to non-specific ankle instability. Conclusions: Evidence from previous systematic reviews does not accurately reflect the CAI population. For treatment of non-specific ankle instability, clinicians should focus on dynamic balance, reaction time and strength deficits; however, these findings may not be translated to the CAI population. Research should be updated with an adequately controlled CAI population. Systematic review registration: PROSPERO 2016, CRD42016032592. [ABSTRACT FROM AUTHOR]

Immigrants are often considered a vulnerable population. Paradoxically, some researchers have reported lower risk of pregnancy-related hypertension (PRH) among immigrants when compared to their non-immigrant counterparts. The lack of consistency and the absence of a synthesis of studies investigating the associations between immigration status and PRH represent a gap in our understanding of socioecological roots of PRH. Of studies published in during the study period, 16 met the inclusion criteria. For each study, we computed relative risks that compared PRH risk by migrant status. The pooled estimate of the relative risk of PRH represented a statistically significantly lower risk among immigrants (RR = 0.74; 95 % CI 0.67, 0.82). The body of evidence indicates that immigrant status is generally associated with reduced risk of PRH. However the strength of this association could vary by country of origin of immigrants. [ABSTRACT FROM AUTHOR]

Background: Late-stage rehabilitation programs often incorporate 'sport-specific' demands, but may not optimally simulate the in-game volume or intensity of such activities as sprinting, cutting, jumping, and lateral movement. Objective: The aim of this review was to characterize, quantify, and compare straight-line running and multi-directional demands during sport competition. Data Sources: A systematic review of PubMed, CINAHL, SPORTDiscus, and Cochrane Central Register of Controlled Trials databases was conducted. Study Eligibility Criteria: Studies that reported time-motion analysis data on straight-line running, accelerations/decelerations, activity changes, jumping, cutting, or lateral movement over the course of an entire competition in a multi-directional sport (soccer, basketball, lacrosse, handball, field hockey, futsal, volleyball) were included. Study Appraisal and Synthesis Methods: Data was organized based on sport, age level, and sex and descriptive statistics of the frequency, intensity, time, and volume of the characteristics of running and multi-directional demands were extracted from each study. Results: Eighty-one studies were included in the review ( n = 47 soccer, n = 11 basketball, n = 9 handball, n = 7 field hockey, n = 3 futsal, n = 4 volleyball). Variability of sport demand data was found across sports, sexes, and age levels. Specifically, soccer and field hockey demanded the most volume of running, while basketball required the highest ratio of high-intensity running to sprinting. Athletes change activity between 500 and 3000 times over the course of a competition, or once every 2-4 s. Studies of soccer reported the most frequent cutting (up to 800 per game), while studies of basketball reported the highest frequency of lateral movement (up to 450 per game). Basketball (42-56 per game), handball (up to 90 per game), and volleyball (up to 35 per game) were found to require the most jumping. Limitations: These data may provide an incomplete view of an athlete's straight-line running load, considering that only competition and not practice data was provided. Conclusions: Considerable variability exists in the demands of straight-line running and multi-directional demands across sports, competition levels, and sexes, indicating the need for sports medicine clinicians to design future rehabilitation programs with improved specificity (including the type of activity and dosage) to these demands. [ABSTRACT FROM AUTHOR]