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The objective of this scoping review was to provide an overview of the variety and characteristics of publications on physical activity (PA) in studies including children with autism spectrum disorder (ASD), and to evaluate the quality of the available information on PA content and description of teaching. This is important because completeness of intervention reporting holds great value for practitioners, patients, community leaders, and policymakers. The following research questions were answered (i) How is the PA content description completeness according to the 12 items in the Template for Intervention Description and Replication (TIDIeR) checklist? (ii) What teaching methods and styles applied in conjunction with PA are described in the included studies? PRISMA-extension for scoping reviews was used to guide the completion and reporting of the study. Publications reporting on children with ASD participating in PA were included. Data on PA content was collected using TIDieR. A qualitative content analysis guided the data collection on teaching methods and styles. None of the included publications reported on all items in TIDieR. Aspects of teaching was described in 40% of the included publications. The existing literature on the relationship between PA participation and ASD-related symptoms in children is extensive and characterized by variations in design and methods. Reporting according to the TIDieR was generally incomplete, and descriptions of teaching could benefit from added detail regarding teaching methods and styles. [ABSTRACT FROM AUTHOR]

The combination of excessive increases in running pace and volume is essential to consider when investigating associations between running and running-related injury. To complete a secondary analysis, using a dataset from a randomized trial, to evaluate the interactions between relative or absolute weekly changes in running volume and running pace on the occurrence of running injuries among a cohort of injury-free recreational runners in Denmark. Prospective cohort study. Running volume and pace were collected during a 24-week follow-up using global positioning systems data. Training data were used to calculate relative and absolute weekly changes in running volume and pace. A total of 586 recreational runners were included in the analysis. All participants were injury free at baseline. Running-related injury was the outcome. Injury data were collected weekly using a modified version of the Oslo Sports Trauma Research Centre questionnaire. Risk difference (RD) was the measure of injury risk. A total of 133 runners sustained running-related injuries. A relative weekly change of progression >10% in running volume and progression in running pace (RD = 8.1%, 95% CI = −9.3%, 25.6%) and an absolute weekly change of progression >5 km in running volume and progression in running pace (RD = 5.2%, 95% CI = −12.0%, 22.5%) were not associated with a statistically significant positive interaction. Given that coaches, clinicians, and athletes may agree that excessive increases in running pace and running volume are important contributors to injury development, we analyzed the interaction between them. Although we did not identify a statistically significant positive interaction on an additive scale in runners who progressed both running pace and running volume, readers should be aware that an interaction is an important analytical approach that could be applied to other datasets in future publications. [ABSTRACT FROM AUTHOR]

Background: In randomised controlled trials (RCTs) of interventions that aim to prevent sports injuries, the intention-to-treat principle is a recommended analysis method and one emphasised in the Consolidated Standards of Reporting Trials (CONSORT) statement that guides quality reporting of such trials. However, an important element of injury prevention trials-compliance with the intervention-is not always well-reported. The purpose of the present educational review was to describe the compliance during follow-up in eight large-scale sports injury trials and address compliance issues that surfaced. Then, we discuss how readers and researchers might consider interpreting results from intention-to-treat analyses depending on the observed compliance with the intervention.Methods: Data from seven different randomised trials and one experimental study were included in the present educational review. In the trials that used training programme as an intervention, we defined full compliance as having completed the programme within ±10% of the prescribed running distance (ProjectRun21 (PR21), RUNCLEVER, Start 2 Run) or time-spent-running in minutes (Groningen Novice Running (GRONORUN)) for each planned training session. In the trials using running shoes as the intervention, full compliance was defined as wearing the prescribed running shoe in all running sessions the participants completed during follow-up.Results: In the trials that used a running programme intervention, the number of participants who had been fully compliant was 0 of 839 (0%) at 24-week follow-up in RUNCLEVER, 0 of 612 (0%) at 14-week follow-up in PR21, 12 of 56 (21%) at 4-week follow-up in Start 2 Run and 8 of 532 (1%) at 8-week follow-up in GRONORUN. In the trials using a shoe-related intervention, the numbers of participants who had been fully compliant at the end of follow-up were 207 of 304 (68%) in the 21 week trial, and 322 of 423 (76%), 521 of 577 (90%), 753 of 874 (86%) after 24-week follow-up in the other three trials, respectively.Conclusion: The proportion of runners compliant at the end of follow-up ranged from 0% to 21% in the trials using running programme as intervention and from 68% to 90% in the trials using running shoes as intervention. We encourage sports injury researchers to carefully assess and report the compliance with intervention in their articles, use appropriate analytical approaches and take compliance into account when drawing study conclusions. In studies with low compliance, G-estimation may be a useful analytical tool provided certain assumptions are met. [ABSTRACT FROM AUTHOR]

Background: Behavioral science methods have rarely been used in running injury research. Therefore, the attitudes amongst runners and their coaches regarding factors leading to running injuries warrants formal investigation. Purpose: To investigate the attitudes of middle- and long-distance runners able to compete in national championships and their coaches about factors associated with running injury development. Methods: A link to an online survey was distributed to middle- and long-distance runners and their coaches across 25 Danish Athletics Clubs. The main research question was: "Which factors do you believe influence the risk of running injuries?". In response to this question, the athletes and coaches had to click "Yes" or "No" to 19 predefined factors. In addition, they had the possibility to submit a free-text response. Results: A total of 68 athletes and 19 coaches were included in the study. A majority of the athletes (76% [95%CI: 66%; 86%]) and coaches (79% [95%CI: 61%; 97%]) reported "Ignoring pain" as a risk factor for running injury. A majority of the coaches reported "Reduced muscle strength" (79% [95%CI: 61%; 97%]) and "high running distance" (74% [95%CI: 54%; 94%]) to be associated with injury, while half of the runners found "insufficient recovery between running sessions" (53% [95%CI: 47%; 71%]) important. Conclusion: Runners and their coaches emphasize ignoring pain as a factor associated with injury development. The question remains how much running, if any at all, runners having slight symptoms or mild pain, are able to tolerate before these symptoms develop into a running-related injury. Level of Evidence: 3b [ABSTRACT FROM AUTHOR]

Background: Injury incidence and prevalence in running populations have been investigated and documented in several studies. However, knowledge about injury etiology and prevention is needed. Training errors in running are modifiable risk factors and people engaged in recreational running need evidence-based running schedules to minimize the risk of injury. The existing literature on running volume and running intensity and the development of injuries show conflicting results. This may be related to previously applied study designs, methods used to quantify the performed running and the statistical analysis of the collected data. The aim of the Run Clever trial is to investigate if a focus on running intensity compared with a focus on running volume in a running schedule influences the overall injury risk differently.Methods/design: The Run Clever trial is a randomized trial with a 24-week follow-up. Healthy recreational runners between 18 and 65 years and with an average of 1-3 running sessions per week the past 6 months are included. Participants are randomized into two intervention groups: Running schedule-I and Schedule-V. Schedule-I emphasizes a progression in running intensity by increasing the weekly volume of running at a hard pace, while Schedule-V emphasizes a progression in running volume, by increasing the weekly overall volume. Data on the running performed is collected by GPS. Participants who sustain running-related injuries are diagnosed by a diagnostic team of physiotherapists using standardized diagnostic criteria. The members of the diagnostic team are blinded. The study design, procedures and informed consent were approved by the Ethics Committee Northern Denmark Region (N-20140069).Discussion: The Run Clever trial will provide insight into possible differences in injury risk between running schedules emphasizing either running intensity or running volume. The risk of sustaining volume- and intensity-related injuries will be compared in the two intervention groups using a competing risks approach. The trial will hopefully result in a better understanding of the relationship between the running performed and possible differences in running-related injury risk and the injuries developed.Trial Registration: Clinical Trials NCT02349373 - January 23, 2015. [ABSTRACT FROM AUTHOR]

Background/Purpose: There is a paucity of knowledge on the association between different foot posture quantified by Foot Posture Index (FPI) and Quadriceps angle (Q-angle) with development of running-related injuries. Earlier studies investigating these associations did not include an objective measure of the amount of running performed. Therefore, the purpose of this study was to investigate if kilometers to running-related injury (RRI) differ among novice runners with different foot postures and Q-angles when running in a neutral running shoe. Methods: A 10 week study was conducted including healthy, novice runners. At baseline foot posture was evaluated using the foot posture index (FPI) and the Q-angle was measured. Based on the FPI and Q-angle, right and left feet / knees of the runners were categorized into exposure groups. All participants received a Global Positioning System watch to allow them to quantify running volume and were instructed to run a minimum of two times per week in a conventional, neutral running shoe. The outcome was RRI. Results: Fifty nine novice runners of mixed gender were included. Of these, 13 sustained a running-related injury. No significant difference in cumulative relative risk between persons with pronated feet and neutral feet was found after 125 km of running (Cumulative relative risk = 1.65 [0.65; 4.17], p = 0.29). Similarly, no difference was found between low and neutral Q-angle (Cumulative relative risk = 1.25 [0.49; 3.23], p = 0.63). Conclusion: Static foot posture as quantified by FPI and knee alignment as quantified by Q-angle do not seem to affect the risk of injury among novice runners taking up a running regimen wearing a conventional neutral running shoe. These results should be interpreted with caution due to a small sample size. Level of Evidence: 2a [ABSTRACT FROM AUTHOR]

Background/Purpose: There is a paucity of knowledge on the association between different foot posture quantified by Foot Posture Index (FPI) and Quadriceps angle (Q-angle) with development of running-related injuries. Earlier studies investigating these associations did not include an objective measure of the amount of running performed. Therefore, the purpose of this study was to investigate if kilometers to running-related injury (RRI) differ among novice runners with different foot postures and Q-angles when running in a neutral running shoe. Methods: A 10 week study was conducted including healthy, novice runners. At baseline foot posture was evaluated using the foot posture index (FPI) and the Q-angle was measured. Based on the FPI and Q-angle, right and left feet / knees of the runners were categorized into exposure groups. All participants received a Global Positioning System watch to allow them to quantify running volume and were instructed to run a minimum of two times per week in a conventional, neutral running shoe. The outcome was RRI. Results: Fifty nine novice runners of mixed gender were included. Of these, 13 sustained a running-related injury. No significant difference in cumulative relative risk between persons with pronated feet and neutral feet was found after 125 km of running (Cumulative relative risk = 1.65 [0.65; 4.17], p = 0.29). Similarly, no difference was found between low and neutral Q-angle (Cumulative relative risk = 1.25 [0.49; 3.23], p = 0.63). Conclusion: Static foot posture as quantified by FPI and knee alignment as quantified by Q-angle do not seem to affect the risk of injury among novice runners taking up a running regimen wearing a conventional neutral running shoe. These results should be interpreted with caution due to a small sample size. Level of Evidence: 2a [ABSTRACT FROM AUTHOR]

Background: Time-to-event modelling is underutilised in sports injury research. Still, sports injury researchers have been encouraged to consider time-to-event analyses as a powerful alternative to other statistical methods. Therefore, it is important to shed light on statistical approaches suitable for analysing training load related key-questions within the sports injury domain., Content: In the present article, we illuminate: (i) the possibilities of including time-varying outcomes in time-to-event analyses, (ii) how to deal with a situation where different types of sports injuries are included in the analyses (ie, competing risks), and (iii) how to deal with the situation where multiple subsequent injuries occur in the same athlete., Conclusion: Time-to-event analyses can handle time-varying outcomes, competing risk and multiple subsequent injuries. Although powerful, time-to-event has important requirements: researchers are encouraged to carefully consider prior to any data collection that five injuries per exposure state or transition is needed to avoid conducting statistical analyses on time-to-event data leading to biased results. This requirement becomes particularly difficult to accommodate when a stratified analysis is required as the number of variables increases exponentially for each additional strata included. In future sports injury research, we need stratified analyses if the target of our research is to respond to the question: ' how much change in training load is too much before injury is sustained, among athletes with different characteristics ?' Responding to this question using multiple time-varying exposures (and outcomes) requires millions of injuries. This should not be a barrier for future research, but collaborations across borders to collecting the amount of data needed seems to be an important step forward., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: 'How much change in training load is too much before injury is sustained, among different athletes?' is a key question in sports medicine and sports science. To address this question the investigator/practitioner must analyse exposure variables that change over time, such as change in training load. Very few studies have included time-varying exposures (eg, training load) and time-varying effect-measure modifiers (eg, previous injury, biomechanics, sleep/stress) when studying sports injury aetiology., Aim: To discuss advanced statistical methods suitable for the complex analysis of time-varying exposures such as changes in training load and injury-related outcomes., Content: Time-varying exposures and time-varying effect-measure modifiers can be used in time-to-event models to investigate sport injury aetiology. We address four key-questions (i) Does time-to-event modelling allow change in training load to be included as a time-varying exposure for sport injury development? (ii) Why is time-to-event analysis superior to other analytical concepts when analysing training-load related data that changes status over time? (iii) How can researchers include change in training load in a time-to-event analysis? and, (iv) Are researchers able to include other time-varying variables into time-to-event analyses? We emphasise that cleaning datasets, setting up the data, performing analyses with time-varying variables and interpreting the results is time-consuming, and requires dedication. It may need you to ask for assistance from methodological peers as the analytical approaches presented this paper require specialist knowledge and well-honed statistical skills., Conclusion: To increase knowledge about the association between changes in training load and injury, we encourage sports injury researchers to collaborate with statisticians and/or methodological epidemiologists to carefully consider applying time-to-event models to prospective sports injury data. This will ensure appropriate interpretation of time-to-event data., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Behavioral science methods have rarely been used in running injury research. Therefore, the attitudes amongst runners and their coaches regarding factors leading to running injuries warrants formal investigation., Purpose: To investigate the attitudes of middle- and long-distance runners able to compete in national championships and their coaches about factors associated with running injury development., Methods: A link to an online survey was distributed to middle- and long-distance runners and their coaches across 25 Danish Athletics Clubs. The main research question was: "Which factors do you believe influence the risk of running injuries?". In response to this question, the athletes and coaches had to click "Yes" or "No" to 19 predefined factors. In addition, they had the possibility to submit a free-text response., Results: A total of 68 athletes and 19 coaches were included in the study. A majority of the athletes (76% [95%CI: 66%; 86%]) and coaches (79% [95%CI: 61%; 97%]) reported "Ignoring pain" as a risk factor for running injury. A majority of the coaches reported "Reduced muscle strength" (79% [95%CI: 61%; 97%]) and "high running distance" (74% [95%CI: 54%; 94%]) to be associated with injury, while half of the runners found "insufficient recovery between running sessions" (53% [95%CI: 47%; 71%]) important., Conclusion: Runners and their coaches emphasize ignoring pain as a factor associated with injury development. The question remains how much running, if any at all, runners having slight symptoms or mild pain, are able to tolerate before these symptoms develop into a running-related injury., Level of Evidence: 3b.

Background/purpose: There is a paucity of knowledge on the association between different foot posture quantified by Foot Posture Index (FPI) and Quadriceps angle (Q-angle) with development of running-related injuries. Earlier studies investigating these associations did not include an objective measure of the amount of running performed. Therefore, the purpose of this study was to investigate if kilometers to running-related injury (RRI) differ among novice runners with different foot postures and Q-angles when running in a neutral running shoe., Methods: A 10 week study was conducted including healthy, novice runners. At baseline foot posture was evaluated using the foot posture index (FPI) and the Q-angle was measured. Based on the FPI and Q-angle, right and left feet / knees of the runners were categorized into exposure groups. All participants received a Global Positioning System watch to allow them to quantify running volume and were instructed to run a minimum of two times per week in a conventional, neutral running shoe. The outcome was RRI., Results: Fifty nine novice runners of mixed gender were included. Of these, 13 sustained a running-related injury. No significant difference in cumulative relative risk between persons with pronated feet and neutral feet was found after 125 km of running (Cumulative relative risk = 1.65 [0.65; 4.17], p = 0.29). Similarly, no difference was found between low and neutral Q-angle (Cumulative relative risk = 1.25 [0.49; 3.23], p = 0.63)., Conclusion: Static foot posture as quantified by FPI and knee alignment as quantified by Q-angle do not seem to affect the risk of injury among novice runners taking up a running regimen wearing a conventional neutral running shoe. These results should be interpreted with caution due to a small sample size., Level of Evidence: 2a.