OBJECTIVES:Fundamental movement skills (FMS) are foundational for lifelong physical activity and health, yet scalable, evidence-based programs remain limited. This study examined the effects of a 14-week integrated functional training (IFT) program on FMS among children aged 4-5 years. DESIGN:Single-center, kindergarten-based, parallel-group randomized controlled trial. METHODS:Sixty preschoolers (Mage = 4.93 ± 0.52; 28 girls) were randomized in a 1:1 ratio to IFT (n = 30; 3 × 45 min/week) or school's usual physical education (n = 30; 2 × 30min/week). The Test of Gross Motor Development-2 (TGMD-2) was used to assess FMS, including TGMD-2 total score, locomotor, and object-control sub-scores. RESULTS:After 14 weeks, the IFT group improved TGMD-2 total score from 61.9 ± 6.6 to 80.3 ± 4.7, whereas the comparison group changed from 67.2 ± 6.2 to 65.6 ± 4.2. After adjustment for baseline scores, the IFT group had significantly higher post-test TGMD-2 total score than the comparison group (adjusted mean difference = 16.8; 95% CI: 14.8 to 18.8; p < 0.001). Significant baseline-adjusted group effects were also observed for locomotor scores (adjusted mean difference = 6.05; 95% CI: 3.83 to 8.27; p < .001) and object-control scores (adjusted mean difference = 11.25; 95% CI: 10.08 to 12.42; p < .001). CONCLUSIONS:A 14-week IFT program delivered 3 × 45 min/week in a kindergarten setting was associated with greater improvements in locomotor and object-control skills among preschool children than the comparison condition delivered 2 × 30 min/week. Further studies using dose-matched designs, larger samples, and longer follow-up are needed.
Objectives Rugby league is a popular collision sport with an inherent risk of concussion. Management systems have been introduced at the elite level to detect and manage head impacts with the potential for concussion; however, little is known about the epidemiology of these events. This study aimed to describe the risk and incidence of head impacts, Head Injury Assessments (HIA), and concussions in Australian National Rugby League (NRL). Design A retrospective cohort study. Methods Official NRL player data from the 2017 through 2023 NRL Premiership seasons was linked to the SCRIMMAGE registry of head impacts, to provide a definitive database of exposure (match participation, player-match hours) and outcomes (head impacts, HIAs, and concussions). The risk and incidence of each outcome were calculated, overall and across each season. Results Between 2017 and 2023 892 individual players participated in at least one NRL game, with a total of 48,113.45 exposure hours. There were 5274 head impacts detected, resulting in 1849 HIAs, and 665 concussions. Incidence rates of head impacts, HIAs, and concussions per 1000 player-match hours were 109.62 (95% CI: 103.47–116.13), 38.43 (95% CI: 35.55–41.55), and 13.82 (95% CI: 12.54–15.23) respectively. Conclusions Head impacts, HIAs, and concussions were common events in NRL, but occurred at comparable, or relatively lower, rates than similar collision sports. This burden of injury justifies the comprehensive NRL concussion management system and supports ongoing efforts to mitigate the risk of head impacts, balanced against sporting considerations.
Objectives To examine the feasibility and acceptability of Beyond the 80 (BT80), a family-based healthy lifestyle intervention for school-aged girls. Design Single-arm mixed-methods feasibility trial. Methods BT80 was an 8-week intervention co-delivered with a National Rugby League Women's Premiership team. Eligible families included ≥1 parent and a daughter aged 7–11 years. Families participated in weekly in-person educational and practical sessions and completed home-based challenges. Topics included physical activity (including muscle-strengthening activity), sedentary behaviour, healthy eating, communication, emotion literacy, and sleep. A priori targets were set for recruitment (20 families), attendance (70%), retention (70%), fidelity (checklist; 80%), enjoyment (self-report; 80%). Child engagement (i.e., active/passive engagement or interfering behaviour via direct observation), compliance (photo evidence of home-based challenges completed), and acceptability (child/parent self-report and focus groups) were also assessed. Results Recruitment (N = 12 families) and attendance (68%) targets were not met, while retention (92%) met the target. Intervention fidelity was high (98% education, 100% practical), as was child active/passive engagement (90% education, 96% practical). Child and parent enjoyment was high for educational (child: 82%, parent: 99%) and practical sessions (child: 87%, parent: 98%). Families completed on average 1–2 home-based challenges, and some families found photo submission burdensome. Data collection averaged 102.1 ± 25.6 min at baseline and 69.7 ± 17.9 min at intervention end. Parents found the time and measures acceptable. Conclusions The preliminary findings for BT80 are promising, however, recruitment strategies, attendance, and home-based challenge engagement require refinement. Our findings may help to inform the development and refinement of similar family-based interventions.
OBJECTIVES:The anti-inflammatory effects of exercise training are hypothesized to involve changes in circulating cytokine concentrations, however the influence of exercise intensity is unclear. We determined the impact of exercise intensity, prescribed relative to lactate threshold (LT), on changes in fitness and plasma cytokines in a 6-week randomized controlled trial. DESIGN:RCT. METHODS:Healthy, young adults (N = 56, 27 males/29 females, age: 22 ± 3 y, peak oxygen consumption [VO2peak]: 38.4 ± 9.5 mL∙kg-1∙min-1) were randomized (2:2:1) to 6 weeks of thrice weekly isocaloric continuous cycling in the moderate (MICT; n = 21) or heavy (HICT; n = 24) intensity domain, or no-exercise control (CTRL; n = 11). Fasting plasma interleukin (IL)-6, IL-10, tumor necrosis factor (TNF)-α, and fitness were assessed at baseline and post-training. RESULTS:There was no impact of training or intensity (all p > 0.05) on changes in IL-6 (MICT +0.03 pg∙mL-1 95% CI -0.08, 0.13; HICT +0.03 pg∙mL-1 95% CI -0.08, 0.13; CTRL -0.14 pg∙mL-1 95% CI -0.30, 0.01), IL-10 (MICT +0.05 pg∙mL-1 95% CI -0.01, 0.11; HICT +0.02 pg∙mL-1 95% CI -0.05, 0.08; CTRL -0.02 pg∙mL-1 95% CI -0.11, 0.08), or TNF-α (MICT +0.12 pg∙mL-1 95% CI -0.01, 0.26; HICT +0.07 pg∙mL-1 95% CI -0.06, 0.21; CTRL -0.03 pg∙mL-1 95% CI -0.22, 0.17). VO2peak (absolute and relative) and power at LT increased with training (p < 0.002) with no significant differences between MICT and HICT (p > 0.331). CONCLUSIONS:In conclusion, 6 weeks of isocaloric, LT-prescribed training in the moderate and heavy domains improves fitness but does not appear to impact fasting plasma cytokine concentrations in healthy young adults.
OBJECTIVES:Rugby is one of the fastest-growing sports for adolescent girls in Canada and worldwide. Tackling is a foundational, high-risk skill, accounting for up to 79% of match injuries in Canadian girls' rugby. Despite the emergence of tackle training programmes, little is known about how coaches understand, adopt, and implement tackle training, particularly in girls' rugby. This study aimed to identify the tackle training-related education needs of Canadian rugby coaches. DESIGN:Qualitative study using a grounded theory analytical approach. METHODS:Interviews and focus groups were conducted with Alberta-based adolescent girls' rugby coaches (n = 16) and coach educators (n = 10) from across Canada at two time points in 2024 and 2025. Data were collected via semi-structured interviews/focus groups and analysed following grounded theory coding procedures. RESULTS:Three categories were constructed: (1) delivery preferences, (2) content needs, and (3) implementation recommendations. First, coaches preferred experiential, 'hands-on' workshops delivered in pre- and off-season, facilitated by credible experts, with opportunities for peer learning. Second, content needs included the rationale ("why"), technical clarity ("what"), and practical guidance on implementation of content ("how"). Third, effective implementation relied on prescriptive simplicity, ongoing reinforcement, and role model engagement. CONCLUSIONS:Coaches' preferences reflect the volunteer-led context of adolescent rugby. Effective tackle training workshops must tailor delivery to contextual constraints, focus on the "why, what, and how," and leverage credible voices to model and reinforce best practices. These findings encourage context-specific strategies for sustainable implementation of tackle training education for coaches in adolescent rugby.
OBJECTIVES:Japan Rugby League One comprises three divisions based on competitive level. We aimed to determine the incidence, severity, burden, and mechanism of match injuries in Japan Rugby League One and to examine the differences across divisions and between higher- and lower-ranked teams, for rankings defined within each division. DESIGN:Prospective cohort study. METHODS:The study conducted over four seasons (2022-2025) recruited male Rugby Union players from all Japan Rugby League One teams; time-loss injuries sustained during official matches were recorded. The injury incidence (injuries/1000 player-hours), mean severity (mean days lost), and burden (days/1000 player-hours) were calculated. Based on their final ranking within each division, teams were classified as higher-ranked or lower-ranked. RESULTS:Overall incidence, mean severity, and burden were 64.0 injuries/1000 player-hours (95% confidence interval: 61.1-67.0), 35 days, and 2235 days/1000 player-hours, respectively. Division 3 had a higher injury incidence (73.2 injuries/1000 player-hours; 95% confidence interval: 66.4-80.7) than Division 1 (incidence rate ratio = 1.23; 95% confidence interval: 1.09-1.38; p < .001). Concussion was the most frequent injury (12.0 injuries/1000 player-hours, 95% confidence interval: 10.8-13.4), whereas knee injuries imposed the greatest burden (592 days/1000 player-hours). Of all injuries, 54% were tackle-related. Lower-ranked teams experienced a higher injury incidence when facing higher-ranked teams (incidence rate ratio = 1.37; 95% confidence interval: 1.25-1.51; p < .001). CONCLUSIONS:Division-level disparities and ranking-related risk factors highlight the need for tailored prevention strategies; enhanced medical support for lower divisions; and interventions targeting concussions, knee injuries, and tackling techniques.
OBJECTIVES:Patients possibly having chronic exertional compartment syndrome of the anterior leg require confirmatory intracompartmental pressure measurements, but this test is invasive, patient unfriendly and imprecise. Ultrasound studies suggested that the morphology of the leg crural fascia covering the muscle might be changed. Aim of this study was to analyse the crural fascia curvature in chronic exertional compartment syndrome of the anterior leg in patients and healthy controls. DESIGN:Observational. METHODS:From February 2023 to February 2024 patients and controls matched for sex, age and body mass index underwent leg imaging with 10 mmHg and 80 mmHg external ultrasound probe pressure. The curvature of the fascia was measured before and after a treadmill test (convex to concave, +40 to -40). RESULTS:209 ultrasound images in 21 patients (13 males; age 31 ± 11; body mass index 26 ± 5) and 21 controls (13 males; age 36 ± 14; body mass index 24 ± 3) were analysed. With 10 mmHg external pressure, fascia curvature at rest was not different (patients 18.6 ± 4.4 versus controls 17.5 ± 6.3, p = 0.53). After exercise, the fascia was more convex in patients compared to controls (30 s: 26.4 ± 5.8 versus 22.8 ± 5.4, p = 0.05; 5 min: 24.3 ± 4.9 versus 20.1 ± 5.9, p = 0.02). No group curvature differences at 80 mmHg external pressure were found. CONCLUSIONS:Following exercise, the crural fascia in patients with chronic exertional compartment syndrome of the anterior leg is more convex compared to controls.
Cognitive-motor training consists of exercises combining cognitive and motor tasks (either applied sequentially or simultaneously) to stimulate both neurocognitive and motor domains. While evidence for the benefits of cognitive-motor training is well established in older adults (e.g., concerning falls as a clinical outcome), its clinical and scientific use nowadays extends toward the treatment of neurological diseases (e.g., multiple sclerosis), the assessment and treatment of sport-related concussion, and performance enhancement in athletes. The application of cognitive-motor training for this novel spectrum is, however, everything but homogeneous, both with respect to terminology and content. For example, depending on the disease or setting, the cognitive-motor training may involve different combinations of cognitive domains (e.g., memory, attention, cognitive speed, executive functions) and motor demands (e.g., endurance, strength, speed, coordination, flexibility). In this narrative cornerstone review, essential aspects of cognitive-motor training (terminology, indications, contents, and examples) are summarized. Neurocognitive domains and motor demands are systematically connected to provide a framework for comprehensive or tailored cognitive-motor training.
OBJECTIVES:To investigate the frequency, characteristics and incidence rate of breast impact events (BIEs) during semi-professional women's rugby union matches using video analysis. DESIGN:Cross-sectional video analysis. METHODS:Video footage of 22 matches were analysed to identify BIEs (i.e., direct, forceful contact of a player's breast with another player, equipment or playing surface). Descriptive statistics (means, 95% CI) reported the frequency and characteristics under three categories: (i) BIE match situation; (ii) ball-carrier/tackler characteristics; and (iii) BIE outcome. Incidence rate (IR) was reported per 1000 match hours. RESULTS:The total number of BIEs was 786 (mean 35.7 per match; IR 1176/1000 h), with an average of five players sustaining multiple BIEs per match. The most common BIE match situation was tackle-related (88%, n = 688), with tackle taken to ground the most common activity (47%, n = 370). For ball-carrier/tackler characteristics, the ball-carriers more commonly sustained BIEs (72%, n = 569) and tacklers inflicted the most BIEs (69%, n = 471). Two-thirds of BIEs (64%, n = 502) resulted from contact with the ball and 32% from direct impact with another player (n = 248), mostly with their shoulder (44%, n = 110) and forearm (48%, n = 116). The most common BIE outcome was players continuing to play after impact. CONCLUSIONS:BIEs occur frequently in women's rugby union matches, commonly during tackle-related activities, with the breast commonly impacting with the ball. Further research is recommended to investigate the magnitude of force involved with BIEs and the effects of accumulated BIEs on breast tissue trauma and pain.
OBJECTIVES:Tackle technique is well researched in male rugby players, but not in female players. This study investigated the relationship between different tackle characteristics for the tackler and ball carrier and head acceleration event magnitude in adolescent female rugby players. DESIGN:A prospective cohort study that followed forty-one, 12-17-year-old female rugby players over 2 seasons. METHODS:Instrumented mouthguards and video analysis were used to quantify head acceleration events, by recording the peak linear and peak rotational acceleration that were associated with tackle events in both games and trainings. RESULTS:We found twice as many head acceleration events ≥8 g for the tackler (n = 1233) than the ball carrier (n = 694). Tackling the ball carrier at the shoulder/chest resulted in the highest peak rotational acceleration (1973.6 ± 85.6 rads rad/s2, mean ± SE) for the tackler, which was higher than tackling the ball carrier at the torso/hip (1609.7 ± 69.8, p = 0.0002). A face up tackle recorded a higher peak rotational acceleration for the tackler than a face down tackle (1958.8 ± 83.3, 1601.6 ± 64.2 rads rad/s2, p < 0.0002, Cohen's d = 0.24). For both the ball carrier and the tackler, an uncontrolled fall resulted in higher peak linear acceleration compared to a controlled fall (3.8 ± 2.7 g, p < 0.005, d = 0.29 and 4.2 ± 3.0 g, p < 0.006, d = 0.30 respectively). CONCLUSIONS:Modifying tackle behaviours in female rugby may reduce head acceleration event magnitude associated with tackles and improve player safety.
OBJECTIVES:Brain health is an emerging public health priority, with dementia now among the leading causes of death in many high-income countries. The long-term brain health of current and former athletes has attracted increasing public and scientific attention in recent years, with attention largely focussed on risks such as sport-related concussion. This review aimed to increase awareness among the sports sector of the multi-factorial nature of brain health, presenting evidence on risk and protective factors alongside recommendations for individuals, sporting organisations, and regulatory agencies. DESIGN:A systematic search strategy was employed across three stages. The search protocol was pre-registered on the Open Science Framework. METHODS:First, position statements from global organisations were used to identify established risk and protective factors for brain health. Second, systematic reviews and meta-analyses from general populations were examined to build understanding of the current evidence base for each of these factors, including recent evidence not captured in stage 1. Third, an athlete-specific search was conducted to identify what is known about the factors within sporting contexts and cohorts. Limited evidence was identified specific to athlete populations; findings from the general population were therefore extrapolated where relevant. Factors considered most relevant to athletic populations were prioritised. RESULTS:Recommendations are presented for different roles within the sporting sector. CONCLUSIONS:Individual athletes are encouraged to address modifiable lifestyle risks; sporting organisations should create environments that actively support brain health during and beyond a sporting career; and regulatory agencies are encouraged to reduce harmful commercial influences on athletes.
OBJECTIVES:This study aimed to compare lower-limb landing kinematics and modeled anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) strains between athletes with and without chronic ankle instability (CAI) during a dynamic inversion-plantarflexion perturbation, and to determine whether altered landing strategies in athletes with CAI were associated with increased or reduced ligament strain. DESIGN:Cross-sectional study. METHODS:55 athletes with CAI and 55 without CAI were recruited. Each participant performed a 30-cm drop landing on a simulated sprain apparatus. The unaffected limb was placed on a support pedal, while the affected limb landed on a tilt pedal that was set to 24° of inversion and 15° of plantarflexion to simulate the condition of lateral ankle sprains. Kinematic data were obtained using a 12-camera motion analysis system, and ATFL and CFL strains were calculated with a 3D rigid-body foot model. Independent sample t-tests and Pearson's correlations were used to analyze data. RESULTS:Athletes with CAI exhibited higher hip flexion (p < 0.001), hip abduction (p < 0.001), knee abduction (p = 0.043), ankle external rotation (p = 0.032), foot toe-out (p < 0.001) angles and lower ATFL strain (p = 0.002). ATFL strain was negatively correlated with ankle external rotation (r = -0.263, p = 0.006), and foot toe-out (r = -0.286, p = 0.002) angles. CONCLUSIONS:Athletes with CAI adopt a protective landing strategy compared to those without CAI. This strategy was associated with reduction in ATFL strain, which may help mitigate the risk of lateral ankle sprain during challenging landings.
OBJECTIVES:High-Intensity Multimodal Training (HIMT) combines high-intensity aerobic, resistance and/or bodyweight training throughout a single session. It is widely used in community settings and may promote time-efficient participation in physical activity and exercise enjoyment. Despite this, there remains large heterogeneity in the literature, limiting the understanding of the best practice methods for practitioners to prescribe and monitor HIMT. Therefore, this study aimed to explore the professional experiences of HIMT practitioners to gain insight into current real-world practice. DESIGN & METHODS:Semi-structured interviews were conducted with 32 HIMT practitioners. Thematic analysis principles underpinned the application of both deductive and inductive codes to the data to generate key themes using a five-phase framework. RESULTS:HIMT practitioners described variety in prescription and monitoring practices. Practitioners also perceived challenges in maintaining client engagement whilst adhering to scientific principles, alongside managing logistical constraints inherent to group-based training environments. Subjective intensity monitoring tools (e.g., rating of perceived exertion) were favoured due to their feasibility and practicality. HIMT was perceived as a time-efficient, engaging training mode. However, concerns were raised that HIMT may limit the magnitude of specific physical adaptations (e.g., strength, skill development). CONCLUSIONS:HIMT practitioners adopt context-driven approaches to exercise prescription and monitoring that prioritise practicality, feasibility and client engagement. Perspectives suggest that clearer prescriptive recommendations are required to support practitioners in aligning HIMT session design with intended training outcomes. These findings highlight the need for ecologically valid research that reflects the realities of HIMT delivery and supports the translation of research to practice.
OBJECTIVES:Preparticipation examinations (PPEs) are commonly used to gather athletes' baseline health information. However, they often lack content specific to the health needs of female athletes. Therefore, this study aimed to: 1) identify which female-specific health questions athletes recall being asked during PPEs; 2) determine what questions athletes believe are missing; and 3) explore female athletes' comfort with disclosing health concerns. DESIGN:Cross-sectional survey. METHODS:The survey was distributed to Canadian varsity female athletes during their 2023-2024 season. It included multiple-choice and open-ended questions spanning five domains: pelvic health, menstrual health, Relative Energy Deficiency in Sport (REDs), musculoskeletal (MSK) health, and mental health. Descriptive statistics were used to summarize quantitative data, while inductive content analysis was used for open responses. RESULTS:Ninety-three athletes (mean age 21 ± 2.2 years) completed the survey. Sixty percent reported completing a PPE, and 84% indicated that there was no follow-up after completion. Fewer than half of athletes recalled being asked about mental health (42%), REDs (37%), menstrual health (33%), or pelvic health (2%). Athletes ranked inclusion of mental, MSK, REDs, menstrual, and pelvic health questions in descending order of importance. Athletes who felt comfortable disclosing health concerns recognized the performance and well-being benefits of doing so. Those who were uncomfortable cited not understanding the relevance of certain questions and/or mistrust regarding who would access their information. CONCLUSION:PPEs in Canadian varsity sport are often lacking female-specific questions. Clarifying PPE purpose, benefits and data sharing may improve trust, disclosure, and athlete health outcomes.
OBJECTIVES:To construct longitudinal developmental trajectories for competitive youth athletes, document sex-specific development, and evaluate cross-sectional performance benchmarks. DESIGN:Retrospective longitudinal cohort study. METHODS:Season-best performances from the Norwegian Athletics Federation database (135,403 observations, 31,028 athletes aged 10-25, seasons 2011-2025) were analysed in 60 m, 800 m, high jump, and long jump for both sexes. Longitudinal panel trajectories (athletes with ≥3 seasons) and within-athlete mixed-effects models were compared with cross-sectional top-100 benchmarks. Age-to-age change in the top-100 was decomposed into within-athlete and between-athlete components, and birth-quarter distributions were analysed for relative age effects using odds ratios. RESULTS:A mixed-effects model showed within-athlete performance improving through the teens and continuing well beyond the age 17-18 plateau of cross-sectional benchmarks, decelerating and levelling off in the early twenties; the descriptive panel rose higher at the oldest ages, consistent with selective persistence. Boys and girls performed almost identically at ages 10-12, then diverged sharply from age 13 to 14 (consistent with puberty), stabilising by age 18. Cross-sectional benchmarks substantially understated development: in the high jump, model-based improvement reached 63% by age 25 (descriptive panel, 81%) against a benchmark that peaked at 61% then declined, with panel-benchmark gaps up to 48 percentage points. Athletes born early in the selection year had up to 2.6 times the odds of top-100 membership at ages 10-13, fading by the twenties. CONCLUSIONS:Cross-sectional top-N curves understate individual development and should not be used to infer it; longitudinal trajectories more closely approximate how individuals develop and provide a more suitable reference for coaching and talent identification.
