Objective To describe the methodological characteristics and content of published hamstring muscle injury (HMI) rehabilitation programmes in order to inform clinical practice and guide future research.Methods We searched the MEDLINE (PubMed), Scopus and Web of Science electronic databases, on October 2024, using key terms “hamstring” and “rehabilitation”, with strategies refined after a preliminary search. Eligible studies included English-language publications involving non-surgically managed acute HMI in humans and reporting rehabilitation protocols.Results We included 137 articles. Primary research (43.1%, n=59) included mostly cohort and randomised controlled trials (RCTs); secondary research articles (54.0%, n=74) were predominantly narrative reviews. Overall, 54.7% of studies had a low level of evidence. Only 44.2% of primary research focused on HMI rehabilitation programmes of which 47.8% were RCTs. Rehabilitation programme details were often missing. In the subacute/functional phases, strengthening (78.3%) and stretching (55.6%) were most frequently reported. Return-to-sport criteria were reported in only 43.5% of primary research, often based on pain resolution. Across both primary and secondary research, 40 different rehabilitation strategies were identified, with the most frequently reported being eccentric-based strengthening, flexibility exercises, progressive running and agility protocols. Key gaps included lack of standardisation, under-reporting of programme parameters and limited inclusion of diverse sporting populations.Conclusions Current scientific literature on HMI rehabilitation programmes shows wide variety, limited high-level evidence primary research and under-reporting of key clinical details. More rigorous and inclusive studies are needed to improve the standardisation and clinical applicability of rehabilitation strategies.
Objectives:To map and summarise the existing scientific literature on on-field rehabilitation (OFR) exercises, progression and principles supporting athletes' return to contact team sports after anterior cruciate ligament (ACL) injury. Design:Scoping review. Data sources:PubMed, CINAHL, AMED, Cochrane, SPORTDiscus, PEDro, Scopus and Embase Library were searched in April 2025. Eligibility criteria for selecting studies:Sources of any design published between 2010 and 2025 that described or evaluated OFR for athletes returning to contact team sports after ACL injury or reconstruction, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines; studies involving athletes of any age, sex or competition level were eligible. Results:The search identified 6880 records; 38 sources met the inclusion criteria. Most sources were descriptive and focused predominantly on football, with limited representation of basketball, rugby and ice hockey. OFR was commonly described using multistage (2-5 steps) frameworks progressing from linear running and controlled drills to multidirectional movements, sport-specific skills and practice simulations. Progression was primarily criterion-based rather than time-based, guided by minimal pain or swelling, restored knee range of motion, adequate strength and limb symmetry, and tolerance to running loads. Several articles applied the control-chaos continuum. Collaboration between physiotherapists, coaches and athletes was emphasised, although roles, responsibilities and organisational structures were rarely described. Conclusion:The current OFR literature after ACL injury is largely descriptive, emphasising staged, criterion-based progression and multidisciplinary collaboration. However, actionable guidance on roles, responsibilities and organisational structures is minimal, underscoring the need for empirical studies to establish and evaluate standardised OFR practices. Trial registration number:10.17605/OSF.IO/T6UN2.
Objectives Around 80% of children/adolescents globally do not meet recommended levels of physical activity (PA). The 2020 WHO consensus updated PA guidelines, changing from ‘60 minutes of PA/day’ to at least ‘an average of 60 min/day’. This means that attaining 420 min/week expresses the minimum threshold for PA.This analysis examined the effects of the changed guidelines on children/adolescents meeting PA guidelines. A coprimary research question examines single-item PA questions to determine the number of days of 60 min of activity that best reflect meeting the new PA guideline.Methods Data were from five population-level Australian and New Zealand surveys (two representative population surveillance datasets and three large community interventions). PA questions included the single item question (days/week of 60 min) and detailed PA measures including International Physical Activity Questionnaire-adolescent questions. The single-item analysis used receiver operating characteristic (ROC) curves to identify the best fit between the single-item and more extensive PA measures (maximising sensitivity and specificity).Results The proportion meeting the old PA guidelines ranged from 28–55%, compared with 35–84% meeting the new guideline (average absolute increase of 26.2%). ROC analysis described areas under the ROC curve between 0.728 and 0.907. The best fit (Youden’s Index >0.5) was 4–5 days/week where the single item best classified children and adolescents meeting the new guideline.Conclusions The new guideline classified 26% more children and adolescents meeting updated PA guidelines. National research reports should use updated PA guideline criteria, and for surveillance, 4–5 reported days/week on the single PA question best estimates meeting the PA guideline threshold.
Background/objectives During adolescence, parents and guardians can play an important role in shaping their child’s attitudes, beliefs and behaviours. Yet research examining their beliefs and behaviours regarding injury and prevention within adolescent female rugby union is limited. The primary aim of the study was to identify attitudes, beliefs and behaviours towards injury and injury prevention among parents and guardians of adolescent female rugby players, including subgroup differences. The second aim was to examine how attitudes and beliefs aligned among parents and guardians and the players (their child).Methods Parents and guardians of adolescent female rugby players were recruited from under-16 and under-18 rugby schools/colleges, clubs, and regional talent pathways teams and asked to complete an online cross-sectional survey.Results Two hundred and eighty-five parents and guardians responded to the survey; 144 parents and guardians and players (their child) completed their respective surveys. Fifty-four per cent believed it was ‘possible to prevent some rugby injuries’. Understanding of equipment effectiveness varied; 12% agreed that wearing a scrum cap could prevent concussions. Agreement between parent and guardian and player responses to statements regarding injury and injury prevention varied; Gwet’s AC ranged from almost perfect agreement (0.8–1) to fair agreement (0.21–0.4).Conclusion The study advances understanding of parents’ and guardians’ attitudes, beliefs and behaviours regarding injury and injury prevention in adolescent female rugby, showing generally safe practices while highlighting notable gaps that constrain effective injury management. Addressing these gaps offers a practical route to improving the consistency of parents’ and guardians’ safeguarding players’ welfare.
Objectives The aim of this study was to determine temporal trends in sports and exercise participation frequency among European Union adults. Methods We analysed Eurobarometer survey data collected among 96 948 adults from 26 European Union countries in 2009, 2013, 2017 and 2022. Self-reported frequency of sports and exercise participation was categorised as: ‘never’, ‘less than once a month’, ‘monthly’ (1–3 times per month) and ‘weekly’ (at least once a week). Multilevel ordinal logistic regression was used to analyse trends in sports and exercise participation frequency for the overall sample and by gender, age, marital status, employment, place of residence, number of household members and country. Results The prevalence of no participation in sports and exercise increased from 41.7% (95% confidence interval [CI] 40.6% to 42.7%) in 2009 to 45.8% (95% CI 44.8% to 46.8%) in 2022. The frequency of sports and exercise participation decreased from 2009 (reference year) to 2017 (adjusted odds ratio [OR] for 2013=0.96; 95% CI 0.92 to 0.99; OR for 2017=0.87; 95% CI 0.84 to 0.91) and then increased in 2022 (OR=0.92; 95% CI 0.89 to 0.95), suggesting a U-shaped trend (p<0.001). The most concerning trends were found for females, middle-aged adults, those living alone, Denmark, Hungary, Poland, Portugal and Sweden. Conclusion The persistently high prevalence of no sports participation highlights the need to strengthen the promotion of sports and exercise in the European Union. The focus should be on the population groups and countries with declining frequency of sports and exercise participation.
