Triangular fibrocartilage complex injuries are common in amateur and professional sports.These injuries are mainly caused by acute or chronic repetitive axial loads on the wrist,particularly on the ulnar side and in a...Triangular fibrocartilage complex injuries are common in amateur and professional sports.These injuries are mainly caused by acute or chronic repetitive axial loads on the wrist,particularly on the ulnar side and in association with rotations or radial/ulnar deviations.In order to treat professional athletes,a detailed specific knowledge of the pathology is needed.Moreover,the clinician should fully understand the specific and unique environment and needs of the athletes,their priorities and goals,the type of sport,the time of the season,and the position played.An early diagnosis and appropriate management with the quickest possible recovery time are the uppermost goals for both the athlete and the surgeon.A compromise between conservative vs surgical indications,athletes’needs and expectations,and financial implications should be achieved.Arthroscopic procedures should be timely planned when indicated as they could allow early diagnosis and treatment at the same time.Conservative measures are often used as first line treatment when possible.Peripheral lesions are treated by arthroscopic repair,whilst central lesions are treated by arthroscopic debridement.Further procedures(such as the Wafer procedure,ulnar osteotomies,etc.)have specific indications and great implications with regard to rehabilitation.展开更多
Spinal cord injury results in paralysis, sensory disturbances, sphincter dysfunction, and multiple systemic secondary conditions, most arising from autonomic dysregulation. All this produces profound negative psychoso...Spinal cord injury results in paralysis, sensory disturbances, sphincter dysfunction, and multiple systemic secondary conditions, most arising from autonomic dysregulation. All this produces profound negative psychosocial implications for affected people, their families, and their communities;the financial costs can be challenging for their families and health institutions. Treatments aimed at restoring the spinal cord after spinal cord injury, which have been tested in animal models or clinical trials, generally seek to counteract one or more of the secondary mechanisms of injury to limit the extent of the initial damage. Most published works on structural/functional restoration in acute and chronic spinal cord injury stages use a single type of treatment: a drug or trophic factor, transplant of a cell type, and implantation of a biomaterial. Despite the significant benefits reported in animal models, when translating these successful therapeutic strategies to humans, the result in clinical trials has been considered of little relevance because the improvement, when present, is usually insufficient. Until now, most studies designed to promote neuroprotection or regeneration at different stages after spinal cord injury have used single treatments. Considering the occurrence of various secondary mechanisms of injury in the acute and sub-acute phases of spinal cord injury, it is reasonable to speculate that more than one therapeutic agent could be required to promote structural and functional restoration of the damaged spinal cord. Treatments that combine several therapeutic agents, targeting different mechanisms of injury, which, when used as a single therapy, have shown some benefits, allow us to assume that they will have synergistic beneficial effects. Thus, this narrative review article aims to summarize current trends in the use of strategies that combine therapeutic agents administered simultaneously or sequentially, seeking structural and functional restoration of the injured spinal cord.展开更多
Acute central nervous system injuries,including ischemic stro ke,intracerebral hemorrhage,subarachnoid hemorrhage,traumatic brain injury,and spinal co rd injury,are a major global health challenge.Identifying optimal ...Acute central nervous system injuries,including ischemic stro ke,intracerebral hemorrhage,subarachnoid hemorrhage,traumatic brain injury,and spinal co rd injury,are a major global health challenge.Identifying optimal therapies and improving the long-term neurological functions of patients with acute central nervous system injuries are urgent priorities.Mitochondria are susceptible to damage after acute central nervous system injury,and this leads to the release of toxic levels of reactive oxygen species,which induce cell death.Mitophagy,a selective form of autophagy,is crucial in eliminating redundant or damaged mitochondria during these events.Recent evidence has highlighted the significant role of mitophagy in acute central nervous system injuries.In this review,we provide a comprehensive overview of the process,classification,and related mechanisms of mitophagy.We also highlight the recent developments in research into the role of mitophagy in various acute central nervous system injuries and drug therapies that regulate mitophagy.In the final section of this review,we emphasize the potential for treating these disorders by focusing on mitophagy and suggest future research paths in this area.展开更多
AIM:To evaluate the prevalence of early post-traumatic stress disorder(PTSD)among young and middle-aged patients who have suffered open globe injuries,and to identify the psychosocial factors influencing PTSD in these...AIM:To evaluate the prevalence of early post-traumatic stress disorder(PTSD)among young and middle-aged patients who have suffered open globe injuries,and to identify the psychosocial factors influencing PTSD in these patients.METHODS:A total of 280 patients who underwent ocular trauma surgery between January 2023 and January 2024 were selected through convenience sampling.Data were collected using a custom-designed demographic questionnaire,the Connor-Davidson Resilience Scale(CDRISC),the Cognitive Emotion Regulation Questionnaire(C-ERRI),and the PTSD Checklist-Civilian Version(PCL-C).Univariate analysis and stepwise multiple linear regression analysis were performed to determine the factors affecting PTSD in these patients.RESULTS:The average PTSD score for the patients was 33.22±13.48.The scores for individual PTSD dimensions,ranked from highest to lowest,were recurrent traumatic experiences,heightened arousal,avoidance reactions,and social dysfunction.Positive PTSD symptoms were observed in 85 patients(30.36%).Univariate analysis indicated that gender,postoperative vision,marital status,psychological resilience,and rumination were significant factors affecting PTSD symptoms(χ^(2)/t=6.53,17.88,8.83,2.17,and 14.1,respectively;all P<0.05).Pearson correlation analysis showed a positive correlation between rumination and PTSD symptoms(r=0.73,P<0.01)and a negative correlation between psychological resilience and PTSD symptoms(r=-0.14,P<0.05).Stepwise multiple linear regression analysis identified postoperative vision(notably eye removal),rumination levels,and psychological resilience(optimism)as major factors influencing PTSD in these patients(R^(2)=0.57,P<0.001).CONCLUSION:Young and middle-aged patients with open globe injuries have a high incidence of PTSD.Significant risk factors for early PTSD include primary enucleation,high levels of rumination,and low psychological resilience(optimism).Conversely,patients with good postoperative vision recovery,low rumination levels,and high levels of optimism are less likely to develop PTSD.Healthcare providers should pay special attention to patients who undergo primary enucleation,strive to reduce their rumination levels,and enhance their psychological resilience,thereby promoting a positive and optimistic attitude towards their condition and reducing the incidence of PTSD.展开更多
Injury to the ulnar collateral ligament(UCL) most commonly occurs in the overhead throwing athlete. Knowledge surrounding UCL injury pathomechanics continues to improve, leading to better preventative treatment strate...Injury to the ulnar collateral ligament(UCL) most commonly occurs in the overhead throwing athlete. Knowledge surrounding UCL injury pathomechanics continues to improve, leading to better preventative treatment strategies and rehabilitation programs. Conservative treatment strategies for partial injuries, improved operative techniques for reconstruction in complete tears, adjunctive treatments, as well as structured sport specific rehabilitation programs including resistive exercises for the entire upper extremity kinetic chain are all important factors in allowing for a return to throwing in competitive environments. In this review, we explore each of these factors and provide recommendations based on the available literature to improve outcomes in UCL injuries in athletes.展开更多
Ankle injuries are commonplace in the athletic population, with lateral ligamentsprains accounting for the majority of them. The medial ligament complex, thedistal tibiofibular syndesmosis as well as any of the bones ...Ankle injuries are commonplace in the athletic population, with lateral ligamentsprains accounting for the majority of them. The medial ligament complex, thedistal tibiofibular syndesmosis as well as any of the bones that constitute the anklejoint can also be injured. Typical mechanisms of injury include inversion-plantarflexionand external rotation on a supinated, dorsiflexed or pronated foot. Lesionsof the ankle present with similar symptoms of pain, swelling and tenderness.Therefore, a thorough history and physical examination must be obtained to makethe correct diagnosis. This is especially critical for athletes as certain injuries canlead to termination of their career if not treated accurately on time. Imaging maybe useful in some cases to confirm or rule out differential diagnoses. Most injuriescan be managed conservatively using the Protection, Rest, Ice, Compression andElevation protocol followed by a comprehensive rehabilitation programme.Surgery is reserved for grade III ligament tears that are refractory to initial nonoperativetreatment and displaced fractures that are unlikely to unite withoutsurgical intervention. The objective of this review is to discuss the common ankleinjuries encountered in the athletic population and the approaches to theirdiagnosis and management.展开更多
Taking the common sports injuries and preventive measures of Yushan County middle school track and field athletes as the research object,the sports injuries of Yushan County middle school track and field athletes were...Taking the common sports injuries and preventive measures of Yushan County middle school track and field athletes as the research object,the sports injuries of Yushan County middle school track and field athletes were investigated and analyzed from the angle,type,location and nature of sports injury.Research on sports injury problems,trying to find the causes of sports injuries in daily training of track and field athletes,and proposed targeted preventive measures based on the specific situation of Yushan County Middle School.The results show that 77.70%of track and field athletes have suffered sports injury and periostitis and ligament/muscle strains are the most common forms of injury,and lower limbs are more prone to sports injuries than upper limbs.展开更多
BACKGROUND:This study aimed to review bicycle-related injuries during the COVID-19 pandemic to assist with reinforcement or implementation of new policies for injury prevention.METHODS:This is a retrospective descript...BACKGROUND:This study aimed to review bicycle-related injuries during the COVID-19 pandemic to assist with reinforcement or implementation of new policies for injury prevention.METHODS:This is a retrospective descriptive analysis of injuries sustained during cycling for patients 18 years old and above who presented to Singapore General Hospital from January to June 2021.Medical records were reviewed and consolidated.Descriptive analyses were used to summarize patient characteristics,and differences in characteristics subgrouped by triage acuity and discharge status were analyzed.RESULTS:The study included 272 patients with a mean age of 43 years and a male predominance(71.7%).Most presented without referrals(88.2%)and were not conveyed by ambulances(70.6%).Based on acuity category,there were 24(8.8%)Priority 1(P1)patients with 7 trauma activations,174(64.0%)and 74(27.2%)P2 and P3 patients respectively.The most common injuries were fractures(34.2%),followed by superficial abrasion/contusion(29.4%)and laceration/wound(19.1%).Thirteen(4.8%)patients experienced head injury and 85 patients(31.3%)were documented to be wearing a helmet.The majority occurred on the roads as traffic accidents(32.7%).Forty-two patients(15.4%)were admitted with a mean length of stay of 4.1 d and 17(6.3%)undergone surgical procedures.Out of 214(78.7%)discharged patients,no re-attendances or mortality were observed.In the subgroup analysis,higher acuity patients were generally older,with higher proportions of head injuries leading to admission.CONCLUSION:Our study highlights significant morbidities in bicycle-related injuries.There is also a high proportion of fractures in the young healthy male population.Injury prevention is paramount and we propose emphasizing helmet use and road user safety.展开更多
Central nervous system injuries have a high rate of resulting in disability and mortality;however,at present,effective treatments are lacking.Programmed cell death,which is a genetically determined fo rm of active and...Central nervous system injuries have a high rate of resulting in disability and mortality;however,at present,effective treatments are lacking.Programmed cell death,which is a genetically determined fo rm of active and ordered cell death with many types,has recently attra cted increasing attention due to its functions in determining the fate of cell survival.A growing number of studies have suggested that programmed cell death is involved in central nervous system injuries and plays an important role in the progression of brain damage.In this review,we provide an ove rview of the role of programmed cell death in central nervous system injuries,including the pathways involved in mitophagy,pyroptosis,ferroptosis,and necroptosis,and the underlying mechanisms by which mitophagy regulates pyroptosis,ferroptosis,and necro ptosis.We also discuss the new direction of therapeutic strategies to rgeting mitophagy for the treatment of central nervous system injuries,with the aim to determine the connection between programmed cell death and central nervous system injuries and to identify new therapies to modulate programmed cell death following central nervous system injury.In conclusion,based on these properties and effects,interventions targeting programmed cell death could be developed as potential therapeutic agents for central nervous system injury patients.展开更多
Background:Determining the incidence and prevalence of injury and illness in short-course triathletes would improve understanding of their etiologies and therefore assist in the development and implementation of preve...Background:Determining the incidence and prevalence of injury and illness in short-course triathletes would improve understanding of their etiologies and therefore assist in the development and implementation of prevention strategies.This study synthesizes the existing evidence on the incidence and prevalence of injury and illness and summarizes reported injury or illness etiology and risk factors affecting short-course triathletes.Methods:This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Studies reporting health problems(injury and illness)in triathletes(all sexes,ages,and experience levels)training and/or competing in short-course distances were included.Six electronic databases(Cochrane Central Register of Controlled Trials,MEDLINE,Embase,APA PsychINFO,Web of Science Core Collection,and SPORTDiscus)were searched.Risk of bias was independently assessed by 2 reviewers using the Newcastle-Ottawa Quality Assessment Scale.Two authors independently completed data extraction.Results:The search yielded 7998 studies,with 42 studies eligible for inclusion.Twenty-three studies investigated injuries,24 studies investigated illnesses,and 5 studies investigated both injuries and illnesses.The injury incidence rate ranged 15.7-24.3 per 1000 athlete exposures,and the illness incidence rate ranged 1.8-13.1 per 1000 athlete days.Injury and illness prevalence ranged between 2%-15%and 6%-84%,respectively.Most injuries reported occurred during running(45%-92%),and the most frequently reported illnesses affected the gastrointestinal(7%-70%),cardiovascular(14%-59%),and respiratory systems(5%-60%).Conclusion:The most frequently reported health problems in short-course triathletes were:overuse and lower limb injuries associated with running;gastrointestinal illnesses and altered cardiac function,primarily attributable to environmental factors;and respiratory illness mostly caused by infection.展开更多
In Sweden, there has been only limited documentation for injuries requiring ambulance responses. The main objective of this study is, through the use of historic data, to assess the suitability of ambulance records to...In Sweden, there has been only limited documentation for injuries requiring ambulance responses. The main objective of this study is, through the use of historic data, to assess the suitability of ambulance records to describe circumstances with fall injuries. Methods: The injury events data around patients were sourced from the ambulance data register. Descriptive statistics were used to describe injured patients based on age group, type of injury, place of injury, injury mechanism and consequence of an injury event. Two-group comparison was performed with Pearson’s chi-squared. Predictors of transport to hospital were identified using logistic regression analyses. Result: Ambulance provides unique data on all injury events, with direct implications for translational research, public policy and clinical practice (safety promotion). In 2002 ambulance attended 3964 injured people which represents 14% of ambulance attended workload in Värmland county, Sweden. The most common trauma location was the traffic area followed by residential area and nursing home. These three injury sites account for 2320 cases (61.6%). The most common cause of injury was falls (63.9%) followed by contact with another person (26.5%). Contact with another person is the most common site of injury in the traffic area (79.5%), and men aged 25-66 years are overrepresented. Conclusion: Logistic regression found that, age-group and place code were significant predictor for being attended by ambulance. Traffic, home and nursing homes were over-represented injury environments (61.6%) that require special attention. Most injury cases occur in the home and nursing homes among people over 67 years of age. Surprisingly, most of the injury events in the traffic environment are about hitting another person. Paramedics can provide rich and valuable data on injury events. Registration of such data is entirely possible and desirable, and can be used in preventive work.展开更多
Purpose The aim of the study was to identify factors associated with prolonged time to return to full performance(RTFP)in athletes with recent severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection.Metho...Purpose The aim of the study was to identify factors associated with prolonged time to return to full performance(RTFP)in athletes with recent severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection.Methods Prospective cohort study with cross sectional analysis.A total of 84 athletes with confirmed SARS-CoV-2 infection assessed at a coronavirus disease 2019 recovery clinic gave a history of age,sex,type/level of sport,co-morbidities,pre-infection training hours,and 26 acute SARS-CoV-2 symptoms from 3 categories(“nose and throat”,“chest and neck”,and“whole body”/systemic).Data on days to RTFP were obtained by structured interviews.Factors associated with RTFP were demographics,sport participation,history of co-morbidities,pre-infection training history,and acute symptoms(type,number).Outcomes were:(a)days to RTFP(median,interquartile range(IQR))in asymptomatic(n=7)and symptomatic athletes(n=77),and(b)hazard ratios(HRs;95%confidence interval)for symptomatic athletes with vs.without a factor(univariate,multiple models).HR<1 was predictive of higher percentage chance of prolonged RTFP.Significance was p<0.05.Results Days to RTFP were 30 days(IQR:23–40)for asymptomatic and 64 days(IQR:42–91)for symptomatic participants(p>0.05).Factors associated with prolonged RTFP(univariate models)were:females(HR=0.57;p=0.014),endurance athletes(HR=0.41;p<0.0001),co-morbidity number(HR=0.75;p=0.001),and respiratory disease history(HR=0.54;p=0.026).In symptomatic athletes,prolonged RTFP(multiple models)was significantly associated with increased“chest and neck”(HR=0.85;p=0.017)and“nose and throat”(HR=0.84;p=0.013)symptoms,but the association was more profound between prolonged RFTP and increased total number of“all symptoms”(HR=0.91;p=0.001)and“whole body”/systemic(HR=0.82;p=0.007)symptoms.Conclusion A larger number of total symptoms and specifically“whole body”/systemic symptoms during the acute phase of SARS-CoV-2 infection in athletes is associated with prolonged RTFP.展开更多
In recent years, the NCAA student athlete population in the United States has surpassed 500,000, and is continuing to rise each year [1]. These student athletes work their entire lives academically and athletically to...In recent years, the NCAA student athlete population in the United States has surpassed 500,000, and is continuing to rise each year [1]. These student athletes work their entire lives academically and athletically to reach the ultimate goal: competing in university athletics. However, when these athletes reach university, they are met with non-stop training, homework, exams, and evolving social lives. We have conducted a study at the University of Evansville evaluating how participation in university athletics may impact mental health status among these student athletes, as well as measuring players’ awareness of accessible mental health resources. Over fifty percent of participants reported experiencing at least one mental health condition while competing in their sport;eighty percent reported having knowledge of the mental health resources available to them on campus, however, nearly thirty percent of those knowledgeable reported not knowing how to access these resources. This has indicated a gap in awareness and utilization of mental health resources among student athletes at the University of Evansville.展开更多
Many young elite athletes do not meet their daily energy and nutrient requirements. However, little research has been done on why these athletes do not meet their daily needs. The aim was to research the barriers and ...Many young elite athletes do not meet their daily energy and nutrient requirements. However, little research has been done on why these athletes do not meet their daily needs. The aim was to research the barriers and motivators of young Dutch elite athletes to optimize their nutritional intake. Quantitative and qualitative research was conducted among 8 handball and 4 volleyball players at the Dutch National Sports Center (17.2 ± 0.8 years). First, the nutritional intake was tracked through food diaries and analyzed in Nutritics. Thereupon, five semi-structured interviews based on the COM-B model were carried out. The interviews were transcribed and coded. The athletes had a reduced intake of energy, carbohydrates, vitamins A, C, E, D, calcium, potassium, zinc, and iron compared to their requirements. Seven themes for optimizing their nutritional intake emerged in the interviews: needs assessment, practical translation, portion size, lack of time, involvement, individuality, and food distribution. Barriers that the athletes experienced were that they did not know what their total daily nutritional needs were and how this translates into practice. In addition, the portion size at dinner was too small. They also had little time to eat a full meal due to time pressure from training and school. On the other hand, motivators were receiving meal options to translate their needs into practice with a distribution of moments when they need to eat. Covering these topics in nutritional workshops where athletes actively participate with more individual focus, could contribute to the optimization of their nutritional intake.展开更多
Neurological disorders,including developmental disorders,Alzheimer’s disease(AD),and psychiatric conditions,have significant social and economic impacts globally.Despite extensive research into the underlying mechani...Neurological disorders,including developmental disorders,Alzheimer’s disease(AD),and psychiatric conditions,have significant social and economic impacts globally.Despite extensive research into the underlying mechanisms of these disorders,effective treatments remain elusive,partly due to the complexity of the brain,the limited availability of human brain tissue,and the blood-brain barrier(BBB)’s impermeability to certain drugs.This perspective article discusses the potential of human induced pluripotent stem cell(iPSC)-based models of brain cells,organoids,assembloids,and BBB to advance our understanding of the etiology,progression,and mechanisms of brain injuries induced by alcohol consumption and general anesthesia.These models could also be used to develop protective and therapeutic approaches.展开更多
Pickleball is a popular sport that includes players from many different demographics. The popularity has resulted in not only increases in participation but also in activity related injuries. The purpose of this study...Pickleball is a popular sport that includes players from many different demographics. The popularity has resulted in not only increases in participation but also in activity related injuries. The purpose of this study was to identify risk factors along with potential mechanisms for injuries related to pickleball and identify effective countermeasures. Methods included the identification of pickleball related injuries from a US National Emergency Room database (NEISS). A narrative section of the database was used to identify and categorize potential mechanisms of injury. Results indicated that the types and mechanisms of injury relate to three specific age groups: younger, middle age, and older players. Injuries to younger players under the age of 26 are likely the result of misuse of sport equipment. Middle aged players from 26 to 50 sustained injuries more related activity overuse. However, there were more concerns with players over 50 years of age with a great percentage resulting in cardia arrest or symptoms leading to more severe cardiovascular conditions. While pickleball activity should be encouraged as it is a beneficial form of physical activity, there should be specific age-group interventions to reduce injury. It should be highly recommended that doctors approve the activity for individual at risk for heart conditions and supervision for adults in that age group.展开更多
1.Introduction For decades,substantial disagreement has persisted as to whether dynamic knee valgus is the cause of the majority of anterior cruciate ligament(ACL)injuries or rather the result of the ACL rupture.1 Con...1.Introduction For decades,substantial disagreement has persisted as to whether dynamic knee valgus is the cause of the majority of anterior cruciate ligament(ACL)injuries or rather the result of the ACL rupture.1 Consequently,great effort and expense has gone into capturing 3-dimensional kinetics and kinematics from live athletes to drive in vitro and in silico models of ACL injury in order to elucidate the actual mechanism of injury,as these factors have been demonstrated to be surrogates of intraarticular structural loading on the ACL.2,3 The elucidation of injury mechanisms for non-contact ACL injuries is of great medical value as such knowledge consequently permits quantified examination and validation of interventions and their respective effectiveness in both prevention and rehabilitation of these traumatic knee injuries.展开更多
To theeditor:Post-traumatic stress disorder(PTSD)arises after traumatic experiences,presenting with symptoms like reliving trauma,avoidance of reminders,mood changes and increased arousal,significantly affecting life ...To theeditor:Post-traumatic stress disorder(PTSD)arises after traumatic experiences,presenting with symptoms like reliving trauma,avoidance of reminders,mood changes and increased arousal,significantly affecting life quality and daily functioning.1 A severe complication of PTSD is suicidality,notably contributing to the higher mortality among PTSD sufferers.展开更多
BACKGROUND Occupational hand and wrist injuries(OHWIs)account for 25%of work-related accidents in low-and middle-income countries.In Colombia,more than 500000 occupational accidents occurred in 2021,and although the r...BACKGROUND Occupational hand and wrist injuries(OHWIs)account for 25%of work-related accidents in low-and middle-income countries.In Colombia,more than 500000 occupational accidents occurred in 2021,and although the rate declined to less than 5%in 2020 and 2021,at least one in four accidents involved a hand or wrist injury.AIM To describe the OHWIs in workers seen at the emergency room at a second-level hospital in Colombia.METHODS An observational study was performed using data from workers who experienced OHWIs and attended a second-level hospital,between June,2020 and May,2021.The overall frequency of OHWIs,as well as their distribution by sociodemo-graphic,clinical,and occupational variables,are described.Furthermore,association patterns between sex,anatomical area(fingers,hand,wrist),and type of job were analyzed by correspondence analysis(CA).RESULTS There were 2.101 workers treated for occupational accidents,423(20.3%)were cases of OHWIs,which mainly affected men(93.9%)with a median age of 31 years and who worked mainly in mining(75.9%).OHWIs were more common in the right upper extremity(55.3%)and comprised different types of injuries,such as contusion(42.1%),laceration(27.9%),fracture(18.7%),and crush injury(15.6%).They primarily affected the phalanges(95.2%),especially those of the first finger(25.7%).The CAs showed associations between the injured anatomical area and the worker’s job that differed in men and women(explained variance>90%).CONCLUSION One out of five workers who suffered occupational accidents in Cundinamarca,Columbia had an OHWI,affecting mainly males employed in mining.This occupational profile is likely to lead to prolonged rehabilitation,and permanent functional limitations.Our results might be useful for adjusting preventive measures in cluster risk groups.展开更多
Purpose:This umbrella systematic review(SR) of SRs and meta-analysis seeks to comprehensively synthesize existing literature to identify and consolidate the diverse range of risk factors contributing to running-relate...Purpose:This umbrella systematic review(SR) of SRs and meta-analysis seeks to comprehensively synthesize existing literature to identify and consolidate the diverse range of risk factors contributing to running-related injuries(RRIs).Methods:Systematic searches were conducted on June 28,2023,across Web of Science,SPORTDiscus,Scopus,PubMed,and Cochrane Library.We included SRs,whether accompanied by meta-analyses or not,that focused on investigating risk factors for RRIs within observational studies.The methodological quality of the SRs was evaluated using the Assessing the Methodological Quality of Systematic Reviews Ⅱ.To assess the extent of overlap across reviews,the corrected covered area metric was calculated.Results:From 1509 records retrieved,13 SRs were included.The degree of overlap between SRs was low(4%),and quality varied from critically low(n=8) to low(n=5).Two hundred seven outcomes assessed in 148 primary studies were identified as being associated with the occurrence of RRIs.The effect sizes of the associations for which risk measures were reported(n=131) were classified as large(n=30,23%),medium(n=38,29%),small(n=48,37%) or no effect(n=15,11%).Running/training characteristics,health and lifestyle factors,along with morphological and biomechanical aspects,exhibit large effect sizes in increasing the risk for RRIs.Conclusion:Drawing from the outcomes of the low-quality SRs and associations with large effect sizes,our findings indicate that running/training characteristics and health and lifestyle factors,as well as morphological and biomechanical aspects,are all implicated in elevating the risk of RRIs,emphasizing the multifactorial basis of injury incidence in running.Given the low quality and heterogeneity of SR,individual findings warrant cautious interpretation.展开更多
文摘Triangular fibrocartilage complex injuries are common in amateur and professional sports.These injuries are mainly caused by acute or chronic repetitive axial loads on the wrist,particularly on the ulnar side and in association with rotations or radial/ulnar deviations.In order to treat professional athletes,a detailed specific knowledge of the pathology is needed.Moreover,the clinician should fully understand the specific and unique environment and needs of the athletes,their priorities and goals,the type of sport,the time of the season,and the position played.An early diagnosis and appropriate management with the quickest possible recovery time are the uppermost goals for both the athlete and the surgeon.A compromise between conservative vs surgical indications,athletes’needs and expectations,and financial implications should be achieved.Arthroscopic procedures should be timely planned when indicated as they could allow early diagnosis and treatment at the same time.Conservative measures are often used as first line treatment when possible.Peripheral lesions are treated by arthroscopic repair,whilst central lesions are treated by arthroscopic debridement.Further procedures(such as the Wafer procedure,ulnar osteotomies,etc.)have specific indications and great implications with regard to rehabilitation.
文摘Spinal cord injury results in paralysis, sensory disturbances, sphincter dysfunction, and multiple systemic secondary conditions, most arising from autonomic dysregulation. All this produces profound negative psychosocial implications for affected people, their families, and their communities;the financial costs can be challenging for their families and health institutions. Treatments aimed at restoring the spinal cord after spinal cord injury, which have been tested in animal models or clinical trials, generally seek to counteract one or more of the secondary mechanisms of injury to limit the extent of the initial damage. Most published works on structural/functional restoration in acute and chronic spinal cord injury stages use a single type of treatment: a drug or trophic factor, transplant of a cell type, and implantation of a biomaterial. Despite the significant benefits reported in animal models, when translating these successful therapeutic strategies to humans, the result in clinical trials has been considered of little relevance because the improvement, when present, is usually insufficient. Until now, most studies designed to promote neuroprotection or regeneration at different stages after spinal cord injury have used single treatments. Considering the occurrence of various secondary mechanisms of injury in the acute and sub-acute phases of spinal cord injury, it is reasonable to speculate that more than one therapeutic agent could be required to promote structural and functional restoration of the damaged spinal cord. Treatments that combine several therapeutic agents, targeting different mechanisms of injury, which, when used as a single therapy, have shown some benefits, allow us to assume that they will have synergistic beneficial effects. Thus, this narrative review article aims to summarize current trends in the use of strategies that combine therapeutic agents administered simultaneously or sequentially, seeking structural and functional restoration of the injured spinal cord.
基金supported by the National Natural Science Foundation of China,Nos.81920108017(to YX),82130036(to YX),82371326(to XC),82171310(to XC)the STI2030-Major Projects,No.2022ZD0211800(to YX)Jiangsu Province Key Medical Discipline,No.ZDXK202216(to YX)。
文摘Acute central nervous system injuries,including ischemic stro ke,intracerebral hemorrhage,subarachnoid hemorrhage,traumatic brain injury,and spinal co rd injury,are a major global health challenge.Identifying optimal therapies and improving the long-term neurological functions of patients with acute central nervous system injuries are urgent priorities.Mitochondria are susceptible to damage after acute central nervous system injury,and this leads to the release of toxic levels of reactive oxygen species,which induce cell death.Mitophagy,a selective form of autophagy,is crucial in eliminating redundant or damaged mitochondria during these events.Recent evidence has highlighted the significant role of mitophagy in acute central nervous system injuries.In this review,we provide a comprehensive overview of the process,classification,and related mechanisms of mitophagy.We also highlight the recent developments in research into the role of mitophagy in various acute central nervous system injuries and drug therapies that regulate mitophagy.In the final section of this review,we emphasize the potential for treating these disorders by focusing on mitophagy and suggest future research paths in this area.
文摘AIM:To evaluate the prevalence of early post-traumatic stress disorder(PTSD)among young and middle-aged patients who have suffered open globe injuries,and to identify the psychosocial factors influencing PTSD in these patients.METHODS:A total of 280 patients who underwent ocular trauma surgery between January 2023 and January 2024 were selected through convenience sampling.Data were collected using a custom-designed demographic questionnaire,the Connor-Davidson Resilience Scale(CDRISC),the Cognitive Emotion Regulation Questionnaire(C-ERRI),and the PTSD Checklist-Civilian Version(PCL-C).Univariate analysis and stepwise multiple linear regression analysis were performed to determine the factors affecting PTSD in these patients.RESULTS:The average PTSD score for the patients was 33.22±13.48.The scores for individual PTSD dimensions,ranked from highest to lowest,were recurrent traumatic experiences,heightened arousal,avoidance reactions,and social dysfunction.Positive PTSD symptoms were observed in 85 patients(30.36%).Univariate analysis indicated that gender,postoperative vision,marital status,psychological resilience,and rumination were significant factors affecting PTSD symptoms(χ^(2)/t=6.53,17.88,8.83,2.17,and 14.1,respectively;all P<0.05).Pearson correlation analysis showed a positive correlation between rumination and PTSD symptoms(r=0.73,P<0.01)and a negative correlation between psychological resilience and PTSD symptoms(r=-0.14,P<0.05).Stepwise multiple linear regression analysis identified postoperative vision(notably eye removal),rumination levels,and psychological resilience(optimism)as major factors influencing PTSD in these patients(R^(2)=0.57,P<0.001).CONCLUSION:Young and middle-aged patients with open globe injuries have a high incidence of PTSD.Significant risk factors for early PTSD include primary enucleation,high levels of rumination,and low psychological resilience(optimism).Conversely,patients with good postoperative vision recovery,low rumination levels,and high levels of optimism are less likely to develop PTSD.Healthcare providers should pay special attention to patients who undergo primary enucleation,strive to reduce their rumination levels,and enhance their psychological resilience,thereby promoting a positive and optimistic attitude towards their condition and reducing the incidence of PTSD.
文摘Injury to the ulnar collateral ligament(UCL) most commonly occurs in the overhead throwing athlete. Knowledge surrounding UCL injury pathomechanics continues to improve, leading to better preventative treatment strategies and rehabilitation programs. Conservative treatment strategies for partial injuries, improved operative techniques for reconstruction in complete tears, adjunctive treatments, as well as structured sport specific rehabilitation programs including resistive exercises for the entire upper extremity kinetic chain are all important factors in allowing for a return to throwing in competitive environments. In this review, we explore each of these factors and provide recommendations based on the available literature to improve outcomes in UCL injuries in athletes.
文摘Ankle injuries are commonplace in the athletic population, with lateral ligamentsprains accounting for the majority of them. The medial ligament complex, thedistal tibiofibular syndesmosis as well as any of the bones that constitute the anklejoint can also be injured. Typical mechanisms of injury include inversion-plantarflexionand external rotation on a supinated, dorsiflexed or pronated foot. Lesionsof the ankle present with similar symptoms of pain, swelling and tenderness.Therefore, a thorough history and physical examination must be obtained to makethe correct diagnosis. This is especially critical for athletes as certain injuries canlead to termination of their career if not treated accurately on time. Imaging maybe useful in some cases to confirm or rule out differential diagnoses. Most injuriescan be managed conservatively using the Protection, Rest, Ice, Compression andElevation protocol followed by a comprehensive rehabilitation programme.Surgery is reserved for grade III ligament tears that are refractory to initial nonoperativetreatment and displaced fractures that are unlikely to unite withoutsurgical intervention. The objective of this review is to discuss the common ankleinjuries encountered in the athletic population and the approaches to theirdiagnosis and management.
文摘Taking the common sports injuries and preventive measures of Yushan County middle school track and field athletes as the research object,the sports injuries of Yushan County middle school track and field athletes were investigated and analyzed from the angle,type,location and nature of sports injury.Research on sports injury problems,trying to find the causes of sports injuries in daily training of track and field athletes,and proposed targeted preventive measures based on the specific situation of Yushan County Middle School.The results show that 77.70%of track and field athletes have suffered sports injury and periostitis and ligament/muscle strains are the most common forms of injury,and lower limbs are more prone to sports injuries than upper limbs.
文摘BACKGROUND:This study aimed to review bicycle-related injuries during the COVID-19 pandemic to assist with reinforcement or implementation of new policies for injury prevention.METHODS:This is a retrospective descriptive analysis of injuries sustained during cycling for patients 18 years old and above who presented to Singapore General Hospital from January to June 2021.Medical records were reviewed and consolidated.Descriptive analyses were used to summarize patient characteristics,and differences in characteristics subgrouped by triage acuity and discharge status were analyzed.RESULTS:The study included 272 patients with a mean age of 43 years and a male predominance(71.7%).Most presented without referrals(88.2%)and were not conveyed by ambulances(70.6%).Based on acuity category,there were 24(8.8%)Priority 1(P1)patients with 7 trauma activations,174(64.0%)and 74(27.2%)P2 and P3 patients respectively.The most common injuries were fractures(34.2%),followed by superficial abrasion/contusion(29.4%)and laceration/wound(19.1%).Thirteen(4.8%)patients experienced head injury and 85 patients(31.3%)were documented to be wearing a helmet.The majority occurred on the roads as traffic accidents(32.7%).Forty-two patients(15.4%)were admitted with a mean length of stay of 4.1 d and 17(6.3%)undergone surgical procedures.Out of 214(78.7%)discharged patients,no re-attendances or mortality were observed.In the subgroup analysis,higher acuity patients were generally older,with higher proportions of head injuries leading to admission.CONCLUSION:Our study highlights significant morbidities in bicycle-related injuries.There is also a high proportion of fractures in the young healthy male population.Injury prevention is paramount and we propose emphasizing helmet use and road user safety.
基金supported by the National Natural Science Foundation of China,No.82101461(to ZL)。
文摘Central nervous system injuries have a high rate of resulting in disability and mortality;however,at present,effective treatments are lacking.Programmed cell death,which is a genetically determined fo rm of active and ordered cell death with many types,has recently attra cted increasing attention due to its functions in determining the fate of cell survival.A growing number of studies have suggested that programmed cell death is involved in central nervous system injuries and plays an important role in the progression of brain damage.In this review,we provide an ove rview of the role of programmed cell death in central nervous system injuries,including the pathways involved in mitophagy,pyroptosis,ferroptosis,and necroptosis,and the underlying mechanisms by which mitophagy regulates pyroptosis,ferroptosis,and necro ptosis.We also discuss the new direction of therapeutic strategies to rgeting mitophagy for the treatment of central nervous system injuries,with the aim to determine the connection between programmed cell death and central nervous system injuries and to identify new therapies to modulate programmed cell death following central nervous system injury.In conclusion,based on these properties and effects,interventions targeting programmed cell death could be developed as potential therapeutic agents for central nervous system injury patients.
文摘Background:Determining the incidence and prevalence of injury and illness in short-course triathletes would improve understanding of their etiologies and therefore assist in the development and implementation of prevention strategies.This study synthesizes the existing evidence on the incidence and prevalence of injury and illness and summarizes reported injury or illness etiology and risk factors affecting short-course triathletes.Methods:This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Studies reporting health problems(injury and illness)in triathletes(all sexes,ages,and experience levels)training and/or competing in short-course distances were included.Six electronic databases(Cochrane Central Register of Controlled Trials,MEDLINE,Embase,APA PsychINFO,Web of Science Core Collection,and SPORTDiscus)were searched.Risk of bias was independently assessed by 2 reviewers using the Newcastle-Ottawa Quality Assessment Scale.Two authors independently completed data extraction.Results:The search yielded 7998 studies,with 42 studies eligible for inclusion.Twenty-three studies investigated injuries,24 studies investigated illnesses,and 5 studies investigated both injuries and illnesses.The injury incidence rate ranged 15.7-24.3 per 1000 athlete exposures,and the illness incidence rate ranged 1.8-13.1 per 1000 athlete days.Injury and illness prevalence ranged between 2%-15%and 6%-84%,respectively.Most injuries reported occurred during running(45%-92%),and the most frequently reported illnesses affected the gastrointestinal(7%-70%),cardiovascular(14%-59%),and respiratory systems(5%-60%).Conclusion:The most frequently reported health problems in short-course triathletes were:overuse and lower limb injuries associated with running;gastrointestinal illnesses and altered cardiac function,primarily attributable to environmental factors;and respiratory illness mostly caused by infection.
文摘In Sweden, there has been only limited documentation for injuries requiring ambulance responses. The main objective of this study is, through the use of historic data, to assess the suitability of ambulance records to describe circumstances with fall injuries. Methods: The injury events data around patients were sourced from the ambulance data register. Descriptive statistics were used to describe injured patients based on age group, type of injury, place of injury, injury mechanism and consequence of an injury event. Two-group comparison was performed with Pearson’s chi-squared. Predictors of transport to hospital were identified using logistic regression analyses. Result: Ambulance provides unique data on all injury events, with direct implications for translational research, public policy and clinical practice (safety promotion). In 2002 ambulance attended 3964 injured people which represents 14% of ambulance attended workload in Värmland county, Sweden. The most common trauma location was the traffic area followed by residential area and nursing home. These three injury sites account for 2320 cases (61.6%). The most common cause of injury was falls (63.9%) followed by contact with another person (26.5%). Contact with another person is the most common site of injury in the traffic area (79.5%), and men aged 25-66 years are overrepresented. Conclusion: Logistic regression found that, age-group and place code were significant predictor for being attended by ambulance. Traffic, home and nursing homes were over-represented injury environments (61.6%) that require special attention. Most injury cases occur in the home and nursing homes among people over 67 years of age. Surprisingly, most of the injury events in the traffic environment are about hitting another person. Paramedics can provide rich and valuable data on injury events. Registration of such data is entirely possible and desirable, and can be used in preventive work.
基金supported by funding from the International Olympic Committee(IOC)CS received a scholarship made possible through funding by the South African Medical Research Council(SAMRC)through its Division of Research Capacity Development under the SAMRC Clinician Researcher ProgrammeResearch reported in this publication was also supported by the SAMRC under a Self-Initiated Research Grant to MS.
文摘Purpose The aim of the study was to identify factors associated with prolonged time to return to full performance(RTFP)in athletes with recent severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection.Methods Prospective cohort study with cross sectional analysis.A total of 84 athletes with confirmed SARS-CoV-2 infection assessed at a coronavirus disease 2019 recovery clinic gave a history of age,sex,type/level of sport,co-morbidities,pre-infection training hours,and 26 acute SARS-CoV-2 symptoms from 3 categories(“nose and throat”,“chest and neck”,and“whole body”/systemic).Data on days to RTFP were obtained by structured interviews.Factors associated with RTFP were demographics,sport participation,history of co-morbidities,pre-infection training history,and acute symptoms(type,number).Outcomes were:(a)days to RTFP(median,interquartile range(IQR))in asymptomatic(n=7)and symptomatic athletes(n=77),and(b)hazard ratios(HRs;95%confidence interval)for symptomatic athletes with vs.without a factor(univariate,multiple models).HR<1 was predictive of higher percentage chance of prolonged RTFP.Significance was p<0.05.Results Days to RTFP were 30 days(IQR:23–40)for asymptomatic and 64 days(IQR:42–91)for symptomatic participants(p>0.05).Factors associated with prolonged RTFP(univariate models)were:females(HR=0.57;p=0.014),endurance athletes(HR=0.41;p<0.0001),co-morbidity number(HR=0.75;p=0.001),and respiratory disease history(HR=0.54;p=0.026).In symptomatic athletes,prolonged RTFP(multiple models)was significantly associated with increased“chest and neck”(HR=0.85;p=0.017)and“nose and throat”(HR=0.84;p=0.013)symptoms,but the association was more profound between prolonged RFTP and increased total number of“all symptoms”(HR=0.91;p=0.001)and“whole body”/systemic(HR=0.82;p=0.007)symptoms.Conclusion A larger number of total symptoms and specifically“whole body”/systemic symptoms during the acute phase of SARS-CoV-2 infection in athletes is associated with prolonged RTFP.
文摘In recent years, the NCAA student athlete population in the United States has surpassed 500,000, and is continuing to rise each year [1]. These student athletes work their entire lives academically and athletically to reach the ultimate goal: competing in university athletics. However, when these athletes reach university, they are met with non-stop training, homework, exams, and evolving social lives. We have conducted a study at the University of Evansville evaluating how participation in university athletics may impact mental health status among these student athletes, as well as measuring players’ awareness of accessible mental health resources. Over fifty percent of participants reported experiencing at least one mental health condition while competing in their sport;eighty percent reported having knowledge of the mental health resources available to them on campus, however, nearly thirty percent of those knowledgeable reported not knowing how to access these resources. This has indicated a gap in awareness and utilization of mental health resources among student athletes at the University of Evansville.
文摘Many young elite athletes do not meet their daily energy and nutrient requirements. However, little research has been done on why these athletes do not meet their daily needs. The aim was to research the barriers and motivators of young Dutch elite athletes to optimize their nutritional intake. Quantitative and qualitative research was conducted among 8 handball and 4 volleyball players at the Dutch National Sports Center (17.2 ± 0.8 years). First, the nutritional intake was tracked through food diaries and analyzed in Nutritics. Thereupon, five semi-structured interviews based on the COM-B model were carried out. The interviews were transcribed and coded. The athletes had a reduced intake of energy, carbohydrates, vitamins A, C, E, D, calcium, potassium, zinc, and iron compared to their requirements. Seven themes for optimizing their nutritional intake emerged in the interviews: needs assessment, practical translation, portion size, lack of time, involvement, individuality, and food distribution. Barriers that the athletes experienced were that they did not know what their total daily nutritional needs were and how this translates into practice. In addition, the portion size at dinner was too small. They also had little time to eat a full meal due to time pressure from training and school. On the other hand, motivators were receiving meal options to translate their needs into practice with a distribution of moments when they need to eat. Covering these topics in nutritional workshops where athletes actively participate with more individual focus, could contribute to the optimization of their nutritional intake.
基金supported by grants R01 GM112696 and 1R35GM148177 from the National Institutes of Health(to XB)Advancing a Healthier Wisconsin(to XB)Medical College of Wisconsin-Neuroscience Research Center-Alzheimer’s Award(to XB).
文摘Neurological disorders,including developmental disorders,Alzheimer’s disease(AD),and psychiatric conditions,have significant social and economic impacts globally.Despite extensive research into the underlying mechanisms of these disorders,effective treatments remain elusive,partly due to the complexity of the brain,the limited availability of human brain tissue,and the blood-brain barrier(BBB)’s impermeability to certain drugs.This perspective article discusses the potential of human induced pluripotent stem cell(iPSC)-based models of brain cells,organoids,assembloids,and BBB to advance our understanding of the etiology,progression,and mechanisms of brain injuries induced by alcohol consumption and general anesthesia.These models could also be used to develop protective and therapeutic approaches.
文摘Pickleball is a popular sport that includes players from many different demographics. The popularity has resulted in not only increases in participation but also in activity related injuries. The purpose of this study was to identify risk factors along with potential mechanisms for injuries related to pickleball and identify effective countermeasures. Methods included the identification of pickleball related injuries from a US National Emergency Room database (NEISS). A narrative section of the database was used to identify and categorize potential mechanisms of injury. Results indicated that the types and mechanisms of injury relate to three specific age groups: younger, middle age, and older players. Injuries to younger players under the age of 26 are likely the result of misuse of sport equipment. Middle aged players from 26 to 50 sustained injuries more related activity overuse. However, there were more concerns with players over 50 years of age with a great percentage resulting in cardia arrest or symptoms leading to more severe cardiovascular conditions. While pickleball activity should be encouraged as it is a beneficial form of physical activity, there should be specific age-group interventions to reduce injury. It should be highly recommended that doctors approve the activity for individual at risk for heart conditions and supervision for adults in that age group.
文摘1.Introduction For decades,substantial disagreement has persisted as to whether dynamic knee valgus is the cause of the majority of anterior cruciate ligament(ACL)injuries or rather the result of the ACL rupture.1 Consequently,great effort and expense has gone into capturing 3-dimensional kinetics and kinematics from live athletes to drive in vitro and in silico models of ACL injury in order to elucidate the actual mechanism of injury,as these factors have been demonstrated to be surrogates of intraarticular structural loading on the ACL.2,3 The elucidation of injury mechanisms for non-contact ACL injuries is of great medical value as such knowledge consequently permits quantified examination and validation of interventions and their respective effectiveness in both prevention and rehabilitation of these traumatic knee injuries.
基金funded by a grant of the National Research Foundation of Korea Grant(NRF-2020M3E5D9080733)and(NRF-2020R1A2C2003472)to J-MK。
文摘To theeditor:Post-traumatic stress disorder(PTSD)arises after traumatic experiences,presenting with symptoms like reliving trauma,avoidance of reminders,mood changes and increased arousal,significantly affecting life quality and daily functioning.1 A severe complication of PTSD is suicidality,notably contributing to the higher mortality among PTSD sufferers.
文摘BACKGROUND Occupational hand and wrist injuries(OHWIs)account for 25%of work-related accidents in low-and middle-income countries.In Colombia,more than 500000 occupational accidents occurred in 2021,and although the rate declined to less than 5%in 2020 and 2021,at least one in four accidents involved a hand or wrist injury.AIM To describe the OHWIs in workers seen at the emergency room at a second-level hospital in Colombia.METHODS An observational study was performed using data from workers who experienced OHWIs and attended a second-level hospital,between June,2020 and May,2021.The overall frequency of OHWIs,as well as their distribution by sociodemo-graphic,clinical,and occupational variables,are described.Furthermore,association patterns between sex,anatomical area(fingers,hand,wrist),and type of job were analyzed by correspondence analysis(CA).RESULTS There were 2.101 workers treated for occupational accidents,423(20.3%)were cases of OHWIs,which mainly affected men(93.9%)with a median age of 31 years and who worked mainly in mining(75.9%).OHWIs were more common in the right upper extremity(55.3%)and comprised different types of injuries,such as contusion(42.1%),laceration(27.9%),fracture(18.7%),and crush injury(15.6%).They primarily affected the phalanges(95.2%),especially those of the first finger(25.7%).The CAs showed associations between the injured anatomical area and the worker’s job that differed in men and women(explained variance>90%).CONCLUSION One out of five workers who suffered occupational accidents in Cundinamarca,Columbia had an OHWI,affecting mainly males employed in mining.This occupational profile is likely to lead to prolonged rehabilitation,and permanent functional limitations.Our results might be useful for adjusting preventive measures in cluster risk groups.
基金supported by the Programa de Bolsas Universitarias de Santa CatarinaBrasil(Uniedu)(Grant No.14786,Grant No.16479)the Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior(CAPES).
文摘Purpose:This umbrella systematic review(SR) of SRs and meta-analysis seeks to comprehensively synthesize existing literature to identify and consolidate the diverse range of risk factors contributing to running-related injuries(RRIs).Methods:Systematic searches were conducted on June 28,2023,across Web of Science,SPORTDiscus,Scopus,PubMed,and Cochrane Library.We included SRs,whether accompanied by meta-analyses or not,that focused on investigating risk factors for RRIs within observational studies.The methodological quality of the SRs was evaluated using the Assessing the Methodological Quality of Systematic Reviews Ⅱ.To assess the extent of overlap across reviews,the corrected covered area metric was calculated.Results:From 1509 records retrieved,13 SRs were included.The degree of overlap between SRs was low(4%),and quality varied from critically low(n=8) to low(n=5).Two hundred seven outcomes assessed in 148 primary studies were identified as being associated with the occurrence of RRIs.The effect sizes of the associations for which risk measures were reported(n=131) were classified as large(n=30,23%),medium(n=38,29%),small(n=48,37%) or no effect(n=15,11%).Running/training characteristics,health and lifestyle factors,along with morphological and biomechanical aspects,exhibit large effect sizes in increasing the risk for RRIs.Conclusion:Drawing from the outcomes of the low-quality SRs and associations with large effect sizes,our findings indicate that running/training characteristics and health and lifestyle factors,as well as morphological and biomechanical aspects,are all implicated in elevating the risk of RRIs,emphasizing the multifactorial basis of injury incidence in running.Given the low quality and heterogeneity of SR,individual findings warrant cautious interpretation.