Following the tragic events surrounding the war in Ukraine, which started on 24 February 2022, Russian troops have been destroying many Olympic sports infrastructures and athletes and Olympic sports professionals are suffering serious consequences, and sports talents are being lost. Therefore, this Delphi study aimed to identify the most important needs of Ukraine\'s Olympic sports in hostile conditions. It sought to formulate priority areas crucial for support during and after the war period, aimed at safeguarding the career prospects of Ukrainian athletes. The study further aimed to identify well-informed priorities for developing Ukraine\'s Olympic sports. These priorities, once discerned, can be advocated for promotion and prioritisation in present and future agendas, thereby shaping the course of international support and ensuring the preservation of Ukrainian athletes\' career prospects. A three-round Delphi study was conducted with 42 participants who had expertise as coaches, athletes and researchers (PhD, professor) in sports science. There was a strong panellist agreement on the needs of Ukraine\'s Olympic sports in the identified hostile conditions. The list of the final top 10 needs included: (1) \'Develop and maintain the athlete\'s fitness level\'; (2) \'Implementation of a better recovery system for athletes\'; and (3) \'To ensure a safe training place for athletes\'. The needs identified in this study are of tremendous value and guide efforts to Ukraine\'s sports talents during wartime and, as a result, will guide the international institutions to direct appropriate aid and international support.

UNASSIGNED: The cardiovascular benefits of physical exercise are well-known. However, vigorous exercise has also been associated with adverse cardiac effects. To improve our understanding of cardiovascular adaptation to exercise versus maladaptation and pathology, the limits of adaptation should be firmly established using state-of-the-art diagnostic modalities. We therefore initiated the Evaluation of Lifetime participation in Intensive Top-level sports and Exercise (ELITE) cohort to investigate the longitudinal (beneficial and pathological) cardiovascular effects of intensive elite sports and exercise.
UNASSIGNED: ELITE is a prospective, multicentre, longitudinal cohort study. Elite athletes, from the age of sixteen, are recruited in The Netherlands. The primary objective is to determine the association between elite sports and exercise-induced cardiac remodelling, cardiac pathology, and health benefits over time. Secondary objectives include determining and identifying genetic profiles of elite athletes, and how these are associated with cardiac indices. ELITE will collect data from consultations, electrocardiography, echocardiography and cardiac magnetic resonance imaging, and training- and injury data. ELITE will also collect blood for biobanking and cardiogenetics. Follow-up will take place at intervals of two to five years, and after the elite athletes\' professional careers have ended. In addition, a subcohort of ELITE has been established to investigate cardiac sequelae following infections associated with myocardial involvement, including SARS-CoV-2. ELITE is a prospective observational study; therefore, analyses will be primarily explorative.
UNASSIGNED: This study has been approved by the Medical Ethics Review Board of the Amsterdam University Medical Centers (NL71682.018.19). The results of the study will be disseminated by publication in peer-reviewed journals (Netherlands Trial Register number: NL9328).

UNASSIGNED: Little is known about the impact of elite sport participation on long-term athlete health. We aimed to: (1) describe musculoskeletal, mental health, reproductive/endocrine and cardiovascular characteristics in retired elite female athletes and compare to the general population and (2) explore athletes\' perceptions of their elite sport participation and its impact on health.
UNASSIGNED: A 136-item online questionnaire was disseminated to Canadian elite female rowing and rugby athletes >18 years old, >2 years retired from elite competition. Matched general population data were obtained from Statistics Canada when available.
UNASSIGNED: Seventy-four (24% response rate) athletes (average age 45 (±9) years; retired 15 (±9) years) completed the questionnaire (30 rowing, 44 rugby athletes). During their career, 63 athletes (85%) experienced a hip/groin, knee, foot/ankle injury, or low back pain, with 42 (67%) reporting ongoing symptoms. Athletes 35-54 years reported worse knee symptoms and quality of life compared with the general population (symptom: p=0.197; d=1.15 [0.66, 1.63]; quality of life: p=0.312 d=1.03 [0.54, 1.51]) while other hip, knee and foot/ankle outcome scores were similar. Retired athletes had lower odds of anxiety (OR=0.155 [95% CI0.062 to 0.384]), greater lifetime/ever odds of amenorrhea (OR=6.10 [95%CI 2.67 to 13.96]) and gave birth when older (p<0.05). Fifty-nine (79%) recalled witnessing or experiencing at least one form of harassment/abuse during their career. Sixty athletes (81%) rated their current health as above average or excellent and 61 (82%) would compete at the same level again if given the choice.
UNASSIGNED: These novel insights can inform future preventative efforts to promote positive elite sport-related outcomes for current, former and future female athletes.

UNASSIGNED: Exercise-induced cardiac remodelling (EICR) results from the structural, functional and electrical adaptations to exercise. Despite similar sports participation, EICR varies and some athletes develop phenotypic features that overlap with cardiomyopathies. Training load and genotype may explain some of the variation; however, exercise \'dose\' has lacked rigorous quantification. Few have investigated the association between EICR and genotype.
UNASSIGNED: (1) To identify the impact of training load and genotype on the variance of EICR in elite endurance athletes and (2) determine how EICR and its determinants are associated with physical performance, health benefits and cardiac pathology.
UNASSIGNED: The Pro@Heart study is a multicentre prospective cohort trial. Three hundred elite endurance athletes aged 14-23 years will have comprehensive cardiovascular phenotyping using echocardiography, cardiac MRI, 12-lead ECG, exercise-ECG and 24-hour-Holter monitoring. Genotype will be determined using a custom cardiomyopathy gene panel and high-density single-nucleotide polymorphism arrays. Follow-up will include online tracking of training load. Cardiac phenotyping will be repeated at 2, 5, 10 and 20 years.
UNASSIGNED: The primary endpoint of the Pro@Heart study is the association of EICR with both training load and genotype. The latter will include rare variants in cardiomyopathy-associated genes and polygenic risk scores for cardiovascular traits. Secondary endpoints are the incidence of atrial and ventricular arrhythmias, physical performance and health benefits and their association with training load and genotype.
UNASSIGNED: The Pro@Heart study is the first long-term cohort study to assess the impact of training load and genotype on EICR.
UNASSIGNED: NCT05164328; ACTRN12618000716268.

BACKGROUND: Little is known about the association between physical fitness and the risk of injury or illness in ice hockey. The least-fit players may be more prone to injury and illness.
OBJECTIVE: To examine the association between preseason fitness level and injury or illness risk among elite ice hockey players during the regular season.
METHODS: Cohort study; Level of evidence, 2.
METHODS: A total of 133 male ice hockey players in the GET League (the premier professional league in Norway) completed 8 different exercises (40-m sprint, countermovement jump, 3000-m run, squat, bench press, chin-ups, brutal bench, and box jump) at the annual 1-day preseason testing combine. During the 2017-2018 competitive season, the players reported all health problems (acute injuries, overuse injuries, and illnesses) weekly (31 weeks) using the Oslo Sports Trauma Research Center Questionnaire on Health Problems.
RESULTS: Overall, the players reported 191 acute injuries, 82 overuse injuries, and 132 illnesses. The least-fit tercile of players did not report more health problems (mean, 3.0; 95% CI, 2.2-3.8) compared with the most-fit (mean, 3.4; 95% CI, 2.6-4.2) or the medium-fit (mean, 2.7; 95% CI, 1.9-3.5) players. The most-fit players reported more substantial health problems (mean, 2.0; 95% CI, 1.6-2.5) compared with the medium-fit (mean, 1.3; 95% CI, 0.8 -1.8) and least-fit (mean, 1.8; 95% CI, 1.3-2.3) (P = .02) players. There was no association between low physical fitness and number of health problems when comparing the least-fit tercile of the players with the rest of the cohort (P > .05); however, there was an association between low physical fitness and greater severity of all health problems when comparing the least-fit tercile of players to the rest of the cohort after adjusting for time on ice per game, playing position, and age (P = .02).
CONCLUSIONS: Low physical fitness was not associated with increased rate of injury or illness but was associated with greater severity of all health problems after adjusting for time on ice per game, playing position, and age.

OBJECTIVE: The British Athletics Muscle Injury Classification (BAMIC) correlates with return to play in muscle injury. The aim of this study was to examine hamstring injury diagnoses and outcomes within elite track and field athletes following implementation of the British Athletics hamstring rehabilitation approach.
METHODS: All hamstring injuries sustained by elite track and field athletes on the British Athletics World Class Programme between December 2015 and November 2019 that underwent an MRI and had British Athletics medical team prescribed rehabilitation were included. Athlete demographics and specific injury details, including mechanism of injury, self-reported gait phase, MRI characteristics and time to return to full training (TRFT) were contemporaneously recorded.
RESULTS: 70 hamstring injuries in 46 athletes (24 women and 22 men, 24.6±3.7 years) were included. BAMIC grade and the intratendon c classification correlated with increased TRFT. Mean TRFT was 18.6 days for the entire cohort. Mean TRFT for intratendon classifications was 34±7 days (2c) and 48±17 days (3c). The overall reinjury rate was 2.9% and no reinjuries were sustained in the intratendon classifications. MRI variables of length and cross-sectional (CSA) area of muscle oedema, CSA of tendon injury and loss of tendon tension were associated with TRFT. Longitudinal length of tendon injury, in the intratendon classes, was not associated with TRFT.
CONCLUSIONS: The application of BAMIC to inform hamstring rehabilitation in British Athletics results in low reinjury rates and favourable TRFT following hamstring injury. The key MRI variables associated with longer recovery are length and CSA of muscle oedema, CSA of tendon injury and loss of tendon tension.

BACKGROUND: The UEFA Elite Club Injury Study is the largest and longest running injury surveillance programme in football.
OBJECTIVE: To analyse the 18-season time trends in injury rates among male professional football players.
METHODS: 3302 players comprising 49 teams (19 countries) were followed from 2000-2001 through 2018-2019. Team medical staff recorded individual player exposure and time-loss injuries.
RESULTS: A total of 11 820 time-loss injuries were recorded during 1 784 281 hours of exposure. Injury incidence fell gradually during the 18-year study period, 3% per season for both training injuries (95% CI 1% to 4% decrease, p=0.002) and match injuries (95% CI 2% to 3% decrease, p<0.001). Ligament injury incidence decreased 5% per season during training (95% CI 3% to 7% decrease, p<0.001) and 4% per season during match play (95% CI 3% to 6% decrease, p<0.001), while the rate of muscle injuries remained constant. The incidence of reinjuries decreased by 5% per season during both training (95% CI 2% to 8% decrease, p=0.001) and matches (95% CI 3% to 7% decrease, p<0.001). Squad availability increased by 0.7% per season for training sessions (95% CI 0.5% to 0.8% increase, p<0.001) and 0.2% per season for matches (95% CI 0.1% to 0.3% increase, p=0.001).
CONCLUSIONS: Over 18 years: (1) injury incidence decreased in training and matches, (2) reinjury rates decreased, and (3) player availability for training and match play increased.

UNASSIGNED: Poor oral health of elite athletes is common and is associated with negative performance impacts. There is a need for oral health promotion strategies that are effective within the elite sport environment.
UNASSIGNED: To develop, implement and evaluate a pragmatic oral health promotion intervention that integrated the capability, opportunity, motivation and behaviour model of behavioural change into the knowledge transfer system for effective implementation of preventive interventions.
UNASSIGNED: Repeated measures study. Athletes and support team together viewed one 10 min presentation and three 90 s information films. Athletes alone received oral health screening, personalised advice and an oral health toolkit. Outcome measures included: (1) oral health knowledge, athlete-reported performance impacts (Oslo Sports Trauma Research Centre, OSTRC score), use of oral hygiene aids, gingival inflammation (bleeding) score, recorded at baseline, 4-6 weeks and 12-16 weeks and (2) athlete feedback.
UNASSIGNED: We recruited 62 athletes; 44 (71%) male and 58 (93.5%) white British, 55 (88.7%) athletes completed the study. Mean knowledge score improved from 5.69 (1.59) to 6.93 (1.32) p<0.001. Mean OSTRC score reduced from 8.73 (14.54) to 2.73 (11.31) p<0.001. Athlete use of prescription strength fluoride toothpaste increased from 8 (12.9%) to 45 (80.4%) p<0.001. Athlete-reported use of interdental cleaning aids at least 2-3 x week increased from 10 (16.2%) to 21 (34%) p=0.013. Bleeding score remained unchanged.
UNASSIGNED: This behavioural change intervention was successfully implemented within different elite sport environments. It was associated with an increase in athlete oral health knowledge, enhanced oral health behaviour, a reduction in self-reported performance impacts and high participant retention.

UNASSIGNED: As previous epidemiological studies in elite ice hockey have focused on acute time-loss injuries, little is known about the burden of overuse injuries and illnesses in ice hockey.
UNASSIGNED: To report the prevalence and burden of all health problems in male professional ice hockey players in Norway during a single competitive season.
UNASSIGNED: Descriptive epidemiological study.
UNASSIGNED: A total of 225 male ice hockey players in the GET League (the premier professional league) in Norway reported all health problems (acute injuries, overuse injuries, and illnesses) during the 2017-2018 competitive season. Players reported all injuries and illnesses for 31 weeks using the Oslo Sports Trauma Research Center Questionnaire on Health Problems.
UNASSIGNED: At any given time, 40% (95% CI, 37%-43%) of players reported symptoms from an injury or illness, and 20% (95% CI, 19%-22%) experienced health problems with a substantial negative impact on training and performance. Acute injuries represented the greatest incidence, prevalence, and burden (defined as the cross-product of severity and incidence). The most burdensome acute injuries were to the head/face, shoulder/clavicle, knee, and ankle. The most burdensome overuse injuries were to the knee, lumbar spine, and hip/groin.
UNASSIGNED: This registration captured a greater burden from overuse injuries than traditional injury registration, but acute injuries did represent a major problem. These data provide guidance in the development of prevention programs for both acute and overuse injuries, which should focus on the lumbar spine, hip/groin, and knee.

The purpose of this pilot study was to examine the quadratic nature of the relationship between the strength and throwing distance in the shot put. A survey was sent to throws coaches with Master Coach or USA Track and Field Level III distinction to examine fifty-three collegiate and elite throwers (24 male, 29 female). The coaches reported the thrower\'s personal best shot put distance and preseason weight room 1RM for bench press, power clean, and squat exercises. Relationship between distance and 1RM was determined via general linear model polynomial contrast analysis and regression. Data analysis showed significant linear and quadratic trends for distance and 1RM power clean for both male (linear: p≤0.001, quadratic: p≤0.003) and female (linear: p≤0.001, quadratic: p=0.001) elite and collegiate shot put athletes. Analysis also provided a quadratic equation to compare personal best distance and 1RM power clean. The power clean was found to be more closely related to shot put distance as compared with squat and also with bench press, which is the least related. Based on the results of this investigation, in addition to strength exercises such as the squat and bench press, power exercises such as the power clean should also be incorporated into strength and conditioning programs of shot put athletes for optimal performance.