ObjectivesTo explore how participation in physical exercise (PE) changes over time after an anterior cruciate ligament (ACL) injury. Additionally, to identify factors associated with participation in PE by analyzing longitudinal data. DesignAn explorative analysis of the NACOX study, a prospective multicenter cohort study. MethodsPatients with an acute ACL injury aged 15-40 years were followed for three years. The patients regularly reported participation in PE, knee function, new injuries, and surgeries. State sequence analysis and Hierarchical Cluster Analysis were used to analyze participation in PE. Clusters were compared using an analysis of variances, the Chi-square test, and Fischer’s exact test. ResultsThe study included 275 patients, 52% female, with a mean age of 25 years. Four clusters were identified, varying from low to high participation in PE after an ACL injury. Clusters differed regarding the number of ACL reconstructions (ACLR) (p = 0.03); time from injury to ACLR (p = 0.03); patient-reported knee function at the follow-ups at 3-months (p = 0.02), 6-months (p = 0.02), and 12-months (p = 0.02) after injury; PE level before injury (p < 0.001); and number of new injuries and surgeries (other than ACLR) (p = 0.001). ConclusionFour clusters, varying from low to high participation in PE after an ACL injury were identified. The results provide valuable insight into factors associated with different levels of participation in PE, which can be helpful for healthcare personnel working with ACL rehabilitation.

ObjectivesVestibular rehabilitation is a recommended treatment after sport related concussion (SRC), but the optimal timing is not fully understood. This research examined the association between the timing of vestibular rehabilitation initiation and recovery time in adolescent patients with SRC. DesignRetrospective cross-sectional. Methods112 patients with SRC were referred to vestibular rehabilitation at a specialty concussion clinic. Vestibular rehabilitation initiation was defined as days from date of injury to date of first vestibular rehabilitation assessment. Patients were dichotomized by vestibular rehabilitation initiation: EARLY (8–10 days) and LATE (>10 days). Recovery time was defined as days between injury and medical clearance from the clinic. Results60 (average age 15.22 ± 1.61 years; 51.7 % male) patients were in the EARLY group and 52 (average age 15.37 ± 1.31 years, 28.9 % male) patients were in the LATE group. There were more female patients in the LATE group (p = 0.01) and the LATE group had their first clinic visit later than the EARLY group (p < 0.02). The EARLY group had shorter recovery time (median 26, IQR [21, 32.5] days) compared to the LATE group (median 31, IQR [23.5, 52.5] days; p = 0.02). After controlling for confounding variables, the LATE group had recovery times that were 1.39 times as long as the EARLY group (p < 0.01). ConclusionsFor patients with vestibular issues after SRC, early vestibular rehabilitation initiation is associated with faster recovery time after SRC. The current study provides clarity on the optimal timing of vestibular rehabilitation after SRC.

ObjectiveThis study aimed to investigate the impact of acute acetaminophen (ACT) ingestion on the responses of neuromuscular function, biomarkers of muscle damage, and physical performance during the 72-h recovery period following simulated soccer match-play. DesignThe study followed a crossover randomized, double-blind, placebo-controlled trial design. MethodsDuring the two experimental sessions, thirteen semi-professional male soccer players completed a 90-min simulated soccer match, 60 min after oral ingestion of 1 g ACT or placebo (PL). Maximal voluntary contraction (MVC) and twitch responses of the knee extensors muscles, elicited through electrical femoral nerve stimulation, were utilized to evaluate both peripheral fatigue (potentiated twitch force, Qtw,pot) and central fatigue (voluntary activation, VA). Performance was assessed through countermovement jump (CMJ) and 20 m sprint tests. Creatine kinase (CK) and lactate dehydrogenase (LDH) were also measured. ResultsSmaller reductions were observed in MVC (−13.3 ± 7.5 % vs. -24.7 ± 11.1 %) and VA (−3.8 ± 4.4 % vs. -12.9 ± 5.4 %) in the ACT compared to the PL condition immediately after simulated soccer match-play (p < 0.05). Afterwards, these parameters were recovered 24 h earlier in the ACT session compared to the PL session. Furthermore, the 20 m sprint performance was significantly better throughout the recovery period in the ACT session compared to the PL session. ConclusionThe findings of this study showed that acute ingestion of 1 g of ACT (1 h before exercise) attenuated the decrease in MVC and VA levels after exercise, as well as improved 20 m sprint performance.

Long-term memory is important for cognitive health across the lifespan. Previously research has indicated that a bout of exercise improves memory retention for approximately one week; however, its prolonged effects are unknown. This study investigated the effects of acute moderate-intensity exercise on long-term memory for 11 months. Participants engaged in the exercise intervention and seated rest control condition, followed by a word encoding memory task. Word retention in the exercise intervention was better than in the control condition at 6- and 8-weeks post-encoding. These findings suggest that exercise before encoding enhances long-term episodic memory recall for at least eight weeks.

To quantify and compare survival and longevity in three populations of male Australian elite athletes, relative to sex- and age-matched referents from the general population. Retrospective cohort study. This study comprised a census of three populations of male Australian elite athletes (i.e. N = 10,502 Australian Football League players, N = 803 national team rugby union players, and N = 1527 Olympic athletes) who debuted from 1-JAN-1921 to 31-DEC-2023. Nonparametric relative survival analysis was conducted using the Kaplan-Meier estimator to generate survival curves, the Pohar Perme method and a log-rank type test to estimate and compare net survival, and the life years difference measure to estimate longevity gains or losses. Olympic athletes had a continuous gain in net survival post-debut, with an average life years difference of 3.40 (95 % confidence interval 2.30 to 4.49) years at the maximum follow-up time. Australian football and rugby union players initially had modest gains in net survival post-debut, followed by a gradual decline in net survival, with average life years differences of 0.31 (95 % confidence interval -0.03 to 0.65) and -0.67 (95 % confidence interval -1.87 to 0.53) years at the maximum follow-up time, respectively. Net survival was significantly different across the three cohorts (test statistic 21.8; degrees of freedom = 2; p < 0.001). Expected survival benefits were offset in elite male Australian football and rugby union players. Further research examining cause-specific mortality is warranted to elucidate the underlying reasons for the observed lack of expected survival benefit in Australian football and rugby union players.