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[This corrects the article DOI: 10.1371/journal.pone.0309232.].

Tennis is a globally popular sport known for its numerous health benefits. However, it also underscores the physical demands and potential injuries associated with high-performance play. This review emphasizes the role of kinetic chains in executing powerful movements and discusses common injuries, particularly in the upper limbs due to the sport's overhead nature. It highlights the importance of effective rehabilitation methods for swift recovery and long-term performance enhancement in high-performance tennis players. The review aims to investigate the relationship between age, sex, and injury prevalence among high-performance tennis players to inform injury prevention strategies. This review protocol will provide a description on effective rehabilitation methods to tennis players, aiding coaches, physiotherapists and physicians. Methodologically, this systematic review will develop following the PRISMA guidelines, focusing on articles published between 2011 and 2024, with eligibility criteria specified. Data collection involved screening titles and abstracts, removing duplicates, and assessing full texts for eligibility. Data extraction will include information on authors, publication year, evidence level, participant demographics, injuries, treatments, etc. The GRADE framework will be used for evidence quality assessment, and NIH criteria were applied for study quality assessment. Prospero registration number: CRD42023453182.

Background: High-performance tennis exposes players to repetitive high-load strokes and abrupt directional changes, which substantially increase musculoskeletal injury risk. This systematic review synthesized evidence on epidemiology, risk factors, and physiotherapy-led preventive strategies in elite adolescent and adult players. Methods: Following a PROSPERO-registered protocol, MEDLINE, Web of Science, and Scopus were searched (2011–2024) for observational studies reporting epidemiological outcomes in high-performance tennis. Methodological quality was appraised with NIH tools, and certainty of evidence was graded with GRADE. Results: Thirty-seven studies met inclusion criteria: 16 in adolescents, 18 in adults, and 3 mixed. Incidence ranged from 2.1 to 3.5 injuries/1000 h in juniors and 1.25 to 56.6/1000 h in adults. Seasonal prevalence was 46–54% in juniors and 30–54% in professionals. Lower-limb trauma (48–56%) predominated, followed by lumbar (12–39%) and shoulder overuse syndromes. Across age groups, abrupt increases in the acute-to-chronic workload ratio (≥1.3 in juniors; ≥1.5 in adults) were the strongest extrinsic predictor of injury. Intrinsic contributors included reduced glenohumeral internal rotation, scapular dyskinesis, and poor core stability. Three prevention clusters emerged: (1) External load control, four-week “ramp-up” strategies reduced injury incidence by up to 21%; (2) Kinetic-chain conditioning, core stability plus eccentric rotator-cuff training decreased overuse by 26% and preserved shoulder mobility; and (3) Technique/equipment adjustments, grip-size personalization halved lateral epicondylalgia, while serve-timing modifications reduced shoulder torque. Conclusions: Injury risk in high-performance tennis is quantifiable and preventable. Progressive load management targeted kinetic-chain conditioning, and tailored technique/equipment modifications represent the most effective evidence-based safeguards for adolescent and adult elite players.

IntroductionTennis is a globally popular sport known for its numerous health benefits. However, it also underscores the physical demands and potential injuries associated with high-performance play. This review emphasizes the role of kinetic chains in executing powerful movements and discusses common injuries, particularly in the upper limbs due to the sport's overhead nature. It highlights the importance of effective rehabilitation methods for swift recovery and long-term performance enhancement in high-performance tennis players.AimsThe review aims to investigate the relationship between age, sex, and injury prevalence among high-performance tennis players to inform injury prevention strategies.MethodologyThis review protocol will provide a description on effective rehabilitation methods to tennis players, aiding coaches, physiotherapists and physicians. Methodologically, this systematic review will develop following the PRISMA guidelines, focusing on articles published between 2011 and 2024, with eligibility criteria specified. Data collection involved screening titles and abstracts, removing duplicates, and assessing full texts for eligibility. Data extraction will include information on authors, publication year, evidence level, participant demographics, injuries, treatments, etc. The GRADE framework will be used for evidence quality assessment, and NIH criteria were applied for study quality assessment.Trial registrationProspero registration number: CRD42023453182.

The dominant SARS-CoV-2 Delta variant (B.1.617.2) became the main circulating variant among countries by mid 2021. Attention was raised to the increased risk of airborne transmission, leading to nosocomial outbreaks even among vaccinated individuals. Considering the increased number of COVID-19 hospital admissions fueled by the spread of the variant, with Spain showing the highest COVID-19 rates in mainland Europe by July 2021, the aim of this study was to assess SARS-CoV-2 environmental contamination in different areas of a University Hospital in the region of Castile-León, Spain, during the peak of the 5th wave of COVID-19 in the country (July 2021). Air samples were collected from sixteen different areas of the Hospital using a Coriolis® μ air sampler. Surface samples were collected in these same areas using sterile flocked plastic swabs. RNA extraction followed by a one-step RT-qPCR were performed for detection of SARS-CoV-2 RNA. Of the 21 air samples, only one was positive for SARS-CoV-2 RNA, from the emergency waiting room. Of the 40 surface samples, 2 were positive for SARS-CoV-2 RNA, both from the microbiology laboratory. These results may be relevant for risk assessment of nosocomial infection within healthcare facilities, thus helping prevent and minimize healthcare staff’s exposure to SARS-CoV-2, reinforcing the importance of always wearing appropriate and well-fit masks at all times and proper PPE when in contact with infected patients.