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Introduction Sports events attract large crowds, necessitating the provision of medical services. Medical issues at these events can include acute injuries, such as falls or incidents related to the sport being played, as well as the worsening of pre-existing health conditions. Study objective The aim of this descriptive study is to report on the extent and type of spectator medicine services needed during major sporting events in ice hockey and what factors affected the use of these services. Methods Data was collected from two top-level men’s world championship tournaments in Finland consisting of 98 games with a total of over 630,000 spectators. Trained nurses working in pairs reported the type, treatment and time of day of spectator medicine services provided at the tournaments, as well as the number of patients requiring treatment outside the arena. Results The average number of health care contacts per game was 3.9. The number of health care contacts increased in concordance with audience size, but when adjusted for audience size there were fewer contacts in host team Finland’s games (0.55, 95% CI 0.3–0.9). 30% of the contacts were due to skin conditions, followed by musculoskeletal conditions and headaches. A total of 25 patients required treatment outside the arena, with 9 requiring an ambulance transfer. Conclusion The preparatory measures and the number of medical staff present were at times abundant, but nevertheless sufficient for the needs of the spectators. This resulted in only a small minority of patients needing to be transferred for further treatment outside the arena. For future events, we recommend there is at least one nurse for every 1000 expected spectators. Additionally, nurses should work in pairs to be able to effectively initiate treatment for severe medical conditions. Clinical trial number Not applicable.

BackgroundAdherence may affect the effectiveness of injury prevention programmes (IPPs), yet no previous meta-analyses have examined the pooled impact of adherence to exercise-based IPPs across multiple injury types. The objective of the systematic review and meta-analysis was to investigate the effect of exercise-based IPP adherence on the risk of sports injuries.MethodsSix databases (PubMed, EMBASE, SPORTDiscus, PEDro, Cochrane Central Register of Controlled Trials and Web of Science) were searched from inception to the end of May 2023. Randomised, quasi-randomised controlled trials and cluster-randomised controlled trials investigating exercise-based sports injury prevention interventions and providing data on adherence were included in the systematic review. Studies included in the meta-analysis were divided into top (≥84%), middle (74%–83%) and bottom (<74%) adherence tertiles according to the percentage of completed intervention sessions with equal distribution in each tertile. Of 2647 identified reports, 52 studies were included in the systematic review and 35 of these were included in the meta-analysis.ResultsThe top-adherence group had a 47% lower injury rate than the control group (rate ratio (RR)=0.53, 95% CI 0.42 to 0.67, p<0.001). In the middle and bottom-adherence groups, injury rates were RR=0.50 (95% CI 0.39 to 0.64, p<0.001) and RR=0.87 (95% CI 0.75 to 1.02, p=0.08), respectively. Meta-regression analysis confirmed the results of the primary meta-analysis showing that adherence level significantly moderates the sports injury rate (β=−0.013, p<0.001).ConclusionsHigher adherence to IPPs resulted in reduced injury rates. When the adherence level was lower, the rate of injuries was not significantly reduced.PROSPERO registration numberCRD42023429370.

Background The decline in physical activity (PA) during adolescence is well-established. However, while some subgroups of adolescents follow the general pattern of decreased activity, others increase or maintain high or low activity. The correlates and determinants of different PA patterns may vary, offering valuable information for targeted health promotion. This study aimed to examine how psychosocial factors, health behaviours, and PA domains are associated with longitudinal PA patterns from adolescence to young adulthood. Methods This prospective study encompassed 254 participants measured at mean ages 15 and 19. Device-measured moderate-to-vigorous PA was grouped into five patterns ( activity maintainers, inactivity maintainers, decreasers from moderate to low PA, decreasers from high to moderate PA, increasers ) via a data-driven method, K-Means for longitudinal data. Multinomial logistic regression was used to analyse the associations between health behaviours, psychosocial factors, PA domains, and different PA patterns. Results A lack of sports club participation characterised inactivity maintainers throughout adolescence. Difficulties in communicating with one’s father at age 15 were associated with higher odds of belonging to inactivity maintainers and to decreasers from moderate to low PA . Lower fruit and vegetable consumption at age 19 was also related to increased odds of belonging to the groups of inactivity maintainers and decreasers from moderate to low PA. S moking at age 19 was associated with being a decreaser from moderate to low PA. Conclusions Diverse factors characterise longitudinal PA patterns over the transition to young adulthood. Sports club participation contributes to maintained PA. Moreover, a father-adolescent relationship that supports open communication may be one determinant for sustained PA during adolescence. A healthier diet and non-smoking as a young adult are associated with more favourable PA development.

Much information is available on electrocardiogram (ECG) and blood pressure (BP) changes in senior athletes. However, corresponding data on adolescent athletes are scarce. To study the differences in resting ECG and BP values among adolescent endurance athletes, nonendurance athletes, and nonathletes. Cross-sectional study. A total of 154 youth sports clubs in Finland and 100 secondary schools for comparison data. We recruited young athletes (n = 410) aged 14 to 16 years in 10 popular sport disciplines, including winter and summer as well as team and individual sports, and categorized them as endurance or nonendurance sports. Comparison data for age-matched, non-sports club participants (n = 164) were collected via secondary schools. Resting ECG, including heart rate, PR interval, QRS duration, QRS axis, QRS amplitude, T axis, and QT interval as well as systolic and diastolic BPs. No differences in any ECG variable of interest were found between the endurance and nonendurance athletes. The PR interval was longer in endurance athletes than in nonathletes (P = .05). The QRS amplitude (P = .03) was higher among nonendurance athletes than among nonathletes. Diastolic BP was lower among endurance (P = .002) and nonendurance (P = .02) athletes than among nonathletes. Endurance athletes (odds ratio [OR] = 2.85; 95% CI = 1.81, 4.50) and nonendurance athletes (OR = 2.19; 95% CI = 1.43, 3.35) were more likely to have sinus bradycardia than were nonathletes. Nonendurance athletes were more likely to have elevated systolic BP than were endurance athletes (OR = 1.70; 95% CI = 1.07, 2.72) and nonathletes (OR = 1.73; 95% CI = 1.04, 2.87). Young athletes had similar ECG and BP findings independent of their sports. Physiological adaptations including sinus bradycardia, higher QRS amplitude, and lower diastolic BP, which are commonly seen in adult athletes, were also present in adolescent athletes.

Background Although sports clubs’ potential for health promotion is acknowledged, research on whether they promote healthy eating is limited. We aimed to evaluate Finnish youth sports clubs’ health promotion orientation, as well as associations between sports clubs’ health promotion orientation, coaches’ nutritional discussions and sports club participants’ (SPs’) fruit and/or vegetable consumption. Methods The cross-sectional study included 554 SPs aged 14–16 years, 275 club officials and 311 coaches. Participants replied to questionnaires about sports clubs’ health promotion and their own health behaviours, including dietary habits. Health promotion orientation was estimated using a Health Promoting Sports Club (HPSC) index (range 0–22) and nutritional discussions and fruit and/or vegetable consumption as frequencies. A mixed-effects multivariable logistic regression was used to analyse the associations. Results Most sports clubs (69%) had a high health promotion orientation, but the variation between the clubs was wide (HPSC index range 5–21). SPs’ daily fruit and/or vegetable consumption was associated with female gender [odds ratio (OR) 3.48, 95% confidence interval (CI) 2.23–5.42, P < 0.001], better self-rated health (OR 3.26, 95% CI 1.13–9.41, P = 0.03), higher average school grades (OR 1.67, 95% CI 1.04–2.67, P = 0.03), and SPs’ responses that their coach had often discussed nutrition (OR 2.11, 95% CI 1.41–3.14, P < 0.001). Conclusion Although sports clubs’ orientation towards health promotion was mostly high, it seems not to be enough to promote healthy eating among adolescent participants. Instead, coaches’ nutritional discussions were associated with adolescents’ fruit and/or vegetable consumption.

ObjectivesTo compare laboratory test results and lung function of adolescent organised sports participants (SP) with non-participants (NP).MethodsIn this cross-sectional study, laboratory tests (haemoglobin, iron status), and flow-volume spirometry were performed on SP youths (199 boys, 203 girls) and their NP peers (62 boys, 114 girls) aged 14–17.ResultsHaemoglobin concentration <120/130 g/L was found in 5.8% of SP and 5.1% NP (OR 1.20, 95% CI 0.54 to 2.68). Ferritin concentration below 15 µg/L was found in 22.7% of both SP and NP girls. Among boys ferritin <30 µg/L was found in 26.5% of SP and 30.2% of NP (OR 0.76, 95% CI 0.40 to 1.47). Among SP iron supplement use was reported by 3.5% of girls and 1.5% of boys. In flow-volume spirometry with bronchodilation test, 7.0% of SP and 6.4% of NP had asthma-like findings (OR 1.17, 95% CI 0.54 to 2.54); those using asthma medication, that is, 9.8% of SP and 5.2% of NP were excluded from the analysis.ConclusionsScreening for iron deficiency is recommended for symptomatic persons and persons engaging in sports. Lung function testing is recommended for symptomatic persons and persons participating in sports in which asthma is more prevalent.

ObjectivesTo determine the inter-rater repeatability of a musculoskeletal examination and to compare findings between adolescent athletes and non-athletes in Finland.MethodsIn this cross-sectional study, a musculoskeletal examination assessing posture, mobility and movement control was carried out by a sports and exercise medicine physician on 399 athletes aged 14–17 years and 177 non-athletes. Within 2 weeks another sports and exercise medicine physician repeated the examination for 41 adolescents to test the inter-rater repeatability.ResultsIn total, 10 of the 11 tests performed had at least moderate inter-rater reliability (κ ≥0.4 or percentage agreement >80%). Athletes more often than non-athletes had one shoulder protruded (8.0% vs 4.0%, OR 2.81, 95% CI 1.16 to 6.81). Forty-six per cent of athletes had good knee control in the two-legged vertical drop jump test compared with 32% of non-athletes (OR 1.99, 95% CI 1.29 to 3.06). Athletes had better core muscle control with 86.3% being able to remain in the correct plank position for 30 s compared with 68.6% of non-athletes (OR 2.70, 95% CI 1.67 to 4.36). In the deep squat test, good lumbar spine control was maintained only by 35.8% of athletes and 38.4% of non-athletes.ConclusionA basic musculoskeletal examination is sufficiently reliable to be performed by trained physicians as a part of a periodic health evaluation. Shortfalls in mobility, posture and movement control are common in both athletes and non-athletes. These deficits could have been caused by sedentary behaviour, monotonous training, or both.

Evaluation of renal function should be performed as part of the follow-up during and after chemotherapy in pediatric cancer patients. The aim of this study was to compare an isotope clearance method [isotope glomerular filtration rate (iGFR)] with alternative methods to determine GFR in such patients. Isotope GFR [ 99m Tc-labeled diethylene triaminopentoacetic acid (DTPA) or 51 Cr-labeled ethylenediaminetetra-acetate (EDTA)] was measured in 36 children (112 studies) and compared with simultaneously measured creatinine clearance (CrCl), serum creatinine (SCr), and cystatin C (CysC) concentrations, as well as the results of Schwartz, Counahan–Barratt, and Cockroft–Gault formulae, using general linear mixed models. Our results showed a significant association between iGFR and CysC concentrations ( p  < 0.001). No linear relationship was observed between CrCl and iGFR ( p  = 0.7). As expected, the results of height-based formulae (Counahan–Barratt and Schwartz) had significantly ( p  = 0.004) better correlation to iGFR than the results of a formula based on weight (Cockroft–Gault) ( p  = 0.19). Despite significant linear correlation, intraclass correlation coefficients showed poor agreement. Tests of similarity between iGFR estimates showed differences between average values of GFR. Therefore, determination of iGFR remains the method of choice in estimation of GFR in cancer patients. In our study population, assay of serum CysC was the most reliable alternative method to measure glomerular function.