Brage NIH (Norwegian School of Sport Sciences)
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What happens to the “social” in psychosocial?: Exploring epistemic practices and therapeutic culture in teacher education
Full text linkThis paper examines the role of the psychosocial as an influential epistemic category in the context of a globalised therapeutic culture. Drawing on empirical data from fieldwork conducted at a teacher education institution in Norway, we conceptualise the psychosocial as epistemic practice and analyse three interrelated social levels: the individual level, concerned with teachers’ performance as social caretakers; the community level, characterised by a diagnosing gaze on individual pupils; and the societal level, understood as structural threats to well-being. Our study suggests that these epistemic practices favour psychological diagnosis and individual protection over shared knowledge and broader social awareness.publishedVersio
Clinical and Imaging Outcomes Over 12 Weeks in Elite Athletes With Early-Stage Tendinopathy
Full text linkKnowledge of how to treat chronic tendinopathy has advanced in recent years, but the treatment of early tendinopathy is not wellunderstood. The main purpose of this prospective observational study was to investigate if changes occur in clinical and imagingoutcomes over 12 weeks in elite athletes with recent debut of tendinopathy. Sixty-five elite adult athletes (24 ± 5 years) with earlyAchilles or patellar tendinopathy (symptoms < 3 months) were examined at baseline and after 12 weeks. Patients were divided intogroups based on the duration of symptoms at the time of inclusion: (T1): 0–1 month, (T2): 1–2 months, or (T3): 2–3 months. Pain-guided activity modification was the only intervention. We assessed the following clinical outcomes: Questionnaires (VictorianInstitute of Sports Assessment (VISA)) and pain scores (0–10 numeric rating scale, NRS), structural outcomes from ultrasonog-raphy: Thickness, echogenicity, and Doppler flow, and from magnetic resonance imaging: Cross-sectional area (CSA), thicknessand length. Tendinopathic Achilles and patellar tendons displayed no significant differences on imaging tendon structural out-comes between T1 (n = 19), T2 (n = 23), and T3 (n = 20) at baseline or after 12 weeks, with one exception: Patellar tendons in T1were thicker than T2 and T3 at baseline. Although athletes improved clinically on VISA and most NRS scores after 12 weeks,affected tendons with greater thickness, CSA and Doppler flow than contralateral tendons at baseline remained unchanged after12 weeks. In conclusion, these data suggest that early tendinopathy in elite athletes can improve clinically after 12 weeks whilemorphology remains unchanged.publishedVersio
The relationship between muscle thickness and pennation angle is mediated by fascicle length in the muscles of the lower extremities
Full text linkMuscle morphological architecture, a crucial determinant of muscle function, has fascinated researchers since the Renaissance. Imaging techniques enable the assessment of parameters such as muscle thickness (MT), pennation angle (PA), and fascicle length (FL), which may vary with growth, sex, and physical activity. Despite known interrelationships, robust mathematical models like causal mediation analysis have not been extensively applied to large population samples. We recruited 109 males and females, measuring knee flexor and extensor, and plantar flexor MT, PA, and FL using real-time ultrasound imaging at rest. A mixed-effects model explored sex, leg (dominant vs. non-dominant), and muscle region differences. Males exhibited greater MT in all muscles (0.1 to 2.1 cm, p ＜ 0.01), with no sex differences in FL. Dominant legs showed greater rectus femoris (RF) MT (0.1 cm, p = 0.01) and PA (1.5°, p = 0.01), while vastus lateralis (VL) had greater FL (1.2 cm, p ＜ 0.001) and PA (0.6°, p = 0.02). Regional differences were observed in VL, RF, and biceps femoris long head (BFlh). Causal mediation analyses highlighted MT’s influence on PA, mediated by FL. Moderated mediation occurred in BFlh, with FL differences. Gastrocnemius medialis and lateralis exhibited FL-mediated MT and PA relationships. This study unveils the intricate interplay of MT, FL, and PA in muscle architecture.publishedVersio
Do women with urinary incontinence and pelvic organ prolapse receive optimal first-line treatment?
Full text linkIntroduction and Hypothesis: There is scant knowledge on previous pelvic floor muscle training (PFMT) in women with urinary incontinence (UI) and pelvic organ prolapse (POP) referred to hospitals. We hypothesized that women with predominately UI and POP had not received optimal primary care conservative management.
Methods: This was a descriptive, cross-sectional survey among women attending a gynecological outpatient’s clinic. The questionnaire included questions about demographics, PFMT dosage, whether ability to contract had been assessed and whether the patients had used precontraction before increase in intra-abdominal pressure (“the knack”).
Results: One hundred two women, mean age 52.5 (SD 13.4) years, responded; 37.3% had never been treated previously. There was no statistically significant difference in age, BMI, level of education, parity, time since last birth, SUI, or POP between the women who had been treated conservatively or not before the hospital visit. Thirty-three percent had trained with a physiotherapist and > 35% reported that their ability to contract had not been assessed or were unsure whether it had been assessed; 37% were not able to stop their urine stream; 52% reported that they performed “the knack,” with 15.7% reporting it to be effective. Reasons for not having trained the PFM before visiting the hospital included not being motivated, not knowing how to do PFMT, not being told/advised to do PFMT and not believing PFMT would help.
Conclusion: The results of this study indicated that there is a need for improvement within first-line health care service for women with predominately UI and POP.publishedVersio
Measured and predicted resting metabolic rate of Dutch and Norwegian Paralympic athletes
Full text linkObjective: The aim of this study was to determine RMR and its predictors in a diverse cohort of Paralympic athletes and evaluate the agreement between measured and predicted RMR from both newly developed and pre-existing equations.
Design: This cross-sectional study, conducted between September 2020 and September 2022 in the Netherlands and Norway, assessed RMR in Paralympic athletes by means of ventilated hood indirect calorimetry and body composition by means of dual-energy x-ray absorptiometry.
Participants: Sixty-seven Paralympic athletes (male: n = 37; female: n = 30) competing in various sports, with a spinal cord disorder (n = 22), neurologic condition (n = 8), limb deficiency (n = 18), visual or hearing impairment (n = 7), or other disability (n = 12) participated.
Main outcome measures: RMR, fat-free mass (FFM), body mass, and triiodothyronine (T3) concentrations were assessed.
Statistical analyses: Multiple regression analyses were conducted with height, FFM, body mass, sex, T3 concentration, and disabilities as potential predictors of RMR. Differences between measured and predicted RMRs were analyzed for individual accuracy, root mean square error, and intraclass correlation.
Results: Mean ± SD RMR was 1386 ± 258 kcal/d for females and 1686 ± 302 kcal/d for males. Regression analysis identified FFM, T3 concentrations, and the presence of a spinal cord disorder, as the main predictors of RMR (adjusted R2 = 0.71; F = 50.3; P ＜ .001). The novel prediction equations based on these data, as well as pre-existing equations of Chun and colleagues and Nightingale and Gorgey performed well on accuracy (＞60% of participants within 10% of measured RMR), had good reliability (intraclass correlation ＞0.78), and low root mean square error (≤141 kcal).
Conclusions: FFM, total T3 concentrations, and presence of spinal cord disorder are the main predictors of RMR in Paralympic athletes. Both the current study’s prediction equations and those from Chun and colleagues and Nightingale and Gorgey align well with measured RMR, offering accurate prediction equations for the RMR of Paralympic athletes.publishedVersio
Altered trunk-pelvis kinematics during load carriage with a compliant versus a rigid system
Full text linkLoad carriage is a key component of hiking and military activity. The design of the load carriage system (LCS) could influence performance and injury risk. This study aimed to compare a traditional and a compliant LCS during walking and a step-up task to quantify differences in oxygen consumption and trunk-pelvis kinematics. Fourteen participants completed the tasks whilst carrying 16 kg in a rigid and a compliant LCS. There were no differences in oxygen consumption between conditions during either task (p > 0.05). There was significantly greater trunk-pelvis axial rotation (p = 0.041) and lateral flexion (p = 0.001) range of motion when carrying the compliant LCS during walking, and significantly greater trunk-pelvis lateral flexion range of motion during the step-up task (p = 0.003). Carrying 16 kg in a compliant load carriage system results in greater lateral flexion range of motion than a traditional, rigid system, without influencing oxygen uptake.publishedVersio
National, regional, and global trends in insufficient physical activity among adults from 2000 to 2022: A pooled analysis of 507 population-based surveys with 5.7 million participants
Full text linkBackground: Insufficient physical activity increases the risk of non-communicable diseases, poor physical and cognitive function, weight gain, and mental ill-health. Global prevalence of adult insufficient physical activity was last published for 2016, with limited trend data. We aimed to estimate the prevalence of insufficient physical activity for 197 countries and territories, from 2000 to 2022.
Methods: We collated physical activity reported by adults (aged ≥18 years) in population-based surveys. Insufficient physical activity was defined as not doing 150 minutes of moderate-intensity activity, 75 minutes of vigorous-intensity activity, or an equivalent combination per week. We used a Bayesian hierarchical model to compute estimates of insufficient physical activity by country or territory, year, age, and sex. We assessed whether countries or territories, regions, and the world would meet the global target of a 15% relative reduction of the prevalence of insufficient physical activity by 2030 if 2010–22 trends continue.
Findings: We included 507 surveys across 163 countries and territories. The global age-standardised prevalence of insufficient physical activity was 31·3% (95% uncertainty interval 28·6–34·0) in 2022, an increase from 23·4% (21·1–26·0) in 2000 and 26·4% (24·8–27·9) in 2010. Prevalence was increasing in 103 (52%) of 197 countries and territories and six (67%) of nine regions, and was declining in the remainder. Prevalence was 5 percentage points higher among female (33·8% [29·9–37·7]) than male (28·7% [25·0–32·6]) individuals. Insufficient physical activity increased in people aged 60 years and older in all regions and both sexes, but age patterns differed for those younger than 60 years. If 2010–22 trends continue, the global target of a 15% relative reduction between 2010 and 2030 will not be met (posterior probability <0·01); however, two regions, Oceania and sub-Saharan Africa, were on track with considerable uncertainty (posterior probabilities 0·70–0·74).
Interpretation: Concerted multi-sectoral efforts to reduce insufficient physical activity levels are needed to meet the 2030 target. Physical activity promotion should not exacerbate sex, age, or geographical inequalities.publishedVersio
Associations of occupational and leisure-time physical activity with all-cause mortality: An individual participant data meta-analysis
Full text linkObjective: Health effects of different physical activity domains (ie, during leisure time, work and transport) are generally considered positive. Using Active Worker consortium data, we assessed independent associations of occupational and leisure-time physical activity (OPA and LTPA) with all-cause mortality.
Design: Two-stage individual participant data meta-analysis.
Data source: Published and unpublished cohort study data.
Eligibility criteria: Working participants aged 18–65 years.
Methods: After data harmonisation, we assessed associations of OPA and LTPA with all-cause mortality. In stage 1, we analysed data from each study separately using Cox survival regression, and in stage 2, we pooled individual study findings with random-effects modelling.
Results: In 22 studies with up to 590 497 participants from 11 countries, during a mean follow-up of 23.1 (SD: 6.8) years, 99 743 (16%) participants died. Adjusted for LTPA, body mass index, age, smoking and education level, summary (ie, stage 2) hazard ration (HRs) and 95% confidence interval (95% CI) for low, moderate and high OPA among men (n=2 96 134) were 1.01 (0.99 to 1.03), 1.05 (1.01 to 1.10) and 1.12 (1.03 to 1.23), respectively. For women (n=2 94 364), HRs (95% CI) were 0.98 (0.92 to 1.04), 0.96 (0.92 to 1.00) and 0.97 (0.86 to 1.10), respectively. In contrast, higher levels of LTPA were inversely associated with mortality for both genders. For example, for women HR for low, moderate and high compared with sedentary LTPA were 0.85 (0.81 to 0.89), 0.78 (0.74 to 0.81) and 0.75 (0.65 to 0.88), respectively. Effects were attenuated when adjusting for income (although data on income were available from only 9 and 6 studies, for men and women, respectively).
Conclusion: Our findings indicate that OPA may not result in the same beneficial health effects as LTPA.publishedVersio
IOC consensus statement on elite youth athletes competing at the Olympic Games: essentials to a healthy, safe and sustainable paradigm
Full text linkI Brage finner du siste tekst-versjon av artikkelen, og den kan inneholde ubetydelige forskjeller fra forlagets pdf-versjon. Forlagets pdf-versjon finner du på bjsm.bmj.com / In Brage you'll find the final text version of the article, and it may contain insignificant differences from the journal's pdf version. The definitive version is available at bjsm.bmj.com.With the pronounced ongoing growth of global youth sports, opportunities for and participation of youth athletes on the world sports stage, including the Olympic Games, are expected to escalate. Yet, adolescence is a vulnerable period of development and inherently dynamic, with non-linear and asynchronous progression of physical, physiological, psychological and social attributes. These non-concurrent changes within and between individuals are accompanied by irregular and unpredictable threats and impediments. Likewise, the evident age-based criteria and conventional path for those youth athletes deemed eligible candidates for the Olympic Games are not well or consistently defined. Furthermore, the unstructured and largely varying policies and practices across the sporting International Federations specific to youth participation underscore the need to establish a contemporary universal paradigm that would enable elite youth athletes to navigate an individualised healthy pathway to personal, athletic and sport success. First, we reviewed and summarised key challenges facing elite youth athletes and the relevant evidence fundamental to facilitating and supporting central aspects of health and well-being, while empowering safe, sustainable and positive engagement during athletic and personal advancement and competition. Second, we developed and present a modern elite youth athlete model that emphasises a child-centred, practical framework with corresponding guidelines and recommendations to protect health and well-being while safely and favourably managing international sport competition. Our proposed evidence-informed paradigm will enable and support individualised pathways for healthy, well-rounded and sustainable positive engagement while achieving sport success for youth contending or aiming to compete at world-class international sporting events.acceptedVersionInstitutt for idrettsmedisinske fag / Department of Sports Medicin
Sport humanism: Contours of a humanist theory of sport
Full text linkThe world of sports today is grappling with dehumanizing tendencies. New technologies are changing sport as we know it, altering the experience of being an athlete in radical ways. These tendencies call for new approaches to sport that consider the human elements of sport. To this end, and as a response to transhumanist and posthumanist arguments, I propose and draw the contours of a humanist theory of sport. I argue that it complements prevailing theories of sport like formalism, broad internalism (or interpretivism), and conventionalism and is better equipped to tackle the pressing concerns of dehumanization in sports. It is rooted in a humanism of embodiment and underscores our corporeal embeddedness in a natural and social world. Taking this into the context of sport, I argue that sport humanism can inform an understanding of sport as a human engagement that involves embodiment, ambiguity, and repetition. On this basis, I outline an ethics of embodiment that can throw new light on moral questions and actions concerning dignity, freedom, and ecology to direct sport toward more sustainable and humane forms of practice.publishedVersio