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To quantify the extent of musculoskeletal injuries in Olympic Athletics (track and field) disciplines by synthesising the current evidence on the prevalence of injured athletes, injury event incidence rates and injury characteristics. Systematic review and meta-analysis. MEDLINE, Web of Science, EMBASE, SPORTDiscus, CINAHL and Cochrane were searched from inception to 28 January 2025. Studies reporting athletics-related musculoskeletal injuries in Olympic Athletics disciplines. From 18 319 identified references, 216 studies were included; 38% of these studies were classified as having low study quality. Data synthesis was performed on 88 studies reporting on all injuries across all Athletics disciplines (21.6% with high study quality). The synthesised prevalence of injured athletes was 11.7% (95% CI 2.0% to 26.9%) for prospective studies only including championship/competition data, and 69.7% (95% CI 52.4% to 84.5%) for prospective studies combining training and competition data. The synthesised injury event incidence rates were 68.8 injuries per 1000 registered athletes (95% CI 39.4 to 120.2) for prospective studies only including championship/competition data, and 4.2 injuries per 1000 athlete-exposures (95% CI 2.1 to 7.7) and 3.8 injuries per 1000 hours of Athletics (95% CI 1.7 to 8.3) for prospective studies combining training and competition data. The Grading of Recommendations, Assessment, Development and Evaluation certainty of evidence was 'very low' for all outcomes, and 'low' for the injury event incidence rate per 1000 registered athletes for prospective studies conducted in championship/competition settings. Injuries were mainly located at the thigh, followed by the lower leg, foot and ankle. The main tissue type affected was the muscle, followed by tendon, ligament, skin, bone and joint. This systematic review with meta-analysis quantified the extent of musculoskeletal injuries in Athletics. Our findings inform future research and healthcare service planning and support targeted injury risk reduction strategies at all levels in Athletics.

To explore sports injury prevention and management strategies, barriers and facilitators, within an elite sport context in Senegal, by giving voice to the stakeholders (including coaches, health professionals, athletes) that are working or competing in the country. The study was conducted as Senegal prepares to host the Youth Olympic Games in 2026. Between February and May 2025, we conducted a qualitative study, with 16 semistructured interviews of athletes (n=5), coaches (n=7) and health professionals (n=4) locally involved in sport at the national level. Interviews were transcribed verbatim and then analysed following the three coding phases of grounded theory: open coding, axial coding and selective coding, before being analysed using ATLAS.ti software. According to these Senegalese elite sports stakeholders, injury prevention is mostly informal and individually led by coaches, often lacking alignment with international standards. Intervention remained reactive rather than proactive and injury management was limited by financial, logistical and cultural constraints. Coaches emerged as central and versatile stakeholders, frequently taking on medical, educational and emotional roles in the absence of structured multidisciplinary systems. Gender-determined practices and mental health stigma further complicated care, especially for women athletes. This study highlights the essential role of coaches in injury prevention and management within sports structures of Senegal, even at the elite level. Our findings underscore the need to strengthen support structures with appropriate tools, education and resources. Developing context-specific and culturally relevant strategies is crucial to improve athlete health and promote injury prevention practices in resource-limited settings.

To explore (1) the risk of injury according to the number of previous injuries, and (2) the risk of progression of the athletes' health status according to the impact on athletics participation (ie, no injury/healthy (H), injury with full athletics participation (IF), injury with partial athletics participation (IP) or injury with no athletics participation (IN)). We performed a secondary analysis of injury data weekly collected using an online self-reported questionnaire from 165 athletics (track-and-field) athletes during 39 weeks. Using Markov chains, we determined the probabilities of (1) sustaining an injury with participation restriction (ICPR=IP+IN) depending on the number of previous ICPR and (2) transitioning from any one injury state to any other (ie, H, IF, IP, IN). Comparisons were made by calculating the ratio and 95% CIs between two probabilities using a bias-corrected accelerated bootstrap method. Compared with the risk of the first ICPR, the risk of a second, third and fourth ICPRs increased on average by 1.9 (1.33 to 2.73), 2.2 (1.43 to 3.56) and 2.42 (1.37 to 4.41) times, respectively. Compared with having no injury (H), experiencing an IF at a given week had a five times higher risk of transitioning to an IP or IN the following week. Subsequent injuries show a higher risk than the first injury. Worse health states at a given week had a higher risk of worsening the following week. Our results highlighted a 'vicious circle' of injuries in athletics.

For competitive adolescent athletes, injury avoidance is a challenge, and causes of injury are complex and multifactorial. Despite an incidence of 8.2 shoulder injuries per 1,000 hours of tennis played, few studies have investigated the association between shoulder strength, range of motion (ROM), and injury. Eccentric and isometric shoulder muscle strength and/or shoulder ROM are associated with new shoulder complaints and/or injuries. Cohort study. Level 3. At baseline 301 adolescent competitive tennis players aged 13 to 19 years completed a questionnaire, were assessed with a shoulder protocol for strength and ROM and followed weekly (for shoulder complaint/injury) for 52 consecutive weeks. Outcomes were a first incidence of a tennis-related shoulder complaint or injury in the dominant arm, defined as a sum score of ≥20 or ≥40, respectively, on the Oslo Overuse Injury Questionnaire. Two cohorts were created for Cox regression analyses, adjusted for age, sex, and playing level: (1) shoulder complaints (n = 204), and (2) shoulder injuries (n = 252). The most definitive adjusted associations were a hazard rate ratio (HRR) of 1.3 (95% CI 1.0-1.8) for a shoulder complaint in eccentric external rotation (eccER) strength, and a HRR for shoulder injuries of 1.4 (95% CI 1.0-1.9) in isometric internal rotation (IIR) strength in the 90-90 position, and 1.5 (95% CI 1.1-2.0) in eccER normalized to body mass. Higher values of eccER shoulder strength, IIR strength at the 90-90 position, and eccER shoulder strength normalized to body mass, were associated with shoulder complaints/injuries in adolescent competitive tennis players. Incorporating a training program that takes volume and intensity into account in the daily oncourt sessions, to build resilience through a well-planned, long-term training and competition plan to minimize shoulder injury risk may be of importance.

To investigate the association between common measures of trunk and lower extremity range of motion (ROM), strength, the results of one-leg jump tests at baseline and the incidence of subsequent substantial knee injuries in adolescent female football players. Players were assessed at baseline regarding (1) ROM of trunk, hip, and ankle; (2) trunk, hip, and knee strength; and (3) one-leg jump tests. Players were prospectively monitored weekly for 1 year regarding knee injuries and the volume of matches and training. Hazard rate ratios (HRRs) and 95% confidence intervals (CIs) were calculated with Cox regression for the association between the baseline tests and the incidence of substantial knee injury (moderate/severe reduction in training volume or performance, or complete inability to participate in football). Exposures were categorized in tertiles (high, medium and low values). The highest tertile was used as reference. 376 players were included without substantial knee injury at baseline (mean age, 13.9 ± 1.1 years), and 71 (19%) reported at least one substantial knee injury during the follow-up. Several associations were found; the strongest was that players in the lowest tertile of knee extension strength had a higher incidence of knee injuries than players in the highest tertile (HRR, 2.28; 95% CI, 1.20-4.38). Players in the lowest tertile of trunk rotation ROM in lunge position half-kneeling (HRR, 0.50; 95% CI, 0.27-0.94) had lower incidence of knee injuries than players in the highest tertile. Poor knee strength and high trunk ROM were associated with an increased incidence of substantial knee injury in adolescent female football players. Therefore, knee-strengthening exercises during season may be recommended. Level II.

The term "risk factor" is commonly used in research. Although many interpret the term to imply that the risk factor causes the outcome, others use the term to mean a marker for the outcome, which may or may not be a cause of the outcome. How the term risk factor is interpreted can importantly influence the way that study findings are applied in real world settings. For example, if a risk factor is wrongly interpreted to be a cause of an outcome when it is merely associated with the outcome because of noncausal reasons, then wasteful interventions may be developed, recommended, and implemented. The primary aims of this article are (1) to describe how varying definitions of the term risk factor can cause misunderstandings and potentially negatively impact the field of sports medicine, and (2) to propose new, more specific, terminology. We first review some basic concepts on how variables can be associated due to either causal or noncausal reasons and then discuss possible explanations for why the term risk factor continues to be misunderstood. We illustrate how using the term risk factor without further specification creates misunderstandings that can lead to the development and implementation of ineffective interventions. Finally, with the hope of improving communication and avoiding ambiguity in sports medicine, we suggest using "causal risk factor" if the evidence supports causality, "noncausal risk factor" if the evidence does not support causality, and "risk marker" for those not wishing to commit to a causal or noncausal claim.

Midwifery knowledge, education and training in practice are challenged in contemporary maternity care by the growing trend towards interventions during childbirth, a dominant risk perspective and medicalised care. There is an ongoing debate about the definition of normal birth, however, midwives continue to advocate for normal birth. To explore midwives' views and definitions of normal birth, and how they work to promote it, in a hospital setting. A qualitative cross-national study was conducted in the Nordic and Baltic regions by student midwives (n = 35) and their university-based supervisors from midwifery education programs, (n = 10). A total of 145 midwives were interviewed individually or in groups. A comprehensive thematic analysis was employed. Midwives' views on normal birth revealed a midwifery identity shaped by the guiding philosophy of the profession. Definitions of normal birth varied among midwives, influenced by their working environment, individual perspectives, and cultural and socio-political backgrounds. Regardless of these differences, midwives emphasized the importance of meeting women's expectations and maintaining a supportive presence during childbirth, fostering effective communication with both women and healthcare colleagues to advocate for physiological birthing processes. Our findings illustrate midwives' dedication to promote healthy, physiological birthing processes, which stands as a core value of their profession. Hindrances exist in the hospital birth setting that impact healthy outcomes. The widespread use of the term normal birth is challenging. This study invites rethinking birth narratives supporting exploration of other terms, such as healthy birth, to better capture the philosophy and practice of midwifery.

To use data from the Global Burden of Disease Study between 1990 and 2017 to report the rates and trends of point prevalence, annual incidence, and years lived with disability for neck pain in the general population of 195 countries. Systematic analysis. Global Burden of Diseases, Injuries, and Risk Factors Study 2017. Numbers and age standardised rates per 100 000 population of neck pain point prevalence, annual incidence, and years lived with disability were compared across regions and countries by age, sex, and sociodemographic index. Estimates were reported with uncertainty intervals. Globally in 2017 the age standardised rates for point prevalence of neck pain per 100 000 population was 3551.1 (95% uncertainty interval 3139.5 to 3977.9), for incidence of neck pain per 100 000 population was 806.6 (713.7 to 912.5), and for years lived with disability from neck pain per 100 000 population was 352.0 (245.6 to 493.3). These estimates did not change significantly between 1990 and 2017. The global point prevalence of neck pain in 2017 was higher in females compared with males, although this was not significant at the 0.05 level. Prevalence increased with age up to 70-74 years and then decreased. Norway (6151.2 (95% uncertainty interval 5382.3 to 6959.8)), Finland (5750.3 (5058.4 to 6518.3)), and Denmark (5316 (4674 to 6030.1)) had the three highest age standardised point prevalence estimates in 2017. The largest increases in age standardised point prevalence estimates from 1990 to 2017 were in the United Kingdom (14.6% (10.6% to 18.8%)), Sweden (10.4% (6.0% to 15.4%)), and Kuwait (2.6% (2.0% to 3.2%)). In general, positive associations, but with fluctuations, were found between age standardised years lived with disability for neck pain and sociodemographic index at the global level and for all Global Burden of Disease regions, suggesting the burden is higher at higher sociodemographic indices. Neck pain is a serious public health problem in the general population, with the highest burden in Norway, Finland, and Denmark. Increasing population awareness about risk factors and preventive strategies for neck pain is warranted to reduce the future burden of this condition.

The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023 estimates health loss from migraine, tension-type headache, and medication-overuse headache. This study presents updated results on headache-attributed burden from 1990 to 2023, along with clinical and public health implications. Data on the prevalence, incidence, or remission of migraine, tension-type headache, and medication-overuse headache were extracted from published population-based studies. We used hierarchical Bayesian meta-regression modelling to estimate global, regional, and country-level prevalence of headache disorders. For the first time in GBD 2023, age-specific and sex-specific estimates of time in symptomatic state were applied by meta-analysing individual participant data from 41 653 individuals from the general populations of 18 countries from all parts of the world. Disability weights were applied to calculate years lived with disability (YLDs). Since medication-overuse headache is a sequela of a mistreated primary headache (due to medication overuse), its burden was reattributed to migraine or tension-type headache, informed by a meta-analysis of three longitudinal studies. In 2023, 2·9 billion individuals (95% uncertainty interval 2·6-3·1) were affected by headache disorders, with a global age-standardised prevalence of 34·6% (31·6-37·5) and a YLD rate of 541·9 (373·4-739·9) per 100 000 population, with 487·5 (323·0-678·8) per 100 000 population attributed to migraine. The prevalence rates of these headache disorders have remained stable over the past three decades. YLD rates due to headache disorders were more than twice as high in females (739·9 [511·2-1011·5] per 100 000) as in males (346·1 [240·4-481·8] per 100 000). Medication-overuse headache contributed 58·9% of the YLD estimates for tension-type headache in males and 56·1% in females, as well as 22·6% of the YLD estimates for migraines in males and 14·1% in females. Headache disorders, in particular migraine, continue to be a major global health challenge, emphasising the need for effective management and prevention strategies. Much headache-attributed burden could be averted or eliminated by avoiding overuse of medication (including over-the-counter medication), underscoring the importance of public education. Gates Foundation.

The primary aim is to assess the impact of a multidomain intervention that integrates education, exercise, psychological techniques and machine learning feedback on the duration athletes remain free from injury complaints leading to participation restriction (ICPR) during a 20-week summer competitive athletics season. The secondary aims are to assess the intervention's effect on reducing (i) the incidence, (ii) the burden, (iii) the period prevalence and (iv) the weekly prevalence of ICPR during the same timeframe. We will perform a two-arm randomised controlled trial. This study will involve an intervention group and a control group of competitive athletes licensed with the French Federation of Athletics, aged between 18 and 45, over an outdoor athletics competitive season lasting 20 weeks (March to July 2025). Data will be collected before the start (demographic, training and injury history) and one time per day (training and competition volume/intensity, perceived physical and psychological state, and illness and injury incidents) for both groups. The intervention group will be required to (i) view a series of 12 educational videos on injury prevention, (ii) engage in discipline-specific exercise programmes, (iii) implement stress and anxiety management techniques and (iv) view daily the injury prognostic feedback generated by the athlete's collected data based on machine learning. Outcomes will be analysed over the final 14 weeks of follow-up to allow time for the intervention to establish any potential efficacy. The primary outcome will be the time-to-event for each ICPR. Secondary outcomes will include (i) incidence, (ii) burden, (iii) period prevalence and (iv) weekly prevalence of ICPR. The primary outcome will be analysed using a Prentice-Williams-Peterson gap-time model. In contrast, the secondary outcomes will employ Poisson (i, ii), logistic (iii) and generalised estimating equations (iv) regression models, respectively.

The objectives of this study were to describe the 1-year trajectories of disabling subacute or persistent neck pain and to investigate whether baseline age, sex, pain characteristics, and depressive symptoms are associated with such trajectories. Participants (n=617) included in a randomized controlled trial provided weekly pain intensity ratings by responding to text messages over 1 year. We used latent class mixed model analyses to identify clusters of individual trajectories. Thereafter, we used logistic regression to determine the association between baseline age, sex, pain characteristics, depressive symptoms and treatment, and trajectories of neck pain. Six different clusters of trajectories were identified. Most participants (73%) followed a trajectory of decreasing pain throughout follow-up. The remaining experienced unfavorable trajectories: persistent pain of high intensity (22%) and slightly (3%) or highly (2%) fluctuating levels of pain reaching high levels of pain intensity. Pain intensity at baseline: odds ratio (OR): 3.76 (95% confidence interval [CI]: 2.49-5.68), depressive symptoms: OR: 3.46 (95% CI: 2.01-5.95), younger age: OR: 2.29 (95% CI: 1.48-3.54), female sex: OR: 1.51 (95% CI: 1.01-2.26), and sudden onset of pain: OR: 1.74 (95% CI: 1.13-2.69) were associated with unfavorable trajectories. Most individuals with disabling subacute or chronic neck pain show improvement in pain intensity over a year. However, a quarter present unfavorable trajectories. High pain intensity at baseline, depressive symptoms, younger age, female sex, and sudden onset of pain are factors associated with unfavorable trajectories.

We aimed to determine whether some events carry a higher risk of injuries than others in combined events (decathlon and heptathlon) during international outdoor Athletics championships. A secondary aim was also to describe injury characteristics according to the different events. We conducted a total population study. During decathlon and heptathlon of 11 international outdoor Athletics championships from 2007 to 2024, in-competition injuries were collected by medical teams and local organizing committees. We performed descriptive analyses and calculated injury incidence rates by events. A total of 66 in-competition injuries and 2901 starts were reported for decathlon, and 67 in-competition injuries and 2063 starts for heptathlon. The proportion of injuries varied across events, with higher proportions in pole vault (19.7%) and high jump (18.2%) for decathlon, and in long jump (23.9%) and 800 m (16.4%) for heptathlon. The injury incidence rates varied across events, with higher rates in pole vault (46.3 (95% CI: 21.7 to 70.8)) and high jump (38.2 (95% CI: 17.0 to 59.4)) for decathlon, and in long jump (54.1 (95% CI: 28.3 to 79.8)) for heptathlon. The distribution of injury characteristics (i.e., location, type, mode of onset, severity) varied according to the events for decathlon and heptathlon. In conclusion, explosive jumping events had a higher risk of injuries than others within combined: pole vault and high jump for decathlon, and long jump for heptathlon. Injury characteristics varied according to the events. Our present study provides information that could help plan medical services during competitions of combined events and prepare athletes to face the injury challenge of combined events.

To analyse the association between the level of use of injury risk estimation feedback (I-REF) provided to athletes and the injury burden during an athletics season. We conducted a prospective cohort study over a 38-week follow-up period on athletes competing at the French Federation of Athletics. Athletes completed daily questionnaires on their athletics activity, psychological state, sleep, self-reported level of I-REF use, and injuries. I-REF provided a daily estimation of the injury risk for the next day, ranging from 0% (no risk of injury) to 100% (maximum risk of injury). The primary outcome was the injury burden during the follow-up, defined as the number of days with injury per 1000 hours of athletics activity. A negative binomial regression model was used to analyse the association between self-reported I-REF use and the injury burden. Of the 897 athletes who met the inclusion criteria, 112 (38% women) were included in the analysis. The mean daily response rate of the follow-up was 37%±30%. The primary analysis found no significant association between the self-reported I-REF use and the injury burden (n=112, e β: 0.992, 95% CI: 0.977 to 1.007; p=0.308). However, when considering athletes' daily response rate in secondary analysis, for a response rate of at least 9%, we observed a significant association between the self-reported level of I-REF use and the injury burden (n=76, e β: 0.981, 95% CI: 0.965 to 0.998; p=0.027). Daily injury risk estimation feedback using machine learning was not associated with reducing injury burden.

Combined events are an Athletics discipline with specific and particular challenges for performance and health, supporting the interest of focused research on this discipline, despite concerning a small proportion of athletes. The study aim was to summarize and map the available scientific literature on performance and health of combined events to establish the current level of understanding and identify knowledge gaps that require further investigation. A scoping review was conducted searching peer-reviewed articles dealing with performance and/or health in combined events (i.e., pentathlon, heptathlon or decathlon) on the MEDLINE (via PubMed), EMBASE (via Ovid), Web of Science, and Google Scholar databases, from inception to October 13, 2025. In total, 111 articles were included, with 95.5% as primary research, 95.5% using quantitative approach, 22.5% with a level of evidence 1b and 48.6% 2b, and 56.8% with study aim(s) focused on combined events understanding and/or analyzing. 64.0% articles dealt with performance and 59.5% with health, including 23.4% dealing with both. Regarding performance, the majority of articles dealt with performance analysis/tactics/data management (56.3%), followed by physiology (21.1%), and nutrition (11.3%). Regarding health, the majority of articles dealt with injuries (62.1%), followed by physiology (22.7%), illnesses (18.2%), and nutrition (12.1%). These findings (i) can help to suggest some clinical implications for performance enhancement and health protection, and (ii) highlighted the need for continuing research on performance and/or health in combined events, preferably with prospective design, large athletes' sample sizes, focused on underrepresented populations (e.g., women, adolescents, Masters athletes), over one or more Athletics season.

Human activities affect the planet by altering natural cycles. They contribute to climate change and pollution, posing challenges to ecosystems, biodiversity, human well-being and health. There is a need to consider Planetary Health, which is described as a solutions-oriented, transdisciplinary field and social movement focused on analysing and addressing the impacts of human disruptions to the Earth's natural systems on human health and all life on Earth. This viewpoint discusses the responsibilities, choices, potential roles and practical initiatives concerning Planetary Health for the Sports and Exercise Medicine (SEM) community. Practices in both medicine and sport impact the environment. We can shift our human and SEM activities and adopt a Planetary Health approach. Our role as the SEM community is to protect and promote the health of athletes and populations. This also involves caring for the environment, given the close link between environmental and human health. Therefore, as an SEM community, we are concerned about the health of our ecosystems and the importance of respecting planetary boundaries. Our scientific expertise, inspirational leadership and ethics should encourage us to raise awareness and become exemplary torchbearers. We must embrace the challenge of addressing humanity's planetary crises to rise to the occasion, uphold our values and strengthen our connection with nature: 'faster, higher, stronger-all together'.

The present special issue of Scandinavian Journal of Medicine & Science in Sports deals with health and fitness benefits of regular participation in small-sided football games. One review article and 13 original articles were the result of a 2-year multi-center study in Copenhagen and Zurich and include studies of different age groups analyzed from a physiological, medical, social and psychological perspective. The main groups investigated were middle-aged, former untrained, healthy men and women who were followed for up to 16 months. In addition, elderly, children and hypertensive patients were studied. A summary and interpretations of the main findings divided into an analysis of the physical demands during training of various groups and the effect of a period of training on performance, muscle adaptations and health profile follow. In addition, social and psychological effects on participation in recreational football are considered, the comparison of football training and endurance running is summarized and the effects of football practice on the elderly and children and youngsters are presented.

The purpose of this study was to assess validity and reliability of sprint performance outcomes measured with an iPhone application (named: MySprint) and existing field methods (i.e. timing photocells and radar gun). To do this, 12 highly trained male sprinters performed 6 maximal 40-m sprints during a single session which were simultaneously timed using 7 pairs of timing photocells, a radar gun and a newly developed iPhone app based on high-speed video recording. Several split times as well as mechanical outputs computed from the model proposed by Samozino et al. [(2015). A simple method for measuring power, force, velocity properties, and mechanical effectiveness in sprint running. Scandinavian Journal of Medicine & Science in Sports. https://doi.org/10.1111/sms.12490] were then measured by each system, and values were compared for validity and reliability purposes. First, there was an almost perfect correlation between the values of time for each split of the 40-m sprint measured with MySprint and the timing photocells (r = 0.989-0.999, standard error of estimate = 0.007-0.015 s, intraclass correlation coefficient (ICC) = 1.0). Second, almost perfect associations were observed for the maximal theoretical horizontal force (F0), the maximal theoretical velocity (V0), the maximal power (Pmax) and the mechanical effectiveness (DRF - decrease in the ratio of force over acceleration) measured with the app and the radar gun (r = 0.974-0.999, ICC = 0.987-1.00). Finally, when analysing the performance outputs of the six different sprints of each athlete, almost identical levels of reliability were observed as revealed by the coefficient of variation (MySprint: CV = 0.027-0.14%; reference systems: CV = 0.028-0.11%). Results on the present study showed that sprint performance can be evaluated in a valid and reliable way using a novel iPhone app.

To describe athletes' coverage by national medical teams, and injuries and illnesses occurring during the four weeks before and during the 2023 African Youth Under 18/20 Athletics Championships. Cross-sectional and prospective cohort study design. We conducted a study with data collection of: 1) national medical teams, 2) injury and illness complaints during the four weeks preceding the championships using an online pre-participation health questionnaire, and 3) newly incurred in-championship injuries and illnesses collected by national medical teams and the local organising committee using daily standardised online report forms, for all registered athletes at the championships. Among the 43 countries participating at the championships, 15 (34.9 %) countries had a medical team with at least one medical personnel. Of the 15 countries, 6 (40.0 %) countries had at least one physiotherapist and one physician, 4 (26.7 %) countries had only physiotherapist(s), and 5 (33.3 %) countries had only physician(s). Nine (60 %) countries participated in the injury surveillance study, including 397 athletes: 61 (15.4 %) completed the pre-participation health questionnaire and 11 athletes (18.0 %) reported an injury complaint and 6 (9.8 %) an illness complaint during the four weeks before the championships. During the championships, there were 52.9 injuries and 50.4 illnesses per 1000 registered athletes. The main injury location was the thigh (33.3 %), and the main injury type was the muscle (47.6 %). The most common system affected by illness was the upper respiratory tract (55.0 %), and the main illness cause was idiopathic (50.0 %). This preliminary study provides foundational information to improve medical coverage and services during international championships, and orient injury/illness prevention in youth athletics across Africa.

It has been hypothesized that post-stroke fatigue (PSF) is associated with reduced physical activity (PA) and impaired physical fitness (fitness). Understanding associations between PSF and PA, and/or fitness could help guide the development of targeted exercise interventions to treat PSF. Our systematic review and meta-analysis aimed to investigate PSF's associations with PA and fitness. Following a registered protocol, we included studies with cross-sectional or prospective observational designs, published in English or a Scandinavian language, which reported an association of PSF with PA and/or fitness in adult stroke survivors. We searched MEDLINE, Embase, AMED, CINAHL, PsycINFO, ClinicalTrials.gov, and World Health Organization's International Clinical Trials Registry Platform from inception to November 30, 2022. Risk of bias was assessed using Quality in Prognosis Studies. Thirty-two unique studies (total n = 4721 participants, 55% male), and three study protocols were included. We used random-effects meta-analysis to pool data for PA and fitness outcomes, and vote-counting of direction of association to synthesize data that could not be meta-analyzed. We found moderate-certainty evidence of a weak association between higher PSF and impaired fitness (meta r = -0.24; 95% confidence interval (CI) = -0.33, -0.15; n = 905, 7 studies), and very low-certainty evidence of no association between PSF and PA (meta r = -0.09; 95% CI = -0.34, 0.161; n = 430, 3 studies). Vote-counting showed a higher proportion of studies with associations between higher PSF and impaired fitness (pˆ = 0.83; 95% CI = 0.44, 0.97; p = 0.22, n = 298, 6 studies), and with associations between higher PSF and lower PA (pˆ = 0.75; 95% CI = 0.51, 0.90; p = 0.08, n = 2566, 16 studies). Very low- to moderate-certainty evidence reflects small study sample sizes, high risk of bias, and inconsistent results. The meta-analysis showed moderate-certainty evidence of an association between higher PSF and impaired fitness. These results indicate that fitness might protect against PSF. Larger prospective studies and randomized controlled trials evaluating the effect of exercise on PSF are needed to confirm these findings.