BMJ openMelissa K Kossman, Ashley N Triplett, Eric G Post, Travis Anderson, Cheri Blauwet, Amber Donaldson, Morgan R Eckenrod, Jonathan Finnoff, Victoria L Goosey-Tolf…
OBJECTIVES: The purpose of this study was to explore athletes' perspectives on existing US Olympic & Paralympic Committee (USOPC) resources and to identify their recommendations for enhancing future initiatives aimed at promoting Paralympic athlete health, well-being and performance. DESIGN: Phenomenological qualitative study SETTING: Online. PARTICIPANTS: A convenience sample of 19 Team USA Paralympic athletes 18 years of age or older participated (female n=11; age 31±9 years) representing four categories of conditions recognised by the International Paralympic Committee (muscle and movement, bone-related, visual and central nervous system). RESULTS: The resulting codebook included 2 themes and 10 corresponding categories. Theme 1, titled Resources for Paralympic Athletes, includes five categories: (1) community-level; (2) university-level; (3) USOPC; (4) National Governing Body and (5) Resources Access, Awareness and Satisfaction. Theme 2, titled Recommendations for Improvements to the USOPC, also included five categories: (1) sports medicine; (2) disability-specific needs and classification systems; (3) sports performance; (4) resources and (5) community awareness. Study participants recognised meaningful improvements in organisational support, including expanded financial assistance and mental-health services yet persistent structural inequities continue to limit equitable access to high-quality resources. Fragmented and geographically uneven sports medicine, coaching and performance infrastructures, along with ongoing challenges in classification transparency and disability-specific programming, remain key barriers to athlete development. CONCLUSIONS: Findings highlight the need for decentralised clinical and performance networks, enhanced evidence-based classification practices and more robust transition planning from collegiate to elite settings. Including athlete perspectives and strengthening equitable resources creates more accessible, consistent and performance-optimising environments within the US Paralympic system.
Journal of the American Academy of Orthopaedic Surgeons. Global research & reviewsTerence L Thomas, Alexander P Zavitsanos, Claude J Regis, John Czarnicki, Harrison S Fellheimer, Gabriel Onor, William L Justice, Jalen Broome, Damon V Briggs,…
BACKGROUND: Despite growing attention to workforce diversity in orthopaedic surgery, limited data exist describing the demographic composition of academic sports medicine faculty. This study examines the diversity of sports medicine fellowship-trained orthopaedic surgery faculty across US orthopaedic surgery residency training programs. METHODS: A cross-sectional analysis of all ACGME-accredited orthopaedic surgery sports medicine faculty was conducted. Faculty data included sex, race, level of professorship, residency attended, year of residency graduation, and h-index. Underrepresented in Orthopaedics (URiO) was defined as non-White and non-Asian by race and all women. Descriptive statistics were performed. RESULTS: A total of 812 sports medicine-fellowship trained faculty were included in the analysis: 91% men and 9% women. Racial distribution of faculty was 83% White, 11% Asian, 4% African American, and 1% Hispanic. The region of the United States with the greatest percentage of URiO faculty was the South Atlantic (26%). Most URiO faculty graduated from residency in the last quarter century: 42% from 2012 to 2025 and 41% from 2001 to 2011. No differences were observed between URiO and non-URiO with regard to academic rank or H-Index. CONCLUSIONS: The present findings highlight persistent disparities in diversity among orthopaedic sports medicine faculty. Intentional efforts remain warranted to mitigate structural barriers in URiO recruitment to the sports medicine subspecialty and orthopaedic surgery as a whole.
Journal of athletic trainingTimothy Neal, Chris Bayh, Brendan Carr, George Everly, Dylan Firsick, Lauren Forsyth, Joanna Foss, Scott G Goldman, Erin Haugen, Jeff G Konin, Vanessa Lalley-D…
OBJECTIVE: To provide athletic trainers, team physicians, and mental health professionals working with collegiate student-athletes updated information since the 2013 "Inter-Association Consensus Statement Recommendations for Developing a Plan to Recognize and Refer Student-Athletes with Psychological Concerns at the Collegiate Level." Updated areas include antecedents of risk that may challenge student-athletes' mental health and wellness and new information to consider when developing in-house student-athlete counseling teams and managing a student-athlete's mental health crisis. RECOMMENDATIONS: These updated recommendations provide new evidence and best practices to better prepare athletic trainers, team physicians, and mental health care professionals who collaborate with the sports medicine staff for recognizing and referring collegiate student-athletes with psychological concerns for evaluation and care.
Journal of athletic trainingAlexander P Derstine, Katelyn M Mitchell, Landon B Lempke, Thomas G Bowman
CONTEXT: Para sport athletes experience concussions at a similar rate to athletes without disabilities; however, published concussion tools have limited applicability to diverse athlete populations. OBJECTIVE: To understand health care provider (HCP) concussion management across different para sports and athlete classifications to identify facilitators and barriers influencing the delivery of concussion care. DESIGN: Cross-sectional study. SETTING: Online survey and virtual interviews. PATIENTS OR OTHER PARTICIPANTS: Para sport HCPs completed online surveys (n = 21) and voluntary follow-up interviews (n = 11). DATA COLLECTION AND ANALYSIS: Researchers designed a survey from an established line of health care evaluation surveys and distributed it via chain-referral sampling following expert review (n = 3) and pilot testing (n = 4). We conducted follow-up interviews via Google Meet using automatic transcription technology and reviewed for accuracy. We used phenomenology to analyze the qualitative data with multianalyst triangulation and peer review as credibility strategies. RESULTS: Health care providers most often used the Sport Concussion Assessment Tool 6 (85.7%) to guide examinations, the modified Balance Error Scoring System (66.7%) for balance testing, and the Vestibular/Ocular-Motor Screening (81.0%) for vestibular ocular-motor testing. Health care providers noted 3 themes: (1) the importance of developing purposefully flexible classification- and para sport-specific frameworks to promote individualized concussion care while (2) building personal HCP-athlete relationships to understand individual needs and improve concussion diagnostics and emphasizing (3) a multidisciplinary, team-based approach to care. Health care providers emphasized these themes as critical for successful management across para sports to overcome limited education and resource allocation available to often volunteer-based HCPs. CONCLUSIONS: Para sport HCPs used current concussion assessment tools but reported a lack of effective adaptive guidelines exemplified by variable athlete-specific modifications for concussion care. Our findings emphasize the need to develop flexible frameworks for para sport concussion management while emphasizing a multidisciplinary, team-based approach to care and HCP-athlete relationships to implement effective para sport concussion care.
MedEdPORTAL : the journal of teaching and learning resourcesJowan Watson, Marie Desir, Claire Twark, Hermioni L Amonoo
INTRODUCTION: Sports psychiatry is a growing subspecialty focusing on the psychiatric care of athletes. However, efforts to increase sports psychiatry training in residency are lacking. METHODS: A 120-minute introductory curriculum for the Brigham and Women's Hospital/Harvard Medical School Psychiatry Residency Program was developed and tested for feasibility. Kern's curriculum design and a literature review on sports psychiatry topics, including a review of the International Society for Sports Psychiatry curriculum for trainees, guided development. Pre- and postassessments were used to assess acceptability and impact on resident learners. Residents provided qualitative feedback on how to improve the curriculum. RESULTS: Thirty-five of 56 residents received the training. Eighteen of 35 residents (51.4%) completed the surveys. Residents had minimal baseline knowledge in sports psychiatry, and this introduction enhanced their objective knowledge scores (mean 0.67 vs 0.93; mean difference = 0.26, 95% CI, 0.16-0.43; P < .001; Cohen d = 1.56), subjective confidence (mean 1.56 vs 3.22; mean difference = 1.65, 95% CI, 1.31-2.00; P < .001; Cohen d = 3.13), and subjective knowledge (mean 1.67 vs 3.40; mean difference = 1.73, 95% CI, 1.42-2.05; P < .001; Cohen d = 3.22). Residents' qualitative feedback suggested allocating more time and a broader scope for curriculum improvement. DISCUSSION: Implementing an introductory sports psychiatry curriculum in psychiatric training is feasible and enhances residents' knowledge and confidence in sports psychiatry topics. More work is needed to explore the best ways of increasing opportunities for sports psychiatry training in graduate medical education programs.
The Journal of sports medicine and physical fitnessBrendan George, Yuka Tsukahara, Jun-Ya Aizawa, Eisaburo Honda, Masahiro Sato, Nobutake Ozeki
BACKGROUND: Sports medicine knowledge is vital for ensuring athlete safety and performance, yet significant gaps in understanding of medical conditions persist among coaches, parents, and athletes. These disparities highlight the need to better assess and improve sports medicine knowledge across those involved in sports. METHODS: This study analyzed data from 18,418 individuals who took the Japan Sports Medicine Certification Examination between 2017 and 2024. The exam is open to diverse stakeholders, including medical professionals, coaches, and athletes, and is designed to assess sports medicine knowledge rather than confer a physician specialty certification. It is offered at three levels - basic (Grade 3), intermediate (Grade 2), and advanced (Grade 1). It covers topics such as injury prevention, anatomy, and return-to-play guidelines. Demographic and survey data from 6629 respondents were linked to exam scores. Linear regression analyses were conducted to identify factors associated with performance. RESULTS: Medical professionals consistently scored higher across all exam levels. Male participants outperformed females in Grades 1 (Coefficient 3.66, 95% Confidence Interval [CI] 2.68-4.65, P<0.001) and 2 (Coefficient 1.62, 95% CI 1.11-2.13, P<0.001). In addition, younger examinees scored higher in Grade 1, whereas older participants performed better in Grade 3. A history of sports injury was positively associated with higher scores in Grades 1 (Coefficient 1.47, 95% CI 0.29-2.64, p=0.014) and 3 (Coefficient 1.75, 95% CI 1.09-2.41, P<0.001). CONCLUSIONS: Knowledge gaps exist among non-medical stakeholders, particularly coaches and athletes. Policymakers and sports organizations may consider integrating basic sports medicine training into coaching certification or athlete development programs.
Frontiers in public healthIsmail Dergaa, Mohamed Amine Dergaa, Mortadha Razzak, Halil İbrahim Ceylan, Valentina Stefanica, Raul Ioan Muntean, Noomen Guelmami
BACKGROUND: Generative artificial intelligence (GenAI), particularly large language models (LLMs) such as ChatGPT, GPT-3.5, and GPT-4, is rapidly being integrated into sports medicine practice. These tools are increasingly used by health professionals, coaches, and athletes for training prescription, rehabilitation, nutrition, mental health support, injury prevention, and academic writing. However, their adoption has outpaced the development of robust evidence regarding their clinical utility, accuracy, and safety, and no comprehensive synthesis of this emerging field currently exists. AIM: This scoping review aimed to map the current evidence on GenAI and LLM applications in sports medicine and athlete health, evaluate their accuracy and hallucination risks across domains, and synthesise reported ethical and governance concerns. METHODS: The review followed PRISMA-ScR guidelines and Joanna Briggs Institute methodology. Six databases (PubMed/MEDLINE, Scopus, Web of Science, SPORTDiscus, IEEE Xplore, and CINAHL) were searched for studies published between January 2022 and March 2026. Eligibility criteria were defined using the Population-Concept-Context framework. Two independent reviewers conducted screening, full-text assessment, and data extraction, with strong inter-rater agreement (κ = 0.82). RESULTS: Of 1,847 records identified, 32 studies were included. Applications were classified into seven domains: training and exercise prescription (n = 5), nutrition (n = 4), rehabilitation (n = 3), mental health (n = 3), clinical decision support (n = 5), academic writing (n = 6), and ethics/governance (n = 6). LLM accuracy varied substantially: in a single validation study, content validity ratios for sleep recommendations ranged from 0.33 (GPT-3.5) to 0.67 (GPT-4), while only GPT-4 achieved acceptable validity for jet lag guidance (CVR = 0.68). In one bibliometric analysis, AI-generated text in sports medicine journals increased from 2.38% (early 2023) to 6.25% (late 2024). Hallucination risk was rated critical for general-purpose chatbots but substantially reduced in retrieval-augmented systems. CONCLUSION: GenAI shows promise as a supervised decision-support tool in sports medicine, but current evidence does not support unsupervised clinical use. Key challenges include hallucination risks, a lack of sport-specific validation datasets, and insufficient ethical and governance frameworks. Addressing these gaps is essential before widespread integration into athlete health and public health contexts.
Frontiers in public healthXinxuan Xu, Jiyuan Li, Lei Jiang, Yang Qiu, Gang Wu, Jing Jin, Gaonian Zhao
BACKGROUND: Adolescent idiopathic scoliosis (AIS) is a common spinal deformity with significant health impacts. This study aimed to investigate the epidemiology of AIS in a Chinese region and evaluate the efficacy of an integrated sports-medicine rehabilitation (ISMR) strategy. METHODS: This study had two parts. First, a cross-sectional school-based screening investigated AIS epidemiology in adolescents aged 11-19 in Taizhou. Second, a retrospective cohort study evaluated the efficacy of an ISMR strategy. Patients with AIS were allocated to either a Conventional Rehabilitation (CR) group or an ISMR group based on their historical rehabilitation protocol. All received 12 weeks of conservative management. Assessments performed before and after the treatment included Cobb angle, vertebral rotation, apical vertebral translation, trunk rotation angle (ATR), and SRS-22 quality of life scores. RESULTS: A total of 66,989 individuals were screened. The overall prevalence was higher in females than males (0.35% vs. 0.16%, p < 0.001). For the rehabilitation trial, 138 patients were enrolled (CR: n = 71; ISMR: n = 67). After treatment, the ISMR group showed statistically significant but modest improvements in Cobb angle (13.66 ° vs. 15.04 °, p = 0.016), vertebral rotation (1.38 ° vs. 1.59 °, p = 0.026), apical translation (20.87 mm vs. 21.89 mm, p = 0.033), and ATR (4.84 ° vs. 5.20°, p = 0.001) compared to the CR group. The ISMR group also demonstrated statistically and clinically relevant improvements in all SRS-22 domains, including function, pain, self-image, and mental health (all p < 0.05). CONCLUSION: This study delineates local epidemiological patterns of AIS and demonstrates that a structured, ISMR strategy is more effective than CR in improving spinal alignment and quality of life for conservatively managed patients.
La Tunisie medicaleAmine Ghram, Karim Chamari, Wassim Moalla, Lilia Zakhama, Rihab Moncer, Imed Latiri, Helmi Ben Saad
Sedentary and non-communicable diseases continue to rise in Tunisia. Yet, graduates from the country's four institutes of Sport Sciences face persistent barriers to employment and lack legal recognition within the healthcare system. Although these graduates receive academic learning and training in exercise physiology, biomechanics, adapted physical activity, and performance sciences, current legislation prevents them from prescribing exercise or working with clinical populations. Across worldwide, many countries such as the United States, United Kingdom, Australia, and Canada have established regulated pathways for Clinical Exercise Physiologists, supported by accredited university programs, national certification systems, and clear scopes of practice. Global initiatives such as Exercise is Medicine®, active in many countries, further demonstrate the integration of physical activity into healthcare; however, Tunisia, like most Middle East and North Africa countries, remains unrepresented. In this policy-oriented narrative review, we reviewed the international models and propose a strategic roadmap for Tunisia to modernize sport-science curricula, develop interdisciplinary degrees in exercise physiology, establish national accreditation and professional registration systems, authorize clinical practice, and integrate exercise into national health policy. Such reforms could reduce unemployment, enhance preventive healthcare, and align Tunisia with global standards in exercise-based medicine.
La Clinica terapeuticaGiuseppe Basile, Luca Bianco Prevot, Michela Basile, Livio Pietro Tronconi
The medico-legal assessment of sports injuries in professional athletes continues to rely on tools designed for an entirely different context. Permanent impairment tables measure the reduction in overall individual function, but not the loss of competitive performance, the reduction in expected athletic lifespan, or the impact on contracts and earnings. In this Editorial we argue that closing this gap does not require new, ad hoc composite indices, but a more rigorous and systematic integration of approaches already validated in the sports medicine and rehabilitation literature: objective quantification of the return-to-sport (RTS) deficit, obtained by comparing validated sport-specific functional and performance outcome measures recorded before and after injury; structured documentation of the rehabilitation pathway, including objective RTS criteria, time-to-RTS, and the psychological readiness to compete; and an evidence-based estimate of the economic and contractual impact, grounded in objective performance-analytics data rather than presumptive percentages. The integration of these indices with clinical-orthopaedic assessment may allow a more accurate definition of "functional-professional" damage in athletes, with significant implications for insurance, legal, and medico-legal practice. The aim is to promote a new multidisciplinary assessment model capable of bridging the traditional distinction between biological damage and economic loss, providing a more realistic and equitable measure of the consequences of sports trauma on athletes' careers.