Abstract

Introduction
Sport-related concussions (SRC) have been a concern in all sports, including soccer. The long-term effects of soccer-related head injuries are a public health concern. The Concussion in Sport Group (CISG) released a consensus statement in 2017 and several soccer governing associations have published their own SRC guidelines while referring to it but it is unclear whether this has been universally adopted.

Research question
We aimed to investigate whether guidelines published by soccer associations have any discrepancies; and the extent to which they follow the CISG recommendations.

Materials and methods
A scoping review of available soccer-specific SRC guidelines was performed via databases PubMed, Google Scholar, and official soccer association websites via web browser Google. The inclusion criteria were soccer-specific SRC guidelines. Comparisons between guidelines were made concerning the following index items: initial (on-site) assessment, removal from play, re-evaluation with neuroimaging, return-to-sport protocol, special populations, and education.

Results
Nine soccer associations with available guidelines were included in this review. Guidelines obtained were from official associations in the United Kingdom, United States of America, Canada, Australia, and New Zealand. When compared to each other and the CISG recommendations, discrepancies were found within guidelines regarding the index items. Additionally, major soccer associations in some countries famous for soccer were found to have not published any publicly available guidelines.

Discussion and conclusion
SRC guidelines from different soccer associations contain discrepancies which may be detrimental to athletes, both short and long-term. We recommend that all major soccer governing associations publish guidelines that are standardised and accessible to all athletes.

Introduction

A concussion can be defined as a transient and sudden alteration of consciousness following traumatic biomechanical forces transmitted to the brain either directly or indirectly (Khurana and Kaye, 2012). Sport-related concussion (SRC) has been a growing concern over several years and has been attracting further attention amongst athletes and healthcare professionals due to recently publicised effects on both their immediate and long-term neurological health. Soccer is a sport with high concussion rates in comparison with others (Pierpoint and Collins, 2021). The injury rates amongst athletes of the National Collegiate Athletic Association (NCAA) being 0.28 and 0.41 per 1000 game exposures for male and female soccer athletes respectively. This is in comparison with other contact sports such as men’s wrestling (0.25), American football (0.37), basketball (0.16), ice hockey (0.41); and women’s basketball (0.22), gymnastics (0.16), and field hockey (0.18) (Hootman et al., 2007). High concussion rates were also seen in a 2020 study by Vedung et al., where the concussion incidence was 1.19 per 1000 game hours (Vedung et al., 2020).

Recent evidence from 2019 (Scotland) and 2023 (Sweden) showed that former elite soccer players are more likely to die from neurogenerative disease, which was attributed to the frequency of concussions and repetitive heading during their playing days (Mackay et al., 2019; Ueda et al., 2023). There has also been coverage from mainstream media reporting on former athletes that have developed neurodegenerative disease after sustaining SRC’s during their playing careers. For example, in an article from 2020, forty ex-soccer players were reported to take legal action against the English Football Association for dementia-related negligence due to brain injuries sustained (PA Media, 2020). Increasing attention has therefore been brought to this issue, which has raised questions on the effectiveness and utilisation of concussion protocols currently in place.

Conclusion

This scoping review identified discrepancies between soccer-specific SRC guidelines published by different official bodies. The major discrepancies identified were found in the timeframes for the return-to-sport protocol; the time recommended for the initial rest phase; and the decision to allow same day return-to-play after a suspected concussion. Possible implications of these discrepancies are that athletes could be managed in vastly different ways without any clarity on which guidelines would be best. This could lead to outcomes where, for example, athletes could be rested for too long or the opposite where athletes could be rushed back into play prematurely. Furthermore, the discrepancies could be putting certain populations at a higher risk of subsequently poorer neurocognitive outcomes after sustaining a concussion; for example, amateur athletes that do not have access to facilities like an individualised management plan with close monitoring of their progression through the different steps of the return-to-sport protocol. Due to the lack of studies in this area, it is unclear whether these discrepancies are detrimental to athletes and whether they may pose a risk, both at short-and long term. Soccer is one of the most popular sports in the world and SRCs continue to be a relevant issue. This is a field of growing interest amongst healthcare professionals and considerations for additional specific information about risk prevention and the use of neuroimaging should be made to include them within future guidelines.

It is fortunate that the most recent update from the CISG was concluded with the 6th International Conference on Concussion in Sport, held in 2022 (Patricios et al., 2023). This consensus statement was only just published in June 2023 and includes updated strategies for return-to-sport and material such as the Sport Concussion Assessment Tool-6 (SCAT-6), the Child SCAT-6, the Concussion Recognition Tool-6 (CRT-6), the Sport Concussion Office Assessment Tool-6 (SCOAT-6), and the Child SCOAT-6. These updates provide a fresh opportunity for soccer associations to update their guidelines in a consistent and collaborative manner.

Abstract

Background
High blood pressure (BP) is a major contributor to mortality and cardiovascular diseases. Despite the known benefits of exercise for reducing BP, it is crucial to identify the most effective physical activity (PA) intervention. This systematic review and network meta-analysis (NMA) aimed to evaluate the available evidence on the effectiveness of various PA interventions for reducing BP and to determine their hierarchy based on their impact on BP.

Methods
A search of PubMed, SPORTDiscus, PsycINFO, Web of Science, CINAHL, Cochrane, and Eric databases was conducted up to December 2022 for this systematic review and NMA. Randomized controlled trials and quasi-experimental studies targeting healthy children and adolescents aged 6–12 years old were included in this study. Only studies that compared controlled and intervention groups using PA or exercise as the major influence were included. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Three independent investigators performed the literature screening, data extraction, and risk of bias assessment. We used Bayesian arm-based NMA to synthesize the data. The primary outcomes were systolic BP and diastolic BP. We calculated the mean differences (MDs) in systolic BP and diastolic BP before and after treatment. Mean treatment differences were estimated using NMA and random-effect models.

Results
We synthesized 27 studies involving 15,220 children and adolescents. PA combined with nutrition and behavior change was the most effective intervention for reducing both systolic BP and diastolic BP ((MD: –8.64, 95% credible interval (95%CI):–11.44 to –5.84); (MD: –6.75, 95%CI: –10.44 to –3.11)), followed by interventions with multiple components ((MD: –1.39, 95%CI: –1.94 to –0.84); (MD: –2.54, 95%CI: –4.89 to –0.29)).

Conclusion
Our findings suggest that PA interventions incorporating nutrition and behavior change, followed by interventions with multiple components, are most effective for reducing both systolic blood pressure and diastolic blood pressure in children and adolescents.

Introduction

High blood pressure (HBP), or hypertension, occurs when the blood exerts too much pressure against the walls of blood vessels due to systolic and diastolic forces.1 It is a significant risk factor for cardiovascular diseases, contributing to 10.1 million deaths and 208.1 million cases of overall disease burden worldwide in the past 2 decades.2 The death rate attributable to HBP increased to 34.2% between 2009 and 2019,3, 4, 5 with hypertension projected to affect 41% of US adults by 2030.6,7 The economic burden of hypertension is expected to rise significantly, with direct costs projected to triple to USD 389.9 billion and indirect costs to double to USD 42 billion by 2030.6,8,9 Around 50% of reported cases of hypertension have a genetic component,10, 11, 12 while modifiable factors like lifestyle, diet, and physical activity (PA) contribute to the other half.13,14

The American Heart Association highlighted that the significance of HBP in children was previously underestimated. Recent studies show that many children and adolescents in the United States face hypertension risks. Data reveals that 5% of this demographic has HBP, while 18% exhibit elevated BP.15 Similarly, the Centers for Disease Control and Prevention reported that among youth aged 12–19, 1 in 25 has hypertension, and 1 in 10 experiences elevated BP.16 Considering these findings, both American Heart Association and Centers for Disease Control and Prevention emphasize the increasing incidence of HBP in young individuals, which could lead to health complications in adulthood. As a result, it’s imperative to implement preventive measures to counteract the rising trend of HBP in this age group. While medical research explores various approaches for monitoring and controlling genetically-based hypertension, non-medical approaches may be more feasible and effective in the interim.

Conclusion

Although medication-based treatments are essential for young individuals with hypertension, non-drug strategies have demonstrated effectiveness for lowering BP among healthy youth. Thus, integrating PA with other alterable factors early on can serve as a protective shield against future health issues. Notably, interventions that amalgamate PA, nutrition, and behavioral adjustments tend to be notably superior at decreasing both SBP and DBP compared to interventions focused solely on PA. Moreover, further investigation is required to classify PA modalities in terms of content, length, and intensity before concluding that PA-only intervention is the least effective approach for reducing BP.

Highlights

Abstract

Keywords

Abbreviations

1. Introduction

2. Iron

3. Antioxidants

4. Vitamin D

5. Calcium

6. Discussion/conclusion

CRediT authorship contribution statement

Declaration of competing interest

References

Abstract

Optimising nutrition intake is a key component for supporting athletic performance and supporting adaption to training. Athletes often use micronutrient supplements in order to correct vitamin and mineral deficiencies, improve immune function, enhance recovery and or to optimise their performance. The aim of this review was to investigate the recent literature regarding micronutrients (specifically iron, vitamin C, vitamin E, vitamin D, calcium) and their effects on physical performance. Over the past ten years, several studies have investigated the impacts of these micronutrients on aspects of athletic performance, and several reviews have aimed to provide an overview of current use and effectiveness. Currently the balance of the literature suggests that micronutrient supplementation in well-nourished athletes does not enhance physical performance. Excessive intake of dietary supplements may impair the body’s physiological responses to exercise that supports adaptation to training stress. In some cases, micronutrient supplementation is warranted, for example, with a diagnosed deficiency, when energy intake is compromised, or when training and competing at altitude, however these micronutrients should be prescribed by a medical professional. Athletes are encouraged to obtain adequate micronutrients from a wellbalanced and varied dietary intake.

1. Introduction The foundations of sport performance are training and nutrition/diet of the athlete, with nutritional strategies providing a supportive role in enhancing training adaption (Stellingwerff et al., 2019). In line with the evolution of methods to optimise training through various training prescriptions, there has been a concurrent evolution in nutrition strategies for athletes. Current nutritional consensus statements promote the periodisation of nutritional intake to optimise the adaptation from the training programme prescribed to the athlete (Stellingwerff et al., 2019). The theory of nutritional periodisation is planned energetic and macronutrient strategies to target the individual exercise sessions and overall training programme to aid in obtaining long term performance gains in athletes (Jeukendrup, 2017). Strategies of nutritional periodisation include manipulating carbohydrate and fat intake to upregulate key signalling pathways in the skeletal muscle and promote mitochondrial biogenesis, angiogenesis and increased lipid oxidation (Hansen et al., 2005; Hulston et al., 2010; Morton et al., 2009) or optimising protein intake to support hypertrophic responses in skeletal muscle (Stellingwerff et al., 2019). However, numerous metabolic processes and reactions involved in energy extraction from macronutrients, oxygen delivery and transfer, tissue repair, and growth and development are dependent on essential vitamins and minerals (Volpe, 2007).

Micronutrients are essential for life and include; vitamins which are organic compounds that support health, growth and reproduction and are needed in small amounts to prevent clinical deficiencies and declines in health (Fogelholm, 2015). A key feature of most vitamins is that the human body is unable to synthesise them (Fogelholm, 2015), therefore they must be obtained from dietary intake. Vitamins are classified based on their in vivo solubility, with A, D, E and K classified as fat-soluble and vitamins B and C classified as water soluble (Fogelholm, 2015). Minerals are inorganic substances that support physiological functioning (Fogelholm, 2015). The daily physiological requirements determine the mineral classifications, hence ~100 mg⋅day− 1 of macrominerals (sodium, potassium, calcium, phosphorus and magnesium) and ~20 mg⋅day− 1 of trace elements (iron, zinc, copper, chromium and selenium) are required by healthy individuals (Fogelholm, 2015).

1- Introduction

2- Material and methods

3- Definition of physical exercise

4- Immune system modulation by the practice of physical exercise

5- Anti-inflammatory effects of physical exercise

6- Physical exercise as a non-pharmacological intervention for neuroprotection

7- Physical exercise and neopterin

8- Physical exercise and inflammation-induced pain: Relevance of BH4

9- Summary and future directions

References

Abstract

A wide array of molecular pathways has been investigated during the past decade in order to understand the mechanisms by which the practice of physical exercise promotes neuroprotection and reduces the risk of developing communicable and non-communicable chronic diseases. While a single session of physical exercise may induce a transient imbalance of cell homeostasis, repeated physical exercise sessions will improve immunosurveillance and immunocompetence. Additionally, immune cells from the central nervous system will acquire an anti-inflammatory phenotype, protecting central functions from age-induced cognitive decline. This review highlights the exercise-induced anti-inflammatory effect on the prevention or treatment of common chronic clinical and experimental settings. It also suggests the use of pterins in biological fluids as sensitive biomarkers to follow the anti-inflammatory effect of physical exercise.

Introduction

The practice of physical activity and/or physical exercise is an efficient free -drug strategy for the prevention and treatment of several chronic diseases. A great body of scientific evidence has contributed to establish a positive correlation between a physically active lifestyle and health benefits [1]. According to the Physical Activity Guidelines for Americans, individuals affected by chronic diseases should practice a minimum of 150 mi n per week of moderate -intensity exercise, or at least 75 min per week of vigorous -intensity aerobic physical activity to improve health [2] . Additional health benefits can also be promoted by performing muscle -strengthening activities involving all main muscle groups at least twice a week [2] . Due to enhanced musculoskeletal function, cardiorespiratory and metabolic health, sleep, pain management, cognition, learning, memory and more, the practice of physical exercise represents a non-pharmacological primary clinical tool for the prevention of many diseases whose physiopathology is linked to acute or sustained immune system activation [3 –5]. In general repeated moderate intensity exercise enhances the immune function response, reinforces the antioxidative capacity, reduces oxidative stress, and increases the efficiency of energy generation , therefore reducing the incidence of inflammatory diseases [6,7] . Acute bouts of physical exercise also regulate the immune response, i.e. by transiently redistributing immune cells to peripheral tissues, resulting in a heightened state of immun ocompetence [8] .

BACKGROUND: The accessibility, low cost and motivation generated by exergames has fostered its rapid expansion as a rehabilitation technique. OBJECTIVE: To estimate the effectiveness of rehabilitation programs using IVGT in improving walking capacity of people aged 60 years and over. MATERIAL AND METHODS: The electronic data research following the PRISMA Statement (Scopus, Cochrane, Web of Science, OT Seeker, National Guideline Clearinghouse, Trip Database, CSIC Spanish National Research Council) was completed in September 2018. The results of randomized clinical trials using exergames for rehabilitation of walking capacity were combined. The calculations have followed the guidelines of the Cochrane Handbook for Systematic Reviews of Interventions. The Grading of Recommendations Assessment, Development and Evaluation system was used to evaluate the quality of the evidence. RESULTS: We obtained data from 14 trials, including 11 meta-analysis studies. The size of exergames effects on walking capacity is moderate, but significant (SMD -0.56; 95% CI: -0.90, -0.21; p=0.002). Effectiveness was greater to recover the ability to transfer from one position or place to another (SMD -1.02; CI 95%: -1.70, -0.35; P=0.003). The intervention protocols, their duration and intensity varied considerably. The lack of masking, the allocation concealment, the absence of assessor blinding were the main causes of bias so the final grade of evidence has been low for walking and very low for transfers. CONCLUSIONS: Positive clinical effects of exergames have been found to improve walking capacity, but the quality of evidence to refute its effectiveness is weak with risk of bias. Further research is needed in order to know the actual magnitude of its effect.

Introduction

Impaired functional mobility of older adults is frequently associated with loss of independence. Maintaining functional independence must be a priority in elderly care plans. Achieving autonomous participation in their own real everyday environment would contribute to improving their community involvement and as well as their overall health. The rehabilitation programs that include the practice of real activities show more effectiveness [1,2]. The use of exergames has the potential to offer treatment settings very similar to actual environments and tasks, offering the possibility of playing by practicing physical exercise in immersive and attractive environments because of its similarity to reality[3] . The involvement of the player, far from being sedentary (as in traditional video games) requires active exercises that mobilize the different parts of the body. Interactive simulations containing exergames such as Wii Fit® (Nintendo), Kinect Sports® (Xbox) or Play Sport Eye Toy® (Play Station) recreate everyday virtual environments that allow repeated physical exercise directly related to the movements needed in activities of daily living.

Objective: This study aimed to examine (1) the independent effects of hypoxia on cognitive function and (2) the effects of exercise on cognition while under hypoxia. Methods: Design: Systematic review with meta-analysis. Data sources: PubMed, Scopus, Web of Science, PsychInfo, and SPORTDiscus were searched. Eligibility criteria for selecting studies: randomized controlled trials and nonrandomized controlled studies that investigated the effects of chronic or acute exercise on cognition under hypoxia were considered (Aim 2), as were studies investigating the effects of hypoxia on cognition (Aim 1). Results: In total, 18 studies met our inclusionary criteria for the systematic review, and 12 studies were meta-analyzed. Exposure to hypoxia impaired attentional ability (standardized mean difference (SMD =
0.4), executive function (SMD =
0.18), and memory function (SMD =
0.26) but not information processing (SMD = 0.27). Aggregated results indicated that performing exercise under a hypoxia setting had a significant effect on cognitive improvement (SMD = 0.3, 95%CI: 0.14
0.45, I 2 = 54%, p < 0.001). Various characteristics (e.g., age, cognitive task type, exercise type, exercise intensity, training type, and hypoxia level) moderated the effects of hypoxia and exercise on cognitive function. Conclusions: Exercise during exposure to hypoxia improves cognitive function. This association appears to be moderated by individual and exercise/hypoxia-related characteristics.

Introduction

Cognitive functions are brain-based skills that allow humans to carry out tasks at various levels of difficulty and that are critical in day-to-day life.1,2 Notably, cognitive performance is possibly affected by environmental cues such as ambient temperature and altitude.3,4 For instance, increasing altitude and the ensuing severity of hypoxia may attenuate oxygen delivery to the brain tissue. Such exponentially reduced oxygen fraction during inspiration may result in impairment of brain function and cognitive abilities, including executive function, attention, episodic memory, and information processing.5
7 This occurrence may be detrimental for particular populations, including those in the armed forces, athletes, mountaineers, mountain rescuers, and other high altitude residents who are repeatedly exposed to hypoxic conditions.8
10 Findings from several primary studies11,12 and a previously published review13 have indicated hypoxia-induced cognitive deficits. Regardless of cognitive task types (i.e., central executive vs. nonexecutive tasks) and hypoxic conditions (i.e., hypobaric vs. normobaric hypoxia), low partial pressure of oxygen (PaO2) levels are strongly associated with greater reductions in cognitive function. In contrast, accumulating evidence suggests that hypoxia has no negative effects on cognitive function.14
17 For instance, an experimental study by Lefferts et al.9 showed that response accuracy on cognitive tasks was similar in normoxia compared to hypoxia in a mixed sample of young men and women. Sun et al.18 reported that moderate hypoxia did not alter either reaction time or accuracy in sedentary young adults. Given the conflicting findings in previous studies, along with new publications on this topic, an updated systematic review is needed to evaluate and synthesize the current evidence on the effects of hypoxia on cognition.

1- INTRODUCTION

2- METHODS

3- RESULTS

4- DISCUSSION

5- CONCLUSION

REFERENCES

Abstract

Background
Prospective cohorts have suggested that physical activity (PA) can decrease the risk of incident anxiety. However, no meta‐analysis has been conducted.
Aims
To examine the prospective relationship between PA and incident anxiety and explore potential moderators.
Methods
Searches were conducted on major databases from inception to October 10, 2018 for prospective studies (at least 1 year of follow‐up) that calculated the odds ratio (OR) of incident anxiety in people with high PA against people with low PA. Methodological quality was assessed using the Newcastle‐Ottawa Scale (NOS). A random‐effects meta‐analysis was conducted and heterogeneity was explored using subgroup and meta‐regression analysis.
Results
Across 14 cohorts of 13 unique prospective studies (N = 75,831, median males = 50.1%) followed for 357,424 person‐years, people with high self‐reported PA (versus low PA) were at reduced odds of developing anxiety (adjusted odds ratio [AOR] = 0.74; 95% confidence level [95% CI] = 0.62, 0.88; crude OR = 0.80; 95% CI = 0.69, 0.92). High self‐reported PA was protective against the emergence of agoraphobia (AOR = 0.42; 95% CI = 0.18, 0.98) and posttraumatic stress disorder (AOR = 0.57; 95% CI = 0.39, 0.85). The protective effects for anxiety were evident in Asia (AOR = 0.31; 95% CI = 0.10, 0.96) and Europe (AOR = 0.82; 95% CI = 0.69, 0.97); for children/adolescents (AOR = 0.52; 95% CI = 0.29, 0.90) and adults (AOR = 0.81; 95% CI = 0.69, 0.95). Results remained robust when adjusting for confounding factors. Overall study quality was moderate to high (mean NOS = 6.7 out of 9).
Conclusion
Evidence supports the notion that self‐reported PA can confer protection against the emergence of anxiety regardless of demographic factors. In particular, higher PA levels protects from agoraphobia and posttraumatic disorder.

INTRODUCTION

Anxiety disorders are common and burdensome across the world (Baxter, Vos, Scott, Norman, et al., 2014; Baxter, Vos, Scott, Ferrari, & Whiteford, 2014). The point prevalence varies across world regions, ranging between 2.1% (range, 1.8–2.5%) in East Asia up to 6.1% (range, 5.1–7.4%) in North Africa/Middle East (Baxter, Vos, Scott, Ferrari, et al., 2014; Baxter, Vos, Scott, Norman, et al., 2014). The prevalence of anxiety symptoms is even higher, at approximately 11% worldwide (Stubbs, Koyanagi et al., 2017). Globally, anxiety disorders are the sixth leading cause of disability regarding years of life lived with disability across all ages, and fourth in adults (18–49 years; Meier et al., 2016). In addition, anxiety disorders are associated with a 39% and 146% increased risk of premature mortality from natural causes and unnatural causes, respectively (Meier et al., 2016). People with anxiety disorders are at higher risk of cardiometabolic diseases, such as diabetes and acute cardiac events (Edmondson & von Kanel, 2017; Smith, Deschenes, & Schmitz, 2018). This is potentially due to shared etiological biological factors between anxiety and cardiovascular disorders (e.g., increased inflammation and oxidative stress; Belem da Silva et al., 2017), but also due to modifiable risk behaviors like lower physical activity (PA) levels and increased sedentary behavior (Stubbs, Koyanagi et al., 2017; Vancampfort, Stubbs, Herring, Hallgren, & Koyanagi, 2018). Although several previous cross‐sectional studies suggest that people with anxiety disorders or higher levels of anxiety symptoms are more likely to engage in lower levels of PA (22.9% versus 16.6%; Dillon, McMahon, O’Regan, & Perry, 2018; Stubbs, Koyanagi et al., 2017) and spend more time in sedentary activities when compared with people without anxiety (Dillon et al., 2018; Teychenne, Costigan, & Parker, 2015; Vancampfort et al., 2016, 2018), PA is not always inversely associated with anxiety symptoms (Nguyen et al., 2013).

Objectives: Elite team-sport athletes are frequently exposed to stressors that have the potentialto depress immunity and increase infection risk. Therefore, the purpose of this review is to describe how team-sport stressors impact upon immune responses, along with exploring whether alterations in these markers have the potential to predict upper respiratory tract illness symptoms. Design: Narrative review. Methods: Salivary secretory immunoglobulin A (SIgA) and T-cell markers have been shown to predict infection risk in individual endurance athletes. Papers discussing the impact of team-sport stressors on SIgA and T-cells were discussed in the review, studies discussing other aspects of immunity were excluded. Journal articles were sourced from PubMed, Web of science and Scopus. Key search terms included team-sport athletes, stressors, immunity, T-cells, cytokines, SIgA and upper respiratory illness. Results: Most team-sport stressors appear to increase risk for illness. An association between reduced SIgA and increased illness incidence has been demonstrated. Intensive training and competition periods have been shown to reduce SIgA, however, itis less clear how additional stressors including extreme environmental conditions, travel, psychological stress, sleep disturbance and poor nutrition affect immune responses. Conclusions: Monitoring SIgA may provide an assessment of a team-sport athletes risk status for developing upper respiratory tract symptoms, however there is currently not enough evidence to suggest SIgA alone can predict illness. Team-sport stressors challenge immunity and it is possible that the combination of stressors could have a compounding effect on immunodepression and infection risk. Given that illness can disrupt training and performance, further research is required to better elucidate how stressors individually and collectively influence immunity and illness.

Introduction

Athletes are continually exposed to stressors that have the potential to depress immune functions and increase infection risk, particularly upper respiratory tract infections (URTI) or the common cold. Indeed, acute URTI is the most common infectious illness reportedinelite athletes.1 Illness is of great concernfor athletes as it can disrupttraining and performance.1 To understand why athletes appear to have a heightened risk for infection, the field of exercise immunology emerged. Studies in this area have been largely concerned with identifying immune markers that can be used to predict athletes’ susceptibility to illness, mostly in endurance athletes. Specifically, mucosal immunity and T-cell cytokine responses have been found to be key determinants of URTI risk in athletes participating in individual endurance sports.2 However, there is comparatively little research in team-sport athletes, therefore whether such immune markers influence a team-sport athletes risk for URTI remains unclear. Team-sport athletes are an important populationto investigate as their closeproximity to teammates and other athletes (e.g. shaking hands, contact sports, changing rooms) may increase their exposure to infection-causing pathogens. Furthermore, team-sport athletes are continually exposed to a range of stressors which may depress immune responses. Such stressors include training, competition,travel, environmental extremes, psychological stress, sleep deprivation, poor nutrition and excessive alcohol consumption. It is possible that the combination of these stressors could amplify immunodepression, resulting in greater URTI risk than if each stressor were applied alone. The purpose of this review is to describe how team-sport stressors impact upon salivary secretory immunoglobulin A (SIgA) and T-cell responses, along with exploring whether alterations in these markers have the potential to predict infection risk. Finally, strategies to counteract the potential immunodepression evoked by these stressors will be proposed.

The purpose of this article is to add to the conceptual discussion on eSport, analyze the role of eSport within sport management, and suggest avenues for future eSport research. The authors suggest that debates surround the degree to which eSport represents formal sport, and disagreements likely stem from conceptualizations of sport and context. Irrespective of one’s notion of eSport as formal sport, the authors suggest the topic has a place in sport management scholarship and discourse. Such a position is consistent with the broad view of sport adopted by Sport Management Review, the perspective that eSport represents a form of sportification, and the association among eSport and various outcomes, including physical and psychological health, social well-being, sport consumption outcomes, and diversity and inclusion. Finally, the authors conclude that eSport scholarship can advance through the study of its governance, marketing, and management as well as by theorizing about eSport.

Introduction

eSport represents tournament level, interactive video games, described by British eSports as “the top level of video gaming in terms of skill and professionalization” (What are eSports?, 2016). Their popularity is evidenced by the amount of participants, spectators, and media coverage, as well as organizers considering eSport for inclusion in major sport competitions. According to Newzoo, a company that specializes in offering market data related to digital media and related activities, there were 191 million eSport enthusiasts around the world in 2017 (Esports, 2017). These figures are up considerably from 2016 (148 million enthusiasts; Rapaport, 2017). Industry revenues have followed suit, with US $493 million generated in 2016 and US$660 million in 2017. Spectator attendance for eSport is equally impressive. The tournaments have sold out large venues, such as Key Arena in Seattle and Madison Square Garden in New York City (Rapaport, 2017). But, even more impressive is the online spectatorship; in fact, the “League of Legends” World Finals drew 12 million more fans than the National Basketball Association (NBA) finals held atthe same time (Clavio, 2017). The growth of eSport has not been lost on popular press outlets, where the likes of Forbes,ESPN, Sports Illustrated, and the Guardian, among others, all cover aspects of the events. Finally, the rise of eSport is perhaps best illustrated by news in 2017 that it would be a medal event in the 2022 Asian Games (Graham, 2017). The rise of eSport has not been lost on academics. At past Sport Management Review (SMR) editorial meetings, as part of broader discussions about the boundaries of sport management, board members have discussed and debated the role of eSport, whether the activity should be considered sport at all, and the implications for sport management as a discipline. When the topic was first broached, some members met the discussion with a healthy skepticism, perhaps thinking that it was a passing fad. As eSport grew, however, so too did attention dedicated to the topic—by sponsors, spectators, and academics. The discussions ultimately resulted in the scholarly exchange presented in this issue of SMR. We asked experts in the field to consider two questions: (a) is eSport a sport; and (b) irrespective of the response to the first question, is eSport relevant for the sport management discipline? In this introductory article to the exchange, we, as the SMR editorial team, address these questions, too. In doing so, we seek to contribute to the emerging dialogue surrounding eSport and identify potential paths forward.

مقاله سال 2016

 مرور مدیریت ورزش – Sport Management Review

always wanted my research to make a difference. It came as a huge shock to me when I did my PhD that the people in the organisations that I was conducting my research with didn’t embrace it. One or two people ‘got it’, but for others it was dismissed as ‘biased’ and ‘anecdotal’. I was astonished! How could my carefully constructed research be rejected in such a cavalier manner? Perhaps my reaction to this criticism was so sharp because I was invested in that research: I wanted to make a difference to sport organisations. This investment is a feature of all of my research; whether to help organisations work out how to govern better, enter into more productive partnerships, or become places where people want to go to work regardless of their gender or sexuality. Qualitative research provides opportunities to do this, using participants’ experiences to understand a topic and then possibly frame alternatives, whether those alternatives are radical or incremental change (Alvesson & Gabriel, 2013). These alternatives can be explicit, for example policy driven, or implicit such as providing alternative ways to create an organisation. Even the status quo might be the outcome, as long as it is considered after critical organizational engagement. Qualitative research also provides the opportunity to ‘write ourselves into’ the research, that is to recognise our personal interest in research but also remember that we are researchers and so have to have some distance from our work.

In short, I think that qualitative research has great potential to help improve sport management and, in order to harness this potential, we need to use it to its fullest. My experience as a reviewer for Sport Management Review, Journal of Sport Management and occasionally for European Sport Management Quarterly is that we shy away from such efforts in our qualitative research. We don’t push qualitative research or ourselves hard enough to articulate those potential changes. In part, this may be because we are afraid to push the boundaries in a competitive educational system that rewards the status quo. It may also be that we don’t know what else to do, so we stick with the tried and true semi-structured interviews and case studies. Larena and I have talked about this on many occasions. What follows is an attempt to put our stake in the ground regarding the role of qualitative research in sport management and to articulate a way through which researchers might use the strengths of qualitative research to their fullest to promote social change?.

مقاله سال 2016

 مرور مدیریت ورزش – Sport Management Review

The sport for development (SFD) field has witnessed considerable growth over the last decade with huge growth in the number of programmes that use sport as a tool to address social issues. Sport development is a contested term that is often used variably to indicate the application of both policy and practice in encouraging, increasing and possibly sustaining participation in sport (e.g. see Bramham & Hylton, 2008; Girginov, 2010). Conceptualisations of sport development (SD) vary, often according to power and interest differentials and it is quite clear that there is a fundamental dichotomy in understanding how SD is conceived of and implemented within programmes. This polarising division is succinctly captured by the terms development of sport or development through sport (Houlihan & White, 2002). The former, also known as sport for sport’s sake (Collins, 2010; Devine, 2013) and/or sport plus (Coalter, 2007), tends to leverage sport participation, for the benefit of those participating. Development through sport or plus sport (Coalter, 2007) conversely tends to use sport as a vehicle to address a range of wider social issues emanating from the social problems industry (Hartmann & Kwauk, 2011; Pitter & Andrews, 1997) such as improving health (Edwards & Casper, 2012), reducing crime and tackling obesity (Houlihan & White, 2002).

These two categories of sport development compete in political, social, economic and cultural ways. Politically, each category infers particular policy contexts that condition and construct what might be regarded as politically useable resources (Allison, 1986; Collins, 2008; Darnell, 2012). Socially, each category suggests a particular approach to collective action problems and the meaning of sport for both the individual and society (Adams, 2012; Hartmann & Kwauk, 2011). Economically, each category sets forth the scale of impact that is possible and implores more of the available scarce resources necessary to make the anticipated impact (Grix & Carmichael, 2012). Culturally, each category addresses separate norms and values that again relate to the meaning of sport, but also address wider issues of socialisation and community development (Coakley, 2011; Lindsey & Adams, 2013). These distinctions and divisions are of relevance to sport management scholars insofar that on the one hand sport development is arguably a sub-branch of the discipline and yet on the other hand it provides a point of tension, an almost dialectic, to the emphasis on managing under dominant contexts in the provision of mass sport opportunities (Adams, 2012). Certainly those familiar with Rittel and Webber’s seminal paper Dilemmas in a General Theory of Planning (1973) will acknowledge the persistence of ‘wicked problems’ in and through the delivery of sport programmes. Their argument when applied to the sport domain–that many problems with which sport is charged with ‘fixing’ are poorly defined, lack clarity and are resistant to clear and agreed solutions (Haudenhuyse, Theeboom, & Nols, 2012)-has a clear resonance for sport managers. These distinctions in the utility of sport have led a range of actors to explore how and where sport can be treated instrumentally for particular purposes or with specific outcomes in mind. It is from this latter field of ‘development through sport’ that sport for development (SFD) has emerged as an umbrella term that captures some of the many roles that sport can play in addressing social issues in different societies. Ontologically SFD is rooted in the idea that participatory forms of sport can be a good thing in making a purposeful, strategic and positive contribution to society. Crucially however, similar to Green (2009), we recognise that it is not sport per se that is responsible for specific outcomes, but rather the manner and context of its implementation.

With an increasing global focus on SFD, the field has regularly been required to demonstrate accountability for investment made by funders via robust and systematic approaches to evidence that centre upon proving the place of sport within development (Kay, 2012). While accepting differences in global contexts, it is clear that similarities persist; none more so than in the dominance of neoliberalism (Hall, Massey, & Rustin, 2013). Globally, idioms of modernisation that share a reciprocal relationship with neoliberal disciplines have dominated the contexts and frameworks within which SFD operates (Coakley, 2011; Green, 2007; Sam, 2009). It is within this broad context of neoliberalism and modernisation, with an emphasis on evidence as the golden goose of validity, that the field of SFD has been roundly criticised. In part this is due to the imposition of performance indicators (PI), which have, in a modernised sport system, depowered delivery agents while reaffirming the dominance of external stakeholders (Coalter & Taylor, 2010; Taylor, 2009). Despite some significant contributions to the field recently concerning the positive attributes associated with SFD (e.g. Crabbe, 2007; Frisby, Crawford, & Dorer, 1997; Schulenkorf, 2012; Sugden, 1991), there still remains scepticism and critique surrounding some of the issues and shortcomings of certain approaches to monitoring and evaluation (M&E) (Coalter, 2007, 2010b; Edwards, 2015; Kay, 2012; Smith & Leach, 2010). This has amplified and exacerbated what Nicholls et al. (2010) call a lack of evidence discourse. Such failings have been attributed to a poor understanding and application of how and why programmes work and a lack of robust, research based evidence concerning the outcomes of sport participation (Adams & Harris, 2014; Coalter, 2007). This amounts to sport being a necessary but not sufficient condition for the achievement of social outcomes (Coalter, 2010a), making sport a contingent variable rather than a lone remedy.