21/10/2021

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The 100 Most Influential Studies in Sports Medicine

1 evaluate of the impact of a scientific idea is how frequently it receives cited by other experts. The leading-cited paper of all time, in accordance to a 2014 evaluation by Mother nature, has now been cited by 344,007 other scientific content considering the fact that its publication in 1951. (The matter? You’d hardly ever guess, for reasons we’ll get into below.) Researchers’ career prospects are affected by their h-index, a measure that rewards obtaining a substantial selection of closely cited papers (and probably, while no a person would truly confess it, by their Kardashian index, which compares their cumulative citations to the number of Twitter followers they have).

You can also use comparable strategies to assess full fields, which is what a new analyze led by Omeet Khatra of the College of British Columbia attempts for athletics and workout medication. In the Orthopaedic Journal of Sports Medication, Khatra and his colleagues place together a list of the 100 posts with the most citations in the field, providing a snapshot of the affect of equally personal papers and broader developments. There are a bunch of attention-grabbing findings, but most likely the most telling is this: only 1 of the 100 papers is a randomized controlled trial, which is the gold-regular type of experimental evidence.

The Subject

A person essential caveat for this evaluation is that the boundaries of athletics and training medicine are fairly hazy. Khatra’s definition contains managing sports activities accidents, improving athletic performance, and the use of workout to boost wellness. Which is pretty wide, but the approach utilized to recognize prime papers was a very little more idiosyncratic. They began by determining a listing of 46 journals targeted on athletics and exercise medication, and then recognized the 100 most-cited articles or blog posts from within these journals.

That implies significant papers printed in non-professional journals really do not present up on the record. A.V. Hill’s first 1923 study on VO2 max was printed in the Quarterly Journal of Medication Karlman Wasserman’s 1964 paper on the anaerobic threshold was published in the American Journal of Cardiology. In truth, you’d expect that the most ground-breaking findings are the most probable to make it into generalist journals like Mother nature and Science (in which, for example, a basic 1937 paper on the cardio energy of planet history-setting runners was revealed).

So it is not a in depth listing, but it nonetheless covers a substantial fraction of the industry. It’s dominated by Medication & Science in Sports activities & Workout, the flagship journal of the American School of Sports activities Medication, which contributes no considerably less than 49 of the papers. Next on the checklist are the American Journal of Sports Drugs, with 18, and Sports activities Medicine, with 7. The oldest paper on the checklist is from 1973, reflecting the field’s fairly current emergence as a unique discipline: MSSE, for instance, was only released in 1969.

The Champion

Topping the checklist with 7,228 citations was Gunnar Borg’s 1982 paper, “Psychophysical bases of perceived exertion.” Borg is the male who sophisticated the strategy of a subjective scale of perceived effort and hard work, which initially ran from six to 20, while there’s a additional logical modified version that runs from zero to ten. He begun developing this plan in the 1960s, but the 1982 English-language paper is the one that gets cited each time people discuss about perceived energy. (An additional a person of Borg’s papers on the subject matter, from 1973, exhibits up at 48th on the checklist.)

You could possibly not think that asking persons to assign a variety to how difficult they are functioning is a key scientific breakthrough. But Borg’s function has had a massive influence. He argued that his scale is “the single greatest indicator of the degree of physical strain,” integrating alerts from the muscle tissue, lungs, coronary heart, and brain. In the final two a long time, much more and extra researchers have taken that argument significantly as they’ve attempted to reveal the brain’s role in analyzing our physical limits, and also as a useful instrument for guiding teaching. Bottom line: I’d say Borg’s paper is a deserving winner.

The Themes

The premier team of papers on the record concentration on methodological applications: how to operate a VO2 max examination, how to compute system composition, how to calibrate your pedometers and accelerometers, what validated questionnaires to use to ask your subjects about their physical exercise patterns, and so on. Which is also what’s observed in other fields: the all-time most cited paper that I outlined at the prime is a procedures paper on “protein measurement with the folin phenol reagent.”

Procedures papers might not sound all that thrilling, but they can definitely be controversial. Various of the papers on the list target on figures, together with the selection 9 paper, from 2008, by Will Hopkins and colleagues: “Progressive figures for scientific tests in sports activities drugs and workout science.” That strategy to statistics is developed to tease out refined efficiency effects in experiments with smaller sample dimensions. But it has come beneath rigorous criticism, most notably subsequent a 2018 posting in FiveThirtyEight by Christie Aschwanden arguing that it is extra likely to create wrong-optimistic results than conventional statistical techniques.

Yet another major bucket is official suggestions, largely the kinds issued by the American Faculty of Sports activities Medicine on topics which includes resistance coaching, training with most cancers, hydration, pounds reduction, blood stress, and exercises for more mature grownups. These are practical overviews to cite in the introduction to an short article when you want to back up general claims like “exercise is great for you” or whatever, but they are not especially floor-breaking.

Immediately after that, it’s additional of a blended bag. The most popular element of the anatomy is the knee, which is the concentrate of 15 papers, largely relating to ACL accidents. Upcoming is the brain, which characteristics in three papers on concussion in activity. Two other themes that rack up multiple mentions: the enduring mystery of delayed-onset muscle mass soreness, and the emerging health and fitness scourge of way too much sitting down.

There are three papers on the physiology of soccer, one on the biomechanics of baseball pitching, and one on Hakan Alfredson’s well known heel-drop protocol for Achilles tendinosis, which squeaks in at 98th location. (Amusing backstory: Alfredson is an orthopedic surgeon who experienced Achilles issues back in the 1990s. When his manager refused to give him time off for surgical procedure mainly because the problem was not critical enough, he decided to aggravate his Achilles with distressing heel drops—but accidentally healed himself.)

The Proof

I outlined at the top rated that only just one of the research on the checklist is a randomized controlled trial, meaning that topics ended up randomly assigned to both obtain possibly an intervention or a placebo. Rather, most of the experimental papers use decrease levels of evidence these kinds of as cohort scientific tests and circumstance sequence, neither of which use randomization or regulate groups. The largest solitary group, with 38 papers, is narrative critiques, which survey the success of many studies on a subject matter but do not pool them into a single major meta-evaluation.

I believe most sports activities experts would agree that the discipline requirements additional randomized trials, alongside with other methodological enhancements like even bigger subject matter groups and a lot more subtle statistical analyses. But the faults in the top rated-100 list most likely aren’t precise to sporting activities science. Watson and Crick’s discovery of the framework of DNA and Einstein’s principle of typical relativity never make their respective lists possibly: the largest breakthroughs turn out to be textbook material that doesn’t even call for a citation. “If citations are what you want,” Yale University chemist Peter Moore explained to Character, “devising a technique that makes it feasible for folks to do the experiments they want at all, or a lot more very easily, will get you a great deal even more than, say, exploring the key of the Universe.”


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