The 100 Most Influential Studies in Sports Medicine

James J. Latham

Just one evaluate of the impression of a scientific strategy is how normally it receives cited by other scientists. The best-cited paper of all time, according to a 2014 investigation by Nature, has now been cited by 344,007 other scientific articles or blog posts because its publication in 1951. (The subject […]

Just one evaluate of the impression of a scientific strategy is how normally it receives cited by other scientists. The best-cited paper of all time, according to a 2014 investigation by Nature, has now been cited by 344,007 other scientific articles or blog posts because its publication in 1951. (The subject matter? You’d never ever guess, for motives we’ll get into under.) Researchers’ job prospective customers are affected by their h-index, a evaluate that rewards possessing a high range of seriously cited papers (and potentially, while no just one would essentially acknowledge it, by their Kardashian index, which compares their cumulative citations to the range of Twitter followers they have).

You can also use very similar strategies to examine complete fields, which is what a new research led by Omeet Khatra of the University of British Columbia tries for sports and training medication. In the Orthopaedic Journal of Sports activities Medication, Khatra and his colleagues set together a list of the a hundred articles or blog posts with the most citations in the subject, giving a snapshot of the influence of each unique papers and broader developments. There are a bunch of exciting findings, but potentially the most telling is this: only just one of the a hundred papers is a randomized controlled demo, which is the gold-common variety of experimental proof.

The Discipline

Just one essential caveat for this investigation is that the boundaries of sports and training medication are really hazy. Khatra’s definition consists of handling sports accidents, improving athletic effectiveness, and the use of training to improve wellness. That is extremely broad, but the system utilised to discover best papers was a minor much more idiosyncratic. They started out by pinpointing a list of 46 journals concentrated on sports and training medication, and then identified the a hundred most-cited articles or blog posts from within those people journals.

That signifies significant papers printed in non-specialist journals do not exhibit up on the list. A.V. Hill’s initial 1923 study on VO2 max was printed in the Quarterly Journal of Medication Karlman Wasserman’s 1964 paper on the anaerobic threshold was printed in the American Journal of Cardiology. In fact, you’d expect that the most ground-breaking findings are the most probable to make it into generalist journals like Nature and Science (in which, for illustration, a classic 1937 paper on the cardio electric power of entire world history-placing runners was printed).

So it is not a extensive list, but it still addresses a substantial fraction of the subject. It’s dominated by Medication & Science in Sports activities & Exercising, the flagship journal of the American College of Sports activities Medication, which contributes no fewer than forty nine of the papers. Next on the list are the American Journal of Sports activities Medication, with eighteen, and Sports activities Medication, with 7. The oldest paper on the list is from 1973, reflecting the field’s rather modern emergence as a unique discipline: MSSE, for illustration, was only introduced in 1969.

The Winner

Topping the list with 7,228 citations was Gunnar Borg’s 1982 paper, “Psychophysical bases of perceived exertion.” Borg is the male who advanced the notion of a subjective scale of perceived hard work, which at first ran from six to twenty, although there is a much more rational modified model that runs from zero to 10. He started out building this strategy in the sixties, but the 1982 English-language paper is the just one that receives cited each time men and women communicate about perceived hard work. (Yet another just one of Borg’s papers on the subject matter, from 1973, shows up at forty eighth on the list.)

You may not think that inquiring men and women to assign a range to how challenging they are doing the job is a main scientific breakthrough. But Borg’s function has had a enormous influence. He argued that his scale is “the single very best indicator of the diploma of actual physical pressure,” integrating indicators from the muscle mass, lungs, coronary heart, and brain. In the past two a long time, much more and much more scientists have taken that argument critically as they’ve tried to demonstrate the brain’s role in analyzing our actual physical limits, and also as a useful tool for guiding training. Base line: I’d say Borg’s paper is a deserving winner.

The Themes

The largest team of papers on the list target on methodological equipment: how to run a VO2 max examination, how to calculate body composition, how to calibrate your pedometers and accelerometers, what validated questionnaires to use to request your subjects about their training behaviors, and so on. That is also what is noticed in other fields: the all-time most cited paper that I outlined at the best is a solutions paper on “protein measurement with the folin phenol reagent.”

Approaches papers could not seem all that interesting, but they can unquestionably be controversial. Several of the papers on the list target on studies, which include the range nine paper, from 2008, by Will Hopkins and colleagues: “Progressive studies for scientific tests in sports medication and training science.” That method to studies is created to tease out delicate effectiveness outcomes in scientific tests with little sample measurements. But it has come under extreme criticism, most notably following a 2018 short article in FiveThirtyEight by Christie Aschwanden arguing that it is much more probable to produce false-favourable findings than traditional statistical solutions.

Yet another big bucket is formal suggestions, mainly the ones issued by the American College of Sports activities Medication on subject areas which include resistance training, exercising with cancer, hydration, weight loss, blood force, and exercises for older grown ups. These are practical overviews to cite in the introduction to an short article when you want to back again up normal claims like “exercise is fantastic for you” or regardless of what, but they are not notably ground-breaking.

Right after that, it is much more of a blended bag. The most preferred part of the anatomy is the knee, which is the target of fifteen papers, mainly relating to ACL accidents. Next is the brain, which options in three papers on concussion in activity. Two other themes that rack up a number of mentions: the enduring thriller of delayed-onset muscle mass soreness, and the emerging wellness scourge of far too a lot sitting down.

There are three papers on the physiology of soccer, just one on the biomechanics of baseball pitching, and just one on Hakan Alfredson’s renowned heel-drop protocol for Achilles tendinosis, which squeaks in at 98th area. (Humorous backstory: Alfredson is an orthopedic surgeon who had Achilles challenges back again in the nineteen nineties. When his boss refused to give him time off for surgical procedure simply because the issue wasn’t serious more than enough, he resolved to irritate his Achilles with unpleasant heel drops—but accidentally healed himself.)

The Proof

I outlined at the best that only just one of the scientific tests on the list is a randomized controlled demo, which means that subjects were randomly assigned to both acquire both an intervention or a placebo. Instead, most of the experimental papers use reduced amounts of proof these kinds of as cohort scientific tests and scenario series, neither of which use randomization or regulate teams. The most significant single class, with 38 papers, is narrative testimonials, which study the final results of a number of scientific tests on a subject matter but do not pool them into just one big meta-investigation.

I think most sports scientists would concur that the subject desires much more randomized trials, along with other methodological advancements like greater topic teams and much more refined statistical analyses. But the faults in the best-a hundred list almost certainly are not specific to sports science. Watson and Crick’s discovery of the composition of DNA and Einstein’s theory of normal relativity do not make their respective lists both: the most significant breakthroughs grow to be textbook content that does not even have to have a quotation. “If citations are what you want,” Yale University chemist Peter Moore advised Nature, “devising a system that can make it achievable for men and women to do the experiments they want at all, or much more quickly, will get you a large amount more than, say, finding the top secret of the Universe.”

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Direct Photograph: Flamingo Photographs/Stocksy

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