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    Use of an Advanced Hybrid Closed Loop System During Marathon Running: Case Examples and Clinical Implications
    (Wiley, 2025-02-28)
    María T. Onetto
    ;
    Denise Montt‐Blanchard
    ;
    Cari Berget
    ;
    Kristel Strodhoff
    ;
    Bruno Grassi
    Maintaining glucose levels in the target range during aerobic training and athletic competition is especially difficult. The use of Automated Insulin Delivery (AID) technology is increasing, but exercise continues to be a challenge for persons with type 1 diabetes (T1D). In this case report series, we present 3 cases (C1, C2 and C3) of persons with T1D who used the MiniMed 780G during marathon races. We describe the strategies they used before, during and after the race to manage their glycaemia as well as the results of these strategies on their glycaemic control during the race.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>The Medtronic CareLink platform was employed to remotely access insulin pump settings and glycaemic outcomes. Race parameters were obtained from sport watches. Supplemental data were obtained through interviews.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Carelink data for Cases 1, 2, and 3 before the race were downloaded: Time in range (TIR) 70–180 mg/dL 89%, 76%, 82%; time above range (TAR) &gt; 180 mg/dL, 9%, 20%, 16%; time below range (TBR) &lt; 70 mg/dL, 1%, 4%, 1%, respectively. The breakfast insulin reduction percentages were −25%, 0%, and 0% for C1, C2, and C3, respectively. In all three cases, insulin dose reduction was applied to the pre‐race snack at percentages of −50%, −100% and −83%. The consumption of carbohydrates during the race was 0.39 g/kg/hour, 0.42 g/kg/hour, and 0.5 g/kg/hour, respectively. The total amount of carbohydrates consumed was 101 g, 120 g, and 115 g, respectively. Throughout the race, a temporary target was used for all cases.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>These cases provide insights for healthcare professionals who assist athletes with T1D using AID systems during prolonged physical activities. Highlighting the significance of specialised education, planning, and personalised approaches.</jats:p></jats:sec>
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    Exploring contextual factors for management and prevention of running-related injuries: runners and experts’ perspectives
    (BMJ, 2025-04)
    BESOMI MOLINA, MANUELA  
    ;
    Roa-alcaino Sonia
    ;
    Ángela Lombardi
    ;
    Rocío Vélez-Rivera
    ;
    LEPPE ZAMORA, JAIME ESTEBAN  
    Running is one of the most accessible and popular physical activities worldwide; however, injuries are the main barrier to sustaining running practice. While quantitative studies have explored prevalence and risk factors, a critical gap exists in understanding subjective experiences, perceptions and contextual influences on injury management and prevention. This qualitative study aimed to explore the perspectives of runners and experts regarding injury perception, management and prevention, as well as the contextual influence of these processes. Using a secondary data analysis approach, this study drew from qualitative semistructured interviews with Chilean runners (n=15) and running experts (n=6). Thematic analysis, guided by an interpretivist approach, uncovered intrinsic factors (identity, motivation, stress and self-learning) and extrinsic factors (environment, information sources, marketing, peer advice, professional guidance, racing, stereotype and clothing) that shaped runners’ behaviours. Less experienced runners associated injury risk with asphalt surfaces, faced challenges in discerning online information reliability and found motivation in peer advice. Experts emphasised the multifactorial nature of running-related injuries, including previous injuries and training-related factors. Both groups acknowledged a global tendency among runners to resist rest when discomfort arose. This research contributed to a nuanced understanding of injury perception, management and prevention, bridging scientific knowledge with individual experiences. Clinicians may use this information to enhance the therapy alliance and set realistic expectations about the runner’s rehabilitation process.
      1Scopus© Citations 3
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    Scopus© Citations 6  5
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      4
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    Frequency of Injury and Illness in the Final 4 Weeks before a Trail Running Competition
    (2021)
    Rubén Gajardo-Burgos
    ;
    Manuel Monrroy-Uarac
    ;
    René Mauricio Barría-Pailaquilén
    ;
    Yessenia Norambuena-Noches
    ;
    Dina Christa Janse van Rensburg
    <jats:p>We aimed to (i) determine self-reported injury and illness frequency in trail runners 4 weeks preceding competition; (ii) compare athletes with and without injury/illness by sex, age, body mass index (BMI) and competition distance; (iii) describe mechanism of injury, anatomical region (injury)/organ system (illness) involved, consequences of injury on preparation and self-perception of injury severity; (iv) compare anatomical region (injury) and organ system (illness) by sex. A total of 654 trail runners (age 36.2, IQR 30.6–43.0; 36.9% females) participated in this retrospective cross-sectional study by completing a self-reported questionnaire. Injury and illness frequency rates were 31.3% (n = 205, CI:27.7–35.0%) and 22.3% (n = 146, CI:19.1–25.7%), respectively. No significant difference was found between injured vs. non-injured or ill vs. non-ill study participants by sex, age, BMI and competition distance. Regarding injuries, gradual onset (41.6%) and knee (33.2%) were the most indicated mechanism and anatomical region of injury. At least 85.4% of trail runners changed their training following injury and 79% indicated that their injury would affect their competition performance. Regarding illness, the respiratory tract was the most frequent organ system involved (82.9%). Male and female participants reported similar proportions of anatomical regions (injury) and organ systems (illness) affected. These results could help to generate education strategies and appropriate medical support before and during these competitions.</jats:p>
      4Scopus© Citations 13
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    Trail running injury risk factors: a living systematic review
    (2022)
    Carel Viljoen
    ;
    Dina C (Christa) Janse van Rensburg
    ;
    Willem van Mechelen
    ;
    Evert Verhagen
    ;
    Bruno Silva
    <jats:sec><jats:title>Objective</jats:title><jats:p>To review and frequently update the available evidence on injury risk factors and epidemiology of injury in trail running.</jats:p></jats:sec><jats:sec><jats:title>Design</jats:title><jats:p>Living systematic review. Updated searches will be done every 6 months for a minimum period of 5 years.</jats:p></jats:sec><jats:sec><jats:title>Data sources</jats:title><jats:p>Eight electronic databases were searched from inception to 18 March 2021.</jats:p></jats:sec><jats:sec><jats:title>Eligibility criteria</jats:title><jats:p>Studies that investigated injury risk factors and/or reported the epidemiology of injury in trail running.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Nineteen eligible studies were included, of which 10 studies investigated injury risk factors among 2 785 participants. Significant intrinsic factors associated with injury are: more running experience, level A runner and higher total propensity to sports accident questionnaire (PAD-22) score. Previous history of cramping and postrace biomarkers of muscle damage is associated with cramping. Younger age and low skin phototypes are associated with sunburn. Significant extrinsic factors associated with injury are neglecting warm-up, no specialised running plan, training on asphalt, double training sessions per day and physical labour occupations. A slower race finishing time is associated with cramping, while more than 3 hours of training per day, shade as the primary mode of sun protection and being single are associated with sunburn. An injury incidence range 0.7–61.2 injuries/1000 hours of running and prevalence range 1.3% to 90% were reported. The lower limb was the most reported region of injury, specifically involving blisters of the foot/toe.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Limited studies investigated injury risk factors in trail running. Our review found eight intrinsic and nine extrinsic injury risk factors. This review highlighted areas for future research that may aid in designing injury risk management strategies for safer trail running participation.</jats:p><jats:p>PROSPERO registration number</jats:p><jats:p>CRD42021240832.</jats:p></jats:sec>
      5Scopus© Citations 23
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      16Scopus© Citations 11
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    Scopus© Citations 13  2