The 100 Most Influential Studies in Sports Medicine

One particular measure of the impact of a scientific notion is how frequently it receives cited by other researchers. The top rated-cited paper of all time, in accordance to a 2014 evaluation by Character, has now been cited by 344,007 other scientific content articles since its publication in 1951. (The subject? You’d never guess, for good reasons we’ll get into beneath.) Researchers’ position prospective clients are motivated by their h-index, a measure that benefits getting a significant number of closely cited papers (and perhaps, although no one particular would really admit it, by their Kardashian index, which compares their cumulative citations to the number of Twitter followers they have).

You can also use comparable approaches to evaluate complete fields, which is what a new examine led by Omeet Khatra of the College of British Columbia attempts for sports and training drugs. In the Orthopaedic Journal of Athletics Drugs, Khatra and his colleagues set with each other a record of the 100 content articles with the most citations in the field, presenting a snapshot of the influence of the two particular person papers and broader developments. There are a bunch of interesting results, but perhaps the most telling is this: only one particular of the 100 papers is a randomized managed demo, which is the gold-standard style of experimental evidence.

The Subject

One particular important caveat for this evaluation is that the boundaries of sports and training drugs are very hazy. Khatra’s definition contains taking care of sports injuries, enhancing athletic efficiency, and the use of training to boost health. That is very broad, but the technique employed to determine top rated papers was a minor much more idiosyncratic. They started by identifying a record of 46 journals targeted on sports and training drugs, and then recognized the 100 most-cited content articles from inside of people journals.

That implies important papers published in non-specialist journals never show up on the record. A.V. Hill’s original 1923 study on VO2 max was published in the Quarterly Journal of Drugs Karlman Wasserman’s 1964 paper on the anaerobic threshold was published in the American Journal of Cardiology. In simple fact, you’d expect that the most floor-breaking results are the most very likely to make it into generalist journals like Character and Science (the place, for illustration, a common 1937 paper on the cardio electrical power of world history-placing runners was published).

So it’s not a comprehensive record, but it nonetheless addresses a big portion of the field. It is dominated by Drugs & Science in Athletics & Physical exercise, the flagship journal of the American Faculty of Athletics Drugs, which contributes no considerably less than 49 of the papers. Up coming on the record are the American Journal of Athletics Drugs, with eighteen, and Athletics Drugs, with seven. The oldest paper on the record is from 1973, reflecting the field’s comparatively new emergence as a unique discipline: MSSE, for illustration, was only introduced in 1969.

The Winner

Topping the record with seven,228 citations was Gunnar Borg’s 1982 paper, “Psychophysical bases of perceived exertion.” Borg is the male who state-of-the-art the thought of a subjective scale of perceived energy, which initially ran from six to 20, whilst there is a much more reasonable modified version that runs from zero to ten. He started developing this notion in the nineteen sixties, but the 1982 English-language paper is the one particular that receives cited anytime people talk about perceived energy. (Another one particular of Borg’s papers on the subject, from 1973, displays up at forty eighth on the record.)

You may possibly not believe that inquiring people to assign a number to how hard they are functioning is a major scientific breakthrough. But Borg’s work has experienced a substantial influence. He argued that his scale is “the one best indicator of the diploma of bodily pressure,” integrating indicators from the muscle mass, lungs, heart, and mind. In the final two many years, much more and much more researchers have taken that argument very seriously as they’ve tried to explain the brain’s function in identifying our bodily boundaries, and also as a useful resource for guiding education. Base line: I’d say Borg’s paper is a deserving champion.

The Themes

The premier group of papers on the record target on methodological instruments: how to operate a VO2 max test, how to calculate entire body composition, how to calibrate your pedometers and accelerometers, what validated questionnaires to use to check with your topics about their training patterns, and so on. That is also what is noticed in other fields: the all-time most cited paper that I mentioned at the top rated is a solutions paper on “protein measurement with the folin phenol reagent.”

Techniques papers may well not seem all that interesting, but they can certainly be controversial. Quite a few of the papers on the record target on figures, which includes the number 9 paper, from 2008, by Will Hopkins and colleagues: “Progressive figures for scientific studies in sports drugs and training science.” That approach to figures is made to tease out subtle efficiency outcomes in scientific studies with tiny sample dimensions. But it has come under intense criticism, most notably following a 2018 short article in FiveThirtyEight by Christie Aschwanden arguing that it is much more very likely to produce untrue-favourable results than traditional statistical solutions.

Another major bucket is official suggestions, generally the kinds issued by the American Faculty of Athletics Drugs on topics which includes resistance education, performing exercises with most cancers, hydration, bodyweight loss, blood strain, and exercises for more mature older people. These are helpful overviews to cite in the introduction to an short article when you want to back up common promises like “exercise is good for you” or regardless of what, but they are not especially floor-breaking.

Following that, it’s much more of a combined bag. The most well-known element of the anatomy is the knee, which is the target of fifteen papers, generally relating to ACL injuries. Up coming is the mind, which attributes in 3 papers on concussion in sport. Two other themes that rack up a number of mentions: the enduring secret of delayed-onset muscle soreness, and the emerging health scourge of too much sitting.

There are 3 papers on the physiology of soccer, one particular on the biomechanics of baseball pitching, and one particular on Hakan Alfredson’s famed heel-drop protocol for Achilles tendinosis, which squeaks in at 98th location. (Humorous backstory: Alfredson is an orthopedic surgeon who experienced Achilles issues back in the 1990s. When his manager refused to give him time off for medical procedures simply because the ailment was not serious more than enough, he made the decision to worsen his Achilles with agonizing heel drops—but accidentally healed himself.)

The Evidence

I mentioned at the top rated that only one particular of the scientific studies on the record is a randomized managed demo, this means that topics were randomly assigned to either obtain either an intervention or a placebo. Instead, most of the experimental papers use reduced ranges of evidence these types of as cohort scientific studies and case collection, neither of which use randomization or management groups. The most significant one category, with 38 papers, is narrative critiques, which survey the success of a number of scientific studies on a subject but never pool them into one particular major meta-evaluation.

I believe most sports researchers would concur that the field wants much more randomized trials, along with other methodological enhancements like more substantial issue groups and much more innovative statistical analyses. But the faults in the top rated-100 record in all probability aren’t precise to sports science. Watson and Crick’s discovery of the framework of DNA and Einstein’s theory of common relativity never make their respective lists either: the most significant breakthroughs become textbook material that does not even involve a citation. “If citations are what you want,” Yale College chemist Peter Moore advised Character, “devising a technique that would make it achievable for people to do the experiments they want at all, or much more simply, will get you a large amount further more than, say, getting the magic formula of the Universe.”

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