Current research suggests that menstruating female athletes might be at greater risk of musculoskeletal injury in relation to hormonal changes throughout the menstrual cycle. A separate body of work suggests that spatial cognition might also fluctuate in a similar manner. Changes in spatial cognition could, in theory, be a contributing risk factor for injury, especially in fast-paced sports that require precise, millisecond accuracy in interactions with moving objects in the environment. However, existing theories surrounding causes for increased injury risk in menstruating females largely focus on biomechanical mechanisms, with little consideration of possible cognitive determinants of injury risk. Therefore, the aim of this proof-of-principle study was to explore whether menstruating females exhibit fluctuations in cognitive processes throughout their cycle on a novel sport-oriented cognitive test battery, designed to measure some of the mental processes putatively involved in these sporting situations. A total of 394 participants completed an online cognitive battery, a mood scale and a symptom questionnaire twice, 14 days apart. After exclusions, 248 eligible participants were included in the analyses (mean: 28 ± 6 years) (male = 96, female(menstruating) = 105, female(contraception) = 47). Cycle phase for menstruating females was based on self-reported information. The cognitive battery was designed to measure reaction times, attention, visuospatial functions (including 3D mental rotation) and timing anticipation. Three composite scores were generated using factor analysis with varimax rotation (Errors, Reaction Time, Intra-Individual Variability). Mixed model ANOVAs and repeated measures ANOVAs were performed to test for between and within-subject effects. There was no group difference in reaction times and accuracy between males and females (using contraception and not). However, within subject analyses revealed that regularly menstruating females performed better during menstruation compared to being in any other phase, with faster reaction times (10ms c.ca, p < 0.01), fewer errors (p < 0.05) and lower dispersion intra-individual variability (p < 0.05). In contrast they exhibited slower reaction times (10ms c.ca, p < 0.01) and poorer timing anticipation (p < 0.01) in the luteal phase, and more errors in the predicted ovulatory phase (p < 0.01). Self-reported mood, cognitive and physical symptoms were all worst during menstruation (p < 0.01), and a significant proportion of females felt that their symptoms were negatively affecting their cognitive performance during menstruation on testing day, which was incongruent with their actual performance. These findings suggest that visuospatial and anticipatory processes may fluctuate throughout the menstrual cycle in the general population, with better performance during the menstrual phase and poorer performance during the luteal phase. If these extend to associations between phase-specific cognitive performance and injury incidence, they would support a cognitive theory of determinants of injury risk in cycling female athletes, opening an opportunity to develop mitigation strategies where appropriate.

Mixed-gender studies predominate in the current literature exploring the interaction between physical activity and dementia risk. Considering that menopause appears to contribute to females’ increased risk of cognitive decline when compared to males, further clarity is required on the impact of physical activity in reducing late-life dementia risk, specifically in perimenopausal females. A literature search of MEDLINE, EMBASE, Web of Science, SCOPUS and CINAHL databases yielded fourteen studies for review. A significant inverse relationship between perimenopausal leisure time physical activity, or physical fitness, and future all-cause dementia risk was found in most studies exploring this interaction. Higher levels of perimenopausal household physical activity and combined non-leisure time physical activity also displayed a favorable impact in lowering dementia risk. A dose-response effect was demonstrated, with approximately 10 MET-hour/week of leisure time physical activity required for significant dementia risk reduction. Three of four papers exploring causality provided analyses proposed to counter the reverse causation argument, suggesting that physical activity may indeed have a protective role in reducing dementia risk post-menopause. The current systematic review provides promising results regarding the impact of pre- and perimenopausal physical activity on reducing late-life dementia risk, suggesting that promoting perimenopausal physical activity may serve as a crucial tool in mitigating the risk of post-menopausal cognitive decline.

Large cohort studies have reported that former professional football players have an increased risk of mortality from neurodegenerative disease. Due to emerging concerns regarding the safety of heading the technique is now banned for players under 12. The aim of this systematic review was to evaluate the association between heading exposure and cognitive function in professional football players. A search strategy was devised and entered into seven electronic databases: MEDLINE, Embase, Web of Science, PsycINFO, CENTRAL, SportDiscus and PEDro. The search identified 563 records. After screening records and applying the eligibility criteria, nine cross-sectional studies (n=925) were included in the review, investigating 452 current and 473 former players (859 males, 66 females). Six studies (n=595) reported evidence for an association between heading and impaired cognitive function, while three studies (n=330) reported no association. Diverse cognitive domains were investigated, which might underline the disparity in these results. The association between heading and cognitive function in professional football appears likely but remains inconclusive. Methodological heterogeneity and variability in the presentation of results limits the conclusions drawn. Prospective longitudinal studies using standardised methods, and including females, are required to provide evidence to support or refute an association.

Introduction: School-based exercise interventions targeted at reducing obesity are often successful in the short term, but they are resource-heavy and do not always lead to long-lasting behaviour changes. This study investigated the effect of reducing sedentary time, rather than increasing exercise, on physical activity (PA) behaviours and obesity in primary school children. Methods: Thirty UK state primary schools participated in this cluster-controlled intervention study (IDACI score = 0.15 ± 0.07, free school meals = 26 ± 9%). Twenty-six intervention and 4 control schools (intervention = 3,529, control = 308 children) completed the Physical Activity Questionnaire for Children (PAQ-C) in terms 1 and 3. Three intervention and 3 control schools (intervention = 219, control = 152 children) also measured waist-to-height ratio (WTHR). The Active Movement Intervention is a school-based programme which integrates non-sedentary behaviours such as standing and walking in the classroom. Data were analysed via ANCOVAs and multiple linear regressions. Results: WTHR was reduced by 8% in the intervention group only (F(2, 285) = 11.387, p < 0.001), and sport participation increased by 10% in the intervention group only (F(1, 232) = 6.982, p = 0.008). Other PAQ-C measures increased significantly in the intervention group, but there was no group*time interaction. Changes in PAQ-C did not predict reductions in WTHR. Instead, the amount of change in WTHR was predicted by intervention group and by baseline WTHR of the pupil, where children with higher baseline WTHR showed greater reductions (F(2, 365) = 77.21, p < 0.001, R2 = 0.30). Socio-economic status (SES), age, or gender did not mediate any of the changes in the PAQ-C or WTHR. Conclusion: Reducing sedentary behaviours during school time can be an effective obesity reduction strategy for primary school children who are overweight. The lack of demographic effects suggests that this method can be effective regardless of the school’s SES, pupil age, or gender.

Background: There is growing interest in understanding if, and how, the menstrual cycle may affect physical and cognitive performance, particularly in the context of sport and physical activity. While hormonal fluctuations are often assumed to impact cognition, especially during menstruation, empirical evidence remains inconclusive. This study aimed to investigate whether cognitive performance, mood, and symptomology vary across menstrual cycle phases and whether these effects are influenced by athletic participation level. Results: Fifty-four females (18–40 years) categorised by athletic participation level (i.e., inactive, active, competing, elite) took part. At each key menstrual phase (menstruation / early follicular, late follicular, ovulation and mid-luteal), they completed a cognitive battery (attention, inhibition and spatial anticipation), and reported their mood and symptoms. Faster reaction times and fewer errors were committed during ovulation ( p < .01), suggesting better overall performance. In contrast, reaction times were slower during the luteal phase ( p < .01), but more errors were committed in the follicular phase ( p = .01). Importantly, participants’ athletic level had a stronger effect on cognitive performance than phase, where inactive participants scored worse across tasks than their more active counterparts, and elite participants exhibited more significant fluctuations in cognition across phases. Mood and symptoms were worse during menstruation regardless of athletic level. However, while mood varied across phases it did not correlate with cognitive performance. Of note, participants perceived that their symptoms negatively impacted their cognitive performance during menstruation, but there was no evidence of any objective detriment to cognitive performance during this phase neither on reaction times nor errors on any task. Conclusion: These findings suggest the existence of mild cognitive fluctuations throughout the menstrual cycle, albeit with high individual variability, and which are incongruent with symptomology. Opposing results between perceived and measured performance challenge common assumptions about menstruation-related performance, and highlight the importance of addressing societal biases in female sport and health. The stronger effects of athletic engagement on cognitive performance, rather than phase, reinforce the cognitive benefits of an active lifestyle. Key Points: This study aimed to investigate cognitive fluctuations in eumenorrheic females recruited from a range of activity levels. We demonstrate mild cognitive fluctuations throughout the menstrual cycle, which are incongruent with symptomology. And reinforce the importance of physical activity for supporting cognitive performance.

Objectives. Musculoskeletal (MSK) complaints are prevalent in law enforcement officers (LEOs), but research that examines their risk factors is limited. This study aimed to identify the self-reported MSK complaint prevalence and perceived causes in LEOs. Methods. The Nordic musculoskeletal questionnaire was used to identify the 12-month and 7-day prevalence of MSK 'trouble' (ache, pain, discomfort) for nine body sites. The perceived cause, participant characteristics and occupational role were reported. Body fat percentage was measured using bioelectrical impedance. Results. Complete submissions of 186 questionnaires were received (80% male, median age 40.6 years, interquartile range 10.1). Eighty-six per cent of officers reported having an MSK complaint in the last 12 months, where lower back, shoulder and neck complaint prevalence was 59.1, 48.4 and 42.5%, respectively. The occupational role was associated with the site and presence of complaints (p < 0.05), where armed officers presented with more shoulder, lower back and hip/thigh complaints. Age, sex and body fat did not impact complaint prevalence. Participants mainly attributed their complaints to occupation equipment or to sport and exercise. Conclusion. MSK complaints were highly prevalent in this cohort, particularly armed officers. Further research is required to establish the impact of these complaints and how they can be mitigated.