Sports Medicine

FOCUS: a football-specific, rapid on-pitch concussion assessment protocol

FOCUS is a 45-item, 11-domain consensus protocol intended for rapid on-pitch concussion evaluation in football match play. The protocol was developed via a international Delphi process with ≥80% agreement for included items. Authors propose FOCUS can harmonize global on-pitch concussion assessments. Feasibility and diagnostic accuracy remain untested, so implement locally with outcome monitoring. 1

BFR low-load exercise improves strength and disability versus low-load alone

This meta-analysis of 45 RCTs (1652 participants) found LLE-BFR improved muscle strength (SMD 0.82) and disability (SMD 0.63) versus low-load exercise alone. No clear difference in strength was seen between LLE-BFR and high-load exercise (SMD 0.08). Adverse-event reporting was inconsistent and evidence certainty ranged from very low to moderate. Use LLE-BFR when high loads are contraindicated, but monitor harms and set realistic expectations. 2

Creatine reliably improves high-intensity performance; beta-alanine adds no benefit

Network meta-analysis of 52 RCTs in healthy athletes showed creatine improved sprint (SMD -0.64), jump (SMD 0.33), RSA (SMD -0.78), and upper-body endurance (SMD 0.43). Beta-alanine effects were inconsistent and adding beta-alanine to creatine produced no synergistic benefit. Heterogeneity was low-to-moderate; authors recommend creatine monotherapy for anaerobic and high-intensity gains. Longer, multi-arm trials are needed for sex- and sport-specific guidance. 3