{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T05:21:22Z","timestamp":1787462482172,"version":"build-2736575974"},"reference-count":88,"publisher":"Springer Science and Business Media LLC","issue":"9","license":[{"start":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:00:00Z","timestamp":1776297600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:00:00Z","timestamp":1776297600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100018947","name":"Vicerrectorado de Investigaci\u00f3n y Transferencia, Universidad de Granada","doi-asserted-by":"publisher","award":["UCE-PP2024-02"],"award-info":[{"award-number":["UCE-PP2024-02"]}],"id":[{"id":"10.13039\/501100018947","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006393","name":"Universidad de Granada","doi-asserted-by":"crossref","award":["P5A2024-81"],"award-info":[{"award-number":["P5A2024-81"]}],"id":[{"id":"10.13039\/501100006393","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100006393","name":"Universidad de Granada","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100006393","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sports Med"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Urinary incontinence is frequently reported in women athletes, yet prevalence estimates vary widely and are commonly interpreted using broad sport classifications that may not capture pelvic floor loading.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We aimed to synthesise evidence on urinary incontinence prevalence in adult women athletes and examine whether commonly used sport classifications or reported training exposure explain between-cohort variability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Five databases were searched (January 2010\u2013September 2025) for systematic reviews reporting urinary incontinence prevalence in women athletes to conduct an umbrella review. Eligible primary observational studies were identified from included reviews and forward citation tracking to conduct a de novo random-effects meta-analysis and meta-regression restricted to adult women athletes (aged 18\u201345\u00a0years).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fourteen systematic reviews were included, most rated as low or critically low confidence. Thirty-two primary studies (120 cohorts;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20094649) were meta-analysed, all rated as high or moderate quality. Urinary incontinence prevalence showed substantial between-cohort heterogeneity. In meta-regression analyses, prevalence did not differ significantly across sport discipline, impact category, or sport modality. Weekly training volume was the most consistently reported exposure metric and showed a positive association with urinary incontinence odds (6% per additional hour\/week;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.011), within the constraints of limited intensity and pelvic floor-specific exposure data, with no evidence of effect modification by impact category or competitive level. Competitive level showed a non-robust directional trend toward higher prevalence among professionals (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.08).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Commonly used sport-label classifications showed limited explanatory value for urinary incontinence prevalence in women athletes when applied as stand-alone proxies for exposure, and may misdirect screening and prevention strategies. Within the current heterogeneous and cross-sectional evidence base, cumulative training exposure emerged as the most consistently reported correlate of urinary incontinence prevalence. These findings highlight the need for prospective studies using standardised training metrics with pelvic floor-specific measures to better characterise a multi-dimensional pelvic floor exposure.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s40279-026-02438-z","type":"journal-article","created":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T15:00:39Z","timestamp":1776351639000},"page":"2185-2208","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Urinary Incontinence in Women Athletes: Umbrella Review and Meta-analysis of Sport-Related Factors"],"prefix":"10.1007","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-5534-2769","authenticated-orcid":false,"given":"Nuria","family":"Dom\u00ednguez-P\u00e9rez","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-4816-1360","authenticated-orcid":false,"given":"Irene","family":"Sevilla-Arrabal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9939-7946","authenticated-orcid":false,"given":"Beatriz","family":"Navarro-Braz\u00e1lez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7051-3130","authenticated-orcid":false,"given":"Mar\u00eda","family":"Torres-Lacomba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2446-1875","authenticated-orcid":false,"given":"Javier","family":"Courel-Ib\u00e1\u00f1ez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,16]]},"reference":[{"key":"2438_CR1","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1007\/s00192-017-3441-1","volume":"29","author":"H Moser","year":"2018","unstructured":"Moser H, Leitner M, Baeyens JP, Radlinger L. Pelvic floor muscle activity during impact activities in continent and incontinent women: a systematic review. Int Urogynecol J. 2018;29:179\u201396.","journal-title":"Int Urogynecol J"},{"key":"2438_CR2","doi-asserted-by":"publisher","first-page":"124","DOI":"10.1097\/JU.0000000000004009","volume":"212","author":"S Sutcliffe","year":"2024","unstructured":"Sutcliffe S, Falke C, Fok CS, Griffith JW, Harlow BL, Kenton KA, et al. Lower urinary tract symptoms in US women: contemporary prevalence estimates from the RISE FOR HEALTH study. J Urol. 2024;212:124\u201335.","journal-title":"J Urol"},{"issue":"61","key":"2438_CR3","first-page":"e1","volume":"228","author":"J Larsudd-K\u00e5verud","year":"2023","unstructured":"Larsudd-K\u00e5verud J, Gyhagen J, \u00c5kervall S, Molin M, Milsom I, Wagg A, et al. The influence of pregnancy, parity, and mode of delivery on urinary incontinence and prolapse surgery: a national register study. Am J Obstet Gynecol. 2023;228(61):e1-13.","journal-title":"Am J Obstet Gynecol"},{"key":"2438_CR4","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1002\/nau.25276","volume":"43","author":"H Sadri","year":"2024","unstructured":"Sadri H, Oliaei A, Sadri S, Pezeshki P, Chughtai B, Elterman D. Systematic review and meta-analysis of urinary incontinence prevalence and population estimates. Neurourol Urodyn. 2024;43:52\u201362.","journal-title":"Neurourol Urodyn"},{"key":"2438_CR5","doi-asserted-by":"publisher","first-page":"520","DOI":"10.1097\/SPV.0000000000001296","volume":"29","author":"N Kupfer","year":"2023","unstructured":"Kupfer N, Clancy A, Maguire F, Stairs J. Prevalence and risk factors for urinary incontinence in nulliparous women: a contemporary, population-based cohort study. Urogynecology. 2023;29:520\u20137.","journal-title":"Urogynecology"},{"key":"2438_CR6","doi-asserted-by":"publisher","first-page":"471","DOI":"10.1007\/s40279-019-01243-1","volume":"50","author":"K B\u00f8","year":"2020","unstructured":"B\u00f8 K, Nygaard IE. Is physical activity good or bad for the female pelvic floor? A narrative review. Sport Med. 2020;50:471\u201384.","journal-title":"Sport Med"},{"key":"2438_CR7","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1249\/JSR.0000000000001045","volume":"22","author":"GM Donnelly","year":"2023","unstructured":"Donnelly GM, Moore IS. Sports medicine and the pelvic floor. Curr Sports Med Rep. 2023;22:82\u201390.","journal-title":"Curr Sports Med Rep"},{"key":"2438_CR8","volume":"9","author":"JG Dakic","year":"2023","unstructured":"Dakic JG, Hay-Smith J, Lin KY, Cook J, Frawley HC. Experience of playing sport or exercising for women with pelvic floor symptoms: a qualitative study. Sports Med. 2023;9:25.","journal-title":"Sports Med"},{"key":"2438_CR9","doi-asserted-by":"publisher","first-page":"1211","DOI":"10.1016\/j.jsams.2021.06.003","volume":"24","author":"JG Dakic","year":"2021","unstructured":"Dakic JG, Cook J, Hay-Smith J, Lin KY, Frawley H. Pelvic floor disorders stop women exercising: a survey of 4556 symptomatic women. J Sci Med Sport. 2021;24:1211\u20137.","journal-title":"J Sci Med Sport"},{"key":"2438_CR10","doi-asserted-by":"publisher","first-page":"1055","DOI":"10.1136\/bjsports-2024-109328","volume":"59","author":"DJ Friedman","year":"2025","unstructured":"Friedman DJ, Hughes D, Thornton JS, Saw R, Girdwood M, Wells KR, et al. Bringing reproductive, pelvic and breast health to light: insights from the Health of Elite Retired Australian female athletes survey (HER-Aus). Br J Sports Med. 2025;59:1055\u201362.","journal-title":"Br J Sports Med"},{"key":"2438_CR11","doi-asserted-by":"publisher","first-page":"889","DOI":"10.1136\/bjsports-2025-110309","volume":"59","author":"RL Bevins","year":"2025","unstructured":"Bevins RL, Holland CJ. Breaking the silence: addressing pelvic floor dysfunction in female athletes. Br J Sports Med. 2025;59:889\u201390.","journal-title":"Br J Sports Med"},{"key":"2438_CR12","doi-asserted-by":"publisher","first-page":"1153","DOI":"10.1007\/s00192-023-05450-3","volume":"34","author":"K B\u00f8","year":"2023","unstructured":"B\u00f8 K, Angl\u00e8s-Acedo S, Batra A, Br\u00e6kken IH, Chan YL, Jorge CH, et al. Strenuous physical activity, exercise, and pelvic organ prolapse: a narrative scoping review. Int Urogynecol J. 2023;34:1153\u201364.","journal-title":"Int Urogynecol J"},{"key":"2438_CR13","doi-asserted-by":"publisher","first-page":"427.e1","DOI":"10.1016\/j.ajog.2017.12.220","volume":"218","author":"K B\u00f8","year":"2018","unstructured":"B\u00f8 K, Ellstr\u00f8m Engh M, Hilde G. Regular exercisers have stronger pelvic floor muscles than nonregular exercisers at midpregnancy. Am J Obstet Gynecol. 2018;218:427.e1-5.","journal-title":"Am J Obstet Gynecol"},{"key":"2438_CR14","doi-asserted-by":"publisher","first-page":"1663","DOI":"10.1080\/02640414.2019.1585312","volume":"37","author":"S Almousa","year":"2019","unstructured":"Almousa S, Bandin Van Loon A. The prevalence of urinary incontinence in nulliparous female sportswomen: a systematic review. J Sports Sci. 2019;37:1663\u201372.","journal-title":"J Sports Sci"},{"key":"2438_CR15","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1590\/1517-869220172301163216","volume":"23","author":"LA Martins","year":"2017","unstructured":"Martins LA, Santos KMdos, Dorc\u00ednio MBA, Alves JO, Roza T, Luz SCTda. A perda de urina \u00e9 influenciada pela modalidade esportiva ou pela carga de treino? Uma revis\u00e3o sistem\u00e1tica. Rev Bras Med Esporte. 2017;23:73\u20137.","journal-title":"Rev Bras Med Esporte"},{"key":"2438_CR16","first-page":"698","volume":"72","author":"MA Cerruto","year":"2020","unstructured":"Cerruto MA, Balzarro M, Rubilotta E, Processali T, Latini MT, Porcaro AB, et al. Lower urinary tract and gastrointestinal dysfunction in sportswomen: a systematic review and meta-analysis of observational studies. Minerva Urol e Nefrol. 2020;72:698\u2013711.","journal-title":"Minerva Urol e Nefrol"},{"key":"2438_CR17","doi-asserted-by":"publisher","first-page":"621","DOI":"10.1007\/s00192-022-05244-z","volume":"34","author":"E Dominguez-Antu\u00f1a","year":"2023","unstructured":"Dominguez-Antu\u00f1a E, Diz JC, Su\u00e1rez-Iglesias D, Ay\u00e1n C. Prevalence of urinary incontinence in female CrossFit athletes: a systematic review with meta-analysis. Int Urogynecol J. 2023;34:621\u201334.","journal-title":"Int Urogynecol J"},{"key":"2438_CR18","doi-asserted-by":"publisher","first-page":"1757","DOI":"10.1007\/s00192-018-3629-z","volume":"29","author":"TR de Mattos Lourenco","year":"2018","unstructured":"de Mattos Lourenco TR, Matsuoka PK, Baracat EC, Haddad JM, Teixeira RV, Colla C, et al. Urinary incontinence in female athletes: a systematic review. Int Urogynecol J. 2018;29:1757\u201363.","journal-title":"Int Urogynecol J"},{"issue":"7","key":"2438_CR19","volume":"16","author":"F Syeda","year":"2024","unstructured":"Syeda F, Pandit U. Urinary incontinence in female athletes: a systematic review on prevalence and physical therapy approaches. Cureus. 2024;16(7):e64544.","journal-title":"Cureus"},{"key":"2438_CR20","doi-asserted-by":"publisher","first-page":"1717","DOI":"10.1007\/s00192-018-3651-1","volume":"29","author":"RV Teixeira","year":"2018","unstructured":"Teixeira RV, Colla C, Sbruzzi G, Mallmann A, Paiva LL, de Mattos Lourenco TR, et al. Prevalence of urinary incontinence in female athletes: a systematic review with meta-analysis. Int Urogynecol J. 2018;29:1717\u201325.","journal-title":"Int Urogynecol J"},{"key":"2438_CR21","doi-asserted-by":"publisher","first-page":"279","DOI":"10.2478\/hukin-2020-0008","volume":"73","author":"T Pires","year":"2020","unstructured":"Pires T, Pires P, Moreira H, Viana R. Prevalence of urinary incontinence in high-impact sport athletes: a systematic review and meta-analysis. J Hum Kinet. 2020;73:279\u201388.","journal-title":"J Hum Kinet"},{"key":"2438_CR22","first-page":"48","volume":"75","author":"C \u00c1lvarez-Garc\u00eda","year":"2022","unstructured":"\u00c1lvarez-Garc\u00eda C, Do\u011fanay M. The prevalence of urinary incontinence in female CrossFit practitioners: a systematic review and meta-analysis. Arch Esp Urol. 2022;75:48\u201359.","journal-title":"Arch Esp Urol"},{"issue":"5","key":"2438_CR23","doi-asserted-by":"publisher","first-page":"955","DOI":"10.1007\/s00192-025-06059-4","volume":"36","author":"ASC Alves","year":"2025","unstructured":"Alves ASC, de Ara\u00fajo MP, Pereira GMV, Brito LGO, Juliato CRT. Influence of powerlifting and weightlifting on female pelvic floor dysfunction: systematic literature review. Int Urogynecol J. 2025;36(5):955\u201364.","journal-title":"Int Urogynecol J."},{"key":"2438_CR24","doi-asserted-by":"publisher","first-page":"92","DOI":"10.18176\/archmeddeporte.00162","volume":"41","author":"N Romero-Parra","year":"2024","unstructured":"Romero-Parra N, Rodr\u00edguez-Faggionato M, Rojo-Tirado MA. Impact of CrossFit\u00ae practice on pelvic floor dysfunction: a systematic review. Arch Med del Deport. 2024;41:92\u20138.","journal-title":"Arch Med del Deport"},{"key":"2438_CR25","doi-asserted-by":"publisher","first-page":"1164","DOI":"10.1136\/bjsports-2022-106620","volume":"57","author":"IS Moore","year":"2023","unstructured":"Moore IS, Crossley KM, Bo K, Mountjoy M, Ackerman KE, Antero JDS, et al. Female athlete health domains: a supplement to the International Olympic Committee consensus statement on methods for recording and reporting epidemiological data on injury and illness in sport. Br J Sports Med. 2023;57:1164\u201374.","journal-title":"Br J Sports Med"},{"key":"2438_CR26","doi-asserted-by":"publisher","first-page":"1042","DOI":"10.1136\/bjsports-2016-096583","volume":"50","author":"T Soligard","year":"2016","unstructured":"Soligard T, Schwellnus M, Alonso J, Bahr R, Clarsen B, Dijkstra H, et al. How much is too much? (Part 1) International Olympic Committee consensus statement on load in sport and risk of injury. Br J Sports Med. 2016;50:1042.","journal-title":"Br J Sports Med"},{"key":"2438_CR27","doi-asserted-by":"publisher","first-page":"206","DOI":"10.1007\/s40141-022-00360-9","volume":"10","author":"HA Garc\u00eda-Perdomo","year":"2022","unstructured":"Garc\u00eda-Perdomo HA, Uribe Bayona AJ, Zamora Segura BD. High-impact exercises associated with an increased risk of stress urinary incontinence: systematic review and meta-analysis. Curr Phys Med Rehabil Reports. 2022;10:206\u201315.","journal-title":"Curr Phys Med Rehabil Reports"},{"key":"2438_CR28","doi-asserted-by":"publisher","first-page":"S151","DOI":"10.1139\/apnm-2020-0564","volume":"45","author":"ME Kho","year":"2020","unstructured":"Kho ME, Poitras VJ, Janssen I, Chaput J-P, Saunders TJ, Giangregorio LM, et al. Development and application of an outcome-centric approach for conducting overviews of reviews. Appl Physiol Nutr Metab. 2020;45:S151\u201364.","journal-title":"Appl Physiol Nutr Metab"},{"key":"2438_CR29","unstructured":"Higgins J, Thomas J, Chandler J, Cumpston M, Li T, Page M, et al. Cochrane handbook for systematic reviews of interventions. Version 6.3. Cochrane, 2022. Available from: https:\/\/training.cochrane.org\/handbook\/current\/chapter-v. Accessed 10 Apr 2026."},{"key":"2438_CR30","doi-asserted-by":"publisher","first-page":"1456","DOI":"10.1136\/bjsports-2017-097621","volume":"51","author":"J Ioannidis","year":"2017","unstructured":"Ioannidis J. Next-generation systematic reviews: prospective meta-analysis, individual-level data, networks and umbrella reviews. Br J Sports Med. 2017;51:1456\u20138.","journal-title":"Br J Sports Med"},{"key":"2438_CR31","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1186\/s13643-021-01626-4","volume":"10","author":"MJ Page","year":"2021","unstructured":"Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Syst Rev. 2021;10:89.","journal-title":"Syst Rev"},{"key":"2438_CR32","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1136\/bjsports-2021-103987","volume":"56","author":"CL Ardern","year":"2022","unstructured":"Ardern CL, B\u00fcttner F, Andrade R, Weir A, Ashe MC, Holden S, et al. Implementing the 27 PRISMA 2020 Statement items for systematic reviews in the sport and exercise medicine, musculoskeletal rehabilitation and sports science fields: the PERSiST (implementing Prisma in Exercise, Rehabilitation, Sport medicine and SporTs science) guidance. Br J Sports Med. 2022;56:175\u201395.","journal-title":"Br J Sports Med"},{"key":"2438_CR33","doi-asserted-by":"publisher","first-page":"1797","DOI":"10.1097\/00005768-200111000-00001","volume":"33","author":"K B\u00f8","year":"2001","unstructured":"B\u00f8 K, Borgen JS. Prevalence of stress and urge urinary incontinence in elite athletes and controls. Med Sci Sports Exerc. 2001;33:1797\u2013802.","journal-title":"Med Sci Sports Exerc"},{"key":"2438_CR34","doi-asserted-by":"publisher","first-page":"451","DOI":"10.2165\/00007256-200434070-00004","volume":"34","author":"K B\u00f8","year":"2004","unstructured":"B\u00f8 K. Urinary incontinence, pelvic floor dysfunction, exercise and sport. Sports Med. 2004;34:451\u201364.","journal-title":"Sports Med"},{"key":"2438_CR35","doi-asserted-by":"publisher","first-page":"899","DOI":"10.1136\/bjsports-2022-105985","volume":"57","author":"S Giagio","year":"2023","unstructured":"Giagio S, Salvioli S, Innocenti T, Gava G, Vecchiato M, Pillastrini P, et al. PFD-SENTINEL: development of a screening tool for pelvic floor dysfunction in female athletes through an international Delphi consensus. Br J Sports Med. 2023;57:899\u2013905.","journal-title":"Br J Sports Med"},{"key":"2438_CR36","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1123\/ijspp.2021-0451","volume":"17","author":"AKA McKay","year":"2022","unstructured":"McKay AKA, Stellingwerff T, Smith ES, Martin DT, Mujika I, Goosey-Tolfrey VL, et al. Defining training and performance caliber: a participant classification framework. Int J Sports Physiol Perform. 2022;17:317\u201331.","journal-title":"Int J Sports Physiol Perform"},{"key":"2438_CR37","unstructured":"Deeks J, Higgins J, Altman D, McKenzie E, Veroniki A-A. Chapter 10: analysing data and under-taking meta-analyses. In: Higgins JPT, Thomas J, Chandler J, Cumpston M. Cochrane handbook for systematic reviews of interventions. Version 650. 2024. Available from: https:\/\/www.cochrane.org\/authors\/handbooks-and-manuals\/handbook\/current. Accessed 10 Apr 2026."},{"key":"2438_CR38","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j4008","volume":"358","author":"BJ Shea","year":"2017","unstructured":"Shea BJ, Reeves BC, Wells G, Thuku M, Hamel C, Moran J, et al. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ. 2017;358:j4008.","journal-title":"BMJ"},{"issue":"12","key":"2438_CR39","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-011458","volume":"6","author":"MJ Downes","year":"2016","unstructured":"Downes MJ, Brennan ML, Williams HC, Dean RS. Development of a critical appraisal tool to assess the quality of cross-sectional studies (AXIS). BMJ Open. 2016;6(12):e011458.","journal-title":"BMJ Open."},{"key":"2438_CR40","doi-asserted-by":"publisher","first-page":"368","DOI":"10.1016\/j.jclinepi.2013.11.007","volume":"67","author":"D Pieper","year":"2014","unstructured":"Pieper D, Antoine SL, Mathes T, Neugebauer EAM, Eikermann M. Systematic review finds overlapping reviews were not mentioned in every other overview. J Clin Epidemiol. 2014;67:368\u201375.","journal-title":"J Clin Epidemiol"},{"key":"2438_CR41","doi-asserted-by":"publisher","first-page":"2681","DOI":"10.1007\/s00192-022-05302-6","volume":"33","author":"E Culleton-Quinn","year":"2022","unstructured":"Culleton-Quinn E, B\u00f8 K, Fleming N, Mockler D, Cusack C, Daly D. Elite female athletes\u2019 experiences of symptoms of pelvic floor dysfunction: a systematic review. Int Urogynecol J. 2022;33:2681\u2013711.","journal-title":"Int Urogynecol J"},{"key":"2438_CR42","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1515\/physio-2017-0001","volume":"25","author":"F Da Silva Pereira","year":"2017","unstructured":"Da Silva Pereira F, Haupenthal A, Scarabelot KS, Brunazo PF, Nunes I, Virtuoso JF. Urinary incontinence prevalence in the day-by-day life and during sports practice in volleyball athletes: a systematic review. Physiother Q. 2017;25:3\u20137.","journal-title":"Physiother Q"},{"key":"2438_CR43","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1034\/j.1600-0838.2002.120207.x","volume":"12","author":"K Eliasson","year":"2002","unstructured":"Eliasson K, Larsson T, Mattsson E. Prevalence of stress incontinence in nullipanous elite trampolinists. Scand J Med Sci Sports. 2002;12:106\u201310.","journal-title":"Scand J Med Sci Sports"},{"key":"2438_CR44","first-page":"3174","volume":"13","author":"N Caylet","year":"2006","unstructured":"Caylet N, Fabbro-Peray P, Mar\u00e8s P, Dauzat M, Prat-Pradal D, Corcos J. Prevalence and occurrence of stress urinary incontinence in elite women athletes. Can J Urol. 2006;13:3174\u20139.","journal-title":"Can J Urol"},{"key":"2438_CR45","doi-asserted-by":"publisher","first-page":"328","DOI":"10.1016\/j.scispo.2025.01.001","volume":"40","author":"H Clapin","year":"2025","unstructured":"Clapin H, Ramiz L, Raoul des Essarts S, Trandeau de Marsac V, Ma\u00eetre C. Stress urinary incontinence in French elite women\u2019s rugby. Sci Sport. 2025;40:328\u201337.","journal-title":"Sci Sport"},{"key":"2438_CR46","doi-asserted-by":"publisher","first-page":"2357","DOI":"10.1007\/s00192-024-05893-2","volume":"35","author":"E Culleton-Quinn","year":"2024","unstructured":"Culleton-Quinn E, B\u00f8 K, Fleming N, Cusack C, Daly D. Prevalence and experience of urinary incontinence among elite female Gaelic sports athletes. Int Urogynecol J. 2024;35:2357\u201365.","journal-title":"Int Urogynecol J"},{"key":"2438_CR47","doi-asserted-by":"publisher","DOI":"10.12659\/MSM.946830","volume":"31","author":"AK Cyga\u0144ska","year":"2025","unstructured":"Cyga\u0144ska AK, Gi\u017cewska B, Zdunek K. Evaluating pelvic floor dysfunction in female horse show jumpers using the Australian Pelvic Floor Questionnaire. Med Sci Monit. 2025;31:e946830.","journal-title":"Med Sci Monit"},{"key":"2438_CR48","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1016\/j.pmrj.2012.09.001","volume":"5","author":"LCM da Silva Borin","year":"2013","unstructured":"da Silva Borin LCM, Nunes FR, De Oliveira Guirro EC. Assessment of pelvic floor muscle pressure in female athletes. PM R. 2013;5:189\u201393.","journal-title":"PM R"},{"key":"2438_CR49","doi-asserted-by":"crossref","unstructured":"de Souza Pereira E, de Lima Ferreira AP, de Oliveira Almeida M, Barbosa CS, de Melo Falc\u00e3o Monteiro G, Barbosa L, et al. Prevalence and factors associated with urinary incontinence in female crossfitters: a cross-sectional study. LUTS Low Urin Tract Symptoms. 2022;14:281\u20138.","DOI":"10.1111\/luts.12437"},{"key":"2438_CR50","doi-asserted-by":"publisher","first-page":"1122","DOI":"10.1002\/pmrj.12502","volume":"13","author":"F da Silva Pereira","year":"2021","unstructured":"da Silva Pereira F, Haupenthal A, Da Roza TH, Mazo GZ, Virtuoso JF. Urine loss during a volleyball competition: comparison between amateur and professional athletes. PM R. 2021;13:1122\u20136.","journal-title":"PM R"},{"key":"2438_CR51","doi-asserted-by":"publisher","first-page":"1687","DOI":"10.1007\/s00192-012-1786-z","volume":"23","author":"C Fozzatti","year":"2012","unstructured":"Fozzatti C, Riccetto C, Herrmann V, Brancalion MF, Raimondi M, Nascif CH, et al. Prevalence study of stress urinary incontinence in women who perform high-impact exercises. Int Urogynecol J Pelvic Floor Dysfunct. 2012;23:1687\u201391.","journal-title":"Int Urogynecol J Pelvic Floor Dysfunct"},{"key":"2438_CR52","first-page":"9","volume":"11","author":"IL Kele\u010di\u0107","year":"2023","unstructured":"Kele\u010di\u0107 IL, Schuster S, Ur\u0161ej E. Urinary incontinence and risk factors among Croatian female athletes: a pilot cross-sectional observational study. Phys Act Rev. 2023;11:9\u201320.","journal-title":"Phys Act Rev"},{"key":"2438_CR53","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1590\/1809-2950\/19028227032020","volume":"27","author":"E Lopes","year":"2020","unstructured":"Lopes E, Apolin\u00e1rio A, Barbosa L, Moretti E. Frequency of urinary incontinence in women who practice crossfit: a cross-sectional study. Fisioter e Pesqui. 2020;27:287\u201392.","journal-title":"Fisioter e Pesqui"},{"key":"2438_CR54","doi-asserted-by":"publisher","first-page":"490","DOI":"10.1080\/03630242.2021.1927288","volume":"61","author":"LdaS Machado","year":"2021","unstructured":"Machado LdaS, Marques Cerentini T, Lagan\u00e0 AS, Viana da Rosa P, Fichera M, Telles da Rosa LH. Pelvic floor evaluation in CrossFit\u00ae athletes and urinary incontinence: a cross-sectional observational study. Women Health. 2021;61:490\u20139.","journal-title":"Women Health"},{"key":"2438_CR55","doi-asserted-by":"publisher","first-page":"316.e1","DOI":"10.1016\/j.ajog.2016.02.031","volume":"215","author":"ML Middlekauff","year":"2016","unstructured":"Middlekauff ML, Egger MJ, Nygaard IE, Shaw JM. The impact of acute and chronic strenuous exercise on pelvic floor muscle strength and support in nulliparous healthy women. Am J Obstet Gynecol. 2016;215:316.e1-7.","journal-title":"Am J Obstet Gynecol"},{"key":"2438_CR56","first-page":"96","volume":"47","author":"R Parr","year":"2023","unstructured":"Parr R, Jones E, Figuers C, Ewen HH. Relationship of sport variables on stress urinary incontinence in nulliparous collegiate athletes. J Women Pelvic Health Phys Ther. 2023;47:96\u2013102.","journal-title":"J Women Pelvic Health Phys Ther"},{"key":"2438_CR57","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1007\/s00192-020-04510-2","volume":"32","author":"E Sandwith","year":"2021","unstructured":"Sandwith E, Robert M. Rug-pee study: the prevalence of urinary incontinence among female university rugby players. Int Urogynecol J. 2021;32:281\u20135.","journal-title":"Int Urogynecol J"},{"key":"2438_CR58","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1177\/1089313X231176629","volume":"27","author":"B Winder","year":"2023","unstructured":"Winder B, Lindegren K, Blackmon A. Prevalence of urinary incontinence and other pelvic floor-related symptoms in female professional dancers. J Danc Med Sci. 2023;27:50\u20135.","journal-title":"J Danc Med Sci"},{"key":"2438_CR59","first-page":"119","volume":"7","author":"A Araujo","year":"2019","unstructured":"Araujo A, Guedes K, Bastos M, de Aguiar I, Carneiro E, Sutter G. Urinary incontinence in CrossFit women practitioners. Arq Cienc Esporte. 2019;7:119\u201322.","journal-title":"Arq Cienc Esporte"},{"key":"2438_CR60","doi-asserted-by":"publisher","first-page":"1405","DOI":"10.1080\/17461391.2018.1496146","volume":"18","author":"AMB Cardoso","year":"2018","unstructured":"Cardoso AMB, Lima CRODP, Ferreira CWS. Prevalence of urinary incontinence in high-impact sports athletes and their association with knowledge, attitude and practice about this dysfunction. Eur J Sport Sci. 2018;18:1405\u201312.","journal-title":"Eur J Sport Sci"},{"issue":"8","key":"2438_CR61","doi-asserted-by":"publisher","DOI":"10.1002\/ejsc.70013","volume":"25","author":"J Dakic","year":"2025","unstructured":"Dakic J, Perraton L, Lindstrom J, Hain E, Chuah S, Stay S. The hidden challenge: pelvic floor symptoms and their impact on performance and well-being in elite female rugby players. Eur J Sport Sci. 2025;25(8): e70013.","journal-title":"Eur J Sport Sci."},{"key":"2438_CR62","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1097\/01274882-200731010-00003","volume":"31","author":"M Dockter","year":"2007","unstructured":"Dockter M, Kolstad AM, Martin KA, Schiwal LJ. Prevalence of urinary incontinence: a comparative study of collegiate female athletes and non-athletic controls. J Womens Health Phys Ther. 2007;31:12\u20137.","journal-title":"J Womens Health Phys Ther"},{"key":"2438_CR63","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1590\/S0080-62342009000200008","volume":"43","author":"ES dos Santos","year":"2009","unstructured":"dos Santos ES, Caetano AS, Tavares MDCGCF, Lopes MHBDM. Urinary incontinence among physical education students. Rev Esc Enferm USP. 2009;43:307\u201312.","journal-title":"Rev Esc Enferm USP"},{"key":"2438_CR64","first-page":"47","volume":"27","author":"K Faulks","year":"2021","unstructured":"Faulks K, Catto T. The prevalence of stress urinary incontinence among elite female rugby union players in Australia. Aust NZ Cont J. 2021;27:47\u201352.","journal-title":"Aust NZ Cont J"},{"key":"2438_CR65","doi-asserted-by":"publisher","first-page":"766","DOI":"10.1097\/JU.0000000000004455","volume":"213","author":"ZS Gan","year":"2025","unstructured":"Gan ZS, Sundaram K, Smith AL. Factors associated with urinary incontinence in nulliparous female elite athletes: an exploratory, cross-sectional study using dynamic pelvic magnetic resonance imaging and questionnaire data. J Urol. 2025;213:766\u201376.","journal-title":"J Urol"},{"key":"2438_CR66","first-page":"104","volume":"13","author":"N Gill","year":"2025","unstructured":"Gill N, Lin KY, Whitford E, Jeffrey S, Frawley H. The prevalence of urinary incontinence in nulliparous and parous adult netball players. Continence (Amst). 2025;13:104\u20135.","journal-title":"Continence (Amst)"},{"key":"2438_CR67","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1016\/j.ijgo.2011.02.004","volume":"114","author":"C J\u00e1come","year":"2011","unstructured":"J\u00e1come C, Oliveira D, Marques A, S\u00e1-Couto P. Prevalence and impact of urinary incontinence among female athletes. Int J Gynaecol Obstet. 2011;114:60\u20133.","journal-title":"Int J Gynaecol Obstet"},{"key":"2438_CR68","first-page":"105","volume":"22","author":"LJ Patrizzi","year":"2014","unstructured":"Patrizzi LJ, Viana DA, Silva LMA, Pegorari MS. Incontin\u00eancia Urin\u00e1ria em Mulheres Jovens Praticantes de Exerc\u00edcio F\u00edsico. Rev Bras Cienc Mov. 2014;22:105\u201310.","journal-title":"Rev Bras Cienc Mov"},{"issue":"12","key":"2438_CR69","doi-asserted-by":"publisher","first-page":"2478","DOI":"10.3390\/healthcare12232478","volume":"7","author":"JM Sebastian-Rico","year":"2024","unstructured":"Sebastian-Rico JM, Mu\u00f1oz-Fern\u00e1ndez MJ, Mart\u00ednez-Aranda LM, Calvo-Lluch \u00c1, Ortega-Becerra M. Prevalence of urinary incontinence in female professional soccer players by category and specific position: a comparative study with a control group. Healthcare (Basel). 2024;7(12):2478.","journal-title":"Healthcare (Basel)"},{"key":"2438_CR70","doi-asserted-by":"publisher","first-page":"74","DOI":"10.5114\/pq\/183031","volume":"32","author":"A Tarczewska","year":"2024","unstructured":"Tarczewska A, Ko\u0142ody\u0144ska G, Zalewski M, Mucha A, Pi\u0105tek A, Andrzejewski W. Evaluation of the quality of life and the incidence of stress urinary incontinence in nulliparous women training selected sports: a cross-sectional survey pilot study. Physiother Q. 2024;32:74\u20139.","journal-title":"Physiother Q"},{"key":"2438_CR71","first-page":"20","volume":"25","author":"G Valastro","year":"2025","unstructured":"Valastro G, Bertuit J, Schoefs B. Prevalence of urinary symptoms among nulliparous women practicing rugby in the Brussels region: an observational descriptive study. Kinesitherapie. 2025;25:20\u20135.","journal-title":"Kinesitherapie"},{"key":"2438_CR72","doi-asserted-by":"publisher","first-page":"3270","DOI":"10.4103\/jfmpc.jfmpc_282_24","volume":"13","author":"F Syeda","year":"2024","unstructured":"Syeda F, Pandit U. Prevalence of urinary incontinence in nulliparous Indian sportswomen. J Fam Med Prim Care. 2024;13:3270\u20134.","journal-title":"J Fam Med Prim Care"},{"key":"2438_CR73","doi-asserted-by":"publisher","DOI":"10.1136\/bmjsem-2023-001832","volume":"10","author":"M McCarthy-Ryan","year":"2024","unstructured":"McCarthy-Ryan M, Perkins J, Donnelly GM, Caithriona Y, Liston M, Leahy K, et al. Stress urinary incontinence prevalence and risk factors in female rugby players: a common health problem across four nations. BMJ Open Sport Exerc Med. 2024;10: e001832.","journal-title":"BMJ Open Sport Exerc Med."},{"key":"2438_CR74","doi-asserted-by":"publisher","first-page":"1957","DOI":"10.1002\/nau.23538","volume":"37","author":"M Hagovska","year":"2018","unstructured":"Hagovska M, \u0160vihra J, Bukov\u00e1 A, Dra\u010dkov\u00e1 D, \u0160vihrov\u00e1 V. Prevalence and risk of sport types to stress urinary incontinence in sportswomen: a cross\u2010sectional study. Neurourol Urodyn. 2018;37:1957\u201364.","journal-title":"Neurourol Urodyn"},{"key":"2438_CR75","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1016\/j.ejogrb.2021.11.424","volume":"268","author":"GK Pisani","year":"2022","unstructured":"Pisani GK, Sato TdeO, de Carvalho DHT, Carvalho C. Impact of urinary incontinence on quality of life in female CrossFit practitioners: a cross-sectional study. Eur J Obstet Gynecol Reprod Biol. 2022;268:56\u201361.","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"2438_CR76","doi-asserted-by":"publisher","first-page":"91","DOI":"10.2478\/hukin-2014-0114","volume":"44","author":"A Po\u015bwiata","year":"2014","unstructured":"Po\u015bwiata A, Socha T, Opara J. Prevalence of stress urinary incontinence in elite female endurance athletes. J Hum Kinet. 2014;44:91\u20136.","journal-title":"J Hum Kinet"},{"key":"2438_CR77","doi-asserted-by":"publisher","first-page":"937","DOI":"10.1055\/s-0043-115736","volume":"38","author":"JO Alves","year":"2017","unstructured":"Alves JO, Luz Da ST, Brand\u00e3o S, Da Luz CM, Jorge RN, Da Roza T. Urinary incontinence in physically active young women: prevalence and related factors. Int J Sports Med. 2017;38:937\u201341.","journal-title":"Int J Sports Med"},{"key":"2438_CR78","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1055\/s-0042-123045","volume":"38","author":"M Hagovska","year":"2017","unstructured":"Hagovska M, \u0160vihra J, Bukov\u00e1 A, Hrobacz A, Dra\u010dkov\u00e1 D, \u0160vihrov\u00e1 V, et al. Prevalence of urinary incontinence in females performing high-impact exercises. Int J Sports Med. 2017;38:210\u20136.","journal-title":"Int J Sports Med"},{"key":"2438_CR79","doi-asserted-by":"publisher","first-page":"270","DOI":"10.1097\/JSM.0000000000000129","volume":"25","author":"T Da Roza","year":"2015","unstructured":"Da Roza T, Brand\u00e3o S, Mascarenhas T, Jorge RN, Duarte JA. Volume of training and the ranking level are associated with the leakage of urine in young female trampolinists. Clin J Sport Med. 2015;25:270\u20135.","journal-title":"Clin J Sport Med"},{"key":"2438_CR80","doi-asserted-by":"publisher","first-page":"776","DOI":"10.1055\/s-0034-1398625","volume":"36","author":"T Da Roza","year":"2015","unstructured":"Da Roza T, Brand\u00e3o S, Mascarenhas T, Jorge RN, Duarte JA. Urinary incontinence and levels of regular physical exercise in young women. Int J Sports Med. 2015;36:776\u201380.","journal-title":"Int J Sports Med"},{"key":"2438_CR81","doi-asserted-by":"publisher","first-page":"381","DOI":"10.3390\/healthcare14030381","volume":"14","author":"S Lopes","year":"2026","unstructured":"Lopes S, Becam M, Pierrot C, R\u00e9ard J, Carvalhais A, Vieira \u00c1, et al. Factors associated with urinary incontinence in female weightlifters. Healthcare (Basel). 2026;14:381.","journal-title":"Healthcare (Basel)"},{"key":"2438_CR82","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1007\/s00404-015-3816-9","volume":"293","author":"H Luginbuehl","year":"2016","unstructured":"Luginbuehl H, Naeff R, Zahnd A, Baeyens JP, Kuhn A, Radlinger L. Pelvic floor muscle electromyography during different running speeds: an exploratory and reliability study. Arch Gynecol Obstet. 2016;293:117\u201324.","journal-title":"Arch Gynecol Obstet"},{"key":"2438_CR83","doi-asserted-by":"publisher","first-page":"1719","DOI":"10.1002\/ejsc.12121","volume":"24","author":"GM Donnelly","year":"2024","unstructured":"Donnelly GM, B\u00f8 K, Forner LB, Rankin A, Moore IS. Up for the tackle? The pelvic floor and rugby: a review. Eur J Sport Sci. 2024;24:1719\u201334.","journal-title":"Eur J Sport Sci"},{"key":"2438_CR84","doi-asserted-by":"publisher","first-page":"2377","DOI":"10.2147\/IJWH.S532149","volume":"17","author":"L Fraz\u00e3o","year":"2025","unstructured":"Fraz\u00e3o L, Couto L, Peres AC, Marques A, P\u00e1ssaro A. Assessment of female pelvic floor muscles: an integrative review. Int J Womens Health. 2025;17:2377\u201393.","journal-title":"Int J Womens Health"},{"key":"2438_CR85","doi-asserted-by":"publisher","first-page":"789","DOI":"10.1007\/s00192-025-06051-y","volume":"36","author":"M Hagovsk\u00e1","year":"2025","unstructured":"Hagovsk\u00e1 M, Bukova A, Svihra J. Measurement of the vaginal pressure profile with the Femfit\u00ae and leakage events using a newly developed pad test during selected sports activities: a pilot study. Int Urogynecol J. 2025;36:789\u201397.","journal-title":"Int Urogynecol J"},{"key":"2438_CR86","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1007\/s00192-023-05674-3","volume":"35","author":"M\u00c8 B\u00e9rub\u00e9","year":"2024","unstructured":"B\u00e9rub\u00e9 M\u00c8, McLean L. The acute effects of running on pelvic floor morphology and function in runners with and without running-induced stress urinary incontinence. Int Urogynecol J. 2024;35:127\u201338.","journal-title":"Int Urogynecol J"},{"key":"2438_CR87","doi-asserted-by":"publisher","first-page":"1733","DOI":"10.1002\/nau.25274","volume":"42","author":"M\u00c8 B\u00e9rub\u00e9","year":"2023","unstructured":"B\u00e9rub\u00e9 M\u00c8, McLean L. Differences in pelvic floor muscle morphology and function between female runners with and without running-induced stress urinary incontinence. Neurourol Urodyn. 2023;42:1733\u201344.","journal-title":"Neurourol Urodyn"},{"key":"2438_CR88","doi-asserted-by":"publisher","first-page":"1539","DOI":"10.1136\/bjsports-2023-107017","volume":"57","author":"JG Dakic","year":"2023","unstructured":"Dakic JG, Hay-Smith EJC, Lin KY, Cook JL, Frawley HC. Women\u2019s preferences for pelvic floor screening in sport and exercise: a mixed-methods study integrating survey and interview data in Australian women. Br J Sports Med. 2023;57:1539\u201349.","journal-title":"Br J Sports Med"}],"container-title":["Sports Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40279-026-02438-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s40279-026-02438-z","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40279-026-02438-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T05:01:55Z","timestamp":1787461315000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s40279-026-02438-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,16]]},"references-count":88,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["2438"],"URL":"https:\/\/doi.org\/10.1007\/s40279-026-02438-z","relation":{},"ISSN":["0112-1642","1179-2035"],"issn-type":[{"value":"0112-1642","type":"print"},{"value":"1179-2035","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,16]]},"assertion":[{"value":"26 March 2026","order":1,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 April 2026","order":2,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Nuria Dom\u00ednguez-P\u00e9rez, Irene Sevilla-Arrabal, Beatriz Navarro Braz\u00e1lez, Mar\u00eda Torres Lacomba and Javier Courel-Ib\u00e1\u00f1ez have no conflicts of interest that are directly relevant to the content of this article.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Ethics approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":3,"name":"Ethics","label":"Consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":4,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All data extracted and used for the analysis in this systematic review and meta-analysis are included in the supplementary material.","order":5,"name":"Ethics","label":"Availability of data and material","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The R Code is included in the supplementary material.","order":6,"name":"Ethics","label":"Code availability","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"JCI, BNB and MTL conceived the study and designed the protocol. NDP and ISA developed the search strategy, screened records and extracted data. JCI performed the statistical analyses and prepared the figures\/tables. All authors interpreted the findings, critically revised the manuscript for important intellectual content, approved the final version and agreed to be accountable for all aspects of the work. This work was completed as part of a doctoral thesis (NDP).","order":7,"name":"Ethics","label":"Author contributions","group":{"name":"EthicsHeading","label":"Declarations"}}]}}