{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T00:54:46Z","timestamp":1793408086502,"version":"4.5.0"},"reference-count":67,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000053","name":"National Eye Institute","doi-asserted-by":"publisher","award":["R01EY023261"],"award-info":[{"award-number":["R01EY023261"]}],"id":[{"id":"10.13039\/100000053","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Sports Med"],"accepted":{"date-parts":[[2025,9,13]]},"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The CONCUSS randomised clinical trial compared the effectiveness of immediate office-based vergence\/accommodative therapy with movement (OBVAM) to delayed therapy for the treatment of concussion-related convergence insufficiency (CONC-CI) in participants 11\u201325 years old with persisting postconcussive symptoms 4\u201324\u2009weeks post injury.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Symptomatic CONC-CI was diagnosed using clinical signs via near point of convergence (NPC) and positive fusional vergence (PFV) and symptoms via the Convergence Insufficiency Symptom Survey (CISS). Participants were randomised to immediate OBVAM (twice weekly for 6\u2009weeks) or delayed OBVAM (starting 6\u2009weeks after baseline enrolment). After 6\u2009weeks (outcome time 1 assessment), the therapeutic outcomes of NPC, PFV and CISS were assessed and compared between the two groups. After the outcome time 1 assessment, the delayed group received twice-weekly OBVAM sessions for 8\u2009weeks, while the immediate group received an additional 2\u2009weeks of twice-weekly OBVAM sessions. The outcome time 2 assessment compared groups after each group received all 16 OBVAM sessions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In the immediate group, 46\/52 (88%) were classified as successful or improved at the outcome time one assessment based on the primary outcome measure, a composite of NPC and PFV, compared with 4\/52 (8%) in the delayed group (p&lt;0.001). The mean NPC decreased (improved) by 7.9\u2009cm in the immediate group and 1.8\u2009cm in the delayed group (mean difference at outcome time 1 assessment: 5.1\u2009cm (95%\u2009CI: 3.9 to 6.3; p&lt;0.001)). The mean PFV increased (improved) by 17.5\u0394 in the immediate group and 2.5\u2206 in the delayed group (mean difference at outcome time 1 assessment: 15.0\u2206 (95%\u2009CI:11.7 to 18.3); p&lt;0.001). At the outcome time 1 assessment, 41\/52 (79%) of the participants in the immediate group had improved symptoms based on CISS scores \u2264 preinjury scores or decreased by 10 points or more, compared with only 7\/52 (13%) of participants from the delayed group (p&lt;0.001). When comparing dosing in the immediate group, for 12 OBVAM sessions, 88% were classified as successful or improved using the composite measurement of NPC and PFV, which increased to 94% after 16 OBVAM sessions. For the outcome time 2 assessment, when both groups had received 16 OBVAM sessions, no significant difference was observed for NPC, PFV or CISS (p=1.0).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>OBVAM therapy is effective in improving the NPC, PFV and symptoms in CONC-CI. Immediate initiation of OBVAM compared with delayed initiation shortens the period of symptoms experienced and fosters an earlier return to activities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      clinicaltrials.gov identifier:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT05262361\">NCT05262361<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bjsports-2025-109807","type":"journal-article","created":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T08:25:33Z","timestamp":1759307133000},"page":"340-354","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["CONCUSS randomised clinical trial of vergence\/accommodative therapy for concussion-related symptomatic convergence insufficiency"],"prefix":"10.1136","volume":"60","clinical-trial-number":[{"clinical-trial-number":"nct05262361","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct05262361","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8797-1613","authenticated-orcid":false,"given":"Tara L","family":"Alvarez","sequence":"first","affiliation":[{"name":"Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, New Jersey, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitchell","family":"Scheiman","sequence":"additional","affiliation":[{"name":"Pennsylvania College of Optometry, Drexel University, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farzin","family":"Hajebrahimi","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, New Jersey, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Noble","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, New Jersey, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suril","family":"Gohel","sequence":"additional","affiliation":[{"name":"Department of Health Informatics, Rutgers Biomedical and Health Sciences, Newark, New Jersey, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Baro","sequence":"additional","affiliation":[{"name":"Pennsylvania College of Optometry, Drexel University, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josie A","family":"Bachman","sequence":"additional","affiliation":[{"name":"Pennsylvania College of Optometry, Drexel University, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina L","family":"Master","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, The Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA"},{"name":"University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arlene","family":"Goodman","sequence":"additional","affiliation":[{"name":"Somerset Pediatric Group, New Jersey Institute of Technology, Newark, New Jersey, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,10,1]]},"reference":[{"key":"2026031210502087000_60.5.340.1","doi-asserted-by":"publisher","DOI":"10.1097\/OPX.0b013e3182772dce"},{"key":"2026031210502087000_60.5.340.2","doi-asserted-by":"crossref","first-page":"1218","DOI":"10.1080\/02699052.2021.1959065","article-title":"Association between post-concussion symptoms and oculomotor deficits among adolescents","volume":"35","author":"Gowrisankaran","year":"2021","journal-title":"Brain Inj"},{"key":"2026031210502087000_60.5.340.3","doi-asserted-by":"crossref","first-page":"794","DOI":"10.1177\/0883073818789320","article-title":"Objective Eye Tracking Deficits Following Concussion for Youth Seen in a Sports Medicine Setting","volume":"33","author":"Howell","year":"2018","journal-title":"J Child Neurol"},{"key":"2026031210502087000_60.5.340.4","doi-asserted-by":"publisher","DOI":"10.1177\/0009922815594367"},{"key":"2026031210502087000_60.5.340.5","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1016\/j.ajo.2019.04.008","article-title":"Postconcussion: Receded Near Point of Convergence is not Diagnostic of Convergence Insufficiency","volume":"206","author":"Raghuram","year":"2019","journal-title":"Am J Ophthalmol"},{"key":"2026031210502087000_60.5.340.6","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/j.visres.2020.09.011","article-title":"Frequency of oculomotor disorders in adolescents 11 to 17 years of age with concussion, 4 to 12 weeks post injury","volume":"183","author":"Scheiman","year":"2021","journal-title":"Vision Res"},{"key":"2026031210502087000_60.5.340.7","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1097\/JSM.0000000000000891","article-title":"Specialty-Specific Diagnoses in Pediatric Patients With Postconcussion Syndrome: Experience From a Multidisciplinary Concussion Clinic","volume":"32","author":"Shah","year":"2022","journal-title":"Clin J Sport Med"},{"key":"2026031210502087000_60.5.340.8","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1097\/OPX.0000000000000910","article-title":"Near Point of Convergence after Concussion in Children","volume":"94","author":"Storey","year":"2017","journal-title":"Optom Vis Sci"},{"key":"2026031210502087000_60.5.340.9","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/j.visres.2021.03.002","article-title":"Vergence, accommodation, and visual tracking in children and adolescents evaluated in a multidisciplinary concussion clinic","volume":"184","author":"Wiecek","year":"2021","journal-title":"Vision Res"},{"key":"2026031210502087000_60.5.340.10","doi-asserted-by":"publisher","DOI":"10.1097\/JSM.0000000000000507"},{"key":"2026031210502087000_60.5.340.11","doi-asserted-by":"publisher","DOI":"10.1097\/OPX.0000000000000977"},{"key":"2026031210502087000_60.5.340.12","doi-asserted-by":"publisher","DOI":"10.1177\/0363546515606430"},{"key":"2026031210502087000_60.5.340.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.optm.2006.11.011"},{"key":"2026031210502087000_60.5.340.14","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1097\/OPX.0000000000000935","article-title":"Vision Therapy for Post-Concussion Vision Disorders","volume":"94","author":"Gallaway","year":"2017","journal-title":"Optom Vis Sci"},{"key":"2026031210502087000_60.5.340.15","doi-asserted-by":"publisher","DOI":"10.7205\/MILMED-D-12-00061"},{"key":"2026031210502087000_60.5.340.16","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.123.1.14"},{"key":"2026031210502087000_60.5.340.17","doi-asserted-by":"publisher","DOI":"10.1097\/01.opx.0000171331.36871.2f"},{"key":"2026031210502087000_60.5.340.18","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.126.10.1336"},{"key":"2026031210502087000_60.5.340.19","doi-asserted-by":"publisher","DOI":"10.1097\/OPX.0b013e3181b6210f"},{"key":"2026031210502087000_60.5.340.20","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1097\/OPX.0000000000001606","article-title":"Convergence Insufficiency Neuro-mechanism in Adult Population Study Randomized Clinical Trial: Clinical Outcome Results","volume":"97","author":"Alvarez","year":"2020","journal-title":"Optom Vis Sci"},{"key":"2026031210502087000_60.5.340.21","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1097\/OPX.0000000000001659","article-title":"Effect of Vergence\/Accommodative Therapy on Reading in Children with Convergence Insufficiency: A Randomized Clinical Trial","volume":"98","year":"2021","journal-title":"Optom Vis Sci"},{"key":"2026031210502087000_60.5.340.22","article-title":"Interventions for convergence insufficiency: a network meta-analysis","volume":"12","author":"Scheiman","year":"2020","journal-title":"Cochrane Database Syst Rev"},{"key":"2026031210502087000_60.5.340.23","doi-asserted-by":"crossref","unstructured":"Alvarez TL , Scheiman M , Santos EM , et al . Clinical and functional imaging changes induced from vision therapy in patients with convergence insufficiency. 2019 41st annual international conference of the IEEE Engineering in medicine and biology society (EMBC). IEEE; 2019:104\u20139.","DOI":"10.1109\/EMBC.2019.8857163"},{"key":"2026031210502087000_60.5.340.24","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-021-86171-9","article-title":"Underlying neurological mechanisms associated with symptomatic convergence insufficiency","volume":"11","author":"Alvarez","year":"2021","journal-title":"Sci Rep"},{"key":"2026031210502087000_60.5.340.25","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1167\/iovs.62.10.19","article-title":"Convergence Insufficiency Neuro-Mechanism Adult Population Study: Phoria Adaptation Results","volume":"62","author":"Sangoi","year":"2021","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"2026031210502087000_60.5.340.26","doi-asserted-by":"crossref","DOI":"10.1111\/cns.70007","article-title":"From convergence insufficiency to functional reorganization: A longitudinal randomized controlled trial of treatment-induced connectivity plasticity","volume":"30","author":"Hajebrahimi","year":"2024","journal-title":"CNS Neurosci Ther"},{"key":"2026031210502087000_60.5.340.27","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.64.3.29"},{"key":"2026031210502087000_60.5.340.28","doi-asserted-by":"publisher","DOI":"10.1016\/j.visres.2021.03.014"},{"key":"2026031210502087000_60.5.340.29","doi-asserted-by":"publisher","DOI":"10.1682\/JRRD.2012.12.0235"},{"key":"2026031210502087000_60.5.340.30","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1080\/01616412.2021.2000825","article-title":"Vision therapy improves binocular visual dysfunction in patients with mild traumatic brain injury","volume":"44","author":"Smaakj\u00e6r","year":"2022","journal-title":"Neurol Res"},{"key":"2026031210502087000_60.5.340.31","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1097\/OPX.0000000000000936","article-title":"Objective Assessment of Vergence after Treatment of Concussion-Related CI: A Pilot Study","volume":"94","author":"Scheiman","year":"2017","journal-title":"Optom Vis Sci"},{"key":"2026031210502087000_60.5.340.32","doi-asserted-by":"publisher","DOI":"10.1212\/CPJ.0000000000200071"},{"key":"2026031210502087000_60.5.340.33","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1002\/ana.25820","article-title":"Vision Therapy: Ocular Motor Training in Mild Traumatic Brain Injury","volume":"88","author":"Barton","year":"2020","journal-title":"Ann Neurol"},{"key":"2026031210502087000_60.5.340.34","doi-asserted-by":"publisher","DOI":"10.1080\/02699052.2022.2105399"},{"key":"2026031210502087000_60.5.340.35","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1097\/00006324-193001000-00001","article-title":"Zones of Ocular Comfort","volume":"7","author":"Sheard","year":"1930","journal-title":"Optom Vis Sci"},{"key":"2026031210502087000_60.5.340.36","doi-asserted-by":"publisher","DOI":"10.1097\/OPX.0b013e3181989252"},{"key":"2026031210502087000_60.5.340.37","doi-asserted-by":"publisher","DOI":"10.1097\/00006324-199904000-00025"},{"key":"2026031210502087000_60.5.340.38","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1080\/09286586.2019.1679192","article-title":"The Convergence Insufficiency Neuro-mechanism in Adult Population Study (CINAPS) Randomized Clinical Trial: Design, Methods, and Clinical Data","volume":"27","author":"Alvarez","year":"2020","journal-title":"Ophthalmic Epidemiol"},{"key":"2026031210502087000_60.5.340.39","first-page":"214","article-title":"Convergence Insufficiency Treatment Trial - Attention and Reading Trial (CITT-ART): Design and Methods","volume":"1","author":"Scheiman","year":"2015","journal-title":"Vis Dev Rehabil"},{"key":"2026031210502087000_60.5.340.40","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/j.sjopt.2019.02.009","article-title":"The distribution of near point of convergence in an Iranian rural population: A population-based cross-sectional study","volume":"33","author":"Hashemi","year":"2019","journal-title":"Saudi J Ophthalmol"},{"key":"2026031210502087000_60.5.340.41","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1111\/cxo.12471","article-title":"The distribution of near point of convergence and its association with age, gender and refractive error: a population\u2010based study","volume":"100","author":"Ostadimoghaddam","year":"2017","journal-title":"Clinical and Experimental Optometry"},{"key":"2026031210502087000_60.5.340.42","doi-asserted-by":"publisher","DOI":"10.1097\/00006324-199807000-00019"},{"key":"2026031210502087000_60.5.340.43","doi-asserted-by":"publisher","DOI":"10.1097\/00006324-200303000-00011"},{"key":"2026031210502087000_60.5.340.44","first-page":"25","article-title":"Association of symptoms and convergence and accommodative insufficiency in school-age children","volume":"74","author":"Borsting","year":"2003","journal-title":"Optometry"},{"key":"2026031210502087000_60.5.340.45","doi-asserted-by":"publisher","DOI":"10.1097\/00006324-200312000-00014"},{"key":"2026031210502087000_60.5.340.46","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1097\/00006324-199810000-00017","article-title":"Vergence facility and target type","volume":"75","author":"Gall","year":"1998","journal-title":"Optom Vis Sci"},{"key":"2026031210502087000_60.5.340.47","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1097\/00006324-198403000-00005","article-title":"Relation of Symptoms to Accommodative Infacility of School-Aged Children","volume":"61","author":"Hennessey","year":"1984","journal-title":"Optom Vis Sci"},{"key":"2026031210502087000_60.5.340.48","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0314027","article-title":"Effectiveness of treatment for concussion-related convergence insufficiency: The CONCUSS study protocol for a randomized clinical trial","volume":"19","author":"Alvarez","year":"2024","journal-title":"PLoS One"},{"key":"2026031210502087000_60.5.340.49","doi-asserted-by":"publisher","DOI":"10.4103\/0976-500X.72352"},{"key":"2026031210502087000_60.5.340.50","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"2026031210502087000_60.5.340.51","unstructured":"Scheiman M , Wick B . Clinical management of binocular vision: heterophoric, accommodative, and eye movement disorders. Lippincott Williams & Wilkins, 2008."},{"key":"2026031210502087000_60.5.340.52","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2022-106685"},{"key":"2026031210502087000_60.5.340.53","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.19394"},{"key":"2026031210502087000_60.5.340.54","doi-asserted-by":"crossref","unstructured":"Cohen J . Statistical power analysis for the behavioral sciences. Routledge, 2013. Available: https:\/\/www.taylorfrancis.com\/books\/9781134742707","DOI":"10.4324\/9780203771587"},{"key":"2026031210502087000_60.5.340.55","doi-asserted-by":"publisher","DOI":"10.1186\/s12874-017-0442-1"},{"key":"2026031210502087000_60.5.340.56","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2019.10.179"},{"key":"2026031210502087000_60.5.340.57","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1016\/j.jaapos.2017.08.001","article-title":"Pediatric ophthalmology and childhood reading difficulties: Convergence insufficiency: relationship to reading and academic performance","volume":"21","author":"Phillips","year":"2017","journal-title":"J AAPOS"},{"key":"2026031210502087000_60.5.340.58","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1016\/j.jaapos.2017.06.019","article-title":"Convergence Insufficiency Symptom Survey scores for required reading versus leisure reading in school-age children","volume":"21","author":"Clark","year":"2017","journal-title":"J AAPOS"},{"key":"2026031210502087000_60.5.340.59","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2016-097475"},{"key":"2026031210502087000_60.5.340.60","doi-asserted-by":"crossref","unstructured":"Master CL , Bacal D , Grady MF , et al . Vision and concussion: symptoms, signs, evaluation, and treatment. Pediatrics 2022;150. doi:10.1542\/peds.2021-056048","DOI":"10.1542\/peds.2021-056047"},{"key":"2026031210502087000_60.5.340.61","doi-asserted-by":"crossref","first-page":"1457","DOI":"10.1097\/OPX.0000000000000975","article-title":"Home-Based Therapy for Symptomatic Convergence Insufficiency in Children: A Randomized Clinical Trial","volume":"93","author":"Scheiman","year":"2016","journal-title":"Optom Vis Sci"},{"key":"2026031210502087000_60.5.340.62","doi-asserted-by":"crossref","first-page":"1391","DOI":"10.1001\/jamaophthalmol.2016.4262","article-title":"Effect of a Binocular iPad Game vs Part-time Patching in Children Aged 5 to 12 Years With Amblyopia: A Randomized Clinical Trial","volume":"134","author":"Holmes","year":"2016","journal-title":"JAMA Ophthalmol"},{"key":"2026031210502087000_60.5.340.63","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1097\/OPX.0000000000001867","article-title":"A Randomized Trial of Binocular Dig Rush Game Treatment for Amblyopia in Children Aged 4 to 6 Years","volume":"99","author":"Manny","year":"2022","journal-title":"Optom Vis Sci"},{"key":"2026031210502087000_60.5.340.64","doi-asserted-by":"publisher","DOI":"10.1167\/8.6.5"},{"key":"2026031210502087000_60.5.340.65","doi-asserted-by":"publisher","DOI":"10.16910\/jemr.2.3.6"},{"key":"2026031210502087000_60.5.340.66","doi-asserted-by":"crossref","first-page":"e107","DOI":"10.1016\/j.brs.2018.12.206","article-title":"Proceedings #37: Virtual Eye Rotation Vision Exercises (VERVE): A Virtual Reality Vision Therapy Platform with Eye Tracking","volume":"12","author":"Yaramothu","year":"2019","journal-title":"Brain Stimul"},{"key":"2026031210502087000_60.5.340.67","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1097\/00006324-194704000-00030","article-title":"A Useful Age-Amplitude Formula","volume":"24","author":"Hofstetter","year":"1947","journal-title":"Optom Vis Sci"}],"container-title":["British Journal of Sports Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bjsports-2025-109807","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T17:51:26Z","timestamp":1773337886000},"score":1,"resource":{"primary":{"URL":"https:\/\/bjsm.bmj.com\/lookup\/doi\/10.1136\/bjsports-2025-109807"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,1]]},"references-count":67,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,3,12]]},"published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1136\/bjsports-2025-109807"],"URL":"https:\/\/doi.org\/10.1136\/bjsports-2025-109807","relation":{},"ISSN":["0306-3674","1473-0480"],"issn-type":[{"value":"0306-3674","type":"print"},{"value":"1473-0480","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,1]]}}}