{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T13:52:08Z","timestamp":1784123528738,"version":"3.55.0"},"reference-count":56,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2025,3,27]],"date-time":"2025-03-27T00:00:00Z","timestamp":1743033600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,3,27]],"date-time":"2025-03-27T00:00:00Z","timestamp":1743033600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Active Life Foundation https:\/\/www.activelife.org\/about-alf\/"},{"DOI":"10.13039\/501100023299","name":"stiftelsen silviahemmet","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100023299","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Sports Health: A Multidisciplinary Approach"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>There is growing awareness that back pain in adolescent soccer (European football) players is not always related to local tissue damage. Approaches taking into consideration lifestyle factors are needed. This study aimed to investigate the association between psychological distress, skipped meals, and insufficient sleep, and the occurrence of back pain among adolescent female soccer players.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Hypothesis:<\/jats:title>\n                    <jats:p>Psychological distress, skipped meals, and insufficient sleep are associated with the occurrence of back pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>Level 3.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Swedish adolescent female soccer players aged 12 to 17 years, without back pain at baseline, were included. The exposures psychological distress, skipped meals, and insufficient sleep were assessed at baseline. The players were followed for 1 year with a weekly web-based survey, where back pain intensity was measured on a numeric rating scale (NRS) ranging from 0 to 10. The outcome back pain was defined as reporting low back pain and\/or upper back\/neck pain intensity of \u22654 on the NRS. Multivariable Cox proportional hazard regression analyses were performed to estimate the hazard rate ratio (HRR) with 95% CI for the association between each exposure and the outcome back pain, adjusted for age at baseline and parents\u2019 education.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>In total, 351 players were included, and 141 players reported back pain at some point during the 1-year follow-up. The adjusted HRR for back pain was 1.79 (95% CI, 1.11-2.91) for insufficient sleep, 1.45 (95% CI, 0.97-2.17) for psychological distress, and 0.98 (95% CI, 0.61-1.59) for skipped meals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Insufficient sleep and psychological distress are associated with the occurrence of back pain among female adolescent soccer players.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance:<\/jats:title>\n                    <jats:p>Our results contribute to the understanding of what may influence the occurrence of back pain in adolescence, offering potential strategies for the prevention of back pain in adolescent female soccer players.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19417381251326498","type":"journal-article","created":{"date-parts":[[2025,3,27]],"date-time":"2025-03-27T09:46:48Z","timestamp":1743068808000},"page":"1166-1173","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Psychological Distress, Skipped Meals, and Insufficient Sleep, and the Occurrence of Back Pain in Adolescent Female Soccer Players: The Karolinska Football Injury Cohort Study"],"prefix":"10.1177","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9091-9560","authenticated-orcid":false,"given":"Luca","family":"Orzali","sequence":"first","affiliation":[{"name":"Musculoskeletal and Sports Injury Epidemiology Center, Department of Health Promotion Science, Sophiahemmet University, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Asker","sequence":"additional","affiliation":[{"name":"Musculoskeletal and Sports Injury Epidemiology Center, Department of Health Promotion Science, Sophiahemmet University, Stockholm, Sweden, and Naprapath\u00f6gskolan - Scandinavian College of Naprapathic Manual Medicine, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan","family":"Weiss","sequence":"additional","affiliation":[{"name":"Musculoskeletal and Sports Injury Epidemiology Center, Department of Health Promotion Science, Sophiahemmet University, Stockholm, Sweden, and Unit of Intervention and Implementation Research on Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara","family":"Onell","sequence":"additional","affiliation":[{"name":"Musculoskeletal and Sports Injury Epidemiology Center, Department of Health Promotion Science, Sophiahemmet University, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Urban","family":"Johnson","sequence":"additional","affiliation":[{"name":"Halmstad University, Halmstad, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"F\u00e4ltstr\u00f6m","sequence":"additional","affiliation":[{"name":"Unit of Physiotherapy, Department of Health, Medicine and Caring Sciences, Link\u00f6ping University, Link\u00f6ping, Sweden, and Region J\u00f6nk\u00f6ping County, Rehabilitation Centre, Ryhov County Hospital, J\u00f6nk\u00f6ping, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrika","family":"Tranaeus","sequence":"additional","affiliation":[{"name":"Unit of Intervention and Implementation Research on Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden, and Department of Physiology, Nutrition, Biomechanic, Sport Performance &amp; Exercise Research and Innovation Center - Stockholm, SPERIC-S, The Swedish School of Sport and Health Sciences, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Skillgate","sequence":"additional","affiliation":[{"name":"Musculoskeletal and Sports Injury Epidemiology Center, Department of Health Promotion Science, Sophiahemmet University, Stockholm, Sweden, Naprapath\u00f6gskolan - Scandinavian College of Naprapathic Manual Medicine, Stockholm, Sweden, and Unit of Intervention and Implementation Research on Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,3,27]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-11-788"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph192113929"},{"issue":"4","key":"e_1_3_3_4_2","first-page":"601","article-title":"Sleep quality, mood and performance: a study of elite Brazilian volleyball athletes","volume":"15","author":"Andrade A","year":"2016","unstructured":"Andrade A, Bevilacqua GG, Coimbra DR, Pereira FS, Brandt R. 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