Activity levels across the intensity spectrum in athletes: a systematic review protocol.

Physical activity (PA) promotes better cardiometabolic health, physical function, brain health and longevity. In contrast, prolonged sedentary behaviour (SB) is a risk factor for many chronic diseases and poor health. Limited research has evaluated or synthesised how competitive sports participation influences PA across the lifespan. Some evidence suggests, ironically, that former competitive athletes may be insufficiently active and current athletes may be highly sedentary away from sport. This study describes the protocol for a systematic review and meta-analysis on activity levels across the intensity spectrum in athletes, addressing the primary research question: is sports participation significantly associated with PA and/or SB among current and former competitive athletes? PubMed, Embase, Cochrane Database of Systematic Reviews, Web of Science and SPORTDiscus databases will be searched. Two reviewers will independently screen titles/abstracts and full texts of selected abstracts. Data will be extracted regarding the study population, sport played, PA measures and protocols, outcomes of interest and findings. Primary outcomes will include step counts, daily activity across the intensity spectrum (ie, sedentary, light, moderate and vigorous PA), metabolic equivalent of task and whole-day energy expenditure. Secondary outcomes will include additional accelerometry measures of PA, activity patterns and self-reported PA. The risk of bias will be assessed using the National Institutes of Health Study Quality Assessment Tools. Extracted data will be presented using narrative synthesis and tabular presentation. Meta-analyses will be conducted to determine outcomes with sufficient data. PROSPERO registration number: CRD42024469267.https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=469267.