Neil Heron

• BSc (Hons), MBChB, DRCOG, DMH (distinction), DCH, MRCGP, Dip SEM, F.FSEM, MPhil, Masters in Public Health (with commendation) Certificate in Medical Education (commendation) PhD
• Consultant at Queen's University Belfast

Background Obesity is a common comorbidity of Type 2 Diabetes mellitus (T2DM), a chronic metabolic condition affecting millions worldwide. Orlistat may be used to reduce weight as an adjunct to diet/lifestyle changes. Aim To assess the evidence of orlistat on weight loss in adults with T2DM/high risk of T2DM and obesity. Design & Setting Systemat...

Introduction: Para-cycling is a competitive sport governed by the World Body for Cycling, Union Cycliste Internationale (UCI), encompassing various cycling disciplines tailored to athletes with physical or visual impairments. This study aimed to prospectively monitor the incidence of injury and illness in Para cyclists during the 2024 Paralympic se...

Introduction Concussion is a common condition, with sources estimating between 1.2% and 6.6% of all ED presentations are related to head injury, and concussion has significant healthcare costs. In April 2023, the UK Government published guidelines for diagnosis and management of concussions in grassroots sport, recommending anyone that has sustaine...

Introduction: Injury and illness rates within cycling are a growing concern for riders, medical personnel, and event organisers. This study is the first to document injury and illness rates in professional cyclists throughout one competitive season including training and racing. Methods: A prospective, longitudinal study was conducted with 47 profe...

Background and aims The Act on Axial SpA campaign is dedicated to minimising the lengthy 8.5-year delay in diagnosing axial spondyloarthritis (axial SpA) by implementing a pioneering Gold Standard diagnosis time of just one year. Collaborating with the Belfast Health & Social Care Trust, our initiative aims to streamline the patient journey from sy...

Historically, women have participated in elite sports for the past century, yet a perception persists that elite sports are incompatible with motherhood. There is a lack of consensus and sport-specific guidance on the upper limits of exercise during these periods. Arguably, this creates a conservative ambiguity for mothers who were active before pr...

Introduction The sport of cycling has witnessed phenomenal growth over the past decade. Globally, over 200 million television hours across five continents watched the recent inaugural World Championships in Glasgow, in 2023. The Union Cycliste Internationale (UCI), the world cycling governing body, has highlighted its mission to “promote and suppor...

Objectives This study aims to understand the prevalence, incidence rate, anatomical sites, injury severity and main medical actions carried out during official training and racing by elite downhill mountain biking (DHMTB) riders during the 2023 Union Cycliste Internationale (UCI) Cycling World Championships. Methods The participants of this prospe...

Background: Interventions within preschool settings have gained prominence due to the need to increase physical activity (PA) in early childhood. We first developed a 10-week preschool-based behaviour change intervention, guided by the UK Medical Research Council’s framework for complex interventions. We then conducted a cluster feasibility randomi...

Bicycle Motocross (BMX), both Racing and Freesyle, have gained popularity since the 1960s, evidenced by their debutes within the 2008 and 2020 Olympics, respectively. Sports-related concussions (SRCs) are ubiquitous within cycling, particularly in the discipline of BMX. The management of concussion in sport is an important issue, and many internati...

Background Wheelchair tennis, a globally popular sport, features a professional tour spanning 40 countries and over 160 tournaments. Despite its widespread appeal, information about the physical demands of wheelchair tennis is scattered across various studies, necessitating a comprehensive systematic review to synthesise available data. Objective...

Background A significant rise in childhood obesity worldwide over the past three decades highlights the urgent need for early interventions, especially in preschools as key settings for child development. This study aimed to assess the feasibility and fidelity of a randomised controlled trial of “I’m an Active Hero” (IAAH), a theory- and evidence-b...

Background Orlistat is recommended as an adjunct to diet and exercise for weight loss in the treatment of type 2 diabetes mellitus (T2DM). Aim To explore associations between patient characteristics and orlistat prescribing, and to determine associations of orlistat with weight loss in T2DM and prediabetes. Design and setting Cohort study using a...

The sport of cycling consists of several individual sporting disciplines. Indeed, the world governing body for cycling, Union Cycliste Internationale (UCI), oversees the various cycling disciplines, with each of these disciplines having a number of subcategories. While several sports have undertaken prospective injury surveillance studies to unders...

Objective: Mobile Health (mHealth) refers to using mobile devices to support health. This study aimed to identify specific methodological challenges in systematic reviews (SRs) of mHealth interventions and to develop guidance for addressing selected challenges. Study Design and Setting: Two-phase participatory research project. First, we sent an o...

The International Olympic Committee (IOC) recently published a framework on fairness, inclusion, and nondiscrimination on the basis of gender identity and sex variations. Although we appreciate the IOC's recognition of the role of sports science and medicine in policy development, we disagree with the assertion that the IOC framework is consistent...

Introduction Downhill Mountain Biking (DHMTB) is one of the more spectacular sub-disciplines of mountain bike (MTB) cycling. The primary aim of our study was to prospectively document the injury rate, severity, aetiology, location and type during official training and racing by elite DHMTB riders during the 2023 UCI Cycling World Championships. Met...

Background Physical inactivity is associated with feelings of burnout and fatigue, which in turn are associated with reduced performance among healthcare practitioners. This study explored movement behaviours of general practitioners (GPs) and the association between these behaviours with burnout and fatigue. Methods GPs in Northern Ireland were a...

Background Insufficient physical activity (PA) in early childhood is linked to adverse health outcomes and a heightened risk of obesity. Successful PA programmes often require input from key stakeholders, such as parents and educators. However, research on stakeholders’ perspectives regarding PA programmes for preschool children is limited, impedin...

Introduction The sport of cycling has witnessed phenomenal growth over the past decade. Globally, over 200 million television hours across five continents watched the recent inaugural World Championships in Glasgow, in 2023. The Union Cycliste Internationale (UCI), the world cycling governing body, has highlighted its mission to “promote and suppor...

Introduction The sport of cycling has witnessed phenomenal growth over the past decade. Globally, over 200 million television hours across five continents watched the recent inaugural World Championships in Glasgow, in 2023. The Union Cycliste Internationale (UCI), the world cycling governing body, has highlighted its mission to “promote and suppor...

Objective Musculoskeletal pain is a common risk factor for co-morbid conditions and might increase the risk of poor outcomes. The objective was to determine whether patients with pre-existing musculoskeletal pain have an increased risk for mortality following a new diagnosis of a co-morbid condition. Methods Patients aged ≥45 years with a new diag...

Introduction Concussion is a common condition, with sources estimating between 1.2% and 6.6% of all ED presentations are related to head injury, and concussion has significant healthcare costs. In April 2023, the UK Government published guidelines for diagnosis and management of concussions in grassroots sport, recommending anyone that has sustaine...

Background Insufficient physical activity (PA) is a significant risk factor that contributes to several health problems and there is a need to improve our understanding of how to increase PA, particularly among young children. This review (PROSPERO registration: CRD42022328841) investigated the relationship between behaviour change techniques (BCTs...

Objective: To investigate the impact of pre-existing painful musculoskeletal conditions on healthcare utilisation and costs among patients with five common conditions: acute coronary syndrome (ACS), stroke, cancer, dementia and pneumonia. Methods: Using primary and secondary care services data from electronic health records, negative binomial regr...

Background: Fibromyalgia is a common cause of chronic pain in the UK, with a huge individual and societal impact. Despite this, it remains difficult to diagnose and treat. The explanation of a fibromyalgia diagnosis can lead to difficult therapeutic relationships, with attitudinal issues and negative profiling of patients. This can lead to frustra...

Background Insufficient physical activity (PA) is a significant risk factor that contributes to obesity and there is a need to improve understanding about how to increase PA, particularly among young children. This review (PROSPERO registration: CRD42022328841) investigated the relationship between Behaviour Change Techniques (BCTs) and interventio...

Introduction The focus on medical management and secondary prevention following Transient Ischemic Attack (TIA) and minor stroke is well-established. Evidence is emerging that people with TIA and minor stroke can experience lasting impairments as fatigue, depression, anxiety, cognitive impairment, and communication difficulties. These impairments a...

Background/Aims The impact of COVID-19 has not been previously documented in an elite sporting population. Previous reports have documented cardiorespiratory sequelae in athletes, and expert opinion-based guidance is generally employed in their rehabilitation. However, there still persists a lack of information on how COVID-19 affects elite athlete...

Background/Aims Osteoarthritis (OA) is the commonest reason for orthopaedic referral in the UK, with the burden of knee OA affecting 10-25% of patients over 60 and 6% of those over 30. Intra-articular (IA) corticosteroid (CS) injections are the mainstay of treatment for symptomatic management in knee OA, particularly in the UK. IA platelet-rich-pla...

Introduction: A concussion or sports-related concussion (SRC) is a traumatic brain injury induced by biomechanical forces. After a SRC diagnosis is made, a concussed individual must undergo a period away from competition while they return to their baseline level of functioning. The Union Cycliste Internationale (UCI) currently recommend a minimum...

Objective Musculoskeletal painful conditions are a risk factor for cardiovascular disease (CVD), but less is known about whether musculoskeletal pain also worsens prognosis from CVD. The objective was to determine whether patients with musculoskeletal pain have poorer prognosis following acute coronary syndrome (ACS) or stroke. Methods The study u...

Introduction: There has been much debate recently on the participation of transgender and gender-diverse (TGD) athletes in sport, particularly in relation to fairness, safety and inclusion. The 2021 IOC Framework on Fairness, Inclusion and Non-discrimination acknowledges the central role that eligibility criteria play in ensuring fairness, particu...

Background: Tennis is a multidirectional high-intensity intermittent sport for male and female individuals played across multiple surfaces. Although several studies have attempted to characterise the physical demands of tennis, a meta-analysis is still lacking. Objective: We aimed to describe and synthesise the physical demands of tennis across...

Objective: This scoping review examines how different levels and types of partial foot amputation affect gait and explores how these findings may affect the minimal impairment criteria for wheelchair tennis. Methods: Four databases (PubMed, Embase, CINAHL and SPORTDiscus) were systematically searched in February 2021 for terms related to partial...

Introduction In competitive road cycling, low body mass is a common focus for many athletes. Due to the high energy expenditure and non-weight bearing nature of competitive road cycling, there are associated health risks including relative energy deficiency and low bone mineral density. Untreated, this can lead to an increased susceptibility to fra...

Introduction Concussion/sports-related concussion(SRC) is a common injury and carries potential for significant acute and long term consequences. The United Kingdom(UK) government are currently developing SRC protocols for use in grass roots sport, requiring doctors to make the diagnosis and management of SRC. Medical students, as the future docto...

Background: People who have experienced a stroke or transient ischaemic attack (TIA) have greater risks of complications from COVID-19. Therefore, vaccine uptake in this vulnerable population is important. To prevent vaccine hesitancy and maximise compliance, we need to better understand individuals' views on the vaccine. Objectives: We aimed to...

Introduction: Downhill mountain biking (DHI) is a form of cycling and does not currently have a specific sports-related concussion (SRC) assessment. Objective: To review the extent, range and nature of research investigating SRC in DMB, provide a summary of key literature findings relating to its identification and management, and then develop a...

Elite Para athletes report a high incidence of sports injuries, illnesses and other health issues. Despite this, there are few prevention programmes in Para sport, and many of the existing prevention programmes are not adapted to Para athletes. To improve the success of preventive measures, it has been suggested that sports safety work should facil...

Elite Para athletes report a high incidence of sports injuries, illnesses and other health issues. Despite this, there are few prevention programmes in Para sport, and a concern is that many of the existing prevention programmes are not adapted to Para athletes. To improve the success of preventive measures, it has been suggested that sports safety...

Track cycling is a fast, exciting sport and requires a specific sports-related concussion (SRC) assessment protocol. This paper proposes the first SRC assessment protocol for use in track cycling and proposes that this should occur in three stages. Stage 1 will occur at the trackside, whilst stage 2 occurs in the changing room immediately after the...

Accurate and reliable evaluation of muscle strength in para-athletes is essential for monitoring the effectiveness of strength training and/or rehabilitation programmes, and sport classification. Our aim is to synthesise evidence related to assessing muscle strength in para-athletes. Four databases were searched from January 1990 to July 2021 for o...

Background: Patients with painful musculoskeletal conditions have an increased risk of developing cancer, but less is known about whether this impacts on the longer-term cancer prognosis. This study aims to determine whether patients with painful musculoskeletal conditions have a greater incidence of hospitalisation and mortality following diagnosi...

See attached introduction for infographic.

Abstract: Objectives To summarise and map the existing evidence relating to the definition, preva- 1 lence, prevention and management of saddle sores within the literature and highlight research gaps. 2 Design Scoping Review. Data Sources 3 databases were searched using an appropriate search 3 strategy agreed on by the authors with the aid of an ex...

Aim: Research has shown that families' participation in a cardiovascular disease (CVD) prevention programme could boost early adoption of healthy lifestyle behaviours in families. Behaviour-based, eHealth interventions are a potential means of achieving this. This study aimed to explore expectations of families-parents and children-at risk of CVD...

Infographic addressing COVID-19 vaccine hesitancy in the athletic population.

Introduction Concussion is a common yet complex condition, with each new case requiring assessment by a medical doctor. Recent research has shown that doctors working in the UK have significant knowledge deficient regarding concussion diagnosis and management. Aim The aim of this scoping review was to map out the evidence about how undergraduate...

Background General practice is a highly sedentary occupation, with many general practitioners (GPs) spending over 10.5 hours sitting each workday. This excessive sedentary behaviour and lack of physical activity (PA) is potentially detrimental to the health of GPs, as well as their ability to counsel patients regarding sedentary behaviour and PA. T...

See attached for introduction to infographic.

Objectives To investigate which United Kingdom (UK) amateur sporting organisations have published sports-related concussion (SRC) guidelines, their accessibility and the extent to which they follow the Berlin statement recommendations. This article is targeted at those involved with designing and implementing SRC guidelines in amateur sport. Design...

Objective Secondary prevention is recommended to reduce cardiovascular risk after transient ischaemic attack (TIA) or ‘minor’ stroke. Mobile health interventions can provide accessible, cost-effective approaches to address modifiable risk factors, such as physical inactivity, hypertension and being overweight. The objective of this study was to eva...

Background Sedentary behaviour, which may have increased among GPs due to increasing use of telemedicine, is associated with many illnesses and increased all-cause mortality. Aim To explore levels of sedentary behaviour among GPs and General Practice Specialty Trainees (GPSTs). Design & setting Sequential, cross-sectional design (initial online s...

Background The important role of primary care in promoting healthy lifestyle behaviours needs informed support. Aim To elicit views on a 39-item shared decision-making (SDM) aid (SHARE-D) for lifestyle change and refine it to improve implementation. Design & setting Mixed methods study. Method Health professionals, patients, and support workers,...

Background: There is evidence that painful musculoskeletal conditions are associated with increased risk of cardiovascular disease, but less is known about whether this impacts on prognosis of cardiovascular disease. The aim was to determine whether patients with painful musculoskeletal conditions have poorer prognosis following acute coronary synd...

Background Sport-related head and neck injuries, including concussion, are a growing global public health concern with a need to explore injury risk reduction strategies such as neck exercises.Objectives To systematically review the literature to investigate: (1) the relationship between neck strength and sport-related head and neck injuries (inclu...

Altered biomechanics due to amputation can contribute to substantial limitations, influencing sporting activities. Individuals with lower extremity amputations or congenital lower limb deficiency are encouraged to participate in para-sports. However, to compete in Paralympic sports, the candidate must have an impairment that results in lower extrem...

Background Despite recent advances in the diagnosis and management of sports-related concussion (SRC) in the sports medicine community; as well as heightened recognition of the condition by the public and media, some sports, such as road cycling, appear to lack effective concussion assessment, diagnosis and management protocols. Objectives Underta...

Background In recent years there has been an increase in focus on the potential role neck muscle strength and strengthening may play in helping to mitigate the risk of sports related concussion (SRC). However, to date there has not been any systematic reviews or analysis to help quantify this role and provide guidance. Objective To systematically...

Objectives: To report COVID-19 illness pattern, symptom duration, and time-loss in UK elite athletes Methods: Observational, clinical and database review of athletes with symptomatic COVID-19 illness managed within the UK Sports Institutes. Athletes were classified as confirmed (positive SARS-CoV-2 PCR or antibody tests) or probable (consistent cl...

1. Introduction This infographic outlines considerations for athletes and their teams around vaccination against the SARS-CoV-2 (Covid-19) virus. There are currently three vaccines approved for use in the United Kingdom (UK); Pfizer/BioNTech, Moderna and Oxford/AstraZenica. It is important for athletes and their physicians to be aware of the poten...

The World Health Organisation (WHO) recommends that adults should do at least 150 19 minutes of moderate-intensity physical activity or 75 minutes of vigorous physical activity 20 per week (1). Despite this, recent statistics show that one in four adults do not meet the 21 recommended physical activity guidelines (2). Road cycling is an effective f...

Background: Intra-articular (IA) corticosteroid (CS) injections are the mainstay of treatment for symptomatic management in knee osteoarthritis (OA), particularly in the UK. IA platelet-rich plasma (PRP) injections are a promising alternative, but no systematic reviews to date have compared them to the current standard of care, IA CS injections. W...

Tingling, pain and numbness in the hand can be a major cause of morbidity for many people. Adequate hand and wrist function are required for a huge variety of daily tasks, therefore disorders of the hand and wrist can have significant detrimental effects on the quality of life for affected individuals. With any upper limb issue, it is important to...

Sports-related concussion (SRC) is a common and increasingly recognised sports related injury and accounts for between 1 & 9% of all cycling specific injuries. Attention has been drawn to the difficulty in managing suspected SRC in a fast-paced sport such as road cycling, particularly the lack of an effective and time efficient assessment protocol....

The Achilles tendon (AT) is the largest tendon in the human body, connecting the gastrocnemius, soleus and plantaris muscles to the calcaneus. Together with these muscles, the AT causes plantarflexion of the foot at the ankle joint and flexion at the knee, which are vital functions within the gait cycle. The AT also prevents excessive dorsiflexion...

Background People who experience a stroke or transient ischaemic attack (TIA) have greater risks of complications from contracting COVID-19. Vaccine uptake in this vulnerable population is important to reduce the burden of COVID-19 on healthcare services and society. To prevent vaccine hesitancy and maximise compliance, we need to better understand...

This paper describes the development of the ‘Brain-Fit’ app, a digital secondary prevention intervention designed for use in the early phase after transient ischaemic attack (TIA) or minor stroke. The aim of the study was to explore perceptions on usability and relevance of the app in order to maximise user engagement and sustainability. Using the...

Background: The purpose of the present study was to investigate how an athlete’s participation in either an individual or team sport is related to their attitude toward sport psychology consulting and their willingness to consult a sport psychology practitioner. Method: The Sport Psychology Attitudes-Revised form (SPA-R) (1) was completed by one...

COVID-19 has strongly impacted sporting participation at all levels of competition, with many large-scale events postponed or even cancelled. Mass gatherings at sporting events have also been severely restricted;(1) such gatherings are a known source of infectious disease transmission, with the potential for global spread upon return to home countr...

Introduction Epidemiology reporting within the cricketing medical literature has emerged over the past 2 years, with a focus on physical injuries. Despite mental health in elite sport gaining increasing recognition, few studies have addressed mental health symptoms and disorders within cricket. Recently, cricketers have been prominent in the mainst...

p class="abstract"> Background: Many general practitioners (GPs) are sedentary for most of their working day. Levels of sedentary behaviour may have been exacerbated by increased use of telemedicine in light of the COVID-19 pandemic, as this is traditionally performed while sitting down. Excessive sedentary behaviour is associated with many adverse...

This infographic outlines evidence- based recommendations on COVID-19 reverse transcriptase PCR (RT- PCR) testing in elite sport settings, aiming to protect personal and population health, and acknowledging resources and expertise that are often available in elite sport. Public health recommendations vary by country and region, and protocol deci-si...

Background: The purpose of the present study was to investigate how an athlete’s participation in either an individual or team sport is related to their attitude toward sport psychology consulting and their willingness to consult a sport psychology practitioner. Method: The Sport Psychology Attitudes-Revised form (SPA-R) was completed by one hundre...

Background Sedentary behaviour is when someone is awake, in a sitting, lying or reclining posture and is an independent risk factor for multiple causes of morbidity and mortality. A dose-response relationship has been demonstrated, whereby increasing sedentary time corresponds with increasing mortality rate. This study aimed to identify current lev...

Introduction and background Sport and exercise scientists have a role to play in supporting people returning to exercise after illness or injury, particularly when there has been a prolonged period of incapacity or inactivity during which fitness and conditioning levels will have significantly deteriorated (Sarto et al., 2020). This expert statemen...

Objectives To allow the implementation of effective injury and illness prevention programmes for road cyclists, we wanted to first identify the injury/illness burden to this group of athletes. We, therefore, undertook a systematic review of all reported injuries/illness in road cycling. Design Systematic review. Data sources Identification of art...