Hilde Moseby Berge

• Isern, Cecilie Benedicte; Bahr, Roald; Flønes, Malin; Jorstad, Harald; Kramer-Johansen, Jo & Mjøs, Ingrid [Show all 8 contributors for this article] (2025). Out-of-hospital cardiac arrest in Norwegians aged 12–49 years: nationwide analysis of preceding symptoms and risk factors related to aetiology and pre-arrest exercise habits. BMJ Open sport & exercise medicine. 11, p. 1–12. doi: 10.1136/bmjsem-2025-002505. Full text in Research Archive Show summary

  Background Out-of-hospital cardiac arrest (OHCA) in the young is a tragic event. Regular exercise reduces cardiovascular disease (CVD) risk but, at certain intensities and volumes, is associated with increased OHCA risk. Understanding symptoms, risk factors and aetiology is central for primary prevention. Objective Assess symptoms and risk factors related to OHCA aetiology in young Norwegians, and the role of exercise volume. Method We obtained data from the Norwegian Cardiac Arrest Registry (2015–2017), medical records, autopsy reports and questionnaires. Inclusion criteria were ages 12–49 years and OHCA of presumed cardiac aetiology. Results Data from 134 individuals (81 survivors, 53 deceased) showed that CVD symptoms were present during both rest/everyday activity and exercise in most victims, and were reported by more survivors than by next-of-kin of the deceased (78% vs 60%). Only 12% had symptoms just during exercise. Ischaemic heart disease was the leading cause (58% in males vs 38% in females), followed by structural, non-ischaemic heart disease. Sudden unexpected death syndrome (SUDS) was most common in individuals aged ≤35 years. Risk factors were present in 74%, with family history for CVD most prevalent (51%) and overweight in at least 33%. There were no significant differences in symptoms, risk factors or OHCA aetiology related to exercise volume prior to OHCA. Conclusion Symptoms and CVD risk factors were prevalent in young Norwegians suffering OHCA regardless of exercise volume. Ischaemic heart disease was the leading cause of OHCA. We suggest evaluating symptoms carefully and addressing risk factors to prevent OHCA in young Norwegians regardless of exercise habits.

• Steenstrup, Sophie; Kramer-Johansen, Jo & Berge, Hilde Moseby (2025). Saving lives together in sport: − A pilot study attempting to increase the number and availability of automated external defibrillators and to initiate voluntary training in cardiopulmonary resuscitation with the use of automated external defibrillators in Norwegian amateur football clubs. Resuscitation. ISSN 0300-9572. 209. doi: 10.1016/j.resuscitation.2025.110586. Full text in Research Archive Show summary

  Objectives In Norway, the potential to increase the number of patients connected to an automated external defibrillator (AED) before ambulance arrival in out-of-hospital cardiac arrests is substantial. A blended learning approach is effective for cardiopulmonary resuscitation (CPR) training with AED usage, and regular hands-on CPR refresher training is recommended. The objective was to test if provision of CPR-training equipment and learning resources combined with a contract to recruit volunteer CPR trainers could facilitate regular refresher CPR-training in Norwegian football clubs and to increase the number and accessibility of AEDs by providing clubs with AEDs and heated cabinets and mandate registration in the national AED registry. Methods Non-randomized pilot study (2020–2023). Clubs signed contracts that they would perform CPR training with the use of AEDs for 70% of football players/coaches/staff/volunteers each year and place their received AED outdoors in heated cabinets and register their AED in the Norwegian national AED registry. We explored barriers through follow-up e-mails. Results We recruited 116 of 278 (42%) eligible football clubs. From 2020 to 2023, 5440 football players and 987 coaches/staff/volunteers from 60 (52%) clubs completed CPR training sessions and 20 (17%) repeated CPR training. We provided 112 AEDs and 116 heated cabinets. By a deadline, 68/116 (59%) of clubs had placed their AED outdoors in the heated cabinet and registered their AED correctly in the national AED registry, 27/116 (23%) placed their AED outdoors but did not complete their registration in the AED registry correctly, 13/116 (11%) kept their AED locked indoors and 8/116 (7%) failed to register their AED. Few clubs (20/116, 17%) provided insights into barriers. Conclusion We recruited a satisfactory number of football clubs. Over 6000 players/coaches/staff/volunteers completing CRP training shows promise. Most clubs complied to the message of 24/7/365 availability of AEDs and found registration in the national AED registry uncomplicated.

• Jevremovic, Diko; Årøen, Asbjørn; Thomas, Owen Matthew Truscott; Berge, Hilde Moseby; Khan, Ahsan Ayub & Ulstein, Svend (2024). Anterior Cruciate Ligament Reconstruction and Concomitant Focal Cartilage Lesions: A Systematic Review and Meta-Analysis of Prognosis after Surgical Treatment. Cartilage. ISSN 1947-6035. doi: 10.1177/19476035241292719. Full text in Research Archive Show summary

  Objective: To synthesize available evidence on the impact of concomitant focal cartilage lesions and their surgical treatment on clinical outcomes in the setting of anterior cruciate ligament (ACL)-reconstruction at short (6-36 months) and midterm (3-8 years) follow-up. Design: Original level 1 or 2 studies comparing any patient-reported or objective outcomes in ACL-reconstructed patients (1) with and without concomitant focal cartilage lesion(s) or (2) after any type of cartilage surgical treatment were considered for inclusion. Systematic searches were conducted in MEDLINE via Ovid, Cochrane Library, EMBASE via OvidSP, and Web of Science. Results: In meta-analysis performed across 6 studies (n=8,789 patients), we discovered with very low certainty, the correlation of concomitant any-thickness cartilage lesions and worse Patient-Reported Outcome Measure scores (PROMS) at cumulative short to mid, (pooled standardized mean difference (psmd) = −0.36; 95% confidence interval (CI) –0.62 to −0.10), short (psmd = −0.43; 95% CI = −0.94 to 0.08), and midterm (psmd = −0.22; 95% CI –0.43 to 0.00). Full-thickness lesions predicted worse PROMS with moderate certainty at cumulative short-midterm (psmd = −0.32; 95% CI = −0.41 to −0.23) and low certainty at both short (psmd = −0.45; 95% CI –0.83 to −0.07) and midterm (psmd = −0.30; 95% CI –0.38 to −0.22). In 4 studies for each outcome, mixed results were reported on osteoarthritis (OA) and reoperation rates. Conclusions: As the main finding, concomitant full-thickness cartilage lesions in ACL-reconstructed patients are a predictor of worse PROMS in the cumulative short to midterm. Correlations of any-thickness lesions or different cartilage treatments with short- or midterm PROMS, OA, or reoperation rates were either with very low certainty, unmeasured, or with mixed results.

• Steffen, Kathrin; Bahr, Roald; Clarsen, Benjamin Matthew; Fossan, Bjorn; Fredriksen, Hilde & Gjelsvik, Hilde [Show all 15 contributors for this article] (2024). Comprehensive periodic health evaluations of 454 Norwegian Paralympic and Olympic athletes over 8 years: What did we learn? British Journal of Sports Medicine. ISSN 0306-3674. 58(15), p. 826–835. doi: 10.1136/bjsports-2023-107942. Full text in Research Archive Show summary

  Objective: A periodic health evaluation (PHE) is a comprehensive and multidisciplinary investigation of athlete health widely used in elite sport, but its contents and benefits can be questioned. This study aimed to determine the prevalence of conditions identified by a PHE among Paralympic and Olympic athletes over four consecutive Games cycles from Rio de Janeiro 2016 to Beijing 2022 and to assess the benefits and potential pitfalls of a comprehensive PHE programme in detecting existing injuries, illnesses and other health issues. Methods: We collected extensive health history and clinical examination data on elite athletes: medical history, ECG, blood pressure, blood samples, spirometry, musculoskeletal health, cognitive function, mental health and compliance with public health programmes. Results: The final cohort included 87 Paralympic and 367 Olympic athletes, representing 565 PHE cycles. Musculoskeletal problems and unspecified pain, infections and allergies were the most frequent health issues. High blood pressure was the most prevalent cardiovascular finding, and vitamin D deficiency the most common laboratory abnormality. Most athletes complied with the public childhood vaccination programmes, but fewer with recommended cancer screening. Follow-up of health issues was variable. Conclusion: Our PHE programme identified musculoskeletal problems, infections, allergies, elevated blood pressure and vitamin D deficiency as common health conditions. Longitudinal follow-up of health conditions identified during screening and improved compliance with public health and cancer screening programmes is needed to determine the true benefits of athlete care prompted by the PHE.

• Clarsen, Benjamin Matthew; Berge, Hilde Moseby; Bendiksen, Fredrik; Fossan, Bjørn; Fredriksen, Hilde & Haugvad, Lars [Show all 11 contributors for this article] (2023). Injury and illness among Norwegian Olympic athletes during preparation for five consecutive Summer and Winter Games. British Journal of Sports Medicine. ISSN 0306-3674. 58(1), p. 18–24. doi: 10.1136/bjsports-2023-107128. Full text in Research Archive Show summary

  Objective: To describe the patterns of health problems among Norwegian Olympic candidates during their preparations for five consecutive Olympic Games (London 2012, Sochi 2014, Rio de Janeiro 2016, PyeongChang 2018 and Tokyo 2020). Methods: This was a descriptive epidemiological study using the Oslo Sports Trauma Research Center Questionnaire on Health Problems to collect data on all self-reported health problems from Norwegian Olympic candidate athletes for 12–18 months prior to each Olympic Games. Team physicians and physiotherapists followed up the athlete reports, providing clinical care and classifying reported problems according to the International Olympic Committee 2020 consensus statement on methods for recording and reporting of epidemiological data on injury and illness in sport. Results: Between 2011 and 2020, 533 athletes were included in the Norwegian Olympic team monitoring programme, with a 78% response to the weekly questionnaire. During this time, athletes reported 2922 health problems, including 1409 illnesses (48%), 886 overuse injuries (repetitive mechanism, 30%) and 627 acute injuries (traumatic mechanism, 21%). Diagnostic codes were recorded for 2829 (97%) of health problems. Athletes reported, on average, 5.9 new health problems per year (95% CI: 5.6 to 6.1), including 1.3 acute injuries (CI: 1.2 to 1.4), 1.7 overuse injuries (CI: 1.6 to 1.9) and 2.9 illnesses (CI: 2.7 to 3.0). Each year, female and male athletes lost an average of 40 and 26 days of training and competition due to health problems, respectively. The diagnoses with the highest health burden were anterior cruciate ligament rupture, respiratory infection, lumbar pain and patellar tendinopathy. Conclusion: The injury burden was particularly high among female athletes and in team sports, whereas endurance sports had the greatest burden of illness. Our data provide a compelling argument for prioritising medical care and investing in prevention programmes not just during the Olympic Games, but also the preparation period.

• Isern, Cecilie Benedicte; Kramer-Johansen, Jo; Tjelmeland, Ingvild Beathe Myrhaugen; Bahr, Roald & Berge, Hilde Moseby (2023). A 3-year population-based study of exercise-related sudden cardiac arrest among 12- to 50-year-old Norwegians. Scandinavian Journal of Medicine & Science in Sports. ISSN 0905-7188. 33(8). doi: 10.1111/sms.14400. Full text in Research Archive Show summary

  Introduction: Regular exercise is associated with reduced risk of cardiovascular disease. Paradoxically, an increased risk of sudden cardiac arrest (SCA) is documented during or immediately after exercise and in athletes compared to the nonathletic population. Our objective was to identify, through multiple sources, the total number of exercise-related versus non-exercise-related SCA in the young population in Norway. Methods: We collected primary data from the prospective Norwegian Cardiac Arrest Registry (NorCAR) for all patients aged 12–50 suffering SCA of presumed cardiac cause from 2015 to 2017. We collected secondary data about prior physical activity and the SCA, through questionnaires. We searched media reports for SCA incidents in sports. Exercise-related SCA is defined as SCA during or <1 h after exercise. Results: Overall, 624 patients, median age 43 years, were included from NorCAR. Two thirds (393) replied to the study invitation, of whom 236 answered the questionnaires: 95 survivors and 141 next of kin. The media search resulted in 18 relevant hits. With a multiple source approach, we identified 63 cases of exercise-related SCA, equivalent to an incidence of 0.8/100 000 person-years, versus 7.8/100 000 person-years of non-exercise-related SCA. Among those who answered (n = 236), almost two thirds (59%) exercised regularly, most commonly (45%) 1–4 h/week. Endurance exercise (38%) was the most prevalent type of regular exercise and the most common activity during exercise-related SCA (53%). Conclusion: The burden of exercise-related SCA was low (0.8 per 100 000 person-years) and ten times lower than non-exercise-related SCA in the young population in Norway.

• Isern, Cecilie Benedicte; Nilsson, Birgitta Blakstad; Garratt, Andrew; Kramer-Johansen, Jo; Tjelmeland, Ingvild Beathe Myrhaugen & Berge, Hilde Moseby (2023). Health-related quality of life in young Norwegian survivors of out-of-hospital cardiac arrest related to pre-arrest exercise habits. Resuscitation Plus. 16. doi: 10.1016/j.resplu.2023.100478. Full text in Research Archive Show summary

  Aim: To compare health-related quality of life (HRQoL) in young survivors of out-of-hospital cardiac arrest (OHCA) in Norway with an age and sex- matched reference population and to assess the associations between exercise volume prior to OHCA and HRQoL after. Methods: We present data from survivors aged 18–50 years registered with OHCA in the Norwegian Cardiac Arrest Registry between January 1st 2015 and December 31st 2017. Survivors were invited to answer two questionnaires; (1) the Short Form 36 (SF-36) Health Survey Version 1, and (2) about exercise habits prior to OHCA. Respondents were randomly matched 1:1 for age and sex with a reference population (data were available from the Norwegian Centre for Research Data). Results: Of the 175 survivors invited, 95 (54%) responded, median age was 44 (range 35–48) years, 26 (27%) females. Valid results for SF-36 were available for 91 survivors, of whom 87 reported pre-OHCA exercise-volume. Prior to OHCA, 21 did no regular exercise, 44 exercised 1–4 hours/week and 22 exercised 5 hours/week. Compared to the reference population survivors had significantly (p < 0.01) poorer SF-36 scores for scales relating to physical- and mental health. SF-36 scale scores were similar in survivors who did and did not exercise regularly. Within the regular exercisers, survivors reporting 5 hours of exercise/week had better SF-36 scores than those exercising less. Conclusion: Poorer HRQoL in survivors compared to the reference population should prompt us to explore how treatment and rehabilitation could be improved and adapted. More exercise before OHCA favoured better HRQoL after, which aligns well with the recognised positive association between HRQoL and physical activity in general.

• Koivisto-Mørk, Anu; Steffen, Kathrin; Finnes, Trine Elisabeth; Pretorius, Mikkel & Berge, Hilde Moseby (2023). High prevalence of low bone mineral density but normal trabecular bone score in Norwegian elite Para athletes. Frontiers in Sports and Active Living. 5. doi: 10.3389/fspor.2023.1246828. Full text in Research Archive Show summary

  Background: Low bone mineral density (BMD) increases the risk of bone stress injuries (BSI) and is one of several clinical concerns in Para athlete sports medicine. However, whether bone microarchitecture is altered in Para athletes is not known. Objective: We aimed to investigate BMD, bone microarchitecture and incidence of bone stress injuries in Norwegian elite Para athletes. Design: In this cross-sectional study in Para athletes, Dual energy x-ray absorptiometry (iDXA, Lunar, GE Health Care) derived areal BMD, trabecular bone score (TBS), a surrogate marker for bone microarchitecture, and body composition (body weight (BW), lean body mass (LBM), fat mass (FM), fat percentage) were investigated and compared between ambulant and non-ambulant athletes. Also, the association between BMD, TBS and body composition variables was investigated. Incidence of BSI was assessed with a questionnaire and confirmed by a sports physician in a clinical interview. BMD Z-score <−1 was defined as low and ≤−2 as osteoporotic. TBS ≥ 1.31 was normal, 1.23–1.31 intermediate and <1.23 low. Results: Among 38 athletes (26 ± 6 yrs, 14 females), BMD Z-score was low in 19 athletes, and osteoporotic in 11 athletes' lumbar spine (LS) or femoral neck (FN). BMD was lower in non-ambulant vs. ambulant athletes both in LS (1.13 ± 0.19 vs. 1.25 ± 0.14 g/cm2, p = 0.030) and FN (0.90 ± 0.15 vs. 1.07 ± 0.16 g/cm2, p = 0.003). TBS was normal for all athletes. BMD Z-score in LS was positively associated with TBS (r = 0.408, p = 0.013), body weight (r = 0.326, p = 0.046) and lean body mass (r = 0.414, p = 0.010), but not with fat mass or fat percentage. None of the athletes reported any BSI. Conclusions: Half of the Norwegian elite Para athletes had low BMD, and 29% had BMD Z-score <−2 suggesting osteoporosis. Non-ambulant athletes were more prone to low BMD than ambulant athletes. However, despite high prevalence of low BMD, TBS was normal in all athletes, and BSI was absent in this young population.

• Hardeland, Camilla; Leonardsen, Ann-Chatrin Linqvist; Isern, Cecilie Benedicte & Berge, Hilde Moseby (2022). Experiences of cardiac arrest survivors among young exercisers in Norway: A qualitative study. Resuscitation Plus. 11. doi: 10.1016/j.resplu.2022.100293. Full text in Research Archive Show summary

  Aim: To explore how young exercisers experience surviving sudden cardiac arrest (SCA), focusing on interpretation of warning signs and experi-ences with the healthcare system. Methods: The study had a qualitative design, and data was collected using individual, semi-structured interviews. Inclusion criteria were SCA sur-vivors aged 18–50 years old who reported at least five hours of exercise/week prior to SCA, or who suffered SCA during or 60 min after exercise. Results: 18 interviews were performed (4 females), age range 19–49 years old. Analysis identified the themes [1] neglected warning signs, [2] fluc-tuating between gratitude and criticism and [3] one size does not fit all. When young exercisers experienced symptoms such as fainting, chest pain, arrythmia, shortness of breath and fatigue, these were often ignored by either the participants, healthcare personnel or both. SCA survivors were grateful to the healthcare system and for the efforts made by healthcare personnel, but experienced a mismatch between what patients needed and could utilize, and what they actually received regarding both information and individualised services. Being young exercisers, the participants reported to have individual needs, but treatment and rehabilitation were not adapted and were mainly targeted to rehabilitation of older patients. Conclusion: Patients and healthcare personnel should be aware of cardiac related symptoms and warning signs for SCA, and these should be properly assessed in the population of young exercisers. SCA survivors need useful and repeated information. The needs of SCA survivors among young exercisers require individualisation of services

• Hardeland, Camilla; Leonardsen, Ann-Chatrin Linqvist; Isern, Cecilie Benedicte & Berge, Hilde Moseby (2022). The aftermath of surviving a sudden cardiac arrest for young exercisers- a qualitative study in Norway. BMC Health Services Research. 22(1), p. 1–9. doi: 10.1186/s12913-022-08674-z. Full text in Research Archive Show summary

  Background: When surviving a sudden cardiac arrest (SCA), physical, cognitive, and emotional efects of surviving may be present for months or years. The survivors’ family and colleagues are also highly afected by the incident. There is little knowledge about experiences of surviving SCA in individuals who prior to the incident were young and reported to exercise regularly. Consequently, the aim of this study was to explore the aftermath of surviving a SCA in young, regular exercisers. Methods: The study had a qualitative design, conducting in-depth individual interviews with SCA survivors<50 years of age reporting to exercise≥5 h/week and/or who sufered SCA during or less than 60 min after exercise. The data were analysed using systematic text condensation in-line with recommendations from Malterud. Results: 18 of 31 eligible participants were included in the study. Through analysis we identifed ‘Establishing a new everyday life’ as superordinate category, with subordinate categories a) being part of my surroundings, b) expecting normality but facing a new reality and c) lucky to be alive! Conclusion: This study adds knowledge about young and regular exercisers’ experiences after surviving a SCA. The obligations of everyday life in young survivors of SCA often imply a high work load and complex tasks, e.g. due to being in the beginning of their career or even still studying. Healthcare personnel, as well as the society, need to acknowledge that although lucky to be alive and apparently well-functioning, young survivors of SCA may have per‑sistent challenges that cause frustration and reduced quality of life.

• Clarsen, Benjamin Matthew; Steffen, Kathrin; Berge, Hilde Moseby; Bendiksen, Fredrik; Fossan, Bjørn & Fredriksen, Hilde [Show all 13 contributors for this article] (2021). Methods, challenges and benefits of a health monitoring programme for Norwegian Olympic and Paralympic athletes: the road from London 2012 to Tokyo 2020. British Journal of Sports Medicine. ISSN 0306-3674. 55, p. 1342–1349. doi: 10.1136/bjsports-2020-103717. Full text in Research Archive Show summary

  Objective: To describe the implementation of a health monitoring programme for Norwegian Paralympic and Olympic candidates over five consecutive Olympic and Paralympic Games cycles (London 2012, Sochi 2014, Rio de Janeiro 2016, PyeongChang 2018 and Tokyo 2020). Methods: Athletes were monitored for 12–18 months preparing for the games using a weekly online questionnaire (OSTRC-H2) with follow-up by physicians and physiotherapists, who provided clinical care and classified reported problems. Results: Between 2011 and 2020, 533 Olympic and 95 Paralympic athletes were included in the monitoring programme, with an overall response of 79% to the weekly questionnaire and a total observation period of 30 826 athlete weeks. During this time, 3770 health problems were reported, with a diagnosis rate of 97%. The average prevalence of health problems at any given time was 32% among Olympic athletes and 37% among Paralympic athletes. Acute traumatic injuries represented the greatest burden for Olympic team sport athletes, and illnesses represented the greatest burden for Olympic endurance and Paralympic athletes. On average, Olympic athletes lost 27 days and Paralympic athletes lost 33 days of training per year due to health problems. Conclusion: Conducting long-term health monitoring of Olympic and Paralympic athletes is challenging, particularly because athletes travel frequently and often relate to many medical providers. This programme has been implemented and improved within Team Norway for five Olympic and Paralympic cycles and during this time we believe it has helped protect our athletes’ health.

• Steffen, Kathrin; Clarsen, Benjamin Matthew; Gjelsvik, Hilde; Haugvad, Lars; Koivisto-Mørk, Anu & Bahr, Roald [Show all 7 contributors for this article] (2021). Illness and injury among Norwegian Para athletes over five consecutive Paralympic Summer and Winter Games cycles: prevailing high illness burden on the road from 2012 to 2020. British Journal of Sports Medicine. ISSN 0306-3674. doi: 10.1136/bjsports-2021-104489. Full text in Research Archive Show summary

  Objective: To describe the illness and injury pattern of Norwegian Para athletes over five consecutive Paralympic Summer and Winter Games cycles and to identify which health problems should be targeted in risk management plans with respect to impairment types. Methods: We monitored athletes from 12 to 18 months prior to each Game using a weekly online questionnaire (Oslo Sports Trauma Research Center-H2 (OSTRC-H2)). We asked them to report all health problems they had experienced in the preceding 7 days, irrespective of their consequences on their sports participation or performance and whether they had sought medical attention. Results: Between 2011 and 2020, 94 candidate athletes were included in this monitoring programme and prepared to represent Norway; of these, 66 (71%) were finally selected for multiple Paralympic Games. The overall response rate to the weekly questionnaires was 87%. At any given time during the five observation cycles, 37% of the athletes (95% CI 36% to 38%) reported having at least one health problem. Athletes with neurological impairments (n=51) lost 10 days per year due to respiratory problems (95% CI 9 to 11) compared with 9 days (8-10) among those with musculoskeletal impairments (n=37). Gastrointestinal problems caused a time loss of on average 4 days per year in athletes with neurological impairments versus 1 day in athletes with musculoskeletal impairments (mean difference 2.7 days, 2.1–3.3). Musculoskeletal injuries generated a high burden for both athlete groups, in particular, to the elbow, shoulder and lumbosacral regions. Conclusion: At any given time, nearly two out of five elite Norwegian Para athletes reported at least one health problem. Respiratory tract and other infections; gastrointestinal problems, injuries to the shoulder, elbow and lumbosacral regions represented the greatest health burden. Our findings can help guide the allocation of clinical resources, which should include a broad network of medical specialists, together with dieticians and physiotherapists, to meet the health challenges in Para athletes.

• Berge, Hilde Moseby; Andersen, Thor Einar & Bahr, Roald (2018). Cardiovascular incidents in male professional football players with negative preparticipation cardiac screening results: an 8-year follow-up. British Journal of Sports Medicine. ISSN 0306-3674. doi: 10.1136/bjsports-2018-099845. Full text in Research Archive Show summary

  Background: Preparticipation cardiac screening of athletes aims to detect cardiovascular disease at an early stage to prevent sudden cardiac arrests and deaths. Few studies have described the cardiovascular outcomes in athletes classified as negative on screening. Objective: To identify cardiovascular incidents in a cohort of male professional football players who were cleared to play after a negative screening result. Methods: This is a retrospective 8-year follow-up study of 595 professional male football players in Norway who underwent preparticipation cardiac screening by experienced cardiologists, including electrocardiography (ECG) and echocardiography, in 2008. We performed a media search to identify sudden cardiovascular incidents between January 2008 and February 2016. Incidents were cross-checked with medical records. Results: Six of the 595 players (1%), all classified as negative on cardiac screening, experienced severe cardiovascular incidents during follow-up. Retrospective review revealed abnormal ECG findings in one case, not recognised at the time of screening. Three players suffered a sudden cardiac arrest (all resuscitated successfully), one a myocardial infarction, one a transient ischaemic attack and one atrial flutter. Three of the players ignored chest pain, paresis, dyspnoea or near-syncope, two completed a match with symptoms before seeking medical assistance, one player’s symptoms were misinterpreted and received inappropriate treatment initially, and two players were discharged from hospital without proper follow-up, despite having serious cardiovascular symptoms. Conclusions: A comprehensive preparticipation cardiac screening did not identify a subset of 6 of 595 players who experienced subsequent cardiovascular incidents as being at risk. It is important to remind athletes that a normal cardiac screening exam does not protect against all cardiac diseases. Timely reporting of symptoms is essential.

View all works in NVA

• Berge, Hilde Moseby (2026). How to deal with sports cardiology as a sports medicine physician. Full text in Research Archive
• Berge, Hilde Moseby (2025). Toppidrett og hjertet – Hvorfor er det ikke anbefalt hjertescreening av idrettsutøvere i Norge? Agder. Full text in Research Archive
• Berge, Hilde Moseby (2025). Blood samples and health evaluations. Full text in Research Archive
• Berge, Hilde Moseby (2025). Toppidrett og hjertet – Hvorfor er det ikke anbefalt hjertescreening av idrettsutøvere i Norge? Full text in Research Archive
• Berge, Hilde Moseby (2025). UngParaFRISK og fysisk aktivitet og idrett for alle. Full text in Research Archive Show summary

  Foredrag om tentative funn i prosjektet til paraidrettsmiljø i Bergen.

• Berge, Hilde Moseby (2025). Idrettshjerte Grunnkurs. Full text in Research Archive
• Berge, Hilde Moseby & Horn, Josefine (2025). UngParaFRISK og svømmere. Full text in Research Archive Show summary

  Presentasjon av tentative resultater knyttet til svømming, og diskusjon med Norges Svømmeforbund og trener i parasvømming.

• Berge, Hilde Moseby & Horn, Josefine (2025). UngParaFRISK og idrett. Full text in Research Archive Show summary

  Presentasjon av prosjektets oppbygning og tentative resultater.

• Berge, Hilde Moseby (2025). UngParaFRISK på Ridderuka. Full text in Research Archive Show summary

  Presentasjon av tentative resultater og deltagelse i paneldebatt i UngParaFRISK på "Mulighetens Arena", en fag- og forskningsdag for rehabilitering.

• Berge, Hilde Moseby & Horn, Josefine (2025). UngParaFRISK og svaksynte. Full text in Research Archive
• Berge, Hilde Moseby & Horn, Josefine (2025). UngParaFRISK -​ Bruk av kartleggingsdata fra paraidrettsutøvere. Full text in Research Archive
• Tangen, Suzanna; Berge, Hilde Moseby & Horn, Josefine (2025). Intervju med UngParaFRISK, ved Suzanna Tangen. [TV]. NRK. doi: https:/tv.nrk.no/serie/dagsrevyen/sesong/202509/episode/NNFA19092025. Full text in Research Archive Show summary

  Den 20. september ble UngParaFRISK fremhevet i et innslag på Dagsrevyen i forbindelse med Forskningstorget. Intervjuet fokuserte på prosjektets arbeid og mål, og Suzanna Tangen representerte prosjektet. Gjennom sin rolle som parasyklist og fagkonsulent ved Olympiatoppen Øst bidro Tangen med innsiktsfulle perspektiver, basert på sin erfaring og engasjement i brukermedvirkning.

• Berge, Hilde Moseby & Horn, Josefine (2025). Hvorfor helse må på agendaen i paraidrett. doi: https:/www.barrierefrifritid.com/barrierefri-konferansen. Full text in Research Archive
• Berge, Hilde Moseby & Horn, Josefine (2025). UngParaFRISK: Delta i idrett med funksjonsnedsettelser? Test selv i hinderløypene våre, både med rullestol og med synshemming. doi: https:/www.med.uio.no/om/aktuelt/arrangementer/2025/forskningstorg-om-kropp-og-sinn.html. Full text in Research Archive Show summary

  UngParaFRISK holdt forskningsbod under Forskningsdagene 2025, ved Teknisk Museum, og ble "vinner av beste bod på forskningstoget". Boden bestod av en hinderløype for rullestol, aktivitetshjørne med tilrettelagte aktiviteter for blinde og svaksynte, og skjerm med visninger av videoer som forklarer hvordan tilrettelegge for blinde og svaksynte i ulike idretter. Målet var å formidle viktigheten av tilgjenglighet, universiell utforming og aktivitetshjelpemidler for deltagele i idrett. Prosjektet ble vinner av beste bod på forskningstoget.

• Berge, Hilde Moseby (2025). How to deal with sports cardiology as a sports medicine physician. Full text in Research Archive
• Berge, Hilde Moseby (2025). Symptoms and risk factors for sudden cardiac arrest - why not refer everyone to cardiac examinations? Full text in Research Archive
• Berge, Hilde Moseby (2024). Idrettshjerte. Full text in Research Archive
• Berge, Hilde Moseby (2024). Evaluering forberedelser og gjennomføring av Paralympics i Paris 2024. Full text in Research Archive
• Berge, Hilde Moseby (2024). UngParaFRISK. Full text in Research Archive
• Berge, Hilde Moseby (2024). How to deal with sports cardiology as a sports medicine physician? Full text in Research Archive
• Steenstrup, Sophie; Kramer-Johansen, Jo & Berge, Hilde Moseby (2024). Saving lives together in sport, part one: Initiating voluntary training in cardiopulmonary resuscitation with the use of automated external defibrillators in Norwegian football clubs. Full text in Research Archive
• Steenstrup, Sophie; Kramer-Johansen, Jo & Berge, Hilde Moseby (2024). Saving lives together in sport, part two: A pilot study to increase the number and availability of automated external defibrillators at Norwegian football arenas. Full text in Research Archive
• Berge, Hilde Moseby (2024). Health Assessment and last minutes preparations – what should we be looking for in our athletes before Paris. Full text in Research Archive
• Berge, Hilde Moseby (2024). Extended Periodic Health Evaluations for Paralympic Athletes to reduce injuries and illnesses. Full text in Research Archive
• Berge, Hilde Moseby (2023). How to deal with sports cardiology as a sports medicine physician. Full text in Research Archive
• Torgalsen, Thomas; Berge, Hilde Moseby; Fossan, Bjørn; Fredriksen, Hilde & Hoksrud, Aasne Fenne (2022). Planning for the Games. Full text in Research Archive
• Haugvad, Lars & Berge, Hilde Moseby (2022). The Periodic Health Evaluation. Full text in Research Archive
• Steffen, Kathrin; Berge, Hilde Moseby & Haugvad, Lars (2022). Optimal health - the Norwegian health evaluation and monitoring program. Full text in Research Archive
• Berge, Hilde Moseby (2022). Veien til Tokyo - helseteamets forberedelser til OL og Paralympics 2020. Full text in Research Archive
• Berge, Hilde Moseby (2022). Lærdom fra Tokyo og Beijing/ Evaluering helse/ ParaFRISK. Full text in Research Archive
• Berge, Hilde Moseby (2022). Registerstudier om hjertestans. Full text in Research Archive
• Berge, Hilde Moseby (2022). Muskel-skjelettskader hos Olympiske og Paralympiske utøvere i Norge - 10 års prospektive data opp mot OL og Paralympics 2012-2022. Full text in Research Archive
• Berge, Hilde Moseby (2021). Idrettshjerte. Full text in Research Archive
• Berge, Hilde Moseby (2021). Helseansvarlig for Paralympics utøvere på OLT. Full text in Research Archive
• Berge, Hilde Moseby (2020). Cardiology and sport. Full text in Research Archive
• Wangensteen, Arnlaug & Berge, Hilde Moseby (2020). Hang in there! Climbing towards a new normal in sport and exercise medicine and sports physiotherapy. British Journal of Sports Medicine. ISSN 0306-3674. 54(19), p. 1123–1124. doi: 10.1136/bjsports-2020-103072. Full text in Research Archive
• Berge, Hilde Moseby (2020). Det norske idrettshjertet. Full text in Research Archive
• Berge, Hilde Moseby (2020). Idrettshjerte. Full text in Research Archive
• Berge, Hilde Moseby (2019). Den store hjertesaken - hva er det som skjer når hjertet til topptrente idrettsutøvere plutselig slutter å slå? [Journal]. Aftenposten. Full text in Research Archive
• Berge, Hilde Moseby (2019). How we treat athletes with respiratory tract infections at Olympiatoppen. Full text in Research Archive
• Berge, Hilde Moseby (2019). Making sport and sports medicine history : Lillehammer 1994, 2019 and 2021. British Journal of Sports Medicine. ISSN 0306-3674. 53(20), p. 1257–1258. Full text in Research Archive
• Berge, Hilde Moseby (2019). "Lift off" for parasport with 100 millions NOK from the VI foundation. What more do we need? Full text in Research Archive
• Berge, Hilde Moseby (2019). The health of the elite Paralympic athlete. Full text in Research Archive
• Berge, Hilde Moseby (2019). Sports cardiology and ECG abnormalities; from diagnosis to management. Full text in Research Archive
• Berge, Hilde Moseby (2019). Idrettsmedisin for medisinerstudenter. Full text in Research Archive
• Berge, Hilde Moseby; Gjelsvik, Hilde; Haugvad, Lars; Moksnes, Håvard & Clarsen, Benjamin Matthew (2019). Sykdom og skader hos paralympiske utøvere. Full text in Research Archive
• Berge, Hilde Moseby & Clarsen, Benjamin Matthew (2019). Helseteknologi i toppidretten: nye muligheter og mulige fallgruver. Full text in Research Archive
• Berge, Hilde Moseby; Andersen, Thor Einar & Bahr, Roald (2019). Hjertekarlidelser hos profesjonelle mannlige fotballspillere med negative funn ved hjertescreening - en 8 års oppfølgingsstudie. Full text in Research Archive
• Isern, Cecilie Benedicte; Tjelmeland, Ingvild Beathe Myrhaugen; Alm-Kruse, Kristin; Berge, Eivind; Kramer-Johansen, Jo & Berge, Hilde Moseby (2018). Forekomst av hjertestans i forbindelse med trening - en sammenligning av funn fra media og Hjertestansregisteret. Full text in Research Archive
• Isern, Cecilie Benedicte; Tjelmeland, Ingvild Beathe Myrhaugen; Kramer-Johansen, Jo & Berge, Hilde Moseby (2018). Is media search a reliable source when investigating the incidence of sports-related out-of-hospital cardiac arrest? Full text in Research Archive
• Berge, Hilde Moseby (2018). Don’t get stuck in the mud: keep climbing for a better view of sport and exercise medicine. British Journal of Sports Medicine. ISSN 0306-3674. 52(18), p. 1155–1156. doi: 10.1136/bjsports-2018-099844. Full text in Research Archive
• Berge, Hilde Moseby (2018). Hjerteproblemer blant idrettsutøvere. Skrekkens liste - Ingen vet helt sikkert hvorfor hjertet sier stopp. [Internet]. Dagbladet. Full text in Research Archive
• Berge, Hilde Moseby (2018). Key note lecture: Medical challenges in the Paralympian/ disabled athlete. Full text in Research Archive
• Berge, Hilde Moseby (2018). Climping the mountain in Paralympic sports medicine – how to improve. Full text in Research Archive
• Berge, Hilde Moseby (2018). Utfordringer ved å være idrettslege for funksjonshemmede. Full text in Research Archive
• Berge, Hilde Moseby (2018). Team handball. Full text in Research Archive
• Berge, Hilde Moseby (2018). Climping the mountain in Paralympic sports medicine – lessons learned on the way up. Full text in Research Archive
• Berge, Hilde Moseby (2018). Dramatikk for OL-håp. [Internet]. Bergensavisen. Full text in Research Archive
• Berge, Hilde Moseby (2018). Prepare for and running health related services during the Paralympic games. Full text in Research Archive
• Berge, Hilde Moseby (2018). Implementing injury and illness surveillance at the national level. Full text in Research Archive
• Berge, Hilde Moseby (2018). Sports cardiology research in Norway. Full text in Research Archive
• Berge, Hilde Moseby (2018). How to become a Paralympic physician and thrive in the position. Full text in Research Archive
• Berge, Hilde Moseby (2018). Idrettsmedisin – hvordan bli en god idrettslege? Full text in Research Archive
• Isern, Cecilie Benedicte; Tjelmeland, Ingvild Beathe Myrhaugen; Kramer-Johansen, Jo & Berge, Hilde Moseby (2018). Is media search a reliable source when investigating the incidence of sports-related out-of-hospital cardiac arrest? Resuscitation. ISSN 0300-9572. 130, p. e95–e96. Full text in Research Archive
• Andersen, Thor Einar; Bahr, Roald & Berge, Hilde Moseby (2018). Hvordan forebygge plutselig hjertedød i idrett? [Journal]. Aftenposten. Full text in Research Archive
• Berge, Hilde Moseby; Andersen, Thor Einar & Bahr, Roald (2018). Mandatory health screen to rule out risk of sudden death in footballers not fail-safe. [Journal]. British Medical Journal. Full text in Research Archive
• Berge, Hilde Moseby (2018). Hjertestans i toppidrett er vanskelig å forutsi. [Internet]. Tidsskriftet Den Norske Legeforening. Full text in Research Archive
• Berge, Hilde Moseby (2018). Sports Cardiology and ECG abnormalities: from diagnosis to management. Full text in Research Archive
• Berge, Hilde Moseby; Andersen, Thor Einar & Bahr, Roald (2017). Cardiovascular incidents, including sudden cardiac arrests, in professional male football players with negative pre-participation cardiac screening results: 8-year follow-up. Full text in Research Archive
• Berge, Hilde Moseby (2017). Paraidrettsmedisin. Full text in Research Archive
• Berge, Hilde Moseby (2017). Paraidrettsmedisin. Full text in Research Archive
• Isern, Cecilie Benedicte; Clarsen, Benjamin; Berge, Eivind & Berge, Hilde Moseby (2017). Value of blood pressure measurements in both arms in olympic and paralympic athletes. European Heart Journal. ISSN 0195-668X. 38. Full text in Research Archive
• Isern, Cecilie Benedicte; Berge, Hilde Moseby & Berge, Eivind (2017). Blodtrykk og hypertensjon hos idrettsutøvere. Full text in Research Archive
• Berge, Hilde Moseby; Andersen, Thor Einar & Bahr, Roald (2017). Cardiovascular incidents, including sudden cardiac arrests, in professional male football players with negative pre-participation cardiac screening results - 8-year follow-up. Full text in Research Archive
• Berge, Hilde Moseby (2017). Kardiovaskulære hendelser hos profesjonelle fotballspillere etter hjertescreening: En 8 års oppfølgingsstudie. Full text in Research Archive
• Isern, Cecilie Benedicte; Berge, Eivind; Clarsen, Benjamin & Berge, Hilde Moseby (2017). Value of blood pressure measurements in both arms in Olympic and Paralympic athletes. Full text in Research Archive
• Isern, Cecilie Benedicte; Berge, Eivind; Clarsen, Benjamin & Berge, Hilde Moseby (2017). Value of blood pressure measurements in both arms in Olympic and Paralympic athletes. Full text in Research Archive
• Berge, Hilde Moseby (2017). Paraidrettsmedisin for medisinerstudenter. Full text in Research Archive
• Berge, Hilde Moseby (2017). Idrettskardiolog for medisinerstudenter. Full text in Research Archive
• Berge, Hilde Moseby (2017). Medisinske utfordringer hos paralympiske utøvere. Full text in Research Archive
• Isern, Cecilie Benedicte & Berge, Hilde Moseby (2017). Hjertestans og fysisk aktivitet. Full text in Research Archive
• Berge, Hilde Moseby; Andersen, Thor Einar & Bahr, Roald (2017). Cardiovascular incidents, including sudden cardiac arrests, in professional male football players with negative pre-participating cardiac screening results: an 8-yr follow-up study. British Journal of Sports Medicine. ISSN 0306-3674. 51(4), p. 294–295. Full text in Research Archive
• Berge, Hilde Moseby; Andersen, Thor Einar & Bahr, Roald (2017). Cardiovascular incidents, including sudden cardiac arrests, in professional male football players with negative pre-participating cardiac screening results: an 8-yr follow-up study. Full text in Research Archive
• Berge, Hilde Moseby; Andersen, Thor Einar & Bahr, Roald (2017). Cardiovascular incidents, including sudden cardiac arrests, in professional male football players with negative preparticipation cardiac screening results: 8-year follow-up. European Heart Journal. ISSN 0195-668X. 38. Full text in Research Archive
• Isern, Cecilie Benedicte; Berge, Hilde Moseby; Kramer-Johansen, Jo & Berge, Eivind (2017). How to increase knowledge about sport-related sudden cardiac arrest in Norway. Full text in Research Archive
• Berge, Hilde Moseby (2017). Sports Cardiology and ECG abnormalities: from diagnosis to management. Full text in Research Archive
• Isern, Cecilie Benedicte; Berge, Hilde Moseby & Kramer-Johansen, Jo (2025). Sudden Cardiac Arrest in Young Norwegians. Assessing the role of Exercise and Implications for Prevention Strategies. Universitetet i Oslo. ISSN 9788234807114. Full text in Research Archive Show summary

  Cardiac arrests in young individuals profoundly affects patients, their family, friends, and communities. These incidents often attract media attention, resulting in prompt calls for preventive measures and potentially fostering fear of exercise in the public. Evaluation of preventive measures as screening requires consideration of the magnitude of the condition (included incidence, mortality and morbidity), assessment of the natural history of the condition, potential for detection trough screening and consequences of screening outcomes.(4, 5) By utilizing the enhanced knowledge on sudden cardiac arrest (SCA) in young Norwegians (papers I-III), this thesis evaluates prevention strategies and discuss SCA risk associated with exercise-habits from a public health perspective. Data collection employed a comprehensive, multi-source approach, integrating insights from the Norwegian Cardiac Arrest Registry (NorCAR), questionnaires, systematic media search, medical records and autopsy reports. Access to the Norwegian Cardiac Arrest Registry (NorCAR), provided a unique data quality. However, NorCAR lacked validated data on exercise-related events. In paper I, we found an SCA incidence of 7.8 per 100,000 person-years, with 10% (0.8 per 100000 person-years) exercise-related SCA. Almost two thirds of respondents (59%) reported regular exercise prior to SCA. Paper II revealed a high prevalence of risk factors (74%) and CVD symptoms (78% of survivors) prior to SCA. Symptoms occurred both during rest/everyday activity and exercise. Ischemic heart disease (IHD) was the most frequent etiology overall, while no identifiable cause classified as sudden arrhythmic death syndrome (SADS) was predominant ≤35 years. No statistically significant difference emerged between exercisers and non-exercisers. Paper III reported reduced health related quality of life (HRQoL) in survivors compared to an age- and gender matched population. There was no statistically significant difference between survivors who performed < or ≥ 5 hours of exercise / week. However, within the group of regular exercisers, we found statistical significantly higher SF-36 summary scores within the group of high-volume exercisers. Findings from paper I-III affirm SCA in the young as an important health problem, with a high potential for positive screening results. The high prevalence of SADS challenges identification of individuals at risk, whereas a high prevalence of IHD suggest a potential for prevention and treatment. Alternative preventive measures, including symptoms awareness and increased availability of automatic external defibrillators (AEDs), emerge as vital prevention strategies. Secondary prevention has the advantage of benefitting all individuals susceptible of SCA, regardless of an established CVD diagnosis. Following the confirmation of IHD as the dominating SCA etiology, the public should be reassured of the powerful effect of exercise in both primary and secondary prevention of disease.

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