Sports-medical integration research (2020–2024): A bibliometric and visual comparative analysis of Chinese and International hotspots and trends

OBJECTIVE: Sports-medical integration (SMI) is a critical strategy for implementing the Healthy China Initiative and promoting public health globally. This study conducts a bibliometric analysis of Chinese and international SMI research from 2020 to 2024, identifying hotspots and trends to provide evidence-based references for researchers and policymakers. METHODS: A bibliometric analysis was performed using CiteSpace 7.0.R0 on literature retrieved from the China National Knowledge Infrastructure and the Web of Science Core Collection. Chinese SMI literature was identified using direct policy terminology (""), while international literature was captured using clinically oriented constructs (exercise prescription, integrated care, Exercise is Medicine). After screening, 979 Chinese articles were retained, and a complete dataset of 2791 international publications was used for analysis. Co-occurrence analysis, clustering, burst detection, collaboration network mapping, and co-citation analysis were employed. RESULTS: International SMI publications increased from 447 in 2020 to 642 in 2022, stabilizing at 564 in 2024. The top 3 institutions were the University of Sydney (80 publications), Harvard University (71), and the University of Toronto (64). Keyword analysis revealed "physical activity" (frequency 1547, centrality 0.21) as the dominant international research theme. Clustering analysis identified 16 major research clusters (Q = 0.8211, S = 0.8742). Author co-citation analysis identified foundational scholars such as Michie S and Braun V. Chinese keyword analysis revealed dominant themes of "Integration of sports and medicine" (frequency 561), "Healthy China" (176), and "Combination of physical exercise and medical treatment" (99). Chinese institutional collaboration networks exhibited significantly lower density than international networks (0.0066 vs 0.0523; bootstrapped 95% CI for the difference 0.038-0.053, effect size r = = 0.82). CONCLUSION: International SMI research is characterized by strong institutional networks, well-established foundational scholarship, and a robust clinical evidence base. Chinese research, while growing rapidly, remains predominantly policy-driven and institutionally fragmented. These divergent patterns appear to reflect distinct disciplinary structures, funding mechanisms, and healthcare system configurations. The findings highlight opportunities for cross-cultural collaboration in exercise prescription, digital health integration, and implementation science, with specific implications for policy interventions such as joint funding mechanisms and the establishment of clinical exercise physiology as a recognized discipline in China.